Holidays are usually for gatherings but many get-togethers are complicated or canceled because of COVID-19. USA TODAY
The U.S. recorded more than 69,000new cases Friday for the first time since July, andupdated virus projections are bringing the long-feared "winter surge" of COVID-19 cases into focus as health experts warn anincreasing number of infectionsin the U.S. will soon mean more deaths.
The University of Washingtons Institute for Health Metrics and Evaluation's latest modelupdates releasedthis weekcontain spots of good news:74,000 American lives can still be saved if mask use becomes nearly universal, and increased testing may explain why more young people are testing positive.
But the influential model still projects daily U.S. deaths will surpass2,000 in January, even with states reimposing stricter orders.
The guidance alsocalled out North Dakota specifically for its alarming death rate, following a well-documented lax approach to health mandates in the state: "North Dakota presently has one of the highest COVID-19 death rates in the world," a briefing on the model says.
The state joins South Dakota as havingsome of the lowest mask use rates in the nation.Rural counties across Wisconsin, North Dakota, South Dakota and Montana sit among thetop in the nationfor new cases per capita over the last two weeks,
Some significant developments:
Today's numbers:The U.S. has reported more than 8.1million cases and 219,000deaths,according to Johns Hopkins data. There have been more than 39.6million confirmed cases around the world and nearly 1.1million deaths.
What we're reading:Italy, once an epicenter for COVID-19, is worlds apart from the United States in its handling of the pandemic. Italians have always looked up to the United States but what is happening now makes us watch in disbelief," saysone Italian professor.
Mapping coronavirus:Track the U.S. outbreak in your state
This file will be updated throughout the day. For updates in your inbox, subscribe toThe Daily Briefing newsletter.
The University of Notre Dame announced a return to stricter rules on gatherings after cases at the school surged in recent days. Officials say off-campus tailgates and watch parties following a recent football home game are part of the reason for the increasein cases.
In a letter posted Thursday to the universitys COVID-19 website, Vice President for Student Affairs Erin Hoffmann Harding and Vice President for Campus Safety and University Operations Mike Seamon said the number of close contacts for each positive case had increased substantially, with as many as 10 to 15 close contacts needing to quarantine. At one time, the number of close contacts was only five per positive test.
The increase, he said, would indicate theyre gathering in groups.
In August, the university temporarily pivoted to online learning to stem a rash of cases.
Andrew S. Hughes, South Bend Tribune
A retired firefighter who was upset with Wichita's mask ordinance was arrested on suspicion of threatening to kidnap and kill the mayor of Kansas' largest city, authorities said.
Police said the 59-year-old suspect who was arrested Friday could face a charge of criminal threat, the Wichita Eaglereported. Wichita Mayor Brandon Whipple, a Democrat, said someone had read him text messages received by another city official that asked about the mayor's address and threatened his life.
He said he was going to kidnap me and slash my throat and he needed my address because I needed to see the hangman me and everyone who, something about tyranny, Whipple said. It sounded like the person was very upset about pretty much mask mandates and he said something about not being able to see his mother because of COVID restrictions on elderly homes.
Wichita police spokesman Charley Davidson said that no other local officials are believed to have been targeted.
The Associated Press
The White House quietly told Tennessee early this week that "a statewide mask mandate must be implemented" to curb its growing spread of COVID-19, strong instructions that the White House and governor did not discuss publicly before the report emerged in a records request.
The Oct. 11 state report for Tennessee, where Republican Gov. Bill Lee has let counties decide whether to require masks in public, first came to light in a records request by WUOT-FM. The Associated Press obtained the report from the Knox County Health Department afterward.
"A statewide mask mandate must be implemented to stop the increasing spread among residents in rural and urban areas of Tennessee," the item in a list of recommendations states.
Associated Press
Persistent layoffs are slowing momentum in the labor market, which bodes poorly for the broader U.S. recovery as millions of out-of-work Americans delay their mortgage and rent payments.
More than 6 million households failed to make their rent or mortgage payments in September, according to the Mortgage Bankers Association's Research Institute for Housing America, a sign that the economic fallout from the pandemic is weighing on jobless Americans as Congress stalls on relief measures.
In the third quarter, the percent of homeowners and renters behind on their payments fell slightly from the prior quarter. Still, the overall amount remains high, experts caution.
Jessica Menton
New York will start allowing movie theaters to reopen with limited capacity Fridayin areas of the state where COVID-19 rates are low, Gov. Andrew Cuomo announced Saturday.
Theaters will be able to reopen outside New York City in counties that are below a 2% infection rate on a 14-day average and have no COVID hot spots, which would rule out Rockland and Orange counties, as well as a few counties upstate, including Broome. Theaters will be allowed to reopen at 25% capacity with up to 50 people per screen.
The announcement comes after movie theaters have been pressing to reopen in New York, where infection rate is among the lowest in the nation.
Joseph Spector, New York State Team
After testing positive earlier this week for COVID-19, Alabama coach Nick Saban has been cleared to resume normal activities and will be on the sideline when the No. 2 Crimson Tide play No. 3 Georgia, the university said Saturday.
"Upon evaluation today, Coach Saban remains completely asymptomatic," Alabama team physician Dr. Jimmy Robinson said in a statement. "To address the potential for a false positive, the SEC Return to Activity and Medical Guidance Task Force Protocol allows for follow-up testing to clear the individuals return to activity. That protocol requires three negative PCR tests 24 hours apart."
Saban was tested on Thursday, Friday and Saturday, and each test was negative, Robinson said.
Paul Myerberg
The Vatican says someone who lives in the same Vatican hotel as Pope Francis has tested positive for the coronavirus, adding to the 11 cases of COVID-19 among the Swiss Guards,who serve as ceremonial guards at papal Masses, guard the Vatican City gates and protect the pope.
The Vatican said Saturday that the resident of the Domus Sanctae Marthae has moved out temporarily and is in isolation, as are all the people who came into direct contact with him.
The hotel serves as a residence for Vatican-based priests as well as visiting clerics and lay people. Francis chose to live there permanently after his 2013 election, shunning the Apostolic Palace, because he said he needed to be around ordinary people. The hotel has a communal dining room and chapel where Francis celebrates Mass each morning.
At 83 and with part of a lung removed when he was in his 20s due to illness, the pope would be at high-risk for COVID-19 complications.
