He was 41 when he died. And though he faced substance use disorder throughout his adult life, David was sober nearly the entire year leading up to the pandemic. When I saw him over dinner and donuts last November on a visit to Los Angeles, he was crushing life. I was proud of him. My handsome, charming big brother finally had it together. (Of course, even when he didn't have it "together," he was still my biggest champion.) David was thriving as a personal trainer at a gym. He loved being a dad and absolutely adored his little girl. Although they weren't living together at the time, he would text me most days with photos and videos of my niece. The last text he ever sent me on March 13 was a paraphrase of a quote he'd heard by myth scholar Joseph Campbell: "When you live a life for someone other than yourself, you are living a hero's journey," my brother wrote.
We worried about him. David plus free time was historically a recipe for disaster. I should have checked in. Aside from an email he sent me on March 17, congratulating me for a new article I wrote that week, I hadn't heard from David. The updates about my niece stopped. I should have known something was wrong.
On the phone with our father an hour or so before we learned of my brother's death, our dad said to me, "I'm worried about David. I don't know what kind of trouble he's going to get into now that he's not working and can't see his daughter. I think he's been sleeping all day." He sounded worried. David wasn't returning his calls that day. That night, I received a Facebook message from David's landlord asking me to give him a call. Thinking, hoping that David owed rent money, I sent his number to our father. My dad called me back shortly after speaking with the landlord, with a message he had long dreaded delivering: "David passed away."
Yet, when history books tally Covid-19's tragedies, David is likely to be left off the official count. Instead, he'll be sectioned off as part of the opioid crisis. In reality, these crises are inextricably connected. President Donald Trump may not have created either, but his attacks on health care and his disregard for science exacerbates these dual crises. In the middle of a pandemic and an economic downturn, the President shamelessly continues his crusade against health care, science, compassion and kindness: some of the most powerful tools we have to treat Americans and society at large.
If he gets his way, the Supreme Court will soon have a sixth vote that could strike down all of the Affordable Care Act and permanently end Obamacare for roughly 20 million people, a devastating scenario for Americans with substance use disorder who rely on Medicaid.
The expansion of Medicare and Medicaid through the Affordable Care Act meant significantly more people with substance use disorder had access to insurance. As with other pre-existing conditions, substance use disorder could no longer be a reason for an insurance company to deny someone coverage.
A compassionate leader would acknowledge the pain and struggles of people impacted by substance use disorder. Trump made it a cruel and factless punch against his opponent.
It is entirely possible my brother would have died regardless of who was president, pandemic or no pandemic. It's also probable that no matter how hard he worked to fight his disease, forces outside his control mixed with his medical condition and created a tragedy. I will never know exactly what happened in the final week of my brother's life. Nor does it matter. He is never coming back. But while it is too late to save my brother, there are countless people out there who can still be saved.
Through kindness, compassion, and modern medicine, we can stop more senseless deaths and tragedies. But we need a president who will champion these values. We need a president who will treat our society with science, compassion, and kindness. When Americans cast their ballots this election, I hope they consider the many layers of loss during this moment. I hope they consider my brother.
The COVID-19 pandemic has not only disrupted the social and economic realities of our communities, but also undermined some of the basic infrastructure we depend on. Our water infrastructure has been at the heart of this realization; its importance to health, hygiene, and safety has never been more obvious, yet millions of disadvantaged and vulnerable households still lack reliable and affordable access to water. Meanwhile, climate change has fueled extreme droughts, fires, and floods that have disrupted or destroyed this essential infrastructure. COVID-19 has exposed the continued neglect of our water infrastructure, magnifying long-standing social and environmental stressors as well as economic inequities.
State and local leaders manage most of our water needs, and many recognize the gravity of its challenges, despite facing massive fiscal constraints due to COVID-19. But federal leaders have not shown the same urgency. As Congress debates recovery strategies and stimulus efforts, water should be a bigger part of the conversation. Water can serve as a lever to achieve greater economic equity and access, environmental resilience, and technological innovation, among other benefits. Now is the time for Washington to elevate water as a core issue to drive a lasting recovery.
In a recent webinar hosted by the Stanford Woods Institute for the Environment (watch video at the end of this post), we discussed a set of practical solutions to address the gaps in water infrastructure and advance new innovations. Below are five key areas of intervention that federal leaders should be focusing on.
Our massive physical infrastructure needs (leaking pipes, overwhelmed sewers, and outdated treatment plants) often overshadow the needs of individual households. Water is ultimately an enabler for health and opportunity, but too many people cannot access or afford it. Lower-income communities of color frequently face some of the greatest water inequitiesincreased lead exposure and other harmful contaminants threaten drinking water quality in many of these communities, while storm and wastewater overflows inundate their streets and backyards. COVID-19s economic impacts have also highlighted persistent struggles to pay bills and avoid water shutoffs.
