St. Lucie County Sheriff Ken Mascara described his health challenges in going through COVID-19. Video produced Aug. 21, 2020. Wochit
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The Florida Department of Health reported 94new COVID-19 cases and fivenewdeaths Friday.
Friday's announcement is the largest daily increase in the number of cases since 124 were reported Sept. 19.
The total number of cases on the Treasure Coast increased to 15,981. The cumulative death toll increased to 532. Three new deaths were reported in Martin County, and two new deaths were reported in St. Lucie County. No new deaths were reported inIndian River County.
More: Horseshoe crabs have a vital role in the development of a coronavirus vaccine. Here's why.
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Health officials have saidthe virus is not necessarily the cause of death, but they record people who at some pointtested positive for the virus and later die.
Here's a breakdown of the latest numbers across the Treasure Coast:
County
Conditions and care
COVID-19 tests administered for Florida residents
Cases by city, if known
Ages
Gender
Race
County
Conditions and care
COVID-19 tests administered for Florida residents
Cases by city, if known
Ages
Gender
Race
County
Conditions and care
COVID-19 tests administeredfor Florida residents
City, if known
Ages
Gender
Race
Check back. To keep up with Treasure Coast-specific news, visit our website often. We will post a daily coronavirus blog on our site. Look at the date in the headline to make sure you have the latest news.
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Its been half a year since COVID-19 upended peoples lives in Illinois.
Since businesses sent employees to work from home, and many shut down. Schools closed and shifted classes online. Parents scrambled to juggle both work and their kids learning. Isolation and loneliness set in as people tried to slow the spread of the coronavirus.
Buzz words like social distancing became the norm, as well as masks covering most of peoples faces (and littering streets and empty playgrounds).
Illinois public health officials say COVID-19 has so far killed more than 8,500 people in Illinois and infected more than 280,000. Thats just cases that have been confirmed through testing.
WBEZ is revisiting several COVID-19-related health care issues we explored in the past six months to see whats changed or hasnt.
During the height of the pandemic this spring, when hospitals in Chicago were overwhelmed with COVID-19 patients, some small hospitals, with the least amount of resources and mainly treating low-income people of color, were stuck. They couldnt get many other hospitals to take their patients.
In Illinois, theres no agency coordinating how patients flow from one hospital to another. And theres no agency that has the power to force hospitals to take patient transfers.
The major gap has created a patchwork transfer system that has led hospitals to rely on old friends and connections to help move patients when theyre overwhelmed.
This remains the status quo. But hospitals are no longer brimming with patients sick with the coronavirus.
Still, with a potential uptick in cases in the coming months, its time to fix the issue now, said Illinois State Rep. La Shawn Ford, who represents some West Side communities hit especially hard during the pandemic. He said he plans to propose legislation when lawmakers meet in November to address hospital transfers for COVID-19 patients.
The pressure is not where it was, Ford said. But thats when we have to make sure that we fix it. Weve learned from the times when it was a crisis.
He said the balancing act will be to get more hospitals to take transfers, without overwhelming them.
It could have unintended consequences, Ford said, like patients lingering in emergency departments, waiting longer to get treated.
A spokeswoman from the Illinois Department of Public Health, which regulates hospitals, did not comment.
Norwegian American Hospital in Humboldt Park on the West Side had to work the phones this spring to get patients transferred. One day, Norwegian contacted 21 hospitals, some in suburbs nearly an hours drive from the West Side, and were able to transfer just two patients.
Heather Khan, Norwegians vice president of patient care services, said the hospital is in a better place now, with just two or three COVID-19 patients a day compared to nearly 40 a day for most of April and May.
I think it would take a lot to get to where we were before, because the beds have emptied out, Khan said.
But if and when Norwegian does get slammed again, the hospital would likely work the phones again, leaning on friends at other hospitals, Khan said.
Rush University Medical Center, a teaching hospital on the Near West Side, fielded hundreds of transfers from other hospitals in the spring, including from Norwegian.
Short of new rules that would help hospitals transfer patients, Rush has been partnering with Chicago public health officials to create a dashboard that would show where in real time there are available critical care beds for the sickest patients. The idea is to steer patients to those beds, even though public health officials cant force transfers.
But some hospitals are still reluctant to share that information, said Rushs chief medical officer, Dr. Paul Casey. Many hospitals are in bad financial shape after they had to cancel money-making elective surgeries during the beginning of the pandemic. The idea of having to share where you have a bed available, instead of using it for your own patient who could generate money for a hospital, could be tough for many hospitals.
The threat or the thought for hospitals that just went through a pandemic that independently was an incredibly challenging time, but on top of that taking away the financial driver of being able to do procedures, really leaves a lot of hospitals in a bit of a tailspin from a financial and operational perspective, Casey said.
In May, a WBEZ investigation found a dramatic drop in the number of people seeking medical care since the pandemic took off in March, potentially contributing to the climbing death toll during the pandemic.
Then earlier this month, a national poll by NPR, the Robert Wood Johnson Foundation and Harvard University revealed even more. Of nearly 530 people surveyed in Chicago, more than one in five people said they werent able to get medical care for a serious problem when they needed it during COVID-19. A majority of those respondents said they got sicker because of it.
In the early days of the coronavirus, hospitals told people to stay away. They needed all the available beds for patients with COVID-19. Doctors offices largely moved online, visiting with patients over video or on the phone.
