The top infectious disease expert in the U.S. issued a warning to young people as cases of the coronavirus continue to climb, with many infections occuring in younger Americans. (June 26) AP Domestic
Florida's record-setting spike in COVID-19 caseshasn't stopped visitors from partyingin Miami Beach, which its mayor, Dan Gelber, calls "the epicenter of the epicenter."
While the fact that Miami is a tourist hot spotis typically a positive, it's exactly the opposite at a time when the city has more than 69,000 cases, the most of any Florida county and more than twice as much as neighboring Broward, the next on the list, according to USA TODAY data.
Florida has recorded more than 77,000 cases in the past week alone and over 300,000 in all. The state all on its own has more infections than the United Kingdom or Spain, reports The Tallahassee Democrat, part of the USA TODAY Network.
Still, crowds continue to gather on Ocean Drive and on party boats, often promoted on Eventbrite, according to Gelber.
R-0 may be the most important scientific term youve never heard of when it comes to stopping the coronavirus pandemic. USA TODAY
Kristen Rosen Gonzalez, a resident of Miami Beach and a former commissioner ofMiami Beach, told USA TODAY that she was on South Beach's iconic Ocean Drive on Monday night as the areastarted to fill with revelers.
"We have this huge party every single night on Ocean Drive," she said, addingthat the party has gone on nightly for years, though it originally began as a holiday weekend tradition. There are "throngs of people in the streets with open containers, nobody is wearing masks, no one is social distancing,no police presence and it presents a real danger."
She said that most attendees are tourists from across the country and notedshe spoke to somefrom New York City and Chicago.
Mitch Novick, who owns the Sherbrooke All Suites Hotel, which is situated behind a nightclub, echoed Rosen Gonzalez's concerns about the parties which both noted havebeen happening for years.
"It's a public safety issue not just with the risk of coronavirus infectionbut with getting shot and stabbed and sexually assaulted all at the same time," Novick said."The latter of incidents I referenced have been going on for years."
Novick said he has seen very few people social distancing or wearing masks in the area which features tight spaces and called the area a "hotbed" for infection
The "chaos," which Novick said happens daily at varying hours, is brought on by tourists. "It's a spring break type of crowd," he said. "Teenagers, 20-somethings just doing what should not be happening now with this global health crisis."
Gelber told USA TODAYthat one statistic stood out during a Wednesday briefing from the Florida Department of Healthhighlighting that the parties are part of the problem.
"By multiples, the largest group of cases is the 18-to-34 age category in Miami-Dade," he said, noting that those people are likely infecting family members ofother age groups in the area."That group is the most likely to be ignoring the social-distance instructions and are also the ones most likely (to get COVID-19)through whatever parties they're having."
And that is worrying for another reason: The surge in casesis straining the county's resources.
"As of today, our county capacity for intensive care patients was 423 beds and we currently have 438 COVID patients," hesaid in a Tuesday statement."That means our county is 'over'capacity."
But the stats aren't enough to discourage all vacationers.
We know theres a pandemic going on but its not like youre not going to live your life, Tamia Young, a 36-year-old visiting from Brooklyn told Reuters.
As a result of the rising cases, Miami-Dade County shut down indoor dining and has imposed a 10 p.m.curfew. The city also put a ban on vacation rentals, including Airbnb, Gelber said.
"If these actions dont reverse these upward arcs, then most certainly in a few weeks or less well have to consider more drastic measures," he said in the statement Tuesday, urging people to wear masks.
On Wednesday, Gelber told USA TODAY that shutting down Ocean Drive entirely could be on the table.
And while authorities have been able to stop some promoted bar parties and may be able to shut down areas of the city, there are other party problems that are less easy to solve.
"The boats are a big issue the promoted party boats have expanded dramatically since weve been stopping promoted parties at bars," Gelber explained, referencing the state's late-June order that essentially shut down bars again. He notedthat some boat parties are organized and others are more impromptu.
But the issue of stopping private parties goes beyond the boats. Gelber said it has been tough to enforce social distancing at private parties.
"We cant really stop private homes from doing stupid things," he said, noting that they are trying to stop people from violating social distancing rules. "There are clearly too many people who are not even trying ... they are actively not complying."
Miami Beach Mayor Dan Gelber says he hasn't ruled out shutting down Ocean Drive, which has attracted young crowds looking to party despite Florida's high COVID-19 infection rate.(Photo: S_Hoss/Getty Images/iStockphoto)
Florida Gov.Ron DeSantis acknowledged Monday that coronavirusis spreading and urged people to take precautions such as wearing masks in public places, social distancing and avoiding crowds.
