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Coronavirus Disease Weekly News

The news posted last week for the coronavirus 2019-nCoV (aka SARS-CoV-2), which produces COVID-19 disease, has been surveyed and some important articles are summarized here. The articles are more or less organized with general virus news and anecdotes first, then stories from around the US, followed by news from other countries around the globe.

US totals are rising again due to sharp increases in the sunbelt. We set a record for new cases nearly every day this week. New cases have nearly tripled since the 2nd week of June. Economic news related to COVID-19 is found here.

How Exactly Do You Catch Covid-19? There Is a Growing Consensus – WSJ – Six months into the coronavirus crisis, there’s a growing consensus about a central question: How do people become infected? It’s not common to contract Covid-19 from a contaminated surface, scientists say. And fleeting encounters with people outdoors are unlikely to spread the coronavirus. Instead, the major culprit is close-up, person-to-person interactions for extended periods. Crowded events, poorly ventilated areas and places where people are talking loudly – or singing, in one famous case – maximize the risk. These emerging findings are helping businesses and governments devise reopening strategies to protect public health while getting economies going again. That includes tactics like installing plexiglass barriers, requiring people to wear masks in stores and other venues, using good ventilation systems and keeping windows open when possible. Two recent large studies showed that wide-scale lockdowns – stay-at-home orders, bans on large gatherings and business closures – prevented millions of infections and deaths around the world. Now, with more knowledge in hand, cities and states can deploy targeted interventions to keep the virus from taking off again, scientists and public-health experts said. That means better protections for nursing-home residents and multigenerational families living in crowded conditions, they said. It also means stressing physical distancing and masks, and reducing the number of gatherings in enclosed spaces. “We should not be thinking of a lockdown, but of ways to increase physical distance,” . “This can include allowing outside activities, allowing walking or cycling to an office with people all physically distant, curbside pickup from stores, and other innovative methods that can facilitate resumption of economic activity without a rekindling of the outbreak.” One important factor in transmission is that seemingly benign activities like speaking and breathing produce respiratory bits of varying sizes that can disperse along air currents and potentially infect people nearby. Health agencies have so far identified respiratory-droplet contact as the major mode of Covid-19 transmission. These large fluid droplets can transfer virus from one person to another if they land on the eyes, nose or mouth. But they tend to fall to the ground or on other surfaces pretty quickly. Some researchers say the new coronavirus can also be transmitted through aerosols, or minuscule droplets that float in the air longer than large droplets. These aerosols can be directly inhaled.

How the Coronavirus Short-Circuits the Immune System – At the beginning of the pandemic, the coronavirus looked to be another respiratory illness. But the virus has turned out to affect not just the lungs, but the kidneys, the heart and the circulatory system – even, somehow, our senses of smell and taste. Now researchers have discovered yet another unpleasant surprise. In many patients hospitalized with the coronavirus, the immune system is threatened by a depletion of certain essential cells, suggesting eerie parallels with H.I.V. The findings suggest that a popular treatment to tamp down the immune system in severely ill patients may help a few, but could harm many others. The research offers clues about why very few children get sick when they are infected, and hints that a cocktail of drugs may be needed to bring the coronavirus under control, as is the case with H.I.V. Growing research points to “very complex immunological signatures of the virus,” said Dr. John Wherry, an immunologist at the University of Pennsylvania whose lab is taking a detailed look at the immune systems of Covid-19 patients. In May, Dr. Wherry and his colleagues posted online a paper showing a range of immune system defects in severely ill patients, including a loss of virus-fighting T cells in parts of the body. In a separate study, the investigators identified three patterns of immune defects, and concluded that T cells and B cells, which help orchestrate the immune response, were inactive in roughly 30 percent of the 71 Covid-19 patients they examined. None of the papers have yet been published or peer reviewed. Researchers in China have reported a similar depletion of T cells in critically ill patients, Dr. Wherry noted. But the emerging data could be difficult to interpret, he said – “like a Rorschach test.” Research with severely ill Covid-19 patients is fraught with difficulties, noted Dr. Carl June, an immunologist at the University of Pennsylvania who was not involved with the work. “It is hard to separate the effects of simply being critically ill and in an I.C.U., which can cause havoc on your immune system,” he said. “What is missing is a control population infected with another severe virus, like influenza.”

Coronavirus: Asymptomatic People Can Still Develop Lung Damage — The first patient with COVID-19 that presented to my hospital was probably typical of initial patients in many other hospitals at the time. He was an elderly man with pneumonia, as yet untested for the new coronavirus but presumed to have it. An expert team carefully assessed him, prescribed high-flow oxygen and monitored him on a respiratory ward. He died unexpectedly that night. The second patient was a middle-aged woman referred to the intensive care unit for mechanical ventilation. The recent death had made me nervous, so I went to assess her. On my way to the ward, I imagined the picture that awaited me – a patient gasping for air, barely able to speak, chest heaving with the effort of trying to drive oxygen into her blood. When I arrived decked out in full PPE and ready to sedate her for immediate ventilation, I thought I had arrived at the wrong bed. She sat comfortably on her chair, speaking on her mobile phone to her daughter, bemused by my appearance. Overcautious colleagues, I thought, but measured her blood oxygen saturation just in case, more from instinct than concern. From her appearance I expected it to be close to normal (100%). It was 75% – a level barely compatible with being conscious. I quickly learned that many patients with advanced COVID-19 disease bore none of the hallmarks of severe respiratory illness until they suddenly collapsed and died. The science behind this early lesson is now emerging, with a study from Wuhan, China, describing pathological lung changes on CT scans of completely asymptomatic patients. Asymptomatic carriage is not uncommon in other virulent infections, such as MRSA and C diff, but what is striking with SARS-CoV-2 (the virus that causes COVID-19) is that it may be accompanied by underlying organ damage. The researchers found lesions consistent with inflammation of the underlying lung tissue (ground-glass opacities and consolidation, to use the medical jargon), which are not specific to SARS-CoV-2 infection and may be seen in many other forms of lung disease. What remains a mystery is why, despite these changes, patients do not display typical symptoms of pneumonia, such as severe shortness of breath. About a quarter of the patients in the study developed a fever, cough and shortness of breath – but many did not. The idiosyncratic response to infection is one of several conundrums of COVID-19, such as why it targets certain groups and not others – two people with exactly the same demography and health may express the disease at opposite ends of the spectrum. The study reinforces that absence of symptoms does not imply the absence of harm. Lack of symptoms in the face of active pathology carries a risk both to infected individuals and to the public. Current advice encourages patients to stay at home if they are asymptomatic, making late presentation to hospital and sudden death a distinct risk.

Not just the lungs: Covid-19 attacks like no other ‘respiratory’ virus – The reports seemed to take doctors by surprise: The “respiratory” virus that causes Covid-19 made some patients nauseous. It left others unable to smell. In some, it caused acute kidney injury. As the pandemic grew from an outbreak affecting thousands in Wuhan, China, to some 10 million cases and 500,000 deaths globally as of late June, the list of symptoms has also exploded. The Centers for Disease Control and Prevention constantly scrambled to update its list in an effort to help clinicians identify likely cases, a crucial diagnostic aid at a time when swab tests were in short supply and typically took (and still take) days to return results. The loss of a sense of smell made the list only in late April. “For many diseases, it can take years before we fully characterize the different ways that it affects people,” said nephrologist Dan Negoianu of Penn Medicine. “Even now, we are still very early in the process of understanding this disease.” What they are understanding is that this coronavirus “has such a diversity of effects on so many different organs, it keeps us up at night,” said Thomas McGinn, deputy physician in chief at Northwell Health and director of the Feinstein Institutes for Medical Research. “It’s amazing how many different ways it affects the body.” One early hint that that would be the case came in late January, when scientists in China identified one of the two receptors by which the coronavirus, SARS-CoV-2, enters cells. It was the same gateway, called the ACE2 receptor, that the original SARS virus used. Studies going back some two decades had mapped the body’s ACE2 receptors, showing that they’re in cells that line the insides of blood vessels – in what are called vascular endothelial cells – in cells of the kidney’s tubules, in the gastrointestinal tract, and even in the testes. Infecting cells is only the first way SARS-CoV-2 wreaks havoc. Patients with severe Covid-19 also suffer a runaway inflammatory response and, often, clot formation, said infectious disease physician Rochelle Walensky of Massachusetts General Hospital. That can cause symptoms as different as a lack of blood flow to the intestines and the red, inflamed “Covid toe.” “We’ve had five cases of patients who’ve had to have their gut removed,” Walensky said. “You see these cases and you say, wait a minute; the virus is doing this, too? It has definitely been keeping us on our toes.”

Coronavirus damages the endocrine system –People with endocrine disorders may see their condition worsen as a result of COVID-19, according to a new review published in the Journal of the Endocrine Society. “We explored the previous SARS outbreak caused by the very similar virus SARS-CoV-1 to advise endocrinologists involved in the care of patients with COVID-19,” said Noel Pratheepan Somasundaram of the National Hospital of Sri Lanka in Colombo, Sri Lanka. “The virus that causes COVID-19–SARS-CoV-2–binds to the ACE2 receptor, a protein which is expressed in many tissues. This allows the virus to enter endocrine cells and cause the mayhem associated with the disease.” SARS-CoV-2 can cause loss of smell and gain entry to the brain. In past coronavirus infections such as the SARS epidemic in 2003, many patients developed a post-viral syndrome with fatigue. This could in part be caused by adrenal insufficiency, a condition where the adrenal glands do not make enough cortisol, as a result of damage to the pituitary system. During the SARS epidemic, patients who developed adrenal insufficiency typically recovered within one year. “Testing for cortisol deficiency and treating patients with steroids may become a vital treatment strategy,” Somasundaram said. “Very recent studies have demonstrated lowered mortality in severely-ill patients with COVID-19 treated with the steroid dexamethasone.” COVID-19 also could lead to new cases of diabetes and worsening of existing diabetes. The SARS-CoV-2 virus attaches to ACE2, the main entry point into cells for coronavirus, and disrupts insulin production, causing high blood glucose levels in some patients. The authors highlight the need for strict glucose monitoring in patients with COVID-19 as a measure to maximize recovery. “People with vitamin D deficiency may be more susceptible to coronavirus and supplementation could improve outcomes, though evidence on the subject is mixed,”

Covid-19 brain complications include strokes and psychosis — A new survey reveals a wide range of serious psychiatric and neurological complications tied to Covid-19 – including stroke, psychosis, and a dementia-like syndrome. The study underscores how aggressively the coronavirus can attack beyond the lungs, and the risk the disease can pose to younger adults.The study looked at 125 hospitalized patients with Covid-19 who also had some sort of neuropsychiatric complication. Fifty-seven had had an ischemic stroke, caused by a blood clot in the brain. The second most common issue, affecting 39 patients, was an altered mental state, researchers reported. That included encephalitis (an inflammation of the brain that can cause a number of symptoms, from confusion to mobility problems) and encephalopathy (a general term for a disease that alters brain function). Ten patients were newly diagnosed with psychosis, and six had cognitive issues akin to dementia, according to the study, published in the Lancet Psychiatry.“What was particularly interesting was that this spanned the neurological spectrum,” said senior a uthor Benedict Michael of the University of Liverpool, a neurologist specializing in infectious diseases.The people in the study ranged from their 20s to their 90s, and the researchers noted that, because they focused on hospitalized patients, the complications detailed likely represent the most serious ones. Whereas the strokes were more common among older patients, the researchers found that about half of those who experienced altered mental status were younger than 60. Smaller studies and case reports from China and other European countries had raised the connection between Covid-19 and neuropsychiatric complications, but for the new study, the researchers set out to get a full picture of the range of those complications. To amass as broad a data set as possible, they built a reporting network across the United Kingdom that enlisted specialists in stroke, neurology, psychiatry, and critical care. “Everybody is focused on mortality, which they should, and respiratory problems, which is the main cause of death,” said Mark George, a psychiatrist and neurologist at the Medical University of South Carolina. But, George said, “the virus certainly does have brain effects.”

