Category: Corona Virus

MATHEWS COUNTY, Va. (WAVY) Multiple studies show coronavirus numbers are on the rise for people in their 20s.

WAVY.com spoke with one 26-year-old from Mathews County who says the road to recovering from COVID-19 was quite a journey.

At the time I caught COVID, I was staying with my grandparents to take care of my grandmother who had just fallen and fractured a rib. I was there for about a month and was getting ready to go back to my normal life when I caught COVID, said Taylor OBier.

OBier, a former WAVY employee, says she and her parents did everything they could to prevent her grandparents from catching coronavirus. They ran errands for her grandparents, got their groceries, and prepared their meals so they didnt have to leave their house. Then, something happened OBier couldnt prevent.

I also found out about that time that a family member who had been around me had gotten COVID.

OBiers mind raced.

My grandma has breathing trouble as it is. My granddaddy has blood cancer. So its just like the two worst people to have COVID and then the place that I wanted COVID to stay away from the most was the place that I got it and it was brought into. So not only was I kind of fighting it myself, but I was scared to death that my grandfather was going to have extreme complications with it.

Shortly after coming in contact with the family member who tested positive for coronavirus, OBier says she got a headache that wouldnt go away. Then, the fever and chills started.

A first coronavirus test in July came back negative.

Which was so crazy to me because I knew that I had it. I knew that I had been in contact with somebody. I knew that I had all the symptoms, because a week in, thats when the fever was really bad, and the fatigue, I mean I slept, oh my gosh, I slept probably 12 hours a day. Each day was kind of crazy, zero energy. Zero appetite.

OBier decided she needed to take another coronavirus test.

I went and got tested at a different doctors office, I guess maybe more for my peace of mind than anything, to confirm you definitely have it, but also, other people around me. When I told them it came back negative and that was definitely false, they were like, Are you sure? So I guess it was kind of for other people, too, but also just for the contact tracing and stuff to make that a little easier because if Im coming back negative, theyre not reporting that to the state.

The test results from that second coronavirus test came back positive.

After about a week I was like, Im good. This is gone. Its out of my system. I felt really good for a day, and then the next day I woke up and thats when I felt it deep in my chest, and its a very different feeling than any other congestion that Ive had. I expected it to feel the same, but you can tell that its much deeper which is much more frightening obviously. What scared me the most was my shortness of breath. I remember getting up one morning and washing the dishes and that took me out of breath.

OBier says she has no pre-existing medical condition. She says her colds usually only last three days and she rarely, if ever, gets wiped out by illness.

To be 26 and to have that much difficulty with it was just very crazy to me and its very frightening, too, because you dont have any control over it.

With treatment of Tylenol and an inhaler, OBiers symptoms ended after roughly two weeks. During that time, her grandfather tested positive for coronavirus. After roughly two weeks, he also made a full recovery. OBiers family followed all protocols for quarantine and her grandmother never contracted the illness.

OBier says she has mixed feelings about coronavirus positivity numbers growing in her age group.

Its frustrating because I do see people that really dont care, but I do see people that do care and are just kind of having to choose between their mental health and their physical health and also their responsibility to society.

OBier has advice for those who have not been diagnosed with the virus: Do not to shame people that catch COVID.

She continued: I found through my experience that theres this weird shame with it that not a lot of people talk about, shame within yourself that you have it, but also shame from your peers and society that you have it. People look at you almost like you caught it on purpose, that you caught it because of negligence or ignorance, and that wasnt the case in my situation.

OBier says she fears that shame will prevent people those who test positive from telling others they came into contact with that they have the virus. She asks for understanding and vigilance to help stop the spread of the coronavirus.

When OBier goes out, she wears a mask, she carries anti-bacterial wipes and hand sanitizer, and she constantly washes her hands. She also tries to limit how much she goes to stores. She says she does have the antibodies, but she isnt sure how long they last, so its important to her to remain vigilant.

I kind of wish more people would take it seriously and be more cautious so we can kind of get over it together, because if we kind of had that mentality from the start, we might be in a different place now.

Excerpt from:

Do not shame people that catch COVID: 26-year-old coronavirus survivor shares her journey - WAVY.com

Holidays are usually for gatherings but many get-togethers are complicated or canceled because of COVID-19. USA TODAY

Americans would love to go on vacation. They're just not sure they shouldactually go.

Two surveys found many travelersexpress hesitation during the coronavirus pandemicabout taking a trip.

Sixty-seven percent of those responding to an AAA Travel survey released Thursday say they are uncertainabout whether to take avacation.

Online booking site Travelocity found 57% of Americans say they won't travel for the year-end holidays this year.

The findings are in line with advice from the Centers for Disease Control and Prevention, which offers a worldmap that indicates thecoronavirus is a threat in just about every country, including the USA.

The AAA survey points to a trend that has become a theme of travel since the pandemic startedcausing broad shutdowns in March more trips by car, often to outdoor destinations and planned days or a week, not months, ahead of time.

About 80% of vacation trips will be by car, and places "known for outdoor recreation and socially distanced fun" will be particularly popular, AAA says.

As if to prove the point, two new outdoor-oriented destinations show up on AAA's list of most popular driving vacation destinations. Keystone, South Dakota, gateway to Mount Rushmore, takessixth place. Colorado, the Rocky Mountain State, adds Colorado Springs in 9th place.

The top 10 are:

Trips that allow people to take advantage of the great outdoors are particularly appealing this fall," Paula Twidale, senior vice president of AAA Travel, said in a statement.

Families are open to vacations at the end of the year, but are wary of the coronavirus. Most of those who take a trip will go by car. Here's how it was done 70 years ago when families loaded up the station wagon.(Photo: Ford, Ford)

She cited state and national parks, beaches and gardens as the kind of COVID-19-safe attractions that are popular.

The Travelocity survey found 25% ofrespondents surveyed in mid-September had planned to take avacation by the end of the year.

