Here's how an unapproved drug like remdesivir, used in COVID-19 treatments, is legal, even if it's unapproved by the FDA with unknown results. USA TODAY
Finding a way to protect against COVID-19 would transform the fight against the coronavirus that has spread across the world since late last year.
Pharmaceutical companies and doctors have been hunting for drugs to treat COVID-19and launched a major effort to develop a vaccine against it, but they haven't focused as much on therapies for preventing infection before or after someone is exposed to the virus that causes the disease.
"The idea of having a way of preventing the infection and/or symptoms remains a critical need," said Dr. Susanna Naggie, vice dean for clinical research and an associate professor at the Duke University School of Medicine.
That's why there was so much excitement over the drug hydroxychloroquine, which President Donald Trump said he was taking for a while, to avoid infection with the virus. A study published last week found hydroxychloroquine failed to prevent infection. Other studies are ongoing, including some larger ones, that will confirm or contradict that finding.
Despite President Trump's thoughts, drug and disease experts seem to agree that hydroxychloroquine is not a proven preventative measure for COVID-19. USA TODAY
Hydroxychloroquine has received the most scientific attention undergoing more than 200 ongoing trials both because it was one of the earliest drugs available to be consideredand because Trump's support drove public interest.
Now that questions have been raised about its effectiveness, focus is slowly beginning to turn elsewhere, and trials of other approaches, from medications to mouthwashes, are beginning.
Even though some of those approaches already are well used, it will be months before scientists will know whether they can prevent COVID-19.
The negative attention on hydroxychloroquine has made it much harder for researchers to get enough volunteers to complete trials of the drug, said Naggie, who is helping to lead one of the largest.
Naggie said her team had hoped to quickly get 15,000 health care workers to volunteer to take hydroxychloroquine and finish her study in five or six months. Instead, only about 800 have signed up, and she expects her study to take months longer.
Public opinion of the drug has suffered, she said, in response to the politics and observational studies such as one in The Lancet, which has since been retracted, that raised questions about its effectiveness and risks in patients very sick with COVID-19.
Her $50 million study, called Healthcare Worker Exposure Response and Outcomes, or HERO, willbe useful to definitively answer the question about hydroxychloroquines effectiveness for pre-exposure prevention, she said.
Other prevention approaches are likely to be added to the study in the hopesthat one or more will eventually prove useful against the virus.
"The level of enthusiasm for something that is not hydroxychloroquine will be much higher," Naggie predicted. "The politicization of hydroxychloroquine, as well as the data that has come out in the inpatient setting, made a murky picture for this drug in particular."
When it comes to searching for a drug to prevent COVID-19, hydroxychloroquine has gotten most of the attention. But research is underway to look at other options that may be effective.(Photo: David J. Phillip, AP)
More: A coronavirus vaccine could require you to get two shots. Here's why.
More: In the race for a coronavirus vaccine, can Operation Warp Speed avoid politics?
A prevention approach differs from a vaccine, though it may be useful in combination, Naggie said. A vaccine hopefully provides long-term protection; a prophylaxis could help in the case of an exposure, or ongoing risk, such as to a health care worker.
For the flu, for example, an annual vaccine is not 100% effective, though it can reduce risk of serious infection. Many people exposed to the flu are prescribed the antiviral Tamiflu to help limit the infection. In HIV, for which researchers have tried for decades to develop a vaccine, people at high risk for the infection canbe prescribed the same drug cocktail for prevention as is used for treatment.
There are no federally approved treatments for COVID-19, though the anti-viral drug remdesivir has shown some effectiveness against it and isroutinely used in many places. For now, remdesivir is delivered only intravenously, so it is not a good option for people looking to prevent disease.
Researchers hope that whatever works as a treatment will also prevent initial infection and visa versa.
In a gigantic global trial called Solidarity, the World Health Organization is testing four different approaches to treating COVID-19: hydroxychloroquine, remdesivirand two combinations of drugs used to combat HIV, Lopinavir and Ritonavir, andLopinavir and Ritonavir plus the multiple sclerosis drug Interferon beta-1a. The two-drug combination was tested in China early in the outbreak and shown not to work as a treatment in very serious disease, but there issome hope that it might work in lesser infections.
Romark, a pharmaceutical company based in Tampa, Florida, is running two different trials of its candidate drug nitazoxanide, which has long been used to treat "traveler's diarrhea." For the past 15 years, the company has been studying whether it can be used to prevent a wide range of respiratory viruses.
Romark is testing the drug in 800 people in nursing homesand800 health care workers and first respondersto see whether it can prevent infection in people who have been exposed to the coronavirus. They hope to have results by the end of the summer, said Marc Ayers, Romark CEO.
Although it's too soon to know whether the drug will be successful, if it is, Romark will be prepared to produce as much as 200 million pills by the end of the year at its production facility in Puerto Rico, Ayers said.
For the trial, the pills will be given twice a day for six weeks. In nursing homes, once someone in the facility has COVID-19, Ayers said, he hopesnitazoxanide will stop the virus from spreading. Nursing homes are eligible to join the trial if they have an outbreak, he said, and the company pledged to enroll a nursing home within 72 hours of first contact with the company.
"We're working with a sense of urgency," he said.
Dr. Alexandra Kejner was in her third trimester of pregnancy and struggling with insomnia this spring when it struck her that the iodine she uses to sterilize the nose and throat of her patients might help clear COVID-19.
"That's what I wash my hands with before surgery,"said Kejner, an assistant professor at the University of Kentucky, adding it's also used for wound packing and sinus disease, and is relatively safe and affordable.
Kejner, the mother of a 2-month-old girl, has since launched a major study examining a specific concentration of iodine to prevent COVID-19. The aim is to coat the inside of the nose and mouth to prevent the virus from getting a foothold.
She's started to enroll 300 patients in the trial, as have collaborators at George Washington University and Louisiana State University.
Eligible participants use the carefully dosediodine nasal spray and gargle with it three times a day. Originally, they were going to be asked to use a nasal swab similar to the COVID-19 testing swabs, but Kejners husband tried it and vetoed it.
"No one will do this three times a day," he warned. So she changed the protocol.