We have to address the virus with steady resolve. We cant get swept away in fear, we have to understand what is going on, understand that we have a long road ahead but we also have to understand that within the context of the moment, he said during a Miami news conference.
While the outbreak has been spreading through much of the state, it has hit South Florida particularly hard, both now and throughout the pandemic. Its three counties Miami-Dade, Broward and Palm Beach only make up about a quarter of the state's population but have been responsible for about half the new cases. That rise promptedallthree counties to closetheir beaches for the July 4th weekend.
Florida International University epidemiologist Dr. Aileen Martycalled the region's situation extremely grave, warning thatthe public is not taking this virus seriously enough andignoring the guidelines DeSantis and others have been pushing.
They have not adhered to guidelines, Marty said at an online news conference with Miami-Dade County Mayor Carlos Gimenez. They have been in those closed spaces without taking the appropriate precautions, and thats the main reason we are where we are.
People are enthusiastically flocking: Florida begins reopening beaches amid coronavirus crisis
Contributing: The Associated Press
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The drive from Silver Lake to Malibu, up the 101, took 30 minutes on a Thursday afternoon. We drove past lettuce farms, lemon trees and a truck advertising cilantro and watercress. The trucks driver smiled, window down, face mask around chin. The 101 gave way to State Route 154, with rolling hills thick with shrub and brush, seemingly devoid of human intervention.
Before walking into the Santa Ynez Inn, a 20-room hotel in the style of a Victorian mansion, we donned our face masks. The general manager, Julio Penuela, also wore a mask while checking us in, though the guests behind us did not, standing by the front door, a good 12 feet away. We arrived shortly before the start of the daily happy hour.
Were doing it a little differently because of the pandemic, said Mr. Penuela, gesturing at the plastic wine glasses and shrink-wrapped cheese plates. Wed usually have more jewelry on display, too, but we dont want to have things that people can touch.
Before heading to wine-tasting rooms in the nearby town of Los Alamos, we walked to Dos Carlitos, a Mexican restaurant up the street. A dozen patrons sat outside, slugging margaritas and wine between scoops of chips and guacamole.
You only have to wear your mask if youre moving about, a server told us. That seemed to be the unofficial rule throughout the region. In an Uber? Mask on. Walking into a tasting room? Mask on. Sitting at a table? Mask off (one could attempt to taste wine with a mask on, but that could present some challenges).
Servers stayed valiantly masked while explaining the varietals and fielding questions. Were new at this, said Kim van der Linden of Stolpman Vineyards, which had outfitted the lawn of its Los Olivos tasting room with wrought-iron tables, chairs and umbrellas. We used to have everyone inside, standing along the bar. Obviously, you cant do that now.
Across the street, a prepaid, 90-minute, private tasting at the pinot-noir producer Dragonette came with an unanticipated bonus freedom to eat the sandwiches we bought from Panino, the deli next door, one of the many food options recommended by tasting room manager Nicholos Luis. (Most wineries generally do not allow guests to bring in outside food.)
With the Covid-19 pandemic rampaging across the U.S. in April and 20 million people filing for unemployment in that month alone, libertarians thought there was a better way. The Heritage Foundation praised Sweden for preserving economic freedom. The Cato Institute said Swedens response to Covid-19 may prove to be superior from a public health perspective. In early May, Sen. Rand Paul (R-Ky.) said at a committee hearing that the U.S. ought to look at the Swedish approach.
The Swedish approach was to largely allow businesses to remain open. And at first, it seemed to work, with a death count nowhere near what it was in countries such as Italy, Spain, and the U.K. But even as Sweden was being hailed as a model, its cases were steadily rising, and its death rate now exceeds that of the U.S. Sweden also did not seem to stave off the economic damage it was aiming to avoid.
Swedens Covid-19 strategy, adopted in March, emerged from the countrys top epidemiologist and other leaders evaluation of what little science about transmission there was at the time, factoring in economic considerations, and making a considered albeit controversial decision to stop well short of the full shutdown that other countries in western Europe (and many U.S. states) adopted.
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In early summer, parts of the U.S. began following a very similar path but one it has stumbled onto, not chosen based on science. Now, the next few weeks will show the consequences of being the accidental Sweden.
In some ways you could say were doing Sweden, but unintentionally and, crucially, without the guardrails that kept that countrys case count from exploding, said physician David Rubin, director of PolicyLab at Childrens Hospital of Philadelphia (CHOP), whose Covid-19 model shows the epidemic resurging through early August almost everywhere in the U.S. but New England.
