A Bangladesh hospital owner has been arrested over allegations he issued thousands of fake negative coronavirus test results, as the Australian state of Victoria recorded the worst daily rise in cases for the nation since the pandemic began, and global coronavirus cases passed 13.5 million, according to Johns Hopkins University data.
Regent hospital owner Mohammad Shahed was arrested trying to fleeing to India in a burqa after a nine-day hunt, police said. He is one of more than a dozen people detained by authorities in recent days over allegations that clinics in Uttara and Mirpur issued fake certificates to patients saying they were virus-free without testing them.
Experts say false documents have worsened the already dire virus situation in the country of 168 million people by casting doubt on the veracity of certificates issued by clinics.
Bangladesh has reported just over 193,000 infections and 2,457 deaths so far but the real figures are likely much higher because little testing has been carried out.
Police spokesman Colonel Ashique Billah told AFP: He was arrested from the bank of a border river as he was trying to flee to India. He was wearing a burqa.
His hospitals carried out 10,500 coronavirus tests, out of which 4,200 were genuine and the rest, 6,300 test reports, were given without conducting tests.
Shahed is also accused of charging for the certificates and virus treatments despite agreeing that his hospitals in the capital, Dhaka, would provide free care.
Italy last week suspended flights to Rome from Bangladesh after several passengers arriving from Dhaka tested positive for Covid-19. Some of those who tested positive in Italy were allegedly carrying negative coronavirus certificates from Bangladesh, said Shakirul Islam of migrant rights group OKUP.
The government must ensure quality of Covid-19 tests in local laboratories for the sake of its overseas job market, said Islam.
Nearly $19bn was sent back to Bangladesh by an estimated 12 million migrant workers last year, according to the central bank.
In Australia, the state of Victoria, reported two more deaths and 317 cases on Thursday: the largest daily increase in cases for an Australian state since the start of the pandemic. Two men in their 80s died, bringing the total coronavirus deaths in the state to 29 and upping the national toll to 113. There are 109 people in hospital with 29 in intensive care, with total of 4750 cases since the pandemic began, state premier Daniel Andrews said.
The state government has paused some elective surgeries including hip and knee surgery at Melbourne health services to make sure extra beds are available.
In the United States, Dr Anthony Fauci, the senior public health expert on the White House coronavirus task force, said the US needed to focus from a federal level on getting the virus now surging in the south and west under control rather than these games people are playing.
Weve got to almost reset this and say, OK, lets stop this nonsense, he said in an interview with the Atlantic when he was asked to describe the truth about the federal response to the pandemic.
Faucis comments came as US cases increased by a world daily record of more than 67,400, taking the total to nearly 3.5 million confirmed infections.
In better news, Fauci predicted on Wednesday the country would meet its goal of a vaccine by years end, he told Reuters in an interview, saying, I feel good about the projected timetable.
His comments follow promising early-stage data for Moderna Incs coronavirus vaccine, released on Tuesday, that was developed by scientists at the National Institute of Allergy and Infectious Diseases, which Fauci directs.
The news about the vaccine being developed by Moderna affected markets, which rallied in response to the rising hopes for a Covid-19 vaccine on Wednesday, and the S&P 500 climbed back to where it was a few days after it set its record early this year.
Other key global developments include:
Canadas efforts to flatten the curve have put the country on the brink of zero deaths for the first time since March, but officials see worrying signs of a new spike as provinces lift restrictions.
Brazils president, Jair Bolsonaro, has again tested positive, he told reporters on Wednesday in Brasilia, suggesting he has yet to recover from an infection first diagnosed last week, Reuters reports.
Irelands prime minister, Micheal Martin, said on Wednesday night the government continues to advise against non-essential overseas travel, as he announced that a planned move to phase 4 reopening had been postponed to 10 August because the countrys reproduction rate the number of people infected by a virus carrier had increased to more than 1.
South Africa surpassed 300,000 confirmed coronavirus cases late on Wednesday. The countrys 311,049 cases make up close to half of Africas total.
The latest:
Florida reportedthe largest one-day increase in deaths from the novel coronavirus since the pandemic began and its second-largest increase in cases ever on Thursday.
Florida announced 13,965 new cases on Thursday, bringing the total number of cases in the state and the centre of the latest outbreak to over 315,775, according to the state health department.
Florida's COVID-19-related deaths rose by 156 to a total of 4,782, surpassing its previous one-day record of 133 new deaths on July 12. Current hospitalizations of patients with COVID-19 was the highest ever reported at 8,626, up 321 in the past 24 hours, according to a state agency.
The United Statesis the worst-affected country in terms of infections, followed by Brazil and India. More than 137,000 people have died in the U.S. as a result of the virus, the highest of any country. As of 12:25 p.m. ETon Thursday, the global coronavirus case count stood at 13,589,273, with 584,990deaths and 7,607,033 cases considered recovered, according to data from Johns Hopkins University.
On Thursday,CVSsaidit would require customers to wear face coverings while shopping at its U.S. pharmacies, joining a host of retailers, including Walmart,in their push to curb the spread of the coronaviruspandemic.
Meanwhile, Republicans will significantly limit the number of attendees at the party's August convention nominating U.S. President Donald Trump for a second White House term in Jacksonville, Fla., amid the ongoing surge of cases.
The shift to a smaller gathering is the latest in a series of changes sought by organizers as they scramble to host a large-scale event next month amid the health crisis.
WATCH |Infection control epidemiologist responds to questions on the evolving risk of coronavirus:
"We had hoped to be able to plan a traditional convention celebration to which we are all accustomed. However, adjustments must be made to comply with state and local health guidelines," Republican National Committee chairRonna McDaniel said in a letter delivered to delegates on Thursday.
Elsewhere in the U.S., bars and restaurants in New York City that receive three "strikes" for failing to enforce physical distancing will be forced to close, Gov.Andrew Cuomo said on Thursday. Separately, an announcement on whether New York City would enter Phase 4 of reopening will be made at 4 p.m. ET on Friday, Cuomo said.
In Georgia, officialswere headed for a clash over masks to fight the spread of the coronavirusafter the Republican governor barred mayors from requiring residents to wear them. Gov.Brian Kemp issued an executive order late on Wednesday suspending local regulations requiring "face coverings, masks, face shields or any other personal protective equipment" in public.