NorthShore University HealthSystem in the northern suburbs was among hospitals where patients stopped showing up. At the time, cardiologist Dr. Mark Ricciardi told WBEZ he believed that some people could be ignoring their symptoms, like chest pain, and dying at home.
Now, Ricciardi said hes busy again and that people are likely more comfortable coming back, especially with constant messaging from hospitals and doctors that they are saf, that they wont get COVID-19 at the hospital or in a doctors office.
In April and May, I think the acuity of patients was worse, Ricciardi said. In other words, they were a little sicker. Now I think that acuity has returned to the level of acuity that we became accustomed to pre-COVID.
The emergency departments at NorthShores four hospitals are busier, too. People are coming back for the usual stuff, such as chest pain, heart attacks and strokes, said Dr. Ernest Wang, chief of emergency medicine.
And while the number of patients with coronavirus NorthShore treats has dwindled, like it has at other hospitals, Wang still worries the deadly disease could come back with a vengeance as people get used to living with it in their communities.
One of my colleagues walked into the ED yesterday and said, COVID is back, Wang said during an interview on Wednesday. I think we havent seen the real sick, dramatic presentations as much, so when we see it
He trailed off.
Another sign more patients are returning to the doctors office? At Esperanza Health Centers, a group of clinics on the Southwest and West sides, the number of deaths for their typically low-income and uninsured patients jumped early on in the pandemic, to 15 deaths in May. By July, the number was back to normal, with around three deaths, said Esperanzas chief medical officer Dr. Andrew Van Wieren.
I see a lot of people who previously were scared to come into the health center now want to come in, Van Wieren said, to get a flu shot or lab work done. I feel like I still do see a pretty significant divide. Some patients still dont want to come in at all. Some patients are willing to come into our health center but not willing to go to the hospital, because they determine thats higher risk in their mind, and then other patients are willing to go anywhere at this point.
When COVID-19 took off in Illinois in March, state public health officials and hospitals advertised top dollar to staff up quickly to treat an expected surge in patients.
Dr. Eileen Murphy, a local obstetrician and gynecologist, was among physicians who were paid some $200 an hour to work at a field hospital set up inside the McCormick Place Convention Center just south of downtown Chicago.
I did meet a fair number of people from out of state, Murphy said, describing her two tours of the field hospital. They literally flew in for the day. One woman was from the Midwest. Another was an ER type doc from Florida. I met a lot of nurses from out of state.
She never ended up working a shift. The field hospital, meant to relieve hospitals by taking their less sick COVID-19 patients, wound down after treating just 38 people. The venture cost about $65 million.
The state ended up hiring at least 400 health care workers to help treat patients in the spring and recruited more than 36,000 volunteers, a spokeswoman said. Some of those contracts have since ended.
Loretto Hospital, a small facility in Austin on the West Side that mainly treats low-income and elderly Black patients, feared that its nurses would get lured by McCormicks high salaries. CEO George Miller said that didnt end up happening, though the hospital did lose a group of physicians to the field hospital that were meant to staff Lorettos emergency department.
Now hes in hiring mode for more nurses.
We thought when flu came, theres going to be a second wave, Miller said. Were preparing for that.
University of Chicago Medical Center, a teaching hospital in Hyde Park on the South Side, has hired more than 200 nurses since June to fill vacancies and beef up staffing in the coming months. And the University of Illinois Hospital on the Near West Side plans to add at least 160 nurses as part of a tentative deal with its unionized nurses after they went on strike for a week.
But as some hospitals hustle to recruit more employees, other facilities are cutting staff or pay, even as COVID-19 could flare in the coming months.
Nobody wants to talk about this because theyre frankly afraid of losing their jobs, said Dr. Jay Chauhan, a head and neck surgeon in the suburbs and past president of the Chicago Medical Society. And really, where are you going to go?
To cut $187 million from its budget, the Cook County Health system is closing two clinics, suspending inpatient pediatric care at one of its hospitals and converting the emergency department at its other hospital into a 24-hour standby department. The health system is the largest provider of medical care by far than any other hospital in the area for people who cant afford to pay for it.
Mercy Hospital in Bronzeville on the Near South Side plans to close entirely next year.
Ironically, Mercys planned closure has been a boon for another financially-stretch hospital: Roseland Community on the Far South Side. CEO Tim Egan said hes fielding calls and resumes from Mercy employees as he looks to staff up. He recently hired a Mercy physician to be the medical director of Roselands emergency department.
Jaline Gerardin, an assistant professor at Northwestern University who models COVID-19 data for Illinois public health officials, is keeping a close eye on whether Illinois could have another bump in COVID-19 cases.
Intervention fatigue is a real thing, Gerardin said. If there is an increase in transmission, are we going to detect it quickly, or are we going to only notice it once theres already kind of substantial transmission and more hospitalizations and deaths happening?
And then theres the flu colliding with COVID-19 this fall and winter. Doctors are pushing flu shots, hoping to control the spread of one disease while scientists work to create a coronavirus vaccine. Then figure out a way to get the public vaccinated.
Another thing doctors are focusing on while waiting for a vaccine? Testing more people for COVID-19 to contain the spread.
Kristen Schorsch covers public health on WBEZs government and politics desk. Follow her @kschorsch.
If you eliminate us in the data, we no longer exist, saysAbigail Echo-Hawk,a citizen of the Pawnee Nation of Oklahoma and director of theUrban Indian Health Institute.