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In addition to places like Arizona, Texas, and Florida that have been hammered since June, the latest run of the CHOP model identifies Las Vegas, Los Angeles, northern California, Kansas City, Mo., Tulsa, Okla., Greenville, S.C., and Atlanta as poised for widespread transmission. And there are early signs that the virus is moving up busy travel routes, spreading north to Baltimore, Philadelphia, and all of Ohios major cities.
By doing Sweden, Rubin and other experts mean Americans pullback from social distancing that dates from May, when states began lifting stay-at-home orders and other policies aimed at reducing viral transmission. The effect has had many of the failed aspects of Swedens approach, but with none of the steps that kept that country from being a total disaster.
Sweden never imposed a total shutdown of nonessential businesses. It closed universities and banned gatherings of more than 50 people, including sports events, and discouraged domestic travel. But most bars, restaurants, schools, salons, and stores were allowed to remain open, with largely voluntary social distancing. If Spain and Italy got hit by an early Covid-19 tsunami, said Peter Kasson of the University of Virginia School of Medicine and Swedens Uppsala University, Sweden said, lets go swimming.
Many of its citizens, however, didnt jump into the deep end. For one thing, a lot of Swedes went well beyond the official recommendations for social distancing, individually taking the kinds of actions that in other countries were mandated, said Kasson, co-author of a recent study of Swedens strategy. A lot of people self-isolated at home, and companies promoted working from home even though it wasnt mandated. That shows that individual decisions that reduce [viral transmission] can have a substantial effect on national outcomes.
Among those individual decisions: 58% of Swedes didnt meet friends, and 74% stayed home during their spare time, researchers reported in May.
Sweden also issued its distancing recommendations early. Imposing less restrictive policies right away can be more effective at slowing transmission and preventing cases than stricter measures later in an outbreak.
In contrast, if Swedes had done everything they were allowed to do (especially since face coverings were never required nationally), such as shop and socialize at the same levels they had pre-pandemic, it would likely have led to runaway infection, Kasson said. But Sweden is a place with a very strong embrace of government authority. When that authority said keep gatherings small, Swedes took individual actions that went beyond the mandated measures, he said.
Sweden is 18th in the world in Covid-19 cases per million people, with 7,524 as of Tuesday. Thats better than the U.S. (10,626), but much worse than European countries that imposed shutdowns. Sweden is seventh in deaths per million people (with 549; the U.S. is ninth, with 419), though the U.K., Spain, and Italy are worse, possibly because of older populations, denser cities, and more imported cases early on. But a death rate nearly 12 times Norways is hardly reason for celebration. (In fairness, however, there is evidence that one reason for Swedens high death toll is that when elderly people contracted Covid-19, they did not receive aggressive treatment, Kasson found; if they had, about one-third might have survived.)
Because factors that kept Swedens numbers from being even more dire are largely absent in much of the U.S., there is growing concern that this country will blow past Swedens death rate and exceed its case rate even further.
Some states, especially in the South, began easing restrictions in late April. But many people seemed to take bars and restaurants can reopen with capacity limits as back to normal! An entrenched culture of dont tell me what to do just about ensured the opposite of Swedes placing greater restrictions on themselves than the government did. And thats what happened.
In early-reopening Tennessee, 20- and 30-somethings packed Nashville clubs, skin-to-skin with scores of strangers (and few face coverings). That pattern repeated from pool parties at Lake of the Ozarks to bar openings, such as one in Michigan blamed for more than 100 cases.
Call it individualism, cultural libertarianism, atomism, selfishness, lack of social trust, suspicion of authority, The Week columnist Damon Linker wrote, it amounts to a refusal on the part of lots of Americans to think in terms of whats best for the community, of the common or public good. Each of us thinks we know whats best for ourselves. We resent being told what to do.
The White Houses coronavirus task force, led by Vice President Mike Pence, is now stressing that individual decisions to distance, wear masks, and practice good hygiene can reduce transmission, even as the Trump administration has not rolled out new strategies to address the skyrocketing case numbers in parts of the country.
Swedens light-handed restrictions, Kasson said, produced results similar to those in countries with stricter policies because so much of the population was willing to voluntarily self-isolate. In the U.S., even though phased reopenings have been accompanied by pleas from experts (but not necessarily state or local officials, at least initially) to social distance and wear face coverings, many people have said, nah.
After Memorial Day, social interactions in the U.S. began creeping up to half or more of what they had been during the period of the strictest mandates. By the beginning of April, people were already tiring of stay-at-home and were increasing their movement, said epidemiologist Jeffrey Shaman of the Mailman School of Public Health at Columbia University, so it actually predates the loosening of restrictions that began at the end of April.
