Category: Corona Virus

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Flushing the Toilet May Fling Coronavirus Aerosols All Over – The New York Times

June 20, 2020

Heres one more behavior to be hyper-aware of in order to prevent coronavirus transmission: what you do after you use the toilet.

Scientists have found that in addition to clearing out whatever business youve left behind, flushing a toilet can generate a cloud of aerosol droplets that rises nearly three feet. Those droplets may linger in the air long enough to be inhaled by a shared toilets next user, or land on surfaces in the bathroom.

This toilet plume isnt just gross. In simulations, it can carry infectious coronavirus particles that are already present in the surrounding air or recently shed in a persons stool. The research, published Tuesday in the journal Physics of Fluids, adds to growing evidence that the coronavirus can be passed not only through respiratory droplets, but through virus-laden feces, too.

And while it remains unknown whether public or shared toilets are a common point of transmission of the virus, the research highlights the need during a pandemic to rethink some of the common spaces people share.

The aerosols generated by toilets are something that weve kind of known about for a while, but many people have taken for granted, said Joshua L. Santarpia, a professor of pathology and microbiology at the University of Nebraska Medical Center who was not involved in the research. This study adds a lot of the evidence that everyone needs in order to take better action.

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Typically, the coronavirus is most at home in cells in the lungs and upper respiratory tract. But studies have found it can also dock to cell receptors in the small intestine. Patients have been reported to experience diarrhea, nausea and vomiting among other symptoms.

And researchers have found viable virus particles in patients feces, as well as traces of viral RNA on toilet bowls and sinks in their hospital isolation rooms, although experiments in the lab have suggested that material may be less likely to be infectious compared with virus that is coughed out.

A computer simulation of the toilet flushing mechanism showed that when water pours into the toilet and generates a vortex, it displaces air in the bowl. These vortices move upward and the centrifugal force pushes out about 6,000 tiny droplets and even tinier aerosol particles.

Depending on the number of inlets in the toilet, flushing can force anywhere from 40 to 60 percent of the produced aerosols high above the seat.

Its very alarming, said Ji-Xiang Wang, who studies fluid dynamics at Yangzhou University and was a co-author of the study.

Its virtually impossible to keep bathrooms sanitized all the time, and sharing a toilet may be unavoidable for family members, even when one person is sick and isolating in a separate room at home, Dr. Wang said.

As cities around the world navigate the reopening of restaurants, offices and other businesses, more and more people will also need to use public or shared restrooms. But while diners can be moved outdoors and employees spaced out, people may find it harder to practice social distancing in small bathrooms.

Aerosolized particles may still linger in single-use toilets, and bathrooms are frequently poorly ventilated spaces, which can increase the risk of exposure to infection. Users also have to consider risks from high-touch surfaces, like doorknobs and faucets.

Experience with other coronaviruses shows how quickly the fecal-oral route can lead to spread of disease. In March 2003, more than 300 people living in the Amoy Gardens apartment complex in Hong Kong got infected with the original SARS coronavirus because infectious fecal aerosols spread through faulty plumbing and ventilation systems.

While Dr. Wang acknowledged that scientists had yet to look at toilet aerosols in real-world situations involving the new coronavirus, other research has shown that viral RNA was found in shared toilet areas at one hospital in Wuhan, China.

But researchers do not know how much infectious virus is in aerosols or whether people with more severe cases of Covid-19 shed more virus than patients with milder illness, he said.

Thankfully, people can also easily prevent the spread of infections from the toilet plume.

Close the lid first and then trigger the flushing process, Dr. Wang said, which he acknowledged isnt always possible in public bathrooms.

Updated June 16, 2020

The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who dont typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the countrys largest employers, and gives small employers significant leeway to deny leave.

So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was very rare, but she later walked back that statement.

Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus whether its surface transmission or close human contact is still social distancing, washing your hands, not touching your face and wearing masks.

A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nations job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.

States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you arent being told to stay at home, its still a good idea to limit trips outside and your interaction with other people.

Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people dont need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks dont replace hand washing and social distancing.

If youve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

You should also wash your hands frequently and thoroughly, especially if youre using a shared restroom where the toilet doesnt have a lid or the flush is automatically triggered on standing up. Avoid touching your face, and keep your mask on in the bathroom, which could prevent some exposure to the coronavirus.

