Category: Corona Virus

As Covid-19 cases surge to their highest levels in dozens of states, the nations testing effort is on the brink of paralysis because of widespread delays in getting back results. And that is very bad news, because even if testing is robust, the pandemic cannot be controlled without rapid results.

This is the latest failure in our national response to the worst pandemic in a century. Since the Trump administration has abdicated responsibility, governors must join forces to meet this threat before the cataclysm that Florida is experiencing becomes the reality across the country.

Testing should be the governors first order of business.

Despite President Trumps boast early this month that testing is so massive and so good, the United States two largest commercial testing companies, Quest Diagnostics and LabCorp, have found themselves overwhelmed and unable to return results promptly. Delays averaging a week or longer for all but top-priority hospital patients and symptomatic health care workers are disastrous for efforts to slow the spread of the virus.

Without rapid results, it is impossible to isolate new infections quickly enough to douse flare-ups before they grow. Slow diagnosis incapacitates contact tracing, which entails not only isolating those who test positive but also alerting the infected persons contacts quickly so they can quarantine, too, and avoid exposing others to the virus unwittingly.

Among those who waited an absurdly long time for her results was the mayor of Atlanta, Keisha Lance Bottoms. We FINALLY received our test results taken 8 days before, she tweeted last week. One person in my house was positive then. By the time we tested again, 1 week later, 3 of us had COVID. If we had known sooner, we would have immediately quarantined.

Another complaint came this week from Mr. Trumps former acting chief of staff, Mick Mulvaney, who wrote in an op-ed commentary for CNBC that my son was tested recently; we had to wait 5 to 7 days for results. Noting, too, that his daughter was told she didnt qualify for a test, he added, That is simply inexcusable at this point in the pandemic.

As summer turns to fall, slow and fragmented testing will fatally undermine the reopening of schools and universities, whose plans are predicated on quickly identifying outbreaks and suppressing spread. Testing for millions of students will feed into an already failing national system.

Vice President Mike Pences casual invocation of an extraordinary national success in testing in a recent call with governors was flatly wrong, as is the presidents similar trumpeting of testing success. These claims contribute to a false sense among the public that testing may have had early stumbles but is ramping up slowly but surely.

The reality is that the spread of the virus has vastly outpaced the expansion of testing capacity. That spread in turn results in more illness and therefore more tests to process, which further slows down turnaround time in a vicious cycle. The dedication and patience of thousands of people waiting in serpentine lines of cars for hours to be tested are wasted when the results arent returned quickly enough.

We are at this point because of the absence of a coordinated federal plan, and, indeed, because of a White House that seems actively hostile to producing one. The nations governors and state legislators must fill the void.

Unity among the states is not just about neighborliness but also about self-interest. So long as interstate travel continues, inadequate testing anywhere threatens public health everywhere, including in places that have found or developed localized testing capacities and are less sensitive to the bottlenecks that Quest and LabCorp are experiencing.

The signal difference between federal and state leadership is that the former can print money and the latter cannot. If states are to step up, they will need resources: money from Congress without executive branch holdup, coordination and mutual aid from one another, and cooperation and expertise from the public itself.

Heres what the governors need to do to bolster the overall testing capability before the end of the summer, best begun with a summit in the next two weeks.

Governors must work collectively to fill gaps in their own testing and contact-tracing programs. The National Governors Association helped in a similar effort to curb the spread of the Zika virus.

In March there was a mad scramble and competition for personal protective equipment. Now, the allocation of tests and test processing may end up in another free-for-all. A coordinated approach by all states would avoid that. Consistent metrics must be established for accountability and to identify trigger points that call for rapid policy responses. Acting in concert can make it easier to undertake tough or controversial decisions like ordering lockdowns when testing shows renewed spread.

Governors should also agree to assist in sharing local test processing capacity, including by university labs, so it is available wherever it is most needed. Relying largely on two large commercial testing companies, as we are now, has proved to be a major vulnerability.

For example, the Broad Institute of M.I.T. and Harvard has stepped up in Massachusetts with more testing capacity so much so that it is not being fully used. But no process is in place for a doctor in, say, Arizona to prescribe a test that the Broad will process. Thats a problem that governors can help solve. They can also find ways to subsidize investments by labs to expand capacity, to help untangle medical insurance complications so tests are covered and to prompt innovations in testing.