The trial will include two groups of participants: patients hospitalized for non-COVID-19 reasonsand health care workers exposed to COVID-19 patients. To enroll, each participant will be tested to ensure he or she is notinfectedand screened for allergies to iodine.
For health care workers,Kejner said she sees iodine as a "second line of defense" in case they don't have enough personal protective equipment or it fails to keep them safe.
She hopes to have at least preliminary data within the next two to three months.
Dr. Michael Paasche-Orlow, a professor of medicine at Boston University School of Medicine and Boston Medical Center, said he wishes such trials had started sooner, so more results could arrive this summer.
The federal government, he said, focused too much on hydroxychloroquine instead of spreading the research into different prevention approaches.
"The early enthusiasm distorted the market," he said. "Why would we have 200 recent studies about hydroxychloroquine and not more diversity of projects? It feels that there was a missed opportunity."
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.
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While tracking Georgia's COVID-19 data we noticed 14 deaths disappeared.
ATLANTA In Georgia, there are now more than 52,000 confirmed casesand over 2,200 deaths, as of Monday.
But it's important to not just look at the numbers, but to analyze what they mean and add perspective.
According to a report generated on May 29, and provided to 11Alive through an open records request, we can now see the county breakdown of how many people have died at the hospital, with COVID-19. The report says that of the around 7,700 hospitalizations, 19 percent of those patients, 1,446 had died.
On that same day, Georgia Emergency Management reported 891 active patients. If you subtract out both those groups, you end up with 5,397. That number represents COVID-19 recoveries, people who were the most seriously ill and went to the hospital, but have since gone home.
Over the weekend, a nurse reached out to us after she noticed the number of fatalities reported on the Department of Public Health's daily status report dropped by 14 people.
Is this possible? How can the number of deaths go down?
We have been tracking this and dozens of other metrics everyday and noticed this change as well. Usually it's a confirmed positive case getting moved back in time or shifted to another county as DPH learns more.
This time, a DPH spokesperson said their quality control team found duplicates.
In a written statement she said, "We can get the same death reported by more than one source. Or sometimes it's a name that was misspelled and resubmitted without being identified as a correction. Many are simply clerical errors."
There are a lot of decisions being made using this data, and as frustrated as we may get with it, national groups like covidtracking.com give Georgia an A for its data quality. And fixing mistakes when theyre caught, is one reason why.
11Alive is focusing our news coverage on the facts and not the fear around the virus. We want to keep you informed about the latest developments while ensuring that we deliver confirmed, factual information.
We will track the most important coronavirus elements relating to Georgia on this page. Refresh often for new information.
OTHER CORONAVIRUS HEADLINES:
Norwegian and British vaccine scientists have published unequivocal evidence that SARS-CoV-2, the coronavirus responsible for the COVID-19 pandemic, is man-made.
The authors state two conclusions: (1) the mutations that would normally be seen in the course of animal to human transmission have not occurred in SARS-CoV-2, indicating that it was fully pre-adapted for human infection and (2) SARS-CoV-2 has insertions in its protein sequence that have never been detected in nature and contribute to its infectivity and pathogenicity.
That is, SARS-CoV-2 has a receptor binding domain specifically designed for the human angiotensin converting enzyme-2 receptor (ACE2) found in lungs, kidneys, intestines and blood vessels.
In addition, SARS-CoV-2 has a furin polybasic cleavage site not found in any closely-related bat coronaviruses as well as other artificially inserted charged amino acids that enhance the virus ability to bind to and enter human cells by forming salt bridges between the virus and the cell surface.
Those modifications are key to understanding the unique transmissibility and potency of SARS-CoV-2.
The authors explain that the COVID-19 pandemic is revealing neurological, haematological and immunological pathogenicity, which cannot be explained by infectivity via the ACE2 receptor alone.
There have been wide-ranging clinical observations such as a loss of taste and smell, sore throat, dry cough, headache and severe gastrointestinal pain with diarrhoea.
SARS-CoV-2 binding to the bitter/sweet receptors in the upper respiratory tract provides a perfect location for transmission by coughing.
According to the authors, oral and upper respiratory infection can lead to transmission to the lower respiratory tract, gastrointestinal effects and a cascade of inflammation-producing immunological responses.
The wide-spread systemic release of the virus, due to its co-receptor enhancement, could explain the multiple clinical findings on the cardiovascular system, immunological T-cells, cells associated with neuropathological conditions and, finally, the severe hypoxia seen in advanced cases of the disease.
As the authors correctly note, the development of an effective vaccine cannot be accomplished without an objective analysis of the structure of SARS-CoV-2, its mode of action and its origin.
That effort has been hampered by Chinas refusal to fully disclose the information it possesses, in conjunction with a politically-motivated scientific misinformation campaign by Beijing to avoid responsibility, by some Western scientists with a vested interest in the outcome and by an uninformed and servile media.
That includes the editorial decisions of scientific and medical journals, which seem to favour, overwhelmingly, the narrative that the COVID-19 pandemic is just another naturally-occurring outbreak, even to the extent of censoring opposing views.
Until now, the cover-up of the true origin of the COVID-19 pandemic has been successful.
No less than the Office of the Director of National Intelligence in the United States has blindly accepted the scientific conventional wisdom promoted by the Chinese Communist Party, issuing the following April 30, 2020 statement:
The Intelligence Community also concurs with the wide scientific consensus that the COVID-19 virus was not manmade or genetically modified.
Remarkedly, there has never been conclusive scientific evidence to support that claim, yet many appear content endorsing the naturally-occurring narrative, mostly out of ignorance or an unwillingness to accept the ugly truth.
That ugly truth is - China manufactured SARS-CoV-2 and, through a combination of hubris, incompetence and recklessness, unleashed it on the world.
(Disclaimer: The opinions expressed above are the personal views of the author and do not reflect the views of ZMCL)
As states open up and some people return to life as usual, others will be staying home and isolated. USA TODAY
Statewide shutdowns across the country may have prevented millions of coronavirus infections in the USA, according to a study published Monday.
Researchers found the USA may have been able to avoid an additional 4.8 million confirmed coronavirus cases, which translates to about 60 million more infections, as a result of statewide lockdowns and mandated social distancing restrictions, according to the report published in the peer-reviewed scientific journal Nature.
