The Vanderbilt Divinity School Public Theology and Racial Justice Collaborative will host a virtual social justice conference Aug. 5-7 to explore increasing racial and ethnic health disparities during the COVID-19 pandemic.
Medical Apartheid Revisited: Pandemic, Politics and Priorities is free and open to the public, but advance registration is required.
A compelling reason to focus on this topic is the disproportionate number of people of color who are becoming infected and dying from COVID-19, said Emilie M. Townes, dean of the Divinity School and director of the Public Theology and Racial Justice Collaborative. Scholars from Vanderbilt and other schools, clergy, organizers, activists, students and concerned citizens will come together to consider how best to respond to this public health crisis.
Harriet Washington, an award-winning medical writer and editor, will deliver the opening keynote. Her book Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present inspired the title of the conference.
Other speakers will include Marcia Riggs, J. Erskine Love Professor of Christian Ethics, Columbia Theological Seminary; Jonathan Metzl, Frederick B. Rentschler II Professor of Sociology and Psychiatry, Vanderbilt University; JoAnne Marie Terrell, associate professor of theology, ethics and the arts, Chicago Theological Seminary; Rochelle Andrews, associate director for the Center for Public Theology, Wesley Theological Seminary; and Teresa L. Smallwood, associate director of the Public Theology and Racial Justice Collaborative.
Wendell Griffen, an Arkansas circuit judge, pastor and activist, will give the closing keynote. Visit the conference website for a complete list of speakers, panelists and moderators.
Advance registration is required for each session. Registrants can attend all or any portion of the conference.
The Public Theology and Racial Justice Collaborative was established in 2017 with a $1 million gift from the Henry Luce Foundation to the Divinity School. In January 2020, the collaborative received an additional $500,000 from the Luce Foundation for its second phase. The initiative supports Vanderbilts highest priorities, including the universitys commitment to equity, diversity and inclusion. For more information, email Teresa Smallwood.
The proportion of COVID-19 tests from out-of-staters that are coming back positive in Maine increased in July, even as the volume of tests remained steady.
Nonresidents are now testing positive in Maine at a rate more than four times that of residents, though the numbers remain reassuringly small, according to the Press Heralds analysis of data from the Maine Center for Disease Control and Prevention.
Between July 1 and July 28, the agency reported nonresident positive test results four times and this week provided the negative test numbers as well, allowing the positivity rate to be calculated. This rate steadily increased from 2.3 percent of nonresident tests performed July 1-9 to 4.9 percent of tests performed July 24-28.
By comparison, the seven-day average positivity rate for Mainers, which stood at 2.1 percent at the start of the month, has remained around 1 percent since July 10. Nonresidents still account for a small share of the positive samples collected in Maine, but their share has grown from 6.5 percent to 11.4 percent over the months four reporting periods.
The trend, while worrisome, involves a small number of people, and a month into the peak summer tourist season there is no indication yet that nonresidents have spread the disease to Mainers. Maines seven-day positivity rate remains lower than that of New Hampshire (2.3 percent) and Massachusetts (2.6) and a tiny fraction of that in hotspots such as Alabama (18.5), Florida (19.3) and Arizona (20.2), according to trackers at the Johns Hopkins University School of Medicine.
From the start of the public health crisis here in mid-March to July 28, 159 nonresidents and 3,861 Maine residents have tested positive for the virus, and Maine has remained a relative oasis, with the second-lowest per capita prevalence of the disease in the country after Vermont as of Thursday, according to a widely followed tracker at The New York Times.
Asked about the Maine trends, two public health experts were cautiously optimistic because the absolute numbers remain so low and the bulk of Maines tourists and summer visitors come from states and regions where compliance with mask wearing and other public health recommendations remains high, as it is in Maine.
Id feel far better knowing that the visitors are coming from the Northeast, since states across the South have had high positivity rates that, although falling, are still close to 20 percent, Dr. Jennifer Horney, founding director of the epidemiology program at the University of Delawares College of Health Sciences, said via email. Requirements for face coverings and other social distancing measures are stronger in the Northeast and compliance is higher as well.
Dr. Peter Millard, an epidemiologist and former U.S. Centers for Disease Control and Prevention staffer who is now medical director at Seaport Community Health Care in Belfast, agreed.
Borders are very porous, and even if you make rules, if theres an epidemic in one state its going to spread to other states, he said. But people have been careful, and I think people from other states in the Northeast are, if anything, being even more careful than Mainers are. If they are following the appropriate guidelines, they really shouldnt be infecting other people.
Dr. Nirav Shah, director of the Maine CDC, said his agency will continue to watch the trend, but noted that Maines overall seven-day average positivity rate, including residents and nonresidents alike, stands at just 0.95 percent. That provides a fuller look at potential spread of the virus in Maine, he said via email.
One hypothesis that were exploring is that visitors to Maine are more likely to seek testing when they become symptomatic seeking testing here when they start feeling ill which would drive up the positivity rate in a relatively small cohort, Shah added. Case investigations and contact tracing are other tools we use to determine if nonresidents are posing a greater risk of virus transmission, and the information we have from those tools does not indicate that nonresidents have caused any kind of statewide or localized spike.
Several testing providers contacted by the Press Herald reported broadly similar results in recent days.
Northern Light Health, which operates 39 primary care offices and 10 hospitals, including Mercy in Portland and Eastern Maine Medical Center, performed 178 COVID-19 tests for nonresidents July 22-29, with just three positives, a rate of 1.7 percent. Most of the tests have been performed on symptomatic individuals who present themselves for treatment, spokesperson Patti Patterson King said.