In particular, they should encourage the academic and commercial sectors to develop, test and produce new, rapid, point-of-care testing. More broadly, they should recruit data scientists and experts in science communication ready to lend their skills to a unified effort.

We cant allow the delays at Quest and LabCorp to mark the start of a downward spiral. Instead, we must marshal a nationwide strategy to place the United States in the ranks of other countries that are successfully beating back the pandemic.

Sorting out testing is foundational to slowing the spread of the virus. From there, governors can build a comprehensive national plan of attack. Doing so will require new forms of coordinated governance. In the absence of federal leadership, its up to governors to step to the fore.

Margaret Bourdeaux is research director of the Program of Global Public Policy at Harvard Medical School. Beth Cameron is the vice president for Global Biological Policy and Programs at the Nuclear Threat Initiative. Jonathan Zittrain is a professor of law and computer science at Harvard and co-chair with Dr. Bourdeaux of the Berkman Klein Centers Digital Pandemic Response Practice.

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Testing Is on the Brink of Paralysis. Thats Very Bad News. - The New York Times

Thirty-nine states reported an increase in the number of new cases from the week before. California, Florida, Arizona and Texas have become the states to watch as surging coronavirus cases lead to a shortage of hospital beds.

In Arizona's Maricopa County, which has the most Covid-19 cases in the state, the medical examiner's office has ordered four portable coolers with additional ones expected in the coming days, said Fields Moseley, the county spokesman. The medical examiner's office morgue had a total of 156 deceased people -- with a surge capacity of just over 200, Moseley said Wednesday.

In Texas, the city of San Antonio and Bexar County have secured several refrigerated trailers to store bodies until they can be released to funeral homes, Mario Martinez, Metro Health Assistant Director, said in a video interview released by the city.

He said that they currently have two in operation and another three will be operational by the end of the week.

Cameron and Hidalgo counties in Texas are sharing a large refrigerated trailer to store bodies of coronavirus patients because of a lack of space at the morgues.

"I'm pleading with everybody in our neck of the woods, help us do your part, people's lives are at stake -- not just the people getting sick, but doctors, nurses working to the bone, EMS personnel, transporting people," Cameron County Judge Eddie Trevio Jr. told CNN affiliate KVEO.

The Dallas County morgue had to use an external refrigerated truck this week due to the increased caseload, the Medical Examiner's Office told CNN.

"We have had to go to the external refrigerated truck once this week due to increased caseload, but today we are back with all cases inside," Dr. Jeffrey Barnard, the Dallas County Medical Examiner, said in a statement. "I anticipate that we will at some point have to use the truck again based on continuing increased volume."

Masks requirements expand

Three more major retailers announced on Thursday they'll require customers to wear masks in their stores.

Publix will require masks as of July 21 and CVS starting on July 20. Target will require customers to wear masks as of August 1, though the retailer noted 80% of its stores already require masks because of state and local regulations.

On Wednesday, retail giant Walmart announced it would require masks in its stores.

Colorado Gov. Jared Polis announced on Thursday that face masks are required in public places when social distancing is impossible. The order takes effect at midnight on Thursday.

Arkansas Gov. Asa Hutchinson announced a statewide order effective Monday. Masks will be required when people are in the presence of non-household members and aren't able to socially distance.

Alabama and Montana issued statewide facial covering orders on Wednesday.

Oklahoma Gov. Kevin Stitt said Wednesday he's tested positive for Covid-19, the same day the state reported a record high number of new cases.

Georgia governor, Atlanta mayor clash

Gov. Brian Kemp extended Georgia's emergency coronavirus restrictions and said while people are "strongly encouraged" to wear face coverings -- they're not required. The order, which expires July 31, limits public gatherings to 50 people and mandates social distancing.

His order also prevents local governments from implementing stricter rules than the state's -- including requiring face masks.

But on Thursday, Michael Smith, press secretary for Atlanta Mayor Keisha Lance Bottoms, told CNN the "Mayor's Order remains in effect, as science and data will continue to drive the City's decisions. Masks save lives."