Dr. Wang hopes the new research will help lead to improvements in bathroom design, including increased attention to contactless dispensers for soap and paper towels, and toilets that flush only after they have been covered with a lid.

Other experts are already considering indoor ultraviolet lights and automated disinfectant sprays that will zap the coronavirus and relieve some of the pressure on keeping public toilets clean.

And Dr. Santarpia said that Dr. Wangs study could point to a way of monitoring coronavirus clusters.

You could simply monitor samples from a shared bathroom on a daily basis, he said. And if something were to come up positive, you could then go look at everyone who was there and who they had contact with, rather than testing everybody all the time.

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Flushing the Toilet May Fling Coronavirus Aerosols All Over - The New York Times

Watney first on PGA Tour to test positive for coronavirus, withdraws from RBC Heritage – Press Herald

June 20, 2020

HILTON HEAD ISLAND, S.C. Five-time PGA Tour winner Nick Watney tested positive Friday for the coronavirus, the first player with a confirmed infection since golf resumed its schedule last week.

Watney immediately withdrew from the RBC Heritage and must self-isolate for at least 10 days under the PGA Tours protocols.

He did not return a telephone call seeking comment. Vaughn Taylor and Luke List, who played with Watney in the first round on Thursday, were notified by a rules official midway through Fridays round.

I was a little shocked, to be honest, Taylor said. Heart started racing, got a little nervous. Just hope Nick is doing well and we get through this.

Watney missed the cut last week in the Charles Schwab Challenge at Colonial in Fort Worth, Texas. He traveled on his own to South Carolina, and his coronavirus test upon arrival at Harbour Town was negative.

Before arriving to the course for his second round, he reported symptoms consistent with COVID-19, the illness caused by the virus. Watney was tested again, and the result came back positive.

Si Woo Kim saw him in passing on the range, and Rory McIlroy said he chatted with Watney on the putting green. McIlroy said they were at a distance, and that Watney sent him a text about the positive result after McIlroy finished his round.

He was just saying, Look, I hope I didnt get too close to you. He feels badly that he was here today at the golf course, McIlroy said. I said to him, If I was in your position, I probably would have been here, too. At this point, you just have to concentrate on getting better and getting healthy.'

List won last week on the Korn Ferry Tour, where one player and three caddies tested positive before the event and did not go to the course, and two non-players tested positive before this weeks event, both in Florida.

List missed the cut at Hilton Head, shooting a 73 on Friday.

It was hard to concentrate out there for me, just thinking about different stuff, and I wasnt playing my best, anyway, List said. It would be nice if they had an option you can kind of say if you want to know or not in a situation like that. I would definitely like to find out after the round next time.

As for another test, List said even if tested, it might not show up until a few days down the road. So theres a lot of different scenarios.

Webb Simpson leads the tournament at 12 under, making a 6-footer on his final hole for his second straight 6-under 65. He was one stroke better than Bryson DeChambeau (64) and Corey Conners (63). Thunderstorms rolled through the island late in the afternoon and halted play with a handful of players still on the course.

The tour had no positive tests of the 487 administered at Colonial, and none among the 98 players tested before taking the charter to Hilton Head or the 369 tests for those arriving on their own.

Players, caddies and essential personnel have mandatory tests.

Jordan Spieth, one of four players on the PGA Tours policy board, didnt sound surprised at golfs first positive test.

The whole plan put in place was not if, but when somebody tests positive, whats the protocol, and what are the next steps, Spieth said. So I feel confident, just in being on those phone calls, in what the PGA Tour is going to do going forward. Hopefully, contact tracing doesnt lead to anybody else testing positive within the bubble.

The tour said in a statement it has started its response plan, which includes those who have had close contact with Watney. It said it would have no further statement.

Taylor, who at 6 under after 36 holes was inside the cut line, said he had no close contact with Watney on Thursday, and he washed his hands immediately after the round.

Nick never coughed or sneezed, so I feel comfortable, he said.

As part of the contact tracing plan, Taylor, List and their caddies were to be tested immediately.

If you contract it, thats fine, but then its the fact that who have you come into contact with, and who you might have exposed and stuff, McIlroy said. Look, were still in the middle of a pandemic. Until this things over, we all just have to stay vigilant and keep your distance and wear our masks if were going out in public and keep washing our hands.

