Michael Lauer, deputy director for extramural researchat the National Institutes of Health
By Meredith WadmanAug. 19, 2020 , 10:55 AM
Sciences COVID-19 reporting is supported by the Pulitzer Center and the Heising-Simons Foundation.
The National Institutes of Health is requiring a small nonprofit research organization to take unusualand perhaps impossiblesteps to end a controversial suspension of an NIH grant related to bat coronavirus research in China. NIHs conditions for reinstating the funding to the EcoHealth Alliance are outrageous, former NIH Director Harold Varmus told The Wall Street Journal (WSJ) in an article published today that first reported the agencys demands.
The controversy began in April, after President Donald Trump complained about NIHs grant to the EcoHealth Alliance because it involved researchers at Chinas Wuhan Institute of Virology (WIV). Conservative commentators, Trump, and Trump administration officials have asserted, without evidence, that the novel coronavirus that causes COVID-19 escaped from WIV. Shortly after Trumps complaint, NIH abruptly canceled the grant, stating that its goal of studying bat coronavirus spillovers into humans did not align with agency priorities. NIHs move drew extensive criticism from the scientific community.
Last month, NIH Deputy Director for Extramural Research Michael Lauer sent the EcoHealth Alliance a letter stating the agency was reinstating the grant, but also instantly suspending it again pending the completion of certain actions. (ScienceInsider has now independently reviewed a copy of the 8 July letter.)Among the conditions included:
NIH declined interview requests for Lauer and agency Director Francis Collins, saying in a statement: NIH does not discuss internal deliberations on specific grants.
The EcoHealth Alliance said in a statement that NIHs letter cynically reinstates and instantly suspends the EcoHealth Alliances funding, then attempts to impose impossible and irrelevant conditions that will effectively block us from continuing this critical work.
Varmus, one of 77 Nobel laureates who wrote to current NIH Director Francis Collins in May demanding that he review the grants initial cancellation, told WSJ that NIHs list of conditions for reinstating the funding is outrageous, especially when a grant has already been carefully evaluated by peer review and addresses one of the most important problems in the world right nowhow viruses from animals spill over to human beings.
Peter Daszak, the EcoHealth Alliances president, called out Collins in an interview with ScienceInsider today, saying: It undermines biomedical science to give in to politics. I think thats a failure. And I think that Dr. Collins fell at the first hurdle. When challenged by the White House to cancel this grant he just gave in.
Jeremy Berg, who directed NIHs National Institute ofGeneral Medical Sciences from 2003 to 2011, notes that Collins is a political appointee who serves at the presidents pleasure. (Berg was also editor-in-chief of the Science family of journals until 2019.) He says: The question for anybody in [such] a leadership position is: Is there a line that you are not willing to cross? And that you think it would be more appropriate to stand on principle and resign rather than to give in? In my view, that line has been crossed with this.
With reporting by Kai Kupferschmidt.
*Update, 19 August,5:10 p.m.: This story has been updated to include additional material from NIHs 8 Julyletter to the EcoHealth Alliance,a statement from NIH,and comments from Jeremy Berg and Peter Daszak.
A fishing vessel that left Seattle in May returned with an unexpected catch: the first direct evidence in humans that antibodies to the coronavirus can thwart infection.
More than a hundred crew members aboard the American Dynasty were stricken by the infection over 18 days at sea. But three sailors who initially carried antibodies remained virus-free, according to a new report.
Although the study is small, it addresses one of the most important questions in the pandemic: whether the immune response to one bout with the virus protects against reinfection.
Knowing the answer to this question is critical for vaccine design and epidemiology, tweeted Jesse Bloom, an evolutionary biologist at the Fred Hutchinson Cancer Research Center in Seattle and one of the studys authors.
The study was posted online last week and has not yet been published in a peer-reviewed journal. Still, the finding set off optimistic chatter among scientists, who have been relying on monkey studies for evidence of antibodies potency.
I thought it was very exciting good enough news that I was telling my family about it, said Michal Tal, an immunologist at Stanford University who was not involved in the work.
Several research teams have reported that an encounter with the virus triggers a robust immune response in most people, including in those who may have been only mildly ill. And the vaccine candidates now in trials also seem to elicit strong neutralizing antibodies, the kind that can block the virus.