California, the country's most populous state, reported 8,544 new cases of the coronavirus and 118 additional deaths on Thursday, according to updated data from the California Department of Public Health. The new cases represent a 2.5% increase and the deaths reflect a 1.6% increase from Wednesday's data. And in Los Angeles County, the public health director warned another stay-at-home order is likely.

"We can't take anything off the table -- there's absolutely no certainty of what exactly is going to happen next," Dr. Barbara Ferrer said.

Florida reported more than 315,000 positive cases statewide on Thursday, an increase of 13,965 cases from the previous day, according to the Florida Department of Health. There were a record 156 coronavirus-related deaths on Thursday, a jump from the previous high of 132 on Tuesday.

Epidemiologist says California needs more contact tracers

To combat the rise in coronavirus cases in California, there needs to be enough contact tracing staff in regions where Covid-19 infections are increasing, the principal investigator for the state's contact tracing program told CNN, but not all regions require an equal number of tracers.

"They're not, in their current level, they're not in all places," said University of California, San Francisco epidemiologist Dr. George Rutherford, who also leads the university's contact tracing training program. "If we spread it evenly there still probably wouldn't be enough in the highest incidence areas."

Health officials, he said, cannot forecast how much contact tracing is needed in a region until public health departments are alerted to positive results, but the teams are scalable. "We can call in extra people if there's a surge," Rutherford said.

Higher death toll expected

The model from the Institute for Health Metrics and Evaluation at the University of Washington is projecting 224,000 people will die from the virus by November 1 -- an increase of almost 16,000 from the week before.

That jump is due to skyrocketing cases around the country, particularly in Florida, Texas, Arizona, California, Louisiana, Kentucky, Mississippi, Nevada, New Mexico, South Carolina, Tennessee and Utah, said Dr. Chris Murray, chair of the IHME.

CNN's Joe Sutton, Jon Passantino, Sarah Moon, Jennifer Henderson and Maggie Fox contributed to this report.

Originally posted here:

Arizona and Texas counties hit hard by coronavirus bring in refrigerated trucks as morgues fill up - CNN

A volunteer receives a shot in a clinical trial for a potential coronavirus vaccine. U.S. intelligence officials say Russian hackers are attempting to break into U.S. health care organizations working on a vaccine. Ted S. Warren/AP hide caption

A volunteer receives a shot in a clinical trial for a potential coronavirus vaccine. U.S. intelligence officials say Russian hackers are attempting to break into U.S. health care organizations working on a vaccine.

The National Security Agency, as well as its counterparts in Britain and Canada, all said Thursday that they're seeing persistent attempts by Russian hackers to break into organizations working on a potential coronavirus vaccine.

The Western intelligence agencies say they believe the hackers are part of the Russian group informally known as Cozy Bear. The intelligence agencies refer to it as APT29.

That group has been linked to Russian intelligence and was blamed for hacking Democratic Party emails in the 2016 U.S. presidential election.

"APT29 has a long history of targeting governmental, diplomatic, think-tank, health care and energy organizations for intelligence gain so we encourage everyone to take this threat seriously," said Anne Neuberger, the NSA's cybersecurity director.

Russia denied the accusation.

"We can say one thing Russia has nothing at all to do with these attempts," Dmitry Peskov, a spokesman for Russian President Vladimir Putin, was quoted as saying by the state-run Tass news agency.

The Western intelligence agencies did not name any of the organizations being targeted. In addition, there was no word on whether the hackers had obtained any information, or what they might do with any such information.

But for several months now, the U.S. and others have been warning health care organizations to safeguard all sensitive information related to a potential vaccine.

"We are imploring all those research facilities and hospitals and pharmaceutical companies that are doing really great research to do everything in their power to protect it," Bill Evanina, the director of the National Counterintelligence and Security Center, told NPR in May.

Prior to Thursday's announcement, U.S. officials had already been warning about China, which has has a long track record of stealing Western intellectual property.

"We have the full expectation that China will do everything in their power to obtain any viable research that we are conducting here in the U.S.," Evanina said back in May. "That will be in line with their capabilities and intent the last decade plus, and we are expecting them to continue to do so."

