Category: Corona Virus

Jasmin Merdan/Getty Images

Jasmin Merdan/Getty Images

Whether it's strange rashes on the toes or blood clots in the brain, the widespread ravages of COVID-19 have increasingly led researchers to focus on how the novel coronavirus sabotages the body's blood vessels.

As scientists have come to know the disease better, they have homed in on the vascular system the body's network of arteries, veins and capillaries, stretching more than 60,000 miles to understand this wide-ranging disease and to find treatments that can stymie its most pernicious effects.

Some of the earliest insights into how COVID-19 can act like a vascular disease came from studying the aftermath of the most serious infections. Those reveal that the virus warps a critical piece of our vascular infrastructure: the single layer of cells lining the inside of every blood vessel, known as the endothelial cells or simply the endothelium.

Dr. William Li, a vascular biologist, compares this lining to a freshly resurfaced ice skating rink before a hockey game on which the players and pucks glide smoothly along.

"When the virus damages the inside of the blood vessel and shreds the lining, that's like the ice after a hockey game," says Li, a researcher and founder of the Angiogenesis Foundation. "You wind up with a situation that is really untenable for blood flow."

In a study published this summer, Li and an international team of researchers compared the lung tissues of people who died from COVID-19 with those who died from influenza.

They found stark differences: The lung tissues of COVID-19 patients had nine times as many tiny blood clots ("microthrombi'') compared with those of the influenza patients, and the coronavirus-infected lungs also exhibited "severe endothelial injury."

"The surprise was that this respiratory virus makes a beeline for the cells lining blood vessels, filling them up like a gumball machine and shredding the cell from the inside out," Li says. "We found blood vessels are blocked and blood clots are forming because of that lining damage."

It's already known that the coronavirus breaks into cells by way of a specific receptor, called ACE2, which is found all over the body. But scientists are still trying to understand how the virus sets off a cascade of events that cause so much destruction to blood vessels. Li says one theory is that the virus directly attacks endothelial cells. Lab experiments have shown that the coronavirus can infect engineered human endothelial cells.

It's also possible the problems begin elsewhere, and the endothelial cells sustain collateral damage along the way as the immune system reacts and sometimes overreacts to the invading virus.

Endothelial cells have a slew of important jobs; these include preventing clotting, controlling blood pressure, regulating oxidative stress and fending off pathogens. And Li says uncovering how the virus jeopardizes the endothelium may link many of COVID-19's complications: "The effects in the brain, the blood clots in the lung and elsewhere in the legs, the COVID toe, the problem with the kidneys and even the heart."

In Spain, skin biopsies of distinctive red lesions on toes, known as chilblains, found viral particles in the endothelial cells, leading the authors to conclude that "endothelial damage induced by the virus could be the key mechanism."

Could the lining of our blood vessels be a common denominator?

With a surface area larger than a football field, the endothelium helps maintain a delicate balance in the bloodstream. These cells are essentially the "gatekeeper" to the bloodstream.

"The endothelium has developed a distant early warning system to alert the body to get ready for an invasion if there's trouble brewing," says Peter Libby, a cardiologist and research scientist at Harvard Medical School.

When that happens, endothelial cells change the way they function, he says. But that process can also go too far.

"The very functions that help us maintain health and fight off invaders, when they run out of control, then it can actually make the disease worse," Libby says.

In that case, the endothelial cells turn against their host and start to promote clotting and high blood pressure.

"In COVID-19 patients, we have both of these markers of dysfunction," says Gaetano Santulli, a cardiologist and researcher at the Albert Einstein College of Medicine in New York City.

The novel coronavirus triggers a condition seen in other cardiovascular diseases called endothelial dysfunction. Santulli, who wrote about this idea in the spring, says that may be the "cornerstone" of organ dysfunction in COVID-19 patients.

"The common denominator in all of these COVID-19 patients is endothelial dysfunction," he says. "It's like the virus knows where to go and knows how to attack these cells."

A runaway immune response adds a plot twist

A major source of damage to the vascular system likely also comes from the body's own runaway immune response to the novel coronavirus.

"What we see with the SARS-CoV-2 is really an unprecedented level of inflammation in the bloodstream," says Yogen Kanthi, a cardiologist and vascular medicine specialist at the National Institutes of Health, who's researching this phase of the illness.

"This virus is leveraging its ability to create inflammation, and that has these deleterious, nefarious effects downstream."

When inflammation spreads through the inner lining of the blood vessels a condition called endothelialitis blood clots can form throughout the body, starving tissues of oxygen and promoting even more inflammation.

"We start to get this relentless, self-amplifying cycle of inflammation in the body, which can then lead to more clotting and more inflammation," Kanthi says.