The order said residents were "strongly encouraged" to wear face coverings in public. Kempsuggested any order mandating masks would be too restrictive. Savannah Mayor Van Johnson, who issued a mask mandate in his city on July 1, reacted swiftly.
"It is officially official. Governor Kemp does not give a damn about us. Every man and woman for himself/herself. Ignore the science and survive the best you can," Johnson, a Democrat, wrote on Twitter. "In Savannah, we will continue to keep the faith and follow the science. Masks will continue to be available!"
Atlanta Mayor Keisha Lance Bottoms, a Democrat, issued an order requiring masks in Georgia's largest city on July 8.
As of 12:25 p.m. ET on Thursday, Canada had 109,082confirmed and presumptive coronavirus cases. Provinces and territories listed 72,782of those as recovered or resolved. ACBC News tallyof deaths based on provincial reports, regional health information and CBC's reporting stood at 8,858.
WATCH |Labour lawyer cautions that enforcing mask policies is likely to cause some conflict:
A Russian hacking group has gone after COVID-19-related vaccine research in Canada, the U.K. and the U.S., according to Canada's cyber spies.
The Communications Security Establishment, responsible for Canada's foreign signals intelligence, said APT29 also known as Cozy Bear and the Dukes is behind the malicious activity. The group "almost certainly operates as part of Russian intelligence services," the CSE said in a statement released Thursday morningin co-ordination with its international counterparts, an allegation the Kremlin immediately denied.
Cozy Bear has been identified by Washington as one of two Russian government-linked hacking groups that broke into the Democratic National Committee computer network and stole emails ahead of the 2016 presidential election. The other group is usually called Fancy Bear.
Spain paid tribute Thursday to the nation's victims of the novelcoronavirus and workers who put their lives at risk during the worst of the pandemic with a solemn state ceremony in Madrid.
Relatives of around 100 people who died during the pandemic, andrepresentatives of medical personnel, police and other essential workers, joined King Felipe VI and Queen Letizia, government members and officials from the European Union and the World Health Organization at an esplanade in Madrid's Royal Palace.
The guests, masked and seated in a physicallydistanced fashion surrounding a central cauldron, included representatives from a dozen religious organizations and ambassadors. As a live performance of string music took over from the speeches, attendees left white roses by the cauldron.
Spain has officially recorded 28,413 deaths from the virus, although excess mortality figures suggest the actual figure is thousands higher. The country is grappling with dozens of fresh outbreaks after it emerged from a strict lockdown last month.
WATCH |White roses, black masks in Spanish tribute to COVID-19 victims:
In France, new Prime Minister Jean Castex said masks will be mandatory in closed public places as of next week, sooner than Aug. 1 as announced earlier by President Emmanuel Macron.
The change in date comes as the Mayenne area of the Loire region has seen several COVID-19 outbreaks, and authorities have recorded a marginal increase in infections in the Paris region.
Calling the situation in Mayenne "problematic," French Health Minister Olivier Veran said he asked the prefect of Mayenne personally to make masks compulsory in closed public places without waiting for the later date.
Australia's coronavirus hot spot the state of Victoria is reporting a record 317 newly confirmed cases in a day. The tally for Thursday surpassed the state's previous high of 288 on July 10.
The previous one-day Australian record was 212 cases set March 28 by New South Wales state duringthe first peak of the pandemic. New South Wales reported only 10 new cases Thursday. Two men in their 80s died in Victoria in the last 24 hours, bringing the country's death toll for the pandemic to 113.
Victoria's government is reducing the number of non-urgent surgeries allowed in hospitals to increase beds available for COVID-19 patients. State officials had planned to restore hospitals to normal medical services by the end of July before infections began to rise in recent weeks.
WATCH | Australian PM says situation in Victoria 'very concerning'
Confirmed coronavirus cases in Tokyo hit a new daily record with 286, raising alarm Japan may be reopening too quickly. Tokyo Gov. Yuriko Koike said one reason for the recent rise in cases is increased testing, which numbered more than 4,000 on Thursday.
She said 760 people are hospitalized, seven of them in serious condition, while more than 350 are quarantined at hotels and homes.Japan has had fewer than 23,000 confirmed coronavirus cases, and about 1,000 deaths.
Israel reached a new daily record of confirmed coronavirus cases, the country's Health Ministry said Thursday, as a new nationwide lockdown to curb the pandemic appeared imminent.
The Health Ministry on Thursday reported 1,898 new cases of the virus. The country has registered more than 44,500 total cases. At least 380 Israelis have died of COVID-19, the illness caused by the virus.
Adding to Prime Minister Benjamin Netanyahu's troubles, a new economic bailout plan announced by the embattled premier came under tough criticism from some of the government's top economic experts.
The growing coronavirus outbreak, coupled with a struggling economy, have marked a dramatic turnaround for Netanyahu. The Israeli leader received widespread praise for moving quickly to contain the coronavirus last spring.
But since lifting a series of restrictions in May, the country has experienced a surge in cases. With unemployment over 20 per cent, the pandemic's economic impact is generating domestic unrest and Netanyahu's approval rating is plummeting.
Hospitals in Iran face acute shortages of medical personnel and beds as the country tackles a powerful second wave of the COVID-19 pandemic, a senior official of Tehran's anti-coronavirus task force said on Thursday.
Iran, the Middle East country hardest hit by the pandemic, began relaxing its lockdown in mid-April. But a second wave of infections emerged in early June and has proven much more serious than the first one, said Reza Jalili-Khoshnood, who is himself infected, the semi-official ISNA news agency reported.
WATCH | Where are we in the pandemic?
Iran recorded 13,608 related deaths as of Thursday, including 198 in the previous 24 hours, according to Health Ministry spokespersonSima Sadat Lari, who wasspeaking on state TV.Sadat Lari told state television that the total number of diagnosed cases in the country had reached 267,061, up by 2,500 in the last 24 hours.
Jalili-Khoshnood was quoted as saying that at one hospital Tehran's Shohada, where he is hospitalized 172 medical staff have been infected themselves or are caring for infected family members. He said he there were also shortages of beds, including of intensive care beds.