Read more here:

U.S. Says Russian Hackers Are Trying To Steal Coronavirus Vaccine Research - NPR

But perhaps what is most surprising, there are real signs that Trump's base is leaving him on the issue of the coronavirus.

Trump's numbers look even worse when you examine where he is with groups that make up that base: whites without a college degree and rural voters.

Among whites without a college degree, Trump's approval rating on coronavirus is an average of the ABC News/Ipsos and Quinnipiac polls is just 50%. That matches his disapproval rating. In other words, Trump's doing no better than even among what is supposed to be a bedrock group.

The numbers are no better for him among rural voters. In an average of the ABC News/Ipsos and Quinnipiac polls, his approval rating is at 48% among rural voters. His disapproval stands at 50%. Again, you want to be running up the score with base groups that voted for you by around 30 points in 2016. Trump's just running even here.

Now, there was no reason it had to be this way for Trump. Back in early April, Trump was getting strong ratings from all of these groups in his base.

He was averaging a 90% approval rating in the ABC News/Ipsos and Quinnipiac University polls when it came to his coronavirus performance.

He was well into the 60s with both whites without a college degree and rural voters in both polls.

What we've seen is that his base is clearly running away with him because they judge his performance over the last few months to be negative.

The big question with an election in the fall is whether these voters are merely saying they disapprove of Trump on the coronavirus but are still going to vote for him.

There are certainly some members of his base who are never going to vote for former Vice President Joe Biden, even though they dislike Trump's handling of coronavirus.

Still, there are signs that Trump's coronavirus performance is hurting him even against Biden.

Likewise, Trump's up 21 points with rural voters in the Quinnipiac poll. That looks a lot like an average of the polling.

Overall, these may seem like large margins, but they're not anywhere near as well as Trump did in 2016.

Read more here:

There are signs Trump's base is leaving him on the coronavirus - CNN

There isnt enough experience with SARS-CoV-2, the virus that causes COVID-19, to know whether mothers can transmit it via breast milk, but according to the Centers for Disease Control and Prevention (CDC), available data suggests breastfeeding isnt a likely source of transmission.

What should you do if you are breastfeeding and have COVID-19 symptoms or a confirmed infection?

Breast milk is still the best source of nutrition for babies and can protect against many diseases, said Kristina A. Bryant, M.D., pediatric infectious disease specialist with Norton Childrens Infectious Diseases, affiliated with the UofL School of Medicine.While it appears that transmitting the coronavirus to a baby while feeding with breast milk is unlikely, you should take precautions. One option is for a mother to express breast milk and have a healthy caregiver feed it to her baby until her own infectious period ends.

If you are breastfeeding and suspect you have COVID-19 or have had confirmation through a nasal swab test, your baby should remain in isolation with you for the duration of your isolation period and for 14 days after that, according to the CDC. The same applies to a baby who has had any other ongoing close contact with a suspected or confirmed COVID-19 patient.

It is still important for your newborn to be seen for all recommended medical visits, so inform your doctor that your baby has potential risk for COVID-19 when making the appointment so the office can take appropriate precautions.

Premature babies often are fed pasteurized breast milk from a donor. While there is no information available about what pasteurization does to the coronavirus, similar viruses are inactivated through pasteurization, according to the CDC.

And, remember, do not put a mask on a child under age 2.

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Breastfeeding and coronavirus: What you need to know - Norton Healthcare

He loved to get his family together, Ms. Flores said. And thats what took him.

My familys encounter with the virus started in the last week of June, when my 17-year-old nephew, who mistook his virus symptoms for strep, joined my 66-year-old mother, 69-year-old father, two sisters and a brother-in-law on a medical road trip to Houston, where my mother had scheduled a mammogram.

Hablas espaol? To read more of our stories in Spanish, subscribe to our newsletter El Times.

On their way back to the Valley, they visited relatives in Galveston. After Fathers Day, about a dozen relatives who had met one another during the trip began describing debilitating headaches, body chills, fever and trouble breathing, all classic Covid-19 symptoms.

The Contreras family was in a similar situation. They gathered for their festive pachanga on June 1, dancing to mariachi music, sharing family stories and savoring classic Mexican barbecue.

Because they kept it small, they thought they were doing the right thing, said Ms. Flores, who stayed home because she worried about the virus.