Another sign of endothelial damage comes from analyzing the blood of COVID-19 patients. A recent study found elevated levels of a protein produced by endothelial cells, called Von Willebrand factor, which is involved in clotting.

"They are through the roof in those who are critically ill," says Alfred Lee, a hematologist at the Yale Cancer Center, who coauthored the study with Hyung Chun, a cardiologist and vascular biologist at Yale.

Lee points out that some autoimmune diseases can lead to a similar interplay of clotting and inflammation called immunothrombosis.

Chun says the elevated levels of Von Willebrand factor show that vascular injury can be detected in patients while in the hospital and perhaps even before, which could help predict their likelihood of developing more serious complications.

But he says it's not yet clear what's the driving force behind the blood vessel damage: "It does seem to be a progression of disease that really brings out this endothelial injury; the key question is what's the root cause of this?"

After they presented their data, Lee says Yale's hospital system started putting patients who were critically ill with COVID-19 on aspirin, which can prevent clotting. While the best combinations and dosages are still being studied, research indicates that blood thinners may improve outcomes in COVID-19 patients.

Chun says treatments are also being studied that may more directly protect endothelial cells from the coronavirus.

"Is that the end-all be-all to treating COVID-19? I absolutely don't think so. There's so many aspects of the disease that we still don't understand," he says.

COVID-19 as a vascular ''stress test'' for people with preexisting vascular problems

Early in the pandemic, Roger Seheult, a critical care and pulmonary physician in Southern California, realized the patients he expected to be most vulnerable to a respiratory virus, those with underlying lung conditions such as chronic obstructive pulmonary disease and asthma, were not the ones ending up disproportionately in his intensive care unit.

Seheult, who runs the popular medical education website called MedCram, says, "Instead, what we are seeing are patients who are obese, people who have large BMIs, people who have Type 2 diabetes and with high blood pressure."

Over time, all of those conditions can cause inflammation and damage to the lining of blood vessels, he says, including a harmful chemical imbalance known as oxidative stress. Seheult says infection with the coronavirus becomes an added stress for people with those conditions that already tax the blood vessels.

"If you're right on the edge and you get the wind blown from this coronavirus, now you've gone over the edge."

He says the extensive damage to blood vessels could explain why COVID-19 patients with severe respiratory problems don't necessarily resemble patients who get sick from the flu.

"They are having shortness of breath, but we have to realize the lungs are more than just the airways," he says. "It's an issue with the blood vessels themselves."

This is why COVID-19 patients struggle to fill their blood supply with oxygen, even when air is being pumped into their lungs.

"The endothelial cells get leaky, so instead of being like Saran Wrap, it turns into a sieve and then it allows fluid from the bloodstream to accumulate in the airspaces," Harvard's Libby says.

Doctors who treat COVID-19 are now keenly aware that complications such as strokes and heart problems can appear, even after a patient gets better and their breathing improves.

"They are off oxygen, they can be discharged home, but their vasculature is not completely resolved, they still have inflammation," he says. "What can happen is they develop a blood clot, and they have a massive pulmonary embolism."

Patients can be closely monitored for these problems, but one of the big unknowns for doctors and patients are the long-term effects of COVID-19 on the circulatory system.

The Angiogenesis Foundation's Li puts it this way: "The virus enters your body and it leaves your body. You might or might not have gotten sick. But is that leaving behind a trashed vascular system?"

This story comes from NPR's partnership with Kaiser Health News.

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Clots, Strokes And Rashes. Is COVID-19 A Disease Of The Blood Vessels? - NPR

A nasal spray that blocks the absorption of the SARS-CoV-2 virus has completely protected ferrets it was tested on, according to a small study released on Thursday by an international team of scientists. The study, which was limited to animals and has not yet been peer-reviewed, was assessed by several health experts at the request of The New York Times.

If the spray, which the scientists described as nontoxic and stable, is proved to work in humans, it could provide a new way of fighting the pandemic. A daily spritz up the nose would act like a vaccine.

Having something new that works against the coronavirus is exciting, said Dr. Arturo Casadevall, the chairman of immunology at the Johns Hopkins Bloomberg School of Public Health, who was not involved in the study. I could imagine this being part of the arsenal.

The work has been underway for months by scientists from Columbia University Medical Center in New York, Erasmus Medical Center in the Netherlands and Cornell University in Ithaca, N.Y., The study was funded by the National Institutes of Health and the Columbia University Medical Center.

The team would require additional funding to pursue clinical trials in humans. Dr. Anne Moscona, a pediatrician and microbiologist at Columbia and co-author of the study, said they had applied for a patent on the product, and she hoped Columbia University would approach the federal governments Operation Warp Speed or large pharmaceutical companies that are seeking new ways to combat the coronavirus.