Three Stages to COVID-19 Brain Damage, New Review Suggests — In stage 1, viral damage is limited to epithelial cells of the nose and mouth, and in stage 2 blood clots that form in the lungs may travel to the brain, leading tostroke. In stage 3, the virus crosses the blood – brain barrier and invades the brain.”Our major take-home points are that patients with COVID-19 symptoms, such as shortness of breath, headache, or dizziness, may have neurological symptoms that, at the time of hospitalization, might not be noticed or prioritized, or whose neurological symptoms may become apparent only after they leave the hospital,” lead author Majid Fotuhi, MD, PhD, medical director of NeuroGrow Brain Fitness Center, McLean, Virginia, told Medscape Medical News.”Hospitalized patients with COVID-19 should have a neurological evaluation and ideally a brain MRI before leaving the hospital; and, if there are abnormalities, they should follow up with a neurologist in 3 to 4 months,” said Fotuhi, who is also affiliate staff at Johns Hopkins Medicine in Baltimore, Maryland. The review was published online June 8 in the Journal of Alzheimer’s Disease.It has become “increasingly evident” that SARS-CoV-2 can cause neurologic manifestations, including anosmia, seizures, stroke, confusion, encephalopathy, and total paralysis, the authors write.The authors note that SARS-CoV-2 binds to angiotensin-converting enzyme 2 (ACE2) that facilitates the conversion of angiotensin II to angiotensin. After ACE2 has bound to respiratory epithelial cells, and then to epithelial cells in blood vessels, SARS-CoV-2 triggers the formation of a “cytokine storm.”These cytokines, in turn, increase vascular permeability, edema, and widespread inflammation, as well as triggering “hypercoagulation cascades,” which cause small and large blood clots that affect multiple organs.If SARS-CoV-2 crosses the blood – brain barrier, directly entering the brain, it can contribute to demyelination or neurodegeneration.”We very thoroughly reviewed the literature published between January 1 and May 1, 2020 about neurological issues [in COVID-19] and what I found interesting is that so many neurological things can happen due to a virus which is so small,” said Fotuhi.”This virus’ DNA has such limited information, and yet it can wreak havoc on our nervous system because it kicks off such a potent defense system in our body that damages our nervous system,” he said.

‘Significant number’ of people may have some natural immunity to coronavirus — Large numbers of the population may have natural immunity against coronavirus even if they have never been infected, scientists believe. Sir John Bell, Regius Professor of Medicine at Oxford University, who is leading an Oxford team to develop a vaccine, said there was likely to be a “background level” of protection for a “significant number of people”. Recent studies have suggested the immune system can be primed by other coronaviruses, such as the common cold, giving the body a head start in fighting off Covid-19. Research shows that a separate part of the immune system, T-cells, respond to chains of amino acids produced by different types of coronaviruses and may be responsible for stopping the virus in people who never show symptoms. Crucially, those T-cells die off in older people, which may be why they are far more likely to develop a more serious illness. Speaking to the Commons science and technology select committee, Sir John said: “What seems clear is you do have cross-reaction from T-cells that are activated by standard endemic coronaviruses. I think they are present in quite a significant number of people. “So there is probably background T-cell immunity in people before they see the coronavirus, and that may be relevant that many people get a pretty asymptomatic disease. “Those T-cells get a bit tired once you’re beyond the age of 65 and may not be as effective at removing a virus, so that may explain a number of different features of the disease.” The vaccine being developed by Oxford University has been found not only to stimulate antibodies but also to boost T-cell response. But many more people may already have some protection, suggesting herd immunity will be easier and quicker to establish, the research suggests.

The list of who’s most at risk for severe cases of COVID-19 just got longer, CDC says – The older you are, the greater your risk of suffering a severe case of COVID-19, according to new guidance from the Centers for Disease Control and Prevention.The CDC has previously warned that people over 65 were especially vulnerable to severe illness if they became infected by the coronavirus. And that is still true.But more recent data from across the United States show that younger adults are also at risk and should not assume they will be spared from a serious case of the disease.“CDC now warns that among adults, risk increases steadily as you age, and it’s not just those over the age of 65 who are at increased risk for severe illness,” the agencywarned Thursday. “Age is an independent risk factor for severe illness.”Data published last week in the CDC’s Morbidity and Mortality Weekly Report revealed that the median age of Americans with confirmed coronavirus cases was 48 years old. That means half of those infected were older than 48 and half were younger. In fact, among more than 1.3 million cases reported through May 30, the incidence was higher among people in their 40s and 50s than for those in their 60s and 70s. Specifically, there were 541.6 cases per 100,000 people ages 40 to 49 and 550.5 cases per 100,000 people ages 50 to 59, compared with 478.4 cases per 100,000 people ages 60 to 69 and 464.2 cases per 100,000 people ages 70 to 79. The highest incidence was seen in the oldest Americans, with 902 cases per 100,000 people ages 80 and up, according to the report. Among those who become infected with the coronavirus, the risk of dying from COVID-19 increases sharply with age, the latest data show. Although the overall mortality rate for those 1.3 million cases was 5.4%, it was 1% or lower for Americans under 50. However, it was 2.4% for those in their 50s, 6.7% for those in their 60s, 16.6% for those in their 70s and 28.7% for those 80 and up.

As coronavirus spreads to people under 40, it’s making them sicker – and for longer – than once thought For the first few months of the coronavirus pandemic, health and government officials assured the public that young people were at little or no risk of falling seriously ill from COVID-19. But many young people who have contracted the virus tell a very different story, one that should serve as a warning to young adults in the Southern and Western states where infections are surging. Last week President Trump discounted the risks COVID-19 poses to young people, saying that increased testing was inflating the numbers of the disease among “young people that don’t have a problem.”But as the number of new cases of the disease has swelled by 76 percent in the U.S. over the past 14 days, young people who considered themselves in little danger from the virus are the ones being admitted to hospitals. Testifying before the House Energy and Commerce Committee last week, Dr. Anthony Fauci, the leading expert on infectious diseases on the coronavirus task force, contradicted Trump’s view that young people “don’t have a problem” with COVID-19.“To think young people have no deleterious consequences is not true. We’re seeing more and more complications in young people,” Fauci said, adding that “some get mild symptoms and some get symptoms enough to put them at home for a few days. Some are in bed for weeks and have symptoms even after they recover, others go to the hospital, some require oxygen, some require intensive care, some get intubated and some die.”While researchers are still trying to determine the extent of the lasting damage inflicted by COVID-19, one thing is clear: Just because the disease may not kill you doesn’t mean it will make you stronger. Studies conducted so far point to possible long-term heart damage, scarring of the lungs, impact on the nervous system and a higher incidence of stroke.

Why Meatpacking Plants Are Superspreaders – If there is a paradise for SARS-CoV-2, it would probably be a slaughterhouse. Work units in meat plants are cooled to under 12 degrees Celsius. Workers stand near one another and sweat as they labor under pressure – an ideal situation for viruses transmitted by droplets, aerosols or contact. Canadian and British researchers working under Quentin Durand-Moreau of the University of Alberta have studied the working conditions in meat plants. The “metallic surfaces” and the “low temperatures,” they report, enhance the longevity of viruses like SARS-CoV-2. They also explain that the plants are often very loud: “The need for raised voices to overcome noise may increase transmission of SARS-CoV-2,” the researchers wrote. Workers, they argue, also feel pressured by their precarious work situation to “keep working despite having symptoms of COVID-19.” “The working conditions in the slaughterhouses cannot be reconciled with the hygiene measures that are currently necessary,” warns Isabella Eckerle, the head of Geneva Center for Emerging Viral Diseases. At the Tönnies slaughterhouse, the virologist says, the large number of infected employees points to “an undetected superspreading event.” She explains that, if there was close contact and unfavorable working and living conditions, a single infected person or a small number of infected people could potentially have infected many other employees. “The physical exertion during the work, which leads to greater virus expulsion, is another possible factor,” Eckerle says. Damp hands and gloves, aprons and clothing worn during meat handling could also facilitate the virus being transmitted via smear infections.Coronaviruses have a relatively strong, fatty shell that gives them a kind of rubber-like protection in cool conditions. That makes them robust. Researchers have already shown that SARS-CoV-2 can survive up to 72 hours on surfaces in temperatures between 21 and 23 degrees Celsius (70 and 73 degrees Fahrenheit). Lower temperatures extend that time even further. Experiments show that the viruses can survive longer than 28 days at 4 degrees Celsius.Coolness is also ideal for the spread of SARS-CoV-2. Health expert Tom Jefferson from Oxford University says the virus transmits best at temperatures between 0 and 10 degrees, with low humidity, high air pressure and little wind. High temperatures and strong UV radiation, he says, inhibit the spread of the virus.

Nursing Homes Account For 11% Of COVID-19 Cases, 43% Of Deaths In US – 43% of all COVID-19 deaths in the United States are residents or employees of nursing homes or other long-term care (LTC) facilities, according to the New York Times (which fails to mention that New York Governor Andrew Cuomo ordered NY nursing homes to accept coronavirus patients from hospitals). Nursing homes, meanwhile, account for just 11% of all COVID-19 cases in the United States. To date, just over 125,000 people in the US have died of COVID-19, 54,000 of which were linked to LTC facilities. By state, New Hampshire LTC facilities are at the top of the list – accounting 80% of COVID-19 deaths in the state. Rhode Island and Minnesota are tied at 77%, while Connecticut comes in at 73% of deaths linked to nursing homes. The share of deaths linked to long-term care facilities for older adults is even starker at the state level. In 24 states, the number of residents and workers who have died accounts for either half or more than half of all deaths from the virus. Infected people linked to nursing homes also die at a higher rate than the general population. The median case fatality rate – the number of deaths divided by the number of cases – at facilities with reliable data is 17 percent, significantly higher than the 5 percent case fatality rate nationwide. -New York Times And while New York ranks at the bottom of the pack when it comes to LTC facility deaths as a percentage of overall deaths in the state, New York nursing homes come in 2nd on the list after New Jersey in terms of overall deaths in LTC facilities, at 6,432.