But the amount of those antibodies needed to prevent the virus from returning is unclear. Scientists measure neutralizing antibodies in titers, an indication of their concentration in the blood.
The three sailors who remained protected from the virus had widely varying titers; two had only moderate quantities, a finding the researchers said was reassuring.
People have been so worried about the titers, and the titers going down, Dr. Alexander Greninger, a virologist at the University of Washington in Seattle, said.
The results indicate even moderate titers prevented reinfection in a situation in which exposure to the virus was high, he said: These are attainable titers, right? Hopefully, itll be helpful to see, and makes make me very optimistic about the vaccines.
The American Dynasty carried 113 men and nine women. All crew members had been tested for both virus and antibodies as part of a routine screening before setting sail. (The researchers did not have access to the results from two members.)
The trawler returned to shore after 18 days at sea when a crew member became ill enough to need hospitalization. The sailors were tested for the presence of virus and antibodies again and for up to 50 days after their return.
The three sailors confirmed to have neutralizing antibodies did not test positive for the virus during the course of the study; 103 of the remaining 117 became infected.
These numbers may be small, but theyre highly significant, Dr. Greninger said.
A lot of people, when they see this are like, Oh come on, it could be due to random chance, he said. In fact, the likelihood that the results are just chance is extremely low, he added.
Updated August 17, 2020
Other experts agreed. Just looking at the numbers, it becomes clear that its unlikely that all of these three people were protected by chance, said Florian Krammer, an immunologist at the Icahn School of Medicine at Mount Sinai in New York.
Dr. Krammer and his colleagues are tracking antibody levels in people who have recovered from the coronavirus once to see at what point they might be vulnerable to reinfection. The team began with people in New York, but the virus is circulating at such low levels in the city now that Dr. Krammer and his colleagues have had to expand the study to other locations.
Data from vaccine trials also will identify the antibody titers required to disarm the virus. But in the meantime, this is the first evidence in humans, Dr. Krammer said. It made my weekend.
The study raised other questions. Based on the Abbott Architect assay, six of the 120 people tested before the boats departure had antibodies to the virus indicating prior exposure.
But when the researchers reanalyzed those samples using more sophisticated tests, only three of the six were confirmed to have antibodies, suggesting that three test results were false positives.
The Abbott test is advertised as returning fewer than one false positive for every 100 samples. Thats a little concerning that the Abbott may be a little less specific than we thought, Dr. Tal said.
The researchers also looked at antibodies in the blood, as most teams do. But those levels may not be the same as those in the nose or in saliva, the two major entry points for infection, Dr. Tal added.
Were looking in the wrong place, she said. If we want to look at protection from reinfection, we need to be looking in the nose.
Another 25 new coronavirus cases have been reported in Maine, health officials said Wednesday.
Wednesdays report brings the total coronavirus cases in Maine to 4,234. Of those, 3,799 have been confirmed positive, while 435 were classified as probable cases, according to the Maine Center for Disease Control and Prevention.
The agency revised Tuesdays cumulative total to 4,209, up from 4,196. As the Maine CDC continues to investigate previously reported cases, some are determined to have not been the coronavirus, or coronavirus cases not involving Mainers. Those are removed from the states cumulative total.
No new deaths were reported Wednesday, leaving the statewide death toll at 127. Nearly all deaths have been in Mainers over age 60.
So far, 403 Mainers have been hospitalized at some point with COVID-19, the illness caused by the coronavirus. Of those, nine people are currently hospitalized, with two in critical care and one on a ventilator.
Meanwhile, 13 more people have recovered from the coronavirus, bringing total recoveries to 3,662. That means there are 445 active and probable cases in the state, which is up from 432 on Monday.
Heres the latest on the coronavirus and its impact on Maine.