The spray attacks the virus directly. It contains a lipopeptide, a cholesterol particle linked to a chain of amino acids, the building blocks of proteins. This particular lipopeptide exactly matches a stretch of amino acids in the spike protein of the virus, which the pathogen uses to attach to a human airway or lung cell.

Before a virus can inject its RNA into a cell, the spike must effectively unzip, exposing two chains of amino acids, in order to fuse to the cell wall. As the spike zips back up to complete the process, the lipopeptide in the spray inserts itself, latching on to one of the spikes amino acid chains and preventing the virus from attaching.

It is like you are zipping a zipper but you put another zipper inside, so the two sides cannot meet, said Matteo Porotto, a microbiologist at Columbia University and one of the papers authors.

The work was described in a paper posted to the preprint server bioRxiv Thursday morning, and has been submitted to the journal Science for peer review.

Dr. Peter J. Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, said the therapy looked really promising.

What Id like to know now is how easy it is to scale production, he said.

In the study, the spray was given to six ferrets, which were then divided into pairs and placed in three cages. Into each cage also went two ferrets that had been given a placebo spray and one ferret that had been deliberately infected with SARS-CoV-2 a day or two earlier.

Ferrets are used by scientists studying flu, SARS and other respiratory diseases because they can catch viruses through the nose much as humans do, although they also infect each other by contact with feces or by scratching and biting.

After 24 hours together, none of the sprayed ferrets caught the disease; all the placebo-group ferrets did.

Virus replication was completely blocked, the authors wrote.

The protective spray attaches to cells in the nose and lungs and lasts about 24 hours, Dr. Moscona said. If it works this well in humans, you could sleep in a bed with someone infected or be with your infected kids and still be safe, she said.

The amino acids come from a stretch of the spike protein in coronaviruses that rarely mutates. The scientists tested it against four different variants of the virus, including both the well-known Wuhan and Italian strains, and also against the coronaviruses that cause SARS and MERS.

In cell cultures, it protected completely against all strains of the pandemic virus, fairly well against SARS and partially against MERS.

The lipoprotein can be inexpensively produced as a freeze-dried white powder that does not need refrigeration, Dr. Moscona said. A doctor or pharmacist could mix the powder with sugar and water to produce a nasal spray.

Other labs have designed antibodies and mini-proteins that also block the SARS-CoV-2 virus from entering cells, but these are chemically more complex and may need to be stored in cold temperatures.

Dr. Moscona and Dr. Porotto have been collaborating on similar fusion inhibitor peptides for 15 years, they said in a conference call. They have developed some against measles, Nipah, parainfluenza and other viruses.

But those products aroused little commercial interest, Dr. Porotto said, because an effective measles vaccine already exists and because the deadly Nipah virus only turns up occasionally in faraway places like Bangladesh and Malaysia.

Monoclonal antibodies to the new coronavirus have been shown to prevent infection as well as treat it, but they are expensive to make, require refrigeration and must be injected. Australian scientists have tested a nasal spray against Covid-19 in ferrets, but it works by enhancing the immune system, not by targeting the virus directly.

Because lipopeptides can be shipped as a dry powder, they could be used even in rural areas in poor countries that lack refrigeration, Dr. Moscona said.

Dr. Moscona, a pediatrician who usually works on parainfluenza and other viruses that infect children, said she was most interested in getting the product to poor countries that may never have access to the monoclonal antibodies and mRNA vaccines that Americans may soon have. But she has little experience in that arena, she said.

Read the original post:

Nasal Spray Prevents Covid Infection in Ferrets, Study Finds - The New York Times

U.S. voters went to the polls starkly divided on how they see President Donald Trumps response to the coronavirus pandemic. But in places where the virus is most rampant now, Trump enjoyed enormous support.

An Associated Press analysis reveals that in 376 counties with the highest number of new cases per capita, the overwhelming majority 93% of those counties went for Trump, a rate above other less severely hit areas.

Most were rural counties in Montana, the Dakotas, Nebraska, Kansas, Iowa and Wisconsin the kinds of areas that often have lower rates of adherence to social distancing, mask-wearing and other public health measures, and have been a focal point for much of the latest surge in cases.

Taking note of the contrast, state health officials are pausing for a moment of introspection. Even as they worry about rising numbers of hospitalizations and deaths, they hope to reframe their messages and aim for a reset on public sentiment now that the election is over.

Public health officials need to step back, listen to and understand the people who arent taking the same stance on mask-wearing and other control measures, said Dr. Marcus Plescia of the Association of State and Territorial Health Officials.

I think theres the potential for things to get less charged and divisive, he said, adding that theres a chance a retooled public health message might unify Americans around lowering case counts so hospitals wont get swamped during the winter months.