Associated Press
A USA TODAY analysis of Johns Hopkins data through late Friday shows 16 states set records for new cases in a week while one state had a record number of deaths in a week.
New case records were set in Alaska, Colorado, Idaho, Illinois, Indiana, Minnesota, Missouri, Nebraska, New Mexico, North Dakota, Ohio, South Dakota, Utah, West Virginia, Wisconsin and Wyoming, and also Guam. Record numbers of deaths were reported in Wisconsin.
Mike Stucka
Dr. Hans Henri P. Kluge,regional director for the World Health Organization in Europe,warnsthat the daily death toll on the continent could reach five times its April peak by January 2021.
And on Friday, the WHO warned that intensive care units in a number of European cities could reach maximum capacity in the coming weeks if the number of infections is not slowed.
New restrictions went into effect in several European nations in an effort to staunch the resurgence of the pandemic, including:
Associated Press
Anopen letterfrom the frontrunner COVID-19 vaccine producer published Friday ends any expectations a vaccine might be available before Election Day.
Pfizer Inc.CEO Albert Bourla'sletter says the earliest the companycould apply for authorization for its COVID-19 vaccine is the third week of November.
The CEO of the other frontrunner, Moderna'sStphane Bancel,said at a biotechnology conferenceon September 30 that it would not have enough safety data to apply for Food and Drug Administration authorization of its vaccine until November 25.
The other twoCOVID-19 vaccine candidates in final stageclinical trials in the United States, Johnson & Johnson and AstraZeneca,are both on holdas possible adverse events are investigated.
Elizabeth Weise
Americans living or working in long-term care facilities, including nursing homes and assisted care living centers, will receive COVID-19 vaccinations for free if and when they become available, the Trump administration said Friday.
The administration announced a partnership with the nation's two largest drug store chains, CVS and Walgreens, "to provide and administer" the vaccines with "no out-of-pocket costs" for the recipients.
Trump, 74, vowed a vaccine would be available before the end of the year, despite his own federal health experts saying that timeline is highly unlikely, and that senior citizens would be "first in line."
The president made the announcement at an event billed as "Protecting America's Seniors" in Fort Myers, Florida. Trump is trying to shore up support among senior citizens, a key voting bloc that helped him win four years ago but which recent polling suggests has eroded in recent months.
Courtney Subramanian andNathan Bomey
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What makes congregating indoors so dangerous?Dr. Lewis Nelson, professor and chair of emergency medicine at Rutgers New Jersey Medical School, said one of the main reasons theres a higher risk of transmission indoors than outdoors is lack of ventilation. Additionally, indoor public places have more surfaces.
If I were to smoke a cigarette (inside), you would see the smoke particles linger, he said. Whereas outdoors the smoke kind of leaves."
Ventilation can be increased by opening a window, turning on a fan or even adding a portable air filter to a room. Most portable air filters cant filter out virus particles if they dont have HEPA filtration, but they still facilitate air circulation. Reducing the number of people in an indoor space also helps. Read more here.
Adrianna Rodriguez
COVID-19 widespread testing is crucial to fighting the pandemic, but is there enough testing? The answer is in the positivity rates. USA TODAY
Contributing: The Associated Press.
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Alaska is in the middle of an unprecedented rise in COVID-19 cases: The current surge far exceeds any other previous increases and has lasted more than three weeks.
Cases of the disease caused by the new coronavirus are showing up in every corner of the state with eight of the states 11 regions in a high-alert zone as Alaska reported one more death and 204 new COVID-19 cases Saturday, according to the Department of Health and Social Services COVID-19 dashboard.
The surge in cases parallels rising virus case numbers in several parts of the Lower 48. Alaskas daily reported cases have hit triple digits for 24 straight days.
The death reported Saturday involved a Fairbanks man in his 90s who died recently, according to the state health department. In total, 67 Alaskans with COVID-19 have died since the pandemic began here in March.
Statewide as of Saturday, 50 people were hospitalized with COVID-19 while 18 other hospital patients were awaiting test results, according to state data. Hospitalizations for COVID-19 are often referred to as a lagging indicator, which means people may show up to the hospital weeks after initially testing positive.
Of the new cases, it wasnt clear how many patients were showing symptoms of the virus when they tested positive. While people might get tested more than once, each case reported by the state health department only represents one person.
The current surge is different from the states previous spike in July, state health officials said on a call with reporters Thursday: There are more cases at the moment, but theres also more testing available though the state still needs more. Plus, there are more cases all over the state, in several rural communities, compared with the concentrated outbreaks in fish processing plants that took place in July.
We have much better treatment and understanding of the disease now than we did in July, and so we think that that is playing a role in deaths as well as hospitalizations, Alaskas chief medical officer, Dr. Anne Zink, said during a Thursday call with reporters.
But the biggest difference between the current spike and the summer surge is that its colder, Zink said. More people are indoors and more people are fatigued. Challenges only mount as more people head inside for the season.
We understand this disease better every day, Zink said. And so we really want to encourage Alaskans to be hopeful (and) at the same time being able to be resilient. I think that this fall and winter could be very challenging as cases are increasing.
But its not too late to slow down the current surge in cases, health officials say.
We know what works with COVID," said Dr. Joe McLaughlin, state epidemiologist. "Weve demonstrated it in Alaska, weve demonstrated it in the United States and weve demonstrated it in multiple countries across the globe. Mitigation works.
Several data points and indicators are the worst theyve been since the start of the pandemic.
Between Oct. 4 and Oct. 10, Alaska witnessed a continued spike in cases, with 40% more cases than the week before.
The states reproductive number, which is the average number of people one single person infects with the virus, saw a significant increase recently up to 1.18 by Oct. 10. A reproductive number over one means the states epidemic is growing because each person is spreading the virus to more than one person.
The states positivity rate, or the percentage of positive tests out of total tests, continued to climb this week with a 4.94% positivity rate as of Saturday, just slightly lower than the national average of 5.3%.
While many states have a higher positivity rate than Alaska does, this rise is concerning because the positivity rate is our best measure of whether our testing capacity can keep up with current cases. A rise in positivity rate reflects that testing is not increasing as fast as the current increase in cases, state health officials wrote in a recent report.
While Alaska has the lowest death rate per capita in the country, Vermont and Wyoming have had fewer total deaths.
State health officials say they have no reason to think that the virus in Alaska is any less severe compared with other places. They say recent studies show that COVID-19 strains in the state are as severe, if not more so, than the strains in other parts of the Western U.S.