Indeed, cellphone data show that, after a month of increases in social distancing, as of April 24, 48 states saw a drop, researchers at the University of Maryland found. Many Americans had said, enough.
Also missing from the U.S.: strong national policy, as Sweden has. Instead, each state and many cities were left to devise their own plans for the initial shutdowns and, especially, re-openings. Although there was federal guidance on what would be safe to do when, based on measures such as case counts and hospital capacity, many states ignored them. Social distancing varied enormously, the Maryland data show: In early May, its index of social distancing ranged from the 50s (on a scale from 0 to 100, with 100 being maximum distancing) in New York, New Jersey, and Massachusetts to the 30s or less in many Southern states.
As a result, risky decisions made in, say, Florida and Texas have started to bleed into surrounding states. We can see the virus moving along travel corridors, said CHOPs Rubin. Even though the number of cases is still low, you can see it in the R, the number of new cases each earlier case is causing.
Swedens Covid-19 messaging was also much clearer than that in the U.S. An important factor in shaping peoples behavior is how governments talk, said epidemiologist Jennifer Nuzzo of the Johns Hopkins Center for Health Security. If you talk about Covid-19 as a hoax, you can be pretty much assured that youll be on a path to a rapid acceleration of cases and deaths.
In the U.S., Pence has highlighted the fact that a larger percentage of new cases in states like Florida and Texas are occurring in younger people. But if the virus is spreading in one population, it wont be contained there. As cases rise among younger people, experts expect more transmission to reach older people. That is what happened in Sweden, driving up the countrys mortality rate. Probably because workers brought the virus into care homes for the elderly, Covid-19 raced through such facilities, which have accounted for about half of all deaths in Sweden; people over 70 accounted for some 90% of deaths.
Anders Bjrkman, an infectious disease expert at Stockholms Karolinska Institute, pointed to another problem that has plagued both the Swedish and U.S. response: a slow rollout of diagnostic testing. Both countries effectively limited testing initially to people who were really sick, which he called a clear mistake. Even now in the U.S., as demand has soared along with cases, some people are still unable to get tested or have to wait more than a week for results. That makes it harder for people to know if they should isolate themselves and tell their contacts to stay home as well.
And if an unstated goal of Swedens approach was to get closer to herd immunity, it does not appear to have been realized. Serology studies looking at how many Swedes have contracted the coronavirus and who are then, scientists hope, protected from another infection for some amount of time have ranged from about 6% to 14% in the Stockholm area (though some Swedish scientists say they believe the figure is higher than that based on different signals of immunity). That leaves the country far short of the 60% or so that experts say will slow down transmission.
I was surprised they didnt recalibrate as the serology findings came out, said University of Florida biostatistician Natalie Dean. My concern with Sweden is that theyre going to muddle along at this level and its not going to go down, for longer than the models say.
In the U.S., states outside the Northeast have started to pause their reopenings and, in some cases, reimposed some restrictions in an attempt to gain a handle over the spiraling outbreaks. But the effects of Americans version of Sweden are becoming alarmingly clear. In the CHOP model, current hot spots such as Miami and Houston get worse over the next few weeks. San Francisco and New Orleans surge, as do suburbs of Kansas City, Mo., and Chicago. Philadelphia and New York City also see an increase in cases.
Weve lost control at this point, said CHOPs Rubin. Unless we go back to the very early phase of our reopening, and do it quickly, the fall could be catastrophic.
Lev Facher contributed reporting.
Coronaviruses have jumped from animals to humans beforeand theyll do it again. Thats why Adagio Therapeutics is working on antibodies that can fight multiple members of the virus family, including SARS-CoV-2, the culprit behind the current pandemic. The startup snagged $50 million to push its lead candidates into the clinic.
The Adimab spinout is working on monoclonal antibodies that could be used to prevent infection by coronaviruses or to treat patients who have fallen ill. The hope is that one injection could protect people from coronaviruses for months. Unlike vaccines, which stimulate the body to produce antibodies against a pathogen, prophylactic antibody treatments give patients ready-made antibodies to fight off the virus.
Adagios antibodies bind to a piece of the spike protein that is found on multiple coronaviruses, including SARS-CoV-2which causes COVID-19SARS-CoV-1, which causes severe acute respiratory syndrome (SARS) and two coronaviruses circulating in bats.
RELATED: Regeneron kicks off prevention trial for COVID-19 antibody cocktail
Broad and potent neutralizing antibodies, like the ones that Adagio is developing, are a very promising long-term solution to controlling not only SARS-CoV-2, but also future coronavirus outbreaks. If we had developed broadly neutralizing antibodies during the SARS outbreak in 2003, we would likely be in a much better place today, said Dennis Burton, Ph.D., co-chair of the Department of Immunology and Microbiology at Scripps Research, in a statement.