With the coronavirus pandemic, it is harder to go on vacation. Here are some ways to feel like you're on vacation by continuing to sit on your couch. USA TODAY

Despite the general trend toward booking trips on short notice, Travelocity found about 60% of those planning Thanksgiving or December holiday trips planned to book by the end of September.Those planning travelsaid they had already made travel arrangements.

"It's going to be a nontraditional holiday season this year, so families are gearing up to make the most of it by planning a holiday away from home and using their vacation days to travel,"Katie Junod, Travelocity's general manager, said in a statement.

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Americans torn between taking vacation and avoiding coronavirus, surveys find - USA TODAY

A study of some of the sickest COVID-19 patients, such as those placed on ventilators, has identified gene variants that put people at greater risk of severe disease.

By Jocelyn KaiserOct. 13, 2020 , 1:25 PM

Sciences COVID-19 reporting is supported by the Pulitzer Center and the Heising-Simons Foundation.

Its one of the pandemics puzzles: Most people infected by SARS-CoV-2 never feel sick, whereas others develop serious symptoms or even end up in an intensive care unit clinging to life. Age and preexisting conditions, such as obesity, account for much of the disparity. But geneticists have raced to see whether a persons DNA also explains why some get hit hard by the coronavirus, and they have uncovered tantalizing leads.

Now, a U.K. group studying more than 2200 COVID-19 patients has pinned down common gene variants that are linked to the most severe cases of the disease, and that point to existing drugs that could be repurposed to help. Its really exciting. Each one provides a potential target for treatment, says genetic epidemiologist Priya Duggal of Johns Hopkins University.

In a standard approach to finding genes that influence a condition, geneticists scan the DNA of large numbers of people for millions of marker sequences, looking for associations between specific markers and cases of the disease. In June, one such genomewide association study in The New England Journal of Medicine (NEJM) found two hits linked to respiratory failure in 1600 Italian and Spanish COVID-19 patients: a marker within the ABO gene, which determines a persons blood type, and a stretch of chromosome 3 that holds a half-dozen genes. Those two links have also emerged in other groups data, including some from the DNA testing company 23andMe.

The new study confirmed the chromosome 3 regions involvement. And because 74% of its patients were so sick that they needed invasive ventilation, it had the statistical strength to reveal other markers, elsewhere in the genome, linked to severe COVID-19. One find is a gene called IFNAR2 that codes for a cell receptor for interferon, a powerful molecular messenger that rallies the immune defenses when a virus invades a cell. A variant of IFNAR2 found in one in four Europeans raised the risk of severe COVID-19 by 30%. Baillie says the IFNAR2 hit is entirely complementary to a finding reported in Science last month: very rare mutations that disable IFNAR2 and seven other interferon genes may explain about 4% of severeCOVID-19 cases. Both studies raise hopes for ongoing trials of interferons as a COVID-19 treatment.

A more surprising hit from the U.K. study points to OAS genes, which code for proteins that activate an enzyme that breaks down viral RNA. A change in one of those genes might impair this activation, allowing the virus to flourish. The U.K. data suggest there is a variant as common and influential on COVID-19 as the interferon genetic risk factor.

Other genes identified by Baillies team could ramp up the inflammatory responses to lung damage triggered by SARS-CoV-2, reactions that can be lethal to some patients. One, DPP9, codes for an enzyme known to be involved in lung disease; another, TYK2, encodes a signaling protein involved in inflammation. Drugs that target those two genes proteins are already in useinhibitors of DPP9s enzyme for diabetes and baricitinib, which blocks TYK2s product, for arthritis. Baricitinib is in early clinical testing for COVID-19, and the new data could push it up the priority list, Baillie says.

The chromosome 3 region still stands out as the most powerful genetic actor: A single copy of the disease-associated variant more than doubles an infected persons odds of developing severe COVID-19. Evolutionary biologists reported last month in Nature that this suspicious region actually came from Neanderthals, through interbreeding with our species tens of thousands of years ago. It is now found in about 16% of Europeans and 50% of South Asians.

But the specific chromosome 3 gene or genes at play remain elusive. By analyzing gene activity data from normal lung tissue of people with and without the variant, the U.K. team homed in on CCR2, a gene that encodes a receptor for cytokine proteins that play a role in inflammation. But other data discussed at last weeks meeting point to SLC6Z20, which codes for a protein that interacts with the main cell receptor used by SARS-CoV-2 to enter cells. I dont think anyone at this point has a clear understanding of what are the underlying genes for the chromosome 3 link, says Andrea Ganna of the University of Helsinki, who co-leads the COVID-19 Host Genetics Initiative.

The U.K. genetics study did not confirm that the ABO variants affect the odds of severe disease. Some studies looking directly at blood type, not genetic markers, have reported that type O blood protects against COVID-19, whereas A blood makes a person more vulnerable. It may be that blood type influences whether a person gets infected, but not how sick they get, says Stanford University geneticist Manuel Rivas. In any case, O blood offers at best modest protection. There are a lot of people with O blood that have died of the disease. It doesnt really help you, says geneticist Andre Franke of the Christian-Albrecht University of Kiel, a coleader of the NEJM study.

Researchers expect to pin down more COVID-19 risk genesalready, after folding in the U.K. data plumbed by Baillies team, the COVID-19 Host Genetics Initiative has found another hit, a gene called FOXP4 implicated in lung cancer. And in a new medRxiv preprint posted last week, the company Ancestry.com reports that a gene previously connected to the effects of the flu may also boost COVID-19 susceptibility only in men, who are more likely to die of the disease than women.

Geneticists have had little luck so far identifying gene variants that explain why COVID-19 has hit Black people in the United States and United Kingdom particularly hard. The chromosome 3 variant is absent in most people of African ancestry. Researchers suspect that socioeconomic factors and preexisting conditions may better explain the increased risks. But several projects, including Baillies, are recruiting more people of non-European backgrounds to bolster their power to find COVID-19 gene links. And in an abstract for an online talk later this month at the American Society of Human Genetics annual meeting, the company Regeneron reports it has found a genome region that may raise the risk of severe disease mainly in people of African ancestry.