Federal policymakers need to focus more on people, not just projects. That means defining and measuring our water needs in light of our must vulnerable households. Fortunately, the Environmental Protection Agency (EPA) has started to revise its inadequate definition of water affordability to serve as guidance for utilities. But this should be just the beginningthe nation requires increased technical and financial support for customer assistance programs, including a comprehensive utility bill assistance program.
Climate change is inextricably linked to changes in the water cycle, such as too much or too little water, shifts in precipitation patterns, and untimely melts. Yet much of our national climate discussion focuses on mitigation (reducing greenhouse gases, improving energy efficiency) rather than adaptation (coping with sea level rise, handling extreme storms, etc.). While both are important, federal policymakers need to clearly acknowledge and invest in water-related adaptation efforts, especially since climate disasters tend to affect lower-income, disadvantaged communities the most.
When addressing wildfires, floods, or droughts, local governments are largely on their own. The Federal Emergency Management Agency (FEMA) and other federal agencies provide disaster relief, but utilities and other local leaders often struggle to accelerate proactive infrastructure investments that would improve their long-term resilience. Federal leaders must prioritize our water challenges in climate discussions, measure the fiscal impacts to states and localities, and build more financial and technical capacity at the state and local level for water-related adaptation. For example, establishing clearer federal regulations to govern private sector environmental, social, and governance (ESG) investmentincluding ways to collaborate with public sector entities such as local water utilitiescould get more projects done and help more communities.
There are more than 50,000 water utilities scattered across the country, making it hard to consistently and comprehensively govern (let alone define) our most pressing water infrastructure needs. Many utilities use antiquated business models that assume resource abundance and steady water sales. Meanwhile, federal agencies such as the EPA operate in the same bureaucratic siloes and oversee the same regulations they did decades ago. These outdated business practices, rigid laws, and fragmented governance structures impair the maintenance of our existing infrastructure and investment in new and innovative solutions.
Federal policymakers need to break down these siloes in order to better manage our national water needs and support a forward-looking governance model centered around the One Water concept. This concept involves looking at our drinking water, wastewater, and stormwater needs collectively, particularly when developing plans and launching investments.
To promote more collaborative governance across and within utilities, federal leaders should provide more guidance on the process for setting water rates so as to guarantee access for all households. Second, they should introduce new financial tools (such as a Public Benefits Charge) to enable more integrated resource management. Finally, leaders should implement new regulatory measures (such as water diversification portfolio standards) to better assess and support the financial standing of all utilities.
Our 21st century water infrastructure must address our 21st century environmental, economic, and health challenges. Federal leaders can embrace this shift in two ways.
First, there needs to be a transition to a hybrid infrastructure model that promotes a combination of gray/green and centralized/decentralized infrastructure improvements. Rather than supporting large, centralized treatment facilities and other traditional gray infrastructure (which can be costly to maintain and susceptible to climate risks), federal leaders need to look toward nature, floodplains, and other green infrastructure for more flexibility and environmental resilience. Doing so can help us recover and reuse every drop of water in our system, create operational redundancies through more distributed systems, and lead to many other environmental and community benefits. Federal leaders can promote these new designs through new financial incentives and pathwaysincluding loans, grants, and tax creditsthat encourage local experimentation.
Second, federal leaders need to embrace the digital transition in our water systems. The COVID-19 pandemic has disrupted our standard operating procedures and highlighted the importance of digital solutions, including advanced metering infrastructure and leak-detection analytics that help utilities prevent resource loss and maintain affordable, dependable service. Federal leaders should revisit regulations that govern federally owned infrastructure systems and federally funded projects to find room for data-driven solutions. For instance, Forecast-informed Reservoir Operations can help avoid dam failures, and revisions to the U.S. Army Corps of Engineers benefit-cost analysis can better evaluate water resources projects.
Improving the nations physical infrastructure depends on a skilled workforce to construct, operate, and maintain our facilities, but federal policymakers have overlooked these needs for decades. Many of the operators, engineers, and technicians who keep our water clean and essential services online are reaching the ends of their careers and frequently lack visibility, resulting in a diminished pipeline of talent. Meanwhile, millions of workers have lost their jobs during the pandemic, and there are mounting struggles to connect the unemployed to stable, well-paying careers. This gap in hiring, training, and retention comes even as water jobsmany of which are in the skilled tradesoffer competitive pay and the opportunity to develop valuable, transferrable work experience.
The COVID-19 recovery gives us a chance to not only rebuild and renew our infrastructure, but to connect more and different types of workers to water careers. Establishing a new, 21st century federal infrastructure workforce program aimed at providing flexible learning and career opportunities in the skilled tradesincluding watercan help disadvantaged and disconnected workers earn higher pay, learn more skills, and seize enduring opportunities. Expanded apprenticeships and work-based learning programs can prepare a new generation of talent while retraining and assisting other workers in water careers.