His comments contrast with President Hassan Rouhani's regular assurances that Iran has sufficient supplies of medical personnel and facilities. While struggling to curb the spread of COVID-19, Iranian authorities are concerned that tougher measures against it could wreck an economy already reeling under U.S. sanctions.
India's virus cases have surged another 32,695, taking the national count closer to one million and forcing a new lockdown in the popular western beach state of Goa, two weeks after it reopened to tourists.
The new confirmed cases took the national total to 968,876. The Health Ministry on Wednesday also reported a record number of 606 deaths for a total of 24,915.
The Indian Medical Association said 99 doctors have died and another 1,302 are infected with the coronavirus. It called for shortening of working hours for health workers following safety concerns. It also said the fatality rate among doctors was 7.6 per cent, much higher than the national average of about 2.5 per cent.
About a dozen states, including Maharashtra, Tamil Nadu, West Bengal and Assam, have put high-risk areas under lockdowns, allowing only essential food supplies and health services.
VIDEO: Coronavirus: 6 tips for staying healthy York Dispatch
York County saw its 67th death linked to COVID-19 as of noon Thursday, while 34 new cases pushed the total to 1,942 since the outbreak began, the state Health Department reported.
Statewide, the case total hit 98,446, an increase of 781 overthe day prior. There were also 16 new deaths. The death toll now stands at 6,973.
There have been 885,195 patients in the state who have tested negative for COVID-19,27,632 of whom reside in York County.
More: Coronavirus pandemic: Here's what York County's data looks like
More: And now ... a coin shortage?
The age breakdown of those who have been tested in the state are as follows, according to the Health Department:
As of Thursday morning,there were more than 13.5million confirmed cases of the coronavirus worldwide, with 585,500 deaths linked to the virus,according to Johns Hopkins University.
About 3.5million cases hadbeen confirmed in the U.S. with cases spiking in some states, particularly across the Sun Belt and in the Westwith the death toll exceeding 137,000.
Logan Hullinger can be reached at lhullinger@yorkdispatch.com or via Twitter at @LoganHullYD.
Read or Share this story: https://www.yorkdispatch.com/story/news/local/2020/07/16/york-county-has-one-new-death-linked-covid-19-16-total-statewide/5450649002/
We rated 20 coronavirus treatments for effectiveness and safety:
We rated 20 coronavirus treatments
for effectiveness and safety:
We rated 20 coronavirus treatments
for effectiveness and safety:
The Covid-19 pandemic is one of the greatest challenges modern medicine has ever faced. Doctors and scientists are scrambling to find treatments and drugs that can save the lives of infected people and perhaps even prevent infection.
Below is an updated list of 20 of the most-talked-about treatments for the coronavirus, including some of the most promising, interesting and potentially harmful. We also included a warning about a few that are just bunk.
The F.D.A. has not fully licensed any treatment specifically for the coronavirus, but it has granted emergency use authorization to a few.
For the current status of vaccine development, see our Coronavirus Vaccine Tracker.
We rate each treatment based on the scientific evidence for its effectiveness and safety. Well update and expand the list as more evidence emerges.
STRONG EVIDENCE: The treatment has been demonstrated to be effective and safe, either through a robust clinical trial or widespread use by doctors. The strongest trials are randomized controlled trials, in which some people get a treatment and others get a placebo.
PROMISING EVIDENCE: Early evidence from studies on patients suggests effectiveness, but more research is needed. This category includes treatments that have shown improvements in morbidity, mortality and recovery in retrospective studies, which look at existing datasets rather than starting a new trial.
TENTATIVE OR MIXED EVIDENCE: Some treatments show promising results in cells or animals, which need to be confirmed in people. Other treatments have produced different results in different experiments, raising the need for larger, more rigorously designed studies to clear up the confusion.
NOT PROMISING: These treatments show mixed evidence that suggests that they do not work.
INEFFECTIVE AND POSSIBLY HARMFUL: These treatments were once seriously considered for Covid-19 but have not held up under scientific scrutiny, proving to be ineffective or even harmful.
PSEUDOSCIENCE OR FRAUD: These are not treatments that researchers have ever considered using for Covid-19. Experts have warned against trying them, because they do not help against the disease and can instead be dangerous. Some people have even been arrested for their false promises of a Covid-19 cure.
All treatmentsStrongPromisingTentative or mixedNot promisingIneffectivePseudoscience
Antivirals can stop viruses such as H.I.V. and hepatitis C from hijacking our cells. Scientists are searching for antivirals that work against the new coronavirus.
STRONG EVIDENCEEMERGENCY USE AUTHORIZATIONRemdesivirRemdesivir, made by Gilead Science, was the first drug to get emergency authorization from the F.D.A. for use on Covid-19. It stops viruses from replicating by inserting itself into new viral genes. Remdesivir was originally tested as an antiviral against Ebola and Hepatitis C, only to deliver lackluster results. But preliminary data from trials that began this spring suggested the drug can reduce the hospital stays of people with severe cases of Covid-19 from 15 to 11 days. These early results did not show any effect on mortality, though retrospective data released in July hints that the drug might reduce death rates among those who are very ill.
TENTATIVE OR MIXED EVIDENCEFavipiravirOriginally designed to beat back influenza, favipiravir blocks a viruss ability to copy its genetic material. A small study in March indicated the drug might help purge the coronavirus from the airway, but results from larger, well-designed clinical trials are still pending.
TENTATIVE OR MIXED EVIDENCEEIDD-2801Another antiviral originally designed to fight the flu, EIDD-2801 has had promising results against the new coronavirus in studies in cells and on animals. It is still being tested in humans.
TENTATIVE OR MIXED EVIDENCERecombinant ACE-2To enter cells, the coronavirus must first unlock them a feat it accomplishes by latching onto a human protein called ACE-2. Scientists have created artificial ACE-2 proteins which might be able to act as decoys, luring the coronavirus away from vulnerable cells. Recombinant ACE-2 proteins have shown promising results in experiments on cells, but not yet in animals or people.
NOT PROMISINGLopinavir and ritonavirTwenty years ago, the F.D.A. approved this combination of drugs to treat H.I.V. Recently, researchers tried them out on the new coronavirus and found that they stopped the virus from replicating. But clinical trials in patients proved disappointing. In early July, the World Health Organization suspended trials on patients hospitalized for Covid-19. But they didnt rule out studies to see if the drugs could help patients not sick enough to be hospitalized, or to prevent people exposed to the new coronavirus from falling ill. The drug could also still have a role to play in certain combination treatments.