“The patients in March didn’t have to die like this, if we would have had more staff and better equipment to work with” – The WSWS recently spoke with a respiratory therapist at Elmhurst Hospital in Queens, New York City, about her experiences in the coronavirus pandemic. For two months, from March through April, Elmhurst Hospital, which serves a large and predominantly immigrant working class community, was “the epicenter of the epicenter” of the COVID pandemic in the US. Respiratory therapists are trained to treat patients with severe respiratory diseases and operate ventilators and other respiratory equipment. They are, therefore, indispensable for the treatment of critically ill COVID-19 patients. Patricia has worked with intubated patients for 22 years. At several points during the interview, she was overcome with emotion, recalling the deeply traumatic experiences of the past months. “We started getting patients in late February, but we didn’t realize they were COVID positive until March. It came on so fast, we were not prepared at all, we tried, but the amount of patients coming with COVID was more than we anticipated.” Later scientific models found that already in early March about 10,000 people must have been infected with the virus in New York. In fact, March, Patricia told the WSWS, was “the hardest month” at Elmhurst. “We had practically no staff and we were not able to get to everybody. We had multiple codes, rapid response teams, and intubations at once. Although there were MDs [doctors] and nurses at these events, we could barely keep up with bringing vents and BiPAPs [Bilevel Positive Airway Pressure machines for non-invasive ventilation] to the floors for intubation. We had to choose who we could help. So many floors were paging us at once. It was so overwhelming physically and emotionally.” She said that they had to “beg” their administrator for more staff. When she proposed that the hospital hire respiratory therapists from agencies for $4,500 to $7,000 a week, he responded, “I’m not paying that.” In late March, an ER doctor from Elmhurst Hospital, Colleen Smith, published a desperate video plea for help in the New York Times, calling conditions at the hospital “apocalyptic.” By then, refrigerated trucks and makeshift morgues were beginning to appear outside major hospitals in New York City. “Prior to getting help, it was pure hell. Ten to 20 patients would die daily. Most of the time you would have two to three floors to yourself and/or multiple ICU units. That’s about 20 to 30 vents to yourself, in addition to responding to cardiac arrests, rapid response teams, transporting vent dependent patients to units or procedures, and trying to give meds. And we were trying to help out our colleagues as well. “Initially, we would have five respiratory therapists for the day shift and four at nights, but this went down as March went on, due to people getting sick and quitting on us. Two elderly co-workers put in their papers early because they were overwhelmed. Another quit because he got sick and was stressed out. Another coworker got really sick and was intubated. He’s not intubated anymore, but it will take a long time for him to recover. He is not the same.” She estimated that five or more hospital workers had died from COVID-19 at Elmhurst.

Public Transit Use Largely Responsible For ‘Racial Discrepancy’ In COVID-19 Death Rates – Black and Hispanic Americans have been dying of the coronavirus at rates 3.5x those of white Americans. For weeks now, politicians and activists have cited these data as evidence that “white supremacy” does, in fact, exist, since minorities – they argued – were more likely to work low-paid “essential” jobs at grocery stores, pharmacies, etc. As it turns out, these theories, reported as if they were undeniable truths by the mainstream press (including the New York Times & Washington Post), didn’t tell the whole story. While it’s true minorities are dying at higher rates than white people from COVID-19, several recently published studies have determined that these higher mortality rates are likely connected to their higher use of public transit to commute to work – either via subway or bus. Furthermore, the study finds, elevated infection and mortality rates impact all people who take public transit, regardless of racial or economic status. A study supervised and published by University of Virginia economist John McLaren found that the racial discrepancy remained even after controlling for income and health insurance rates. At first, this result puzzled the team of economists. Until they examined these infection rates through a different lens: that of transportation. About 10.4% of black commuters take public transit, versus 3.4% of white commuters, according to Census data. McLaren and his team found that by controlling for the use of public transit, the racial disparity in COVID-19 deaths becomes far less pronounced. This suggests that no matter what your job, or your race, one of the most dangerous things you can do to put yourself at risk during the outbreak is to rely on public transit, be it buses or subways, in NYC, or elsewhere.

Gilead Will Charge More Than $3,000 For A Course Of COVID-19 Drug Remdesivir – All those stories about patients being billed for tens of thousands of dollars for coronavirus-related care elicited promises from the White House that “everything will be covered”. Still, as thousands of Americans complain about charges related to COVID-19 testing and care being passed on by their insurance companies, Gilead, the pharmaceutical company that has pushed remdesivir down the world’s throat despite the fact that the cheap steroid dexamethasone has proven – in at least one high quality study – more effective at lowering mortality rates, has just published its expected pricetag for a five-dose course of the drug. On Monday, Gilead disclosed its pricing plan for Gilead as it prepares to begin charging for the drug at the beginning of next month (several international governments have already placed orders). Given the high demand, thanks in part due to the breathless media coverage despite the drug’s still-questionable study data, Gilead apparently feels justified in charging $3,120 for a patient getting the shorter, more common, treatment course, and $5,720 for the longer course for more seriously ill patients. These are the prices for patients with commercial insurance in the US, according to Gilead’s official pricing plan. As per usual, the price charged to those on government plans will be lower, and hospitals will also receive a slight discount. Additionally, the US is the only developed country where Gilead will charge two prices, according to Gilead CEO Daniel O’Day. In much of Europe and Canada, governments negotiate drug prices directly with drugmakers (in the US, laws dictate that drug makers must “discount” their drugs for medicare and medicaid plans). But according to O’Day, the drug is priced “far below the value it brings” to the health-care system. However, we’d argue that this actually isn’t true. Remdesivir was developed by Gilead to treat Ebola, but the drug was never approved by the FDA for this use, which caused Gilead to shelve the drug until COVID-19 presented another opportunity. Even before the first study had finished, the company was already pushing propaganda about the promising nature of the drug. Meanwhile, the CDC, WHO and other organizations were raising doubts about the effectiveness of steroid medications. Months later, the only study on the steroid dexomethasone, a cheap steroid that costs less than $50 for a 100-dose regimen, has shown that dexomethasone is the only drug so far that has proven effective at lowering COVID-19 related mortality. Remdesivir, despite the fact that it has been tested in several high quality trials, has not.

US buys up world stock of key Covid-19 drug remdesivir — The US has bought up virtually all the stocks for the next three months of one of the two drugs proven to work against Covid-19, leaving none for the UK, Europe or most of the rest of the world. Experts and campaigners are alarmed both by the US unilateral action on remdesivir and the wider implications, for instance in the event of a vaccine becoming available. The Trump administration has already shown that it is prepared to outbid and outmanoeuvre all other countries to secure the medical supplies it needs for the US. “They’ve got access to most of the drug supply [of remdesivir], so there’s nothing for Europe,” said Dr Andrew Hill, senior visiting research fellow at Liverpool University. Remdesivir, the first drug approved by licensing authorities in the US to treat Covid-19, is made by Gilead and has been shown to help people recover faster from the disease. The first 140,000 doses, supplied to drug trials around the world, have been used up. The Trump administration has now bought more than 500,000 doses, which is all of Gilead’s production for July and 90% of August and September. “President Trump has struck an amazing deal to ensure Americans have access to the first authorised therapeutic for Covid-19,” said the US health and human services secretary, Alex Azar. “To the extent possible, we want to ensure that any American patient who needs remdesivir can get it. The Trump administration is doing everything in our power to learn more about life-saving therapeutics for Covid-19 and secure access to these options for the American people.” The drug, which was invented for Ebola but failed to work, is under patent to Gilead, which means no other company in wealthy countries can make it. The cost is around $3,200 per treatment of six doses, according to the US government statement. The US has recorded more than 2.5 million confirmed cases of Covid-19. Some states lifted restrictions only to have to clamp down again. On Monday, the governor of Arizona ordered bars, cinemas, gyms and water parks to shut down for a month, weeks after they reopened. Texas, Florida and California, all seeing rises in cases, have also reimposed restrictions. Buying up the world’s supply of remdesivir is not just a reaction to the increasing spread and death toll. The US has taken an “America first” attitude throughout the global pandemic.

Coronavirus cases are declining in only 2 states as virus surges in US – As the coronavirus surges in the US, only two states – – Connecticut and Rhode Island – are reporting declining cases, per CNN. In 36 states, cases are rising, with the country reaching an all-time one-day high of 40,000 new cases on Friday, according to data from Johns Hopkins University. Globally, confirmed cases have exceeded 10 million, with 2,510,337 of those in the US, per Johns Hopkins University. The growth of new US cases could have multiple causes, Surgeon General Jerome Adams, the nation’s top doctor, said in an interview with Business Insider on Saturday. “In some places it may be because they did in fact reopen too early,” Adams told Business Insider. “In other cases it may be that they reopened right on time and that the governmental institutions and public health institutions did everything right, but that the citizens did not have the will or desire or the follow through to do the social distancing that we have recommended, and to wear coverings as we have recommended.” Nearly half of US states started reopening in late April and early May without meeting White House requirements, which dictated that states should wait to see downward trends in cases or positive tests before reopening, as Business Insider’s Aria Bendix recently reported. Now, the 36 states seeing a surge in new cases include California, Florida, Georgia, Hawaii, Nevada, and Texas. Texas Gov. Greg Abbott said last week he would pause the state’s reopening, and the next day he closed bars and limited restaurant capacity. In Connecticut, the first phase of reopening from its lockdown started on May 20, after several days of declining cases and hospitalizations. The state entered its second reopening phase of on June 17, a few days ahead of schedule, as hospitalizations and infection rates remained low. Rhode Island’s first phase of reopening started on May 9, after Gov. Gina Raimondo said that cases and hospitalizations had held steady for two weeks, with a 25% drop in new cases in that time period. Since then, average new cases have continued to decline, with hospitalizations dropping below 100 on Friday. Gov. Raimondo had said back in April that, before reopening, Rhode Island would need to meet requirements that included 14 days with decreasing new cases, the capacity to quickly identify community spread, adequate capacity in the healthcare system, and plans for long-term social distancing measures.

States with highest income inequality experienced a larger number of COVID-19 deaths – States with the highest level of income inequality had a larger number of COVID-19-related deaths compared with states with lower income inequality. New York state, with the highest income inequality, had a mortality rate of 51.7 deaths per 100,000. This is 125 times greater than Utah, the state with the lowest income inequality and which had a mortality of 0.41 per 100,000 at the end of the period studied. Looking at the top three in each category, New York was followed by Louisiana with 19 deaths per 100,000, and Connecticut with 16.9 deaths per 100,000. States in addition to Utah with the lowest COVID deaths that were linked to income inequality were South Dakota, with 0.7 deaths per 100,000 and North Dakota, which had one death per 100,000. The researchers limited their analysis to January 22 through April 13, 2020. They used data on cases and deaths from the COVID-19 Dashboard maintained by the Center for Systems Science and Engineering at Johns Hopkins University. State income inequality data came from the 2018 American Community Survey as measured by the Gini index, a statistical formula used to measure income distribution.