The PGA Tour is scheduled to play next week in Cromwell, Connecticut, where the Travelers Championship is testing everyone including volunteers and media who will be on property.

Tournament organizers made that decision. The PGA Tour has tried to create a bubble of its key people at tournaments, designating player hotels as an option and urging everyone in the bubble to avoid outside contact. Some players have been renting houses. There is no regulation if they choose to eat out.

Hilton Head has been particularly busy this week, with local restaurants packed with people who typically come to this quiet island on the Atlantic coast for vacation.

South Carolinas open. If you go anywhere to a restaurant, theres a lot of people there right now, Spieth said. So I guess thats probably best case is that he got it on his own outside the bubble.

Sebastin Muoz said theres just too many people hanging around the island.

Its a pandemic, you know? A lot of people get it, and eventually one of us was going to get it, Muoz said. I feel good that we caught early with one guy so far. So hopefully, it doesnt rise up pretty quick.

Under the tours guidelines for a positive test, Watney can end his self-isolation after 10 days provided he has no subsequent symptoms or has two negative test results 24 hours apart or more.

The tour will provide a stipend to pay for the costs of his self-isolation.

Watneys most recent victory was in 2012 at Bethpage Black in the FedEx Cup playoff opener. He has struggled to regain his top form since missing 10 months in 2016 because of back surgery.

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Watney first on PGA Tour to test positive for coronavirus, withdraws from RBC Heritage - Press Herald

Contact Tracing to Tackle Coronavirus in England Off to a Slow Start – The New York Times

June 20, 2020

LONDON Prime Minister Boris Johnson of Britain unveiled last month a world beating operation to track down people who had been exposed to the coronavirus, giving the country a chance to climb out of lockdown without losing sight of where infections were spreading.

As with much of the governments response to the pandemic, however, the results have fallen short of the promises, jeopardizing the reopening of Britains hobbled economy and risking a second wave of death in one of the countries most debilitated by the virus.

In almost three weeks since the start of the system in England, called N.H.S. Test and Trace, some contact tracers have failed to reach a single person, filling their days instead with internet exercise classes and bookshelf organizing.

Some call handlers, scattered in offices and homes far from the people they speak with, have mistakenly tried to send patients in England to testing sites across the sea in Northern Ireland.

And a government minister threatened on a conference call to stop coordinating with local leaders on the virus-tracking system if they spoke publicly about its failings, according to three officials briefed on the call, who spoke on the condition of anonymity for fear of retribution.

Contact tracing was supposed to be the bridge between lockdown and a vaccine, enabling the government to pinpoint clusters of infections as they emerged and to stop infected people from passing on the virus. Without it, a World Health Organization official said recently, England would be remiss in reopening its economy.

But the system, staffed by thousands of poorly trained and low-paid contact tracers, was rushed out of the gate on May 28 before it was ready, according to interviews with more than a dozen contact tracers, public health officials and local government leaders. At the time, the government was making a barrage of announcements while also trying to douse a scandal involving Mr. Johnsons most senior aide, who had violated lockdown orders.

The troubled rollout has left public health officials across England trying to battle a virus they still cannot locate. Test results from privately run sites, now numbering in the tens of thousands daily, were not being reported at a local level as recently as last week, leaders in six councils said. Public health officials say they catch wind of outbreaks from the news. And while the virus is cooling off in London, infection rates remain high in other parts of England, notably the northwest.

Other nations in Europe are building their public sectors to support contact-tracing systems that might be needed for years to come. Germany, for instance, has hired contact tracers in 375 public health authorities, with doctors on hand to administer tests.

But in England, where a decade of austerity has starved public health departments of workers who used to regularly track illnesses, Mr. Johnson has entrusted the job largely to Serco, an outsourcing giant that was recently obliged to pay the government a hefty fine for fraud on a previous, unrelated contract. The New York Times has learned that the contact-tracing contract, awarded in a secretive procurement process, cost 108 million pounds, or about $136 million.

Allyson Pollock, a professor of public health at Newcastle University, said, The government has dismantled, fragmented and eviscerated so much of its health service over the last 20 years that it was much more difficult to get a coordinated system.