It only took a few days for Mr. Contreras to develop a severe respiratory illness. Two of his sons soon joined him in the hospital with difficulty breathing. Soon uncles, aunts and cousins also fell ill.

Ms. Flores told me that when she heard her grandfathers brain was bleeding, she rushed to the hospital and found him unconscious and connected to several tubes.

Your gera is here, she whispered, using the nickname he had given her as a child, alluding to her light complexion.

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I Went Home to Texas to Cover the Virus. Then My Family Got It. - The New York Times

Good morning.

(This article is part of the California Today newsletter. Sign up here to receive it by email.)

Californians who dont have symptoms of Covid-19 will probably have a harder time getting tested for the coronavirus, according to new, stricter guidelines state officials unveiled on Tuesday.

It is critical we continue to be deliberate and creative about testing, Dr. Mark Ghaly, the states head of health and human services, said in a statement. We must do this so that testing is readily available and affordable to those who need it, especially those communities experiencing the worst impacts.

In a virtual news conference, Dr. Ghaly said California was also exploring opportunities for pooled testing, a strategy that could help identify infections in large groups more quickly.

The shift in testing strategy comes as more states around the country have scrambled to ramp up testing, which has resulted in tighter supply chains and longer turnaround times in California, the nations most populous state.

California has contended with an explosion in cases, prompting Gov. Gavin Newsom on Monday to announce the most sweeping rollback yet of reopening plans.

[Read about which businesses were ordered to close down.]

As of Tuesday, California was averaging 8,334 new cases per day over the past week, compared with 3,041 new cases per day on average just a month ago.

Heres what to know about the changes:

Why are they happening now?

Over the past two weeks, the state reported 107,600 tests per day on average a huge increase over the past couple of months. But the states percentage of tests that have come back positive for the virus has inched upward, as well, to 7.1 percent on average over the past two weeks.

Our testing capacity has increased exponentially, Dr. Ghaly said in the statement. At the same time, new national supply chain challenges and large volumes of specimens sent to commercial laboratories have resulted in growing delays in processing times.

What do the new guidelines say?

Previously, state and local officials had encouraged anyone who wanted to get tested to see if they were eligible, whether or not they had symptoms, as testing capacity ramped up across California and case numbers were less troubling.

Under the new guidelines, Dr. Ghaly said that testing would be much more strategically targeted at people in communities where risks of transmission are higher.

Of course, people who have severe symptoms will be prioritized for tests with quick results so they can get a diagnosis and be treated.

According to the new rules, people who have been hospitalized fall in the Tier 1 priority group, along with people who must be tested as part of investigations into specific outbreaks.

Tier 2 includes everyone else with Covid-19 symptoms, as well as people who live or work in the kinds of facilities where outbreaks have been most severe, such as nursing homes, prisons and homeless shelters. It also includes health care workers who have frequent interactions with the public or with people who may have Covid-19.

Tier 3 includes workers in remaining essential sectors, like grocery stores, logistics, manufacturing and education, if they dont have symptoms.

And then, theres Tier 4, which will be implemented only when the test turnaround time is less than 48 hours, as monitored by the state. Thats when anyone else who doesnt have symptoms, but is worried they may have been infected, can get tested.

How will these new rules help stop the spread of the virus?

While individual actions, like following distancing and mask-wearing rules, are critical for curbing the spread of the virus, increasingly, experts have recognized that many transmissions are taking place because Californians who work in low-wage, high-risk jobs havent been able to stop working.

In a first-of-its-kind analysis, researchers at the University of California, Merced, Community and Labor Center found a connection between high concentrations of low-wage work in certain counties like at farms and in warehouses and the prevalence of Covid-19.

Our findings emphasized the importance of not just regulating business openings, but mitigating Covid spread by innovating health and safety reforms for workers, Ana Padilla, the centers executive director, told me.

One way to do that is to ensure that workers in those communities have access to testing and that workplace outbreaks are transparent. That would mean requiring counties to report test results by industry, the report said.

Although we have guidance and support, we know that testing in those environments is key, Dr. Ghaly said on Tuesday, adding that thats why the new testing strategy involves homing in on workplace outbreaks.