Infections were much higher than confirmed cases, they argued, because many people didn't have access to a coronavirus test or didn't go to their doctors to obtain one. The study documented changes in testing procedures and availability, as well as differences in case detection across the country.
Johns Hopkins University reportedmore than 1.9 million confirmed coronavirus cases and more than 110,000 deaths as of Monday.
The studys authors used a reduced-form techniquemore commonly used to measure economic growth rates. They argued that, similar to COVID-19 infections, economic output generally increases exponentially as a result of policies and other conditions.
The study looked at 1,717 local, regional and national policies, including travel restrictions, the cancellation of events, the closing of schools, retailand religious gatherings,quarantinesand other emergency declarations, from early April.
"Theyre using economic growth as a proxy for interconnectedness, and its the interconnectedness that drives the epidemic," saidDr. Kevin Dieckhaus, chief of infectious diseases at University of Connecticut Health.
Dieckhausexpects the USA will be able to decouple economic activity and case transmission as some businesses restructure office settings to promote social distancing, schedule constant disinfecting and require a mask.
A separate study, also published Monday in the journal Nature, found such lockdown methods may have prevented more than 3 million deaths across 11 European countries.
Both studies contribute to the growing evidence that national and regional lockdowns helped prevent coronavirus transmission and infection. Experts are concerned about a second wave of cases as the USA begins to ease restrictions and reopen the economy.
Giant kookaburra: A man built a giant, laughing kookaburra while he was in lockdown to 'cheer us up'
A website created by three college students is helping volunteers link up with organizations to provide services from food delivery and tutoring to mental health and support for older adults during the coronavirus pandemic. (June 4) AP Domestic
"Thelockdown measures have served an important role in our society to prevent and mitigate unabated spread of the virus probably saving many millions of lives in doing so," saidMichael Mina, assistant professor of epidemiology at Harvard T.H. Chan School of Public Health.
He's concerned the millions of confirmed cases prevented by social distancing restrictionsin the spring may reappear in the fall. Most seasonal coronaviruses thrive in the fall,then begin to settle down in February and March.
"We have yet to experience this particular novel coronavirus during a season when it's usually most transmissible, and thats a scary thought," hesaid.
Dieckhaus said the fall may bring more cases asthe physical properties of the coronavirus prefer the cold, dry weather and more people spend less time outdoors in the well-circulated air. He said officials and residents have the power to manage cases by upholding preventive measures.
"The idea with all these changes is to continue the economicactivity but doing it in a way that doesn'ttransmit the virus," he said.
Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.
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In the last two days, Los Angeles County officials announced 81 new coronavirus-related deaths, the highest total reported over a weekend in more than a month.
The highest weekend total of deaths was previously reported April 18-19, when 105 deaths were announced. Officials also reported 3,000 new cases on Saturday and Sunday.
When officials announced that the county would more fully reopen businesses and outdoor venues, such as beaches and parks even as the case count and death rate continued to climb they reiterated a message repeated countless times in weeks prior: The virus has not changed; the only change has been in peoples behavior and the commitment to practice social distancing.
Now, two weeks after Memorial Day weekend saw crowds gather at newly reopened beaches and just over a week since restaurants and most businesses were given the green light to resume operations, officials have reported that the transmission rate of the virus appears to have increased, an expected reality as activity rose.
Dr. Christina Ghaly, director of health services for L.A. County, said Friday the effective transmission rate had now risen above 1 meaning each infected person goes on to infect more than one other individual and was gaining ground.
While we dont know precisely yet how reopening and the recovery activities will affect transmission of COVID-19, Ghaly said, the transmission rate does appear now to be greater than 1, and slightly uptrending.
On Monday, officials announced an additional 10 deaths and 823 new cases of the virus, bringing the total number of infections to 64,644. The numbers are typically lower on Mondays because of fewer reports over the weekend.
The latest rise in cases cannot be linked to the thousands who have taken to the streets in the past week to protest over police killing of George Floyd and racial inequality. The incubation period for the virus is can take up to 14 days, so numbers currently reported reflect actions from weeks prior, officials have said.
Thats not to say that activities at the protests wont affect the case count in the coming days.
Officials have continued to commend peaceful protesters for exercising their 1st Amendment rights while also reminding them to remain cautious.
Public Health Director Dr. Barbara Ferrer on Monday compared the risk of exposure at protests to the risk posed by gathering in other public settings, including indoor malls and restaurants. In such instances, contact tracers would not be in touch with individuals who might have been exposed to the virus.
Nobody knows you were there, she said. No one will call you.
Ferrer encouraged protesters Monday to be proactive and to get tested for the virus, while reminding demonstrators that it could take up to two weeks for the virus to show up in a persons system.
A negative test result doesnt mean you cant become infected during the 14-day incubation period.
Those who came into contact with someone who was not wearing a face mask or had a known case of exposure should self-quarantine during the incubation period.
The risk is still there. Even though it may not be a huge risk, its enough of a risk for everyone to take these universal precautions, she said.
Although many have worn face coverings while protesting, it is nearly impossible to maintain a six-foot separation amid a crowd. Various state officials, as well as health experts with the U.S. Centers for Disease Control and Prevention, are warning protesters to get tested amid concerns that the demonstrations might lead to another surge in cases.
Those individuals that have partaken in these peaceful protests or have been out protesting, and particularly if theyre in metropolitan areas that really havent controlled the outbreak ... we really want those individuals to highly consider being evaluated and get tested, CDC Director Dr. Robert Redfield told a congressional hearing last week.
Citing concerns over violence that erupted during early protests, L.A. County officials closed or modified hours at several testing sites last week. The decision concerned experts, as tests and social distancing practices remain the only real weapons against the virus in the absence of a vaccine and medical therapies.
The virus has remained on the minds of protesters, who have ended months of self-isolation to voice their outrage over the death of Floyd last month at the hands of Minneapolis police officers. In addition to the free food and water that volunteers have passed out at protests, there has been an ample supply of hand sanitizer distributed.
A group of about 50 nurses and healthcare workers who have been battling the coronavirus on the front lines at Santa Monica Medical Center, Childrens Hospital Los Angeles, Ronald Reagan UCLA Medical Center, USC Keck Medical Center and Kaiser Permanente joined Saturdays protest in front of Los Angeles City Hall with bags full of sanitizer.