Theyre basically trying to build a centralized, parallel, privatized system, she added.

As a result, she said, Weve had far more deaths than we should have. And lockdown has had to go on much longer than in other countries because weve let the virus rip for so long.

Asked for comment, a spokesman for the Department of Health and Social Care said that its contact-tracing system was already helping to save lives by curbing the spread of the illness.

In the first week, tens of thousands of people have engaged with the N.H.S. Test and Trace service, the spokesman said. We are working to reach more people and making improvements to the service to do that.

Garry Robinson, Sercos customer services director for Britain, said in a statement that the company was committed to supporting the governments test and trace program and had successfully mobilized 10,500 contact tracers in four weeks, which he called a significant achievement.

The first part of contact tracing involves health professionals calling people who test positive for the virus and obtaining a list of their recent contacts. Then, a lower-level tier of workers call those contacts to ask them to isolate themselves.

But in the first week of virus tracking in England, government figures show, thousands of infected patients were overlooked: Callers reached 5,407 people with the virus, while missing another 2,710 positive cases that had been transferred into the system along with an unspecified number that had not.

At the same time, contact tracers have waited to be assigned cases that never came, a problem that officials have ascribed to low numbers of new cases and infected people submitting their contacts online instead. One employee, who like others spoke on the condition of anonymity for fear of being fired, said that most days he watched three films, one after the next, at a salary of about $11 per hour.

Local public health officials were asked to make plans by the end of June for possible tailor-made shutdowns around clusters of infections. But they say they still have neither the powers to do that nor the testing data to pinpoint infections.

We are kind of driving the car while building it, said Dominic Harrison, the director of public health in Blackburn, in northwest England. There are still enormous problems to be resolved.

The troubled rollout bears the hallmarks of Britains disastrous efforts to respond to the coronavirus: haphazard data, an emphasis on political theater and a heavy dependence on the private sector. With deaths nearing 50,000, Britain sits alongside the United States and Brazil among the countries suffering the greatest blows from the coronavirus.

After working to trace contacts in the early days of the pandemic, Britain largely scrapped that plan by March 12, with government scientists saying it was no longer practical. Eleven days later, Mr. Johnson declared a lockdown.

The government has denied that contact tracing was ever stopped, and said that to claim otherwise would be entirely wrong. However, in internal notes mistakenly forwarded to The New York Times in response to questions about why it initially ended contact tracing in March, government officials wrote: The answer to this is we basically didnt have the testing capacity.

By April, with the death toll soaring, the government reversed course and promised to reconstitute the system for England.

Other nations within the United Kingdom, including Wales and Scotland, which are in charge of their own contact tracing, appointed public health officials to run their programs.

For England, however, Mr. Johnsons government contracted Serco and another company to hire most of its 25,000 contact tracers, despite Serco having recently been fined 19 million over claims involving a separate contract that it had charged the government for monitoring convicts who were dead, jailed or living outside the country.

The government said that Serco was regularly monitored and that no concerns had been raised about the company before it was awarded the test and trace contract.

The government has spent heavily on private companies in its response to the pandemic: Deloitte, an accounting firm, manages testing centers; and Palantir, a data-mining company, has helped organize supplies of protective gear.

But it is trying to do contact tracing on the cheap. While some American states are paying tracers salaries of around $50,000 a year, many English tracers said in interviews that they were paid 8.72 an hour, barely above the minimum wage, a figure equivalent to less than $24,000 a year. Some of them were teenagers who had never held jobs before.

After answering online ads for generic customer service jobs, they started work with little or no training. One Serco-employed contact tracer said that at least a third of his 40 or so colleagues in London had not received any online training before starting.

Updated June 16, 2020

The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who dont typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the countrys largest employers, and gives small employers significant leeway to deny leave.

So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was very rare, but she later walked back that statement.

Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus whether its surface transmission or close human contact is still social distancing, washing your hands, not touching your face and wearing masks.

A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nations job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.

States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you arent being told to stay at home, its still a good idea to limit trips outside and your interaction with other people.

Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people dont need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks dont replace hand washing and social distancing.

If youve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

We werent talked through how a conversation could go or anything, said a tracer working in Sheffield, England.