Mount Desert Island Hospital in Bar Harbor, hub of a community-wide sentinel testing program to protect front-line tourism workers, saw three positive COVID tests since July 23 after not having one since May. All three were from people who were not residents of Hancock County, said spokesperson Oka Hutchins, though she could not say whether they were from out of state. The hospital has now seen a total of eight positive tests since the start of the pandemic, of which five were from outside the county.
Rep. Brian Hubbell, a Bar Harbor Democrat who represents the island in the legislature and helped create the sentinel program, said the sense in the community was that things still seem relatively under control, and mask usage seems increasingly well-observed.
The situation remained encouraging at the other end of the state in York, whose beaches are within an easy day trip from Massachusetts and New Hampshire. At the drive-thru rapid testing site it established at its Route 1 urgent care center, York Hospital hasnt seen any sharp changes. From July 1 to Thursday morning, the lab had run over 2,000 tests and had only 15 positives, up by just four since July 23, according to testing director Erich Fogg. Sixty-nine percent of those who use the service which gets results in 20 minutes but now has a wait list three weeks long are from out of state.
Were in a vulnerable area because York and Ogunquit and Wells are very popular, but theres no uptick of the disease in our out-of-state folks, Fogg said. Thats encouraging.
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More than six months into the coronavirus pandemic, the list of symptoms caused by the disease Covid-19 is still getting longer.
Beyond the most common symptoms of cough, fever, and shortness of breath, patients have reported other troubling maladies: vomiting, rashes, a loss of taste and smell, muscle aches, and even toe lesions dubbed Covid toes.
With more than 16.5 million confirmed cases worldwide, researchers are getting a better handle on the early warning signs of infection and how it plays out throughout the body during the course of the disease. These new insights into symptoms are shedding light on what the virus does to the body, when patients are at highest risk of infecting others, and potential ways to treat it.
And with a larger pool of people recovered from the infection, long-term effects of the illness are also emerging, including symptoms that wont go away. Covid-19 can result in prolonged illness, even among young adults without underlying chronic medical conditions, according to a July 24 Centers for Disease Control and Prevention report. The same report found that one in three symptomatic adults who were surveyed still werent fully recovered between two and three weeks after testing positive for Covid-19.
It is such a unique infection in its ability to cause so much damage in so many different ways, in so many different organ systems, said Andrew Chan, a professor of immunology and infectious disease at the Harvard T.H. Chan School of Public Health and co-founder of the COVID Symptom Study app. Its been very humbling for us as physicians and as a scientific community.
The growing of list of Covid-19 symptoms, short- and long-term, is yet another example of our evolving understanding of the disease, from how it spreads to how long immunity may last to what treatments may be effective. There is likely much more still to learn about Covid-19 symptoms as scientists gather more data, but here is what theyve uncovered in recent months about the signs of the disease, how clusters of symptoms can signal more severe complications, and the collateral damage throughout the body.
A recent survey from the CDC identified several symptoms common across the infected. Among 164 symptomatic COVID-19 patients, nearly all experienced fever, cough, or shortness of breath, according to a July 17 report from the agency. However, a wide variety of other symptoms were also reported; chills, myalgia [muscle soreness], headache, fatigue, and the presence of at least one [gastrointestinal] symptom (most commonly diarrhea) were each reported by >50% of patients.
This aligns with earlier surveys, like one from the World Health Organization back in February, which found conventional symptoms of a respiratory infection were common in Covid-19 patients in China. The most common signs among more than 55,000 confirmed cases were: fever (87.9 percent of confirmed cases), dry cough (67.7 percent), fatigue (38.1 percent), sputum [phlegm] production (33.4 percent), shortness of breath (18.6 percent), sore throat (13.9 percent), and headache (13.6 percent).
But surveys like this from earlier in the pandemic had a harder time detecting milder symptoms. Most of the reports were among patients who were hospitalized or had received medical treatment for Covid-19, meaning they were already experiencing a severe course of the disease. People with less alarming signs were often not detected.
To suss out some of the more subtle symptoms of Covid-19, Harvards Chan and his team developed the COVID Symptom Study app, a mobile app that lets users self-report symptoms daily, whether or not they feel sick or have had a test for Covid-19.
The app has more than 4 million users in the US alone. By tracking symptoms across large groups of people, Chan and his collaborators have been able to identify emerging Covid-19 hot spots and detect new signals of the virus.
The symptom that appears to be the strongest predictor of Covid continues to be a loss of taste or smell, and thats been a thing thats been continually shown in the data were getting in the app, said Chan. In particular, the fact that that symptom is relatively uncommon in other viral syndromes, certainly uncommon in seasonal allergies, makes it useful.
The CDC added a loss of taste and smell to its symptoms guidelines in April, and Chan published his findings in a May 11 paper in the journal Nature Medicine.
Since its a more unique symptom to Covid-19 than fever, Chan suggested that screening for taste and smell could serve as a stopgap way to detect infections, especially in places with testing shortages and backlogs. You can imagine that tests that are able to pick up a loss of smell might be easier to deploy at a large scale, might be more cost-efficient, and could really address some of the shortcomings of our present efforts with respect to testing, Chan said.