The series A financing, drawn from Polaris Partners, Mithril Capital, Fidelity, OrbiMed, M28 Capital and GV, will bankroll IND-enabling studies and early clinical work. The company plans to be in the clinic by the end of the year.
The repeated spillover of coronaviruses into the human population is now well documented and requires a more comprehensive strategy, particularly when you take into account the emerging doubts about the robustness and durability of the immune response in SARS-CoV-2 patients, said Adagio CEO Tillman Gerngross, Ph.D., in the statement. A professor of bioengineering at Dartmouth College, Gerngross has co-founded multiple companies, including Alector, Avitide, Arsanis and GlycoFi in addition to Adimab.
RELATED: Adimab broadens R&D deals with Novartis, Regeneron, Takeda
Although vaccine development efforts against COVID-19 are moving at warp speed, antibody makers think their drugs will reach patients first. Whats more, it is uncertain how long they will be able to protect people from infection, and some groups, including older or immunocompromised people, may not be able to receive a vaccine at all.
Regeneron, Amgen, AstraZeneca, GlaxoSmithKline and Eli Lilly are among the other drug developers working on antibodies that could be used to treat or prevent COVID-19 infection. Of the group, AstraZeneca and Regeneron have chosen to test a combination of two antibodies that target different areas of the receptor-binding domain on the new coronaviruss spike protein. Using two antibodies rather than one could reduce the risk that a mutant, drug-resistant form of the virus will escape treatment and become the dominant strain.
Our path to normalcy envisions a product, based on the well-known safety profile of antibodies, that can be administered twice a year, while providing greater than 90% protection against SARS-CoV-2, can be used as an effective treatment, and can offer protection against future emerging coronaviruses for everyone, Gerngross said.
Jena Martinez-Inzunza tested positive for COVID-19. Her colleague died. She's cautious about reopening schools, despite the difficulties of online instruction. Jena Martinez-Inzunza hide caption
Jena Martinez-Inzunza tested positive for COVID-19. Her colleague died. She's cautious about reopening schools, despite the difficulties of online instruction.
As school districts consider how to approach learning this fall with no sign of the coronavirus slowing, the virus has already had devastating consequences in one rural Arizona school district.
Jena Martinez-Inzunza was one of three elementary school teachers at the Hayden Winkelman Unified School District who all tested positive for COVID-19 after teaching virtual summer school lessons together from the same classroom.
Martinez's colleague and friend, Kimberley Chavez Lopez Byrd, who taught in the district for nearly four decades, died.
"She was very dear to me. She's one of my closest friends," Martinez told Morning Edition.
Kimberley Chavez Lopez Byrd died after testing positive for coronavirus. Other teachers she worked with tested positive as well. "She was a very loving, very faithful person and she was very kind," says her colleague Jena Martinez-Inzunza. Luke Byrd hide caption
Kimberley Chavez Lopez Byrd died after testing positive for coronavirus. Other teachers she worked with tested positive as well. "She was a very loving, very faithful person and she was very kind," says her colleague Jena Martinez-Inzunza.
"She was a very loving, very faithful person and she was very kind. She always loved watching kids find their way, find their strong points and be able to get them to understand that everyone is different. We all have strengths and weaknesses. And that's OK. And that was the message and the love that she brought to our lives."
When teaching summer school classes together from June 8-11, the three teachers: Martinez, Byrd and Angela Skillings, all took precautions and followed CDC guidelines, Martinez says. They kept their distance, wore masks and constantly used hand sanitizer.
Byrd started feeling sick and went to the hospital on June 13. She had underlying conditions, including asthma, and often had sinus infections, according to CNN. She died on June 26.
Byrd's death not only leaves a community mourning, it illustrates the risk of in-person schooling. No students were physically present when the three teachers taught their online classes.
But the alternative, online-only instruction, has its own challenges for teachers and students.
Martinez had already been doing online instruction since schools closed in March. It's "made for very long days," she says, because of the constant and different types of communication between teachers, parents and students: FaceTime, text, email, phone calls and sending physical learning packets. Not all the students have access to the Internet.
As of now, the Hayden Winkelman district will be going online-only when classes resume in August. The school has been working to help unconnected families get online and provide iPads to students, Martinez says.
It will still be a challenge, but Martinez says "it's not the right time" for students to be back in the school building, with Arizona being a coronavirus hot spot.