Air conditioning may be factor in COVID-19 spread in the South – Drawing on insights from another deadly airborne disease, tuberculosis, a Harvard infectious disease expert suggested Friday that air conditioning use across the southern U.S. may be a factor in spiking COVID-19 cases and that ultraviolet lights long used to sterilize the air of TB bacteria could do the same for SARS-CoV-2. Edward Nardell, professor of medicine and of global health and social medicine at Harvard Medical School (HMS) and professor of environmental health and of immunology and infectious diseases at the Harvard T.H. Chan School of Public Health, said that hot summer temperatures can create situations similar to those in winter, when respiratory ailments tend to surge, driving people indoors to breathe – and rebreathe – air that typically is little refreshed from outside. “The states that, in June, are already using a lot of air conditioning because of high temperatures are also the places where there’s been greater increases in spread of COVID-19, suggesting more time indoors as temperatures rise,” Nardell said. “The same [thing] happens in wintertime, with more time indoors.” Though transmission of the SARS-CoV-2 virus has been understood to transmit mainly through large droplets expelled during coughing, sneezing, or talking, Nardell said that evidence has risen that at least some cases of COVID-19 occur via airborne transmission. That happens when virus particles contained in smaller droplets don’t settle out within six feet and instead hang in the air and drift on currents. Airborne transmission would make people even more vulnerable to the virus in a closed room. Nardell said that in an office occupied by five people, as windows are closed and air conditioners turned on, CO2 levels rise steeply, a sign that occupants are rebreathing air in the room and from each other. “As people go indoors in hot weather and the rebreathed air fraction goes up, the risk of infection is quite dramatic,” Nardell said, adding that the data, while gathered related to tuberculosis, would apply to any infection with airborne potential.

COVID-19 Outbreak Associated with Air Conditioning in Restaurant, Guangzhou, China, 2020 – – CDC — Lu et al. (1) describe the indoor airborne spread of COVID-19 (coronavirus disease) facilitated by a type of standard, wall-mounted, ductless air conditioner (AC) used in most countries. These units are low-cost in comparison to ducted AC units, which can cost 3 times as much to purchase, install, and operate. Ductless units cool and dehumidify indoor air but have little ability to filter or remove airborne contaminants. A wall-mounted ductless system blows air directly onto those closest to it, potentially disseminating infectious droplets or aerosols along the airflow. Lu et al. use arrows to point out the airflows emanating from and returning to the AC unit, delineating a possible trajectory of putative airborne droplets. This trajectory coincides with the seating distribution of other persons at the restaurant who later became ill (1). We agree that the AC probably contributed to the upstream and downstream airborne spread of the virus. The type of AC system required to mitigate airborne transmission is neither affordable nor architecturally feasible for many buildings or regions. To prevent the spread of coronavirus disease in indoor spaces, we need work-around solutions in addition to distancing and fresh air exchange. Viable, low-cost possibilities might include operating AC on low fan settings and installing units near the ceiling, which would channel airflow towards the ceiling instead of directly onto patrons. Other methods might include the installation of high-efficiency particulate air filters, ultraviolet germicidal irradiation (which can disinfect some airborne coronaviruses such as mouse hepatitis virus and Middle Eastern respiratory syndrome coronavirus) (2), or a combination of these methods.

June 28 COVID-19 Test Results, Highest Percent Positive Since Early May -The US is now conducting over 500,000 tests per day, and that might be enough to allow test-and-trace in some areas. Based on the experience of other countries, the percent positive needs to be well under 5% to really push down new infections, so the US still needs to increase the number of tests per day significantly. According to Dr. Jha of Harvard’s Global Health Institute, the US might need more than 900,000 tests per day. There were 539,333 test results reported over the last 24 hours. There were 42,161 positive tests. This is the third consecutive day with over 40,000 positive cases. This data is from the COVID Tracking Project.The percent positive over the last 24 hours was 7.8% (red line).For the status of contact tracing by state, check out testandtrace.com.

California, Texas see record COVID-19 surges, Arizona clamps down – (Reuters) – California and Texas both marked record spikes in new COVID-19 infections on Monday, a Reuters tally showed, as Los Angeles reported an “alarming” one-day surge in America’s second-largest city that put it over 100,000 cases. Los Angeles has become a new epicenter in the pandemic as coronavirus cases and hospitalizations surge there despite California Governor Gavin Newsom’s strict orders requiring bars to close and residents to wear masks in nearly all public spaces. “The alarming increases in cases, positivity rates and hospitalizations signals that we, as a community, need to take immediate action to slow the spread of COVID-19,” Barbara Ferrer, director of public health for Los Angeles County, said in a statement announcing the sharp rise. “Otherwise, we are quickly moving toward overwhelming our healthcare system and seeing even more devastating illness and death,” Ferrer said. Los Angeles Mayor Eric Garcetti announced a “hard pause” on when movie theaters, theme parks and other entertainment venues can reopen. Los Angeles County is the biggest movie theater market in the United States. Los Angeles County said its beaches will be closed for the Independence Day weekend and fireworks displays will be banned. Statewide positive tests for COVID-19, the respiratory illness caused by the virus, rose by at least 7,418 in California Monday to nearly 223,000, the biggest one-day increase since tracking began. Los Angeles County, with a population of 10 million, has recorded 100,000 cases. California is among a number of U.S. states including Florida, Texas and Arizona battling a new wave of infections as the nation emerges from weeks of clamp-downs on residents and businesses. COVID-19 infections in Texas rose by 6,545 on Monday to nearly 160,000, also setting a record for a one-day increase. Nationally, cases rose by more than 40,000, for the fourth time in the past five days.

Arizona orders bars and gyms to close, joining other states in reversing reopening – The governor of Arizona has ordered bars, movie theaters, gyms and water parks to shut down, in a dramatic move that echoed similar efforts by states around the country to roll back plans for reopening. The order from the Republican governor, Doug Ducey, came on Monday and went into effect immediately, and will last for at least 30 days. Ducey also also ordered public schools to delay the start of the classes at least until 17 August. “Our expectation is that our numbers next week will be worse,” he said. Arizona health officials reported 3,858 more confirmed coronavirus cases Sunday, the most reported in a single day in the state so far and the seventh time in the last 10 days that daily cases surpassed the 3,000 mark. Since the pandemic began, 74,500 cases and 1,588 deaths stemming from the virus have been reported in Arizona. Most Arizona bars and nightclubs opened after Ducey’s stay-at-home and business closure orders were allowed to expire in mid-May. The state is not alone in its reversal. Places such as Texas, Florida and California are backtracking, closing beaches and bars in some cases amid a resurgence of the virus. Oregon and Kansas, meanwhile, announced Monday that everyone would be required to wear masks in public. In California over the weekend, the governor, Gavin Newsom, ordered bars and nightclubs in nine counties to close, including Los Angeles, which has nearly 100,000 cases – the most of any region of the state. The state is in the midst of trying to “toggle back” plans to reopen as case numbers and hospitalizations flare up in sections of the state. Red flags have been raised on a number of metrics, including “disturbing trendlines” in positivity rates, hospitalizations and ICU admissions. Particularly hard hit is southern California’s Imperial county, where an outbreak is taxing the region’s hospital system. In recent weeks, health officials have had to move roughly 500 patients into neighboring regions, burdening their hospital systems, too.

Global Covid-19 Cases Top 10 Million As HHS Secretary Warns ‘Window is Closing’ to Get Disease Back Under Control in US – Confirmed global cases of the coronavirus hit 10 million Sunday, a grim milestone that came as reported deaths from the disease climbed toward 500,000 and a top U.S. health official warned the country’s chances of getting the outbreak back under control were fast disappearing.“This is a very, very serious situation and the window is closing for us to take action and get this under control,” Health and Human Services secretary Alex Azar told CNN‘s Jake Tapper Sunday.NEW: Health and Human Services Secretary Alex Azar warns on CNN that the “window is closing” for the U.S. to get the coronavirus under control, calling the current state of the outbreak a “very, very serious situation.” https://t.co/fPJeGET2Ti – Axios (@axios) June 28, 2020Data from Johns Hopkins University, which has tracked the disease for months, showed the total confirmed cases around the world at over 10 million by early Sunday afternoon. Total deaths as of press time had nearly exceeded the 500,000 mark.The U.S. leads the world in total cases with over 2.5 million and in deaths with 125,709. Brazil is a distant second in both categories with around 1.3 million cases and just over 57,000 deaths. “We are 4% of the world’s population and we are 25% of the cases and the deaths,” House Speaker Nancy Pelosi (D-Calif.) said on an appearance on ABC Sunday. As CNN reported:Thirty-six states are reporting a rise in positive coronavirus cases, and only two are reporting a decline in cases compared to last week.On Friday, the U.S. reported the highest number of new cases in a single day, with at least 40,173 new infections. The previous daily high was reported on Thursday.Several states, including Texas and Washington state, and localities have paused their reopening plans or reimposed some restrictions in hopes of curbing the spread of the virus.President Donald Trump’s management of the disease has been blamed by critics for the nation’s high rate of infection and death count. Trump and members of his administration have blamed a host of other factors, including testing, on the high rate.Former Centers for Disease Control director Dr. Tom Frieden told Fox News Sunday that rationale was simply untrue.“As a doctor, a scientist, an epidemiologist, I can tell you with 100% certainty that in most states where you’re seeing an increase, it is a real increase,” said Frieden. “It is not more tests, it is more spread of the virus.”

Coronavirus dashboard for June 29: renewed exponential growth in infections, decline in deaths has stalled

Total US infections: 2,549,069, 42,161 in last day
Total US deaths: 125,803, 273 in last day
Here is the regional breakdown of the 7 day average of new cases per capita: There is renewed exponential growth in the South and West. The Midwest also is beginning to look bad. Also, here is some more evidence that, when you recklessly reopen, and the pandemic roars back, customers pull back, thus defeating the entire purpose of “reopening the economy:” The scientific phrase for this phenomenon is, “Well, duh!” The “top 10″ States for new infections per capita are now dominated by the Confederacy, plus Arizona and Utah: However, while Arizona now heads the “top 10″ jurisdictions for deaths per capita, and Louisiana, Arkansas, and Florida have joined the list, the majority is still from the Northeast megalopolis where the death rate, while steeply declining, remains high: I expect the Northeastern States and DC to drop out of this list over the next 7 to 10 days. Aside from the situation in the recklessly reopened States, the big issue has been the disconnect between new cases and deaths. The main driver is almost certainly the demographic change from older to younger victims. An important sub-part of that change may be that nursing homes, the “dry tinder” that were first struck by the pandemic, are no longer the epicenter. One complication in making sense of the data is that NJ had a big data dump of reassigned death rulings earlier last week: So, the below two graphs take the NYC metro area, including NJ, out of the data, and compare the remaining 47 States plus DC. Here is the 7 day growth in new cases: This looks very much like the exponential growth we were seeing back in March. Now, here is the 7 day change in deaths: There has been a very slight decline over the past 10 days of the 7 day average. The change in trajectory of deaths happened roughly one week after the new exponential growth in infections started. Because the young are not totally invulnerable from dying of the disease, I expect the death rate to slowly start rising, pretty much imminently. One final note. How much did the Black Lives Matter protests affect new cases? Obviously social distancing went out the window, but the protests were outdoors and by all accounts almost all of the protesters wore masks. Since the protests started in Minnesota on May 25, 35 days ago, the effects ought to be apparent in cases by now. So here is what Minnesota looks like: New infections continued to decline for 25 days, but have risen slightly in the past 10 days. This suggests, thankfully, that the protests will have little effect on the trajectory of new cases.