Racism is a public health crisis, said Delilah Garcia, 24, about why she was attending the protests despite the risk of COVID-19, which has disproportionately affected black communities. Enough is enough.
Meanwhile, as thousands continue to protest against police brutality and inequality, protests over coronavirus restrictions continue. A crowd gathered Monday to protest for the reopening of the nail industry at the Asian Garden Mall in Westminster. The protest came after industry association Nailing it for America released a statement Saturday calling Gov. Gavin Newsoms previous comments about nail salons nothing short of a fiasco for business owners.
In May, Gov. Gavin Newsom said that the coronavirus in California originated from a nail salon. Activists said that wasnt true after meeting with the governor last week. Nail salons are one of the businesses that are currently not allowed to reopen under the state orders.
For the foreseeable future, MinnPost will be providing daily updates on coronavirus in Minnesota, published following the press phone call with members of the Walz administration each afternoon.
Here are the latest updates from June 8, 2020:
Eleven more Minnesotans have died of COVID-19, the Minnesota Department of Health said Monday, for a total of 1,197.
Of the deaths announced Monday were two people in their 90s, three in their 80s, one in their 70s, four in their 60s and one in their 20s. Six of the 11 were residents of long-term care. Of the 1,197 deaths reported in Minnesota so far, 955 were among residents of long-term care.
The person in their 20s had no underlying health conditions. The same was true of a person in their twenties whose death was reported Saturday.
The current death toll only includes Minnesotans with lab-confirmed positive COVID-19 tests.
MDH also said Monday there have been 28,224 total confirmed cases of COVID-19 in Minnesota, up 338 from Sundays count.
Since the start of the outbreak, 3,401 Minnesotans have been hospitalized and 452 are currently in the hospital, 198 in intensive care. You can find more information about Minnesotas current ICU usage and capacity here.
Of the 28,224 confirmed positive cases in Minnesota, 23,657 are believed to have recovered.
A total of 354,226 COVID-19 tests have been completed in Minnesota.
More information on cases can be found here.
MDH released new guidance on youth and adult sports over the weekend. The guidance takes into account the amount of contact involved in a given sport as well as shared equipment and other factors, dividing sports into low, medium and high-risk.
Were very hopeful that if the COVID-19 health measures continue to improve, we expect to be able to resume games and competitions for medium-risk sports by the end of June, Health Commissioner Jan Malcolm said.
MDH is encouraging anyone who was part of a protest, community clean-up, or providing food or water to demonstrators to get tested for COVID-19 whether they are symptomatic or not.
MDH is finalizing the details on three community testing sites in Minneapolis and one in St. Paul that will be open Tuesday and Wednesday of this week, Malcolm said.
MDHs coronavirus website: https://www.health.state.mn.us/diseases/coronavirus/index.html
Hotline, 7 a.m. to 7 p.m.: 651-201-3920
Editors note:This is a live account of COVID-19 updates fromMonday,June 8,as the day unfolded. Tofind resources and the latest extended coverage of the pandemic,click here.
Health experts warn that tear gas and pepper spray could make respiratory illnesses such as COVID-19 spread more easily by inducing coughs, sneezes and irritation. Despite these admonitions, Seattle Police again used both to disperse crowds of protesters on Capitol Hill late Sunday night and early Monday morning. (Follow live protest updates here.)
Counties around Washington state are confirming they likely missed some early deaths from undiagnosed novel coronavirus disease. Although retrospective testing elsewhere hasset back the timelinefor its spread in the country, medical examiners and coroners offices here in Washington have had limited ability to do the same, and counties have prioritizedusing resources to detect and contain current outbreaks.
State health officials confirmed 287 new COVID-19 cases in Washington on Sunday, as well as six additional deaths. The update brings the states totals to 23,729 cases and 1,159 deaths, according to the state Department of Healthsdata dashboard. The dashboard reports 3,669 hospitalizations in Washington.
Throughout Monday, on this page, well post updates from Seattle Times journalists and others on the pandemic and its effects on the Seattle area, the Pacific Northwest and the world. Updates from Sunday can be foundhere, and all our coronavirus coveragecan be found here.
The following graphic includes the most recent numbers from the Washington State Department of Health, released Monday.
For months, immigrant advocates have feared the novel coronavirus was silently spreading at the Northwest detention center.The results of court-ordered testing have now come back, and all but one of 45o were negative, according to a Monday filing by federal authorities.
Not everyone was tested at the Tacoma facility because 111 detainees declined to give their consent, according to the filing.
The person who tested positive, who arrived at the detention center May 29, was initially held with one other detainee in a unit reserved for new arrivals and was transferred, after the positive test result, to a medical isolation unit.The detainee exposed to that person tested negative for COVID-19 but will still be held alone in a cell and under medical observation for 14 more days.
The findings appear to be a validation for Immigration and Customs Enforcement (ICE), which faces a proposed class-action lawsuit on behalf of vulnerable detainees seeking release.
Read the full story here.
Nina Shapiro
When looters broke into the Simply Seattle shop near Pike Place Market two weekends ago, owner Jamie Munson tried to take the long view.
None of his employees had been hurt. Insurance was likely to help with broken windows and smashed cash registers. And while the damage meant he couldnt open the shop last Friday, when King County allowed retailers and others to partly reopen, Munson doubts the delay will matter much, given the heavy restrictions and tough economic climate businesses will probably face for months.
That sort of weary pragmatism seems common among the scores of Seattle-area businesses swept up in the incidents of destruction that followed recent protests over police violence.
By latest count, vandals and looters struck more than 100 stores, restaurants, and other businesses in Seattles downtown, Belltown, Capitol Hill, and Chinatown-International District neighborhoods, according to the Downtown Seattle Association.
Aside from the looting and vandalism, area businesses faced unprecedented challenges in recovering from COVID-19.
Read the full story here.
Paul Roberts
EL CENTRO, Calif. The tinyEl Centro Regional Medical Center has seen spikes in emergency department visits here and there a bad flu season, injured off-road vehicle drivers, overheated farmworkers. But they've always been able to manage.
Then came COVID-19.