This means that the virus present in many communities in Alaska has the ability to make people of all ages very sick if it is allowed to continue to spread, state health officials said.
Over the past week, Anchorage saw a 40% increase in new cases, said Dr. Janet Johnston, epidemiologist with the Anchorage Health Department, at a Friday briefing. It was the first week that Anchorage averaged above 100 new cases per day, with 102.2 new cases a day on average.
Given estimates that only one in 10 people with COVID-19 are actually identified as being infected, Johnston said its possible as many as 8,500 people in Anchorage are infectious with the virus.
Statewide as of Saturday, several regions of the state had tilted into the high alert zone, with more than 10 cases per 100,000 people reported over the last two weeks. The high alert level indicates there is widespread community transmission of the virus and many undetected cases as well as frequent outbreaks, according to the state health department.
Some places, like Anchorage, Northwest Alaska and the Fairbanks North Star Borough, reported triple that threshold, with averages in the low 30s. Other regions, like the Matanuska-Susitna Borough and the Kenai Peninsula Borough, newly entered the red zone on Saturday, with a little over 10 cases per 100,000.
Only three regions on the states alert level map were not in the red zone as of Saturday, including the Southwest region and much of Southeast Alaska outside of the City and Borough of Juneau.
Of the 201 new cases of COVID-19 involving residents, 90 were in Anchorage; three were in Chugiak; 10 were in Eagle River; one was in Girdwood; one was in Homer; one was in Kenai; four were in Soldotna; two were in Sterling; one was in Kodiak; two were in Healy; 15 were in Fairbanks; four were in North Pole; five were in Delta Junction; two were in Tok; five were in Palmer; 15 were in Wasilla; three were in Willow; five were in Utqiagvik; 12 were in Juneau; two were in Ketchikan; three were in Petersburg; one was in Craig; one was in Unalaska; three were in Bethel; and two were in Chevak.
Among communities smaller than 1,000 not identified to protect confidentiality, there was one in the northern Kenai Peninsula; one in the Fairbanks North Star Borough; two in the Yukon-Koyukuk Census Area; one in the Nome Census Area; and three in the Bethel Census Area.
Of the three nonresident cases, two were in Anchorage and one was in Wasilla.
The states testing positivity rate as of Saturday was 4.94% over a seven-day rolling average.
[Correction: A previous version of this story incorrectly reported that the individual who died was from Anchorage. He was a Fairbanks resident.]
Just as our final exit from the EU comes into view, noise from the media and politics about Covid-19 is sounding discomfortingly similar to the furies that erupted around the 2016 referendum.
On one side stands the political right, opposed to lockdown, apparently spurning the advice of experts, and seemingly convinced that a mixture of true-Brit common sense and derring-do will somehow see us through. The left, meanwhile, emphasises the importance of the science, and the prospect of disaster. As in the US, it is beginning to feel like any contentious political question will now trigger these polarised responses not necessarily in the population at large, but certainly among the people whose opinions define what passes for the national conversation.
News coverage of the second wave has so far tended to focus on which places should go in which official tiers, the distinction between pubs and restaurants, and the decision to send students back to universities. What has not been discussed nearly as much is the plain fact that the coronavirus crisis even more so in its second phase is all about basic inequalities, and the kind of questions of work, housing and poverty that deep crises always bring to the surface. In other words, Covid-19 is a class issue. That may sound simplistic, but what it actually denotes is an intricate set of considerations that the argument over lockdown is not acknowledging.
Since the start of the crisis, I have been regularly talking to many of the leaders in the north of England whose anger at condescending treatment from Boris Johnson and his colleagues continues to make the headlines. As many of them see it, one reason for the recent increases in infection is that the initial lockdown affected many of their areas differently than more affluent places. Rather than retreating inside to bake their own bread and have work meetings on Zoom, people in such trades as construction, warehousing and care work had to carry on venturing outside and mixing with others in the first wave, so levels of the virus remained comparatively high, even before the summer reopening then took them back to dangerous levels. Clearly, the ability to render yourself housebound is also dependent on whether your domestic environment makes remaining at home either viable or all but impossible. The basic point was recently nailed by the Financial Times writer Anjana Ahuja: This crisis has broadly separated us into the exposed poor and the shielded rich.
Andy Burnham, the Greater Manchester mayor, recently told me about one correlation that highlights this disparity. He said that in a swathe of the country that takes in Greater Manchester, east Lancashire and West Yorkshire, Covid hotspots map on to areas that were the focus of the last Labour governments so-called Pathfinder scheme: the programme that aimed to replace old housing by bringing in private developers, and left a legacy of unfinished work and huge resentment. The quality of housing in those areas is still extremely poor, said Burnham. Lots of families live intergenerationally. Its very overcrowded. How would you self-isolate in a situation like that?
This is a good riposte to the oft-heard suggestion that most people who fail to follow the rules are degenerate Covidiots, and further proof that in a society as insecure as ours, trying to stringently control anything let alone a highly infectious disease will tend to be very difficult indeed. According to research done at Kings College London, only 18% of people self-isolate after developing symptoms, and only 11% quarantine after being told by the governments test and trace system that they have been in contact with a confirmed case. Among the factors the study associates with non-compliance are lower socio-economic grade, and greater hardship during the pandemic. A lot of people, it seems, would like to do what they are told, but simply cant.
This is the basic point the government does not seem to have grasped painfully highlighted by Johnsons claim that infections increased because the public became complacent. Threatening people with fines of up to 10,000 if they fail to self-isolate and, we now learn, passing their details to the police is an example of the same cast of mind, less likely to persuade people in precarious circumstances to follow the rules than to keep their distance from the authorities. The fact that some people on very low incomes are finally eligible for a lump sum of 500 to cover a fortnights quarantine will not solve what is obviously a massive problem; in terms of basic practicalities, it is of a piece with Rishi Sunaks plan to pay only two-thirds of lost wages to people affected by local restrictions.
But before anyone on the left starts feeling too self-righteous, they also have questions to answer. There is a cold, dogmatic attitude in certain quarters that seems to define itself against anything that smells of Tory laissez-faire. Earlier in the year, it was manifested in rigid opposition to schools reopening, as some people averted their eyes from the inequalities the suspension of education was making worse. Now, some of the same voices stridently argue for strict national measures, as if that proposition is straightforward. It is actually not just complex, but full of potential contradictions. A prime example: given that poverty and precarity are what make millions of people vulnerable to both Covid infection and the life-threatening complications that can come with it, the hardship that any lockdown creates will make those problems even worse. This, surely, is the circuit that desperately needs to be broken, but after so many wasted years it will take a long time to do it.