Portland Public Schools officials have pitched a comprehensive plan to return to classrooms on Sept. 14, after the Maine Department of Education and Center for Disease Control and Prevention cleared them to do so. But about 15 percent of district employees have asked for a waiver from returning to their school buildings, citing heightened risks from the coronavirus and childcare conflicts among their concerns. Schools officials have contracted with Falmouth-based KMA Human Resources Consulting, a private firm, to help determine which Portland teachers may work remotely and which ones should return to the classroom this fall. Nick Schroeder, BDN
Health care advocates in Maine are waiting to see if a deadlocked Congress will boost a federal Medicaid funding match provision as the state prepares across-the-board spending cuts due to the coronavirus pandemic. Caitlin Andrews, BDN
Building supply, online and automobile sales all rose by double digits in June, although other parts of Maines economy still are down significantly compared to last year, new tax data from Maine Revenue Services showed. Lori Valigra, BDN
The Maine Principals Association expects to make its recommendation regarding the high school fall sports season on Aug. 27. The recommendation to be presented to the MPAs Interscholastic Management Committee might include going forward with all fall sports cross country, field hockey, football, golf, soccer and volleyball. It also might recommend a partial slate of sports during the ongoing COVID-19 pandemic or having no high school sports at all when students return to classes. Ernie Clark, BDN
On Tuesday, the day after state health officials confirmed a coronavirus outbreak of at least two dozen cases connected to an Aug. 7 wedding reception in Millinocket, some residents of the Katahdin region were shocked that their area had been hit by such a large virus outbreak while others believed it was simply a matter of time before the virus hit. Eesha Pendharkar, BDN
As of Wednesday evening, the coronavirus has sickened 5,516,639 people in all 50 states, the District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands and the U.S. Virgin Islands, as well as caused 172,667 deaths, according to Johns Hopkins University of Medicine.
Discipline for those who violate the rules is handled by each sorority, Ms. Weatherford said.
Where youre going to have problems with this will not be within the universitys care, Mayor Walt Maddox of Tuscaloosa said, nodding to new university policies that banned rites of Greek life like swaps and formals. But he acknowledged that safeguards could ebb behind closed doors or away from campus, and that outbreaks could emerge within the universitys Greek organizations.
Despite all the restrictions, both fraternities and sororities say they are reporting swelling numbers of applicants. Students are pining for the connections that college life is supposed to offer. And with many of the normal avenues of meeting people and making friends closed off, many students are turning to the Greek system. There are about 800,000 undergraduate members of fraternities and sororities.
So far our recruitment registration numbers have been phenomenal, record-breaking, Ms. Weatherford said.
But that enthusiasm can sometimes translate into behavior that non-Greek students say endangers others.
Robert Beyer, a senior at the University of Southern California, said he had observed good social distancing practices in neighborhoods around campus except fraternity row, where he said he routinely saw large groups of students standing close together.
Their attitudes are so selfish, Mr. Beyer said. They dont care about spreading it to other people. Ive heard people say, Its worth it to socialize and be with my friends even if it means getting Covid.
Some students and faculty said university administrators, not Greek-system students, were to blame for bringing students back to campus and not reining in bad behavior: I feel like the school should have more strictly enforced the parameters they set in the first place, said Kesan Ucheya, 17, a freshman at the University of North Carolina.
Schools and universities across the United States are split on whether to open for the fall semester, thanks to the ongoing pandemic.
Albion College, a small liberal arts school in Michigan, said in June it would allow its nearly 1,500 students to return to campus for the new academic year starting in August. Lectures would be limited in size and the semester would finish by Thanksgiving rather than December. The school said it would test both staff and students upon their arrival to campus and throughout the academic year.
But less than two weeks before students began arriving on campus, the school announced it would require them to download and install a contact-tracing app called Aura, which it says will help it tackle any coronavirus outbreak on campus.
Theres a catch. The app is designed to track students real-time locations around the clock, and there is no way to opt out.
The Aura app lets the school know when a student tests positive for COVID-19. It also comes with a contact-tracing feature that alerts students when they have come into close proximity with a person who tested positive for the virus. But the feature requires constant access to the students real-time location, which the college says is necessary to track the spread of any exposure.
The schools mandatory use of the app sparked privacy concerns and prompted parents to launch a petition to make using the app optional.
Worse, the app had at least two security vulnerabilities only discovered after the app was rolled out. One of the vulnerabilities allowed access to the apps back-end servers. The other allowed us to infer a students COVID-19 test results.
The vulnerabilities were fixed. But students are still expected to use the app or face suspension.
Exactly how Aura came to be and how Albion became its first major customer is a mystery.
Aura was developed by Nucleus Careers in the months after the pandemic began. Nucleus Careers is a Pennsylvania-based recruiting firm founded in 2020, with no apparent history or experience in building or developing healthcare apps besides a brief mention in a recent press release. The app was built in partnership with Genetworx, a Virginia-based lab providing coronavirus tests. (We asked Genetworx about the app and its involvement, but TechCrunch did not hear back from the company.)