By Lizzie WadeSep. 24, 2020 , 12:20 PM
Sciences COVID-19 reporting is supported by the Pulitzer Center and the Heising-Simons Foundation.
Abigail Echo-Hawk cant even count how many times shes been called a troublemaker. Its happened at conferences, workshops, and even after she testified before Congressall places where she has advocated for the full and ethical inclusion of American Indians and Alaska Natives in public health data. I didnt used to know what to say, she says. Now, my answer is, Is calling for justice making trouble?
As the director of the Urban Indian Health Institute (UIHI) and the chief research officer for the Seattle Indian Health Board, Echo-Hawk has been working for years with Indigenous people, mostly in cities, across the United States to collect data about their communities. She has also advised the Centers for Disease Control and Prevention (CDC), the National Institutes of Health, and many universities on best practices for analyzing data about American Indian and Alaska Native communities. Now, the COVID-19 pandemic has given Echo-Hawks work even more urgency.
The virus has taken a disproportionate toll on many Indigenous communities in the United States. But its full impact is unclear because of problems Echo-Hawk has long fought to correct, including racial misclassification and the exclusion of Indigenous communities from data sets and analyses used to make health policy decisions.
Abigail has highlighted the inadequacy of, the restricted access to, and the delays in receiving data about how COVID-19 is affecting Indigenous people in the United States, says Spero Manson, director of the Centers for American Indian and Alaska Native Health at the Colorado School of Public Health, who is Pembina Chippewa. But it all builds on her prior work.
Echo-Hawk, who is a citizen of the Pawnee Nation of Oklahoma, grew up in rural Alaska. She credits her interest in public health to the values she saw modeled by the leaders and members of her tribal communities. They think about the health and well-being of an entire community in a very holistic way, Echo-Hawk says.
She had a different experience after moving to Seattle for college and seeking prenatal care for her first pregnancy at a local hospital. When a medical assistant found out that Echo-Hawk was Indigenous, she began to aggressively question her about drinking and drug use. (Echo-Hawk was doing neither.) That was very traumatic for me I was treated in a way that a lot of people of color are, and that is with disdain, discrimination, and outright racism. And it inhibited my care, she says.
She didnt see a doctor again until her second trimester, when she went to the Seattle Indian Health Board. There she was welcomed, trusted, and treated with respect. That experience set Echo-Hawk on a path that eventually led to studying health policy at the University of Washington, Bothell, and working at the research program Partnerships for Native Health, now at Washington State University. She became director of UIHI in 2016.
The system of colonialism in the United States has created, and continues to increase risk factors for, poor health outcomes in Native communities, Echo-Hawk says. The U.S. government removed many Indigenous communities from their lands and confined them to reservations. Many didnt have access to medical care and were cut off from their traditional diets and lifestyles, including spiritual practices that were tied to their homelands. Today, American Indians and Alaska Natives have higher rates of obesity, diabetes, asthma, and heart disease than white Americans, as well as higher rates of suicide. The system of oppression in the United States, Echo-Hawk says, has built a perfect environment to kill us in a pandemic.
But data showing the pandemics full impact on Indigenous communities across the country have not been collected, and accessing the information that does exist can be an uphill battle. Citing privacy concerns, for example, CDC initially denied tribal epidemiology centers, including UIHI, access to data about testing and confirmed COVID-19 cases, even though it was making those data available to states. Whats more, data collected by tribes, local and state health departments, and national agencies are often wildly inconsistent, says Desi Rodriguez-Lonebear, a social demographer at the University of California, Los Angeles, and a citizen of the Northern Cheyenne Nation. I cannot tell you with any sort of certainty the number of positive cases of COVID-19 on my reservation right now, she says. Its shocking.
It also reflects an old pattern, Rodriguez-Lonebear says. For so long, data has been used against our people. For example, the U.S. census, which began in 1790, excluded all American Indians until 1860, and didnt count those living on reservations until 1900. The census data were then used to justify the invasion and settlement of supposedly empty land, Rodriguez-Lonebear says.
Today, American Indians and Alaska Natives make up about 2% of the U.S. population but are often left out of national data analyses or marked as statistically insignificant. I see being eliminated in the data as an ongoing part of the continuing genocide of American Indians and Alaska Natives. If you eliminate us in the data, we no longer exist, Echo-Hawk says.
One way this erasure happens is through racial misclassification, Echo-Hawk says. Documents such as hospital intake forms might not give people the option to identify as American Indian or Alaska Native, lumping them into an other category. Similarly, CDC reports maternal mortality data by three racial categories: white, Black, and Hispanic. All other races are classified as other. When UIHI did its own analysis of maternal mortality, it found that urban American Indian mothers were 4.2 times more likely to die during or shortly after pregnancy than non-Hispanic white mothers.
Echo-Hawk is pushing for similar detail on COVID-19 cases. Before the pandemic, she traveled the country working with Indigenous communities and training scientists at universities and other institutions to change their data collection and analysis practices. Now, she cant leave Seattle because of the pandemic, but shes working up to 15 hours a day, 7 days a week. This is probably the most troubling time ever in my career, she says. Echo-Hawk and others pushed CDC to give tribal health authorities access to COVID-19 caseswith some success. Still, the data are a sliver of what she asked for, she says. The federal government is failing to uphold their end of the bargain, Rodriguez-Lonebear agrees. CDC did not respond to a request for comment.
