Here are the latest developments in the COVID-19 pandemic in Minnesota and Wisconsin.
The Walz administration announced Tuesday The Minnesota Department of Employment and Economic Development (DEED) is now accepting applications from businesses wishing to tap into the $62.5 million Small Business Relief Grants Program signed into law last week.
COVID-19 has brought historic challenges for our small business owners," Walz said in a statement Tuesday. "This program is a result of bipartisan collaboration and conversations with the communities most impacted by this pandemic. I encourage our small business owners to apply for this funding, which will provide a lifeline for our communities and help Minnesota build a stronger and more equitable economy."
According to an afternoon press release put out by the Governor's office, businesses with 50 or fewer employees are now eligible to apply for grants up to $10,000.
Echoing the governor's sentiment, Lieutenant Governor Flanagan said, Minnesotas small business owners deserve support through this unprecedented time. Im proud of this program to support our historically under-supported communities, including our business owners who are women, veterans, Black, Indigenous, and people of color. But we have a lot of work left to do to rebuild our communities.
The money is intended to be spread evenly across regions of Greater Minnesota and the Twin Cities metro. The release states at least $10 million will go toward minority-owned businesses, $2.5 million toward veteran-owned businesses and $2.5 million toward female-owned businesses.
The release states by law an additional $2.5 million will be allocated for grants up to $250,000 each to the operators of cultural malls, in order to sustain existing tenants.
The Governor's Office states that applications will be evaluated immediately for a 10-day period ending on July 2 at 5 p.m. Eligible businesses will be selected using a randomized lottery process in partnership with the Minnesota Lottery - which will then be observed by an independent third party, the release states.
Grants will be administered by "qualified local and regionally based nonprofit agencies," and can be allocated toward supporting payroll expenses, rent, mortgage payments, utility bills, "and other similar business expenses."
Applications and more information can be found on DEED's website.
New numbers released Tuesday by the Minnesota Department of Health (MDH) reflect another day of single-digit deaths from COVID-19.
Nine Minnesotans perished from the virus over the last 24-hour reporting period, raising the number of fatalities to 1,393 since the pandemic began. Of those deaths, 1,101, or 79% of them occurred in long-term or assisted living settings.
MDH says 245 people tested positive for the coronavirus in the past day, elevating the number of confirmed cases to 33,469. Private and state labs processed an additional 7,261 tests, for a total of 520,045 since the department started compiling statistics in late January.
Currently 339 patients are hospitalized with complications from COVID-19, with 158 of them being cared for in the ICU. A total of 3,860 have been treated in hospitals since the start of the pandemic.
Health officials say Minnesotans continue to recover from the virus, with 29,399 people who at one time tested positive now recovered to the point they no longer require isolation.
Of those testing positive for the coronavirus, people ages 30 to 39 make up the largest segment with 6,715 cases, followed by those between 20 and 29 who account for 6,629 cases. People from 80 to 89 have tested positive just 1,514 times, but account for 477 of Minnesota's deaths.
The Minnesota Department of health (MDH) is issuing a warning about two areas of concern in light of the COVID-19 pandemic: decreased use of emergency rooms, and decreased vaccinations for children.
MDH Infectious Disease Division Director Kris Ehresmann said they're seeing a drop-off in the percentage of children getting their vaccines because parents are not going in for well-child visits. About three months ago, the MMR vaccination for measles, mumps and rubella was down by 70% as compared to 2019. Last week it was down by about 34%.
"We know that if introduced that measles can take off anytime we have low vaccination rates," Ehresmann said, referencing Minnesota's outbreak in 2017.
"As we take our eye off very critical preventive measures, we may see some very tragic consequences of that," MDH Commissioner Jan Malcolm said.
Ehresmann also said she wanted to put in an "early plug" for the influenza vaccine.
"Thinking ahead this year it will be even more important that we have as many people protected from influenza as we can," she said.
Ehresmann said national data that includes Minnesota also shows a 23% decrease in ER visits for heart attacks, 20% decrease for stroke, and 10% for hyperclycemic crises. That data is taken from the 10 weeks after the national emergency was declared for coronavirus, and compared with the 10 weeks prior.
Ehresmann said MDH wants to make sure that people who are experiencing signs of serious illness seek emergency care.
Malcolm said that the new COVID-19 case numbers reported Monday are not a big change from what they've been seeing lately.
"We are still seeing that couple days up, couple days down pattern," she said.
There were 308 new cases reported Monday, based on the positive tests that were confirmed Sunday. That decrease came after a couple days of increase, with 430 on Friday and 460 on Saturday. Before that, 360 new cases were identified Thursday.
The median age of cases is now 40.4 years old in Minnesota. Ehresmann said that is likely because they have expanded testing beyond just older, more vulnerable populations.
Although overall hospitalizations increased Monday for the first time in just under a week, Malcolm said there is a "stable hospitalization picture" from COVID-19. However, she said, "Many of the hospitals still are running at a very high occupancy rate from other business."
More than 15,000 people have been tested at community sites and by HealthPartners after the large gatherings and protests following George Floyd's death in Minneapolis police custody. Malcolm said the positivity rate so far is under 2%.