The app helps students locate and schedule COVID-19 testing on campus. Once a student is tested for COVID-19, the results are fed into the app.
If the test comes back negative, the app displays a QR code which, when scanned, says the student is certified free of the virus. If the student tests positive or has yet to be tested, the students QR code will read denied.
Aura uses the students real-time location to determine if they have come into contact with another person with the virus. Most other contact-tracing apps use nearby Bluetooth signals, which experts say is more privacy-friendly.
Hundreds of academics have argued that collecting and storing location data is bad for privacy.
The Aura app generates a QR code based on the students COVID-19 test results. Scan the QR code to reveal the students test result status. (Image: TechCrunch)
In addition to having to install the app, students were told they are not allowed to leave campus for the duration of the semester without permission over fears that contact with the wider community might bring the virus back to campus.
If a student leaves campus without permission, the app will alert the school, and the students ID card will be locked and access to campus buildings will be revoked, according to an email to students, seen by TechCrunch.
Students are not allowed to turn off their location and can be suspended and removed from campus if they violate the policy, the email read.
Private universities in the U.S. like Albion can largely set and enforce their own rules and have been likened to shadow criminal justice systems without any of the protections or powers of a criminal court, where students can face discipline and expulsion for almost any reason with little to no recourse. Last year, TechCrunch reported on a student at Tufts University who was expelled for alleged grade hacking, despite exculpatory evidence in her favor.
Albion said in an online Q&A that the only time a students location data will be accessed is if they test positive or if they leave campus without following proper procedure. Butthe school has not said how it will ensure that student location data is not improperly accessed, or who has access.
I think its more creepy than anything and has caused me a lot of anxiety about going back, one student going into their senior year, who asked not to be named, told TechCrunch.
One Albion student was not convinced the app was safe or private.
The student, who asked to go by her Twitter handle @Q3w3e3, decompiles and analyzes apps on the side. I just like knowing what apps are doing, she told TechCrunch.
Buried in the apps source code, she found hardcoded secret keys for the apps backend servers, hosted on Amazon Web Services. She tweeted her findings with careful redactions to prevent misuse and reported the problems to Nucleus, but did not hear back.
A security researcher, who asked to go by her handle Gilda, was watching the tweets about Aura roll in. Gilda also dug into the app and found and tested the keys.
The keys were practically full access, Gilda told TechCrunch. She said the keys since changed gave her access to the apps databases and cloud storage in which she found patient data, including COVID-19 test results with names, addresses and dates of birth.
Nucleus pushed out an updated version of the app on the same day with the keys removed, but did not acknowledge the vulnerability.
TechCrunch also wanted to look under the hood to see how Aura works. We used a network analysis tool, Burp Suite, to understand the network data going in and out of the app. (Weve done this a few times before.) Using our spare iPhone, we registered an Aura account and logged in. The app normally pulls in recent COVID-19 tests. In our case, we didnt have any and so the scannable QR code, generated by the app, declared that I had been denied clearance to enter campus as to be expected.
But our network analysis tool showed that the QR code was not generated on the device but on a hidden part of Auras website. The web address that generated the QR code included the Aura users account number, which isnt visible from the app. If we increased or decreased the account number in the web address by a single digit, it generated a QR code for that users Aura account.
In other words, because we could see another users QR code, we could also see the students full name, their COVID-19 test result status and what date the student was certified or denied.
TechCrunch did not enumerate each QR code, but through limited testing found that the bug may have exposed about 15,000 QR codes.
We described the apps vulnerabilities to Will Strafach, a security researcher and chief executive at Guardian Firewall. Strafach said the app sounded like a rush job, and that the enumeration bug could be easily caught during a security review. The fact that they were unaware tells me they did not even bother to do this, he said. And, the keys left in the source code, said Strafach, suggested a just-ship-it attitude to a worrisome extreme.
An email sent by Albion president Matthew Johnson, dated August 18 and shared with TechCrunch, confirmed that the school has since launched a security review of the app.
We sent Nucleus several questions including about the vulnerabilities and if the app had gone through a security audit. Nucleus fixed the QR code vulnerability after TechCrunch detailed the bug. But a spokesperson for the company, Tony Defazio, did not provide comment. I advised the company of your inquiry, he said. The spokesperson did not return follow-up emails.