Together, these five areas of intervention reveal a national need to focus on future water priorities, not just prevailing trends. Water remains an essential service to all households and industries, but we cant keep taking it for granted; federal leaders need to intentionally elevate it as an economic and environmental priority. Proactive federal investment in new types of projects and people-centered strategies can support climate resilience, affordable access, and equitable growth. The COVID-19 pandemic has highlighted waters foundational role and the cracks in our existing systemnow its time to strengthen our commitment to water solutions that can support us for years to come.
Calumet County will host a free COVID-19 community testing site starting Thursday, the latest in a string of new testing sites opening in the Fox Valley in the last week.
The drive-through site at Christ the Rock Community Church will be operated by the Wisconsin National Guard. Anyone experiencing symptoms of the virus or who has been in contact with someone who is infected is eligible for a test.
Those symptoms can include fever, cough, difficulty breathing, sore throat, runny nose, nausea, vomiting, diarrhea, headache, chills, muscle aches or loss of taste or smell.
Like other Guard-run COVID-19 testing sites, it's highly recommended but not required that people register ahead of time at register.covidconnect.wi.gov.
RELATED:U.S. surgeon general announces creation of federal COVID-19 testing site at ThedaCare clinic in Neenah
RELATED:New community testing site for COVID-19 opens at Appleton North High School
RELATED:Need a COVID test? Here's how and where you can get one in the Appleton area
Public health officials recommend that if you've been exposed to COVID-19, you wait five to seven days before coming in for a test, as the virus may take time to reach levels that would be noticeable by the test.
The site, at W6254 U.S. 10/State 114 in Menasha, will be open at the following dates and times:
The Guard will not be testing on Nov. 26-28.
Children ages 5 and older can be tested at the site, though those under 18 must be accompanied by a guardian.
The church site is the third site in a week to open for the area, including another Wisconsin National Guard-run site at Appleton North High School and a surge site set up by the federal government at ThedaCare Physicians-Neenah. This comes after months in which Fox Valley residents had to drive to Oshkosh or Green Bay for community testing.
Contact reporter Madeline Heim at 920-996-7266 or mheim@gannett.com. Follow her on Twitter at @madeline_heim.
Read or Share this story: https://www.postcrescent.com/story/news/2020/10/20/fox-valley-covid-19-test-site-open-christ-rock-church/5990421002/
WATCH ABOVE: Governor JB Pritzker announces additional COVID-19 mitigation measures in Chicagos west and south suburbs Tuesday
CHICAGO Governor JB Pritzker said additional COVID-19 mitigation measures will be put in place in DuPage, Kane, Kankakee and Will counties this week after two suburban regions hit the State of Illinois COVID-19 test failsafe level Tuesday.
According to the Illinois Department of Public Health, both the West Suburban and South Suburban regions established in the Restore Illinois plan hit its COVID-19 failsafe level of three days with a 7-day test positivity rate above 8% Tuesday.
Starting Friday, new restrictions will be put in place DuPage, Kane, Kankakee and Will counties, including limits on gatherings to 25 people or 25 percent of room capacity, no indoor service at bars and restaurants, and all outdoor service must end at 11 p.m.
A complete listing of restrictions is available here
The measures are the same as those put in place in the states Southern Region Monday, and also remain in effect across northwest Illinois. Pritzker cited a spillover effect from neighboring states as partly to blame for the rise in cases in Illinois.
As colder weather approaches and flu season is upon us were going to see the rippling effect of these current unfortunate trends, Pritzker said. There is no easy fix for the effects of this virus on our economy and our public health.
Both regions initially passed the 8% level on October 15, while data released Tuesday shows a third day above the limit with rates of 9% in the West Suburban Region and 8.6% in the South Suburban Region as of Saturday.
The South Suburban region was previously subject to additional restrictions on August 26, but returned to Phase 4 of the states reopening plan on September 18.
Pritzker said previously that experts predictions of a surge in COVID-19 cases as temperatures drop and people move inside appears to be coming true and a new wave could be upon us.
Positivity rates in the suburban regions had been stable but began to rise over the past two weeks, while every other region has seen an increase as well. The North Suburban Region outside Chicago reached 7.5% as of Tuesday, while Cook County outside Chicago reported a rate of 7.1%.
Additional restrictions will remain in place until the rolling 7-day positivity rate drops below 6.5 percent for three days, and more stringent measures could be put in place if it remains above 8.5 percent after 14 days.
Advocate Sherman Hospital Interim Chief Medical Officer Dr. Justin Macariola-Coad said they are seeing an increase in hospitalizations across the hospital system.
Across our communities in Kane and the surrounding counties, we are seeing the start of what is most likely the second wave, Macariola-Coad said. Wisconsin is already surging and northern Illinois is likely next.