NOT PROMISINGHydroxychloroquine and chloroquineGerman chemists synthesized chloroquine in the 1930s as a drug against malaria. A less toxic version, called hydroxychloroquine, was invented in 1946, and later was approved for other diseases such as lupus and rheumatoid arthritis. At the start of the Covid-19 pandemic, researchers discovered that both drugs could stop the coronavirus from replicating in cells. Since then, theyve had a tumultuous ride through the first few months of the pandemic. A few small studies on patients offered some hope that hydroxychloroquine could treat Covid-19. The World Health Organization launched a randomized clinical trial in March to see if it was indeed safe and effective for Covid-19, as did Novartis and a number of universities.
Meanwhile, President Trump repeatedly promoted hydroxychloroquine at press conferences, touting it as a game changer, and even took it himself. The F.D.A. temporarily granted hydroxychloroquine emergency authorization for use in Covid-19 patients which a whistleblower later claimed was the result of political pressure. In the wake of the drugs newfound publicity, demand spiked, resulting in shortages for people who rely on hydroxychloroquine as a treatment for other diseases.
When data emerged from the randomized clinical trials, the message was clear: hydroxychloroquine didnt help people with Covid-19 get better or prevent healthy people from contracting the coronavirus. (One large-scale study that concluded the drug was harmful as well was later retracted.) The World Health Organization, the National Institutes of Health and Novartis have since halted trials investigating hydroxychloroquine as a treatment for Covid-19, and the F.D.A. revoked its emergency approval. The F.D.A. now warns that the drug can cause a host of serious side effects to the heart and other organs when used to treat Covid-19.
In July, researchers at Henry Ford hospital in Detroit published a study finding that hydroxychloroquine reduced mortality in Covid-19 patients. President Trump praised the study on Twitter, but experts raised doubts about it because it was not a randomized controlled trial. Still, the White House has initiated a push for the F.D.A. to reauthorize hydroxychloroquine as an emergency Covid-19 treatment.
Despite negative results, a number of hydroxychloroquine trials have continued. A recent analysis by STAT and Applied XL found more than 180 ongoing clinical trials testing hydroxychloroquine or chloroquine, for treating or preventing Covid-19. Although its clear the drugs are no panacea, its possible they could work in combination with other treatments, or when given in early stages of the disease.
Most people who get Covid-19 successfully fight off the virus with a strong immune response. Drugs might help people who cant mount an adequate defense.
PROMISING EVIDENCEEMERGENCY USE AUTHORIZATIONConvalescent plasmaA century ago, doctors filtered plasma from the blood of recovered flu patients. So-called convalescent plasma, rich with antibodies, helped people sick with flu fight their illness. Now researchers are trying out this strategy on Covid-19. Early trials with convalescent plasma have yielded promising, if preliminary, results, and the F.D.A. has authorized its use on very sick patients infected by the coronavirus.
TENTATIVE OR MIXED EVIDENCEREGN-COV2 and other monoclonal antibodiesConvalescent plasma contains a mix of different antibodies, some of which can attack the coronavirus, and some of which cant. Researchers have been sifting through the slurry for the most potent antibodies against Covid-19. Synthetic copies of these molecules, known as monoclonal antibodies, can be manufactured in bulk and then injected into patients. Safety trials for this treatment have only just begun, with several more on the way.
TENTATIVE OR MIXED EVIDENCEInterferonsInterferons are molecules our cells naturally produce in response to viruses, rousing the immune system to attack. Injecting synthetic interferons is now a standard treatment for a number of immune disorders. Rebif, for example, is prescribed for multiple sclerosis. Early studies, including experiments in mice and cells, hint that injecting interferons may help against Covid-19. Theres even some evidence that the molecules could help prevent healthy people from getting infected.
The most severe symptoms of Covid-19 are the result of the immune systems overreaction to the virus. Scientists are testing drugs that can rein in its attack.
STRONG EVIDENCEDexamethasoneThis cheap and widely available steroid blunts many types of immune responses. Doctors have long used it to treat allergies, asthma and inflammation. In June, it became the first drug shown to reduce Covid-19 deaths. That study of more than 6,000 people, which has not yet been published in a scientific journal, found that dexamethasone reduced deaths by one-third in patients on ventilators, and by one-fifth in patients on oxygen. It may be less likely to help and may even harm patients who are at an earlier stage of Covid-19 infections, however. In its Covid-19 treatment guidelines, the National Institutes of Health recommends only using dexamethasone in patients with COVID-19 who are on a ventilator or are receiving supplemental oxygen.
PROMISING EVIDENCEEMERGENCY USE AUTHORIZATIONCytosorbCytosorb is a cartridge that filters immune-signalling molecules called cytokines from the blood. Although cytokines are essential for fighting off diseases, they can sometimes trigger a runaway response. The body produces so much inflammation that it damages itself. By removing excess cytokines, Cytosorb may be able to cool this so-called cytokine storm. The machine can purify a patients entire blood supply about 70 times in a 24-hour period. It was granted emergency use authorization by the F.D.A. for Covid-19 after reports in March suggested that it had helped dozens of severely ill Covid-19 patients in Europe and China. Many clinical trials evaluating the devices effectiveness against Covid-19 are now underway.
TENTATIVE OR MIXED EVIDENCECytokine InhibitorsResearchers have created a number of drugs that can potentially halt cytokine storms, and have proven effective against arthritis and other inflammatory disorders. Some turn off the supply of molecules that launch the production of the cytokines themselves. Others block the receptors on immune cells to which cytokines would normally bind. A few block the cellular messages they send. Against the coronavirus, several of these drugs, including tocilizumab, sarilumab and anakinra, have offered modest help in some trials, but faltered in others. The drug company Regeneron recently announced that a branded version of sarilumab, Kevzara, failed Phase 3 clinical trials.
TENTATIVE OR MIXED EVIDENCEStem cellsCertain kinds of stem cells can secrete anti-inflammatory molecules. Over the years, researchers have tried to use them as a treatment for cytokine storms, and now dozens of clinical trials are under way to see if they can help patients with Covid-19. But these stem cell treatments havent worked well in the past, and its not clear yet if theyll work against the coronavirus.