In response to the students findings, Albion said that the app was compliant with the Health Insurance Portability and Accountability Act, or HIPAA, which governs the privacy of health data and medical records. HIPAA also holds companies including universities accountable for security lapses involving health data. That can mean heavy fines or, in some cases, prosecution.
Albion spokesperson Chuck Carlson did not respond to our emails requesting comment.
At least two other schools, Bucknell University and Temple University, are reopening for the fall semester by requiring students to present two negative COVID-19 tests through Genetworx. The schools are not using the Aura app, but their own in-house student app to deliver the test results.
Albion students, meanwhile, are split on whether to comply, or refuse and face the consequences. @Q3w3e3 said she will not use the app. Im trying to work with the college to find an alternative way to be tested, she told TechCrunch.
Parents have also expressed their anger at the policy.
I absolutely hate it. I think its a violation of her privacy and civil liberties, said Elizabeth Burbank, a parent of an Albion student, who signed the petition against the schools tracking effort.
I do want to keep my daughter safe, of course, and help keep others safe as well. We are more than happy to do our part. I do not believe however, a GPS tracker is the way to go, she said. Wash our hands. Eat healthy. And keep researching treatments and vaccines. That should be our focus.
I do intend to do all I can to protect my daughters right to privacy and challenge her right to free movement in her community, she said.
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This story will be updated.
A Mainer has died as 20 new coronavirus cases are reported in Maine, health officials said Thursday.
Thursdays report brings the total coronavirus cases in Maine to 4,253. Of those, 3,812 have been confirmed positive, while 441 were classified as probable cases, according to the Maine Center for Disease Control and Prevention.
The agency revised Wednesdays cumulative total to 4,233 , down from 4,234. As the Maine CDC continues to investigate previously reported cases, some are determined to have not been the coronavirus, or coronavirus cases not involving Mainers. Those are removed from the states cumulative total.
New cases were reported in Cumberland (3), Penobscot (2), York (7), Androscoggin (1), Aroostook (2), Oxford (1), Kennebec (3) and Somerset (1) counties state data show
The death toll now stands at 128. Nearly all deaths have been in Mainers over age 60.
So far, 405 Mainers have been hospitalized at some point with COVID-19, the illness caused by the coronavirus. Of those, seven people are currently hospitalized, with one in critical care and one on a ventilator.
Meanwhile, 17 more people have recovered from the coronavirus, bringing total recoveries to 3,679. That means there are 446 active and probable cases in the state, which is up from 445 on Monday.
A majority of the cases 2,385 have been in Mainers under age 50, while more cases have been reported in women than men, according to the Maine CDC.
As of Thursday, there have been 223,023 test results out of 229,055overall. Just under 2.3 percent of all tests have come back positive, Maine CDC data show.
The coronavirus has hit hardest in Cumberland County, where 2,148 cases have been reported and where the bulk of virus deaths 69 have been concentrated. It is one of four counties the others are Androscoggin, Penobscot and York, with 582, 202 and 713 cases, respectively where community transmission has been confirmed, according to the Maine CDC.
There are two criteria for establishing community transmission: at least 10 confirmed cases and that at least 25 percent of those are not connected to either known cases or travel. That second condition has not yet been satisfied in other counties.
Other cases have been reported in Aroostook (35), Franklin (47), Hancock (42), Kennebec (175), Knox (28), Lincoln (35), Oxford (59), Piscataquis (7), Sagadahoc (58), Somerset (42), Waldo (64) and Washington (15) counties. The location of one case was unknown Thursday.
As of Thursday morning, the coronavirus has sickened 5,532,566 people in all 50 states, the District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands and the U.S. Virgin Islands, as well as caused 173,241 deaths, according to Johns Hopkins University of Medicine.
Pooling accounts for about one-third of the samples that are processed at Poplar, Mr. Sweeney said, adding that percentage is going to get much higher.
But in many other regions, experts are having trouble clearing the hurdles to benefit from pooling in part because needs differ so vastly from institution to institution, and even from test to test.
Theres been a lot of concerns about all the challenges, said Dr. Bobbi Pritt, director of the clinical parasitology laboratory at Mayo Clinic, which processes tens of thousands of coronavirus tests each week, but has yet to roll out pooling.