The APs analysis was limited to counties in which at least 95% of precincts had reported results, and grouped counties into six categories based on the rates of COVID-19 cases theyd experienced per 100,000 residents.

Polling, too, shows voters who split on Republican Trump vs. Democrat Joe Biden differed on whether the pandemic is under control.

Thirty-six percent of Trump voters described the pandemic as completely or mostly under control, and another 47% said it was somewhat under control, according to AP VoteCast, a nationwide survey of more than 110,000 voters conducted for the AP by NORC at the University of Chicago. Meanwhile, 82% of Biden voters said the pandemic is not at all under control.

The pandemic was considered at least somewhat under control by slim majorities of voters in many red states, including Alabama (60%), Missouri ( 54%), Mississippi (58%), Kentucky (55%), Texas (55%), Tennessee (56%) and South Carolina (56%).

In Wisconsin, where the virus surged just before the election, 57% said the pandemic was not under control. In Washington state, where the virus is more in control now compared to earlier in the year, 55% said the same. Voters in New York and New Hampshire, where the virus is more controlled now after early surges, were roughly divided in their assessments, similar to voters nationwide.

Trump voters interviewed by AP reporters said they value individual freedom and believed the president was doing as well as anyone could in response to the coronavirus.

Michaela Lane, a 25-year-old Republican, dropped her ballot off last week at a polling site at an outdoor mall in Phoenix. She cast her vote for Trump.

I feel like the most important issue facing the country as a whole is liberty at large, Lane said. Infringing on peoples freedom, government overrule, government overreach, chaos in a lot of issues currently going on and just giving people back their rights.

About half of Trump voters called the economy and jobs the top issue facing the nation, roughly twice the percentage who named the pandemic, according to VoteCast. By contrast, a majority of Biden voters about 6 in 10 said the pandemic was the most important issue.

In Madison, Wisconsin, Eric Engstrom, a 31-year-old investment analyst and his wife, Gwen, voted absentee by mail in early October.

Trumps failure to control the pandemic sealed his vote for Biden, Engstrom said, calling the coronavirus the most immediate threat the nation faces. He and his wife are expecting their first child, a girl, in January and fear the potential of one of us or both of us being sick when the baby is born, he said.

Engstrom called Trumps response to the virus abysmal. If there was any chance that I was going to vote for Trump, it was eliminated because of the pandemic, he said.

The political temperature has added to the stress of public health officials, Plescia said. Our biggest concern is how long can they sustain this pace? he said.

Since the start of the pandemic, 74 state and local public health officials in 31 states have resigned, retired or been fired, according to an ongoing analysis by AP and Kaiser Health News.

As the election mood dissipates, rising hospitalizations amid colder weather create a really pivotal moment in the pandemic, said Sema Sgaier, executive director of the Surgo Foundation, a Washington, D.C.-based nonprofit that worked with Harvard University-affiliated Ariadne Labs to develop a tool for estimating vaccine needs in states.

We really need to get our act together. When I say we I mean collectively, Sgaier said. Finding common ground may become easier if one of more of the vaccine candidates proves safe and effective and gains government approval, she said.

The vaccine provides the reset button, Sgaier said.

Dr. Anthony Fauci may be another unifying force. According to VoteCast, 73% of voters nationwide approve of the way Fauci, the director of the National Institute of Allergy and Infectious Diseases, has been handling the pandemic.

Even among Trump voters, 53% approve of Faucis performance. About 9 in 10 Biden voters approve.

Read more:

The Counties With The Worst Coronavirus Surges Overwhelmingly Voted For Trump - WBEZ

City officials in Boston are continuing to urge people to get tested for the coronavirus.

The city's positive test rate was 7.2% for the week ending on Oct. 31, down slightly from 8% the week before.There is still a 10% positive test rate in Dorchester, Mattapan and East Boston.

"We increased testing and at the same time we saw fewer total positive tests," Mayor Marty Walsh said at a press conference Thursday.

He is advocating for increased testing as a way for the city to get a better understanding of where transmission is occurring.

There aretwo mobile testing sites where residents can be tested regardless of symptoms in addition to 30 testing sites across the city.

Since announcing the pushlast week, Walsh says the city saw an 8% increase in the number of people getting tested.

Health and Human Services Chief Marty Martinez says transmission is occurring across a range of different interactions.

"There's not just one scenario, but it's a lot of scenarios," Martinez said at Thursday's press conference. "It includes people who are still going to work then who are coming home ... and living in multigenerational homes, who are infecting other people in their houses. We see folks having small gatherings in their home ... three, four or five people. We see folks getting it from being out and about."