Cuomo expands New York quarantine order to 8 additional states – New York Gov. Andrew Cuomo (D) expanded the state’s mandatory quarantine to include travelers from eight additional states experiencing spikes in coronavirus cases. The mandatory 14-day quarantine now includes travelers from California, Georgia, Iowa, Indiana, Louisiana, Mississippi, Nevada and Tennessee. If you’re traveling to New York from the following states you must self-quarantine for 14 days. The states are: AL, AR, AZ, CA, FL, GA, IA, ID, LA, MS, NC, NV, SC, TN, TX, UT. – Andrew Cuomo (@NYGovCuomo) June 30, 2020 Last week New York, New Jersey and Connecticut announced a joint travel advisory requiring travelers from states with an infection rate above 10 cases per 100,000 people on a seven-day rolling average to quarantine when entering their states. The order at the time applied to travelers from Alabama, Arkansas, Arizona, Florida, North Carolina, South Carolina, Washington, Utah and Texas. New York, once the epicenter of the coronavirus pandemic, has made progress mitigating its spread. But other states, mainly in the South and West, have seen significant surges in COVID-19 cases, causing officials in some cases to pause reopening plans or reimpose restrictions that had been lifted. Cuomo has said that people found breaking the order could be subject to fines, but he indicated that police would not be patrolling the borders of the state.

Food processing plants in Ohio and New York hit with outbreaks – The number of workers in food processing plants infected with coronavirus continues to grow. More than 230 workers at a Dole Foods salad processing plant in Springfield, Ohio, have now tested positive for COVID-19. Last week, 82 workers or 46 percent of the workforce also tested positive at Champlain Valley Specialty of NY, a company that packages sliced apples in upstate New York. Dole Foods as well as county and State of Ohio health officials have refused to close the plant despite the fact that more than a quarter of the plant’s 829 workers have now tested positive. Dole management has known for a long time that COVID-19 was spreading among its employees. The first positive case was back in April. Yet the company failed to close and thoroughly clean the plant to prevent the spread of the virus. On Saturday, June 20, the health officials organized the testing of everyone at the plant. Infected workers continued to work while their test results were pending. Barry Scuttles, who works at the plant, told local TV station WHIO-TV, “The proper thing to do was shut the place down until all the tests came back. Keep all the positives at home and then bring the other workers back.” Scuttles said he personally had to inform three co-workers that they were positive and pull them from the line. In a statement, Dole rejected closing, citing conversations with county health officials that “the plant is not likely the source of transmission and closure is not warranted.” Such an absurd statement exposes the contempt of these giant corporations for the working class. Regardless of where the source of transmission began, the plant is now a vector for the transmission of the disease. To ignore that the virus is spreading between workers is not just neglect but an act of corporate murder. Many workers are worried about safety but are concerned about speaking out. The State of Ohio has now declared three ZIP codes around the plant as hot spots for virus. Scuttles told WHIO-TV “Corporate America is worried about money. They’re not worried about their workers. I can get another job. I can’t get another life.” Workers are now reportedly being forced to work 12-hour shifts to make up for the time lost by infected employees missing work.

Reopening Of Popular Michigan College Bar Results In 85 COVID-19 Infections A popular bar near Michigan State University’s campus in East Lansing was site of a recent ‘super spreader’ event. This single location has been reportedly linked to at least 85 confirmed COVID-19 cases, a number expected to climb given that health authorities are now desperately announcing that anyone who visited Harper’s Restaurant and Brew Pub between June 12 and June 22 immediately self-quarantine for 14-days. Local media said further that a recent cluster of 30 infections 100 miles away are also linked to the bar. According to Fox News: Eighty of the cases involve individuals who visited the bar and then tested positive, WLIX-TV reported. Most of those infected have only shown mild symptoms. At least 10 have been asymptomatic. College students without masks could be seen in photos on social media crowded together on a line to get into Harper’s after the bar reopened June 12 when Michigan eased coronavirus restrictions that had shuttered bars and restaurants for three months. The business closed again June 22, shortly after two people tested positive for the coronavirus, the station reported.

South Carolina emerges as new COVID-19 hot spot – South Carolina has emerged as a national hot spot for the spread of COVID-19. A record 1,599 new cases were announced on June 27. Since then, the numbers have only been slightly lower, with 1,366 new cases reported on Sunday and 1,320 reported on Monday. However, the percentage of positive test results has increased precipitously from 9.6 percent on June 14 to 20.1 percent on June 27, indicating a vast underestimation of the actual number of active cases. As of this writing the official death toll stands at 717 confirmed and 3 probable coronavirus deaths. COVID-19 hospitalizations in the state stand at 954. In response to the surge in cases in South Carolina several states have imposed self-quarantine requirements on visitors from the state. A few South Carolina cities including Columbia, Charleston and Greenville, have belatedly instituted mask requirements in the past week. However, Republican Governor Henry McMaster has continued to insist that a blanket mask requirement for the entire state is unconstitutional and unenforceable. South Carolina was among the last to implement measures to contain the spread of the coronavirus and among the earliest to relax them. A statewide “home or work” order was not announced until April 6. Then, in an effort to prepare public opinion for an end to all social distancing requirements, several nonessential businesses were reopened on April 21 even before the “home or work” order was allowed to expire on May 4. On May 4, restaurants were reopened for outdoor seating, forcing restaurant workers back to work even as the virus continued to spread among the general population. On May 12, restaurants were allowed to reopen their dining rooms, further endangering restaurant staff. As cases of the virus rose in mid-June following this series of irresponsible reopenings, Governor McMaster absurdly combined a call for “individual responsibility” in slowing the spread of the virus with the reopening of bowling alleys. Since then, although COVID-19 cases have continued to soar even higher, the governor has insisted repeatedly there will not be another shutdown.

Texas Daily COVID-19 Cases Top Italy’s Record When It Was Global Epicenter – Texas reported its latest record-breaking daily increase in cases of the novel coronavirus on Tuesday, with 6,975 new infections identified. The number surpassed Italy’s highest single-day jump in virus cases to date, which the nation’s health officials confirmed while it was still considered the pandemic’s global epicenter. According to data published by the Ministry of Health, Italy saw its highest single-day increase in cases of the novel virus on March 21, with 6,557 new diagnoses. Texas and Italy reported similar weekly average increases in cases surrounding their respective peaks, with both identifying at least 3,500 new infections per day. Italy’s record increase came roughly two weeks into the country’s national lockdown, which Prime Minister Giuseppe Conte originally implemented March 9. The country continued to diagnose several thousand new cases daily until early May. In Texas, virus cases and related hospitalizations began to multiply at unprecedented rates in early June, one month after businesses started to reopen under Governor Greg Abbott’s phased economic recovery plan. Initially implemented May 1, the plan’s guidelines allowed restaurants, bars, retail establishments, salons and other businesses to resume in-person services with added safety measures in place throughout the month. A few days into June, Phase III of Texas’ recovery plan allowed businesses already operating to expand occupancy limits, while amusement parks reopened for visitors. Texas set new records for daily increases in virus cases almost a dozen times throughout the state’s month-long surge. After 24-hour case reports reached new heights on three consecutive days, Abbott announced that Texas would pause further reopening developments indefinitely on June 25. He directed bars to close earlier than previously allowed and lowered occupancy limits for Texas restaurants. His announcement followed the Texas Department of State Health Services’ (DSHS) latest case report, which showed 5,551 infections were confirmed the previous day. The next day’s report from the Texas DSHS broke a new record, with close to 6,000 cases reported. Texas health officials have confirmed nearly 160,000 virus cases and 2,424 fatalities statewide since the start of the pandemic. The DSHS estimates roughly 72,744 of those cases are currently active, while more than 84,800 individuals previously infected have recovered. The Italian Ministry of Health has recorded more than 240,500 virus cases and at least 34,767 subsequent deaths. It estimates roughly 15,560 people are currently infected.

Fauci predicts 100,000 new COVID-19 cases per day if US can’t control outbreaks – Anthony Fauci, the nation’s top infectious disease expert, warned members of Congress on Monday that the U.S. could reach 100,000 new COVID-19 cases per day if the country does not get a handle on the pandemic. Speaking before the Senate health committee, Fauci said the country is heading in the “wrong direction,” with growing outbreaks in four states accounting for 50 percent new infections in the U.S. “We’re going in the wrong direction if you look at the curves of the new cases,” Fauci said. “We need to do something about that and we need to do it very quickly.” The U.S. is now recording 40,000 new cases per day, surpassing previous records set in April when New York was the epicenter of the outbreak. Now Texas, Arizona, Florida and California are leading the nation in new COVID-19 cases and hospitalizations. However, Fauci stressed that the U.S. can’t just focus on those four states. “It puts the entire country at risk,” he said. Fauci declined to estimate potential COVID-19 deaths when pressed by Sen. Elizabeth Warren (D-Mass.), but said the situation is “going to be very disturbing, I will guarantee you that because when you have an outbreak in one part of the country, even though in other parts of the country they’re doing well, they are vulnerable.” “I would not be surprised if we go up to 100,000 [cases] a day if this does not turn around and so I am very concerned,” he added.

L.A. County faces ‘critical moment’ as coronavirus cases keep surging – – Another day of big increases in coronavirus cases and hospitalizations prompted health officials Saturday to warn that Los Angeles County is entering a “critical moment” and that some of the easing of stay-at-home orders is in jeopardy unless the trend changes.Los Angeles and many other parts of California have seen big COVID-19 surges in recent weeks, as the economy has reopened. Officials say it’s essential to follow social distancing rules and other safety regulations.“If we can’t find it in us to follow these mandates, including wearing face coverings and distancing when around others, we jeopardize our ability to move forward on the recovery journey,” Barbara Ferrer, the county health director, said Saturday in a statement. “Our collective responsibility is to take immediate action, as individuals and businesses, to reverse the trends we are experiencing.”Los Angeles County public health officials on Saturday reported 2,169 new coronavirus cases.The county also reported 23 coronavirus-related deaths, bringing its total to more than 95,500 cases and nearly 3,300 deaths. There were 1,698 confirmed coronavirus patients in county hospitals, an increase from the 1,350 to 1,450 daily hospitalizations the county was seeing two weeks prior, officials said.This comes a little over a week after the county permitted the latest round of business sectors, including bars, nail salons and tattoo parlors, to reopen, and about a month after hundreds of thousands of people began taking to the streets for protests decrying the police killing of George Floyd and other Black Americans. The alarm over the rising case numbers extends across California, where statewide cases approached 210,000. Some officials are cracking down on scofflaw businesses while others are preparing to help overwhelmed hospitals.