Details of the procurement process, shared by a senior civil servant, suggest a possible reason for the low pay and sketchy training: Serco offered to provide the service at an extraordinarily tight profit margin of less than 5 percent, roughly half the margin of the next cheapest contender.

The contract was awarded without any real competition, the senior civil servant said, speaking on the condition of anonymity to describe a confidential process.

Serco are pretty much the only people who can stand up a work force in that time, and love them or hate them, it is about having the numbers, the civil servant said.

The virus-tracking system was supposed to be augmented by a smartphone app that automated some tracing. But the tool, promised initially by mid-May, has been shadowed by fears about technical glitches and data breaches, and the government said it was now trying to introduce the app before winter.

Even some of the more experienced, higher-paid contract tracers who speak to infected people said they were feeling underutilized. Gerry, a former nurse, said she had expected to begin work as a contact tracer in early June. Instead, at 10:30 p.m. on May 27, she received an email telling her the program would begin the next day. The computer system crashed as thousands of contact tracers tried to log on.

More than two weeks later, she still has not spoken to a single contact. Other contact tracers complained on a private Facebook group that they were still waiting for login details two weeks after the start date, according to screenshots from the group.

Some contact tracers also said they were unaware of any translation services, a problem that could keep England from tracking the virus through migrant and ethnic minority communities, which have suffered disproportionately.

Its a total shambles, said Ben Bradshaw, an opposition Labour lawmaker, who has spoken to government officials about contact tracing.

Everyone has accepted all the way through this crisis that the countries that have dealt with it best have always had effective track and trace systems in place, and that any country wishing to emerge from lockdown and live with this virus for the foreseeable future will need an effective track and trace system, he said. Yet, the history of this in Britain is a catalog of disasters.

Originally posted here:

Contact Tracing to Tackle Coronavirus in England Off to a Slow Start - The New York Times

Church tied to Oregon’s largest coronavirus outbreak – ABC News

June 17, 2020

By

SARA CLINE Associated Press/Report for America

June 17, 2020, 2:28 AM

3 min read

3 min read

SALEM, Ore. -- A church in rural northeastern Oregon is now the epicenter of the state's largest coronavirus outbreak, as 236 people tested positive for the disease, authorities said Tuesday.

The outbreak also led to Oregon's second consecutive record-setting daily case count.

I think generally we are seeing increasing numbers, which is what we expected with reopening, said Thomas Jeanne, the deputy state health officer and deputy state epidemiologist.

In response to the increasing case counts Gov. Kate Brown last week said she was putting all county applications for further reopening from her COVID-19 restrictions on hold for seven days.

The Oregon Health Authority reported 278 new statewide cases Tuesday a 51% increase from Mondays case count. Officials cited the rise in cases due largely to increased testing, contact tracing, workplace outbreaks as well as potential spread in the community.

The largest outbreak, which was first made public Monday, is associated with Lighthouse Pentecostal Church in Union County.

The Observer newspaper of La Grande reported that the church held services in April and May even though Oregon COVID-19 restrictions limited gatherings. Also, The Observer reported the facility recently held a wedding and a graduation ceremony, each with more than 100 people.

Attempts by The Associated Press to reach representatives of the church were not successful Tuesday.

The health authority and county officials teamed up with the church over the weekend to hold a clinic where 356 people were tested for the virus 66% tested positive for coronavirus, officials reported.

Currently, five people associated with the outbreak are hospitalized, Jeanne said. The county does not have any confirmed fatalities from coronavirus.

Prior to the outbreak, the county had less than 25 cases during the pandemic.

We have tested the majority of the congregation at the church in Union County, Jeanne said. At this point we hope there will not be a lot more (cases), but that is what contact tracing, quarantine and follow up will be important for.

Over the last 14 days, 35% of cases have not been linked to a specific transmission, Jeanne said.

We are concerned about these trends, particularly the sporadic cases that can't be traced to a specific outbreak or cluster, because they indicate how much community spread is occurring the type of spread that we are less able to control through testing, case investigation, contact tracing, isolation and quarantine, Jeanne said.

Tuesdays case count brings the new total number of people who have tested positive for coronavirus in Oregon to 6,098. In addition, two more people have died from the disease, raising the states death toll to 182.

For most, the coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia and death.