KARE 11s coverage of the coronavirus is rooted in Facts, not Fear. Visit kare11.com/coronavirus for comprehensive coverage, find outwhat you need to know about the Midwest specifically, learn more about thesymptoms, and see what businesses are open as the state slowly lifts restrictions. Have a question? Text it to us at 763-797-7215. And get the latest coronavirus updates sent right to your inbox every morning. Subscribe to the KARE 11 Sunrise newsletter here. Help local families in need: www.kare11.com/give11.
The state of Minnesota has set up a data portal online at mn.gov/covid19.
Amy Watson, is among a growing number of people experiencing coronavirus-related symptoms lasting months
A pre-school teacher in Portland, Amy first experienced coronavirus-like symptoms in mid-march, just a few days before schools closed because of pandemic lockdowns. She still suffers from various symptoms to this day.
LOS ANGELES - Since the first reported cases of the novel coronavirus, several support groups have emerged on Facebook consisting of thousands of members calling themselves long haul survivors, reporting COVID-19 symptoms that they say have lasted for months.
Today is day 93, said Amy Watson, a preschool teacher who lives in Portland, Oregon as she shared a photograph of her thermometer that read 100.3 on June 18. She first tested positive for COVID-19 on April 11, after falling ill with flu-like symptoms in mid-March.
Watson said she has had a persistent fever for nearly three months now, along with a handful of other disconcerting symptoms.
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Photograph of Amy Watsons temperature taken on June 18. (Credit: Amy Watson)
Watson said she first came down with the flu-like symptoms on March 15, when she developed a cough and fever. She felt some of the worst of the illness for about a week, until, she said, she started to feel better, only to have the illness return like a ton of bricks.
While she said the initial symptoms of congestion and cough have since subsided, she continues to experience other manifestations of the illness.
These other symptoms that have just been hanging on are the ones that nobody knows how to treat and fix, said Watson. Ive got this fever, I got this crazy burning sensation, nerve pain thats like under my skin, incredible fatigue.
Watson, whose only underlying condition before contracting COVID-19 was asthma, added that she has to sit down and rest every time she performs any menial task.
Back in March when she first reported feeling sick, it was nearly impossible for her to get a COVID-19 test. She said she called an advice nurse, who told her to assume it was the novel coronavirus and isolate herself for two weeks, which she did.
The 14 days passed and I was still sick, said Watson. She was prescribed multiple rounds of antibiotics after she reached three weeks of being symptomatic with the illness.
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The problem with testing
Watsons long-term fever sparked concerns that she might have cancer, but after several lab tests, her results came back normal. At that point, Watson said she was told that only medical workers and front-line responders to the coronavirus were permitted to take a COVID-19 test in her area.
But because of her asthma, she was finally able to get tested, nearly a month into her illness. Two days later, the test came back positive.
A screenshot of Amy Watsons COVID-19 test results.
Despite Watson testing negative for the novel coronavirus at the end of April, she still felt sick, and doctors gave her the discouraging news that she should expect at least another eight weeks before fully recovering from the disease.
Watsons experience with testing also resonated with many members of the various long haul Facebook groups. Many said they have simply been unable to get tested.
Health officials have said that testing in the United States early on was insufficient for optimal containment of the virus. In early March, Dr. Anthony Fauci, a member of the White House coronavirus task force, testified that the nation's testing system was not really geared to what we need right now and added, it is a failing. Lets admit it.
By mid-February, when some of the first CDC coronavirus tests were administered, technicians reported getting inconclusive results, which the CDC said could be due to the test looking for signs of generic coronaviruses, of which there are many, rather than the specific virus that causes COVID-19.
By then, only about a half-dozen state and local public health labs had reliable tests.
In March, President Donald Trump assured Americans that the COVID-19 test developed by the Centers for Disease Control and Prevention was perfect and that anyone who wants a test can get a test. But more than two months after the first U.S. case of the new disease was confirmed, many people still could not get tested.
When Watson was still experiencing symptoms long after testing negative for the virus, she decided to search for others with a similar experience. She found several COVID-19 support groups on Facebook, many of which she said consisted of members who did not actually suffer from the virus.
Watson said she had a negative experience with people in those groups, so she decided to start her own after connecting with other people who she said sounded like me.
She said she initially expected the group to have maybe a dozen members when it started on April 29, but it has since drawn more than 3,000 people from over 58 countries.
The group has been an amazing source of comfort, said Watson. On our header it says, welcome, no youre not crazy and youre not alone.
Since the groups creation, Watson and other members have started a petition, which had received 9,367 signatures as of June 22, in hopes of clarifying official COVID-19 guidelines to accurately reflect recovery periods.
Currently, the U.S. Centers for Disease Control and Prevention recommends that individuals who contract the novel coronavirus self-isolate for 14 days. A report from the World Health Organization said that the median time from onset to clinical recovery for mild cases is approximately 2 weeks and is 3-6 weeks for patients with severe or critical disease.
In an interview regarding recent increases in coronavirus cases in the U.S., Dr. Tom Tsai, a surgeon and health policy researcher at Harvard T.H. Chan School of Public Health, said he had not heard of stories like Amys, most likely because we are still in the midst of it.