Coronavirus: California shatters another record for daily cases -For the second time in the past week, California on Monday blew its previous daily COVID-19 case record out of the water, and practically across the Pacific. Hospitals are beginning to near capacity in parts of the state, while more regions have put their reopening plans on hold amid what one local health official described as an “alarming” surge in cases.Health departments around the state reported 8,184 new positive tests Monday, shattering the previous record set last Monday and raising the total count to more than 222,000, according to data compiled by this news organization. While data on Monday can be inflated from reporting delays over the weekend – and this past weekend, some counties weren’t able to access CalREDIE, the state’s reporting system – the 8,184 new cases is 25% higher than any previous Monday. Before last Monday, the state hadn’t experienced a single day of 5,000 cases; now, it is averaging well over 5,000 a day – 5,475 over the past week. That is 33% higher than a week ago, despite the number of tests increasing 20% in that time.In Los Angeles County alone, there were nearly 3,000 new cases – more than all but three states on Monday.“The alarming increases in cases, positivity rates and hospitalizations signals that we, as a community, need to take immediate action to slow the spread of COVID-19,” Dr. Barbara Ferrer, the Los Angeles County public health director, said in a statement. “Otherwise, we are quickly moving toward overwhelming our healthcare system and seeing even more devastating illness and death.” The statewide positive-rate of tests over the past seven days is 5.9%. As recently as two weeks ago, an average of 4.6% of tests were coming back positive, indicating the increase is cases is attributable to more than increased testing. Cases Both rates, however, pale in comparison to other states where cases are spiking. In Florida, 15.6% of tests were coming back positive, while in Arizona, the positivity rate was 24.4%. California is also now testing more people than all but five states at a rate of 2.4 tests per 1,000 residents. Seventeen states have a higher positivity rate than California.

Arizona reports record spike in new coronavirus cases and deaths ahead of Pence’s visit – The Arizona Department of Health Services on Wednesday reported nearly 4,900 new coronavirus cases and 88 new deaths, a record single-day jump in both grim markers ahead of Vice President Mike Pence’s visit to the state later in the day. The coronavirus has infected a total of 84,092 people and killed 1,720 people in Arizona so far. The state’s previous single-day high in the number of additional cases was 3,593 on June 23 ahead of President Donald Trump’s scheduled event in Phoenix. While an increase in Covid-19 testing and a potential lag in data reporting of the daily case numbers could account for the rise in positive cases, the number of hospitalizations in Arizona has steadily increased over the past weeks. According to a CNBC analysis of data compiled by the Covid Tracking Project, Arizona as of Tuesday reported 2,516 people currently hospitalized on a seven-day average, a near 35% increase compared with a week ago. Arizona is nearing max capacity of intensive care unit beds with 1,495, or 89%, of the state’s ICU beds in use as of Tuesday. The number of ventilators being used at hospitals also reached a record high of 795, according to the state’s department of health. Arizona Gov. Doug Ducey rolled back the state’s reopening plans and closed all bars, gyms, movie theaters and water parks Monday. He said Arizona will try to restart the businesses in 30 days. “We can’t be under any illusion that this virus is going to go away on its own. Our expectation is that next week our numbers will be worse. It will take several weeks for the mitigation that we have put in place and are putting in place to take effect,” Ducey said. The record surge in daily coronavirus cases comes as Pence is scheduled to arrive in Phoenix later on Wednesday to meet Ducey to discuss the state’s effort to curb the spread of the virus. The trip was pushed back by a day. Last weekend, Pence postponed his “Faith in America” 2020 campaign events in Arizona and Florida “out of an abundance of caution.” No new dates for the tour have been disclosed but the vice president announced that he will still travel to Texas, Arizona and Florida this week to meet governors and health experts about response efforts to Covid-19.

Arizona Department of Health Services activates plan to ration healthcare for COVID-19 patients – The state of Arizona, and the American Southwest more generally, have become a new epicenter of the coronavirus pandemic. This region was among the first where state governments ended lockdowns and other restrictions, and record infections and rising deaths are the consequence. On Wednesday, Arizona, with over 84,000 cases (24,118 cases in one week), surpassed its previous one-day high set on Tuesday with 4,877 new cases and 88 fatalities. The death toll for Arizona stands at 1,720 (257 deaths since last week). With a per capita infection rate of 43 new daily cases per 100,000 residents on a seven-day rolling average, Arizona leads nationally, with Florida second with 34 new cases per 100,000 residents. By way of comparison, New York state with 2,009 total cases per 100,000 residents experienced a one percent rise since June 24. Arizona, with 1,290 total cases per 100,000, experienced a 40 percent increase. With testing capacity strained, 28 percent of diagnostic tests are returning positive, which indicates both dwindling resources as well as a significantly entrenched community transmission. Last Friday, Arizona hospitals asked their state’s health department to formally activate the “Crisis Standards of Care” guidelines that would provide hospitals the legal right to determine who and how patients should be treated for the coronavirus. This essentially means hospitals will have to decide who receives life-saving measures and who will not. Throughout June, the local media, via updates from the health department, had been highlighting Arizona hospitals’ dwindling ICU capacity. The plan ushered in with the words “a compassionate and ethically-based healthcare response for catastrophic disasters within the State of Arizona” went into effect Monday afternoon. The Arizona Department of Health promulgated a COVID-19 addendum for the allocation of scarce resources in acute care facilities back in April during the initial surge of the pandemic in the United States. Health systems throughout the country were facing severe shortages of PPEs and testing capacity. Based on estimates provided by various health officials, concerns were raised that there would be insufficient capacity to ventilate patients. Equally distressing was the shortage of critical care capacity at health systems overwhelmed by COVID-19 cases. Infected patients who have arrived for life-saving treatments and critical care at the hospital will have to first undergo an assessment on “the best available relevant and objective medical evidence.”

Arizona Covid-19 Cases Jump 5.1%, Exceeding 4.7% Weekly Average – Arizona reported 4,433 new Covid-19 cases on Friday, a 5.1% rise from a day earlier but below the record set Wednesday. Cases have been rising at a 4.7% rate over the past seven days and now stand at 91,858. The state had 4,878 new cases on Wednesday, the most for a day. The state reported 31 new deaths, down from a record 88 on Wednesday, putting the total at 1,788. Fatalities among those over age 65 accounted for 73.5% of all state deaths, according to the Department of Health website. Arizona Governor Doug Ducey announced on Monday the state would impose a month-long closure of bars, gyms, movie theaters, water parks and tubing rentals.

US daily coronavirus cases jump by more than 50,000 for first time – The number of new US daily coronavirus cases surpassed 50,000 for the first time ever on Wednesday, propelled by record rises in some of the most populous states, including California and Texas.The surge in cases has increased concerns about the speed at which the disease is spreading in emerging US hotspots ahead of the July 4 holiday weekend. A further 52,982 people in the US tested positive for coronavirus over the past 24 hours, according to Covid Tracking Project, topping the previous record increase from June 26 by more than 8,600. Throughout the month of June, the daily case rate in the US rose 105 per cent. California, which had some of the earliest cases of coronavirus in the US, had largely escaped the early wave of cases that hit states such as New York in the north-east. However, that trend has reversed in recent weeks, after it began to loosen some restrictions. The state’s health department reported 9,740 cases since Tuesday, taking the total number of positive cases there to almost 233,000. Texas reported 8,076 cases, topping a record set the previous day by more than 1,100, with 57 deaths – the biggest one-day increase since the middle of May. Hospitals in some parts of Texas, which was among the last US states to lock down and first to reopen, have been overwhelmed by the sudden rise in cases. More than 6,900 people are hospitalised there as of July 1, a record for America’s second most populous state.Houston-based Texas Medical Center – the largest hospital system in the US – revealed on Wednesday there were 1,350 patients in its intensive care unit wards in the area, surpassing normal capacity of 1,330. Patients with coronavirus accounted for 36 per cent of those beds. Arizona also reported a record one-day rise in cases, with 4,878 people testing positive over the past day, and a record 88 deaths, the state’s health department said. Mike Pence, the US vice-president, was in the capital Phoenix on Wednesday to discuss the situation with state and local officials. The relentless increase in cases in some states, particularly in the US south and west, has prompted businesses and local governments to slow, halt or reverse reopening plans, as optimism that the worst of the pandemic has passed continues to fade.

US posts largest single-day jump in new COVID-19 cases – The Centers for Disease Control and Prevention (CDC) today reported a record of 54,357 new coronavirus cases over yesterday – a record single-day jump that presses the United States further than what some thought was the peak this spring. For reference, as CNN reported, it took the United States a little more than 2 months to report its first 50,000 cases. Total US cases were at 2,679,230, including 128,024 deaths, according to the CDC. The infection curve is rising in 40 of 50 states, and 36 states are seeing an increase in the percentage of positive coronavirus tests, AP reported today. Some public health officials and governors are blaming bars for the increase in cases, the New York Times reported today, while others are pointing to hasty business reopenings, according to Politico. Without directly acknowledging the recent surge of new cases, Trump said that, along with governors, the White House was working at “putting out the flames or the fires, and that’s working out well.” Trump said that states will decide how quickly to reopen their economies but that “we’d like to see churches open quickly.” However, economists caution that the situation isn’t nearly as rosy as it might seem, with at least 10 million more jobless Americans than before the pandemic, and millions are still applying for unemployment benefits weekly, CNBC reported. At the same time, Vice President Mike Pence said that the White House would “keep opening up America” despite the surge in COVID-19 cases, according to CNBC. Florida set a state record for daily new coronavirus cases when it passed the 10,000 mark,Reuters reported. Florida infections increased 168% in June when it recorded more than 95,000 news cases. Since the end of May, positive test results have risen to 15%, a 9% increase. Only one other state, New York, has recorded more than 10,000 cases in a single day, at 12,847 on Apr 10, 3 weeks after the state issued stay-at-home orders. In fact, no European country reported more new daily cases than Florida at the peak of their outbreaks.Arizona reported 4,878 cases, including 88 deaths, for a total of 87,425 cases and 1,757 deaths, with Governor Doug Ducey calling for an additional 500 healthcare workers yesterday, Yahoo Newsreported. In Texas, Governor Greg Abbott today issued an executive order that requires face coverings in counties with 20 or more positive cases and limiting gatherings to 10 or fewer people. Also, theTexas Tribune reported that more than 300 kids in childcare centers and 460 staff members have tested positive for COVID-19; more than 8,100 new cases were recorded on Wednesday. In California, where some businesses are again being shut down amid rising cases, new cases were at 7,600, according to the New York Times.North Carolina, Tennessee, and Texas all set single-day records on Wednesday, and the formerly stable-appearing states of Ohio, Kansas, and Louisiana reported some of their highest single-day tallies in weeks. Only Nebraska and South Dakota were reporting a downward trend in cases, according to the AP.

U.S. Breaks World Record With More Than 55,000 New Coronavirus Cases in a Day The U.S. reported more than 55,000 new coronavirus cases on Thursday, in a sign that the outbreak is not letting up as the Fourth of July weekend kicks off.Thursday’s tally of 55,274 new cases was both more than the country has reported on any single day so far and more than any other country has reported over 24 hours, according to Reuters figures. The previous record was held by Brazil, which reported 54,771 cases on June 19.Thursday’s high caseload is not an isolated incident. The U.S. has reported more than 40,000 new cases each day for seven days in a row and has broken records for new cases three days running, according to Reuters data. Thursday was also the second consecutive day that the daily tally topped 50,000, The Financial Times reported.”What we’ve seen is a very disturbing week,” National Institute of Allergy and Infectious Diseases Director Dr. Anthony Fauci said in a livestream with the American Medical Association, The Associated Press reported Wednesday.It also doesn’t look like the surge in cases is down to increased testing, as some Trump administration officials have suggested in recent weeks.”There is no question that the more testing you get the more you will uncover, but we do believe this is a real increase in cases because the percent positivities are going up,” Assistant Secretary of Health Admiral Brett Giroir told Congress Thursday, as The New York Times reported. “So this is real increases in cases.”In fact, Thursday’s total represents a more than 85 percent increase in new cases compared to two weeks ago, when states began to reopen following an extended lockdown. Cases have risen in 40 out of 50 states in the past 14 days, according to COVID Tracking Project data reported by The Associated Press, and the number of tests coming back positive has risen in 36 states. Eight states set individual records for their highest case tally Thursday, The New York Times reported. They were Alaska, Arkansas, California, Georgia, Montana, South Carolina, Tennessee and Florida, which reported more than 10,000 cases for the first time.