Continued here:

Church tied to Oregon's largest coronavirus outbreak - ABC News

June 17 morning update: The latest on the coronavirus and Maine – Bangor Daily News

June 17, 2020

Robert F. Bukaty | AP

Robert F. Bukaty | AP

Kevin Norsworthy, State Theater's "marquee master," puts a new message outside the venue Tuesday in Portland.

Today is Wednesday. There have now been 2,819 confirmed and likely cases of the new coronavirus in all of Maines counties since the outbreak began here in March, according to the Maine Center for Disease Control and Prevention.

Tuesday saw the fewest new daily cases nine since April 27, when eight infections were confirmed. No new deaths were reported on Tuesday. In the past week, only one death has been confirmed.

So far, 321 Mainers have been hospitalized at some point with COVID-19, the illness caused by the coronavirus, while 2,233 people have fully recovered from the virus, meaning there are 485 active and likely cases in the state, according to the Maine CDC. Thats down from 520 on Monday.

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

Heres a roundup of the latest news about the coronavirus and its impact in Maine.

The Maine CDC will provide an update on the coronavirus at 2 p.m. The BDN will livestream the briefing.

Twelve of Maines 16 counties are now reporting fewer than 10 active cases of the virus, including three Piscataquis, Aroostook and Washington counties with zero. The prevalence of COVID-19, the disease caused by the virus, also seems to finally be dropping in more heavily populated southern Maine counties even as the state has ramped up testing in recent weeks. Charles Eichacker, BDN

Wednesday marks a major milestone in Maines gradual economic reopening as restrictions lift on restaurants and other businesses in the three counties where the majority of Maines coronavirus cases have been concentrated. Here is a guide to Wednesdays reopenings. Michael Shepherd, BDN

As businesses reopen across the U.S. after coronavirus shutdowns, many are requiring customers and workers to sign forms saying they wont sue if they catch COVID-19, the illness caused by the new virus. Critics argue that liability waivers open the door for corporations to skirt protocols like erecting Plexiglas barriers, providing face masks and other protective equipment and keeping people the proper distance apart without suffering any repercussions. Tom Krisher and Mark Sherman, The Associated Press

Workers who rely on direct deposit for their unemployment benefits did not see usual payments on Tuesday morning due to what the Maine Department of Labor described as an unprecedented volume of claims. The department said Tuesday morning that benefits might be delayed by 24 hours. Benefits were delayed for a similar reason the first week of April. Jessica Piper, BDN

While Ntension is far from the only company that has pivoted to mask-making during the pandemic Maine-based L.L. Bean and New Balance also started using their manufacturing facilities to make masks it stands out as a company that now sees the manufacturing of PPE as a permanent part of its business model. Emily Burnham, BDN

At a time when the remaining restaurants across the state prepare to reopen indoor dining Wednesday under health and spacing guidelines, one Maine chain has fared comparatively well during pandemic restrictions. Portland Pie Co., which has five company-owned restaurants and two franchises, plans to open another location in Windham next week and start construction on one in Lewiston in the fall, its owner said. It also is scouting an Augusta location. Lori Valigra, BDN

Bangor will reopen its playgrounds, parks and basketball courts starting Wednesday due to Penobscot Countys low number of active cases of COVID-19. Nick Sambides Jr., BDN

Researchers in England say they have the first evidence that a drug can improve COVID-19 survival: A cheap, widely available steroid called dexamethasone reduced deaths by up to a third in severely ill hospitalized patients. Marilynn Marchione, The Associated Press

As early Wednesday morning, the coronavirus has sickened 2,137,731 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 116,963 deaths, according to Johns Hopkins University of Medicine.

Elsewhere in New England, there have been 7,664 coronavirus deaths in Massachusetts, 4,210 in Connecticut, 865 in Rhode Island, 326 in Connecticut and 55 in Vermont.

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June 17 morning update: The latest on the coronavirus and Maine - Bangor Daily News

Texas coronavirus surge linked to more Texans in their 20s getting sick – The Texas Tribune

June 17, 2020

Texans under the age of 30 are testing positive for the new coronavirus at a higher rate than previously seen since the pandemic began, contributing to a recent surge in the number of cases in the state, Gov. Greg Abbott said during a press conference Tuesday.

Data from several counties and health experts confirms the trend in younger people testing positive across Texas.