Even as more genetic risk factors are identified, their overall effect on infected people will be modest compared with other COVID-19 factors, Duggal says. But studies like the U.K. teams could help reveal the underlying biology of the disease and inspire better treatments. I dont think genetics will lead us out of this. I think genetics may give us new opportunities, Duggal says.

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Found: genes that sway the course of the coronavirus - Science Magazine

Another 26 coronavirus cases have been reported in Maine, health officials said Tuesday.

Mondays report brings the total number of coronavirus cases in Maine to 5,780. Of those, 5,160 have been confirmed positive, while 620 were classified as probable cases, according to the Maine Center for Disease Control and Prevention.

The agency revised Mondays cumulative total to 5,754, up from 5,752, meaning there was an increase of 26 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.

New cases were reported in Cumberland (5), Androscoggin (3), Franklin (2), Oxford (1), Somerset (5), York (6), Kennebec (4), Penobscot (2) and Sagadahoc (2) counties, state data show.

The seven-day average for new coronavirus cases is 34.3, up from 33.4 a week ago and up from 22.6 a month ago.

The state continues to see outbreaks of the coronavirus in which three or more cases in a particular place are connected largely in counties that have seen a recent uptick in case numbers. In Kennebec County, for example, four cases have been recorded in the fire department that serves the Togus VA Medical Center in Chelsea, Maine CDC Director Nirav Shah said Tuesday. A number of other outbreaks announced recently have also grown, Shah said, including an outbreak at Community Regional Charter School in the Skowhegan area in Somerset County and The Meadows independent living facility in the Androscoggin County town of Greene.

The Maine CDC is also keeping an eye out for cases potentially connected to a hockey referee who tested positive after refereeing eight games in southern Maine and New Hampshire on Oct. 3 and 4, potentially exposing 400 people to the virus. The CDC hasnt learned of any connected cases yet, Shah said, but were entering the time period at which those might happen.

We hope that there are no cases, but we dont know, he said.

No new deaths were reported Tuesday, leaving the statewide death toll at 143. Nearly all deaths have been in Mainers over age 60.

So far, 463 Mainers have been hospitalized at some point with COVID-19, the illness caused by the coronavirus.

Meanwhile, eight more people have recovered from the coronavirus, bringing total recoveries to 5,006. That means there are 631 active confirmed and probable cases in the state, which is up from 611 on Monday.

A majority of the cases 3,357 have been in Mainers under age 50, while more cases have been reported in women than men, according to the Maine CDC.

As of Friday, there had been 493,158 negative test results out of 501,020 overall. About 1.5 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 2,392 cases have been reported and where the bulk of virus deaths 70 have been concentrated. It is one of four counties the others are Androscoggin, Penobscot and York, with 817, 271 and 1,284 cases, respectively where community transmission has been confirmed, according to the Maine CDC.

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. That second condition has not yet been satisfied in other counties.

Other cases have been reported in Aroostook (53), Franklin (72), Hancock (56), Kennebec (268), Knox (52), Lincoln (50), Oxford (158), Piscataquis (10), Sagadahoc (74), Somerset (123), Waldo (80) and Washington (20) counties.

As of Tuesday afternoon, the coronavirus had sickened 7,829,476 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 215,476 deaths, according to Johns Hopkins University of Medicine.

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26 new cases of coronavirus reported in Maine - Bangor Daily News

Even as vaccines are hailed as our best hope against the coronavirus, dozens of scientific groups are working on an alternate defense: monoclonal antibodies. These therapies shot to prominence just this month after President Trump got an infusion of an antibody cocktail made by Regeneron and credited it for his apparent recovery, even calling it a cure.

Monoclonal antibodies are distilled from the blood of patients who have recovered from the virus. Ideally, antibodies infused early in the course of infection or even before exposure, as a preventive may provide swift immunity.

An enthusiastic Mr. Trump has promised to distribute these experimental drugs free to anyone who needs them. But they are difficult and expensive to produce. At the moment, Regeneron has enough to treat only 50,000 patients; the supply is unlikely to exceed a few million doses in the foreseeable future.

Dozens of companies and academic groups are racing to develop antibody therapies. Already Regeneron and the drug company Eli Lilly have requested emergency use authorizations for their products from the Food and Drug Administration.

These drug companies have the long experience and deep pockets needed to win the race for a powerful antibody treatment. But some scientists are betting on a dark horse: Prometheus, a ragtag group of scientists who are months behind in the competition and yet may ultimately deliver the most powerful antibody.

Prometheus is a collaboration between academic labs, the United States Army Medical Research Institute of Infectious Diseases, and a New Hampshire-based antibody company called Adimab.

The groups antibody is not expected to be in human trials until late December, but it may be worth the wait. Unlike the antibodies made by Regeneron and Eli Lilly, which fade in the body within weeks, Prometheuss antibody aims to be effective for up to six months.

A single dose goes a long way, meaning we can treat more people, said Kartik Chandran, a virologist at Albert Einstein College of Medicine and the groups leader.

In mice and laboratory tests, Prometheuss antibody protects against not just the coronavirus, but also the SARS virus and similar bat viruses suggesting that the treatment may protect against any coronaviruses emerging in the future.

A study published last year recorded about 400 strains of bat-origin coronaviruses in China, some of which had already spilled over into people.

Among scientists, Dr. Chandran and Prometheus are famous for careful and clever work that has unearthed critical insights into deadly pathogens. While working on Ebola, for example, the team discovered a new entryway into human cells used by the virus, and used that information to design an antibody combination that works against all major strains of Ebola.

They do very innovative stuff, said Florian Krammer, an immunologist at the Icahn School of Medicine at Mount Sinai in New York. If they find something cool, they dig deep.