Thehospital, which has a 20-bed intensive-care unit, has been overwhelmed with ailing residents of the Imperial Valley, as well as Americans and U.S. green card holders fleeing overcrowded clinics and hospitals in Mexicali, a city of 1.1 million on the other side of the border.
To alleviate the pressure, hospitals in nearby San Diego and Riverside counties began accepting transfers in April. But the intensifying crisis prompted California last week to activate an extraordinary response, enlisting hospitals as far north as Santa Barbara, San Francisco and Sacramento to accept patients from this remote southeastern corner of the state.
The swelling numbers of COVID-19 patients entering the United States from Mexico comes as many parts of California have pushed down their infection rates, enabling many counties to lift stay-at-home restrictions and reopen businesses.
Read more here.
The New York Times
Police departments have used tear gas and pepper spray on protesters in recent weeks, raising concern that the chemical agents could increase the spread of the coronavirus.
The chemicals are designed to irritate the mucous membranes of the eyes, nose and throat. They make people cough, sneeze and pull off their masks as they try to breathe.
Medical experts say those rushing to help people sprayed by tear gas could come into close contact with someone already infected with the virus who is coughing infectious particles. Also, those not already infected could be in more danger of getting sick because of irritation to their respiratory tracts.
Read more here.
The Associated Press
RALEIGH, N.C. Republican lawmakers in North Carolina are planning to vote this week on a measure that would allow President Donald Trump to speak in front of a packed Republican National Convention without some of the restrictions officials have required elsewhere to stop the coronavirus.
The first vote, which could be held as early as Tuesday, will largely be a symbolic one, given the measure will almost assuredly be rejected by Democratic Gov. Roy Cooper and Republicans will be unlikely to have the votes to override his veto.
During a Monday news conference, the governor called the proposal irresponsible and suggested state lawmakers do not have a role in the decision-making process.
Read more here.
The Associated Press
WASHINGTON The U.S. economy entered a recession in February as the coronavirus struck the nation, a group of economists declared Monday, ending the longest expansion on record.
The economists said that employment, income and spending peaked in February and then fell sharply afterward as the viral outbreak shut down businesses across the country, marking the start of the downturn after nearly 11 full years of economic growth.
A committee within the National Bureau of Economic Research, a private nonprofit group, determines when recessions begin and end. It broadly defines a recession as a decline in economic activity that lasts more than a few months.
For that reason, the NBER typically waits longer before making a determination that the economy is in a downturn. In the previous recession, the committee did not declare that the economy was in recession until December 2008, a year after it had actually begun. But in this case, the NBER said the collapse in employment and incomes was so steep that it could much more quickly make a determination.
Read more here.
The Associated Press
KENNEWICK A Washington labor union for farm workers has sued two state agencies, asking a Thurston County Superior Court judge to strike down emergency rules on temporary housing.
Union president Ramon Torres says the rules do not protect farm workers who live in dormitory-style housing during the harvest season.
The Tri-City Herald reports the lawsuit was filed last week by the union Familias Unidas por la Justicia because of fears sparked by the coronavirus pandemic.
Read more here.
The Associated Press
State health officials confirmed 312 new COVID-19 cases in Washington on Monday, as well as two additional deaths.
The update brings the states totals to 24,041 cases and 1,161 deaths, according to the state Department of Healths (DOH) data dashboard. The dashboard reports 3,699 people hospitalized in Washington.
So far, 410,290 tests for the novel coronavirus have been conducted in the state, per DOH. Of those, 5.9% have come back positive.
King County, the state's most populous, has reported 8,496 positive test results and 579 deaths, accounting for 49.9% of the state's death toll.
Marriott, Hilton and other big hotel companies are used to competing on price or perks. Now, they're competing on cleanliness.
From masked clerks at the front desk to shuttered buffets, hotels are making visible changes in the wake of the pandemic. Signage will tout new cleaning regimens: Red Roof Inns promise RediClean, while Hilton boasts of CleanStay with Lysol.
Hotels are still mostly empty; in the U.S., occupancy stood at 37% the week ending May 30, down 43% from the same period a year ago, according to STR, a data and consulting firm. But leisure travel is starting to pick up, and hotels see cleaning standards as a way to soothe jittery guests and possibly win back business from rivals like home-sharing companies like Airbnb.
Read the full story here.
The Associated Press
A U.S. federal agency approved a new highly sought-after respirator mask made by Chinese automotive conglomerate BYD Co., paving the way for Washington and other states to complete orders totaling hundreds of millions of dollars and distribute the masks.
The National Institute for Occupational Safety and Health approved BYDs application for the N95 mask on Sunday, a spokeswoman for the federal agency told The Seattle Times on Monday.
The masks, which are designed to filter out tiny airborne particles, have been in high demand globally to protect against the coronavirus that causes COVID-19. Washington states Department of Enterprise Services (DES) had ordered 55 million of the N95 masks for $178 million but has been waiting for federal approval to complete the orders.
The scarcity of N95 masks early in the pandemic prompted Washington and other states to initially order a Chinese alternative known as the KN95, but officials later canceled orders due toproblems with quality and fit.
Read the full story here.
Daniel Gilbert and Mike Reicher
The Columbia City Farmers Market will be open Wednesday, for the first time since it shut down in March amid the coronavirus pandemic.
Seattle's year-round neighborhood farmers markets shut down as social-distancing measures ramped up in March and have been slowly reopening since then.
The market, on 35th Avenue South, will be open from 3 to 7 p.m. There will be only one entrance, and shoppers are encouraged to wear masks and keep 6 feet of distance.
David Gutman
It's not just the protests.
Across the country and around the world, people are slowly beginning to move away from social distancing. Economies are starting to reopen and people are inching back toward their normal routines.
In Barcelona, Spain, above, teachers tried to prevent elementary school students from hugging on their first day back.
Click here for more images of a world beginning to venture out.
The Associated Press
Researchers are still trying to figure out a great many things about the new coronavirus, including how easily it is spread by people showing no, or mild symptoms of COVID-19.
The World Health Organization believes the transmission by asymptomatic people of SARS-CoV-2 is rare, but that the issue needs more study.
The WHO's position is based on data from countries doing extensive contact tracing investigations and is finding that asymptomatic people are not widely spreading the disease, said Maria Van Kerkhove, the WHO's technical lead for COVID-19, at a press briefing Monday.