Caregivers can physically adjust a patients body to help weather Covid-19.
STRONG EVIDENCEProne positioningThe simple act of flipping Covid-19 patients onto their bellies opens up the lungs. The maneuver has become commonplace in hospitals around the world since the start of the pandemic. It might help some individuals avoid the need for ventilators entirely. The treatments benefits continue to be tested in a range of clinical trials.
STRONG EVIDENCEEMERGENCY USE AUTHORIZATIONVentilators and other respiratory support devicesDevices that help people breathe are an essential tool in the fight against deadly respiratory illnesses. Some patients do well if they get an extra supply of oxygen through the nose or via a mask connected to an oxygen machine. Patients in severe respiratory distress may need to have a ventilator breathe for them until their lungs heal. Doctors are divided about how long to treat patients with noninvasive oxygen before deciding whether or not they need a ventilator. Not all Covid-19 patients who go on ventilators survive, but the devices are thought to be lifesaving in many cases.
Covid-19 can harm not just the lungs, but other parts of the body. Researchers are searching for ways to block or reverse this devastation.
STRONG EVIDENCEEnoxaparin and other anticoagulantsThe coronavirus can invade cells in the lining of blood vessels, leading to tiny clots that can cause strokes and other serious harm. Breaking up these clots with anticoagulants, which have long been used on patients with various heart conditions, improves the prospects of seriously ill patients. Early data has linked the use of anticoagulants to survival among Covid-19 patients, and many clinical trials teasing out this relationship are now underway.
PROMISING EVIDENCERenal replacement therapyAbout one in five people with Covid-19 who are admitted to the ICU suffer from acute kidney injury. Its not clear yet why possibilities include the coronavirus infecting kidney cells or the immune system attacking the kidneys with a cytokine storm. In its guidelines for treating Covid-19, the National Institutes recommends filtering toxins from the blood with dialysis or other forms of renal replacement therapy. But they warn that few studies have yet been carried out to determine the best treatment for damaged kidneys.
False claims about Covid-19 cures abound. The F.D.A. maintains a list of more than 80 fraudulent Covid-19 products, and the W.H.O. debunks many myths about the disease.
WARNING: DO NOT DO THISDrinking or injecting bleach and disinfectantsIn April, President Trump suggested that disinfectants such as alcohol or bleach might be effective against the coronavirus if directly injected into the body. His comments were immediately refuted by health professionals and researchers around the world as well as the makers of Lysol and Clorox. Ingesting disinfectant would not only be ineffective against the virus, but also hazardous possibly even deadly. In July, Federal prosecutors charged four Florida men with marketing bleach as a cure for COVID-19.
WARNING: NO EVIDENCEUV lightPresident Trump also speculated about hitting the body with ultraviolet or just very powerful light. Researchers have used UV light to sterilize surfaces, including killing viruses, in carefully managed laboratories. But UV light would not be able to purge the virus from within a sick persons body. This kind of radiation can also damage the skin. Most skin cancers are a result of exposure to the UV rays naturally present in sunlight.
WARNING: NO EVIDENCESilverThe F.D.A. has threatened legal action against a host of people claiming silver-based products are safe and effective against Covid-19 including televangelist Jim Bakker and InfoWars host Alex Jones. Several metals do have natural antimicrobial properties. But products made from them have not been shown to prevent or treat the coronavirus.
Treatment ratings will be updated as new evidence emerges. We cannot list every possible treatment. For more details on evaluating treatments, see the N.I.H. Covid-19 Treatment Guidelines.
Note: The tracker rates individual treatments, but doctors are also testing a number of combination treatments.
Sources: National Library of Medicine; National Institutes of Health; Paul Knoepfler, University of California, Davis; Phyllis Tien, University of California, San Francisco; John Moore and Douglas Nixon, Weill Cornell Medical College.
Thirty-nine states reported an increase in the number of new cases from the week before. California, Florida, Arizona and Texas have become the states to watch as surging coronavirus cases lead to a shortage of hospital beds.
In Arizona's Maricopa County, which has the most Covid-19 cases in the state, the medical examiner's office has ordered four portable coolers with additional ones expected in the coming days, said Fields Moseley, the county spokesman. The medical examiner's office morgue had a total of 156 deceased people -- with a surge capacity of just over 200, Moseley said Wednesday.
In Texas, the city of San Antonio and Bexar County have secured several refrigerated trailers to store bodies until they can be released to funeral homes, Mario Martinez, Metro Health Assistant Director, said in a video interview released by the city.
He said that they currently have two in operation and another three will be operational by the end of the week.
Cameron and Hidalgo counties in Texas are sharing a large refrigerated trailer to store bodies of coronavirus patients because of a lack of space at the morgues.
"I'm pleading with everybody in our neck of the woods, help us do your part, people's lives are at stake -- not just the people getting sick, but doctors, nurses working to the bone, EMS personnel, transporting people," Cameron County Judge Eddie Trevio Jr. told CNN affiliate KVEO.
The Dallas County morgue had to use an external refrigerated truck this week due to the increased caseload, the Medical Examiner's Office told CNN.
"We have had to go to the external refrigerated truck once this week due to increased caseload, but today we are back with all cases inside," Dr. Jeffrey Barnard, the Dallas County Medical Examiner, said in a statement. "I anticipate that we will at some point have to use the truck again based on continuing increased volume."
Masks requirements expand
Three more major retailers announced on Thursday they'll require customers to wear masks in their stores.
Publix will require masks as of July 21 and CVS starting on July 20. Target will require customers to wear masks as of August 1, though the retailer noted 80% of its stores already require masks because of state and local regulations.
On Wednesday, retail giant Walmart announced it would require masks in its stores.
Colorado Gov. Jared Polis announced on Thursday that face masks are required in public places when social distancing is impossible. The order takes effect at midnight on Thursday.
Arkansas Gov. Asa Hutchinson announced a statewide order effective Monday. Masks will be required when people are in the presence of non-household members and aren't able to socially distance.
Alabama and Montana issued statewide facial covering orders on Wednesday.
Oklahoma Gov. Kevin Stitt said Wednesday he's tested positive for Covid-19, the same day the state reported a record high number of new cases.