Updated July 16, 2020

Still, he said the state hadnt specifically asked counties to report test results by industry or employer.

[Read more about how the pandemic has put warehouse workers in the Inland Empire in a tough spot.]

We often link to sites that limit access for nonsubscribers. We appreciate your reading Times coverage, but we also encourage you to support local news if you can.

The Trump administration abandoned its plan to strip international college students of their visas if they didnt attend at least one class in person. It was a rare and swift reversal in response to fierce opposition. [The New York Times]

Most of the nations big school districts including in Los Angeles and San Diego arent ready to reopen, because the test positivity rates in the communities where theyre located are much too high. And reassuring examples of schools reopening abroad dont apply here. [The New York Times]

Bankruptcy forced Stockton to defund its Police Department, making it an inadvertent laboratory for pushes to reduce the roles of law enforcement officers in keeping communities safe. [The Los Angeles Times]

If you missed it, heres what Stocktons mayor had to say about calls to defund the police now. [The New York Times]

Transit agencies around the country are struggling. In the Bay Area, there are too many disjointed systems and not enough riders. [Bloomberg CityLab]

Wineries were beginning to settle into a new normal. Then they were told they had to shut down indoor operations.[The San Francisco Chronicle]

He goes by Bruce or Paco or Peter or Pierre or Abraham. He is a peacock. And hes tearing a North Oakland neighborhood apart. [SFGate]

We joke about it: How many years has it been since 2020 started? How many lifetimes?

Theres a sense that were living through a momentous period in history a global pandemic, uprisings over racial justice that have poured into every corner of society and broad recognition that the world is changing rapidly.

So museums and curators are asking us all to help them help future generations understand this time by documenting it. Everything, like protest signs, shopping lists, or snippets of video.

Whatever were taking to be ordinary within this abnormal moment can, in fact, serve as an extraordinary artifact to our childrens children, Tyree Boyd-Pates, an associate curator at the Autry Museum of the American West, told Lesley M.M. Blume, in this article. The Autry is asking for submissions to its Collecting Community History Initiative.

California Today goes live at 6:30 a.m. Pacific time weekdays. Tell us what you want to see: CAtoday@nytimes.com. Were you forwarded this email? Sign up for California Today here and read every edition online here.

Jill Cowan grew up in Orange County, went to school at U.C. Berkeley and has reported all over the state, including the Bay Area, Bakersfield and Los Angeles but she always wants to see more. Follow along here or on Twitter.

California Today is edited by Julie Bloom, who grew up in Los Angeles and graduated from U.C. Berkeley.

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Why You May Not Be Able to Get a Coronavirus Test in California - The New York Times

But vaccines spritzed through the nose or mouth would also tap into another set of immune cells that hang around mucosal tissues. The B cells that reside here can make another type of antibody, called IgA, that plays a large role in bringing gut and airway pathogens to heel. And T cells in this neighborhood can memorize the features of specific pathogens, then spend the rest of their lives patrolling the places they first encountered them.

These mucosal immune responses seem to underlie the success of the oral polio vaccine, which contains a weakened form of polio virus and has helped most of the world eradicate polio. When it debuted in the 1960s, the vaccine was considered, in many ways, an enormous improvement over its injected predecessor because it targeted the bodys immune response in the gut, where the virus thrives. Many people who took the oral vaccine seemed to quash infections even before they felt symptoms or passed the germ on to others.

It was a fabulous vaccine to stop the transmission of polio, said Dr. Anna Durbin, a vaccine expert at Johns Hopkins University. It helped induce herd immunity, she said, referring to the threshold of the population that needs to be immune to a pathogen to keep it from spreading.

Vaccines given through muscle are great for prompting the body to churn out antibodies in the bloodstream, like IgG. If a pathogen shows up, hordes of these on-call molecules will rush to meet it.

For many respiratory infections, thats good enough.

The majority of respiratory vaccines, like the measles vaccine, are given intramuscularly, and it works, Dr. Iwasaki said. If enough antibodies reach the right mucosal surface, it doesnt really matter how they were induced.

Still, relying on that strategy alone can be risky a bit like shoring up a banks security at every entrance except for the one a thief would most likely hit. Sentinels roving throughout the building could subdue the interloper after they trip the alarm. But by that point, some damage has probably already been done.