Martinez again reminded everyone to wear face masks, social distance and avoid being around large groups of people.

With increased testing, delaying the next phase of reopening and the state's new stay-at-home advisories, Walsh said he's "hopeful" the city will not have to shut down again. Still, he said "we'll have to deal with that at that point"if numbers continue to rise in the next two to three weeks.

The governor's new orders go into effect at 12:01 a.m. on Friday. They limit indoor gatherings at home to 10 people, and outdoor gatherings to 25 people. They also include a stay-at-home advisory between 10 p.m. and 5 a.m. and require that some businesses close by 9:30 p.m.

Read more here:

Walsh Says Coronavirus Testing Is Up 8% In Boston. Here's Why The Mayor Wants Even More - WBUR

CNBC's Jim Cramer on Thursday recommended investors take a look at buying stock in diagnostic companies as the coronavirus pandemic rages on.

"With Covid spiking and a very good chance that Joe Biden wins the White House, ushering in a more test-friendly administration, I bet the testing stocks have a lot more room to run," the "Mad Money" host said.

While Americans tuned into the election count, the U.S. counted a ghastly new record for coronavirus cases with 102,000-plus positive tests on Wednesday. Officials have tallied more than 1,000 deaths, which lag new cases, in consecutive days in the country.

"The pandemic is once again out of control," Cramer said.

More than 1 million Covid-19 tests have been conducted in the U.S. each day since late October, according to The Covid Tracking Project.

"That's huge, although we need even more [testing] given these hideous case numbers," said Cramer, who noted a "major bottleneck" in processing tests.

The seven stocks he recommended on Thursday include large players like Thermo Fisher, a $204 billion diagnostics manufacturer, and a speculative play in Fluidigm, a $485 million company that makes life science tools.

While a number of his suggestions are at or near their highs, Cramer says investors can buy them on pull backs. Below is his take on each testing stock pick:

Thermo Fisher Scientific

"The stock [has] had such a remarkable run. It's up roughly 59 for the year, including a 40-point gain over the past week," he said. "As much as I hate to chase, I think it's worth buying into any kind of pullback."

Hologic

"Hologic's had a monster run, "It's up 45% for the year, but you know when you put pen to paper and you look at the new estimates," Cramer said, "the stock's only trading at 12 times next year's earnings. I give you permission to start nibbling on it tomorrow."

Abbott Laboratories

"When the company reported a couple weeks ago, we learned their diagnostics segment was up 39% just versus the previous quarter. Abbott said they've sold 100 million total tests and they left the quarter with a run rate of $1.3 to $1.4 billion in COVID testing sales," he said.

"I've been telling you to buy this one for ages, and while it's rocketed 8% this week alone, I think you stick with it."

PerkinElmer

"PerkinElmer shot the lights out when it reported last month, but the stock hit a new high today. Now you want to wait for a pull back," Cramer said.

Quidel

"Quidel's competing directly against Abbott Labs here, but seeing as we still have a shortage of testing, competition really isn't that much of a problem. However, the stock's up 275% for the year and it's been a wild trader," he said. "Why not let it cool down a little."

Fluidigm

"While the stock's up 95% for the year, it's still a long way from its all-time highs from over the summer. This thing was briefly at $12.45 in August," Cramer said. "Fluidigm kind of feels too risky for me, but if you want something to speculate on, it's worth looking into."

Laboratories Corporation and Quest Diagnostics

"These companies are practically printing money right now because they're pretty much a duopoly. That's actually been a serious problem in terms of coping with the pandemic, they've got a bottleneck, but it's also great for Labcorp and Quest's shareholders," he said. "Both stocks remain cheap."

Read more from the original source:

Coronavirus testing stocks have 'a lot more room to run,' Jim Cramer says - CNBC

U.S. voters went to the polls starkly divided on how they see President Donald Trumps response to the coronavirus pandemic, with a surprising twist: In places where the virus is most rampant now, Trump enjoyed enormous support.

An Associated Press analysis reveals that in 376 counties with the highest number of new cases per capita, the overwhelming majority 93 percent of those counties went for Trump, a rate above other less severely hit areas. Most were rural areas in the Dakotas, Montana, Nebraska, Wisconsin and Iowa.

Taking note of the contrast, state health officials are pausing for a moment of introspection. Even as they worry about rising numbers of hospitalizations and deaths, they hope to reframe their messages and aim for a reset on public sentiment now that the election is over.

Public health officials need to step back, listen to and understand the people who arent taking the same stance on mask-wearing and other control measures, said Dr. Marcus Plescia of the Association of State and Territorial Health Officials.

I think theres the potential for things to get less charged and divisive, he said, adding that theres a chance a retooled public health message might unify Americans around lowering case counts so hospitals wont get swamped during the winter months.