Antibodies are as variable as the people who produce them. Some antibodies are weaker than others; some target a different part of the coronavirus than others; and some are powerful protectors, while a small number may even turn against the body, as they do in autoimmune diseases.

Monoclonal antibodies are artificially synthesized copies of the most effective antibodies produced naturally by patients. In late February, AbCellera fished out an apparent winner from among 550 antibodies drawn from the blood of an infected patient. Barely three months later, partner Eli Lilly began the first trial of a synthesized version in patients.

Regeneron, which has a $450 million contract from the federal government to develop its treatment, was not far behind. Its drug is a cocktail of two antibodies. One was discovered in a patient in Singapore, while the other was made using a synthetic viral snippet in mice.

On Sept. 29, days before Mr. Trump received his infusion, Regeneron announced that this cocktail seemed particularly helpful for people who did not produce enough antibodies of their own against the coronavirus.

Both Regeneron and Eli Lilly have stockpiled tens of thousands of doses of their drugs, rather than wait for F.D.A. approval.

Without the resources or reach of these bigger companies, Prometheus has lagged behind.

With a $22 million federal grant, the group had been developing therapies for deadly viruses like the one causing Crimean-Congo hemorrhagic fever and various hantaviruses. But in the earliest days of the pandemic, the group was not able to take on the coronavirus.

We had all of the technology, all the tools ready to go, Dr. Chandran said. The only thing we didnt have was a patient sample.

Most of those samples had been handed to large pharmaceutical companies by the federal government. So the Prometheus researchers took an unusual tack, instead relying on blood from a survivor of the 2003 SARS outbreak. (The coronavirus is a close cousin.)

These scientists had experience on their side. One teammate, Jason McLellan of the University of Texas at Austin, was an expert in coronaviruses; another, John Dye of the Armys infectious diseases institute, had done pioneering work on Ebola antibodies.

In March, Dr. McLellan was the first to publish the structure of the new coronavirus in the journal Science. He supplied Adimab, Prometheuss commercial arm, with the pathogens spike protein, a protrusion on its surface that latches on to human cells and breaks in.

Using the protein as a lure, Adimab snared 200 antibodies from the patient sample. Dr. Chandran screened those antibodies against a proxy for the coronavirus, and Dr. Dye against the live virus in a high-safety laboratory.

Together, they refined the list to seven antibodies that recognized both SARS and the new coronavirus. Scientists at Adimab then enhanced the neutralizing power of one antibody by about 100-fold, yet retaining its effectiveness against all SARS family coronaviruses.

The goal was to do what we did with Ebola find an antibody that not only works against the current virus, but also past viruses that might re-emerge, like SARS, and future viruses that exist already in the bat reservoir, said Laura Walker, an immunologist and a director at Adimab.

If you had something on Day 1 to prevent all of this from happening in the first place, that would be a very good thing.

Monoclonal antibodies can rapidly prevent the virus from taking hold in the body say, in the residents of a nursing home with one confirmed case of infection. Vaccines, which require weeks to unspool an immune response, are useless in such a scenario.

But limited production capacity is likely to keep monoclonal antibodies out of reach for most people.

Regeneron expects to have enough of its cocktail to treat 300,000 patients within the next few months. The company may eventually produce about two million doses annually worldwide in partnership with Roche. Eli Lilly hopes to have 100,000 doses available later this month.

Even dozens of companies manufacturing antibodies could not produce the billions of doses required for the world or just the minimum estimate of 25 million doses needed for Covid-19 patients and high-risk people in the United States alone.

And its not clear how quickly manufacturing capacity could be scaled up. For one, the treatments are made in specialized facilities with ingredients sterile vials, protein resins, culture media needed to make other antibodies and vaccines, as well.

Its a finite capacity, and there are only so many things you can do to try to increase that capacity, said John Kokai-Kun, the director of external scientific collaboration at U.S. Pharmacopeia, an organization that monitors manufacturing quality.

The antibodies are also expensive to produce. Some cost up to $200,000 even the cheapest cost about $15,000 per year of treatment, making them unattainable for all but the richest of countries, according to a report released in August.

I dont see monoclonal antibodies being at large-scale use in the public, Dr. Kokai-Kun said. Theyre just too complicated to make and too expensive to really be effective in that regard.

Like vaccines, the antibodies have to be injected, and the amounts, which are calibrated to a persons weight, can be significant. (Mr. Trump received eight grams vaccine doses tend to be in micrograms or even nanograms.) The protection wanes after just a few weeks.

That puts a strain on your manufacturing infrastructure already to make the kinds of doses that we think are going to be required worldwide, said Andrew Adams, a vice president at Eli Lilly. We have to start thinking about the populations that we should prioritize.

Dozens more companies, and scores of academic groups including many in China are in the hunt for antibodies against the coronavirus. Given the urgent need, some may combine their resources as some did at the height of the AIDS pandemic to keep prices affordable for low- and middle-income countries.

In July, six companies, including Eli Lilly and AstraZeneca, successfully appealed to the Department of Justice to allow them to share information about manufacturing facilities, raw materials and supplies without violating antitrust laws.

Using a single antibody, as Lilly does, poses some risk of the virus mutating to escape it.

Prometheus is testing its first antibody in isolation, but plans to create a cocktail with a second antibody that is specific to the new coronavirus. The two antibodies have to be chosen carefully to complement each other or, at the very least, to not hinder each other, because they bind within the same small piece of the virus.

But each additional antibody requires more manufacturing capacity, increasing time and cost. For now, the first priority is a single powerhouse antibody that broadly protects against bat-origin coronaviruses, Dr. Chandran said.

We believe its a matter of when, and not if, the next coronavirus spillover happens.

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The Race for a Super-Antibody Against the Coronavirus - The New York Times

Reports of reinfection with the coronavirus evoke a nightmarish future: Repeat bouts of illness, impotent vaccines, unrelenting lockdowns a pandemic without an end.