832 new virus cases reported in Pa., marking highest daily jump in weeks – – Pennsylvania health officials reported more than 800 new COVID-19 cases on Thursday. There were 832 new cases, the highest daily jump since May 22, according to health department data. That pushes the statewide total to 88,074 since March. Lehigh and Northampton counties saw an increase of 22 and 16 respectively, while Berks County had just 4 new cases. The state health department also reported 25 more virus-related deaths, making 6,712 total. Pennsylvania has seen an uptick in new cases since mid-June, as officials in Allegheny County and Philadelphia have taken steps to impose new restrictions or keep them in place. On Wednesday, Gov. Tom Wolf expanded his mandatory mask order to include all public places, indoor and outdoor, where consistent social distancing is not possible. Wolf also said Wednesday he doesn’t envision another broad shutdown order to contain the coronavirus and, rather, hopes to let local governments make decisions based on conditions they are seeing in their area.

Florida shatters records with over 10,000 new COVID-19 cases in single day – (Reuters) – Florida shattered records on Thursday when it reported over 10,000 new coronavirus cases, the biggest one-day increase in the state since the pandemic started, according to a Reuters tally. Outbreaks in Texas, California, Florida and Arizona have helped the United States break records and send cases rising at rates not seen since April. In June, Florida infections rose by 168% or over 95,000 new cases. The percent of tests coming back positive has skyrocketed to 15% from 4% at the end of May. Florida, with 21 million residents, has reported more new daily coronavirus cases than any European country had at the height of their outbreaks. To contain the outbreak, Florida has closed bars and some beaches but the governor has resisted requiring masks statewide in public or reimposing a lockdown. Only one other state has reported more than 10,000 new cases in a single day. New York recorded 12,847 new infections on April 10, three weeks after the state implemented a strict lockdown that closed most businesses. While the state has relaxed many measures, it requires masks in public and mandates anyone arriving from 16 other U.S. states with high infections self-quarantine for two weeks. Once the epicenter of the U.S. epidemic, New York saw cases rise by about 6% in June – the lowest rate in the entire country.

Infectious disease specialist: Florida ‘heading a million miles an hour in the wrong direction’ – An infectious disease specialist is warning that Florida is “heading a million miles an hours in the wrong direction” on its handling of the coronavirus pandemic. “Right now, we are heading a million miles an hour in the wrong direction,” Dr. Aileen Marty, an expert who helped write Miami-Dade’s reopening rules, told “CBS This Morning.” She added, however, that people are not properly following the rules and it’s playing a role in rising cases of COVID-19 in the area. “It’s absolutely the saddest thing, the most unnecessary situation that we’re finding ourselves in,” Marty said. “And it’s behaviorally driven.” Her warning comes as Florida recorded 10,109 new COVID-19 cases on Wednesday, the highest single-day increase for the state. There are now more than 175,000 confirmed cases in Florida. The state has seen back-to-back record-breaking days of coronavirus cases and Gov. Ron De Santis (R) has said the state will not reverse course on its reopening. “We’re not going back, closing things,” he said on Wednesday. “I don’t think that that’s really what’s driving it. People going to a business is not what’s driving it. I think when you see the younger folks – I think a lot of it is more just social interactions, so that’s natural.” The climbing cases have prompted fears of further outbreaks by July Fourth weekend gatherings. In response to those concerns, Miami-Dade County in announced it was imposing a curfew this weekend. Infectious disease expert: Trump Mount Rushmore event is ‘beyond… Study ties hydroxychloroquine use to lower COVID-19 death rate The curfew, starting Friday night at 10 p.m. and lasting until 6 a.m., will be implemented “until further notice,” said Carolos Gimenez, the county’s mayor. Florida is one of the states being hit hardest by COVID-19 right now, making up about 20 percent of new cases in the U.S.

Several US states post record Covid-19 cases, curfew ordered in Miami – Alabama and six other U.S. states reported record increases in coronavirus cases on Friday as Florida’s most populous county imposed a curfew ahead of the Independence Day weekend and Arkansas joined a push toward mandating mask-wearing in public.North Carolina, South Carolina, Tennessee, Alaska, Missouri, Idaho and Alabama all registered new daily highs in cases of COVID-19, the illness caused by the novel coronavirus. Texas hit a new peak for hospitalizations, with one doctor calling for a “complete lockdown” in the state o get the virus under control.The daily U.S. tally of cases stood at 53,483 late on Friday, below the previous day’s record 55,405.The recent surge, most pronounced in southern and western states, has alarmed public health officials, who urged caution ahead of a July 4th holiday weekend to celebrate the Declaration of Independence of the United States in 1776.North Carolina, for one, reported 951 hospitalizations and 2,099 cases, both record highs.Bill Saffo, mayor of Wilmington, North Carolina, said many infections had been traced to large gatherings and predicted a further jump after the holiday weekend as people disregarded guidelines on social distancing and masks.”We know that the spread is going to happen. We know probably in about two weeks we’ll see a spike from the July 4th weekend,” Saffo told CNN.Despite the jump in infections, the average daily death count in the United States has gradually declined in recent weeks, a reflection of the growing proportion of positive tests among younger, healthier people who are less prone to severe outcomes.However, U.S. Surgeon General Jerome Adams warned that the impact on fatalities from the recent surge, which started in mid-June, had yet to be seen. “Deaths lag at least two weeks and can lag even more,” he told “Fox & Friends” on Friday.

Alabama Records Its Biggest Rise in COVID-19 Cases with 1,758 Jump – Led by the Birmingham, Huntsville and Mobile areas, Alabama experienced its worst day yet in the spread of COVID-19, the Alabama Department of Public Health reported Friday. The agency’s COVID dashboard showed 1,758 new confirmed cases of the disease in its 24-hour report. That brought the total to 41,362 since the pandemic began in March. Another 507 cases were listed as probably from the virus, but not yet confirmed. The number of deaths rose by 22 for a total of 983, plus 24 that are probably from the disease but still under study. The daily figures reflected a dramatic increase in the growth of COVID-19. Statistics this week showed an average daily increase of 974 for the seven-day period thorugh Wednesday and an average increase of 823 a day for the 14-day period. Jefferson County reported one of its biggest spikes on Friday, with 270 new confirmed cases to bring its total to 4,802. The state’s most populous county also listed nine deaths for a total of 152. Jefferson leads the state in both of those categories. Madison County, home of Huntsville, had 167 new cases for a total of 1,271 but its death toll remained at seven. Mobile County reported 104 cases to raise its total to 3,904; its death count remained at 134. Montgomery County, which had been the state’s covid hotspot during part of June, listed 72 cases to raise its total to 3,947, second behind Jefferson. It had one death for a total of 103,

State reports record new COVID-19 cases Friday – The number of confirmed COVID-19 cases in Carteret County remains at 104 heading into the Fourth of July holiday weekend as the state reports a record number of new cases Friday. As of Thursday, 41 of the 104 confirmed COVID-19 cases in Carteret County were considered active. Statewide, North Carolina reported a record 2,099 new COVID-19 cases Friday. It is the first time the single-day case increase has exceeded 2,000 and marks the 10th day in a row the state is reporting more than 1,000 new daily cases. Hospitalizations in North Carolina also hit a new single-day record Friday with 951 patients currently hospitalized. “We are seeing significant spread of the virus and it is very concerning,” N.C. Department of Health and Human Services Secretary Dr. Mandy Cohen said in a statement Friday. “Today we have the highest reported day of new cases and hospitalizations – and that should be a warning to us all as we go into this holiday weekend. We don’t get a holiday from COVID-19. We all need to wear a face covering, avoid crowds

Is the coronavirus pandemic entering a second wave? – As countries around the world relax Covid-19 restrictions and some areas see an increase in infections, questions are being raised about whether the pandemic is entering what is known as a second wave. In the United States, where new cases had levelled off at roughly 20,000 a day for a period of weeks, infections have again spiked. The US on Friday reported one of its largest single-day increases since the start of the pandemic, with more than 40,000 new cases on the previous day, according to data from the Centres for Disease Control and Prevention. On Thursday, the World Health Organisation’s regional director for Europe Hans Kluge said 30 countries and territories in the region had seen increases in new cumulative cases in the past two weeks as they eased social distancing measures, with 11 of those experiencing a “significant resurgence”.But whether this means such areas are seeing a second wave remains unclear, largely due to the ambiguity of the term, experts say. Many caution against declaring a new rise in case numbers in areas or countries where cases had appeared to decline as a “second wave”, since an uptick of cases as social distancing restrictions are relaxed did not necessarily mean the start of a new cycle – or the end of old one – especially if there was still a significant amount of transmission. Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases, speaking in a June 18 interview with The Washington Post, said the United States was still in the first wave, even as case rates decline and increase at different times in various regions of the country. “But no one has really defined the scale that is required to call a second wave, either in terms of the time, or space, or the scale of the [case] numbers involved.” Mathews, a former deputy medical officer to the Australian government, said “second wave” was an ambiguous term, and not one “to use loosely”. The second wave phenomenon is most widely associated with past influenza pandemics. The 1918 flu pandemic, which infected 500 million people and killed 50 million worldwide, is infamous for its far deadlier second wave in the autumn, months after the first wave. A third wave occurred in a number of countries in 1919. Mathews said influenza-like second waves could be driven by a change in the virus or shifts in people’s behaviour, with changes in the virus thought to play a role in the second wave in 1918. Immunity had developed among a sufficient proportion of the population which drove the flu virus to evolve to “dodge immune response” and continue to infect people, he said.

Excess Deaths, March-May 2020 – Menzie Chinn -From “Estimation of Excess Deaths Associated With the COVID-19 Pandemicin the United States, March to May 2020,” JAMA, today: Across the United States, there were 95 235 reported deaths officially attributed to COVID-19 from March 1 to May 30, 2020. In comparison, there were an estimated 122 300 (95% prediction interval, 116 800-127 000) excess deaths during the same period (Table). The deaths officially attributed to COVID-19 accounted for 78% of the excess all-cause deaths, leaving 22% unattributed to COVID-19. The proportion of excess deaths that were attributed to COVID-19 varied between states and increased over time (Table and Figure 1). Figure 1: Excess Deaths in the United States From March 1 Through May 30, 2020. The observed number of deaths is indicated by the solid line, and the expected number of deaths, adjusting for seasonality, influenza epidemics, and reporting delays, is indicated by the dashed line. The area between these 2 lines represents the total number of excess deaths: blue-gray (bottom), deaths recorded as due to COVID-19; orange (narrow middle section), additional pneumonia and influenza excess deaths not coded as due to COVID-19; and beige (top), deaths that were not attributed to COVID-19, pneumonia, or influenza. This implies a point estimate for undercount of Covid-19 fatalities by 27,000 for the March-May period.(This approach is not persuasive if you thought the excess deaths were primarily people who were going to die in the very near future; for examples, see the excess fatalities debate for Puerto Rico/Hurricane Maria.)