The APs analysis was limited to counties in which at least 95 percent of precincts had reported results, and grouped counties into six categories based on the rates of COVID-19 cases theyd experienced per 100,000 residents.

Polling, too, shows voters who split on Republican Trump vs. Democrat Joe Biden differed on whether the pandemic is under control.

Thirty-six percent of Trump voters described the pandemic as completely or mostly under control, and another 47 percent said it was somewhat under control, according to AP VoteCast, a nationwide survey of more than 110,000 voters conducted for the AP by NORC at the University of Chicago. Meanwhile, 82 percent of Biden voters said the pandemic is not at all under control.

The pandemic was considered at least somewhat under control by slim majorities of voters in many red states, including Alabama (60 percent), Missouri ( 54 percent), Mississippi (58 percent), Kentucky (55 percent), Texas (55 percent), Tennessee (56 percent) and South Carolina (56 percent).

In Wisconsin, where the virus surged just before the election, 57 percent said the pandemic was not under control. In Washington state, where the virus is more in control now compared to earlier in the year, 55 percent said the same. Voters in New York and New Hampshire, where the virus is more controlled now after early surges, were roughly divided in their assessments, similar to voters nationwide.

Trump voters interviewed by AP reporters said they value individual freedom and believed the president was doing as well as anyone could in response to the coronavirus.

Michaela Lane, a 25-year-old Republican, dropped her ballot off last week at a polling site at an outdoor mall in Phoenix. She cast her vote for Trump.

I feel like the most important issue facing the country as a whole is liberty at large, Lane said. Infringing on peoples freedom, government overrule, government overreach, chaos in a lot of issues currently going on and just giving people back their rights.

About half of Trump voters called the economy and jobs the top issue facing the nation, roughly twice the percentage who named the pandemic, according to VoteCast. By contrast, a majority of Biden voters about 6 in 10 said the pandemic was the most important issue.

In Madison, Wisconsin, Eric Engstrom, a 31-year-old investment analyst and his wife, Gwen, voted absentee by mail in early October.

Trumps failure to control the pandemic sealed his vote for Biden, Engstrom said, calling the coronavirus the most immediate threat the nation faces. He and his wife are expecting their first child, a girl, in January and fear the potential of one of us or both of us being sick when the baby is born, he said.

Engstrom called Trumps response to the virus abysmal. If there was any chance that I was going to vote for Trump, it was eliminated because of the pandemic, he said.

The political temperature has added to the stress of public health officials, Plescia said. Our biggest concern is how long can they sustain this pace? he said.

Since the start of the pandemic, 74 state and local public health officials in 31 states have resigned, retired or been fired, according to an ongoing analysis by AP and Kaiser Health News.

As the election mood dissipates, rising hospitalizations amid colder weather create a really pivotal moment in the pandemic, said Sema Sgaier, executive director of the Surgo Foundation, a Washington, D.C.-based nonprofit that worked with Harvard University health experts to develop a tool for estimating vaccine needs in states.

We really need to get our act together. When I say we I mean collectively, Sgaier said. Finding common ground may become easier if one of more of the vaccine candidates proves safe and effective and gains government approval, she said.

The vaccine provides the reset button, Sgaier said.

Dr. Anthony Fauci may be another unifying force. According to VoteCast, 73 percent of voters nationwide approve of the way Fauci, the director of the National Institute of Allergy and Infectious Diseases, has been handling the pandemic.

Even among Trump voters, 53 percent approve of Faucis performance. About 9 in 10 Biden voters approve.

By CARLA K. JOHNSON, HANNAH FINGERHUT and PIA DESHPANDE Associated Press

Johnson reported from Washington state. Deshpande reported from Chicago and Fingerhut reported from Washington, D.C. AP reporters Todd Richmond in Madison, Wisconsin, and Terry Tang in Phoenix contributed.

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Hard-hit coronavirus counties overwhelmingly voted for Trump - Tampa Bay Times

This story will be updated.

Another 147 coronavirus cases have been reported across the state, Maine health officials said Friday.

Fridays report brings the total number of coronavirus cases in Maine to 7,444. Of those, 6,565 have been confirmed positive, while 879 were classified as probable cases, according to the Maine Center for Disease Control and Prevention.

The agency revised Thursdays cumulative total to 7,297, up from 7,260, meaning there was a net increase of 184 over the previous days report, state data show. As the Maine CDC continues to investigate previously reported cases, some are determined to have not been the coronavirus, or coronavirus cases not involving Mainers. Those are removed from the states cumulative total. The Bangor Daily News reports on the number of new cases reported to the Maine CDC in the previous 24 hours, rather than the increase of daily cumulative cases.