Echo-Hawk is a co-author on a recent article in theMorbidity and Mortality Weekly Reportthat found American Indians and Alaska Natives were 3.5 times more likely to be diagnosed with COVID-19 than non-Hispanic white people. That is a gross underreporting, she says, because the study could only analyze data from the 23 states that reported patients race and ethnicity over 70% of the time. The data is a national disgrace, and the gaps affect all communities of color, Echo-Hawk says. How can decisions be made in the United States to prevent, intervene, and treat COVID-19, when you cant even truly tell what populations are most affected?
Data can be used as a weapon to further marginalize and harm communities of color, especially Indigenous communities, agrees Kelly Gonzales, a citizen of the Cherokee Nation who studies the effects of systemic racism and colonialism on health at the Oregon Health & Science UniversityPortland State University School of Public Health. As a founding member of the independent Black, Indigenous, and People of Color (BIPOC) Decolonizing Research and Data Council, she draws on Echo-Hawks work to design and teach methods of data collection and analysis that advance racial justice. On days where doing this work in the context of ongoing white supremacy and colonial violence feels really challenging and impossible, I remember her doing this work, and I remember Im not alone.
White-crowned sparrows can cope with noisy cities, but their songs suffer.
By Erik StokstadSep. 24, 2020 , 5:25 PM
Sciences COVID-19 reporting is supported by the Pulitzer Center and the Heising-Simons Foundation.
White-crowned sparrows are tough birds, able to survive the hustle and bustle of many North American cities. But growing noise pollution has forced males to sing louder, less effective songs in order to be heard by rivals and mates. During the pandemic lockdown this spring, the background din quieted. A new study shows that, in just a matter of weeks, the sparrows songs recovered the acoustic quality of songs sung decades ago, when city life was less noisy.
Elizabeth Derryberry, a behavioral ecologist at the University of Tennessee, Knoxville, and her colleagues have studied white-crowned sparrows in and around San Francisco for more than 2 decades, comparing their songs with recordings made in the 1970s. As traffic levels increased, the lowest frequencies of the sparrows songs rose, so as not to be drowned out by the background hum of vehicles. But their top frequencies remained about the same, narrowing the total bandwidth of their communication.
For many bird species, songs degraded in this way are less effective at deterring rivals and attracting females. Birds sing louder in noisy environments, and research has shown the resulting stress can speed aging and disrupt their metabolisms. Noise can also keep them from hearing their own chicksor the warnings of fellow birds; it may even be driving down bird diversity in many cities.
When the pandemic lockdown began in mid-March, Derryberry remembers seeing a striking photo of the Golden Gate Bridge. I was like, Oh my God, its empty. And that made her wonder how the sparrows were responding to the quieter conditions.
Derryberry couldnt travel to California, but her colleague, Jenny Phillips, a behavioral ecologist at California Polytechnic State University, recorded the birds in San Francisco and the surrounding areas (below). Her recordings revealed that the sparrows were singing 30% softer, on average, than before the lockdown. Whats more, they were singing songs with bandwidths typical of birds recorded in the 1970s. The combination of less background noise and the better signal from wider bandwidth meant the males could likely hear each other from twice as far away than before, they report today in Science.
The improved communication may have helped rival males avoid each other, meaning fewer fights. Phillips has previously found that urban birds are generally quicker to attack rivals. I think that the aggression levels might have gone down so that everybody chilled out, Derryberry says.
The new finding is good news from the point of view of the birds, says Sue Anne Zollinger, an ornithologist at Manchester Metropolitan University, who was not involved in the work. By showing the sparrows can adjust their songs to their environment, the study suggests species with more flexible behaviors can cope with aspects of changing environments. Reducing noise might allow other noise-sensitive bird species, such as California quail, to return to cities where they once sang. If we can work to make things quieter, it will really have a big impact.
But the respite provided by the pandemic has been short lived, as traffic and noise return to cities. When the birds start their springtime serenades next year, Derryberry and her colleagues plan to see whether their songs are suffering again.
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The state on Thursday reported one new death and 142 new cases of COVID-19, according to the Department of Health and Social Services COVID-19 dashboard.
The state health department said Thursday that the newly reported death involved a Fairbanks man in his 50s. In total, forty-six Alaskans have died with COVID-19 since the pandemic began here in March. Alaskas death rate is among the lowest in the country.
Statewide as of Thursday, 39 people were hospitalized with COVID-19 while four other hospital patients were awaiting test results, according to state data. Of Alaskas 153 intensive care unit beds, 85 were in use statewide.
Infections continued to surge in the North Slope Borough community of Utqiagvik, where the state reported 15 new resident cases and one nonresident case for a total of 45 active cases. An emergency hunker down order is in place in Utqiagvik through Oct. 5, and other Arctic communities facing a rise in virus cases have also sought to enact more stringent pandemic restrictions.
Active cases of COVID-19 among Alaska residents rose from 4,482 on Wednesday to 4,519 on Thursday. According to state data, there are 694 active cases among nonresidents.
Of the new cases, it wasnt clear how many people were showing symptoms of the virus when they tested positive.
Of the 130 new cases of COVID-19 involving residents, there were 67 new cases in Anchorage; 15 in Utqiagvik; eight in Fairbanks; eight in Juneau; three in North Pole; three in Wasilla; two in Eagle River; one in Chugiak; one in Kenai; one in Seward; one in Palmer; one in Douglas; one in Sitka; and one in Bethel.