A case study published on Monday, about a 25-year-old man in Nevada, has stoked those fears anew. The man, who was not named, became sicker the second time that he was infected with the virus, a pattern the immune system is supposed to prevent.

But these cases make the news precisely because they are rare, experts said: More than 38 million people worldwide have been infected with the coronavirus, and as of Monday, fewer than five of those cases have been confirmed by scientists to be reinfections.

Thats tiny its like a microliter-sized drop in the bucket, compared to the number of cases that have happened all over the world, said Angela Rasmussen, a virologist at Columbia University in New York.

In most cases, a second bout with the virus produced milder symptoms or none at all. But for at least three people, including one patient in Ecuador, the illness was more severe the second time around than during the first infection. An 89-year-old woman in the Netherlands died during her second illness.

Rare as these cases may be, they do indicate that reinfection is possible, said Akiko Iwasaki, an immunologist at Yale University, who wrote a commentary accompanying the Nevada case study, published in The Lancet Infectious Diseases.

Its important to note that there are people who do get reinfected, and in some of those cases you get worse disease, Dr. Iwasaki said. You still need to keep wearing masks and practice social distancing even if you have recovered once from this infection.

We asked experts what is known about reinfections with the coronavirus, and what the phenomenon means for vaccinations and the course of the pandemic.

First, the good news: Reinfection seems to be vanishingly rare.

Since the first confirmed case of reinfection, reported in Hong Kong on Aug. 24, there have been three published cases; reports of another 20 await scientific review.

But its impossible to know exactly how widespread the phenomenon is. To confirm a case of reinfection, scientists must look for significant differences in the genes of the two coronaviruses causing both illnesses.

In the United States, where testing was a rare resource much of this year, many people were not tested unless they were sick enough to be hospitalized. Even then, their samples were usually not preserved for genetic analysis, making it impossible to confirm suspected reinfections.

A vast majority of people who do get reinfected may go undetected. For example, the man in Hong Kong had no symptoms the second time, and his infection was discovered only because of routine screening at the airport.

There are a lot of people that are going to also have been exposed that arent having symptoms, that were never going to hear about, said Marion Pepper, an immunologist at the University of Washington in Seattle.

People whose second infections are more severe are more likely to be identified, because they return to the hospital. But those are likely to be even rarer, experts said.

If this was a very common event, we would have seen thousands of cases, Dr. Iwasaki said.

Reinfections can occur for any number of reasons: because the initial infection was too mild to produce an immune response, for example, or because the immune system was compromised by other health conditions. On occasion, a patient may be exposed to a large amount of virus that seeded an infection before the immune response could respond.

This variability is entirely expected, experts said, and has been observed in patients with diseases like measles and malaria.

Youll never have the distribution of anything with millions of people where you dont have some very severe rare cases happening at the fringe, said Dr. Michael Mina, a pediatric immunologist at the Harvard T.H. Chan School of Public Health.

At least two of the reinfected patients in Europe had compromised immune systems, for example, and the 89-year-old woman who died was receiving chemotherapy. In other reinfected patients, genetic factors or the lack of certain previous immune exposures may have blunted the bodys ability to fight off a second attack.

There are some people who just dont develop good immune responses to certain pathogens, said Florian Krammer, an immunologist at the Icahn School of Medicine at Mount Sinai. What is causing that? Were not sure, but its rare, usually.

In a vast majority of known infected patients, experts said, the immune system functions as it should against other pathogens.

There are a lot of different infections where you can get re-exposed to the virus, and we would probably not know because you dont have symptoms, Dr. Pepper said. And that might be an important part of boosting immunity.

When the body is exposed to an unfamiliar virus, its normal first to develop some immunity and then to increase that response with each additional exposure. This phenomenon is well known among children, but it is less often seen in adults because they rarely encounter new viruses, Dr. Mina said.

I think its important to recognize that reinfections are literally embedded in the evolution of our immune system, he added. We sometimes lose track of that with so many people talking about this who really havent studied the immune system.

For every confirmed case of reinfection, there are dozens of anecdotal reports of infected people who were sick and seemingly recovered but then became ill again weeks to months later.

Usually there are crucial data missing in those cases, like a confirmed lab diagnosis, or a virus sample that can be sequenced.

The question is always, Is it a real reinfection? Dr. Krammer said. Its very often very challenging to kind of get that kind of data.

A vast majority of these cases are unlikely to be true infections. More likely, these are people experiencing a resurgence of symptoms connected to the original infection. The virus may set off an inflammatory response that can flare up even weeks later and cause symptoms like fatigue and heart problems. In rare cases, some patients may develop a chronic low-grade infection with the virus that never quite goes away.

Even with viruses that can cause acute infections, like flu, Dr. Krammer said, you can have persistent infections if your immune system is sufficiently compromised.

Although these are not real reinfections, they are still worrying if they lead to renewed illness or hospitalization months after the initial infection, Dr. Rasmussen said. If theres recrudescence happening frequently, and people are getting severely ill the second time around, thats potentially its own problem, she said.

Reinfected people without symptoms may still transmit the virus to others. The patient in Hong Kong, for example, was isolated in a hospital even though he had no symptoms. But his viral load was high enough that he could have passed the virus to others.

Obviously, that person wasnt ill, so it bodes well for him, but it doesnt bode well for the community, Dr. Pepper said.

But to be sure of infectiousness, researchers may need to look for live virus. South Korean researchers investigated hundreds of reports of reinfection and were able to rule them out as real cases after failing to grow infectious virus from the samples.

Similar procedures would be needed to rule out the possibility of transmission in each patient, Dr. Rasmussen said, adding, I think thats the only way youd be able to get to the bottom of that.

Reports of reinfection have raised concerns about whether vaccines for the coronavirus will be effective and help communities achieve population immunity. The worry is that the immunity produced by vaccines will not be sufficient in preventing reinfections with the virus.