I dont think we have enough clinical or medical data, said Tsai. I havent seen anything in the medical literature about the long-term consequences from COVID infections, and that is probably just because its only been six months since COVID reared its head.
Tsai added that while most disease models suggest that people recover from the virus from a transmissibility standpoint, there is not enough information to understand the long-term effects of the novel coronavirus in terms of symptoms, calling instances like Watsons and other long haul survivors, a legitimate concern.
Its important to study that [long-term effects of COVID-19], the hard part is that COVID symptoms are so vague, and its so variable, said Tsai. People dying, people in the ICU, people who have almost no symptoms, thats part of the challenge of the pandemic is that its effect is so variable across populations, across different demographic groups, different ages.
I think its too early to know whether this is truly people who may be at risk for a longer disease course, Tsai said.
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COVID toes and other anomalous effects of the virus
Dr. Mady Hornig has been confronted with an array of concerning symptoms that have persisted in patients, as well as herself.
Dr. Mady Hornig, an immunologist and professor of epidemiology at Columbia University who is currently researching the long-term effects of a viral infection like COVID-19, has been confronted with an array of concerning symptoms that have persisted in patients, as well as herself.
Hornig can personally attest to the variety of symptoms that have been reported in coronavirus patients, ever since she began to experience COVID-19 symptoms herself in April that have continued to impact her daily life for the past 11 weeks.
Hornig listed an array of long-term effects that she and her fellow researchers are finding in COVID-19 patients, including one illness that has been frequently described in the long haul Facebook groups, and by Watson as well. It has been referred to as COVID toes.
Hornig said shes not entirely clear on what can cause such a symptom, but said that she did experience swelling in her feet.
When sufferers describe COVID toes, they describe a painful swelling in their feet in which red or purple lesions can develop on fingers or toes.
The most common coronavirus symptoms are fever, a dry cough and shortness of breath -- and some people are contagious despite never experiencing symptoms. But as this bewildering virus continues to spread, less common symptoms are being reported including loss of smell, vomiting and diarrhea, and increasingly, a variety of skin problems.
In one report, dermatologists evaluated 88 COVID-19 patients in an Italian hospital and found 1 in 5 had some sort of skin symptom, mostly red rashes over the trunk. In another, Spanish doctors reported a series of 375 confirmed virus patients with a range of skin complaints, from hives to chickenpox-like lesions to the toe swellings.
Pictures of reddened toes and rashes all over social media and doctor chat groups have already enabled the rapid recognition of skin signs by dermatologists. It is now time for rigorous science to understand the link, Dr. Kanade Shinkai of the University of California, San Francisco wrote in a recent JAMA Dermatology editorial.
Since getting sick, Hornig said shes had to carry a pulse oximeter with her, a device which registers her pulse since she began to have tachycardia episodes when her fever began to decline. Tachycardia is a condition that can make your heart beat abnormally fast, reducing blood flow to the rest of your body, according to The Mayo Clinic.
Her most recent episode was on June 22. Her pulse registered at 135 beats per minute, which she said occurred just from her sitting at her computer. She said a normal pulse for someone her age would be around 60-70 beats per minute.
Watson also said that her heart rate has been known to escalate and drop dramatically since she has been sick, and she said she was forced to go to urgent care after an incident she had last week when she thought she was having a heart attack.
While it was not a heart attack Watson was experiencing, she was diagnosed with pleurisy, a very painful illness in which tissue that separate the lungs from the chest wall becomes inflamed.
While symptoms like COVID toes and month-long fevers have left some medical workers perplexed, some illnesses stemming from the coronavirus are not entirely without precedent.
Hornig has been researching one particular illness that has previously been linked to other coronaviruses like SARS and MERS.
According to the CDC, coronaviruses are a large family of viruses that are common in people and many different species of animals. Many people have previously experienced a coronavirus in the form of the common cold. But COVID-19 has not previously been identified in humans
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is an illness Hornig said has been found in patients who have recovered from coronaviruses such as SARS. The CDC cites a 2015 report from the nations top medical advisory body, the Institute of Medicine, which says that an estimated 836,000 to 2.5 million Americans suffer from ME/CFS.
The CDC says that people with ME/CFS experience severe fatigue, sleep problems, as well as difficulty with thinking and concentrating while experiencing pain and dizziness.
Hornig said SARS-CoV-1 and MERS have been associated with longer-term difficulties, in which many people appeared to have symptoms of ME/CFS.
In April, advocates of the Solve ME/CFS Initiative (Solve M.E.) virtually stormed Capitol Hill for the fourth annual ME/CFS Advocacy day, which the organization calls a national event to educate congress about the neuroimmune disease.
According to the organization, nearly 35 percent of COVID-19 patients are experiencing ME/CFS adding that the illness typically follows a viral infection.
ME/CFS is an urgent public health crisis based on what is happening in our country right now, says Emily Taylor, Director of Advocacy and Community Relations at Solve M.E. Evidence suggests that a virus as serious and widespread as COVID-19 could ignite rapid and significant growth in the ME/CFS population in just 36 months This is a very real, science-based concern, adding an even stronger sense of urgency to take action today. We must get the attention of our countrys leaders.