In the meantime, a daily ritual of political futility goes on. Some people on the right yearn for a return to shrunken government, rugged individualism and the primacy of the economy, whatever that is. On the opposing side, people would like us to diligently follow the edicts of a reborn state, but social conditions are too far gone to allow many people to do anything of the kind. To those at the sharp end of this crisis, neither position will sound particularly convincing.
So it is that increasing numbers of people ignore the current political drama, and muddle through as best they can. Parallels with the vote to leave the EU are not only about the divisive arguments that have gripped the political class, but the fact that many of the same places whose experience fed into their vote for Brexit Hartlepool, Preston, Oldham, Middlesbrough are also suffering the worst of the pandemic. The inequality they embody remains the essence of the 21st-century British condition: four years on from 2016, this is still a country so imbalanced that it keeps falling over.
John Harris is a Guardian columnist
Are we going with it, or not? And what is the language? Pelosi said on ABCs This Week with George Stephanopoulos. Asked about the timeframe later on Sunday, Pelosi's office clarified that an agreement would need to be clinched by Tuesday night. If not, a bill would need to be pushed until after the election.
Pelosi and Mnuchin have been negotiating on and off since August about the size and scope of Congress next stimulus package, with much of the U.S. economy still in tatters as the pandemic rages on. Washington has already approved more than $3 trillion in aid, but it's been six months since any new cash has gone out the door.
Those bipartisan talks have intensified in the last few weeks, though many lawmakers and aides say theyve grown skeptical that an accord can be reached let alone passed through Congress in the final days before the election.
Pelosi also reiterated to her members Sunday afternoon that she believes a deal is within reach, even as key issues remain.
I am optimistic that we can reach agreement before the election, Pelosi wrote in a letter to update her members on the talks Saturday afternoon. Democrats are fully prepared to move forward once we reach agreement, she added.
The situation has been made even more complicated by President Donald Trump himself, who called off the talks during his own battle with Covid-19 only to backtrack a day later, and then call for an even bigger deal.
Pelosi said Sunday that she and Trump administration officials are still seeking clarity on the GOPs specific offer on a national testing and contract tracing plan, which remains one of the key areas of disagreement.
Were seeking clarity, because with all due respect to some of the people in the president's administration they're not legislators, she said, noting the administration had made small adjustments in language that were actually significant.
They changed shall to may, requirements to recommendations, a plan to a strategy, not a strategic plan. They took out 55 percent of the language that we had there for testing and tracing, Pelosi said.
Pelosi and Mnuchin spoke for more than an hour Saturday night, where Pelosi received some encouraging news on testing but remained not in agreement in other areas, according to her spokesman Drew Hammill.
There remains an array of additional differences as we go provision by provision that must be addressed in a comprehensive manner in the next 48 hours, Hammill said Saturday night.
Pelosi elaborated on the GOPs latest proposal in her letter to House Democrats on Sunday, describing the changes to the testing plan as unacceptable.
Other differences, Pelosi said, include funding for state and local governments, the child tax credit, child care programs and the Trump administrations attempts to undermine the census. All of the issues were discussed on the call Saturday evening.
Even if a deal on coronavirus relief between Pelosi and the White House is reached, Senate Majority Leader Mitch McConnell would need to bring it to the Senate floor and get Senate Republicans on board with the package. The matter could also be complicated by Mnuchin's focus abroad, leading an Israeli-American delegation to Bahrain and the United Arab Emirates this weekend.
McConnell did say Saturday that he would put a deal on the floor if it ever came together: If Speaker Pelosi ever lets the House reach a bipartisan agreement with the Administration, the Senate would of course consider it.
But the Senate GOP has been perennially skeptical of any funding agreement over $1 trillion, let alone a deal closer to $2 trillion as Pelosi and Mnuchin have been discussing.
Under pressure to pass some kind of relief bill before the election, McConnell has instead teed up Senate votes next week on a much narrower proposal than what Democrats and Mnuchin have floated.
Speaker Pelosi keeps saying she feels nothing is better than something and clinging to far-left demands that are designed to kill any hope of a deal, McConnell said Saturday.
Senate Democrats have not yet said whether they will block the measure, saying they dont know the specifics of the proposal.
We dont know what the substance is, we dont know the procedure hes proposing, so were not going to comment until we get more, Senate Minority Leader Chuck Schumer (D-N.Y.) told reporters Sunday, though he was critical of the GOP maneuver broadly.
Its a total stunt, Schumer said.
Mnuchin who has been largely optimistic throughout the talks acknowledged earlier this week that the odds were diminishing to reach a deal before the election. He told the Milken Institute Global Conference that getting something done before the election and executing on that will be difficult.
Heather Caygle contributed to this article.
In this Fool Live video, Healthcare and Cannabis Bureau Chief Corinne Cardina and longtime Motley Fool contributor Brian Orelli discuss the drugs that President Donald Trump received to treat his case of COVID-19. They discuss the difference between an emergency use authorization from the Food and Drug Administration and a full approval. They also get into whether it's worth investing in companies making COVID-19 treatments considering that data from late-stage clinical trials testing coronavirus vaccines are imminent.
Corinne Cardina: For anyone who has been living under a rock, on Friday, last Friday, President Trump announced that he and the First Lady have confirmed cases of COVID-19. Later that day, he was admitted to the Walter Reed Medical Center. His doctor said he received an eight gram dose of Regeneron's (NASDAQ:REGN) experimental antibody cocktail. He also received remdesivir, Gilead Sciences' (NASDAQ:GILD) antiviral treatment and a common steroid treatment called dexamethasone.
The President has since left the hospital. He tweeted a video crediting Regeneron's experimental treatment with his recovery. Of course, all this excitement has bled over into the stock market. Regeneron's stock is up seven percent since Friday, Oct. 2, continuing a nice if volatile streak since the pandemic began. It's actually up a little more than 60% since Jan. 1.
All that is to say that it's a great time to take a fresh look at all the stocks involved in the COVID-19 treatment field. Today, we're going to dive into some of the stocks investors might have their eye on. Brian, let's start with a question that I think a lot of us have as we toggle back and forth between news on treatments and news about the development of a vaccine. Will the need for these COVID-19 treatments decrease substantially once a safe and efficacious vaccine is widely distributed? Is this a fleeting field, a band-aid while we wait for a vaccine, or is it here to stay?