Even more recently, the app has started to pick up signs that skin rashes raised skin bumps, itchy and red skin, and inflammation on fingers and toes could be a harbinger of Covid-19 for some. In a recent preprint paper, a study that has not yet been peer-reviewed, researchers conducted a subsequent survey based on these hints. They found that of 11,546 respondents, 17 percent of people with a confirmed Covid-19 infection reported that a rash was their first symptom. Of the patients reporting rashes, 21 percent said that rashes were their only symptom.
Even though skin rashes may not be that common in Covid, the fact that they do arise, the fact that they may be a more specific sign, highlight how important it is to really assess their prevalence and how predictive they are, Chan said.
Other preliminary studies, like one of 204 patients in China, found that more than half of Covid-19 patients experienced gastrointestinal problems like diarrhea, vomiting, and abdominal pain. Some Covid-19 patients reported runny noses. Others experienced feelings of discomfort and malaise. In children, Covid-19 even previously undetected cases can spur an inflammatory condition similar to one known as Kawasaki disease. Several older people infected with the virus exhibited neurological maladies like confusion and seizures. Patients of all ages have also experienced abnormal blood clotting, causing strokes in otherwise healthy people.
In short, there are a lot of different ways that Covid-19 can show up in a person. But at the same time, an unknown number of people may be infected without showing any outward signs. Studies have found the share of asymptomatic patients can comprise anywhere from 18 percent to 40 percent of infected people.
The precise fraction of people infected with Covid-19 who are completely asymptomatic is still being studied, but its clear that there are infected people who can spread the virus without coughing or feeling feverish. Even among patients who do show symptoms, some studies have found that they are most infectious just before they start feeling off, rather than when they suffer their worst fevers, rashes, or breathing problems.
That means its critical to identify infected people as early as possible and have them isolate from others in order to control the pandemic. And while symptoms can serve as a diagnostic tool in a pinch, robust testing is still needed to identify hidden infections to contain the spread of Covid-19.
Many Covid-19 symptoms overlap with those of other illnesses, so the patterns of how they emerge together can be a more useful warning sign for the virus than any one symptom alone. In another preprint paper using data from the tracking app, researchers identified six distinct clusters of symptoms for Covid-19.
These groupings were associated with varying degrees of severity of illness. For instance, among patients experiencing one cluster of symptoms headache, loss of smell, loss of appetite, cough, fever, hoarseness, sore throat, chest pain, fatigue, confusion, and muscle pain 9.9 percent of them ended up needing supplemental oxygen or ventilation.
Meanwhile, patients who experienced the above symptoms, but in addition experienced shortness of breath, diarrhea, and abdominal pain, faced far more severe outcomes. About half of the patients with this second symptom cluster were hospitalized, and 19.8 percent of them required breathing support.
So its not just one symptom but several together that are associated with how the disease progresses. These clusters often emerge in the first five days of the illness, but people who need help breathing often arrive nearly two weeks after they first start showing signs. That means symptom clusters could serve as an early alert, helping health providers anticipate the likelihood of a patient needing to be hospitalized and perhaps prompt earlier treatment.
When testing is slow or lacking, a cough and fever are often enough for a person to get diagnosed as a Covid-19 patient, with the associated protocols for isolation. And while waiting for a test result, people often have to decide how to isolate from others and take precautions based on what they feel.
After exposure to the virus, it can take two to 14 days for a patient to experience symptoms, if they feel them at all. During that time, these presymptomatic people can spread the virus to other people especially in the couple of days before they start feeling sick.
Figuring out when key symptoms set in is also important because guidelines for distancing after an infection are often based on when they arise. For most persons with COVID-19 illness, isolation and precautions can generally be discontinued 10 days after symptom onset and resolution of fever for at least 24 hours, without the use of fever-reducing medications, and with improvement of other symptoms, according to new CDC guidance based on new information about how long the virus is active and transmissible (emphasis in the original document).
And as the recent findings about symptom clusters show, a specific group of warning signs can signal that a more severe course of the disease is in store in the coming days.
Fever, rashes, and inflammation are often the signs of the immune systems battle with an infection. But sometimes, the immune system can overreact, causing conditions like cytokine storms where the body overproduces cytokines, signaling molecules that alert cells to an infection. That can cause immune cells to attack otherwise healthy cells, leading to the failure of organs like the liver and kidneys and, eventually, death. Even among survivors, this can cause lasting damage.
Still, despite its complexity as a disease, researchers are learning that Covid-19 operates in ways that are distinct from many other infections. Acute respiratory distress syndrome (ARDS) stemming from Covid-19 is a case in point.
ARDS is a condition in some of the most severe Covid-19 cases, causing the lungs to flood with fluid, cutting off oxygen supply to the blood. Patients with ARDS often need to be treated with a ventilator and are frequently left with severe organ damage.
Nuala Meyer, a critical care lung doctor at the University of Pennsylvanias Perelman School of Medicine who studies ARDS, typically treats patients suffering with ARDS as the result of the flu. But, she said, the patients we were seeing [with Covid-19] were quite different.
With flu patients who have ARDS, doctors expect the very worst cases to be among those with asthma, or those who are immunocompromised. Instead, the worst-faring Covid-19 cases were more likely to have heart disease, high blood pressure, diabetes, or obesity. They generally did not have asthma, Meyer said. And some of the patients who were immunocompromised did do really poorly and others did surprisingly well.
Its been hard for doctors to predict which Covid-19 patients will fare worse, and develop severe complications like ARDS. But recently, a study from Meyer and her colleagues added new evidence to whats long been a theory: that its not the virus thats causing the symptoms, but the patients immune system.