Among communities smaller than 1,000 not identified to protect confidentiality, there was five in the Bethel Census Area; four in the Nome Census Area; four in the Northwest Arctic Borough; one in the Denali Borough; one in the Fairbanks North Star Borough; one in the North Slope Borough; and one in the Prince Wales-Hyder Census Area.
Of the 12 nonresident cases, eight were in Anchorage; two were in Fairbanks; one was in Utqiagvik; and one was in an unknown region of the state.
The states testing positivity rate as of Thursday was 2.09% over a seven-day rolling average.
[Because of a high volume of comments requiring moderation, we are temporarily disabling comments on many of our articles so editors can focus on the coronavirus crisis and other coverage. We invite you to write a letter to the editor or reach out directly if youd like to communicate with us about a particular article. Thanks.]
TheWest Virginia Department of Health and Human Resources (DHHR) reports as of 10:00 a.m., September 24,2020, there have been 528,658 total confirmatorylaboratory results received for COVID-19, with 14,706 totalcases and 325 deaths.
DHHR has confirmed the deaths of a 96-year old female from Mason County, a 62-yearold female from Fayette County, a 72-year old male from Fayette County, an 86-yearold male from Kanawha County, a 69-year old female from Kanawha County, and an 89-yearold male from Pleasants County. Ourdeepest condolences are extended to these families for their loss, said BillJ. Crouch, DHHR Cabinet Secretary. We are thankful for our healthcareprofessionals and all those on the front line who continue to treat WestVirginians battling COVID-19.
CASESPER COUNTY: Barbour(52), Berkeley (968), Boone (206), Braxton (13), Brooke (111), Cabell (759),Calhoun (25), Clay (34), Doddridge (19), Fayette (583), Gilmer (39), Grant(156), Greenbrier (125), Hampshire (103), Hancock (145), Hardy (87), Harrison(346), Jackson (258), Jefferson (427), Kanawha (2,468), Lewis (38), Lincoln(157), Logan (599), Marion (261), Marshall (162), Mason (140), McDowell (80),Mercer (407), Mineral (171), Mingo (366), Monongalia (1,959), Monroe (147),Morgan (53), Nicholas (98), Ohio (362), Pendleton (52), Pleasants (16),Pocahontas (59), Preston (151), Putnam (529), Raleigh (497), Randolph (240),Ritchie (11), Roane (49), Summers (47), Taylor (120), Tucker (17), Tyler (15),Upshur (64), Wayne (381), Webster (7), Wetzel (51), Wirt (12), Wood (356),Wyoming (108).
Pleasenote that delays may be experienced with the reporting of information from thelocal health department to DHHR. As case surveillance continues at the localhealth department level, it may reveal that those tested in a certain countymay not be a resident of that county, or even the state as an individual inquestion may have crossed the state border to be tested.Suchis the case of Clay, Marshall, and Mingo counties in this report.
Pleasevisit the dashboard located at www.coronavirus.wv.gov for more information.
Free COVID-19 testing locations are available today in Cabell, Marion, andSummers counties:
Cabell County, September24, 9:00 AM - 2:00 PM, Bloomingdale Baptist Church, 5241 State Route 10, SaltRock, WV
Marion County, September24, 9:00 AM - 3:00 PM, 1 Everest Drive, Fairmont, WV
Summers County, September24, 9:00 AM - 2:00 PM, Hinton Freight Depot, 506 Commercial Street, Hinton, WV
State health officials warned again Thursday about the potential for exponential growth of COVID-19 infections in York County, urging residents to follow health precautions as the virus becomes prevalent in the wider community.
The 18 additional COVID-19 cases reported in York County on Thursday accounted for more than 40 percent of the 43 new confirmed or probable new cases reported. The now weeks-long spike in cases in York County has, in turn, driven up Maines statewide rolling average from 28 new infections daily for the week ending Sept. 17 to an average of 38 new daily infections on Thursday.
There were no additional deaths reported among individuals who have contracted the coronavirus.
The Maine Center for Disease Control and Prevention continues to monitor outbreaks in York County, including a new potential cluster at Brink Chiropractic Practice in Sanford. But Maine CDC director Dr. Nirav Shah said the rate of virus has achieved a certain level that its everywhere in wide circulation across the county.
Shah said Maine CDCs contract tracers are finding fewer cases emanating from specific outbreaks, but instead are seeing the virus spread from person to person in more casual settings because of its prevalence in the community. Shah gave the generic example of an infected person having lunch with one or two other people, who then go on to infect others in the personal circle.
That is concerning because those are the preconditions for exponential growth, Shah said during a Thursday briefing. So weve got an ever-shrinking window in which to get a lid on what is happening in York County. And if we are not successful in doing so, that pattern of transmission could quickly lead to exponential growth.
Statewide, Maine continues to have lower COVID-19 infection rates than most other states.
Maine averaged 2.3 new cases for every 100,000 residents during the previous seven-day period, which is the second-lowest in the country after Vermont, according to the Harvard Global Health Institute. North Dakota and South Dakota had the highest rates at 45.8 and 35.5 new cases for every 100,000 people.
Maine and Vermont also had the two lowest per capita infection rates to date of 388 and 276 cases, respectively, for every 100,000 residents, according to tracking by The New York Times.
The positivity rate for the more than 8,000 test results received by the Maine CDC from the previous day stood at 0.45 percent while the seven-day average positive rate was 0.6 percent, compared to a national average of 5 percent.