Georgia governor, Atlanta mayor clash
Gov. Brian Kemp extended Georgia's emergency coronavirus restrictions and said while people are "strongly encouraged" to wear face coverings -- they're not required. The order, which expires July 31, limits public gatherings to 50 people and mandates social distancing.
His order also prevents local governments from implementing stricter rules than the state's -- including requiring face masks.
But on Thursday, Michael Smith, press secretary for Atlanta Mayor Keisha Lance Bottoms, told CNN the "Mayor's Order remains in effect, as science and data will continue to drive the City's decisions. Masks save lives."
California, the country's most populous state, reported 8,544 new cases of the coronavirus and 118 additional deaths on Thursday, according to updated data from the California Department of Public Health. The new cases represent a 2.5% increase and the deaths reflect a 1.6% increase from Wednesday's data. And in Los Angeles County, the public health director warned another stay-at-home order is likely.
"We can't take anything off the table -- there's absolutely no certainty of what exactly is going to happen next," Dr. Barbara Ferrer said.
Florida reported more than 315,000 positive cases statewide on Thursday, an increase of 13,965 cases from the previous day, according to the Florida Department of Health. There were a record 156 coronavirus-related deaths on Thursday, a jump from the previous high of 132 on Tuesday.
Epidemiologist says California needs more contact tracers
To combat the rise in coronavirus cases in California, there needs to be enough contact tracing staff in regions where Covid-19 infections are increasing, the principal investigator for the state's contact tracing program told CNN, but not all regions require an equal number of tracers.
"They're not, in their current level, they're not in all places," said University of California, San Francisco epidemiologist Dr. George Rutherford, who also leads the university's contact tracing training program. "If we spread it evenly there still probably wouldn't be enough in the highest incidence areas."
Health officials, he said, cannot forecast how much contact tracing is needed in a region until public health departments are alerted to positive results, but the teams are scalable. "We can call in extra people if there's a surge," Rutherford said.
Higher death toll expected
The model from the Institute for Health Metrics and Evaluation at the University of Washington is projecting 224,000 people will die from the virus by November 1 -- an increase of almost 16,000 from the week before.
That jump is due to skyrocketing cases around the country, particularly in Florida, Texas, Arizona, California, Louisiana, Kentucky, Mississippi, Nevada, New Mexico, South Carolina, Tennessee and Utah, said Dr. Chris Murray, chair of the IHME.
CNN's Joe Sutton, Jon Passantino, Sarah Moon, Jennifer Henderson and Maggie Fox contributed to this report.
As Covid-19 cases surge to their highest levels in dozens of states, the nations testing effort is on the brink of paralysis because of widespread delays in getting back results. And that is very bad news, because even if testing is robust, the pandemic cannot be controlled without rapid results.
This is the latest failure in our national response to the worst pandemic in a century. Since the Trump administration has abdicated responsibility, governors must join forces to meet this threat before the cataclysm that Florida is experiencing becomes the reality across the country.
Testing should be the governors first order of business.
Despite President Trumps boast early this month that testing is so massive and so good, the United States two largest commercial testing companies, Quest Diagnostics and LabCorp, have found themselves overwhelmed and unable to return results promptly. Delays averaging a week or longer for all but top-priority hospital patients and symptomatic health care workers are disastrous for efforts to slow the spread of the virus.
Without rapid results, it is impossible to isolate new infections quickly enough to douse flare-ups before they grow. Slow diagnosis incapacitates contact tracing, which entails not only isolating those who test positive but also alerting the infected persons contacts quickly so they can quarantine, too, and avoid exposing others to the virus unwittingly.
Among those who waited an absurdly long time for her results was the mayor of Atlanta, Keisha Lance Bottoms. We FINALLY received our test results taken 8 days before, she tweeted last week. One person in my house was positive then. By the time we tested again, 1 week later, 3 of us had COVID. If we had known sooner, we would have immediately quarantined.
Another complaint came this week from Mr. Trumps former acting chief of staff, Mick Mulvaney, who wrote in an op-ed commentary for CNBC that my son was tested recently; we had to wait 5 to 7 days for results. Noting, too, that his daughter was told she didnt qualify for a test, he added, That is simply inexcusable at this point in the pandemic.
As summer turns to fall, slow and fragmented testing will fatally undermine the reopening of schools and universities, whose plans are predicated on quickly identifying outbreaks and suppressing spread. Testing for millions of students will feed into an already failing national system.
Vice President Mike Pences casual invocation of an extraordinary national success in testing in a recent call with governors was flatly wrong, as is the presidents similar trumpeting of testing success. These claims contribute to a false sense among the public that testing may have had early stumbles but is ramping up slowly but surely.
The reality is that the spread of the virus has vastly outpaced the expansion of testing capacity. That spread in turn results in more illness and therefore more tests to process, which further slows down turnaround time in a vicious cycle. The dedication and patience of thousands of people waiting in serpentine lines of cars for hours to be tested are wasted when the results arent returned quickly enough.
We are at this point because of the absence of a coordinated federal plan, and, indeed, because of a White House that seems actively hostile to producing one. The nations governors and state legislators must fill the void.
Unity among the states is not just about neighborliness but also about self-interest. So long as interstate travel continues, inadequate testing anywhere threatens public health everywhere, including in places that have found or developed localized testing capacities and are less sensitive to the bottlenecks that Quest and LabCorp are experiencing.
The signal difference between federal and state leadership is that the former can print money and the latter cannot. If states are to step up, they will need resources: money from Congress without executive branch holdup, coordination and mutual aid from one another, and cooperation and expertise from the public itself.
Heres what the governors need to do to bolster the overall testing capability before the end of the summer, best begun with a summit in the next two weeks.
Governors must work collectively to fill gaps in their own testing and contact-tracing programs. The National Governors Association helped in a similar effort to curb the spread of the Zika virus.
In March there was a mad scramble and competition for personal protective equipment. Now, the allocation of tests and test processing may end up in another free-for-all. A coordinated approach by all states would avoid that. Consistent metrics must be established for accountability and to identify trigger points that call for rapid policy responses. Acting in concert can make it easier to undertake tough or controversial decisions like ordering lockdowns when testing shows renewed spread.