While Macariola-Coad said many are experiencing pandemic fatigue, he called on residents to follow the same basic health protocols experts have been stressing for months: observing social distancing, wearing face coverings and washing hands.
Governor Pritzker is returning to daily COVID-19 briefings as Illinois sees a resurgence in cases, and is expected to speak at 2:30 p.m. Tuesday.
Statewide, the IDPH reported 3,714 new COVID-19 cases and 41 coronavirus-related deaths Tuesday. The statewide positivity rate from October 13-19 rose slightly to 5.5%, near levels last seen in early June, although the weekly testing average has more than tripled since then according to data compiled by WGN-TV.
Data shows the 7-day average of cases in Illinois has risen from around 2,000 a day on October 6 to more than 3,700 as of Tuesday, while testing rose less sharply from around 58,000 to more than 67,000. The 7-day average of deaths has been rising over the past two weeks as well, from around 28 to 36 a day.
While the number of patients hospitalized with COVID-19 is beginning to rise statewide, the availability of ventilators and intensive care beds remains within state guidelines. According to the IDPH, 2,261 patients were hospitalized with COVID-19 as of Monday night, including 489 in intensive care and 195 on ventilators.
Several other regions reported 7-day positivity rates above 7% as of Tuesday, including Region 3 (7.5%), Region 4 (7.4%), Region 6 (7.6%), Additional restrictions remain in effect in the northwest Illinois region, which reported a 7-day positivity rate of 11.8% Tuesday.
The City of Chicago added Colorado, Delaware, Ohio, Texas and West Virginia to its emergency travel order requiring anyone arriving from those states to self-quarantine for 14 days Tuesday. Neighboring Indiana and Wisconsin remain on the list as well.
Mayor Lori Lightfoot said Monday some coronavirus restrictions could return in Chicago if the number of COVID-19 cases in the city continue to rise. Health officials said cases have risen by more than 50% over the past two weeks, increasing at a rate last seen in March and April.
(Clarinda) -- Page County Public Health officials are managing the overlap between COVID-19 and the start of flu season.
During the Page County Board of Supervisors meeting Tuesday, Public Health Administrator Jessica Erdman told the board that her office is managing the county's first two cases of co-infection, where an individual has influenza and COVID-19 at the same time.
"They have influenza and COVID-19," said Erdman. "That's new territory to us. We don't really know how that's going to pan out. We do know one of the people is very ill. So we are just keeping an eye on that to see what is going to come from that."
Additionally, Erdman says she is keeping her eye out for any cases of re-infection of COVID-19 in the county. Currently, she says the CDC says individuals remain immune from contracting COVID-19 a second time for 90 days.
"There were some studies done that came out a couple weeks ago about the possibility of re-infection before those 90 days are up," said Erdman. "The CDC has said that people have an immunity for 90 days after catching COVID-19. Now, there's a possibility that that could be false. There's been two studies that have been done of two positive cases that did come back positive again before their 90 days was up. That is nationwide."
Erdman says her office continues to work with the schools in Page County to manage cases and close contacts.
"We're working really closely with the schools," said Erdman. "We have a good amount of kids out for quarantine. That does not mean that they are positive. That means that they've been in close contact. We are waiting for some results of some of those kiddos."
The latest COVID-19 numbers from Page County and other southwest Iowa counties can be found on our daily COVID-19 tracker page
At KMA, we attempt to be accurate in our reporting. If you see a typo or mistake in a story, please contact us by emailing kmaradio@kmaland.com.
Travis Commissioners expected to hear details of COVID-19 local resurgence KEYE TV CBS Austin
Minnesota reported 1,732 more confirmed COVID-19 cases on Sunday the 11th consecutive day that the state has seen new case counts of more than 1,000.
State health officials also reported 17 more COVID-19 deaths, the fourth time in five days that the daily death toll has been in the double digits.
Sundays case count was a slight increase over Saturdays report as testing also increased. The seven-day average test positivity rate ticked up slightly, to 5.7 percent above the 5 percent figure thats a key threshold in policy decisions by state leaders.
Cases have been increasing in all parts of the state in recent weeks.
"Things that we maybe did a month ago, when there was much, much less community spread and number of cases, are riskier today," Health Commissioner Jan Malcolm told reporters on Friday. "And heading into the fall when we're going more indoors it's just going to be all the more important that we really pay attention to those gathering limits and social distancing and masking."
The 17 deaths reported Sunday included 14 residents of long-term care facilities. New COVID-19 hospitalizations in Minnesota continue to trend upward to the highest levels seen since late May.
Here are Minnesotas current COVID-19 statistics:
2,234 deaths (17 new)
122,812 positive cases (1,732 new), 108,316 off isolation
2,509,734 tests, 1,681,318 people tested
5.7 percent seven-day positive test rate
With COVID-19 case counts skyrocketing and deaths climbing, state public health leaders struck a decidedly somber tone this past week, pleading with Minnesotans to shoulder more personal responsibility to stem the spread of the disease.