To date, the Maine CDC has tracked 5,215 confirmed or probable cases of COVID-19 since the coronavirus was first detected in the state in mid-March. At least 140 people have died after contracting the virus but 4,478 individuals have recovered.
But new outbreaks have been reported this week in York County at Sanford High School and Sanford Regional Technical Center, the Sanford Wolves Club, Hussey Seating Company in North Berwick and the Ogunquit Beach Lobster House.
Shah said Thursday that the number of cases at Sanford High School had held steady at 12 but he urged all students, teachers and staff to get tested so epidemiologists could better determine the extent of the virus within the school.
The high school switched to all-online classes this week following the outbreaks at the school and in the community.
Some of the outbreaks in York County, including a large one at the county jail, have been linked to an Aug. 7 wedding and reception in Millinocket, located roughly 200 miles to the north. The number of total cases linked to that wedding held steady at 178 on Thursday.
York County has emerged as the coronavirus hotspot in Maine. Neighboring Cumberland County had been the virus epicenter in Maine all spring and for much of the summer but has only had a handful of days during the past month in which new cases climbed out of the single digits.
Thursday was one of those days as Maine CDC reported 11 additional cases in Cumberland County. Asked whether Maine CDC epidemiologists are seeing the virus spread from York County into Cumberland County, Shah said that is certainly a concern although it is too early to tell.
We dont know that with scientific precision yet but that is, again, our leading hypothesis as we start to see an increase in cases initially in Cumberland County but then also now, more recently, in Androscoggin County as well, Shah said.
Political events held in Maine on Wednesday and Thursday are also drawing attention and scrutiny.
President Trumps son, Donald Trump Jr., held a rally in Holden on Wednesday night and swung through Auburn on Thursday to stump for his father and other Republicans, including former state lawmaker Dale Crafts in his bid for the 2nd Congressional District seat.
Media reports and social media posts show several hundred people attending the outdoor event in Holden, with the vast majority not wearing masks or physically distancing from each other. Executive orders issued by the administration of Gov. Janet Mills state that outdoor events should be limited to 100 people or less.
And in Auburn, Trumps eldest son greeted about 80 people outside of Rollys Diner. According to the Lewiston Sun Journal, Trump shook hands with many people after the event and even posed for up-close-and-personal selfies while not wearing a mask.
The Trump campaign hopes to at least repeat its 2016 performance in Maine when the Republican picked up one of Maines four Electoral College votes by winning majority support in the 2nd Congressional District.
Asked about the rallies, Shah steered well clear of the politics of the event and said other agencies are responsible for enforcing Maines size limits on gatherings and other health requirements. But Shah urged everyone, regardless of the event, to take precautions such as wearing masks or keeping distance from others.
It doesnt matter for what purpose the gathering was organized or who is there, Shah said. What weve seen is whether its a wedding, whether its a funeral, whether its any type of place where people are together for a longer period of time in high density, COVID-19 can pass from person to person to person, potentially even generating outbreaks.
The administration of Gov. Janet Mills announced Wednesday that residents of Massachusetts would no longer be required to receive a negative COVID-19 test or quarantine for 14 days in order to visit Maine because of falling infection rates there.
Other states with similar exemptions are New Hampshire, Vermont, New York, New Jersey and Connecticut.
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Theres still no clear path back to any sense of business-as-usual as the COVID-19 pandemic continues, but United Airlines is embarking on a new pilot project to see if easy access to COVID-19 testing immediately prior to a flight can help ease freedom of mobility. The airline will offer COVID-19 tests (either rapid tests at the airport, or mail-in at home tests prior to travel) to passengers flying from SFO in San Francisco to Hawaiian airports, beginning on October 15.
United worked directly with the Hawaiian government and health regulators to meet the states requirements when it comes to quarantine measures, so that travelers who return a negative result with this pre-trip test wont have to observe the mandatory quarantine period in place upon their arrival. Thats obviously a major barrier to travel to a popular tourist destination like Hawaii, as a two-week quarantine eats up all or more of the typical period of stay for anyone coming from the mainland.
The airline has partnered with two companies to provide the tests: Color for the at-home kit, which is ordered by a physician and provides results within 1-2 days of receiving the sample, and GoHealth Urgent Care, which will be providing the on-site tests at the airport using the Abbot ID NOW rapid COVID-19 test that returns results in just 15 minutes.
If passengers choose the Color option, theyre advised to request the test kit at least 10 days before they fly, and then to provide their sample for testing within 72 hours before they fly, in order to ensure first that they receive the sample kit in time, and second that the results are recent enough that its extremely unlikely theyve contracted COVID-19 in the ensuing time prior to their flight. Passengers choosing this method can even return the sample via a drop box at SFO, with the results arriving after their landing, but still curtailing their mandatory quarantine period once received.
The on-site option will require scheduling a visit to the testing facility in SFOs international terminal in advance, with tests available between 9 AM to 6 PM PT every day at the airport.
This is just a pilot program, and thats a very good thing, because it will be crucially important to see what happens as a result of this kind of deployment, and its ability to skip the quarantine period. The two-week quarantine after traveling, which is fairly widely adopted globally at this stage in the pandemic, is intentionally meant to apply in most locations regardless of test results, no matter the source or recency.