The number of COVID-19 deaths in the United States has surpassed the number of Americans who were killed during WWI.
Despite long haul sufferers, pandemic still in early stages
After personally experiencing her own mysterious and frustrating long-term COVID-19 effects, Hornig reiterated the importance of studying cases like Watsons as an opportunity to learn the potential future effects of a viral infection like the novel coronavirus.
We owe it to these patients to really take these issues seriously, Hornig said. Its a challenge because we may have missed the window for getting the right diagnosis, people may no longer be infectious, and we dont know how long the antibodies are going to last.
And while the term long haul has been coined for people who have experienced COVID-19 symptoms for months now, medical experts like Hornig are emphasizing that much is still unknown about the disease and that we still may be in an early stage of the pandemic.
Alarming surges in coronavirus cases across the U.S. South and West raised new fears Monday that the outbreak is spiraling out of control and that hard-won progress against the scourge is slipping away because of resistance among many Americans to wearing masks and keeping their distance from others.
Confirming predictions that the easing of state lockdowns over the past month-and-a-half would lead to a comeback of the virus, cases surpassed 100,000 in Florida, hospitalizations are rising dramatically in Houston and Georgia, and a startling 1 in 5 of those tested in Arizona are proving to be infected.
Over the weekend, the virus seemed to be everywhere at once: Several campaign staff members who helped set up President Donald Trump's rally in Tulsa, Oklahoma, tested positive, as did 23 Clemson University football players in South Carolina. At least 30 members of the Louisiana State University team were isolated after becoming infected or coming into contact with someone who was. Meatpacking plants were also hit with new outbreaks.
It is snowballing. We will most certainly see more people die as a result of this spike, said Dr. Marc Boom, CEO and president of Houston Methodist Hospital, noting that the number of COVID-19 hospital admissions has tripled since Memorial Day to more than 1,400 across eight hospital systems in the Houston metropolitan area.
He warned that hospitals could be overwhelmed in three weeks, and he pleaded with people to cover their faces and practice social distancing.
It is possible to open up at a judicious pace and coexist with the virus, but it requires millions and millions of people to do the right thing," Boom said.
Texas is among a number of states including Arizona, Alabama, Florida and South Carolina whose governors have resisted statewide mask requirements, leaving the matter to local authorities.
The number of new coronavirus cases across the country per day has reached more than 26,000, up from about 21,000 two weeks ago, according to an Associated Press analysis of data compiled by Johns Hopkins University. Over 120,000 deaths in the U.S. have been blamed on the virus, the highest toll in the world.
The Associated Press contributed to this story.
Introduction
Breastfeeding is the cornerstone of infant and young child survival, nutrition and development and maternal health. The World Health Organization recommends exclusive breastfeeding for the first 6 months of life, followed by continued breastfeeding with appropriate complementary foods for up to 2 years and beyond.1 Early and uninterrupted skin-to-skin contact, rooming-in2 and kangaroo mother care3 also significantly improve neonatal survival and reduce morbidity and are recommended by WHO.
However, concerns have been raised about whether mothers with COVID-19 can transmit the SARS-CoV-2 virus to their infant or young child through breastfeeding. Recommendations on mother-infant contact and breastfeeding must be based on a full consideration of not only of the potential risks of COVID-19 infection of the infant, but also the risks of morbidity and mortality associated with not breastfeeding, the inappropriate use of infant formula milks, as well as the protective effects of skin-to-skin contact. This scientific brief examines the evidence to date on the risks of transmission of COVID-19 from an infected mother to her baby through breastfeeding as well as evidence on the risks to child health from not breastfeeding.
WHO recommends that mothers with suspected or confirmed COVID-19 should be encouraged to initiate or continue to breastfeed. Mothers should be counselled that the benefits of breastfeeding substantially outweigh the potential risks for transmission.4
Mother and infant should be enabled to remain together while rooming-in throughout the day and night and to practice skin-to-skin contact, including kangaroo mother care, especially immediately after birth and during establishment of breastfeeding, whether they or their infants have suspected or confirmed COVID-19.
A living systematic review of evidence that followed the procedures of the Cochrane handbook for systematic reviews of interventions was carried out with the latest search done on 15 May 2020 to identify studies including mothers with suspected or confirmed COVID-19 and their infants or young children.5 The search was conducted on Cochrane Library, EMBASE (OVID), PubMed (MEDLINE), Web of Science Core Collection (Clarivate Analytics) and the WHO Global Database. A total of 12,198 records were retrieved, 6945 were screened after removing duplicates, and 153 records with mother-infant dyads in which the mother had COVID-19 were included in full-text review.
A total of 46 mother-infant dyads had breastmilk samples tested for COVID-19. All mothers had COVID-19, while 13 infants tested COVID-19 positive. Breastmilk samples from 43 mothers were negative for the COVID-19 virus while samples from 3 mothers tested positive for viral particles by RT-PCR. Among the 3 infants whose mothers breastmilk tested positive for virual RNA particles, not live virus, one infant tested positive for COVID-19 but infant feeding practices were not reported. The two other infants tested negative for COVID-19; one was breastfed, and the other newborn was fed expressed breast milk after viral RNA particles were no longer detected. In the single child with COVID-19, it was unclear through which route or source the infant became infected, i.e. through breastmilk or droplet from a close contact with the infected mother.