Clearly frustrated by repeating the same advice for months, officials again implored people to wear masks in indoor public spaces, social distance and take other measures to stem the spread even when gathering with family and friends.
Officials ticked off a range of concerns about the current state of the pandemic, including uncontrolled spread in communities across Minnesota and the rising numbers of health care workers contracting the disease outside of their workplaces, workers that then become sidelined and temporarily unable to provide care for others.
New COVID-19 related deaths reported in Minnesota each day.
Active, confirmed cases last week topped 10,000 and then rose again Sunday to more than 12,200 another record in the pandemic.
Officials had anticipated seeing an October surge in cases expected from Labor Day weekend gatherings, sporting events, college student meetups and other informal affairs at the start of fall semester.
They also expected the wave would put more people in the hospital. That appears to be happening.
While the spike early in the pandemic was driven largely by illnesses tied to long-term care facilities and workplace sites such as meatpacking plants, officials say the current spread is diffused, making it even harder to trace and isolate cases.
Daily new case confirmation numbers have ebbed and flowed over the past seven months. However, the lows are getting higher and the highs are getting higher, Ehresmann told reporters last week, describing it as an escalating roller coaster.
The positive test rate trend remains above 5 percent, the threshold where officials become concerned.
State officials recently unveiled plans to massively expand COVID-19 testing opportunities across Minnesota as active caseloads remain at record highs and hospitalizations continue to climb.
Collectively, Minnesota will soon be able to process 60,000 tests per day, officials said, about twice what its managed on its best days until Friday, when the Health Department reported 44,500 tests completed.
The biggest thing we can do to ensure our kids have an opportunity to be in school, that our businesses and restaurants remain open, is to simply follow the science around masking, around social distancing, getting tested, Gov. Tim Walz told reporters Tuesday. To not do these things will guarantee that others get it.
New cases are up dramatically over the past month in all age groups. That includes a concerning rise in the number of new cases among Minnesotans ages 60 and older. Its not clear whats behind those increases.
People in their 20s still make up the age bracket with the states largest number of confirmed cases more than 27,700 since the pandemic began, including more than 15,800 among people ages 20-24.
The numbers help explain why experts remain particularly concerned about young adults as spreaders of the virus.
While less likely to feel the worst effects of the disease and end up hospitalized, experts worry youth and young adults will spread it to grandparents and other vulnerable populations and that spread could hamper attempts to reopen campuses completely to in-person teaching.
The number of high school-age children confirmed with the disease has also grown, with more than 11,200 total cases among children ages 15 to 19 since the pandemic began.
Regionally, central, northern and southern Minnesota have driven much of the recent increase in new cases while Hennepin and Ramsey counties show some of the slowest case growth in the state.
Central Minnesota cases are leaping relative to its population. Its not clear why. Northern Minnesota, once by far the region least affected by the disease, has also seen its caseload grow dramatically in recent weeks.
Collectively, rural areas of Minnesota continue to report the most new COVID-19 cases.
Early on, many Minnesotans thought COVID-19 would be only a Twin Cities metro area problem, but now the biggest problems are happening outside the suburban and urban parts of the state.
The hottest of our hot spots are outside the metro area, Ehresmann said last week.
The six Minnesota counties with the fastest per-capita growth in COVID-19 cases
David H. Montgomery | MPR News
In Minnesota and across the country, COVID-19 has hit communities of color disproportionately hard in both cases and deaths.
Minnesotans of Hispanic descent are testing positive for COVID-19 at about five times the rate of white Minnesotans. They, along with Black Minnesotans, are also being hospitalized and moved to intensive care units at higher rates than the overall population.
Similar trends hold true for Minnesotas Indigenous and Asian residents. Counts among Indigenous people have jumped in the last week.
Fridays numbers also show newly confirmed cases continuing to accelerate among Latino people in Minnesota.
Distrust of the government, together with deeply rooted health and economic disparities, have hampered efforts to boost testing among communities of color, particularly for undocumented immigrants who fear their personal information may be used to deport them.
Minnesota health officials on Monday put out new guidance to ease visiting rules for nursing homes and other long-term care facilities in the state.
Visitors must now be allowed if the long-term care facility has not had a COVID-19 exposure in the last 14 days. Another requirement for opening nursing homes is if there's low to medium virus transmission in the county.
There are exceptions if there is a reasonable or clinical safety cause not to open, such as staffing issues.
The new rules go into effect Saturday. They are being introduced to align with new federal recommendations. Visitors still must schedule their time with the facilities, be screened for symptoms and wear masks.
Long-term care settings have long been a deep concern for the states public health authorities. Among the 2,180 whove died from COVID-19 related complications in Minnesota, about 71 percent had been living in long-term care or assisted living facilities; nearly all had underlying health problems.