Thats because at this stage in testing, the results arent anywhere near foolproof testing has potentially less efficacy at detecting COVID-19 in asymptomatic individuals, for instance, and when viral loads arent yet high enough to provide reliable measurement. Those situations can result in false negatives, which isnt an issue when the 14-day quarantine periods are mandatory and universal.
Tourism, especially domestic U.S. tourism, is vital to the economic well-being of states like Hawaii and widespread testing could be a lever to open up more of this kind of economic activity both elsewhere in the U.S. and internationally. But itll require close and careful study, scrutinized by health professionals, as well as improvements in the accuracy and consistency of diagnostics before these measures should expand beyond the pilot stage.
An illegal roadside graveyard in northeastern Namibia. People in the townships surrounding Rundu, a town on the border to Angola, are too poor to afford a funeral plot at the municipal graveyard and resorted to burying their dead next to a dusty gravel road just outside of the town. Brigitte Weidlich/AFP via Getty Images hide caption
An illegal roadside graveyard in northeastern Namibia. People in the townships surrounding Rundu, a town on the border to Angola, are too poor to afford a funeral plot at the municipal graveyard and resorted to burying their dead next to a dusty gravel road just outside of the town.
It's hard to keep track of the dead.
And even the records we do have are not accurate.
As the world approaches the 1 million mark for COVID-19 fatalities, public health experts believe the actual toll the recorded deaths plus the unrecorded deaths is much higher.
But that's not just an issue with the novel coronavirus.
According to World Health Organization data, each year, two-thirds of global deaths are not registered with local authorities. That's a total of 38 million annual deaths that aren't part of any permanent record. Not only are the numbers not part of any global death tally, but the cause of death is also not recorded leaving policymakers without critical information about population trends and health.
Now, that vast undercount of deaths might be changing thanks to the virus. It's pushed the science of death-counting into the international spotlight, highlighting the importance of strong and developed death registries.
"The pandemic has been a game-changer," says Romesh Silva, a demographer working for the United Nations Population Fund. "It's prompted the realization [among national governments] that comprehensive death registration is the most preferable way of understanding mortality."
Public health experts agree: From the perspective of national planning, having good death data is imperative. You need good numbers to assess and understand risk factors that cause death. And to assess the success of health programs.
That's why counting the dead and describing causes represent "the GPS" to better global health, says Dr. Prabhat Jha, an epidemiologist and the founding director of the Centre for Global Health Research. Without the numbers, he says, you're flying blind.
"If you don't know how many people are dying of malaria in Mozambique, or how many people are dying of HIV/AIDS in Kenya, then you can't adjust your program to say, well, we're going to have treatment or prevention programs that meet the need," says Jha. "In the absence of that information, you don't really have a roadmap to improving health."
Counting deaths: 'much easier said than done'
Jha spearheads the seminal Million Death Study (MDS), an ongoing human mortality project rolled out in collaboration with the Registrar General of India the country's official unit for coordinating and unifying birth and death records. It began in 1998 to better understand and document causes of death in India, where the vast majority of deaths occur outside the official medical system. He says the paucity of reliable mortality data has posed a long-standing challenge to the development and implementation of timely and life-saving public health interventions.
But why the undercount?
Intuitively, it seems important that we understand something so fundamental as why people die. Turns out it's much easier said than done.
For one, deaths in the developing world are simply hard to count by virtue of where they happen. In lower-income countries, deaths often occur in rural areas far from hospitals. Individuals largely die at home, explains Jha, and deaths are largely unreported -- so they're never officially registered with local authorities, nor are the causes of death established and documented.
Researchers hypothesize that the undercount could also be due to cultural factors. Jha says in poor countries, incentives to record a death are often weak. In the West, those incentives often revolve around financial matters proof of death is needed to open an estate and claim an inheritance. But many countries in the Global South follow informal ways of transferring assets, so families don't have a huge reason to record a death. In many religions, getting a quick burial or cremation is considered tantamount by the time proceedings are over, many miss the small window of opportunity to be able to report the information surrounding a family member's death.
Just as individuals in lower-income countries may not be as rigorous about recording deaths, neither are governments. It's hard to muster enthusiasm for what seems like the bureaucratic science of death registration and vital stats which is why, on an international level, it's been difficult to generate traction on death registration, Silva says. Especially for countries grappling with an array of health and poverty matters, shoring up support and funding for death registration has been a pretty hard sell, he adds. As Silva puts it: "vital statistics aren't particularly sexy."
The consequence has been a stagnation in the quality of death estimates and data collection, Silva says. In recent decades, commitment to civil registration and death registration systems has faltered for various reasons, resulting in limited progress in terms of mortality statistics.
This isn't to note that some countries haven't seen success, as quite the contrary is true. A handful have.
"Sri Lanka, for example, has been able to get pretty much all of the deaths, even those that occur at home, recorded," Jha says. "[For decades,] they've used community doctors to try and get a diagnosis of the cause of death [in different areas]."
Furthermore, public health experts and population demographers have been on a quest to improve death estimates for years piloting new systems and testing novel methods to get a better count of those who pass away. They've rolled out fleets of trained medical interviewers to conduct verbal autopsies in India and Sierra Leone, inquiring about deaths and relaying the information to a central body, and propelled similar efforts across Asia and Africa.
Even still, the World Health Organization says progress has been limited. As it stands, more than 100 developing countries still lack functioning systems that "can support efficient registration of births and other life events like marriages and death." And globally, nearly 230 million children under the age of five are not registered, according to the same report.