A preprint article reported secretory immunoglobulin A (sIgA) immune response against the COVID-19 virus found in 12 of 15 breastmilk samples from mothers with COVID-19.6 The implications of this finding on the effect, duration and protection against COVID-19 for the child was not addressed.
To date, studies of mother-infant dyads with data on feeding practices and COVID-19 infection have come from case reports, case series or a report of a family cluster. Other study designs such as cohort studies or case-control studies were eligible for inclusion, but none were identified. We are thus unable to measure and compare risks of infection based on feeding practices.
Although 1 of the 3 infants of mothers with viral particles in breast milk had COVID-19, it was unclear through which route or source the infant was infected, i.e., through breastfeeding or close contact with the mother or other infected person. RT-PCR detects and amplifies viral genetic material in samples, such as breastmilk, but does not provide information on viability or infectivity of the virus. Documented presence of replicative COVID-19 virus in cell culture from breast milk and infectivity in animal models are needed to consider breast milk as potentially infectious.
The presence of IgA in breast milk is one of the ways in which breastfeeding protects infants against infection and death. IgA antibodies with reactivity to the COVID-19 virus have been detected in breastmilk of mothers previously infected with COVID-19 but their strength and durability have not yet been adequately studied to address protection from COVID-19 among breastfed infants.
Detection of COVID-19 viral RNA in breastmilk is not the same as finding viable and infective virus. Transmission of COVID-19 would need replicative and infectious virus being able to reach target sites in the infant and also to overcome infant defense systems. If in the future COVID-19 virus from breastmilk were shown to be replicative in cell culture it would need to reach target sites in the infant and overcome infant defense systems for transmission of COVID-19 to occur.
The implications of transmission risk need to be framed in terms of COVID-19 prevalence in breastfeeding mothers and the scope and severity of COVID-19 infection in infants when transmission occurs compared to the adverse consequences of separation and using breastmilk substitutes and also separation of newborns and young infants from mothers.
Children appear to be at low risk of COVID-19. Among the cases of confirmed COVID-19 in children, most have experienced only mild or asymptomatic illness.7,8 This is also the case with other zoonotic coronaviruses (SARS-CoV and MERS-CoV), which seem to affect children less commonly and to cause fewer symptoms and less severe disease compared with adults.9
Secretory IgA have been detected in breastmilk of mothers with previous COVID-19 infection. Although the strength and durability of sIgA reactive to COVID-19 have not yet been determined, multiple bioactive components have been identified in breastmilk that not only protect against infections but improve neurocognitive and immunologic development of the child since Lars A Hanson first described sIgA in breastmilk in 1961.10-12
Skin-to-skin contact and kangaroo mother care facilitate breastfeeding as well as improve thermoregulation, blood glucose control, and maternal-infant attachment, and decrease the risk in mortality and severe infection among low birth weight infants.13,14 Beyond the neonatal period, positive effects of mother-infant holding include improved sleep patterns, lower rates of behavioural problems in the child and higher quality parental interaction.15,16
Exclusively breastfed infants, the risk of mortality is 14-fold higher in infants who are not breastfed.17 Over 820 000 childrens lives could be saved every year among children under 5 years, if all children 0-23 months were optimally breastfed. For mothers, breastfeeding protects against breast cancer and may protect against ovarian cancer and type 2 diabetes.18 On the other hand, children are at low risk of COVID-19.
It is still not clear whether the virus can or cannot be transmitted though breast milk. Risk of transmission based on feeding practices have not been quantified, compared, or modelled against the benefits of breastfeeding and nurturing mother-infant interaction.
At present, data are not sufficient to conclude vertical transmission of COVID-19 through breastfeeding. In infants, the risk of COVID-19 infection is low, the infection is typically mild or asymptomatic, while the consequences of not breastfeeding and separation between mother and child can be significant. At this point it appears that COVID-19 in infants and children represents a much lower threat to survival and health than other infections that breastfeeding is protective against. The benefits of breastfeeding and nurturing mother-infant interaction to prevent infection and promote health and development are especially important when health and other community services are themselves disrupted or limited. Adherence to infection prevention and control measures is essential to prevent contact transmission between COVID-19 suspected or confirmed mothers and their newborns and young infants.
Based on available evidence, WHO recommendations on the initiation and continued breastfeeding of infants and young children also apply to mothers with suspected or confirmed COVID-19.
WHO continues to monitor the situation closely for any changes that may affect this interim guidance. Should any factors change, WHO will issue a further update. Otherwise, this scientific brief will expire 2 years after the date of publication.
UNIVERSITY PARK, Pa. - Many epidemiologists believe that the initial COVID-19 infection rate was undercounted due to testing issues, asymptomatic and alternatively symptomatic individuals, and a failure to identify early cases.
Now, a new study from Penn State estimates that the number of early COVID-19 cases in the U.S. may have been more than 80 times greater and doubled nearly twice as fast as originally believed.