In reality, experts said, vaccines have a better chance at generating robust immunity than does natural infection with the virus.

For example, the coronavirus is particularly adept at dodging the bodys early immune alarms, buying valuable time to seed an infection. In some people, this lag eventually triggers a cascading immune overreaction that can be more harmful than the infection itself.

Vaccines are intended to unfurl an immune response without interference from the virus, and thus may avoid this inflammatory sequence. Vaccines can also be manipulated to enhance immune memory, in that way producing more lasting, more protective responses.

Vaccine trials are designed to look for an absence of disease, rather than of infection, and its unclear whether vaccines can suppress virus levels enough to prevent transmission to others.

Still, vaccine-induced immunity should perform better than natural immunity, Dr. Rasmussen said, adding, Im optimistic.

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Coronavirus Reinfections Are Real but Very, Very Rare - The New York Times

The news: A man in the US caught covid-19 for a second time in the space of just two months, according to a study published in The Lancet Infectious Diseases. That makes him the fifth person to have officially caught the coronavirus twice, after cases recorded in Hong Kong, Belgium, Ecuador, and the Netherlands (and there will certainly be more cases we don't know about). However, whats strange about his case is that he had had a worse bout of illness the second time. His doctors compared the genome of the virus during the two illnesses and found they were too different to have been caused by the same infection. Theres only one other recorded instance where this has happenedthe case in Ecuador.

The details: The 25-year-old man tested positive for the first time on April 18, after experiencing several weeks of symptoms including sore throat, cough, headache, nausea, and diarrhea. He felt fully recovered by April 27, and tested negative for the virus on both May 9 and 26. But just two days later, on May 28, he developed symptoms again, this time with fever and dizziness too. He tested positive on June 5 and needed to be hospitalized after his lungs were unable to get enough oxygen into his body, causing hypoxia and shortness of breath. He had no underlying health conditions. The man has now recovered.

The significance: Being infected once does not mean youre protected from being infected again, even if such cases are still vanishingly rare, with just five identified out of nearly 40 million confirmed cases worldwide. That means people who have had covid-19 still need to stay vigilant, following the advice on social distancing, wearing face masks, and avoiding crowded, poorly ventilated spaces. This was not altogether unexpected: coronavirus experts warned us that other coronaviruses, such as the common cold, are seasonal. However, there are still many questions that researchers are racing to answer. How much protection does having covid-19 confer? Is that mainly through antibodies or T cells? How long does protection last? What does it mean for the medical treatments that are being developed, or for vaccines? Will we all require a yearly shot rather than a one-off vaccine, for example? If nothing else, this new case is a reminder of how much about this virus we still dont know.

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A man caught coronavirus twiceand it was worse the second time - MIT Technology Review

R-0 may be the most important scientific term youve never heard of when it comes to stopping the coronavirus pandemic. USA TODAY

Nearly 10,000 people are gearing up to attend President Donald Trump's rally at the Des Moines International Airport on Wednesday, defying advice from White House experts on limiting social gatherings there to 25 people.

Meanwhile, the director of the Centers for Disease Control and Prevention is warning that small, intimate gatherings inside homes this holiday season are an "increasing threat" to the spread of the coronavirus.

And as the need for a vaccine grows more dire with some White House officials apparently endorsing a herd immunity approach widely condemned by public health officials experts say the recent pauses of vaccine studies and trials are reassuring and mean theprocesses are working as they should.

Some significant developments:

Today's numbers:The U.S. has reported more than 7.8million cases and 215,000deaths,according to Johns Hopkins data. There have been more than 38million confirmed cases around the world and 1million deaths.Five states had a record number of deaths in a week, and 12 states set records for new cases in a week, a USA TODAY analysis found.

Mapping coronavirus:Track the U.S. outbreak, state by state.

This file will be updated throughout the day. For updates in your inbox, subscribe toThe Daily Briefing newsletter.

A Sawyer County judge has, for now, blocked Gov. Tony Evers' latest order to curb the spread of coronavirus by limiting public gatherings and the number of customers bars and restaurants may serve at one time.

The order from Judge John Yackel comes at a time of record hospitalizations, new casesand deaths and after bars and restaurants have lost a massive amount of revenue ascustomers stay away while the pandemic rages on in the state.

Democratic state Sen. LaTonya Johnson of Milwaukee said if the decision becomes permanent, the state will be exacerbating the already out-of-control spread.

"Make no mistake, if this dangerous decision stands, Wisconsin will be choosing full bars over full classrooms. What a pathetic set of priorities to teach our children," she tweeted.

Molly Beck, Milwaukee Journal Sentinel

Brigham Young University's Rexburg, Idaho campus is warning against students intentionally contracting COVID-19 in order to sell plasma with antibodies for spare cash.

The alert comes weeks after the National Institutes of Healthexpanded clinical trials for convalescent plasma, which has received emergency use authorization by the FDA.Nearbycentersare offering as much as$200 per visit for convalescent plasma. according tothe Salt Lake Tribune

Students found intentionally spreading COVID-19will be suspended, the school cautions, and possibly expelled from campus.

As President Donald Trump embarks to a Wednesday campaign rally in Des Moines, Iowa,areport by the New York Times found that the White House is welcoming a declaration by a group of epidemiologiststhat calls for young people to re-enter society to stimulate "herd immunity."

Herd immunity is when a disease stops spreading because the majority of the population has had it.

The New York Times reported that two senior administration officials cited The Great Barrington Declaration, whichcalls for schools and universities to reopen, "young low-risk adults" to work normally and restaurants to reopen a stance that has largely been condemned by most public health officials, who have called it "scientifically and ethically problematic."

The declaration came out of a meeting from the libertarian-leaning American Institute for Economic Research and its website says it has more than 9,000 signatures, though most names are not public.

"Herd immunity is achieved by protecting people from a virus, not by exposing them to it," WHO Director-General Tedros Ghebreyesus said Monday, before the report dropped.