In a study of 125 patients, Meyer and colleagues observed three different immunotypes or broad patterns of immune response, which may account for the range in severity of disease. Its currently not clear what leads someone to one immune response or another, but this work, and other work like it, can lead to the detection of biomarkers that indicate people most likely to experience severe disease. Those who had some of the worst outcomes, and spent the most time on a hospital ventilator, were more likely to have dysregulated immune response, Meyers said.
The fear is that either too persistent an [immune] activation or too robust an activation might contribute to the organ damage that we see, she said. In Nature, researchers led by Akiko Iwasaki of Yale have noted that many of the most severe Covid-19 symptoms are correlated with an elevated cytokine response, which can lead to damaging inflammation.
The hope is, with a better understanding of the immune response to the SARS-CoV-2 virus, doctors could diagnose patients who are most likely to have this severe reaction, and take steps to prevent the worst reaction from occurring. Thats where wed certainly like to go, Meyer said.
Researchers have already found that drugs that suppress the immune system like dexamethasone can save the lives of the most severely ill Covid-19 patients. But since it tamps down the immune response, it can cause a milder infection to get worse or leave a patient susceptible to another pathogen. That severely limits how useful it can be as a treatment, but it highlights the importance of tuning the immune system to thwart a disease without going any further.
Understanding the immune response to the virus is also critical to making a vaccine for Covid-19, a tool that can ultimately end the pandemic. As knowledge of Covid-19 and immunity improves, researchers expect to gain ground both in fighting the illness and preventing it altogether.
While Covid-19 is a respiratory infection, its become increasingly apparent in recent months that its effects can have cascading consequences throughout the body. Scientists are now piecing together the mechanisms behind these effects in hopes of stopping some of the worst outcomes and to get ahead of long-term problems.
Donald Landry, chair of the department of medicine at Columbia University, co-authored a recent study in the journal Nature Medicine looking at all the ways Covid-19 can impair the body beyond the lungs and airways. The list is long: blood clots, irregular heartbeat, acute kidney injury, gastrointestinal distress, liver damage, high blood sugar, neurologic illnesses, vision problems, and skin complications.
To understand why, it helps to examine how the virus itself works. SARS-CoV-2, the virus behind Covid-19, starts an infection by docking one of its spike proteins with a receptor on a human cell known as ACE2, which is involved in the regulation of blood pressure. So the virus interfering with this mechanism can lead to problems stemming from constricted blood vessels. That interference, plus direct viral damage in blood vessels that have the ACE2 receptor, can cause inflammation and blood clots.
But the virus may be doing something else still unknown thats causing blood clots. Landry noted that when Covid-19 patients were receiving treatments like ECMO and hemodialysis that involved circulating blood outside the body, the tubing transporting blood in and out of the body also clotted.
The clotting system itself seems to be revved, Landry said. Its not just inflamed blood vessels; its a hyper-coagulable state, so it would seem.
Those blood clots are dangerous because they can easily choke off tiny blood vessels and impede the blood supply to parts of the body lungs, kidneys, liver. However, the damage to those organs can confusingly manifest in other parts of the body. A failing kidney could mean less fluid is removed from the body, leading more fluid to accumulate in the lungs, worsening the respiratory symptoms of Covid-19, according to Landry.
The effects of organ damage can also linger and become permanent, even after the virus is eliminated. If a blood clot blocks a vessel leading to the heart, for example, it can cause the death of a section of heart muscle, a condition known as a myocardial infarction. You could be surviving the pulmonary part but you could be dying of the cardiac part, Landry said.
The ACE2 receptors are not just in blood vessels. They can be found in cells in the lungs, so SARS-CoV-2 may be directly causing respiratory symptoms like coughing as it damages those cells. Similarly, heart and kidney cells have this receptor and may be vulnerable to direct attack from the virus, potentially causing some of the observed cardiovascular symptoms.
So there are three potential sources of Covid-19 symptoms: the virus, the immune response to it, and the collateral damage from both. However, sorting out what damage is caused by which mechanism remains a challenge.
Thats an open question as to what extent is it a primary cytotoxic effect from the virus infection, where it actually damages the cells its infecting, versus whether its damaging blood vessels, Landry said. That whole area needs to be investigated.
By understanding the mechanisms of Covid-19, doctors can better anticipate the myriad ways it can present and come up with ways to counter its worst effects. But it will take yet more research to build this foundation.
Were now far enough into the pandemic that millions of people have recovered from Covid-19. While many are no longer contagious, some are finding that the illness has lasting effects on their health.
For many people, the infection is not a self-limited condition, Chan said. Sometimes theyre left with longer-term symptoms that could be quite impairing.
Already, recovered patients have reported ongoing coughing, trouble concentrating, and muscle weakness. Doctors have also found lesions on the hearts, lungs, and brains of Covid-19 patients that can take a long time to heal and may be permanent in some cases.
Patients who have had terrible pneumonias or ARDS with Covid-19, are beginning to present now with syndromes of pulmonary fibrosis, said Landry. And this is really a grave lesion that can progress to end stage, requiring lung transplantation.
Meanwhile, patients with brain damage can suffer lasting speech and mobility issues. Covid-19 survivors with heart damage can have persistent arrhythmias that can make it hard for them to conduct basic tasks. Diminished functions of organs like kidneys could progress and contribute to future health problems.
There may be many more patients on hemodialysis in the future as a result of the severe damage they suffered to their kidney during the acute Covid-19 [pandemic], Landry said.
And its not just people who fell severely ill who can suffer residual impacts. Even people who had a less severe course of the disease have reported long-lasting symptoms.