Updated July 16, 2020

Its mainly a timing issue, Dr. Bhattacharya said. If you have circulating cells and molecules, theyll eventually find the infection. But youd rather have a more immediate response.

Read the original here:

Nasal Coronavirus Vaccines May Work Better Than Injected Ones, Researchers Say - The New York Times

CHICAGO Chicago could close businesses and go back to Phase 3 if new cases continue to climb, Mayor Lori Lightfoot warned Wednesday morning.

The announcement comes as the citys average number of new cases continues to climb, as does the positivity rate. Young people are driving the uptick in new cases, with people age 18-29 now accounting for 30 percent of coronavirus cases reported in recent weeks in Chicago, officials said.

The Lincoln Park area is the spot thats seen the most increases in cases of people age 18-29.

Lightfoot said people age 18-29 must stop gathering in large groups and start wearing masks in public if the city wants to stay on track.

After that age group, the most new cases have been seen among people 30-39 and 40-49 years old, officials said.

The rise in cases comes as other cities across the country are rolling back their reopenings because theyve faced more significant surges in new cases.

Yes, our metrics are tracking better than the rest of the country, but that doesnt mean that we can ever let our guard down, Lightfoot said. It means our precautions are working and that we need to continue to be diligent.

The city is now seeing an average of 192 new cases per day. That number has been slowly climbing for weeks and its now worryingly close to 200, the number at which Chicago goes back to being considered a city with a high incidence of coronavirus.

And Dr. Allison Arwady, commissioner of the Chicago Department of Public Health, said she expects new cases to keep climbing.

When we get back above 200 were back in a high incidence state, and for me that means we are back in a caution state, Arwady said during Wednesdays press conference. At another point, she added, I think there is wishful thinking happening that COVID is over.

It is not over.

Hitting and staying above 200 will be a great concern for officials, Arwady said. Lightfoot said they had the press conference so they could warn Chicagoans theyre close to the 200 mark; they hope the warning can keep people from violating social distancing rules and driving up new cases.

If the city does hit more than 200 cases per day, it will not equal an automatic rollback to Phase 3, but officials will look at problem areas, Arwady said. If theyre seeing cases come from bars, theyd consider closing bars, for example.

For you following every day how were doing in Chicago, thats the number I want you to watch, Arwady said. And I want you to help us drive that number down. Its how we move ahead in Chicago and not backwards.

What things are closed or rolled back would depend on how much cases increase and how quickly, but the city could consider a full move back into Phase 3 if Chicago was seeing an average of more than 400 new cases per day, officials said.

An uptick would mean Chicago has no choice but to go back to Phase 3, Lightfoot said. Thatd mean an end to indoor dining, the closing of businesses like theaters and prohibiting people from gathering in groups larger than 10. Thered be restrictions on mobility again, as well, Lightfoot said.

Lightfoot said people must wear masks in public and stop gathering in large groups if they want to prevent a rollback and keep businesses open.

Minimize gathering in large groups. I repeat: The larger the group the higher risk that someone in that group has COVID-19. So minimize gathering in large groups, Lightfoot said. Wear a face covering when you leave your house everywhere not just some of the time, but all of the time. Thats critically important to reduce the spread.

Young people are at less risk for serious adverse effects of COVID-19, but they can happen, Arwady said. A Chicago woman in her 20s who had no significant underlying conditions had to get a double lung transplant last month coronavirus severely damaged her lungs.

You are not immune to COVID-19, Lightfoot said to young people. The reality is actually quite different, and the data proves it. Were seeing these increases across race and ethnicity and all over the city [among young people]. And this should be the proof that you need: If you are in the 18-to-29-year-old cohort, you are catching COVID-19. You are getting sick.

The problem isnt just that youre hurting yourself. The problem isnt just that youre hurting people in your network. Youre hurting the whole city.

Officials also pointed out young people could transmit the virus to older people, who are more at risk from COVID-19. Arwady said shes concerned Chicago could see an increase in cases among elderly people.

Especially if youre in a younger age group, Im not surprised youre out more, Arwady said. Youre at a lower risk, it is true, for these serious outcomes; but, if you have in your close circle people who have underlying conditions or especially people in those older age groups, I need you to be extra careful with those vulnerable folks in your life.