Brian Orelli: It obviously depends on how well the vaccines work. It's likely they won't be 100%. Even people who do get the vaccine, eventually, some of those people will get COVID and will need treatment. So I think the treatments aren't going away completely.
Will the demand go down as the amount of vaccine goes up assuming the vaccine works? Yes, absolutely. But we also don't really know how many people are going to be interested in taking the vaccine and also how much the vaccine is going to be available. Certainly in the beginning, only the most at-risk people are going to be able to get the vaccine. Until everybody is vaccinated, and that will be a long time, and maybe never if people decide they don't want to take it, then that's the only way we get it so that there wasn't any treatments needed.
Corinne Cardina: Yeah, absolutely. There's a lot of uncertainties and question marks that's basically going to decide that as things keep coming out about the vaccine trials.
Speaking of the treatments, a lot has been said about emergency-use authorizations. Can you tell us what that means compared to true FDA approvals? Do emergency-use authorizations expire?
Brian Orelli: Yeah. First, let's start off with what you need to get one, and then you need less data basically to get an emergency-use authorization compared to a FDA approval. The reason is because they understand that there's a higher risk and so therefore you can have less data and still be able to get the emergency-use authorization. Then the authorization only lasts as long as there's an emergency. As soon as the pandemic is over, the companies would have to apply for a full approval if they wanted to keep their drugs or vaccines on the market.
The prevalence of comorbid chronic obstructive pulmonary disease (COPD) among patients hospitalized with coronavirus 2019 (COVID-19) is actually lower than its presence in the general population, according to a new observational cohort analysis.
In new data presented online during the American College of Chest Physicians (CHEST) 2020 Annual Meeting this week, investigators reported just 1 in 20 observed patients hospitalized with COVID-19 suffered from COPDversus significantly greater rates of cardiometabolic disease among the most severely ill patients.
Study authors Vikramaditya Samala Venkata, MD, and Gerard N. Kiernan, MD, both of Dartmouth-Hitchcock Medical Center, conducted a systematic electronic search-based assessment of COVID-19 clinical trials to define associations between baseline COPD and overall outcomes of hospitalized patients.
Current understanding of such associations is not yet comprehensive, but nonetheless troubling given the respiratory burden of the pandemic virus.
Although clinical data is limited, studies published so far raise concerns about an association between COPD and worse clinical outcomes in COVID-19, they wrote.
The systematic search included retrospective studies including original hospitalized COVID-19 patient data from any of 3 major databases. Venkata and Kiernan used pooled analysis with a random-effects model in order to interpret the associations between COPD and COVID-19.
Their analyses included 22 studies from 8 countries including 11,000-plus patients hospitalized with COVID-19. Mean patient age was 56 years old, with 58% reported as male.
Among all comorbidities, hypertension was the most prevalent in hospitalized patients, at 42%. Another 23% of patients had diabetes mellitus.
Investigators observed a COPD prevalence rate of just 5% (n = 437) in patients hospitalized with COVID-19. However, such patients faced a three-fold greater risk of mortality (odds ratio [OR], 3.23; 95% CI, 1.59 6.57; P <.05). They noted the global prevalence of COPD among patients >40 years old is approximately 9%.
One explanation may be precautions put in place by COPD patients and their friends, family, and neighbors to limit their risk of COVID-19 exposure, given fears of more severe disease risks for such patients.
While one would expect patients with prior lung disease to have greater mortality with COVID-19, it is curious to see that the prevalence of COPD was lower than the general population may reflect greater measures taken by COPD patients to avoid coronavirus exposure, investigators wrote.
Uniquely, Venkata and Kiernan also found that smoking was present in more than one-third (37%) of COVID-19 patientsyet patients who smoked faced only a 52% worsened risk of disease severity (OR, 1.52; 95% CI, 0.81 2.87; P = .20). Reasoning for a mixed association, they noted, is still unclear.
Investigators concluded that more randomized trials are necessary to understand relationships between COPD, smoking status, and hospitalized COVID-19 prognosis in patients.
This will alert clinicians to the worse prognosis of COVID-19 infection in patients with history of COPD and it will raise a question for future studies to look at the association between baseline COPD and COVID-19, they concluded.
The study, COVID-19 and COPD: Pooled Analysis of Observational Studies, was presented at CHEST 2020.
In just six months, the worlds largest randomized control trial on COVID-19 therapeutics has generated conclusive evidence on the effectiveness of repurposed drugs for the treatment of COVID-19.
Interim results from the Solidarity Therapeutics Trial, coordinated by the World Health Organization, indicate that remdesivir, hydroxychloroquine, lopinavir/ritonavir and interferon regimens appeared to have little or no effect on 28-day mortality or the in-hospital course of COVID-19 among hospitalized patients.
The study, which spans more than 30 countries, looked at the effects of these treatments on overall mortality, initiation of ventilation, and duration of hospital stay in hospitalized patients. Other uses of the drugs, for example in treatment of patients in the community or for prevention, would have to be examined using different trials.
The progress achieved by the Solidarity Therapeutics Trial shows that large international trials are possible, even during a pandemic, and offer the promise of quickly and reliably answering critical public health questions concerning therapeutics.
The results of the trial are under review for publication in a medical journal and have been uploaded as preprint at medRxiv available at this link: https://www.medrxiv.org/content/10.1101/2020.10.15.20209817v1
The global platform of the Solidarity Trial is ready to rapidly evaluate promising new treatment options, with nearly 500 hospitals open as trial sites.
Newer antiviral drugs, immunomodulators and anti-SARS COV-2 monoclonal antibodies are now being considered for evaluation.
Throughout Michigan's worst public health crisis in a century, Senate Majority Leader Mike Shirkey has decried Gov. Gretchen Whitmer's management of the coronavirus pandemic as heavy-handed.
The Republican from Jackson County has even gone as far as saying the Democratic governor is "very comfortable being a dictator."
Shirkey and House Speaker Lee Chatfield sued Whitmer over her emergency powers and encouraged a petition drive to strip the governor of these extraordinary powers just in case they lost in the courts.
The Michigan Supreme Court ultimately sided with the GOP-run Legislature in a different lawsuit over the 1945 emergency powers law the governor used to keep certain businesses closed for months and limit social gatherings to contain the virus was unconstitutional.