Taken together, the early findings about the long-term impacts of Covid-19 show that the world will likely be seeing signs of the illness for years to come even if the virus were to vanish tomorrow. And in the coming months, even more symptoms and manifestations of the disease may yet emerge.
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By Kevin Crowley on 7/31/2020
HOUSTON (Bloomberg) --U.S. oil giant Chevron posted its worst quarterly loss in at least three decades and warned that the global pandemic wreaking havoc upon energy markets may continue to drag on earnings.
Chevron fully erased the value of its Venezuela operations from its books, amounting to $2.6 billion, after they were effectively frozen by U.S. sanctions, and wrote down another $1.8 billion in assets due to lower commodities prices. Even stripping out the impairments, Chevrons adjusted loss was $3 billion, more than twice the average analyst estimate in a Bloomberg survey and the deepest since at least 1989.
Earnings Bloodbath
Without the massive trading operations that shielded European oil explorers such as Royal Dutch Shell Plc and Total SE from losses, Chevron was exposed to the full force of this years oil price rout, which savaged both its oil fields and huge refining complexes. While Chief Executive Officer Mike Wirth expressed confidence in the companys financial strength and commitment to the dividend this month, Chevron warned that the pain would continue to be felt.
The companys shares fell as much as 3% in pre-market trading.
While demand and commodity prices have shown signs of recovery, they are not back to pre-pandemic levels, and financial results may continue to be depressed into the third quarter 2020, Chevron said in a statement Friday.
Oil has become the darkest corner of U.S. equity markets as an unprecedented confluence of economic, political and structural threats coalesce to imperil the very foundations of the petroleum industry. Sweeping layoffs, budget cuts and project cancellations havent been enough to arrest the sectors decline as fleeing investors made energy the worst-performing sector in the S&P 500 Index this year.
Exxon Mobil Corp., Chevrons bigger North American rival, is expected to report the worst loss in its modern corporate history before Fridays opening of regular U.S. equity trading. On Thursday, ConocoPhillips posted its worst adjusted net loss in four years, prompting holders to dump the stock.
Meanwhile, Shell and Total were saved from deep losses by cascades of cash from their secretive oil-trading operations as volatile markets created lots of arbitrage opportunities.
Venezuela and low prices aside, Chevron also had a one-off charge of $780 million related to its plan to cut 6,000 jobs, or about 13%, of its workforce.
Despite the red ink, Chevrons Wirth saw an opportunity for expansion amid the rout: the $5 billion, all-stock takeover of Noble Energy Inc. announced less than two weeks ago. The deal comes at a minuscule premium and plugs holes in Chevrons long-term portfolio, analysts noted.
Pierre Breber, Chevrons chief financial officer, and Jay Johnson, executive vice president for upstream, are hosting a conference call to discuss the earnings at 11 a.m. Eastern Time.
The Barron County Health Department is urging residents to stop unnecessary travel and avoid all gatherings following a dramatic surge of new cases of COVID-19. More than 150 new cases have been reported since mid-July, nearly half of which occurred at a food processing plant.
In the past two weeks, the number of people testing positive for COVID-19 has increased by more than 162 percent according to data from the Barron County Department of Health and Human Services. A press release issued by the department Wednesday reported 150 new cases across the county includinga cluster at a processing facility in the city of Cumberland owned by Seneca Foods, though it did not specify how many employees had gotten sick. DHS data for Barron County showed79 total positives on July 16. On Thursday, the agency reported 207 cases in the county.
Matt Henschler, Seneca Foods senior vice president of technical services, was quoted in the county announcement as saying the company is taking a "united approach"in identifying people who have tested positive or are symptomatic.
"Individuals are being isolated and monitored until cleared to resume activity,"said Henschler. "CDC guidelines regarding the preparation and management for COVID-19 are being followed."
Henschler did not respond to an interview request for this story.
Laura Sauve, thecounty health officer, also noted in the press release that the cases at the Seneca food processing facility "is not the only cause for the increase in cases."She also said the company did a good job of following CDC recommendations in hopes of preventing cases.
"This situation shows just how quickly the virus can spread,"said Sauve.
In an interview with WPR, Barron County Public Health specialist Sarah Turner said preliminary numbers show that just less than half of the 150 new county COVID-19 cases in the past two weeks could be traced to Seneca Foods. She said the health department did not know if masks had been required at the plant prior to the outbreak. Much of the other new cases in Barron County were reported in the city of Rice Lake, she said.
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"A lot of the cases outside of the outbreak (at the Cumberland facility) can be traced back to travel gatherings, crowded spaces, things like that,"Turner said.
During a Wednesday discussion with the Milwaukee Press Club, Wisconsin U.S. Sen. Tammy Baldwin touted a bill she co-introduced that would require the Occupational Safety and Health Administration to issue an emergency standard establishing a legal obligation for all workplaces to implement control plans to limit worker exposure to COVID-19.
"We're in the end of July," Baldwin said. "And we don't have a federal agency who's issued standards. All we have is voluntary guidelines. Sothat to me is an essential piece of it."
As of Wednesday, there had been three deaths in Barron County. Data from the DHS shows two of those deaths happened within the last week. Barron County Health's Turner said six people were hospitalized as of Thursday afternoon, with "several of them"in the intensive care unit.
Another press release from the county health department issued Wednesday urged residents to practice steps recommended in the now defunct "Safer-at-Home"executive order issued by Gov. Tony Evers and DHS Secretary Andrea Palm in March. Those include avoiding gatherings of more than 10 people indoors, stopping all unnecessary travel, not eating in restaurants or going to bars and frequent hand washing.