"There are certain counties where a majority of the people who are tested positive in that county are under the age of 30, and this typically results from people going to bars," Abbott said during the conference. "That is the case in Lubbock County, Bexar County, Cameron County."

Abbott said that its unclear why more young people are contracting the virus, but he speculated that it could be from increased activity over Memorial Day weekend, visits to bars or other types of social gatherings.

This comes as Texas businesses have begun to reopen with relaxed restrictions under Abbotts executive orders. As of last Friday, restaurants can operate at 75% capacity, while almost all other businesses can operate at 50%. Texas water parks and amusement parks have been allowed to reopen as well. In recent weeks, thousands of Texans have also flooded the streets of some of the largest cities to protest police brutality in the wake of George Floyds death.

One of the areas of concern Abbott mentioned was Hays County, where 476 of the 938 confirmed cases are people ages 20 to 29. People in their 20s accounted for 50.7% of all the cases in Hays County as of Monday, an increase from Friday, when the age group made up 42% of total cases.

Last week, epidemiologist Eric Schneider warned that those numbers are "staggering" for Hays County.

San Antonio Mayor Ron Nirenberg also expressed concern Monday about more young people getting sick.

Whats most concerning is that weve seen the largest increase in infection among 20-year-olds, Nirenberg said in a televised interview with ABC, adding that city officials are seeing younger patients in the hospitals as well. While they may survive an illness, younger people are going to be stuck with a pretty hefty medical bill at the end of it.

In Travis County and the city of Austin, the median age of all positive cases has ticked downward to 38 years old this week, from 39 years old last week. Twenty- to 29-year-olds make up 24% of all cases in the area and 8.3% of the hospitalizations.

As for Dallas County, the trend is reflected in hospitalizations rather than new cases. Almost a month ago, on May 19, 18% of all people hospitalized were between the ages of 18 and 40, the age range used by local officials to designate young adults. On Tuesday, that age group made up 21% of hospitalizations.

Dr. David Persse, public health authority for the Houston Health Department, said the same trend is materializing in Harris County. Overall, 17.5% of all people impacted in that area are people in their 20s.

"It is my current theory that elder persons have become more vigilant in taking precautions," Persse said.

Angela Clendenin, an epidemiologist and biostatistician at Texas A&M University, said young people may be acting less cautious than older Texans because they're careless or more confident in their ability to fight off the virus, she said.

"It boils down to behaviors," she said. "Younger people, because they're asymptomatic or mildly symptomatic, going about business as usual, still wanting to hang out with each other. ... They feel perfectly comfortable that they're fine and they will be fine."

Some have suggested the surge in cases could be due to increased testing access.

But for Galveston County, the increase in cases affecting young people is not a result of more testing, said Dr. Philip Keiser, the local health authority.

Fewer people are getting tested, but more people are becoming positive. Of those becoming positive, they are overrepresented by young people, he said.

Keiser estimated that last week, about half of the new cases in that county were in their 20s, which he says could be due to COVID fatigue and more people are going out than before.

During the press conference, Abbott blamed lax adherence to social distancing at bars for part of the problem. He reiterated the Texas Alcoholic Beverage Commissions recent warning to bars and restaurants that serve alcohol that if they do not follow COVID-19 guidelines, their licenses could be suspended for 30 or 60 days.

There have been pictures that I have seen and others have seen about these bar-type settings where clearly the standards are not being followed, Abbott said. Enforcements from the TABC should bring these types of settings more and align to being safer standards.

Abbotts comments come as the number of people hospitalized for the virus in Texas reached record highs eight of the last nine days.

There were more than 2,500 confirmed COVID-19 patients in Texas hospitals Tuesday, nearly 200 more than the day before, according to state data. That number a gauge for the severity of the disease and the amount of available hospital beds has risen almost every day since the beginning of June. There are still about 15,000 hospital beds open in the state, as well as 1,700 ICU beds.

Even though there are more people hospitalized, we still remain at the lowest threat level to our hospital capacity, Abbott said Tuesday. The number of new reported cases has also increased. Abbott attributed recent and sometimes dramatic upswings to targeted testing that has been done in hard-hit facilities like meatpacking plants and nursing homes.