In a paper published today (June 22) in the journal Science Translational Medicine, researchers estimated the detection rate of symptomatic COVID-19 cases using the Centers for Disease Control and Preventions influenza-like illnesses (ILI) surveillance data over a three week period in March 2020.
We analyzed each states ILI cases to estimate the number that could not be attributed to influenza and were in excess of seasonal baseline levels, said Justin Silverman, assistant professor in Penn States College of Information Sciences and Technology and Department of Medicine. When you subtract these out, youre left with what we're calling excess ILI cases that can't be explained by either influenza or the typical seasonal variation of respiratory pathogens.
The researchers found that the excess ILI showed a nearly perfect correlation with the spread of COVID-19 around the country.
Said Silverman, This suggests that ILI data is capturing COVID cases, and there appears to be a much greater undiagnosed population than originally thought.
Remarkably, the size of the observed surge of excess ILI corresponds to more than 8.7 million new cases during the last three weeks of March, compared to the roughly 100,000 cases that were officially reported during the same time period.
At first, I couldnt believe our estimates were correct, said Silverman. But we realized that deaths across the U.S. had been doubling every three days and that our estimate of the infection rate was consistent with three-day doubling since the first observed case was reported in Washington state on Jan. 15.
The researchers also used this process to estimate infection rates for each state, noting that states showing higher per capita rates of infection also had higher per capita rates of a surge in excess ILI. Their estimates showed rates much higher than initially reported but closer to those found once states began completing antibody testing.
In New York, for example, the researchers model suggested that at least 9% of the states entire population was infected by the end of March. After the state conducted antibody testing on 3,000 residents, they found a 13.9% infection rate, or 2.7 million New Yorkers.
Excess ILI appears to have peaked in mid-March as, the researchers suggest, fewer patients with mild symptoms sought care and states implemented interventions which led to lower transmission rates. Nearly half of the states in the country were under stay-at-home orders by March 28.
The findings suggest an alternative way of thinking about the COVID-19 pandemic.
Our results suggest that the overwhelming effects of COVID-19 may have less to do with the virus lethality and more to do with how quickly it was able to spread through communities initially, Silverman explained. A lower fatality rate coupled with a higher prevalence of disease and rapid growth of regional epidemics provides an alternative explanation to the large number of deaths and overcrowding of hospitals we have seen in certain areas of the world.
Other collaborators on the project included Nathaniel Hupert of Weill Cornell Medicine and New York-Presbyterian Hospital, and Alex Washburne of Montana State University.
As a trained disaster responder, Dr. Robin Brennen was well versed in proper safety procedures when she entered a coronavirus patients apartment on Manhattans Upper West Side in late March. She pulled on protective plastic bootees, a face mask and an eye shield.
Then, with a gloved hand, she picked up the rest of her equipment: a 5-pound bag of cat kibble and a litter box.
The pandemics devastating human toll in New York City has been well documented. But it has also affected peoples lives in ways that have gotten less attention, including what happens to the pets of those who become seriously ill.
Dr. Brennen, a veterinarian at Animal Care Centers of NYC, is part of a team of specialists who help the animal companions that have been left behind.
Across the city, animal specialists in full-body personal protective gear enter homes to feed, at no charge, famished pets whose owners are hospitalized with the virus, or to take custody of pets belonging to patients who do not return home.
Pet owners who have died of the virus have left behind dogs, guinea pigs and cats, at least one of which starved to death before anyone had checked the owners apartment, according to Animal Care Centers of NYC.
For cats, which are susceptible to coronavirus infection, the citys standard strategy is to essentially quarantine them in their homes for at least 14 days, with city animal specialists monitoring them. (It is unclear whether cats can pass the disease to humans.)
On the Upper West Side that day in March, residents of the co-op building had alerted Dr. Brennens organization that a woman who lived there was in intensive care battling the virus, and that her two beloved cats had been left behind.
Dr. Brennen went in and fed the cats twice a week.
I knew how much she wanted those cats and loved them, she said. And I wanted them to be there for her when she got home.
Ultimately, the cats owner died; a neighbor later adopted them.
They dont have her, but they had people willing to help her, said Dr. Brennen, the animal care organizations vice president of animal health and welfare. And that is something."
Some virus patients, intubated and in intensive care units, have been unable to tell anyone that their dog or cat has been left behind, leaving neighbors to figure it out from plaintive pet sounds down the hall.
In late April, New York Citys emergency management and animal welfare offices introduced a hotline for people who were struggling to care for their pets because of the virus.
Some questions that come into the hotline, which is staffed by members of local animal rescue groups and representatives of the city agencies, are fairly basic. One example: Can my dog get the virus? (There have been few documented cases of dogs contracting the disease.)
The hotlines primary goal is to help struggling or sick New Yorkers avoid surrendering their pets, connecting callers to things like subsidized emergency veterinary medicine and the citys network of free pet food pantries.
But sometimes, surrendering pets is the only option: As of June 17, roughly 145 had been turned over via the hotline. The animals have been cared for by Dr. Brennens organization and by the American Society for the Prevention of Cruelty to Animals in Manhattan.
Animals surrendered by people who have contracted the virus must be quarantined for 14 days. After that, they can be adopted.