Turner said the county is encouraging everyone in the community to "please stay home"and isolate if they show flu-like symptoms.
"You know, one thing in our area of the world in the Midwest we have an awesome work ethic, which is a great thing,"said Turner. "But unfortunately, in times of COVID-19, it can also be not such a great thing because, you know, even outside of this Seneca outbreak, we've seen people who have gone to work symptomatic because we always go to work."
The statewide stay-at-home order was struck down by the state Supreme Court May 13. That day there were a total of 10,902 positive cases of COVID-19 reported by DHS. That number has swelled to 51,409 as of Wednesday.
On Thursday, Evers announced a statewide mask mandate aimed at slowing the spread of the disease. The order goes into effect Aug.1 and is set to expire Sept. 28 and requires individuals5 years and older to wear masks in indoor or "enclosed public places"when non-family members are present. Indoor public places, under the order, include indoor and outdoor bars, restaurants, stores, outdoor park structures and public transit. Those who don't follow the mandate could be fined up to $200.
Governor has said jurisdictions can decide for themselves
| Published: 2020-07-31 08:23
Montgomery County Health Officer Dr. Travis Gayles pictured at a press conference on March 12. During a media briefing on Thursday, he said the county is looking at possibly reinstating some restrictions.
File photo
COVID-19 cases have been increasing across the state while Montgomery Countys have plateaued to about 70 to 80 new cases a day. But now officials are considering whether to reinstate some restrictions to try to decrease the viruss spread and reduce cases.
As the increase of COVID-19 cases has accelerated in recent weeks, county officials have suggested that the state slow down, or even reverse, some of its reopening.
At a media briefing Thursday, Dr. Travis Gayles, Montgomery Countys health officer, said hes concerned about the increase of coronavirus cases in Maryland and surrounding regions, including the Baltimore and Washington, D.C. areas.
The state has seen an increase in numbers thats it, he said. Theres no sugarcoating it, wordsmithing it or twisting it around. We are at a point the governor talked about it yesterday, being at a fork in the road. Some of us would argue that weve actually already gone down a path that is moving towards seeing increased numbers.
More jurisdictions are beginning to pull back on provisions and put more restrictions in place, he said.
We actually are reviewing our internal policies to see if theres anything we need to tweak or further adjust in terms of rolling back provisions to keep our residents safe, Gayles said. We will continue to monitor those as we move through those. We will announce those accordingly to the public.
Gayles and health officers in Marylands other major jurisdictions wrote last week to Fran Phillips, the states deputy health secretary, urging a possible statewide rollback of loosened restrictions if the situation worsens.
Asked during a press conference on Wednesday about the possibility of re-imposing restrictions, Gov. Larry Hogan said the state is holding steady at phase 2 of its reopening. But local jurisdictions, including Montgomery County, may impose tighter restrictions if theyd like.
Montgomery County has been harder hit than most counties and has taken longer to go through stages of reopening. It moved to phase 1 on June 1, then phase 2 where it remains on June 19. Officials have not seen enough improvement since then to progress to phase 3.
County Executive Marc Elrich said during Thursdays briefing that the county would be staying in its second phase of reopening, like the state is, and wont be moving to a third phase yet.
When numbers come down, then well talk about progress, he said. But obviously, no one feels comfortable going forward right now.
He noted that the state is requiring face coverings to be worn inside and outside, unless people are in a swimming pool or are six feet apart outdoors. That matches what already was in place in Montgomery County.
Gatherings in the county are capped at 50 people, with everyone required to wear face coverings and maintain physical distance at those events, he said.
The governor made note of some of the results theyre getting from contact tracing which shows that family gatherings and other social gatherings have been a significant source of transmission, he said. This is not something totally new, not something that we didnt expect to find, but now youre getting data from the contact tracing that confirms that.
Three weeks ago, the question was when the county would be moving into phase 3, Gayles said.Our realities have changed and I know a lot of people continue to write in requesting that other things be added and additional provisions be made, he said.
In order to move forward to phase 3 of reopening, Gayles said, the county would need to see its daily case numbers continue to drop. The county is not in a bubble and could be affected by other close jurisdictions, he said.
Rather than a constant decline in additional cases, the county is seeing what Gayles described as an extended plateau staying about the same. The county has found it difficult to drive numbers down further.
I would say right now, where we are, is a point where we have to look at saying, do we need to tighten things up? he said.
Certain activities that have been tied to cases in contact tracing, such as gatherings, restaurants and bars, could have stricter provisions, he said.
Gayles said the pandemic and health principles have become political.
There are certain [principles] that should never be political and we should follow them by looking at facts, data and evidence, he said. And health is one of those.
There may be decisions we make that you may not be happy with or may impact you in a way thats not beneficial, but we make these decisions based on the full constellation of data and evidence that we have available. We have to make decisions for all of the residents of the county, not one particular group, not one particular ZIP code, or one particular part of society.
Dr. Earl Stoddard, executive director of the countys Office of Emergency Management and Homeland Security, said the county is continuing to distribute masks and personal protective equipment, or PPE, to nursing homes, nonprofits and other facilities. However, he urged those entities to seek to build up their own stockpiles in case of another surge of cases.
Emergency management staff members have started working with the countys Board of Elections to plan for the 2020 general election in November.