Experts disagree, for instance, on the cutoff at which pooling stops being useful. The Centers for Disease Control and Preventions coronavirus test, which is used by most public health laboratories in the United States, stipulates that pooling shouldnt be used when positivity rates exceed 10 percent. But at Mayo Clinic, wed have to start to question it once prevalence goes above 2 percent, definitely above 5 percent, Dr. Pritt said.
And prevalence isnt the only factor at play. The more individual samples grouped, the more efficient the process gets. But at some point, poolings perks hit an inflection point: A positive specimen can only get diluted so much before the coronavirus becomes undetectable. That means pooling will miss some people who harbor very low amounts of the virus.
Updated August 17, 2020
Are we going to cause harm if we miss them? I think thats still a difficult question to answer, Dr. Liesman said. These people may be less likely to pass the virus to others, and may be at lower risk of getting severely ill. But thats no guarantee. Some might simply be early on in their infection.
Pooling can also be onerous for lab technicians many of whom have been working grueling hours for months on end. Though simple in theory, batching samples is tedious and time-consuming, as researchers carefully transfer precise amounts of liquid from one tube to another hundreds, perhaps thousands, of times over.
As the lone nurse for her school district in central Washington State, Janna Benzel will monitor 1,800 students for coronavirus symptoms when classrooms open this month, on top of her normal responsibilities like managing allergies, distributing medications and writing hundreds of immunization plans.
Ill have to go to these schools and assess every sniffle and sneeze that could potentially be a positive case, she said. I just dont know if I can do it alone.
School nurses are already in short supply, with less than 40 percent of schools employing one full time before the pandemic. Now those overburdened health care specialists are finding themselves on the front lines of a risky, high-stakes experiment in protecting public health as districts reopen their doors amid spiking caseloads in many parts of the country.
The American Academy of Pediatrics recommends that every school have a nurse on site. But before the outbreak, according to the National Association of School Nurses, a quarter of American schools did not have one at all. And there has been no national effort to provide districts with new resources for hiring them, although some states have tapped federal relief funds.
Washington State is one of the places where nurses are a rarity in school hallways, with 7 percent of schools employing one full time, and nearly 30 percent of districts having one available for no more than six hours per week. Like Ms. Benzel, many are being asked to do more than ever before, with little in the way of new resources, training or backup.
In some places, administrators have been scrambling to get more nurses into schools. New York City, the nations largest district and one of the few big cities planning to physically reopen its schools on the first day back, went on a hiring spree after the citys powerful teachers union said its members should not return to classrooms without a nurse in each of the citys roughly 1,300 school buildings.
Mayor Bill de Blasio said last week that the city had finally secured enough nurses to fulfill that demand, less than a month before the scheduled start of in-person instruction.
Those nurses will be charged with evaluating children for coronavirus symptoms and determining whether they should report to an isolation room away from other students and staff members, and communicating with parents already anxious about dropping their children off at school.
Its weird that it takes a pandemic for people to be like, Oh, look at that, what you do is useful, said Tara Norvez, a school nurse in Queens. Ms. Norvez said she was looking forward to the start of the school year, as long as there was enough personal protective equipment and other safety measures in place.
What we are going to do is just step up our game, she said.
Across the country, though, concerns are growing over the ability to prevent the spread of infections, with outbreaks already emerging in schools that have reopened, requiring mass quarantines and even shutdowns.
Nurses fear they may contract the virus, and worry whether specially designated isolation rooms and personal protective equipment will be enough to contain outbreaks.
Most school nurses are the only health care experts in their school community able to understand infection control and do disease surveillance, said Linda Mendonca, president-elect of the National Association of School Nurses. But not every school has a nurse whos going to look after the children and staff. You need that expertise as a resource to safely reopen schools.
In Washington, some nurses have been actively involved in the planning process for reopening schools, but most have been called in only after the decisions were made, or were asked to review plans already in motion, said Amy Norton, an administrator with the states school nurse corps, which helps provide smaller districts with nursing services.
School districts are going, Oh yeah, our nurse can do that, and just keep adding on these responsibilities, Ms. Norton said. They dont understand that we dont have a nurse in every building. We dont have the staffing to cover all of these new needs, like training staff on P.P.E. and educating families on how to check for symptoms.