Pandemic surpasses 10 million COVID-19 cases and over 500,000 deaths globally – Over the weekend, the number of COVID-19 cases surpassed the 10 million mark as the pandemic accelerated throughout North and South America, the Indian subcontinent, the Middle East and South Africa. As of this writing, the Worldometer coronavirus tracker had logged 10,196,711 cases. In another grim milestone, the number of global deaths due to COVID-19 rose above 500,000, standing at 503,149. The number of serious and critical cases has also begun to climb again. On Saturday, the United States posted a one-day high of 47,341 new COVID-19 cases, fueled by the reckless and premature “reopening” of the country. Brazil also posted another massive one-day total of 46,907 COVID-19 cases, pushing the global number of new cases close to 200,000. In addition, the number of fatalities internationally has been slowly climbing since May 27. A truck deliver coffins to a funeral store in Santiago, Chile. (AP Photo/Esteban Felix) By all accounts, most European countries have been faring better on the basis of a more measured lifting of lockdowns, having turned case numbers down sharply and reduced fatalities to the single digits, with the exception of the United Kingdom and Russia, which posted 100 and 188 deaths yesterday, respectively. However, on June 25, Hans Henri Kluge, the World Health Organization regional director for Europe, reported that Europe had seen an increase in weekly cases for the first time in months. “Thirty countries and territories have seen increases in new cumulative cases over the past two weeks,” he said. “In 11 of these, accelerated transmission has led to a very significant resurgence that, if unchecked, will push health systems to the brink once again in Europe.” South America, with 2.1 million cases, recorded 52,943 new COVID-19 cases and 2,664 deaths. Brazil continues to remain the epicenter of the pandemic, with 35,887 new cases yesterday and 994 fatalities. Presently, only hospital patients can be tested there, making its per capita testing abysmally low. At a health ministry briefing this weekend, officials indicated that plans were being worked out to acquire 46.5 million tests by the end of the year. In only two weeks, COVID-19 cases have soared from 867,000 to 1,344,000, an increase of nearly one-half million. With its high crude case fatality rate of 12.4 percent, Mexico’s cases continue to accelerate, and deaths continue to climb. There are now over 213,000 cases and more than 26,000 deaths.

Brazil set to pass 1.5 million coronavirus cases, cities reopen anyway (Reuters) – Brazil was set to pass 1.5 million confirmed coronavirus cases on Friday, as the virus continues to ravage Latin America’s largest country even as cities reopen bars, restaurants and gyms sparking fears infections will keep rising. Brazil has the world’s second largest outbreak after the United States and the virus has killed over 60,000 people in the country. In Rio de Janeiro, crowds gathered to drink on the sidewalk of an upscale beach-side neighborhood on Thursday night, the first evening bars in the city were allowed to reopen. Pictures of the revelry in Leblon, where few were wearing face masks and people were huddled close together, went viral on social media drawing condemnation and concern. “A tragedy foretold,” David Miranda, a federal congressman for Rio, wrote on Twitter above a picture of the crowded sidewalk. He criticized the city’s mayor Marcelo Crivella. “Crivella’s decision to throw open the doors of business will come with a high cost,” he added. In Rio alone, more than 6,600 people have died of COVID-19 in the past four months. Only 14 countries in the world have a death toll higher than the city. Intensive care units in public hospitals are at 70% capacity. Sao Paulo, Brazil’s largest and worst hit city, is expected to open bars and restaurants next week. President Jair Bolsonaro has been widely criticized by health experts for downplaying the severity of the virus which he has dismissed as just “a little flu.” Bolsonaro has pressured governors and mayors for months to reverse lockdown measures and reopen the economy.

Coronavirus live news: Brazilian cases pass 1.5m – as it happened – Here’s the coronavirus news for Friday:

There are now 11m confirmed cases of coronavirus worldwide
The US reported a daily global record of more than 55,000 new coronavirus cases on Thursday as infections rose in the vast majority of states and America’s top public health expert spoke of a “very disturbing week”. Thursday’s tally topped the previous single-day record of 54,771 set by Brazil on 19 June.
The US will be on a “red list” of high-risk countries that people in England are advised not to visit for non-essential reasons because of its continued high level of coronavirus cases, the UK government said.
The UK prime minister, Boris Johnson, stood by his decision to allow pubs, bars and restaurants to reopen in England on a Saturday despite concerns from the public that it could put extra strain on the police and the health service.
Cases of coronavirus are surging in South Africa, a month after the country lifted most of the restrictions brought in with one of the world’s strictest lockdowns. On Thursday, authorities reported the country’s biggest single-day jump in coronavirus cases, adding 8,728 confirmed infections and taking the total count to 168,061.
The number of confirmed cases of coronavirus in Iraq increased sevenfold in June, the International Rescue Committee said as it urged a redoubling of efforts to contain the spread of the disease in the country. By 1 July there had been 53,708 infections detected in the country, up from 6,868 on 1 June. The ministry of health said that hospitals are almost at full capacity.
A fresh state of emergency was declared in Belgrade, with a number of restrictions restored after a new increase in coronavirus infections in the Serbian capital. Local authorities across the country had already declared emergencies in several other municipalities where a rise in coronavirus cases had threatened to disrupt the functioning of the health system.
The Philippines reported its highest single-day increase in coronavirus infections, with 1,531 new cases detected in the past 24 hours, bringing the national total to 40,336. The country’s Covid-19 death toll has reached 1,280, after 12 more deaths from the disease.
Life in Russia is unlikely to return to normal until next February at the earliest, the country’s health minister said. Many restrictions have already been eased, but with thousands of new cases still being reported every day, and a death toll approaching 10,000, some measures remain in force, including a ban on international flights, extended on Thursday until August.
Mexico vastly underestimating virus death toll, studies say Mexico has been grossly underestimating its Covid-19 death toll, according to a growing number of independent studies suggesting there have been tens of thousands of deaths in excess of the official count, casting doubt on president Andrés Manuel López Obrador’s insistence that the pandemic has been tamed. As of Friday, Mexico has officially reported 283,511 infections and 29,189 deaths among its 129m population. But the true picture may be far worse. One study by independent researchers Mario Romero and Laurianne Despeghel shows at least 3.5 times more deaths in Mexico City than the official data, an undercount of some 22,705 deaths in the capital alone. In another, Raúl Rojas, a Mexican professor of artificial intelligence at Berlin University, calculated that Mexico could have as many as 6m cases and nearly 78,000 deaths – almost three times the official count. “I find it incredible that instead of giving numbers, they’re hiding them to conceal the seriousness of the situation,” he said. More than half the world’s average daily deaths from the virus are now in Latin America, making it one of the global centres for Covid-19. Brazil has the world’s highest official number of daily deaths, but with an average of 4.7 new deaths per 1m people in the last week, Mexico and Brazil are neck and neck in proportion to population. Mexico is only counting cases and deaths that have been confirmed by a laboratory – and only 610,495 people have been tested. In part because of the low level of testing, some 67 per cent of tests come back positive – an indication that many more cases are being missed.

Coronavirus cases in India: Record 23,500+ cases on Friday, 446 deaths -The Covid-19 pandemic continued to surge in the country as fresh cases rose to another record high on Friday, with over 23,500 reported during the day. With more than 22,000 new infections on Thursday, India’s coronavirus caseload has jumped by about 45,500 in just two days. The death toll from the virus has risen to 18,662 with 446 fatalities recorded on Friday. Covid-19 cases in India stood at 6,49,708, having crossed the 6 lakh mark just two days ago, as per data collated from state governments. Meanwhile, the recovery rate crossed 60%, with more than 3.93 lakh patients having been declared cured. As many as 23,526 new cases were reported on Friday. The spike was again led by Maharashtra, which recorded a new high of 6,364 infections. At least seven other states reported their biggest single-day jump in cases, led by a massive increase of 1,892 in Telangana and 1,694 in Karnataka. The others were Uttar Pradesh (972 new cases), Gujarat (687), Bengal (669), Odisha (561) and Kerala (211). Tamil Nadu became the second state in the country to cross the 1-lakh mark, reporting its second highest count of 4,329 on Friday. Delhi reported 2,520 cases, taking its caseload to over 94,600. The southern states together accounted for nearly 9,000 fresh cases (8,987 to be precise), on the back of a major surge of the pandemic in the region since the past few days. For the second day in a row, Maharashtra added over 6,000 cases to its Covid-19 tally. Friday’s 6,364 cases are the highest so far in a day, beating the previous high of 6,330 cases on Thursday. With this, the total number of cases in the state is now 1,92,990. Maharashtra added 198 deaths on Friday, of which 150 were from the last 48 hours and 48 from previous days.

250,000 babies may die indirectly due to COVID-19. Worst-case scenario: 1.2 million babies worldwide – Disruptions to health care and lack of food from COVID-19 are likely to cost the lives of at least 250,000 babies and young children and more than 10,000 mothers in low- and moderate-income countries over the next six months, according to a study from researchers at Johns Hopkins University.The study, published in The Lancet Global Health, modeled how many extra deaths could be expected from COVID-19’s impact on the food supply and medical systems in these countries. The study found a dramatic increase in maternal deaths from the absence of childbirth interventions like antibiotics and clean birth environments. Children will be more likely to die from lack of nutrition, reduced availability of antibiotics for pneumonia, sepsis and rehydration solution for diarrhea, according to the study.In the worst-case scenario, nearly 1.2 million additional babies and about 57,000 mothers would die across the 118 countries in six months, the research found. “If routine health care is disrupted and access to food is decreased (as a result of unavoidable shocks, health system collapse, or intentional choices made in responding to the pandemic), the increase in child and maternal deaths will be devastating,” the study concluded. “We hope these numbers add context as policy makers establish guidelines and allocate resources in the days and months to come.”

New, more infectious strain of COVID-19 now dominates global cases of virus – Researchers have shown that a variation in the viral genome of Covid-19 improved its ability to infect human cells and helped it become the dominant strain circulating around the world today. The study, published today in the journal Cell, shows the variation is more infectious in cell cultures under laboratory conditions. The variant, named ‘D614G’, makes a small but effective change in the ‘spike’ glycoprotein that protrudes from the surface of the virus, which it uses to enter and infect human cells. The D614G variant of Covid-19 quickly took over as the dominant strain soon after it first appeared, with geographic samples showing a significant shift in viral population from the original, to the new strain of the virus. Researchers from the Los Alamos National Laboratory in New Mexico and Duke University in North Carolina, partnered with the University of Sheffield’s Covid-19 Genomics UK research group to analyse genome samples published on GISAID, an international resource for sharing genome sequences among researchers worldwide. “We have been sequencing SARS-CoV-2 strains in Sheffield since early in the pandemic and this allowed us to partner with our collaborators to show this mutation had become dominant in circulating strains. The full peer-reviewed study published today confirms this, and also that the new D614G genome mutation variant is also more infectious under laboratory conditions. “Data provided by our team suggested that the new strain was associated with higher viral loads in the upper respiratory tract of patients with Covid-19, meaning the virus’s ability to infect people could be increased.

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