A USA TODAY analysis of Johns Hopkins data through late Tuesday shows 12 states set records for new cases in a week, while five states had a record number of deaths in a week.

New case records were set in Colorado, Illinois, Indiana, Minnesota, Nebraska, New Mexico, North Dakota, Ohio, South Dakota, West Virginia, Wisconsin and Wyoming. A record numbers of deaths were reported in Kansas, Montana, North Dakota, South Dakota and Wisconsin.

Wisconsin and North Dakota are alsoreporting new cases at a rate more than 10 times faster than they did in their worst week of the spring, though changes in testing mean it's not clear how much cases have actually gone up.

Michael Stucka

Robert Redfield, the director of the Centers for Disease Control and Prevention, cautioned governors during a call that small household gatherings are emerging as a key threat during the COVID-19 pandemic as many states report a record number ofcases.

Accordingto audio obtained by CNN, the agency chief emphasized that people shouldremain wary ofbreaking social distancing guidelines as the holidays approach.

"Particularly with Thanksgiving coming up, we think it's really important to stress the vigilance of these continued mitigation steps in the household setting, he said.

'Small events add up to a lot': Limited gatherings quietly emerge as source of coronavirus infections

Students who were involved in an off-campus party at Monmouth University in New Jersey, which forced hundreds of students into isolation and shut down in-person instruction,are not cooperating with investigators who have yet to find out where the party was held.

Monmouth County health officials who are investigating the event blamed for spreading the coronavirus to an estimated 125 students so far said they have reached out to students through contact tracing, but none will disclose where the party occurred or who organized it.

Monmouth University President Patrick Leahy revealed in a Friday letter that the off-campus gathering occurred in recent weeksbut had no location or exact date.

Joe Strupp, Asbury Park Press

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Recent pauses to two large-scale COVID-19 vaccine trials and a treatment study should reassure peoplenot frighten them vaccine experts said, though it is a reminder of the messiness of science.

Its not unusual for late-stage trials of drugs and vaccines to be stopped briefly to examine safety concerns.This is an indication that the system is working as it was designed to work to protect human subjects in clinical trials, Lawrence Gostin, a public health and legal expert at Georgetown and Johns Hopkins, told USA TODAY.

There are 49 COVID-19 candidate vaccines in clinical trials around the world, andnine are in large, late-stage studies, said Alan Barrett, director of the Sealy Institute for Vaccine Sciences at The University of Texas Medical Branch at Galveston. Only three people out of the roughly 300,000 volunteers in all those trials have been known to have suffered serious side effects.

Karen Weintraub and Elizabeth Weise

Travelers from 38 states and territories will now have to isolate upon entering New York, New Jersey and Connecticut after the three neighboring states expanded their quarantine list again.

Michigan, Virginia and Ohio were all added Tuesday to the tri-state travel advisory, whichdirects out-of-state travelers to self-quarantine for 14 daysin an effort to slow the spread of COVID-19.

Restrictions are appliedto any state that averaged 10 daily positive COVID-19 cases per 100,000 residents over the past week, as well as states where 10% of tests came back positive over the same time period.

Jon Campbell, New York State Team

Pediatricians and public health experts predict a potentially dramatic increase in childhood obesity this year as months of pandemic eating, closed schools, stalled sports and public space restrictions extendindefinitely.

About one in seven children have met the criteria for childhood obesity since 2016, when the federal National Survey of Children's Healthchanged its methodology, a report out Wednesday by the Robert Wood Johnson Foundation found.

Thetrend,already seen in pediatricoffices, is especially concerning as the Centers for Disease Control and Prevention this week expanded its definition of those at elevated risk of severe COVID-19 disease and death to include people with a body mass index of 25 to 30. Previously, only those with a BMI 30 and higher were included

Jayne O'Donnell and Adrianna Rodriguez

House Speaker Nancy Pelosi, D-Calif., called CNN anchor Wolf Blitzer an "apologist for the Republican position" during a tense interview aboutthe current state of a COVID-19 stimulus package.

As you know, there are Americans who are being evicted from their homes. They cant pay their rent. Many Americans are waiting in food lines for the first time in their lives, Blitzer toldPelosi. Can you look them in the eye, MadamSpeaker, and explain why you dont want to accept the presidents latest stimulus offer?

Pelosi then pondered if Blitzer would ask the same question of the Republicans before insistingthe GOP bill doesnt meet the needs of Americans.Blitzer asked Pelosi why she would not take the $1.8 trillion deal, referencing statementsfromRep. Ro Khanna, D-Calif., and former Democraticpresidential candidateAndrew Yang, who say she should.

"I dont know why youre always an apologist and many of your colleagues are apologists for the Republican position," Pelosi said during the nearly 14-minute interview."I want this very much now because people need help now. But it's no use giving them a false thing just because the president wants to put a check with his name on it in the mail."

Savannah Behrmann

New York's iconic Roosevelt Hotelis saying goodbye after being a midtown Manhattanmainstay for nearly 100 years.

The New York Cityhotel, which has been around since 1924 and has made cameos in movies including "The Irishman" and "Maid in Manhattan" is closing its doors by the end of this year because oftheeffects of the coronavirus pandemic.

Thehotel is owned by Pakistan International Airlines and has been home to manyhistoric American momentsfrom serving as the headquarters for Gov. Thomas Dewey's election campaign in 1984 when he incorrectly announced he'd defeatedHarry Truman to being the first placeGuy Lombardo and his orchestra performed in 1929.

Rasha Ali

Facebook is injecting itself into the public health debate by encouraging flu shots and banning anti-vaccination advertisements. But the social network may not be going far enough, some say, because nonpaidanti-vaccination posts are still allowed.

In a post Tuesday, Facebook said it would begin a flu shot campaign this week with a tool to find where to get a shot. Other features: News feed itemsand shareable flu reminders.