In Enid, Okla., where schools reopened last week with five-day in-person instruction, Karry Easterly, the head nurse at an elementary school, said she was confident in the districts plan despite a growing number of positive virus cases in the community.
To prepare, she said, the district spent about $200,000 on protective equipment, installed plexiglass around the desks of school secretaries, ordered thermometers for teachers, and worked with nurses to create isolation rooms for sick students.
We know things are going to happen, but the kids need to get back in school, she said. But Ms. Easterly voiced concern about schools in nearby districts where the health protocols were considerably more lenient, including the school that her son attends, which lacks a nurse.
To me, its unreasonable, she said.
School nurses in Suffolk County on Long Island are better prepared for the new academic year than most. Every building has a nurse on site, and they have worked closely on reopening protocols, said Holly Giovi, an elementary school nurse in the Deer Park Union Free School District.
Gov. Andrew M. Cuomo has said schools across New York can reopen in the fall, and Ms. Giovi expects her district to offer in-person, remote and hybrid instruction models, with strict social distancing and face mask requirements. A plan is still coming together, even though were at the 11th hour, she said.
Ms. Giovi has already divided her nurses office into separate areas for triage, assessment and isolation. Her district appears to be on track to have enough protective equipment, and she supports the federal recommendations for children to be screened at home each morning before school, even though I know that parents can lie, she said.
Updated Aug. 20, 2020
The latest on how schools are reopening amid the pandemic.
But Ms. Giovi said she remained concerned about ventilation in older school buildings that lack air-conditioning, despite the districts promises to ensure sufficient filtration and fresh air through open windows.
Im worried Im going to be taking care of teachers passing out from heat exhaustion as much as I am about them coming down with symptoms of Covid, she said.
Not all school nurses are willing to wait and see how things play out.
In July, Amy Westmoreland resigned as an elementary school nurse in the Paulding County School District in Dallas, Ga., because of its decision to make masks optional, while requiring that she tend to both healthy and symptomatic students in a small clinic room.
How could I do my job protecting children if I were to have been infected and made them or their family sick? she said. I would not be able to live with myself.
This month, widely shared photos showed students without masks in packed hallways in the districts North Paulding High School, and nine students and staff members tested positive for the virus, prompting the school to shift classes online.
Its truly my worst fear that I knew would probably happen, Ms. Westmoreland said.
In some districts that are not planning to teach in-person classes, nurses are out of work for the time being. The Palm Beach County Health Care District in Florida furloughed about 140 school nurses and health technicians this month, after the county school district decided to teach online until further notice.
But some other large districts set to teach only online are continuing to provide health care. As the school nurse administrator for Columbus City Schools, Kate King is responsible for the health of 50,000 students and 10,000 staff members in Ohios largest district.
Aided by more than 100 nurses, she has created immunization plans and developed online platforms for connecting with families so students, especially those with chronic illnesses like asthma and diabetes, can remain healthy while learning remotely.
When school buildings are shut, she said, were still reaching out to make sure their health care needs are met.
Eliza Shapiro contributed reporting.
1. How COVID-19 is affecting the world
Confirmed cases of COVID-19 have now reached more than 22.4 million globally, according to the Johns Hopkins Coronavirus Resource Center. The number of confirmed coronavirus deaths now stands at more than 787,000.
South Korea has reported 288 new cases as of midnight Wednesday, suggesting a new outbreak shows no signs of slowing. This is a grave situation that could possibly lead to a nationwide pandemic," said Vice Health Minister Kim Gang-lip.
India recorded a record daily jump in COVID-19 cases of 69,672. Total cases have now reached 2.84 million, according to data from the federal health ministry.
New Zealand has also reported new cases - five in total - as part of a fresh outbreak in Auckland. Some lockdown restrictions were reimposed last week.
Germany's environment ministry says it could meet its 2020 climate target, but would have missed the target were it not for the coronavirus pandemic.
Global confirmed cases as of 19 August.
Image: Our World in Data
This crisis has put healthcare workers in harms way at a time when they are needed the most, the head of ICRCs Health Care in Danger initiative, Maciej Polkowski, said in a statement.
These attacks have a devastating impact on access to and provision of healthcare when many health systems are overwhelmed, Polkowski added.
The ICRC added that attacks against medical staff, patients and medical infrastructure are likely driven by a fear of infection, anger at being unable to perform traditional burials or grief related to death.