Raising the stakes, death registration infrastructure is often weakest where need is most severe, Jha says. The largest gaps are in South Asia India, Bangladesh and Pakistan and in sub-Saharan Africa, precisely the places where premature mortality is the highest. In other words, though these nations face a disproportionate number of preventable deaths, they have much weaker systems to be able to report the causes of death.
'Back-solving' for a pandemic's impact
Mortality figures hold humongous weight on their own for priority and policy setting. But they take on pronounced importance during a pandemic, says Srdjan Mrki, chief of the United Nations Statistical Commission's (UNSD) demographic statistics section especially for statisticians and public health experts. Liana Rosenkrantz Woskie of the Harvard Global Health Institute explains why: these figures offer a unique way to "back-solve" for the impact of the pandemic.
Unlike virus death totals, disease mortality rates or COVID-19 caseloads, national death statistics don't rely on testing, which can vary significantly from country to country. By looking at excess mortality, or the number of deaths above and beyond what we would have expected to see under "normal" conditions in a particular time period, public health authorities and statisticians can make inferences about the scope and severity of the virus.
These inferences are key to rolling out an appropriate public health response the number of health workers that should be deployed, or ventilators needed, or hospital strain to be expected.
The caveat is that for countries to use excess mortality as an effective measure, they need years of benchmark data to compare the new numbers to. And that's a big if for most countries, mostly low-income, which have historically lacked the resources to mount strong civil registries and death reporting infrastructure.
Collecting death data amid COVID-19
Mrki has been working alongside UNICEF and other members of the UNSD to follow up with a number of national governments to understand how their registries and death reporting strategies have been impacted by the virus.
The results were clear across the board: According to Mrki, the COVID-19 pandemic has resulted in widespread disruptions to vital statistics collection due in part to the sheer volume of new deaths and also international pressure for governments to produce timely mortality counts. But it's also been a wellspring of innovation, as some nations have worked to scale up death reporting and take steps to modernize existing infrastructure.
At the start of the pandemic, Mrki says the UNSD drew up a questionnaire that was dispatched to U.N. member states worldwide. The survey asked how countries were prepared to capture new deaths, record births and provide timely health data amid lockdowns.
The United Nations observed two clusters of national results: First, largely developed countries, for which the pandemic did not have an adverse effect on the functioning of civil registry; and also a cluster of low-resource countries, where the pandemic's effects on counting deaths had been severe and negative.
In this second cluster of nations, Mrki explains that families, fearing the virus, were often hesitant to bring a critically ill relative to the hospital, where deaths are legally required to be registered.
What's more, in at least 15% of the countries, like Malawi for example, civil registry isn't classified as an essential pandemic service so some population bureaus and their services were scaled back altogether, with reduced working hours and staff. According to a presentation from the United Nations Legal Identity Agenda Task Force, an effort dedicated to tackling issues of legal identity from birth to death, these cutbacks had a "considerable impact" on production of timely and reliable death statistics.
"What I am afraid of is that in the wake of the pandemic you will have an unaccounted number of deaths that will never be included in vital statistics," Mrki says. "It might be impossible to get the actual numbers in many countries."
Researchers stress it's important not to be discouraged. Mrki points out that there are some hopeful stories.
Some countries, like Costa Rica and Uganda, have dispatched workers to typically disconnected areas to get better counts, while others have deployed civil health units to different regions facing higher death burdens due to the pandemic.
Other nations, especially in Latin America, have expanded electronic registration systems for registering deaths, which has improved efficiency and equal access, says Mrki.
Helena Cruz Castanheira, a population affairs officer for the United Nations Economic Commission for Latin America and the Caribbean, says though results were mixed, many countries, like Colombia and Brazil, have removed barriers to facilitating online death registry via technology.
"South Africa and Ecuador are real standouts they've moved from annual to weekly reporting of mortality statistics," Silva says. "This pandemic has brought to bear the importance of innovation prioritizing data and dispensing it quickly."
"We have a long way to go," Silva says. But he is hopeful given the groundswell of support for better ways to count pandemic deaths.
For a path forward, it will be critical, he says.
"As we like to say, 'In order to look after the living, you need to count the dead.'"
Pranav Baskar is a freelance journalist.
Google Maps will soon include information on COVID-19 spread in states, counties, and some cities. Toggling on the COVID layer in the app will show the seven-day average number of confirmed cases in each area per 100,000 people. Areas of the map will be color-coded based on case rate, and a label shows if cases are going up or down. The feature will roll out on Android and iOS this week.
The layer is designed to help people make more informed decisions about where to go and what to do, wrote Sujoy Banerjee, a Google Maps project manager, in a blog post. Public health experts and the Centers for Disease Control and Prevention (CDC) recommend that people keep track of the amount of COVID-19 spread in their area to figure out the risk of certain activities. Transmission rates in local communities is important for parents to consider when deciding if they should send their kids to school and for families to monitor in advance of any holiday plans.
The COVID overlay pulls its data from Johns Hopkins COVID-19 dashboard, The New York Times, and Wikipedia.
This is one of many pandemic-related features introduced in Google Maps over the past few months the app also includes alerts about face-covering mandates on public transportation, information about takeout options at restaurants, and warnings to call ahead to a doctors office if you think you have COVID-19.
The rollout of the new feature comes as rates of COVID-19 in the United States are starting to climb again, driven in part by growing outbreaks in the Midwest. Experts are worried that a fall spike is on its way.