New cases were reported in Androscoggin (13), Cumberland (50), Franklin (1), Kennebec (8), Knox (10), Lincoln (1), Oxford (1), Penobscot (10), Piscataquis (2), Somerset (7), Waldo (3), Washington (7) and York (28) counties, state data show. Information about where additional cases were reported wasnt immediately available.

Only three counties Aroostook, Hancock and Sagadahoc reported no new cases.

The seven-day average for new coronavirus cases is 129.4, up from 124.3 a day ago, 77.7 a week ago and up from 30.4 a month ago.

Fridays report comes as Gov. Janet Mills has issued a new executive order requiring Mainers to wear face coverings in public spaces no matter their distance from others. Its the latest move from the Mills administration to halt the surge in coronavirus cases as forceful and widespread community transmission is seen throughout the state.

There are two criteria for establishing community transmission: at least 10 confirmed cases and that at least 25 percent of those are not connected to either known cases or travel.

No new deaths were reported Friday, leaving the statewide death toll at 150. Nearly all deaths have been in Mainers over age 60.

So far, 513 Mainers have been hospitalized at some point with COVID-19, the illness caused by the coronavirus. Information about those currently hospitalized wasnt immediately available.

Meanwhile, 79 more people have recovered from the coronavirus, bringing total recoveries to 5,830. That means there are 1,464 active confirmed and probable cases in the state, which is up from 1,359 on Thursday. Its yet another record high for active cases.

A majority of the cases 4,398 have been in Mainers under age 50, while more cases have been reported in women than men, according to the Maine CDC.

As of Thursday, there have been 670,542 negative test results out of 679,283 overall. About 1.2 percent of all tests have come back positive, the most recently available Maine CDC data show.

The coronavirus has hit hardest in Cumberland County, where 2,872 cases have been reported and where the bulk of virus deaths 70 have been concentrated. Other cases have been reported in Androscoggin (922), Aroostook (73), Franklin (120), Hancock (85), Kennebec (436), Knox (125), Lincoln (76), Oxford (187), Penobscot (355), Piscataquis (14), Sagadahoc (95), Somerset (262), Waldo (169), Washington (98) and York (1,546) counties. Information about where an additional nine cases were reported wasnt immediately available.

As of Friday morning, the coronavirus had sickened 9,611,293 people in all 50 states, the District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands and the U.S. Virgin Islands, as well as caused 234,949 deaths, according to Johns Hopkins University of Medicine.

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147 new coronavirus cases have been reported in Maine - Bangor Daily News

By Jamie Martines|Spotlight PA

Pennsylvania health officials still cannot say when a coronavirus vaccine will be available, but plans for how one will be distributed and who will get it first are coming into focus.

The states three-phase plan will prioritize health-care personnel, frontline and emergency workers, and those working with vulnerable populations, Health Secretary Rachel Levine said during a press call Thursday.

Seniors and people living in congregate care facilities, like nursing homes and assisted living facilities, will also be among the first to receive a vaccine, as long as it is deemed safe for use among those populations by the federal Food and Drug Administration.

Members of the general public will be included in the third phase of Pennsylvanias distribution plan, Levine said.

The update came the same day Pennsylvania reported yet another single-day record for new confirmed coronavirus cases, adding 2,900 cases and bringing the statewide total to 220,566. Thursday was the second record-setting day this week.

Hospitalizations in the state have also been steadily increasing, but so far, there has not been a significant rise in the death count. That number often lags behind other indicators.

Masks, hand sanitizer, physical distancing, and smaller gatherings will still be part of day-to-day life, even after a vaccine is rolled out, Levine said.

Theyre not going to be a magical cure for the coronavirus and will not immediately end the pandemic, Levine said of coronavirus vaccines, adding that it will take many months to get enough of the population vaccinated and slow community spread.

A coronavirus vaccine is likely to work similar to a flu vaccine: Those who receive it will be more protected against the virus. If they do contract it, those people will be less likely to get a severe case, Levine said.

Until that time and I cant tell you when that will be we need people to continue all of the safety measures theyre doing right now, she said.

Six drug manufacturers are conducting clinical trials of a coronavirus vaccine. The Food and Drug Administration will review the results of those trials which are used to determine dosage, examine side effects, and to make sure the vaccine is safe for all age groups before issuing an emergency use authorization that will allow distribution.

Pennsylvania at this time does not have plans to conduct an independent review of any federally approved vaccine. California, Washington, Oregon, and Nevada have joined together to review a vaccine before it is distributed.

I feel very comfortable that science will determine when they are available, Levine said. So we do not plan to have our own independent review of the safety and efficacy.

As for future closures, Levine said that there are no plans to return to the red-yellow-green shutdown system the state used earlier this year.