Officials had placed severe visiting restrictions early on in the pandemic, hoping to stem the spread of the disease. Theyve also acknowledged the psychological toll that takes on residents and their families.
Peter Cox | MPR News
The Health Department on Wednesday also unveiled new changes to the way it reports data on cases and deaths. Health authorities have begun reporting the results of antigen tests, a more rapid form of COVID-19 test, along with the results from the more traditional COVID-19 test known by its initials PCR.
The agency said it made the move so its reporting would align with federal guidance. Antigen testing had been relatively small prior to this, so the change to previous case counts wont be dramatic.
The state, though, is nowadding to the COVID-19 death toll people who died after having had COVID-19 confirmed by an antigen (rapid) test but not a PCR test. That added six people to the states death toll Wednesday on top of 23 newly reported deaths.
Even without the statistical tweak, it was still the highest number of daily deaths reported since mid-June. The jump follows similar spikes Wisconsin, which reported 34 deaths in its Tuesday report. North Dakota set a new record for daily deaths last week at 24.
MPR News Staff
Minnesota jobless rate falls to 6 percent, but fewer seeking jobs: Minnesota's seasonally adjusted unemployment rate dropped sharply last month to 6 percent, down from 7.4 percent in August, but that decrease was due mostly to a significant dip in the number of people seeking work, state officials said.
Amid pandemic, Minnesota snowbirds wonder whether to stay put or go south: The pandemic is forcing some snowbirds to reevaluate their winter plans. One Minnesota couple is gearing up for their first winter in the state in 10 years.
National Guard tapped to fill staffing gap at Austin care facility: Staffing problems at Austins Sacred Heart Care Center started near the end of August, with the problem getting worse and worse over the course of several weeks until the facility needed help having enough care workers.
Judge blocks Wisconsin governor's indoor capacity limits amid spike in COVID-19 cases: The rules issued last week limited indoor public gatherings to no more than 25 percent of total occupancy limits. The state's Tavern League argued the caps would effectively put its members out of business.
Data in these graphs are based on the Minnesota Department of Health's cumulative totals released at 11 a.m. daily. You can find more detailed statistics on COVID-19 at theHealth Department website.
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Patients get tested for COVID-19 in India, one of 30 countries that took part in the Solidarity trial.
By Kai KupferschmidtOct. 16, 2020 , 3:45 AM
Sciences COVID-19 reporting is supported by the Pulitzer Center and the Heising-Simons Foundation.
One of the worlds biggest trials of COVID-19 therapies released its long-awaited interim results yesterdayand theyre a letdown. None of the four treatments in the Solidarity trial, which enrolled more than 11,000 patients in 400 hospitals around the globe, increased survivalnot even the much-touted antiviral drug remdesivir. Scientists at the World Health Organization (WHO) released the dataas a preprint on medRxivlast night, ahead of its planned publication in The New England Journal of Medicine.
Yet scientists praised the unprecedented study itself and the fact that it helped bring clarity about four existing, repurposed treatments that each held some promise against COVID-19. Its disappointing that none of the four have come out and shown a difference in mortality, but it does show why you need big trials, says Jeremy Farrar, director of the Wellcome Trust. We would love to have a drug that works, but its better to know if a drug works or not than not to know and continue to use it, says WHOs chief scientist, Soumya Swaminathan.
The prospects of two of the four treatmentsthe malaria drug hydroxychloroquine and the HIV drug combination ritonavir/lopinavirhad faded after another large study, the United Kingdoms Recovery trial,showed they did not increase survivalin June. After analyzing that study and its own data up until then, WHO decided to drop both from the study.
There was still hope for remdesivir and for interferon-beta, which had initially been given in combination with ritonavir/lopinavir but was tested as a standalone drug after the Recovery data came out. But neither of those treatments lowered mortality or delayed the moment patients needed ventilation to help them breathe. The results in these two treatment arms are likely to be the most scrutinized.
Remdesivir, which attacks a specific enzyme in several RNA viruses and was previously tested against Ebola, was initially seen as a promising candidate. In a U.S. trial with more than 1000 COVID-19 patientspublished last week, those who received remdesivir had a shorter recovery time than patients in the control group, but there was no significant difference in mortality. Two smaller trials found few significant benefits. Remdesivir received an emergency use authorization from the U.S. Food and Drug Administration (FDA) in May for severe COVID-19 patients that was later expanded to include all patients.
But the Solidarity trial suggests the drug does little in severe cases. Of 2743 hospitalized patients who received the drug, 11% died, versus 11.2% in a control group of roughly the same size. The difference is so small it could have arisen by chance.
When the authors pooled Solidaritys data with those from the three other trials, they found a slight reduction in mortality that wasnt statistically significant either. This absolutely excludes the suggestion that remdesivir can prevent a substantial fraction of all deaths, the authors write. The confidence interval is comfortably compatible with prevention of a small fraction of all deaths but is also comfortably compatible with prevention of no deaths.