Our Board of Elections is concerned that were going to have as few as a third of the election judges that we would normally have, given the number of people who have said theyre, either for health concerns or other concerns, not willing to be election judges this year, Stoddard said. Thats a huge challenge for us, as is things like plexiglass and other accommodations to make it safer.
Hogan has called for precincts to be open on Election Day for in-person voting and for an application for a mail-in ballot to be sent to every voter in the state.
Gayles said the county is open to providing guidance on how individuals or organizations can safely host events, but the gathering limit is strict.
Were not trying to be the boogeyman that comes in and shuts things down, he said. But there are practices that we have to adhere to.
Stoddard said individuals and organizations must show how they intend to make events safe and within the countys guidelines.
Just because an event is outside or another jurisdiction is allowed to do it, he said, does not make it safe.Briana Adhikusuma can be reached at briana.adhikusuma@bethesdamagazine.com.
The ingredients arrive by mail, to be prepared by recipients in their homes or labs. No, this isn't a DIY meal kit it's an unproven COVID-19 vaccine distributed by a group called the Rapid Deployment Vaccine Collaborative, or RADVAC, and no one knows if it actually works, MIT Technology Review reported.
The collaborative, composed of more than 20 scientists, technologists and "science enthusiasts," some affiliated with Harvard University and MIT, did not seek authorization from the U.S. Food and Drug Administration (FDA) before designing their vaccine, or before spraying it up their own noses. Nor did the group seek approval from any ethics board before launching the project and volunteering as their own test subjects in what could potentially be seen as an unofficial clinical trial, according to MIT Technology Review. They have also distributed materials for the vaccines to dozens in their social circles.
The FDA did not immediately respond to questions from MIT Technology Review as to whether the initiative can be considered legal. However, geneticist Preston Estep, who founded RADVAC and serves as its chief scientist, said that the FDA does not have jurisdiction over the project because participants mix and administer the vaccine themselves, without paying the collaborative any fees in exchange. It remains to be seen whether the FDA might step in to regulate the project, particularly as more people learn about, and take, the experimental vaccine.
Related: Here are the most promising coronavirus vaccine candidates out there
"We don't suggest people change their behavior if they are wearing masks, but [the vaccine] does provide potentially multiple layers of protection," Estep told MIT Technology Review. However, RADVAC does not yet have evidence that the vaccine prompts an adequate immune response to be protective at all. The group has begun conducting studies to answer that question, some of which are being conducted in the Harvard lab of geneticist George Church, who has already taken two doses of the vaccine. (Estep is a former graduate student and current collaborator in Church's lab.)
"I think we are at much bigger risk from COVID [than from the experimental vaccine], considering how many ways you can get it, and how highly variable the consequences are," Church told MIT Technology Review. Church added that, while he believes the vaccine is safe (in the absence of data proving that's the case), he thinks the "bigger risk is that it is ineffective."(Church is also head of Harvard's Woolly Mammoth Revival team, whose aim is to insert genes from the extinct mammoth into DNA of Asian elephants.)
But regardless of whether or not the vaccine grants protection against the coronavirus, vaccines always carry some risk of side effects. The more than 30 candidate COVID-19 vaccines being tested in sanctioned clinical trials must undergo several rounds of efficacy and safety tests to be approved, Live Science previously reported. In early trials, vaccine developers watch for acute side effects that occur shortly after vaccine administration, which may include swelling, redness and soreness at the administration site, or potentially fever. In advanced clinical trials, they can monitor for side effects that may emerge when a vaccinated person becomes exposed to the virus in a real-world scenario.
Related: 5 dangerous myths about vaccines
One side effect that could occur upon exposure is known as antibody dependent enhancement (ADE); this rare phenomenon paradoxically leaves the body more vulnerable to severe infection after vaccination, and was previously observed in animal studies of vaccines for coronaviruses related to SARS-CoV-2, the virus that causes COVID-19, Live Science previously reported.
Self-experimenting with the RADVAC vaccine is "not the best idea especially in this case, you could make things worse" by triggering ADE, George Siber, the former head of vaccines at the pharmaceutical company Wyeth, told MIT Technology Review. "You really need to know what you are doing here."
Siber added that, given the vaccine's ingredients and its route of administration through the nose, he's not sure that the vaccine would be potent enough to be protective, even if it is safe.
RADVAC published a white paper detailing the recipe for the vaccine in July, with a disclaimer that states that anyone using the information must be a consenting adult, based in the U.S., who agrees to "take full responsibility" for their use of the information, vaccine and materials required for production and administration. In addition, anyone accessing the site must first "acknowledge and agree that any use of that information to develop and self-administer a substance is an act of self-experimentation," the legality of which may differ depending on where you live.
Below the disclaimers in the paper, the group describes the formulation of the vaccine, which contains short protein fragments, called peptides, found on the coronavirus. These peptides cannot cause COVID-19 on their own, but should in theory be recognized by the immune system and prompt the construction of antibodies that can target and deactivate the virus. That said, Estep called Siber about the vaccine earlier this year and Siber told him that short peptides don't consistently prompt a strong immune response, according to MIT Technology Review.
In addition to peptides, the RADVAC vaccine contains chitosan, a substance found in the shells of crustaceans like shrimp, according to the white paper. The chitosan is intended to coat the peptides and ease their delivery through mucosal tissue in the nose, MIT Technology Review reported. The RADVAC developers chose to deliver their vaccine in a nasal spray, rather than through an injection, in an attempt to trigger a strong, localized immune response in the nose, where COVID-19 infection often takes hold.