Another metric to evaluate the situation is the length of stay in hospitals. Dr. Mark Escott, the interim health authority for Austin and Travis County, said that about half of the people hospitalized go out in four days or less.

But we still have some which are prolonged for 30, 60 days, sometimes longer, he warned.

Disclosure: Texas A&M University has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.

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Texas coronavirus surge linked to more Texans in their 20s getting sick - The Texas Tribune

Coronavirus news and updates: Florida, Arizona, Texas see record daily COVID-19 cases; Russia builds disinfection tunnels for Putin – USA TODAY

June 17, 2020

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Coronavirus news and updates: Florida, Arizona, Texas see record daily COVID-19 cases; Russia builds disinfection tunnels for Putin - USA TODAY

President of Honduras says he and his wife have coronavirus – CNN

June 17, 2020

"Over the weekend I started to feel bad, and today they have diagnosed me with being infected with Covid-19," Hernndez said in a televised presidential address on Tuesday night.

The President added that he had mild symptoms and was receiving treatment. He said he would continue to carry out his presidential duties while in isolation and under observation.

He is the first president in Latin America to have tested positive for the virus.

Hernndez's wife, first lady Ana Garca de Hernndez, and two presidential aides have also tested positive for the disease.

Hernndez said his wife was asymptomatic at present. The first lady is self-isolating following her diagnosis.

"The President at all times maintained the preventive measures recommended by the health authorities, yet due to the nature of his work it wasn't possible to to stay in total isolation," according to a statement released by the presidential office Tuesday.

The statement urged Hondurans to continue following recommended coronavirus guidelines, including measures such as wearing masks and washing hands frequently.

The Honduran President is a controversial figure in the country.

The President's brother was accused during trial of using drug money "to impact Honduran presidential elections in 2009, 2013, and 2017."

President Hernndez has denied all allegations of wrongdoing.

Alejandro Giammattei, President of neighboring Guatemala, said on Twitter that he was praying for Hernndez and his wife.

"I raise my prayers for their fast recovery and express to you my consideration, respect and esteem," Giammattei wrote.

Natalie Galln reported from Mexico City. Zamira Rahim wrote in London.

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President of Honduras says he and his wife have coronavirus - CNN

Doctors Know the Second Coronavirus Wave Is Coming – The New York Times

June 17, 2020

A few of these messages of support remain on the wall of the empty unit a card with a childs sweet drawing of a heart, a family photograph, a colorful thank-you poster from a local Girl Scout troop. On my way out of the empty unit, I snap a photo of the posters on the wall.

Still, even as I say so long to nurses returning to their own units, I am sadly aware that this is not an ending. The numbers of the sick and dying in my city decreased because we were practicing social distancing. And now, cases in areas of the country that reopened more rapidly are rising, with patients in respiratory failure filling intensive care unit beds in Arizona and Texas.

I see photos of the doctors and nurses there gearing up in their P.P.E., and I feel only exhaustion and dread, knowing what comes next isolated deaths, terrible FaceTime goodbyes. I had believed that the hard-won knowledge of those of us in hard-hit places like New York City and Boston would begin to spread as efficiently as the virus, but now I am not so hopeful.

Just a few nights ago, at home in my own bed, I was awakened by a page alerting me to a patient in the E.R. She was Covid-19-positive, a recent diagnosis.

It continues.

So we keep the closed unit empty and waiting. Though the hospital is filling once again with heart attack and cancer patients and those who are awaiting transplants, we dont move any of them into these Covid-19 beds. Not yet. We maintain a backup schedule of critical care doctors who will return to work in the event of another surge.

These empty beds remind us that the virus is still here, and if we do not stay far from one another and wear our masks and wash our hands, if we do not continue to sacrifice our desires and do these uncomfortable things, the beds will inevitably fill again. And if they do, we will be more prepared. My state has ramped up testing and a robust system of contact tracing. Here in the hospital, we are more familiar with the nuances of this disease and its management.

But everyone is tired. The adrenaline of those early days has turned to profound fatigue.

And, of course, there are still people to care for, many of whom have been intubated for weeks. On my recent night shift, Im relieved to learn that one of our patients, a young and previously healthy gardener who was intubated and comatose the last time I saw him, is finally waking up after nearly 60 days.

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Doctors Know the Second Coronavirus Wave Is Coming - The New York Times

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