This trial doesnt help remdesivir, thats for sure, says Eric Topol, director of the Scripps Research Translational Institute. Its not a dead duck as much as hydroxychloroquine, but it certainly is not the hope that was initially signaled.
But the drugs manufacturer, Gilead Sciences, casts doubt on the study. The trial design prioritized broad access, resulting in significant heterogeneity in trial adoption, implementation, controls and patient populations, the companysays in a statement, and consequently, it is unclear if any conclusive findings can be drawn from the study results.
Gilead received the manuscript about Solidarity on 28 September, according to WHO. On 8 October, before the results became public, the company signed a$1 billion deal with the European Commissionfor a 6-month supply of the drug.
Solidaritys most disappointing results, however, are those for interferon-beta, Topol says. Mortality among the 2050 people who received that drug (either alone or in combination with lopinavir/ritonavir) was 11.9%, versus 10.5% in the control group. Prior studies have suggested interferon can only help if given early, however, and not once patients have been hospitalized. So I think thats still an open question, Topol says.
Treating COVID late is very difficult, Benjamin tenOever, a virologist at the Icahn School of Medicine at Mount Sinai, wrote in an email toScience. At this point in the disease the issue is more about inflammation and clotting, which is likely why these four drug regimens showed little value.
The silver lining may be that the trial itself, unprecedented in several ways, succeeded. Set up in a short time in March as the pandemic engulfed the world, it used a simple protocol that allowed doctors in overstretched hospitals anywhere to randomize their patients to whatever study drug was available or to standard care. To get four different drug strategies nailed down, and in this short period of time and across the world, is just fantastic, Topol says. I give them a lot of praise for getting us these results with extraordinary velocity. I think that Recovery and the Solidarity trial between them have set the standard of the scale thats required in order to give you clear answers, Farrar adds.
To get four different drug strategies nailed down, and in this short period of time and across the world, is just fantastic.
The biggest hurdle was the long time it took to get regulatory approval for the study in some countries, says WHOs Marie-Pierre Preziosi. Regulators, as well as the ethics committees for that matter, need to rethink their approaches in pandemics and need to be much more ready to cope with this because sometimes the duration for authorization is really not appropriate.
Still, the trial has ramped up to more than 11,000 patients from 30 countries, including Argentina, Peru, India, the Philippines, and Spain, with more slated to join. About 2000 patients are now included every month. For the moment, the remdesivir arm will continue to get more precise evidence, says John-Arne Rttingen, CEO of the Research Council of Norway, who heads the executive group of Solidaritys steering committee. But new drugs will be added, he says.
As early as next week, Solidarity participants could start to receive acalabrutinib, a cancer drug that inhibits an enzyme that plays an important role in the human immune system. The hope is to soon include targeted therapies such as monoclonal antibodies as well because they are more likely to be successful than repurposed drugs. Trying to find off-target benefits from FDA-approved drugs is not a great strategy (although arguably the best we can do under these conditions), tenOever wrote.
Solidarity built on experience from the 201416 Ebola epidemic in West Africa, says Ana Maria Henao Restrepo, who heads the Research and Development Group at WHO. Back then, there were many debates about whether it was even ethical to do randomized clinical trialswhich withhold a potential therapy from patients in control groupsduring a deadly outbreak. Now, you dont see any debate on that question, she says. The community, all of us, we have moved, we have learned a lot since West Africa.
The studys global reach has important benefits, says Nahid Bhadelia, a physician at Boston Medical Center. Conducting a trial in many places simultaneously means more patients can be included, leading to faster results but also to more robust data, she says. Youre including many different types of subgroups and populations in different parts of the world.
Another advantage: The 1300 participating doctors worldwide will have a sense of ownership of the results, Henao Restrepo says. When they see the results inThe New England Journal of Medicine, [they will] say, Ive contributed to that and I understand why that drug works or doesnt work. I know, I trust it, she says. That is different from some Northern Hemisphere group publishing, and they say: Somewhere in a rich country they did a trial and now we all have to believe the results.
National Governors Association Submits List of Questions to Trump Administration on Effective Implementation of COVID-19 Vaccine | Governor Andrew M. Cuomo Skip to main content October 18, 2020
Albany, NY
Questions on Funding, Allocation, Supply Chain, Communication and Information Requirements
Federal/State Cooperation Crucial to Safely and Effectively Distribute Covid-19 Vaccine
Questions Were Submitted from Republican and Democratic Governors From Around the Country
The National Governors Association, Chaired by Governor Andrew M. Cuomo, today sent a list of questions to the Trump Administration seeking clarity on how to most effectively distribute and administer a COVID-19 vaccine. The distribution and implementation of the vaccine is a massive undertaking that cannot be managed without significant logistical coordination, planning and financial assistance between states and the federal government. The list of questions -- whichwere submitted from Republican and Democratic governors from around the country --covers funding for the administration of a vaccine, allocation and supply chain, and communication and information requirements.