Related: 20 of the worst epidemics and pandemics in history
Mucosal tissues, like that of the nose, have their own specialized fleet of immune cells that help guard the somewhat-permeable tissues against debris and pathogens, Live Science previously reported. Ideally, an effective COVID-19 vaccine would trigger both this localized immune response and a systemic immune response throughout the body. Some experts share the view of RADVAC, in that they think COVID-19 vaccines delivered through the nose would be more protective than injectable ones, The New York Times reported. However, Siber told MIT Technology Review that he's not aware of any existing vaccines that are both based on peptides and delivered through the nose; studies would be needed to confirm that such vaccines could reliably trigger a robust immune response.
While the underlying theory may prove true, the efficacy of individual vaccines can only be shown through rigorous analysis of the body's immune response. RADVAC has not completed such studies.
Having presented no evidence that the vaccine provides protection against COVID-19, or that it's safe to administer, the researchers have already distributed materials for the vaccine to others in their social circles.
"We have delivered material to 70 people," Estep told MIT Technology Review. "They have to mix it themselves, but we haven't had a full reporting on how many have taken it."
Originally published on Live Science.
Most people would like to see a coronavirus vaccine approved this year, but far fewer are willing to be the first in line, a new poll has revealed.
Recently, WebMD surveyed its readers to explore their sense of urgency and concern regarding a vaccine for COVID-19. Of the 1,000 respondents, less than half, 42%, said they would opt-in for treatment within the first 12 months of a vaccines release.
Alarmingly, nearly a third of participants, 28%, told the medical news and information website that they had no intention of getting any vaccine, ever.
This serves as a wake-up call, said Dr. John Whyte, chief medical officer of WebMD, in an article appearing on the website. If immunization rates are low, then were not going to achieve the level of herd immunity needed to protect us from this virus.
Whyte later told The Post in an e-mail statement that now is too early to make a call.
Its too early to know whether you should, or should not, be hesitant about getting the vaccine, he said. All we have now are the early results from a couple of major studies on a few hundred people.
Health experts have estimated that 70% of a population must be protected either with a vaccine or by having recovered from the virus to reach herd immunity status meaning COVID-19 will no longer be a pandemic-level threat and the worlds economies can safely reopen.
Unfortunately, many may be forced to achieve immunity the hard way by getting the virus as only 26% have said theyd step up within the first 90 days.
How are we going to reopen if people arent getting the vaccine? We need a Plan B, Whyte said.
Currently, there are more than five pre-eminent therapies being studied as part of Operation Warp Speed, a government-backed initiative to help scientists and drug companies fast-track a vaccine to market. Since its launch in May, the White House has ordered 500 million doses total from three such potential cures for SARS-CoV-2 for clinical trials. On Monday, a fourth option entered its third and final round of clinical testing on 30,000 US adult volunteers.
Around the world, there are more than 165 vaccines being developed, according to WebMD.
The poll suggests that Americans arent confident that expedited testing will be thorough enough to guarantee the vaccines safety. Three-quarters of respondents reported having concerns over potential side effects, while 15% didnt believe a vaccine would be effective.
The best way to build public trust, Whyte suggested, would be for the Food and Drug Administration to show Americans how the drugs are vetted.
I think it is critical that we have a transparent process when the FDA reviews the completed trial results, he said. The safety and efficacy must be publicly available and broadly disseminated.
The White Houses top health adviser, Dr. Anthony Fauci, has implored the public to get over their skepticism of a coronavirus vaccine. During a CNN broadcast on Monday, the director of the National Institute of Allergy and Infectious Diseases told viewers, If we get a widespread uptake of vaccine, we can put an end to the pandemic and we can create a veil of immunity that would prevent the infection coming back.
ANDOVER, Mass. (WPRI) Pfizer could file for approval for its potential COVID-19 vaccine as early as October, according to Dr. Meg Ruesch, the pharmaceutical companys vice president of worldwide research and development.
While authorization of the treatment is dependent on a review by the U.S. Food and Drug Administration (FDA) and clinical data, Pfizer hopes to win approval by the end of the year, Ruesch said Thursday during a news conference with Gov. Charlie Baker at the companys Andover, Mass., facility.
As we continue to fight against COVID-19, a vaccine and a treatment cant come soon enough, Baker said. Pfizer is developing one of the most advanced COVID-19 vaccines.
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Earlier this month, Pfizer reported positive findings from the preliminary trials and on Monday, announced the study would be moving ahead to the next phase.
Clinical data for the vaccine has been encouraging so far, Ruesch said.
The vaccine is manufactured in Andover, then purified and shipped as a frozen solution for further manufacturing and to be filled into vials, according to Ruesch.
She said they are working to manufacture as much of the vaccine as possible, so it will be ready if the clinical trials are successful and it wins FDA approval.
We have the potential, subject to technical success and regulatory authorization, to manufacture up to 100 million vaccine doses by the end of the year and up to 1.3 billion doses by the end of 2021, she said.
Reusch said scientists are also studying the production process in an effort to make larger batches and implement testing protocols, but reassured that the quality will not be compromised.
The review process will be rigorous and in collaboration with the FDA, she added.
Pfizer is seeking 30,000 people for their clinical trial, mostly in places that have seen high COVID-19 rates. People involved will receive two injections, three weeks apart.
More information on COVID-19 vaccine clinical trials
The Massachusetts Department of Public Health reported 304 new confirmed cases and 15 new deaths on Thursday.
Full breakdown of Thursdays COVID-19 data (Mass.gov)