There are also currently no plans to shut down schools.

We have no plans to shut down schools at this time, Levine said. No plans at all.

Spotlight PA is an independent, non-partisan newsroom powered by The Philadelphia Inquirer in partnership with PennLive/The Patriot-News, TribLIVE/Pittsburgh Tribune-Review, and WITF Public Media. Sign up for our free newsletters.

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Here's Who In PA Will Get Coronavirus Vaccine First When One Is Approved - LevittownNow.com

Dr. Meyers said he hoped his team would undertake such studies soon, and noted that a handful of clinical trials had already begun investigating these questions.

The studys findings arent necessarily surprising, or even unprecedented. Other researchers have conducted similar experiments, including one that looked at the effects of mouthwash on the new coronavirus, with comparable results. And since the early days of the pandemic, scientists have stressed the effectiveness of hand-washing and disinfection with soap, alcohol and other similar chemicals that can bust through the new coronaviruss fragile outer layer, or envelope. (Not all mouthwashes or nasal rinses contain such potent ingredients, however.)

Dr. Valerie Fitzhugh, a pathologist at Rutgers University, pointed to a study from the 1990s, in which researchers in Texas inactivated a strain of flu virus by swirling it in Listerine for 30 seconds. But that study was never shown to be clinically relevant, she said.

Even if people did a very thorough job coating the inside of their mouths or noses with a coronavirus-killing chemical, a substantial amount of the virus would still remain in the body. The new coronavirus infiltrates not only the mouth and nose, but also the deep throat and lungs, where mouthwash and nasal washes hopefully never enter.

Viruses that have already hidden away inside cells will also be shielded from the fast-acting chemicals found in these products. Its not like your cells get infected and then they secrete a bunch of virus and theyre done, Dr. Rasmussen said. Infected cells are constantly making more virus. Its a timing issue.

Relying on mouthwash or a nasal rinse to rid the body of infectious virus would be about as futile as trimming the top of a cluster of weeds, paying the roots little mind, and expecting the garden pests to disappear.

Dr. Meyers acknowledged this limitation. After a quick swizzle of mouthwash, How long do you have? I dont know, he said. All were saying right now is, this could add an extra layer of protection, he explained, on top of proven protective measures like mask-wearing and physical distancing.

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No, Mouthwash Will Not Save You From the Coronavirus - The New York Times

Joe Biden is inching his way toward a win, but Congress is on track to be more divided than ever. POLITICO's Dan Diamond explains how the coronavirus pandemic split the nation and how polarized views of President Trump's response shaped results up and down the ballot.

Coronavirus relief talks have stalled since the summertime, though Speaker Nancy Pelosi (D-Calif.) and Treasury Secretary Steven Mnuchin have insisted they have made progress in recent months. Meanwhile, the virus has killed more than 230,000 Americans and millions remain unemployed with an even worse economic hit expected over the winter as more people are forced indoors.

In one sign of the enormous political hurdle ahead, Democrats and Republicans still cannot agree on a price tag for the stimulus package, and its unclear if a lame duck session will only contribute to the stalemate.

McConnell added that a coronavirus relief package and keeping the government funded past the December 11th deadline will be the top priorities for the Senate, which will come back to Washington Monday.

McConnell said that he and Pelosi have agreed on the need for an omnibus bill in December to fund the government instead of a continuing resolution that would push the budget fight to a later date potentially avoiding a disastrous government shutdown at the end of the year.

Speaker of the House Nancy Pelosi, D-Calif., holds a news conference at the Capitol in Washington, Thursday, Oct. 29, 2020. (AP Photo/J. Scott Applewhite) | AP Photo/J. Scott Applewhite

Its a basic function of government that we havent handled very well in recent years and we need to do that, he said. So we have two big things to do before the end of the year.

Congress and the White House have been at sharp odds over trillions of dollars in coronavirus aid since the summer, with talks that ramped up ahead of Election Day as both parties sought a last-minute advantage. But negotiators couldnt agree to a deal.

In a last-ditch effort before Tuesdays election, the White House offered a $1.8 trillion deal to Pelosi, but the two sides couldn't agree on several outstanding issues, including testing. Meanwhile, many Senate Republicans are reluctant to support any package that exceeds $1 trillion.

State and local aid remains another obstacle to reaching an agreement, and McConnell acknowledged that Republicans may need to offer some concessions.

This is a big item for Democrats as you can imagine and theyre still going to control the House but well have to reach some kind of agreement ... its not something that my side is very fond of, McConnell said. Id like to see it done a little more skillfully than simply providing borrowed money for everyone regardless of their need.

Sarah Ferris contributed to this report.

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McConnell calls for coronavirus package before end of the year - POLITICO