"It's just going to be worse when we repopulate schools" this fall, she says, if Arizonans don't become more diligent in stopping the virus's spread.
NPR's Krista Kapralos and Taylor Haney produced and edited the audio version of this story.
Authorities in Bangladesh say Mohammad Shahed, 43, who had evaded authorities for nine days, was caught trying to cross a river into neighboring India while wearing a burqa.
Shahed is accused of providing patients with fake negative test results for the novel coronavirus, said Col. Ashique Billah, a spokesman for the country's Rapid Action Battalion, an elite security force.
Shahed is also accused of charging people for virus treatments and documents certifying they did not contract the coronavirus after agreeing with the government that he would provide those services free of charge.
Billah said that two medical facilities owned by Shahed conducted some 4,000 genuine coronavirus tests, but faked the results of another 6,500.
A court Thursday granted police the opportunity to keep Shahed in custody for 10 days for questioning. CNN is attempting to locate a lawyer who represents Shahed for comment.
Shahed is not the first person in Bangladesh arrested on charges of committing medical fraud during the pandemic. Last week, owners of a different private testing facility were arrested for providing fake Covid-19 test certificates without actually testing people, authorities said.
Experts are concerned that these scams could discourage people from getting tested in Bangladesh, which is already facing limited testing capacity. Since March, the government has tested an average of between 13,000 to 17,000 people per day, a comparatively small number for a country with a population of more than 168 million people.
Those seeking tests have faced frustrating delays, with many forced to wait in long lines, sometimes overnight. The new scandal could affect public confidence in testing, and further dissuade people from getting tested altogether.
More than 193,500 people in Bangladesh have contracted the virus, 2,457 of whom have died, according to data from Johns Hopkins University. But many are concerned that the true number could be much higher owing to Bangladesh's limited testing capacity.
Critics have lashed out at the government for not doing more to protect vulnerable populations, especially in densely populated areas like the capital of Dhaka or along the Ganges River Delta.
Bangladesh went into lockdown for 68 days but reopened in a "limited scale" on June 1 to help jumpstart the economy, despite the fact that public health authorities are still identifying thousands of new cases each day.
Schools remain closed but businesses and government offices have opened.
South Asia is one of the world's current coronavirus hotspots. India is expected to hit 1 million confirmed cases of Covid-19 within days, while Pakistan has recorded more than 255,000 infections.
"Covid-19 is spreading at an alarming rate in South Asia, home to a quarter of humanity," John Fleming, who heads the International Federation of Red Cross and Red Crescent Societies' (IFRC) health unit for Asia-Pacific, said in a statement Thursday.
"We now need to urgently turn our attention to this region, urgently step up prevention measures and expand our resources to save thousands of lives," Fleming said.
The pandemic has been particularly devastating to Bangladesh's economy. Though the country's service and technology sectors have grown in recent years, garment production is still the country's economic backbone, raking in an estimated $30 billion a year.
Factories in the country had furloughed or laid off more than half of the country's nearly 4.1 million garment workers by April, the association said at the time.
This story has been updated to accurately reflect the day that Shahed was arrested.
Chicago's top health official encouraged people to "bring the outdoors in" in an attempt to lower the risk of spreading COVID-19.
Dr. Allison Arwady, commissioner for the Chicago Department of Public Health, said that while she's not concerned about residential air conditioning spreading coronavirus, opening windows and doors can lower risk.
"I want to address this because I think particularly with the heat and with you know, 25 years post our really significant heat wave here, I want to be clear that it is safe and appropriate for individuals to use air conditioning in their apartments or in their homes," Arwady said. "I am not concerned about a window air conditioner or an air conditioner in a residential setting being a source of COVID spread. I would apply the same guidance that we give to the large buildings to individuals that a really good way to decrease any potential risk of COVID is just to open your window, open your door, have additional airflow running through your apartment or through your home. And, broadly, letting the outdoors in is one, it has turned out to be, one of the more important things for limiting the risk of COVID in buildings."
Arwady said much of the guidance surrounding air flow has centered on ventilation in large buildings.
"There is very specific guidance that the CDC has put out and that CDPH in the city have pushed out particularly to larger businesses that would have large scale ventilation or air conditioning systems in place," she said. "The bottom line is you want to do what you can to increase air exchanges with the outside. And so our big buildings here in Chicago have done that at an individual level."
The CDC advised office building owners to "increase circulation of outdoor air as much as possible by opening windows and doors if possible, and using fans" as employees return to work.
According to the guidance from the agency, buildings were also encouraged to increase airflow supply to occupied spaces, consider using natural ventilation to "increase outdoor air dilution of indoor air when environmental conditions and building requirements allow," and improve central air filtration.