It is so important, especially at this time, that this human-animal bond is taken care of, said Christine Kim, the city animal welfare offices senior community liaison. This is the time when people need that the most.
Updated June 22, 2020
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise comes with issues of potential breathing restriction and discomfort and requires balancing benefits versus possible adverse events. Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. In my personal experience, he says, heart rates are higher at the same relative intensity when you wear a mask. Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who dont typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the countrys largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was very rare, but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus whether its surface transmission or close human contact is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nations job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you arent being told to stay at home, its still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If youve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
When Howard Katz, 61, a limousine driver from Massapequa, on Long Island, was hospitalized with the virus in April, his primary concern was not for himself, his sister, Cynthia Hertz, said. Instead, he was worried about Lucy, his Shiba Inu, who was readjusting after surgery for an illness that necessitated removing her eyes.
Ms. Hertz said she and her boyfriend spent three days calling vets, dog boarding facilities and rescue shelters to find someone to care for Lucy. No one would.
They were afraid, she said. Lucy could be carrying the Covid, and nobody was able to help.
A call to the pet hotline connected her with Jenny Coffey, the community engagement director at the rescue group Animal Haven.
The group, which Ms. Coffey said had fielded 215 cases so far, arranged for Lucy to stay at a Long Island boarding facility for three weeks. The cost was covered by a grant from Red Rover, a group that provides financial help to people with pets in crisis.
It was like a lifeline for my brother, said Ms. Hertz, adding that Mr. Katz was overjoyed to be reunited with Lucy after three weeks in a hospital and rehabilitation center. I didnt know if he was going to make it if something had happened to Lucy.
Entering homes where the virus is believed to have been present can be nerve-racking, said Feraz Mohammed, an animal control officer at Animal Care Centers of NYC.
On one recent day, Mr. Mohammed drove an agency van covered with images of cats and dogs to a South Bronx apartment building. A resident who was thought to have contracted the virus had been hospitalized; her dog and cat had not had food or water for five days.
Mr. Mohammed pulled on a mask, gloves and a Tyvek suit, meticulously sealing the openings around his wrists and ankles with tape. Then he grabbed his dog-catching stick and cat carrier.
Upstairs, a blond mop of a dog bounded out of the apartment, a blur of canine joy. Mr. Mohammed snapped a leash on the small dog and then went inside. He fished a tabby cat out from under the couch, and he cooed gently at the two pets as he brought them downstairs and locked them in cages in the truck.
Once we get them fed, get them water, he said, stroking the little dogs head, it makes me feel better about all of this.
(CNN) - Whether a person gets a severe form of COVID-19 could depend on blood type and their DNA, according to a new study conducted by a team of European scientists.
Their findings, published in the New England Journal of Medicine, could help explain why some people get seriously ill with the virus while most barely show any symptoms at all.
The researchers found people with type A blood are at a higher risk of contracting the virus and getting extremely sick from it, while people with type O blood have a lower risk.
The researchers can't say if your blood type is the main reason you may be more or less susceptible to the virus, but they detected genetic variations common in the sickest patients and those could just happen to be linked to a person's blood type.
The variations could be associated with a person's immune response.
An overwhelming overreaction of the immune system is blamed for the deadliest effects of the coronavirus in many patients.
The difference in risk between blood types is small. Researchers say the findings are more useful for designing drugs or vaccines against coronavirus.
Its still unclear how good COVID-19 tests are at finding these presymptomatic cases, but the timing of the test matters. As soon as the coronavirus finds its way into a new host, it hijacks cells to copy itself. The amount of virus builds over this time, peaking at or right before symptom onset, which can take two to 14 days but usually takes an average of five or six. Accordingly, public-health authorities have advised getting tested about four days after exposure.
Read: The protests will spread the coronavirus
This is a reasonable recommendation, given the knowns, but surprisingly little data exists on how early COVID-19 tests can detect infection before symptom onset. One model using COVID-19 cases from seven previously published studies suggests that the false-negative rate is 100 percent on day one of exposure, which falls to 38 percent on day five (when symptoms on average appear) and then a minimum of 20 percent on day eight. But in combing the literature, the researchers behind this model found only one case where a patient was tested before feeling sickas part of a cluster at a chalet in the French Alps. Moreover, the model doesnt address a whole other set of people who never develop symptoms at all. It gave no information about people who are permanently asymptomatic, Justin Lessler, an epidemiologist at Johns Hopkins University who co-authored that study, told me.
More data are likely to come soon. On Tuesday, the Food and Drug Administration released recommendations for labs and manufacturers that want to validate COVID-19 tests in people who dont have symptoms. (Currently, no tests are FDA-authorized for screening asymptomatic people.) Testing large numbers of asymptomatic peoplesuch as by pooling samplesto identify potential silent carriers will also be an essential part of the reopening strategy for schools and businesses.
Read: COVID-19 can last for several months
For individuals, however, the FDA cautions that negative results do not rule out infection. It asks that asymptomatic tests include this statement: Negative results must be considered in the context of an individuals recent exposures, history, presence of clinical signs and symptoms consistent with COVID-19. And this, in the face of imperfect COVID-19 tests, is key to interpreting a negative result. It depends on your probability of having COVID-19 in the first place.