Shirkey, who has long argued government cannot eliminate all risk, says people should have the freedom to choose their own level of risk in contracting or spreading this deadly virus.
Call this the Shirkey Doctrine.
It's a let-it-burn-through strategy with the virus that, in his words, includes "an element of herd immunity."
Except there's no safe, effective and readily available vaccine yet to inoculate the herd.
And just as new cases of coronavirus, hospitalizations and deaths are starting to rise again in Michigan in what might be a second wave of the pandemic, we're now sort of trying out the Shirkey Doctrine.
In the absence of Whitmer's executive orders, there's now a patchwork of regulations for businesses and individuals to follow from the Michigan Department of Health and Human Services, the Michigan Occupational Safety and Health Administration and county health departments.
In Detroit, there's another set of rules for businesses to adhere to with some slight differences. Other cities hard-hit by the virus are considering ordinances that are more restrictive than state-level orders under the public health and workplace statutes.
But none of these government bodies has the full weight and force of Michigan's chief executive.
Few people know who Robert Gordon or Sean Egan are (they're the director of MDHHS and MIOSHA's COVID workplace safety director, respectively).
Their orders don't carry nearly the same kind political and legal weight as the governor.
The MDHHS public health orders and MIOSHA's temporary rules are left open to potential legal challenges, adding more confusion among the masses about what's the law and what's not.
Confusion and sowing doubt in the science also is part of the Shirkey Doctrine moving forward.
For months, he has publicly encouraged mask-wearing and social distancing. He's even in the mask-sanitizing business.
But Shirkey has resisted any kind of public mandate and has been casting doubt on the effectiveness of two layers of cloth stopping droplets from the nose and mouth from escaping into the air other people breathe in confined indoor places.
He's resisting the precautions that the public had grown accustomed to in the interest of protecting their own health and the health of others.
Shirkey has, so far, resisted having the Legislature temporarily write a universal mask mandate into law, leaving the door open for more court battles for the Whitmer administration and counties to defend the various orders.
The Whitmer Doctrine has centered on the governor using the centralized powers of her office to try to limit the ways people can come in contact with COVID-19.
Whitmer's approach has, at times, been frustrating to many and financially devastating to some of the businesses that were left hanging in the wind for months on end.
The governor's communication of the reasoning and science behind keeping certain businesses closed and letting others reopen has been downright maddening at times.
But there's almost no debating that the spring lockdown produced the curve-flattening results that Whitmer promised.
By mid-June, as the economy was reopening, the daily case count was down to an average of about 150 new COVID-19 infections each day.
The 4,045 new cases reported Thursday and Friday pushed the new seven-day average to 1,425 nearly 10 times more COVID cases each day than four months ago when the Whitmer Doctrine was Michigan's strategy for navigating a once-in-a-lifetime pandemic.
As Whitmer gradually reopened sectors of the economy and people let their guard down, the virus started spreading again.
It was an inevitable outcome, especially when schools and college campuses reopened.
And, yes, the death rate from this virus for young people is very, very low.
But the death rate for their parents and grandparents is alarmingly high not to mention the long-term health scars COVID is leaving in people in already poor health.
A group of nationally recognized infectious disease experts wrote Shirkey a letter last week saying that in order to achieve herd immunity, 6.5 million people in Michigan alone would have to get infected.
"At the current mortality rate, this would mean more than 30,000 additional deaths more than four times the number of deaths to date," wrote the group of public health experts that included former Centers for Disease Control Director Tom Frieden.
There are 2.4 million residents in Michigan over the age of 60 (Shirkey being one of them).
The death rate for people in their 60s who have contracted COVID-19 in the past three months is about 3 percent, according to state data.
For people in their 70s, that death rate jumps to between 8 percent and 10 percent. For those older than 80, the death rate approaches 20 percent, according to state data.
One-in-five people over age 80 who contract COVID-19 are succumbing to this virus.
But what will happen if the societal expectation to wear masks, wash your hands and not go to a rock concert dissipates without a clear legal mandate from the people who write this state's laws?
That's something to bear in mind as we enter this period of trying it Shirkey's way.
Hospitals in and around Kansas City, Missouri, are overwhelmed amid a troubling spike in COVID-19 cases that has forced some facilitates to refuse non-emergency care and others to turn away ambulances due to over-occupancy.
Average daily COVID-19 hospitalizations were up about 10% this week across the Kansas City region as the Midwest grapples with record-breaking daily infection rates and intensive care unit bed shortages, according to the Mid-America Regional Council's dashboard.
Earlier this week, the Kansas City metro area saw its highest number of new COVID-19 hospitalizations on record with the seven-day average rising to about 133. Separately, hospitals in the area reported a 28% increase in the average number of patients on ventilators, week-over-week, while daily ICU occupancy rose about 11% from last week, according to the dashboard.
All in all, total weekly hospitalizations jumped to 867, compared to 835 last week, pushing several area hospitals to refuse ambulances due to lack of beds.
Marc Larsen, operations director of Saint Luke's COVID Response Team, the second-largest care provider in the region, said Kansas City area hospitals are "bursting at the seams."
Saint Luke's daily patient average rose to about 85 for the month of October, compared to about 63 per day in September, Larsen said. The system reported a daily patient average of only about 15 COVID-19 patients a day in May and June.
"The current trajectory and the rapid increase in infections is a big concern for me," Larsen told ABC News in an interview Friday. "And with our numbers where they are coming into influenza season, I worry that the facilities will continue to be pushed to the brink on our ability to care for each and every single one of these patients like we need to."
He added, "As a result, our emergency departments and having to leverage alternative care units in our facilities, meaning that we wind up seeing emergency department patients in our pre-anesthesia care units, recovery rooms and sometimes in waiting rooms."
Fans take in a flyover before the Kansas City Chiefs take on the Las Vegas Raiders at Arrowhead Stadium in Kansas City, Mo., Oct. 11, 2020.
Larsen, who is also an emergency care physician at the downtown Kansas City hospital, said at least eight metro hospitals and emergency departments had to temporarily stop accepting ambulances due to the high volume of patients on Tuesday and Wednesday.
"We had eight facilities at one given time that were on 'diversion,' or what we call high-volume status," he said. "That doesn't mean that we don't still take the time-critical diagnoses -- we still take our stroke patients, our trauma patients and our heart attack patients -- but it does limit our ability to provide care to the remainder of ambulances."