When questioned in more detail about these cases, Van Kerkhove said many of them turn out to have mild disease or unusual symptoms.
We are constantly looking at this data and were trying to get more information from countries to truly answer this question, she said. It still appears to be rare that asymptomatic individuals actually transmit onward.
Kerkhove's comments come despite warnings from numerous experts worldwide that such transmission is more frequent and likely explains why the pandemic has been so hard to contain.
Although health officials in countries including Britain, the U.S. and elsewhere have warned that COVID-19 is spreading from people without symptoms, WHO has maintained that this type of spread is not a driver of the pandemic and is probably accounts for about 6% of spread, at most. Numerous studies have suggested that the virus is spreading from people without symptoms, but many of those are either anecdotal reports or based on modeling.
The Associated Press
Canada is slightly easing border restrictions enacted due to the coronavirus pandemic and will allow immediate family members of citizens or permanent residents to come to the country, Prime Minister Justin Trudeau announced Monday.
Trudeau stressed anyone entering the country will be required to quarantine for 14 days or face serious penalties.
Immigration Minister Marco Mendicino said the limited exception will apply to spouses, common law partners, dependent children, parents and legal guardians. He said they will have have to stay in Canada for at least 15 days.
Canada had allowed only Canadians and permanent residents into the country under a border closure to nonessential travel imposed in March.
The Associated Press
HCA Healthcare is one of the worlds wealthiest hospital chains. It earned more than $7 billion in profits over the last two years. It is worth $36 billion. It paid its chief executive $26 million in 2019.
But as the coronavirus swept the country, employees at HCA repeatedly complained that the company was not providing adequate protective gear to nurses, medical technicians and cleaning staff. Last month, HCA executives warned that they would lay off thousands of nurses if they did not agree to wage freezes and other concessions.
A few weeks earlier, HCA had received about $1 billion in bailout funds from the federal government, part of an effort to stabilize hospitals during the pandemic.
HCA is among a long list of deep-pocketed health care companies that have received billions of dollars in taxpayer funds but are laying off or cutting the pay of tens of thousands of doctors, nurses and lower-paid workers. Many have continued to pay their top executives millions, although some executives have taken modest pay cuts.
Read the full story here.
The New York Times
Shutdown orders meant to blunt the spread of the novel coronavirus were largely successful, according to two new studies.
The measures prevented about 60 million infections in the United States and 285 million in China, according to a study by researchers at the University of California at Berkeley.
A separate study from epidemiologists at Imperial College London estimated that the shutdowns saved about 3.1 million lives in 11 European countries, including 500,000 in the United Kingdom, and dropped infection rates by an average of 82%, sufficient to drive the contagion well below epidemic levels.
The reports, both published Monday in the journal Nature, provide fresh evidence that aggressive and unprecedented shutdowns, which caused massive economic disruptions and job losses, were necessary to halt the exponential spread of the novel coronavirus.
Read the full story here.
The Washington Post
Cities, counties and states continue to reopen even as the new coronavirus shows no signs of slowing down in many regions of the country.
A Washington Post analysis shows that 23 states and the District of Columbia and Puerto Rico, are showing an increase in the rolling seven-day average of coronavirus cases compared to the previous week.
None of the plans for how the nation might safely emerge from the coronavirus lockdown involved thousands of Americans standing shoulder to shoulder in the streets of major cities or coughing uncontrollably when the authorities used tear gas to disperse them. No one planned on protesters being herded into crowded prison buses or left in crowded cells.
Before the eruption of outrage over the killing of George Floyd in police custody in Minneapolis, debates about reopening centered on whether states had adequate systems in place to detect and treat cases of the coronavirus, which has killed more than 110,000 people in the United States since the beginning of the year.
But as the protests against police brutality continue for a second week, public officials are warily watching for signs that an unanticipated end to social distancing on a mass scale has led to new cases of the virus. The question has become part of the politicized debate over the economic repercussions of the lockdown, which some critics have argued went too far.
And on Sunday, infectious disease experts on Twitter debated how to supply a reliable estimate of the impact of the protests on virus transmission or whether trying to do so may wrongly be seen as discouraging participation in the growing racial justice movement.
In what he called a back-of-the-envelope estimate, Trevor Bedford, an expert on the virus at the Fred Hutchinson Cancer Research Center, wrote on Twitter that each day of protests would result in about 3,000 new infections. Over several weeks, as each infected person infected just under one other person on average the current U.S. transmission rate those infections would in turn lead to 15,000 to 50,000 more, and 50 to 500 eventual deaths. Given the racial disparities so far in the pandemic, he noted, those deaths will be disproportionately among black people. Societal benefit of continued protests must be weighed against substantial potential impacts to health, he wrote.
Marc Lipsitch, an epidemiologist at Harvard, agreed that those projections were reasonable, and said in an email that Dr. Bedford had done a service by making an approximate estimate with explicit assumptions.
But he also noted that if states where the virus was still spreading managed to rein it in, that would massively overshadow the effects of the protests. About 20,000 new cases are identified across the country on most days, and about 1,000 new deaths are announced. If all communities were performing enough tests and contact tracing to bring down those numbers, fewer of those acquiring infections at protests would infect others, shortening the transmission chain and reducing the number of eventual deaths.
Dr. Bedford wrote that his estimates contained a lot of uncertainty. There is no official estimate for how many people are protesting on an average day, for instance. Still, he thought it was important, he said, to provide a framework grounded in epidemiologic principles to counter the offhand assumptions being made by political pundits. But, in response, other scientists voiced concern that Dr. Bedfords posts would give fodder to those opposing civil rights.
Many epidemiologists, including Dr. Bedford, have noted in recent days that Americas entrenched racial inequalities themselves translate into disproportionate early deaths and illness among African-Americans. That has been especially evident in the coronavirus pandemic, in which black Americans are dying at about twice the rate of white Americans. A group of more than 1,000 people working in health and medicine signed a letter recently that said protests were, in fact, vital to public health.
Racism and police violence are major threats to public health in this country, and protest is one of the only options available to people who have been systematically disenfranchised, said Eleanor Murray, an epidemiologist at Boston University.