The guidance comes as states across the country shut down indoor dining as cases spike.
Experts have suggested that a lack of airflow could play a role in the spread of the virus.
"If youre indoors there is also less air circulation, so its more likely that COVID-19 can spread through respiratory droplets when people talk, cough or sneeze," said Heather Voss, a program director of epidemiology and infection prevention at Northwestern Medicine.
Earlier this month, the World Health Organization published new guidance, saying it cant rule out the possibility that the coronavirus can be transmitted through air particles in closed spaces indoors, including in gyms and restaurants.
The new guidance recognizes some new research that suggests the virus may be able to spread through particles in the air in indoor crowded spaces.
In these events, short-range aerosol transmission, particularly in specific indoor locations, such as crowded and inadequately ventilated spaces over a prolonged period of time with infected persons cannot be ruled out, the United Nations health agencysnew guidance says.
Airborne transmission of the coronavirus could occur if virus-carrying droplets generate microscopic aerosols by evaporating, the WHO said, or if normal breathing and talking results in exhaled aerosols. In theory, WHO says someone could inhale the aerosols and become infected. But it remains unknown, WHO says, if such aerosols would actually carry enough viable virus to cause infection.
Still, the WHO said in its guidance that while early evidence suggests the possibility of airborne transmission in such environments, spread by droplets and surfaces could also explain transmission in those cases.
The WHO added that more research is needed to further investigate preliminary findings. The agency says the main mode of transmission is still believed to be through respiratory droplets.
If airborne transmission proves to be a major factor in the spread of the virus, it could have wide-ranging policy consequences. Masks may prove to be even more important in reducing infections, especially in indoor environments and even in areas where physical distancing is possible. And more specialized masks designed to block microscopic particles may become more important. Specially outfitted ventilation units designed to kill the virus in circulating air could prove critical in preventing spread in indoor, congregate settings.
Photo by Matthew Bowler
Above: A San Diego county employee explains the testing process to a person with an appointment at a San Diego County COVID 19 testing station by the SDCCU Stadium on May 18, 2020.
The San Diego County COVID-19 case total sits just shy of the 21,500 mark as county public health officials reported over 500 new cases for the fifth time in the last seven days.
The 559 cases and 12 deaths reported Wednesday raise the total number of cases to 21,446 and the number of deaths to 448. Of the 8,436 tests reported Wednesday, 7% returned positive, bringing the 14-day rolling average to 7.2%.
County public health officials previously reported 560 cases last Thursday, 508 on Saturday, 558 on Sunday and 539 on Tuesday.
Four new community outbreaks were reported Wednesday, bringing the weekly total to 14 well above the county's metric of no more than seven in a one-week span. The new outbreaks were reported in a laboratory, hair salon, barber shop and restaurant/bar.
A community outbreak is defined as three or more COVID-19 cases in a setting and in people of different households.
Of the total positive cases, 2,093 or 9.8% have been hospitalized and 546 or 2.5% of cases have been admitted to an intensive care unit.
About 147.2 of every 100,000 San Diegans are testing positive for the illness, well above the state's criterion of 100 per 100,000 and the highest daily rate since the pandemic began.
The last metric the county has failed to maintain is the percentage of cases that have been handled by a contact investigator. Although there are more than 500 investigators currently employed by the county and 98% of all cases had been investigated as recently as June 25, that rate has dropped to a dismal 46%.
Dr. Wilma Wooten, the San Diego County's public health officer, said as a response to these flagging rates, the county is attempting to hire more contact investigators. In just a three-hour period after the job posting went online, more than 300 applications came in.
The number of cases continues to rise in people between the ages of 20 and 49 and particularly in people in their 20s, prompting the county to make efforts at educating younger people.
"While it's true that the mortality for younger people is lower, it's also true that the rate is not zero," said Dr. Scott Eisman, pulmonologist at Scripps Memorial Hospital Encinitas. "The complications from this illness are far greater, much longer lasting and far more serious than the flu."
Eisman said in studies following SARS and MERS outbreaks other coronaviruses people who had the disease and showed symptoms sometimes didn't regain original lung capacity until a year or longer after the symptoms began.
"All indications lead us to expect it to be at least as serious as those diseases and much more aggressive," he said, adding that even otherwise healthy people could see months of complications from the illness.
Eisman also said heart attacks, strokes and serious blood clots were increasing among younger people confirmed to have COVID-19. A total of 58% of those confirmed to have COVID-19 in the county were between the ages of 20 and 49.