Governors should also agree to assist in sharing local test processing capacity, including by university labs, so it is available wherever it is most needed. Relying largely on two large commercial testing companies, as we are now, has proved to be a major vulnerability.
For example, the Broad Institute of M.I.T. and Harvard has stepped up in Massachusetts with more testing capacity so much so that it is not being fully used. But no process is in place for a doctor in, say, Arizona to prescribe a test that the Broad will process. Thats a problem that governors can help solve. They can also find ways to subsidize investments by labs to expand capacity, to help untangle medical insurance complications so tests are covered and to prompt innovations in testing.
In particular, they should encourage the academic and commercial sectors to develop, test and produce new, rapid, point-of-care testing. More broadly, they should recruit data scientists and experts in science communication ready to lend their skills to a unified effort.
We cant allow the delays at Quest and LabCorp to mark the start of a downward spiral. Instead, we must marshal a nationwide strategy to place the United States in the ranks of other countries that are successfully beating back the pandemic.
Sorting out testing is foundational to slowing the spread of the virus. From there, governors can build a comprehensive national plan of attack. Doing so will require new forms of coordinated governance. In the absence of federal leadership, its up to governors to step to the fore.
Margaret Bourdeaux is research director of the Program of Global Public Policy at Harvard Medical School. Beth Cameron is the vice president for Global Biological Policy and Programs at the Nuclear Threat Initiative. Jonathan Zittrain is a professor of law and computer science at Harvard and co-chair with Dr. Bourdeaux of the Berkman Klein Centers Digital Pandemic Response Practice.
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A volunteer receives a shot in a clinical trial for a potential coronavirus vaccine. U.S. intelligence officials say Russian hackers are attempting to break into U.S. health care organizations working on a vaccine. Ted S. Warren/AP hide caption
A volunteer receives a shot in a clinical trial for a potential coronavirus vaccine. U.S. intelligence officials say Russian hackers are attempting to break into U.S. health care organizations working on a vaccine.
The National Security Agency, as well as its counterparts in Britain and Canada, all said Thursday that they're seeing persistent attempts by Russian hackers to break into organizations working on a potential coronavirus vaccine.
The Western intelligence agencies say they believe the hackers are part of the Russian group informally known as Cozy Bear. The intelligence agencies refer to it as APT29.
That group has been linked to Russian intelligence and was blamed for hacking Democratic Party emails in the 2016 U.S. presidential election.
"APT29 has a long history of targeting governmental, diplomatic, think-tank, health care and energy organizations for intelligence gain so we encourage everyone to take this threat seriously," said Anne Neuberger, the NSA's cybersecurity director.
Russia denied the accusation.
"We can say one thing Russia has nothing at all to do with these attempts," Dmitry Peskov, a spokesman for Russian President Vladimir Putin, was quoted as saying by the state-run Tass news agency.
The Western intelligence agencies did not name any of the organizations being targeted. In addition, there was no word on whether the hackers had obtained any information, or what they might do with any such information.
But for several months now, the U.S. and others have been warning health care organizations to safeguard all sensitive information related to a potential vaccine.
"We are imploring all those research facilities and hospitals and pharmaceutical companies that are doing really great research to do everything in their power to protect it," Bill Evanina, the director of the National Counterintelligence and Security Center, told NPR in May.
Prior to Thursday's announcement, U.S. officials had already been warning about China, which has has a long track record of stealing Western intellectual property.
"We have the full expectation that China will do everything in their power to obtain any viable research that we are conducting here in the U.S.," Evanina said back in May. "That will be in line with their capabilities and intent the last decade plus, and we are expecting them to continue to do so."
But perhaps what is most surprising, there are real signs that Trump's base is leaving him on the issue of the coronavirus.
Trump's numbers look even worse when you examine where he is with groups that make up that base: whites without a college degree and rural voters.
Among whites without a college degree, Trump's approval rating on coronavirus is an average of the ABC News/Ipsos and Quinnipiac polls is just 50%. That matches his disapproval rating. In other words, Trump's doing no better than even among what is supposed to be a bedrock group.
The numbers are no better for him among rural voters. In an average of the ABC News/Ipsos and Quinnipiac polls, his approval rating is at 48% among rural voters. His disapproval stands at 50%. Again, you want to be running up the score with base groups that voted for you by around 30 points in 2016. Trump's just running even here.
Now, there was no reason it had to be this way for Trump. Back in early April, Trump was getting strong ratings from all of these groups in his base.
He was averaging a 90% approval rating in the ABC News/Ipsos and Quinnipiac University polls when it came to his coronavirus performance.
He was well into the 60s with both whites without a college degree and rural voters in both polls.
What we've seen is that his base is clearly running away with him because they judge his performance over the last few months to be negative.
The big question with an election in the fall is whether these voters are merely saying they disapprove of Trump on the coronavirus but are still going to vote for him.
There are certainly some members of his base who are never going to vote for former Vice President Joe Biden, even though they dislike Trump's handling of coronavirus.
Still, there are signs that Trump's coronavirus performance is hurting him even against Biden.
Likewise, Trump's up 21 points with rural voters in the Quinnipiac poll. That looks a lot like an average of the polling.
Overall, these may seem like large margins, but they're not anywhere near as well as Trump did in 2016.
Good morning.
(This article is part of the California Today newsletter. Sign up here to receive it by email.)
Californians who dont have symptoms of Covid-19 will probably have a harder time getting tested for the coronavirus, according to new, stricter guidelines state officials unveiled on Tuesday.
It is critical we continue to be deliberate and creative about testing, Dr. Mark Ghaly, the states head of health and human services, said in a statement. We must do this so that testing is readily available and affordable to those who need it, especially those communities experiencing the worst impacts.
In a virtual news conference, Dr. Ghaly said California was also exploring opportunities for pooled testing, a strategy that could help identify infections in large groups more quickly.
The shift in testing strategy comes as more states around the country have scrambled to ramp up testing, which has resulted in tighter supply chains and longer turnaround times in California, the nations most populous state.
California has contended with an explosion in cases, prompting Gov. Gavin Newsom on Monday to announce the most sweeping rollback yet of reopening plans.
[Read about which businesses were ordered to close down.]
As of Tuesday, California was averaging 8,334 new cases per day over the past week, compared with 3,041 new cases per day on average just a month ago.