Consider again the decision to visit elderly relatives after a negative test. If you have symptoms or you work in a place where youre at high risk for exposure, then even with a negative test, you might want to think really hard about it, Steven Woloshin, a co-director of the Center for Medicine and Media at the Dartmouth Institute, explained to me. If youre at low risk because you live in some remote area, youre practicing social distancing, you always wear a mask, and you feel fine, a negative test is probably a true negative. So even with widespread testing, social distancing and masks will continue to be important for controlling the spread of COVID-19.
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World No. 1 Novak Djokovic is among four players who have tested positive for COVID-19 following their participation in the Adria Tour, an exhibition series.
Djokovic confirmed today that he and his wife Jelena had tested positive for the virus. Grigor Dimitrov, Borna Coric and Viktor Troicki, who also played in the series, which has made stops in Belgrade, Serbia, and Zadar, Croatia, have also tested positive.
Djokovic said in a statement: "We organised the tournament at the moment when the virus has weakened, believing that the conditions for hosting the tour had been met... I am extremely sorry for each individual case of infection. I hope that it will not complicate anyone's health situation and that everyone will be fine."
Djokovic said that he would self-isolate for the next 14 days and that he would have another test in five days.
Djokovic, who is now back in Belgrade, issued a second statement Tuesday evening (CET), saying in part, "I am so deeply sorry our tournament has caused harm. Everything the organisers and I did the past month, we did with a pure heart and sincere intentions. We believe the tournament met all the health protocols and the health of our region seemed in good condition to finally unite people for philanthropic reasons. We were wrong and it was too soon. I cant express enough how sorry I am for this and every case of infection."
Djokovic confirmed that his two children had tested negative for the virus.
ATP STATEMENT ON POSITIVE COVID-19 TESTSThe ATP wishes a complete and quick recovery for the ATP players and members of their staff who tested positive for COVID-19 following involvement in the Adria Tour exhibition tournament. The ATP continues to urge strict adherence to responsible social distancing and health and safety guidelines to contain the spread of the virus.
In planning for the resumption of the ATP Tour season from 14 August, ATP and other stakeholders have made exhaustive plans to mitigate risks through a variety of precautions and protocols to be implemented at ATP events. We continue to plan and adjust these precautions and protocols according to latest medical information and prioritise safety in assessing every decision.
Editor's Note: This story was updated Tuesday 8.45pm CEST to include an excerpt of Novak Djokovic's additional statement.
ThePhiladelphia Philliestested 32 additional players and staff members following a coronavirus outbreak at the team's spring training facility in Clearwater, Florida last week. On Monday, the team announced one player and two additional staff members in Clearwater tested positive for COVID-19. The team also said another player who had not been at the club's spring facility tested positive, bringing the total number of cases in the organization to 12 (seven players and five staff members).
Five Phillies players and three staff members have tested positive for the novel coronavirus (COVID-19)last week, the team confirmed on Friday. The identities of those infected is unknown.
Soon after the Phillies announced the original eight cases Friday, the Toronto Blue Jaysclosed their Dunedin, Florida. spring training facilityafter a pitcher on the 40-man roster began experiencing COVID-19 symptoms. The pitcher had recently spent time with players in the Phillies' minor league system, and Toronto's spring complex in Dunedin is 2.4 miles apart from the Phillies' Clearwater facility. MLB reportedly ordered all spring training facilities shut down and disinfected Friday.
The Phillies released the following statement Friday:
Phillies are confirming that five players and three staff members working at the club's Clearwater facility have tested positive for COVID-19. The first confirmed case occurred this past Tuesday, June 16. In addition, eight staff members have tested negative for the virus, while 12 staff members and 20 players (both major league and minor league players) living in the Clearwater area are in the process of being tested and are awaiting the results of those tests.
Managing Partner John Middleton said, "The Phillies are committed to the health and welfare of our players, coaches and staff as our highest priority, and as a result of these confirmed tests, all facilities in Clearwater have been closed indefinitely to all players, coaches and staff and will remain closed until medical authorities are confident that the virus is under control and our facilities are disinfected."
In terms of the implications of this outbreak on the Phillies' 2020 season, the club declines comment, believing that it is too early to know.
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In addition, theSan Francisco Giantshave shut down their training facility in Scottsdale, Arizona.Per Andrew Baggarly, Giants president of baseball operations Farhan Zaidi said the decision was made "after one person who had been in the facility and one family member exhibited mild symptoms and were tested."
The Astros on Friday also announced that a player at their Palm Beach, Florida facilities tested positive "several days ago" and is recovering after experiencing mild symptoms.
In Florida -- where the state's reopening process has started-- the daily total of coronavirus cases is rising with the state's hospitalization count nearly doubling since May 4. Clearwater is in Pinellas County, which had record-high single-day case numbers, with 203 new COVID-19 cases on Thursday. Cases have also surged in Arizona recently.
The COVID-19 outbreak comes withnegotiations between MLB and the Players Associationat their end. MLB commissioner Rob Manfred said Monday night that he is planning to implement a 2020 season, which could reportedly start July 24.
Coronavirus: California sets another daily record as Bay Area surges past 20,000 cases The Mercury News