Following Gov. Gavin Newsom's updated health order Monday, all indoor operations ceased at midnight Tuesday in gyms, houses of worship, non-critical office businesses, hair salons and barber shops, indoor malls and personal care services, such as massage businesses and tattoo parlors.
The Del Mar Thoroughbred Club, which began its racing season five days ago, canceled its racing program for the upcoming weekend on Wednesday after 15 jockeys recently tested positive for COVID-19. Racing is slated to resume July 24.
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A robot introduces itself to patients in Kigali, Rwanda. The robots, used in Rwanda's treatment centers, can screen people for COVID-19 and deliver food and medication, among other tasks. The robots were donated by the United Nations Development Program and the Rwanda Ministry of ICT and Innovation. Cyril Ndegeya/Xinhua News Agency/Getty Images hide caption
In some places in the world right now, getting tested for COVID-19 remains difficult or nearly impossible. In Rwanda, you might just get tested randomly as you're going down the street.
"So whenever someone is driving a vehicle, bicycle, motorcycle or even walking, everyone is asked if you wish to get tested," says Sabin Nsanzimana, director general of the Rwanda Biomedical Center, which is the arm of the ministry of health that's in charge of tackling COVID-19. Health officials in personal protective equipment administer the test. Nsanzimana says the testing is voluntary, although some others say refusal is frowned upon.
The sample collection from a swab up the nose and filling out the contact information paperwork takes about five minutes.
"All these samples are sent that day to the lab," Nsanzimana says. "We have a big lab here in Kigali. We have also six other labs in the other provinces."
Despite being classified by the World Bank as a low-income country, and despite its limited resources, Rwanda has vowed to identify every coronavirus case. Anyone who tests positive is immediately quarantined at a dedicated COVID-19 clinic. Any contacts of that case who are deemed at high risk are also quarantined, either at a clinic or at home, until they can be tested.
Nsanzimana says health workers call or visit every potential contact of someone who tests positive.
"We really believe that doing so is important to make sure we detect and trace where the virus could be," he says.
Comprehensive contact tracing is a task that has overwhelmed countries with far more resources than Rwanda. Rwanda's per capita income is roughly $2,000 per year. Yet all testing and treatment for the virus is provided for free.
It costs the government between $50 and $100 to run a single coronavirus test, Nsanzimana says. In order to test thousands a day, Rwanda has started using a process called "pool testing." Material from 20-25 nasal swabs are all put into one vial and run through the machine. This allows them to test far more samples at once. If they get a positive result, then all the swabs that went into that initial vial are tested individually to pinpoint the person who's infected.
Nsanzimana says Rwanda's experience dealing with other infectious disease outbreaks is helping it now during the pandemic.
The country is using systems and equipment it already had in place to address HIV.
"The main machines we are using for COVID testing are the HIV machines that were (already) there," he says. "We are using the same structure, same people, same infrastructure and laboratory diagnostics, but applying it to COVID testing."
Since recording its first case in mid-March, the country of 12 million has recorded just over 1,200 cases. Ohio has a similar size population and has recently been reporting roughly 1,200 cases a day.
"Rwanda did a few things that are quite smart," says Sema Sgaier, the head of the Surgo Foundation, which has just launched a new data tool to analyze trends around COVID-19 across Africa. "One is they responded really early. They put some of the most stringent lockdowns in place compared to every other African country. In fact, we've been monitoring physical distancing data across the continent and Rwanda fares, I think, second; they've physical distanced the second most across Africa" a conclusion based on mobile phone movement data. South Africa is No. 1.
Rwanda mobilized community health care workers and police and college students to work as contact tracers. It set up national and regional command posts to track cases. It's even using human-size robots in the COVID-19 clinics to take patients' temperatures and deliver supplies.
Tolbert Nyenswah, who ran the Liberian ministry of health's response to Ebola in 2014, gives Rwanda high marks for how it has been handling COVID-19, even if at times it's heavy-handed.
"Rwanda, from all indications, is a success story for Africa," Nyenswah says. The strong leadership from President Paul Kagame, which Nyenswah says can even be authoritarian, has been effective during this crisis. Kagame demands accountability from his health ministry.
Whether the people trust or fear the government, Rwandans listen to their government and have been following the orders regarding masks, washing hands and staying home.
Nyenswah worries that the worst is yet to come in Africa with this pandemic.
"No country is out of the woods yet," he says. However, he adds that Rwanda is an example to other low-income countries that even with limited resources, this virus can be contained. "So what needs to be done is to follow the (prevention and containment) measures. Political leadership is very, very crucial. Rwanda should continue what it is doing now. And other countries should emulate Rwanda."