Because it can take up to two weeks for a newly infected person to show symptoms and the protests started shortly after Mr. Floyds death, health experts expect that any increase in cases will begin to surface this week. Demonstrators in several places have contracted the virus, including in Lawrence, Kan., where someone who attended a protest last weekend tested positive on Friday. That person did not wear a mask while protesting, local officials said. In Athens, Ga., a county commissioner who attended a protest said that she had tested positive.
In Oklahoma, a college football player who participated in a demonstration revealed that he later tested positive for the virus.
After attending a protest in Tulsa AND being well protective of myself, I have tested positive for Covid-19, Amen Ogbongbemiga, a linebacker at Oklahoma State University, wrote on Twitter. Please, if you are going to protest, take care of yourself and stay safe.
Many did their best. In Califoria, Jarrion Harris, 32, wore a cloth mask for a march in Hollywood on Sunday.
Im definitely not out here because I think Covid-19 has gone into the shadows, he said. Its worth the risk.
Politicians and public health officials have urged demonstrators to wear face coverings and to maintain social distancing. In some places, including Atlanta, Illinois, Los Angeles and Minnesota, officials have also urged protesters to seek coronavirus tests to make sure they have not become infected.
The surge of protests throughout American cities and the seeming support of some political leaders have not gone unnoticed on the right. Pundits and commentators have made the point in recent days that mayors and governors who sternly warned against public gatherings are now giving their blessing to the protests.
Dr. Tom Frieden, the former director of the Centers for Disease Control and Prevention who was appointed by President Barack Obama, tweeted last week that the threat to controlling the coronavirus was tiny compared with the threat created when governments act in ways that lose community trust.
That struck Jonah Goldberg, a writer for The Dispatch, an online conservative magazine, as an unfair double standard.
You know what erodes public trust in people like Frieden? Mr. Goldberg wrote. When they say that youre a fool or monster who will get people killed for wanting to go to church or keep your business open but youre a hero when you join a protest they approve of.
As the virus has spread across the country, many conservatives have rebelled against the stringent measures supported by public health experts, and there have been skirmishes over wearing masks in public, allowing in-person religious services and placing a premium on restoring the economy over other concerns.
If the virus surges again, said Christopher F. Rufo, director of the Center on Wealth and Poverty at the Discovery Institute, a conservative think tank, the experts standing will have been undermined. Youre going to have half the country that has lost faith almost completely in the public health establishment, he said.
But it may be hard to trace infections to other protesters, who are often marching side by side with strangers. And infectious disease experts have said that any increase in cases may well be the result of the continued reopening of restaurants, workplaces and mass transit.
In Las Vegas, casinos are reopening. In New York City, long the center of the coronavirus outbreak in the United States, as many as 400,000 workers on Monday can begin returning to construction jobs, manufacturing sites and retail stores as the city enters the first phase of its reopening.
You cannot pin this on the protests, said Jeffrey Shaman, an epidemiologist at Columbia University, whose projections of the viruss path suggest that U.S. coronavirus deaths will increase in the coming weeks. The protests are not in and of themselves going to drive the resurgence in cases. This is associated with all the new opportunities that are providing a way for people to get together and pass the virus to one another.
For their part, activists said the drive to protest in the face of the virus reflected the larger gravity of the moment and the intensity of their passion.
If I get infected fighting for justice, my soul can sit with that, said Sara Semi, 27, a protester in Minneapolis who wears a mask with a filter and carries cans of disinfectant spray. I cant sit at home protected by my privileges if others arent. I cant sit inside my house safe while my friends and neighbors are not. Yes, corona is happening. Its real, its deadly. But racism kills way more lives.
Vidal Guzman, 29, a protester in New York, said: People are more scared of the police than Covid-19. They are willing to do anything.
Different conditions and the many remaining unknowns about how the virus is transmitted can make it difficult to predict the spread of the virus at any given protest. Outdoor gatherings are much lower risk than indoor ones. How many people are wearing masks, whether they are shouting or using noisemakers and even the weather may all affect the risk of infection.
Still, expert say it is within the power of law enforcement authorities to minimize or eliminate some of the chief risk factors, like arrests and tear gas. And they add that protesters, if they choose to take to the streets, should do everything they can to stay safe.
If you attended a protest, Gov. Andrew M. Cuomo of New York said on Sunday, assume you may have been exposed to Covid. Get tested.
Mitch Smith, Sabrina Tavernise, Anjali Tsui, Jill Cowan and Kimiko de Freytas-Tamura contributed reporting.
Why a treatment used for over a century on diseases like measles, mumps and influenza could work to treat the new coronavirus strain. USA TODAY
As the government works double-time alongside companies to test and manufacture an effective vaccine for the coronavirus, researchersexamine other drugs and treatments for COVID-19, the illness caused by SARS-CoV-2.
Many scientific articles and government officials have been focused on drugs such ashydroxychloroquine and remdesivir, but little attention has been directed towarda less glamorous form of treatment: convalescent plasma therapy.
Although it's anold tool introduced to science in the 19th century, it's still considered experimental during thecoronavirus pandemic as the U.S. Food and Drug Administration says theresno approved treatment for COVID-19.
Congressmen and celebritieshave donated plasma after recovering from COVID-19 and urge others to do the same.Before you do, here's everything you need to know about convalescent plasma therapy.
According to the FDA, convalescent plasma is the liquid part of blood collected from patients who have recovered from COVID-19. These patients develop antibodies, proteins that might help fight the infection.
Plasmafrom survivorsgives patientsan immediate injection of virus-fighting antibodiesso they don't haveto wait for their own immune systems to kick in. The use of plasma from survivors to treat those sick with the same illness goesback more than a century and has been used to stemoutbreaks of polio, measles, mumps and influenza.
Convalescent plasma therapy fell out of fashion in the mid-20th century as antimicrobials gained more popularity in the field, according to a scientific article published in The Lancet. The therapy reemergedperiodically duringepidemics such as SARS in 2002-2004, influenza A H1N1 in 2009 and MERS in 2012.
A study done in 2004 in Hong Kongshowed patients with SARS who were given convalescent plasma earlierin the infection process weredischarged from the hospital soonerand were less likely to die than patients who were given it later. The World Health Organization published official guidance on convalescent plasma donor selection and treatment after research showed positive results for Ebola.