"When we get to that volume and when we get to that capacity we're force to hold patients, because may not physically even have a bed available," he added.
Hospitals volumes were in much better shape as of Friday afternoon, but he said he "would not be surprised if this evening and throughout the weekend that we continue to see high volumes and emergency departments across the region."
He said Saint Luke's hospitals were currently experiencing volumes that they only see during peak flu season, warning the public that the situation could get a lot worse by winter.
"Peak flu season is always our busiest time of the year. We have a lot of sick patients and our volumes are a lot higher," Larsen said. "The volumes that we're seeing at this moment are very similar to what we see, typically, in January or February. If we're already at that level and we have this large influx of influenza patients -- as we typically do -- where will we take care of all these patients?"
Like many health officials, he urged all Americans to get a flu shot this year, even if you've never gotten one before.
"Aside from the social distancing, masking and hand hygiene, we don't have a way to prevent this, but we do have one for the other pandemic that we're looking at and that's influenza," Larsen said. "I've been encouraging all my patients to get their flu shots now because I think that's gonna really help us prevent this second surge, not of COVID patients but other patients that need the same type of resources that COVID patients need."
As of Friday, Missouri had reported 2,017 new confirmed cases over the last 24 hours, bringing the total number of cases since the start of the pandemic to 152,571.
The state now ranks fourth nationally in reported deaths over the past seven days, and eighth in the number of new cases, according to the statewide dashboard.
In this Aug. 6, 2020 file photo, Missouri Republican Gov. Mike Parson speaks during a news conference in St. Louis.
Missouri also reported 17 new virus-related deaths on Friday, pushing the total number of COVID-19 fatalities to 2,459, state officials said Friday.
As of late Thursday, COVID-19 hospitalizations were up to 1,443 across the state, the highest on record. Health officials had not released Fridays data as of the time of publication.
Gov. Mike Parson recently announced that the state had submitted its plan for administering the impending COVID-19 vaccine to the Centers for Disease Control and Prevention in an effort to be proactive about slowing the spread.
"This has been an incredible collaborative effort, and I want to thank all of the agencies and partners involved for their hard work and dedication. In the midst of an ever-changing and unprecedented situation, our team of professionals has done outstanding work to develop a detailed plan," Parson said in a statement this week after submitting the plan. "We are in a great place in the planning process and will be well-prepared to take action as soon as a vaccine becomes available."
Just south of the Galapagos Marchena Island, theres a dive spot known by locals as the fish arena.
There, within the choppy, cool waters of the Pacific, thousands of colorful fish swim in schools, lobsters poke their long antennae out of rocky outcrops, dolphins bear their young and moray eels gape menacingly at visitors who swim too close.
Charles Darwin documented the rich biota of these islands in the early 1800s. In more recent times, an unofficial network of local tour boats and fishing vessels has worked to protect it, by keeping an eye out for those who might harm the marine bounty. But the pandemic has grounded this surveillance fleet, creating an opening for outsiders.
Earlier this summer, more than 300 Chinese fishing vessels many designed to hold 1,000 tons of catch waited at the marine preserves border, ready to snatch up sea life as it migrated south toward the waters off Peru and Chile.
By some estimates, China has a distant water fishing fleet of 17,000 vessels that has been involved in fishing conflicts off the coasts of West Africa, Argentina and Japan in recent years. Now this fleet is triggering similar anger off Ecuador and Peru, two nations highly dependent on their robust near-shore fisheries.
This is an attack on our resources, said ngel Ynez Vinueza, the mayor of Santa Cruz canton, the Galapagos equivalent of a province. They are killing the species we have protected and polluting our biota with the plastic waste they drop overboard. They are raping the Galapagos.
The fleet is hardly the only threat to this park, a UNESCO world heritage site.
As a result of the COVID-19 pandemic, tourism has plummeted tour boats have been moored in Santa Cruz Islands Academy Bay for months, while shops and restaurants are shuttered along Puerto Ayoras main drag, Avenida Charles Darwin.
It has laid bare the vulnerability of an economic model that is 90% dependent upon tourism dollars, while also highlighting the extraordinary beauty and remoteness of the islands and the magic that is lost when thousands of tourists descend daily into this fragile ecosystem.
The Galapagos marine reserve faces threats from industrial fishing, climate change and reduced funding for conservation.
During a recent visit to the Galapagos, a Times reporting team the only visitors touring the park by boat witnessed penguins swimming alongside tropical fish and sea turtles, krill blooms clouding the shallow waters with pink flotsam, and migrating tuna and hammerhead sharks meandering through the darker, deeper waters.
Normally, pods of dolphins and whales stay out of the busy harbor in Academy Bay. But with the tourist boats out of commission, they are swimming around the area for the first time in decades. Brown pelicans are nesting in the nearby cliffs and mangroves a sight Fiddi Angermeyer, 68, a local tour operator and business owner, says he hasnt seen since he was a kid.
Animals like these Galapagos penguins have flourished as the pandemic keeps visitors away, but the lack of tourism could devastate the parks funding and has left an opening for poachers to move in.
(Carolyn Cole / Los Angeles Times)
The situation has prompted politicians, environmentalists and business owners to wonder how the region can regrow and provide a vibrant economy and jobs for its residents while maintaining the wild essence of the park and tamping down on its carbon-intensive requirements the jet planes and cruising boats of international tourism.
Its like it was 30 or 40 years ago, said Mary Crowley, the director of Ocean Voyages Institute, a Sausalito, Calif., environmental organization working to rid the oceans of plastic. Shes been to the Galapagos 23 times since 1972. That splendor has returned.
Its also exposed the critical role tourism plays in the upkeep and safety of the park: Without visitors traveling to the outer islands and local fishing crews patrolling the parks waters, no one is watching for poaching or picking up the litter and plastic floating in from the mega-fleets and mainland.
The calculus is clear, said Angermeyer: If there are no tourists, there is no park. And if theres no park, there are no tourists.
A world heritage site, the Galapagos marine reserve faces threats from industrial fishing, climate change and a drastic drop in tourism and funding for conservation.
Mosquera Island is not much more than a skinny spit of sand and rock off Baltra Island, where the Galapagos Islands main airport is located.