The first global pandemic in more than 100 years, COVID-19 has spread throughout the world at an unprecedented speed. At the time of writing, 4.5 million cases have been confirmed and more than 300,000 people have died due to the virus.
As countries seek to recover, some of the more long-term economic, business, environmental, societal and technological challenges and opportunities are just beginning to become visible.
To help all stakeholders communities, governments, businesses and individuals understand the emerging risks and follow-on effects generated by the impact of the coronavirus pandemic, the World Economic Forum, in collaboration with Marsh and McLennan and Zurich Insurance Group, has launched its COVID-19 Risks Outlook: A Preliminary Mapping and its Implications - a companion for decision-makers, building on the Forums annual Global Risks Report.
The report reveals that the economic impact of COVID-19 is dominating companies risks perceptions.
Companies are invited to join the Forums work to help manage the identified emerging risks of COVID-19 across industries to shape a better future. Read the full COVID-19 Risks Outlook: A Preliminary Mapping and its Implications report here, and our impact story with further information.
3. Tough Eurozone economic outlook
A Reuters poll of economists suggests a challenging outlook for the Eurozone economy. Seventy percent of those questioned said it will take two or more years for the bloc's gross domestic product (GDP) to reach pre-COVID levels.
Although there have been encouraging reports with regard to a potential (COVID-19) vaccine by early 2021, as long as there isnt any effective one, containment measures will have to be kept in place regardless," said Elwin de Groot, head of macro strategy at Rabobank. "A second series of partial lockdowns could have some serious economic effects.
Tough times ahead?
Image: Reuters
The poll also warned that job recovery gains could reverse by the end of the year, as short-term work schemes come to an end. Eighty-five percent of those polled thought there was a high risk of this.
Eurozone unemployment almost looks like a Cinderella story. With barely any increase in unemployment, it is currently the belle of the global labour market ball, at least compared to many other developed economies, said Carsten Brzeski, Chief Economist at ING Bank.
When the clock strikes midnight, however, and short-term work schemes come to an end, the fairy tale is unlikely to continue. We expect a second wave of job losses towards the end of the year and going into 2021.
Health officials are urging people to get flu shots this year in an effort to avoid the seasonal illness exacerbating issues caused by coronavirus.
But when should you be vaccinated? The Centers for Disease Control has a recommendation.
Getting vaccinated in...August is too early, especially for older people, because of the likelihood of reduced protection against flu infection later in the flu season. September and October are good times to get vaccinated. However, as long as flu viruses are circulating, vaccination should continue, even in January or later, CDC said.
Manufacturers are expected to provide as many as 194-198 million doses of flu vaccine this year, more than the 175 million dose record set during the 2019-2020 flu season.
And while a flu vaccine wont protect your against COVID-19, there are other health benefits.
Flu vaccines have been shown to reduce the risk of flu illness, hospitalization and death. Getting a flu vaccine this fall will be more important than ever, not only to reduce your risk from flu but also to help conserve potentially scarce health care resources, CDC said.
Here are more coronavirus headlines across the country:
Vaccine by spring?
A coronavirus vaccine will likely be widely available next spring, according to Operation Warp Speed chief adviser.
Moncef Slaoui, who is heading the White Houses accelerated vaccine program, said he expects the coronavirus vaccine to be offered between April and June of 2021. The immunizations will initially focus on the high-risk individuals, such as those with underlying health conditions and the elderly.
I feel pretty confident we will be there, Slaoui said about the vaccine.
Latest numbers
Latest data shows172,418 people in the U.S. have died from coronavirus with 5,505,074 documented cases. On Wednesday, the U.S. reported 22,658 new cases and 597 new deaths.
2,000 Mississippi students quarantined
Just under 2,000 K-12 students in Mississippi have been quarantined due to possible exposure to COVID-19.
Dr. Thomas Dobbs of the Mississippi Department of Health said 1,970 students and 328 school staff are quarantined. The state is also watching two outbreaks at universities in the state - the University of Mississippi and Mississippi University for Women.
Mississippi reported 1,348 new COVID-19 cases and 31 new deaths today.
Appalachian State University suspends football practice
Appalachian State University has suspended football practice after seven students and four teachers at the North Carolina university tested positive for COVID-19. The outbreak has been linked to the schools football team, officials said.
The infected individuals are recovering in isolation as contact tracing continues.