Though studies suggest convalescent plasma therapy is effective in combating other coronaviruses, there has been little evidence to suggest it can do the same for SARS-CoV-2.
The FDA issued guidance for health care providers that recommends using convalescent plasma therapy for clinical trials and patients with serious or immediately life-threatening disease who arent eligible to participate in trials.
Some experts argue the disease is too advanced in critically ill patients for the treatment to work.
'Plasmatic!'Tom Hanks shares picture of himself donating plasma to combat COVID-19
More evidence: Use of survivor plasma is considered safe, but two new tests will see if it combats COVID-19
"Once they get to the ICU stage, it seems like theyre too far gone becausethere's all these physiologicalthings going on with them that antibodies won't touch at that point," said Dr. Camille van Buskirk, medical director for the Mayo Clinic Blood Donor Program.
Astudy from Chinapublished in JAMA Wednesday, found convalescent plasma in addition to standard treatment didnt significantly improve patients with severe or life-threatening COVID-19. Researchers conceded results may be limited as theywere unable to recruit more patients and terminatedthe study early.
Van Buskirk said other studies show early signs of improvement among patients who are hospitalized but not yet severely ill, those in the "middle ground."
A recovered COVID-19 patient donates blood at the Arnulfo Arias Madrid Hospital in Panama City on May 13.(Photo: Arnulfo Franco, AP)
Though efficacy may be up in the air, safety isn't. In a Johns Hopkins University study, more than 16,000 Americans with COVID-19 were infused with plasma from recovered patients, andno major safety issues were reported.
Dr. Shmuel Shoham, associate professor at Johns Hopkins Medicine, is involved in two randomized, controlled studies at the university looking at convalescent plasma as a prevention method and treatment for COVID-19 in an outpatient setting. Although there aren't any preliminary results from those two studies, previous studies give him a glimmer of hope.
The trend tends to go the same way again and again, Shoham said. The people who get it seem to have a positive response and, when comparisons are made, they tend to do better than the people who didnt get it.
An obstacle for convalescent plasma therapy is supply.
Unlike manufactured antimicrobial medicines,convalescent plasmais a natural treatment that must be harvested from recovered COVID-19 patients who meet the criteria and are willing to donate.
Van Buskirk said declining infection rates in some parts of the country have allowed the Mayo Clinic to build up inventory, but they've also made it more difficult to finddonors.
"Were hoping if everyone can get out there and collect as much as they can that well have enough for the next wave that comes along," she said. Many experts predict that wave of infections will be in the fall.
Plasma can be frozen and stored for up to 18 months.
A lab technician freeze-packs convalescent plasma donated by recovered COVID-19 patients for shipping to hospitals at Inova Blood Services on April 22 in Dulles, Va.(Photo: ALEX EDELMAN, AFP via Getty Images)
To maximize donations, most centers use standard apheresis technology thatseparates the plasma from the blood, then pumps that blood back into the donor. Van Buskirk said the process takes longer than traditionally donating blood and separating the plasma afterward, but it can double the amount of plasma collected.
In late May, the Department of Defense announced a nationwide initiative to collect more than 8,000 units of plasma at 15 Armed Services Blood Program centers across the country using the technology.
In an attempt to promote plasma transfusions, more than 40 of the nation's top health institutionsjoined theNational COVID-19 Convalescent Plasma Project.People who want to donate plasmacanregister withthe MayoClinic, the lead institutionforthe program.
More donation programs can be found on the FDA website. Van Buskirk recommended checking in with your local center before donating as requirements have changed over the course of the pandemic.
'Someones life could depend on it': Two congressmen donate plasma after COVID-19 recovery
Have you recovered from coronavirus?Want to help doctors find a treatment? Here's what they need from you.
Even with a healthy supply, the concept ofconvalescent therapy may be difficult for patients to grasp,Shoham said.
"It does require a paradigm shift in people's minds," he said. "It's a product that needs to be given by IV infusion as opposed to getting a pill or a shot in the arm."
One treatment can take up to an hour, which makes it harder to line up health workers who may be more at risk for exposure as the country's economy begins to open.
Shohamsaid people are more receptive to the idea of immunotherapy, and he hopes the acceptance will continue past thepandemic.
"It could change things, not just for the coronavirus, but a host of different viruses that don't have traditional therapies and change from season to season," he said.
Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.
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In this handout released by the U.S. Navy, The aircraft carrier USS Theodore Roosevelt (CVN 71) leaves its San Diego homeport Jan. 17, 2020.
US Navy | Getty Images
A U.S. Navy investigation into the spread of the coronavirus aboard the Theodore Roosevelt aircraft carrier has found that about 60% of sailors tested had antibodies for the virus, two U.S. officials told Reuters on Monday, suggesting a far higher infection rate than previously known.
In April, the Navy and the Centers for Disease Control and Prevention (CDC) started conducting serology tests to look for the presence of specific antibodies that are created by the immune system's attack response to the presence of the virus and remain in the blood for a period of time.
More than 1,100 aboard tested positive for the virus as of April, less than 25% of the crew.
The spread of the virus on the ship put into motion a series of events that led to the captain of the ship being relieved of his command after the leak of a letter he wrote calling on the Navy for stronger measures to protect the crew.
One sailor from the ship died from the coronavirus and several others were hospitalized. But broadly, sailors, who are generally healthier and younger, fared better than the general population and most showed no symptoms whatsoever.
The officials, speaking on the condition of anonymity, said that about 400 volunteers participated in the serology tests, lower than the 1,000 volunteers that were sought, but enough to provide statistically relevant data about how the virus spread aboard one of world's largest warships.
The Roosevelt has about 4,800 personnel on the ship.
The officials said a formal announcement was expected as early as Tuesday.
The Navy declined to comment.
The serology test results appear to track closely with data from the Roosevelt in early April, which showed that 60 percent of the sailors who were testing positive for the virus itself not antibodies were in fact symptom-free.
Medical groups, such as the American Medical Association, have warned that serology tests can lead to false positives.
The CDC has said that definitive data is lacking on whether individuals with antibodies are protected against reinfection from the coronavirus.
In addition to the serology tests, volunteers were also swabbed again for Covid-19, the respiratory disease caused by the virus, as well as asked to answer a short survey.