"The National Governors Association, which I chair, sent a letter to the president of the United States last week. We asked to meet with the president to discuss how this is supposed to work between the federal government and the states,"Governor Cuomo said."We are now releasing a compilation of questions from governors all across the country, Democratic and Republican, saying to the White House: how is this going to work? We need to answer these questions before the vaccine is available so that we are ready to go and no one is caught flat-footed when the time comes to vaccinate people."
The list of questions NGA gathered from the nation's governors is available below:
Funding for Vaccine Administration
Allocation and Supply Chain
Communication and Information Requirements
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The COVID-19 pandemic has led to a dramatic loss of human life worldwide and presents an unprecedented challenge to public health, food systems and the world of work. The economic and social disruption caused by the pandemic is devastating: tens of millions of people are at risk of falling into extreme poverty, while the number of undernourished people, currently estimated at nearly 690 million, could increase by up to 132 million by the end of the year.
Millions of enterprises face an existential threat. Nearly half of the worlds 3.3 billion global workforce are at risk of losing their livelihoods. Informal economy workers are particularly vulnerable because the majority lack social protection and access to quality health care and have lost access to productive assets. Without the means to earn an income during lockdowns, many are unable to feed themselves and their families. For most, no income means no food, or, at best, less food and less nutritious food.
The pandemic has been affecting the entire food system and has laid bare its fragility. Border closures, trade restrictions and confinement measures have been preventing farmers from accessing markets, including for buying inputs and selling their produce, and agricultural workers from harvesting crops, thus disrupting domestic and international food supply chains and reducing access to healthy, safe and diverse diets. The pandemic has decimated jobs and placed millions of livelihoods at risk. As breadwinners lose jobs, fall ill and die, the food security and nutrition of millions of women and men are under threat, with those in low-income countries, particularly the most marginalized populations, which include small-scale farmers and indigenous peoples, being hardest hit.
Millions of agricultural workers waged and self-employed while feeding the world, regularly face high levels of working poverty, malnutrition and poor health, and suffer from a lack of safety and labour protection as well as other types of abuse. With low and irregular incomes and a lack of social support, many of them are spurred to continue working, often in unsafe conditions, thus exposing themselves and their families to additional risks. Further, when experiencing income losses, they may resort to negative coping strategies, such as distress sale of assets, predatory loans or child labour. Migrant agricultural workers are particularly vulnerable, because they face risks in their transport, working and living conditions and struggle to access support measures put in place by governments. Guaranteeing the safety and health of all agri-food workers from primary producers to those involved in food processing, transport and retail, including street food vendors as well as better incomes and protection, will be critical to saving lives and protecting public health, peoples livelihoods and food security.
In the COVID-19 crisis food security, public health, and employment and labour issues, in particular workers health and safety, converge. Adhering to workplace safety and health practices and ensuring access to decent work and the protection of labour rights in all industries will be crucial in addressing the human dimension of the crisis. Immediate and purposeful action to save lives and livelihoods should include extending social protection towards universal health coverage and income support for those most affected. These include workers in the informal economy and in poorly protected and low-paid jobs, including youth, older workers, and migrants. Particular attention must be paid to the situation of women, who are over-represented in low-paid jobs and care roles. Different forms of support are key, including cash transfers, child allowances and healthy school meals, shelter and food relief initiatives, support for employment retention and recovery, and financial relief for businesses, including micro, small and medium-sized enterprises. In designing and implementing such measures it is essential that governments work closely with employers and workers.
Countries dealing with existing humanitarian crises or emergencies are particularly exposed to the effects of COVID-19. Responding swiftly to the pandemic, while ensuring that humanitarian and recovery assistance reaches those most in need, is critical.
Now is the time for global solidarity and support, especially with the most vulnerable in our societies, particularly in the emerging and developing world. Only together can we overcome the intertwined health and social and economic impacts of the pandemic and prevent its escalation into a protracted humanitarian and food security catastrophe, with the potential loss of already achieved development gains.
We must recognize this opportunity to build back better, as noted in the Policy Brief issued by the United Nations Secretary-General. We are committed to pooling our expertise and experience to support countries in their crisis response measures and efforts to achieve the Sustainable Development Goals. We need to develop long-term sustainable strategies to address the challenges facing the health and agri-food sectors. Priority should be given to addressing underlying food security and malnutrition challenges, tackling rural poverty, in particular through more and better jobs in the rural economy, extending social protection to all, facilitating safe migration pathways and promoting the formalization of the informal economy.
We must rethink the future of our environment and tackle climate change and environmental degradation with ambition and urgency. Only then can we protect the health, livelihoods, food security and nutrition of all people, and ensure that our new normal is a better one.