Facebook will also globally begin rejecting ads discouragingpeople from getting a vaccine and work with health groups to increase immunization rates, the network said. "Our goal is to help messages about the safety and efficacy of vaccines reach a broad group of people, while prohibiting ads with misinformation that could harm public health efforts," the authors said.

Mike Snider

Delta Air Lines posted a massive $5.4billion loss for the quarterthat endedSept. 30, results showing how the coronavirus pandemic is wrecking the airline industry.

Delta, the first of the largest airlines to report earnings for the quarter, said it plans to take additional steps cut its losses and conserve its remaining cash, including retiring 400 aircraft by 2025 and delaying taking new planes.

Though its losses are staggering, the company said it still has $21.6 billion in reserve to try to get it through the crisis.

While our September quarter results demonstrate the magnitude of the pandemic on our business, we have been encouraged as more customers travel and we are seeing a path of progressive improvement in our revenues, financial results and daily cash burn, said CEO Ed Bastian in a statement.

Chris Woodyard

Contributing: The Associated Press

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Coronavirus updates: Small home gatherings are 'a threat'; White House reportedly wants herd immunity by infecting young people - USA TODAY

4. ICE

5. Russia

The NY Philharmonic has canceled its entire concert season for the first time in its 178-year history

A Utah hiker stalked by a cougar spent six whole minutes slooowly backing away from the animal

Second giant 'murder hornet' escapes after it was captured by scientists in Washington

We have gone from being unable to vote legally to a highly courted voting bloc -- all in little more than a century. Despite this and despite the way so many have embraced messages about racial justice this year, Black women are still constantly disrespected and disregarded in so many areas of life.

Continued here:

5 things to know for October 14: Coronavirus, Supreme Court, Election 2020, ICE and Russia - CNN

The estimate is based on the number of infections "that have already occurred," Dr. Tom Frieden said Saturday, during CNN's "Coronavirus: Facts and Fears" town hall.

"Anytime we ignore, minimize or underestimate this virus, we do so at our peril and the peril of people whose lives depend on us," Frieden said.

By February, the coronavirus death toll in the US could double to about 400,000, a model from the Institute for Health Metrics and Evaluation at the University of Washington School of Medicine projected. Daily deaths will peak at about 2,300 in mid-January, the model predicted.

Projections aren't set in stone, however, and what the public does can have a big impact, another former CDC director, Dr. Richard Besser, said.

New Covid-19 cases continue to grow across the country, though. Florida health officials reported 5,570 new cases of Covid-19 on Sunday after there was no case or death update on Saturday, according to the Florida Department of Health.

There were also 178 Floridian deaths reported on Sunday, bring that total to 15,364, according to the data.

In Montana, it took almost five months from the beginning of the pandemic for the state to reach 5,000 confirmed coronavirus cases. But in just the past 11 days the state has reported a further 5,000 cases as the virus continues to spread throughout the country.

Impacts could be much greater than officials think

Officials are tracking coronavirus infections and deaths, but Frieden said those numbers may be too small.

The true number of coronavirus deaths in the United States is well over a quarter million, Frieden said Saturday.

Part of the problem in determining the true impact is how deaths are listed on death certificates, especially for older patients who are more likely to have other health problems along with a coronavirus infection. Often the other health condition is listed as the cause of death, he said.

"If you die from cancer, and you also have diabetes, you still died from cancer," Frieden explained. "If you died from Covid, and you also had diabetes, you died from Covid."

The number of infections is likely closer to 40 million people, he said.

"You may not get sick at all from this, but you may spread it to someone who then dies, or spreads it to someone else who dies," he said. "That's why we all have to recognize that we're in this together. There's only one enemy, and that's the virus."

Regaining trust in vaccines and health agencies

While researchers are racing to develop a coronavirus vaccine, health experts said Saturday that improving trust and accessibility around any potential vaccine is essential.

"For a vaccine to actually work, it's got to not only be safe and effective, but also be accessible and trusted. And that's why it's so important that it not get politicized and not be seen as from any political party or political figure," Frieden said. "It's a big job to get vaccines out there."

Opinion polls show that the public doesn't trust the CDC with information around coronavirus.

The way to regain trust "depends first and foremost on telling the truth, even when it's hard," Dr. Julie Gerberding said in the townhall.

"Americans can tolerate really tough truths, but it has to come from reliable and credible sources," Gerberding said. "One of the reasons that we have so much anxiety among Americans is because they're hearing different things from different political leaders. We haven't consolidated and cascaded the messages from reliable sources."

She reiterated what the other former CDC leaders said during the town hall: Transparency is key.

"It is going to be very difficult to crawl back into a situation where people believe that we really do have their best interest at heart. The good news is that science is on our side," she said.

A wake-up call for politicians and public health officials

Former CDC directors warned that both politicians and public health officials need to take the virus seriously for the sake of the public.

President Donald Trump said that Americans shouldn't let fear of coronavirus dominate their lives, but former director Dr. Jeffrey Koplan said the country should "absolutely" be afraid.

"When your leadership is working against you in this virus, the virus has an ally that makes it a pretty strong contender for further destruction," Koplan said.

Koplan said he believes this pandemic will serve as a wake-up call for politicians and public health officials.

"I would very much hope that we see stronger state and local health departments, working with a stronger CDC -- that there is particularly more attention paid to an up-to-date surveillance system, early detection of problems, and then approaches towards ameliorating them," he said.

Correction: A previous version of this story incorrectly reported the number of daily deaths predicted by a model from the Institute for Health Metrics and Evaluation at the University of Washington School of Medicine. Daily deaths will peak at about 2,300 in mid-January, the model predicts.

CNN's Lauren Mascarenhas, Andrea Kane, Leanna Faulk, Shelby Lin Erdman, Nicole Chavez and Christina Maxouris contributed to this report.

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The US should expect 20,000 more coronavirus deaths by the end of the month, former CDC director says - CNN