On a recent afternoon, baby sea lions, Galapagos pigeons and Sally Lightfoot crabs scrambled across the rocks or lolled in the sunbaked sand on Mosqueras southern shore. The airport and the channel separating the islands were largely silent just the sound of waves lapping and sea lion moms and pups barking back and forth.
But a walk around the rocky edge of the island showed something deeply distressing to Fernando Ortiz, a park guide and former director of the regions chapter of Conservation International: Scores of plastic bottles, shoes and equipment packaging labeled with Chinese characters poked out of the jagged rocks.
Fernando Ortiz, a park guide and former director of the regions chapter of Conservation International, picks up bottles, shoes and equipment packaging from the jagged rocks of Mosquera Island in the Galapagos.
(Carolyn Cole / Los Angeles Times)
These are from those boats, said Ortiz, pointing south, toward the horizon, where the fleet of Chinese fishing vessels had congregated roughly 200 nautical miles away. He noted the newness of the items, with labels not faded by sun or sea.
In July, the Ecuadorian navy had become alarmed as the fleet approached the edge of the 200-mile zone around the park where commercial fishing is illegal.
For years, fishing crews have trawled this zone, hoping to capitalize on the fruits of conservation increasingly healthy and robust fish stocks said Boris Worm, a researcher at Dalhousie University in Canada who has studied the fishery.
But last summer, the number of vessels exploded. In late August, a U.S. Coast Guard cutter was called in to help Ecuadors navy patrol the area.
Capt. Brian Anderson, commanding officer of the Coast Guard cutter Bertholf, said the Chinese brought in a tanker ship, which provided fuel to the other ships, and processing ships, where the fishing vessels could dump their harvest and go out and collect more.
It was like a city, he said, noting the fleet had all the pieces it needed to stay out for months without returning to home ports.
Several of the Chinese vessels werent reporting their location electronically, he said, and one was reporting its location as Alaska. But without jurisdiction in the area, and nothing blatantly illegal to report to the Ecuadorian navy, the Coast Guard was relegated to watching, he said.
A Chinese fishing boat off the coast of Peru lights up the surrounding water to attract squid in 2018.
(Simon Ager Photography)
For its part, China has contended it has zero tolerance toward illegal fishing. In a July 23 statement, the Chinese Embassy in Quito said China respects Ecuadors measures to protect the environment and preserve marine resources.
But John Serafini, chief executive of a Virginia-based military defense and commercial data analytics start-up called HawkEye 360, said his companys research which relies on radio frequency and satellite imagery to process movement showed many suspicious signals coming from within the zone this summer.
In 2017, a Chinese fishing vessel intercepted off of the Galapagos was found to be hauling 300 tons of fish, which included tens of thousands of illegally caught sharks.
Mayor Vinueza said the continuing presence of the fleet is an assault on the preserve and his residents livelihood, especially in the face of the economic devastation the park is suffering.
Local fishermen try to sell lobster to boaters in Santa Cruz Islands Academy Bay. The pandemic has caused a desperate economic situation for the residents who depend on tourism in the Galapagos.
(Carolyn Cole / Los Angeles Times)
In August, hundreds of Santa Cruz canton residents took to the streets to protest the fishing fleet worried it was depleting the parks natural resources, potentially giving one more reason for tourists not to return.
On Sept. 24, a commercial flight from Guayaquil to Baltra Island had only nine passengers aboard. Though Avianca Airlines once had daily flights to the island, those have dropped to a sporadic two or three a week.
The lack of tourists has clearly hit the businesses that rely on them, as well as the fishermen and farmers who supply the industry.
Denato Rendon, a local fisherman, has been giving his fish away while his cooperative tries to find new buyers on the mainland and overseas. William and Noralma Cabrera, farmers in the hills outside Puerto Ayora, are also giving food away, and sometimes bartering trading their tomatoes and cucumbers for goods such as fish, chicken or milk.
Were a close-knit community, the father of two said as he stood in front of greenhouses where beans, lettuce and tomatoes were ripening.
The dearth of tourists has also hit the park, which relies on $100 entry fees from visitors. The fees provide money for preservation, conservation, upkeep and enforcement. More than 97% of the Galapagos is protected parkland; the rest is residential.
On Sept. 24, the park pulled in $1,240 from tourist fees at the islands two airports just 4% of last years collection for the same day, said Norman Wray, president of the Government Council of Galapagos.
Noralma Cabrera and her husband, William, are farmers in the hills outside Puerto Ayora. Without tourism driving the economy, theyve started giving food away.
(Carolyn Cole / Los Angeles Times)
We cant keep things going like this, Wray said of the high unemployment and tourism exodus from the islands. To try to counteract that, Wray and others are underscoring the safety of the islands and the seriousness with which the industry takes the pandemic.
Look around you, Vinueza said, it is safe here. We have strict protocols. We wont let the virus in.
Proof of a negative PCR coronavirus test, taken within 96 hours of arrival in the Galapagos, is required for entry. Thats more stringent than the requirement to get into Ecuador, which requires a PCR coronavirus test to be taken within 10 days of arrival.
Seemingly everyone in the now-quiet Puerto Ayora wears a mask, and all businesses require patrons to douse their hands and shoe soles in alcohol before entry. Boat crews are even spraying the hands of scuba divers just emerging from the ocean before they let them back on their boats.
We just cant be too careful, said Ortiz, who works on Angermeyers ship, the Passion, as a guide. And its important that people know how seriously we take this disease.
As a result of the pandemic, tourism has plummeted in the Galapagos and tour boats have been moored in Academy Bay for months, while shops and restaurants are shuttered.
(Carolyn Cole / Los Angeles Times)
Still, theres the sense here that the pandemic may have changed the tourist economy in the islands forever and in some respects, Wray said, that may be for the better.
He noted that broadband cables are being laid along the ocean floor, which soon will connect the islands with high-speed internet making it possible for a high-tech academic center or industry, such as Google or Amazon, to relocate or establish satellite offices in the islands.
What a laboratory to work in, he said, describing the wildness, beauty and history of the islands. And such a prospect, he said, could help park managers imagine a future that didnt require international tourists to board jumbo jets or gas-guzzling pleasure cruisers to meander around the islands.
For the park to survive and its wildlife to thrive, the future of tourism on the island and in the region must change, Wray said.
Though the pandemic and Chinese fishing fleet pose threats, he said, they also have offered a moment for the parks leaders to consider more sustainable models for the Galapagos and the flora and fauna that tourists come to see.
We cant survive without them, he said. But we need to find a balance.