Still, Arwady noted, Chicago has seen fewer deaths in recent weeks. The city is down to an average of four deaths per day from coronavirus, the lowest that number has been since March. The doctor expects there will soon be a day when Chicago sees no deaths from COVID-19.

And hospitalization data looks great, Arwady said, with the numbers of people hospitalized, in the ICU and using a ventilator all declining.

Lightfoot said she wants to avoid shutting down the economy again, but, if we must, we must.

We are dangerously close to going back to a dangerous state of conditions, she said.

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Chicago 'Dangerously Close' To Reversing Course On Coronavirus Progress And Going Back To Phase 3, Mayor Warns - Block Club Chicago

Well, I was writing just the other day about what we dont know about the T-cell response to coronavirus infection, and as of today we know quite a bit more. And from what I can see, we have encouraging news, mixed with some things that were going to need to keep an eye on.

Heres a post from May on a paper in Cell that looked at T cell responses in recovering SARS CoV-2 patients and compared them to reports of people who had been infected with original SARS back in 2003, and to people who had never encountered either. It also has some background on T cells in general, which might be useful if you dont have that info right at the top of your brains queue. Thats the paper that showed that the T-cell response to this virus is less Spike-o-centric than it was to SARS. It also showed that there are, in fact, people who have both CD4+ and CD8+ T cells that recognize protein antigens from the new coronavirus even though they have never been exposed to SARS, MERS, or the new virus. The paper speculated that this might be due to cross-reactivity with proteins from the common cold coronaviruses, and raised the possibility that there might be a part of the population that has at least some existing protection against the current pandemic.

Now comes a new paper in press atNature. It confirms that convalescent patients from the current epidemic show T-cell responses (mostly CD4+ but some CD8+ as well) to various epitopes of the N (nucleocapsid) protein, which the earlier paper had identified as one of the main antigens as well (along with the Spike and M proteins, among others, with differences between the CD4+ and CD8+ responses as well). Turning to patients who had caught SARS back in 2003 and recovered, it is already known (and worried about) that their antibody responses faded within two or three years. But this paper shows that these patients still have (17 years later!) a robust T-cell response to the original SARS coronaviruss N protein, which extends an earlier report of such responses going out to 11 years. This new work finds that these cross-react with the new SARS CoV-2 N protein as well. This makes one think, as many have been wondering, that T-cell driven immunity is perhaps the way to reconcile the apparent paradox between (1) antibody responses that seem to be dropping week by week in convalescent patients but (2) few (if any) reliable reports of actual re-infection. That would be good news indeed.

And turning to patients who have never been exposed to either SARS or the latest SARS CoV-2, this new work confirms that there are people who nonetheless have T cells that are reactive to protein antigens from the new virus. As in the earlier paper, these cells have a different pattern of reactivity compared to people who have recovered from the current pandemic (which also serves to confirm that they truly have not been infected this time around). Recognition of the nsp7 and nsp13 proteins is prominent, as well as the N protein. And when they looked at that nsp7 response, it turns out that the T cells are recognizing particular protein regions that have low homology to those found in the common cold coronaviruses but do have very high homology to various animal coronaviruses.

Very interesting indeed! That would argue that there has been past zoonotic coronavirus transmission in humans, unknown viruses that apparently did not lead to serious disease, which have provided some people with a level of T-cell based protection to the current pandemic. This could potentially help to resolve another gap in our knowledge, as mentioned in that recent post: when antibody surveys come back saying that (say) 95% of a given population does not appear to have been exposed to the current virus, does that mean that all 95% of them are vulnerable or not? Ill reiterate the point of that post here: antibody profiling (while very important) is not the whole story, and we need to know what were missing.

There are still major gaps in our knowledge: how many people have such unknown-coronavirus-induced T-cells? How protective are they? How long-lasting is the T-cell response in people who have been infected with the current SARS CoV-2 virus, and how protective is it in the declining-antibody situation that seems to be common? What sorts of T cell responses will be induced by the various vaccine candidates? We just dont know yet. But were going to find out.

Go here to read the rest:

New Data on T Cells and the Coronavirus - Science Magazine