Heres what to know about the changes:
Why are they happening now?
Over the past two weeks, the state reported 107,600 tests per day on average a huge increase over the past couple of months. But the states percentage of tests that have come back positive for the virus has inched upward, as well, to 7.1 percent on average over the past two weeks.
Our testing capacity has increased exponentially, Dr. Ghaly said in the statement. At the same time, new national supply chain challenges and large volumes of specimens sent to commercial laboratories have resulted in growing delays in processing times.
What do the new guidelines say?
Previously, state and local officials had encouraged anyone who wanted to get tested to see if they were eligible, whether or not they had symptoms, as testing capacity ramped up across California and case numbers were less troubling.
Under the new guidelines, Dr. Ghaly said that testing would be much more strategically targeted at people in communities where risks of transmission are higher.
Of course, people who have severe symptoms will be prioritized for tests with quick results so they can get a diagnosis and be treated.
According to the new rules, people who have been hospitalized fall in the Tier 1 priority group, along with people who must be tested as part of investigations into specific outbreaks.
Tier 2 includes everyone else with Covid-19 symptoms, as well as people who live or work in the kinds of facilities where outbreaks have been most severe, such as nursing homes, prisons and homeless shelters. It also includes health care workers who have frequent interactions with the public or with people who may have Covid-19.
Tier 3 includes workers in remaining essential sectors, like grocery stores, logistics, manufacturing and education, if they dont have symptoms.
And then, theres Tier 4, which will be implemented only when the test turnaround time is less than 48 hours, as monitored by the state. Thats when anyone else who doesnt have symptoms, but is worried they may have been infected, can get tested.
How will these new rules help stop the spread of the virus?
While individual actions, like following distancing and mask-wearing rules, are critical for curbing the spread of the virus, increasingly, experts have recognized that many transmissions are taking place because Californians who work in low-wage, high-risk jobs havent been able to stop working.
In a first-of-its-kind analysis, researchers at the University of California, Merced, Community and Labor Center found a connection between high concentrations of low-wage work in certain counties like at farms and in warehouses and the prevalence of Covid-19.
Our findings emphasized the importance of not just regulating business openings, but mitigating Covid spread by innovating health and safety reforms for workers, Ana Padilla, the centers executive director, told me.
One way to do that is to ensure that workers in those communities have access to testing and that workplace outbreaks are transparent. That would mean requiring counties to report test results by industry, the report said.
Although we have guidance and support, we know that testing in those environments is key, Dr. Ghaly said on Tuesday, adding that thats why the new testing strategy involves homing in on workplace outbreaks.
Updated July 16, 2020
Still, he said the state hadnt specifically asked counties to report test results by industry or employer.
[Read more about how the pandemic has put warehouse workers in the Inland Empire in a tough spot.]
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The Trump administration abandoned its plan to strip international college students of their visas if they didnt attend at least one class in person. It was a rare and swift reversal in response to fierce opposition. [The New York Times]
Most of the nations big school districts including in Los Angeles and San Diego arent ready to reopen, because the test positivity rates in the communities where theyre located are much too high. And reassuring examples of schools reopening abroad dont apply here. [The New York Times]
Bankruptcy forced Stockton to defund its Police Department, making it an inadvertent laboratory for pushes to reduce the roles of law enforcement officers in keeping communities safe. [The Los Angeles Times]
If you missed it, heres what Stocktons mayor had to say about calls to defund the police now. [The New York Times]
Transit agencies around the country are struggling. In the Bay Area, there are too many disjointed systems and not enough riders. [Bloomberg CityLab]
Wineries were beginning to settle into a new normal. Then they were told they had to shut down indoor operations.[The San Francisco Chronicle]
He goes by Bruce or Paco or Peter or Pierre or Abraham. He is a peacock. And hes tearing a North Oakland neighborhood apart. [SFGate]
We joke about it: How many years has it been since 2020 started? How many lifetimes?
Theres a sense that were living through a momentous period in history a global pandemic, uprisings over racial justice that have poured into every corner of society and broad recognition that the world is changing rapidly.
So museums and curators are asking us all to help them help future generations understand this time by documenting it. Everything, like protest signs, shopping lists, or snippets of video.
Whatever were taking to be ordinary within this abnormal moment can, in fact, serve as an extraordinary artifact to our childrens children, Tyree Boyd-Pates, an associate curator at the Autry Museum of the American West, told Lesley M.M. Blume, in this article. The Autry is asking for submissions to its Collecting Community History Initiative.
California Today goes live at 6:30 a.m. Pacific time weekdays. Tell us what you want to see: CAtoday@nytimes.com. Were you forwarded this email? Sign up for California Today here and read every edition online here.
Jill Cowan grew up in Orange County, went to school at U.C. Berkeley and has reported all over the state, including the Bay Area, Bakersfield and Los Angeles but she always wants to see more. Follow along here or on Twitter.
California Today is edited by Julie Bloom, who grew up in Los Angeles and graduated from U.C. Berkeley.
He loved to get his family together, Ms. Flores said. And thats what took him.
My familys encounter with the virus started in the last week of June, when my 17-year-old nephew, who mistook his virus symptoms for strep, joined my 66-year-old mother, 69-year-old father, two sisters and a brother-in-law on a medical road trip to Houston, where my mother had scheduled a mammogram.
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On their way back to the Valley, they visited relatives in Galveston. After Fathers Day, about a dozen relatives who had met one another during the trip began describing debilitating headaches, body chills, fever and trouble breathing, all classic Covid-19 symptoms.
The Contreras family was in a similar situation. They gathered for their festive pachanga on June 1, dancing to mariachi music, sharing family stories and savoring classic Mexican barbecue.
Because they kept it small, they thought they were doing the right thing, said Ms. Flores, who stayed home because she worried about the virus.
It only took a few days for Mr. Contreras to develop a severe respiratory illness. Two of his sons soon joined him in the hospital with difficulty breathing. Soon uncles, aunts and cousins also fell ill.
Ms. Flores told me that when she heard her grandfathers brain was bleeding, she rushed to the hospital and found him unconscious and connected to several tubes.
Your gera is here, she whispered, using the nickname he had given her as a child, alluding to her light complexion.
