Category: Covid-19

California now has one of the lowest coronavirus infection rates in the country, with 1.9% of people testing positive for the disease in the last week as the nations most populous state has so far avoided the uptick feared heading into the end-of-year holidays.

Coronavirus hospitalizations in the state have fallen about 14% in the last month a trendstate data modelsforecast will continue for the next month but Gov. Gavin Newsom on Monday continued to sound the alarm about the potential for another winter spike that could overwhelm hospitals in some areas.

Visiting a coronavirus vaccination clinic in San Francisco, Newsom urged people to wear masks and get COVID shots ahead of the long Thanksgiving holiday weekend. He pointed to at least 27 states that have seen at least a 10% increase in cases in the past week.

Ask the governor of Michigan (or) Colorado how they are doing, Newsom said. States are struggling because people are taking down their guard or claiming mission accomplished. I dont want to see that happen here in California.

Newsom has struck a more cautious tone compared to the spring when he lifted nearly all of Californias pandemic restrictions and told people who were vaccinated they could stop wearing masks and socially distancing in some places. But a summer surge prompted some of the states largest local governments to bring back mask mandates and other restrictions, creating a dizzying patchwork of policies across the state.

Last winter brought the deadliest surge of the pandemic to California and while a repeat isnt expected because so many people are vaccinated the state still could see a lesser surge as people gather indoors for the holidays. That possibility prompted Santa Cruz County to reinstate its mask requirement on Sunday, just a few days after neighboring Monterey County lifted its mandate,

Unfortunately, a potential winter surge appears to be a significant threat to the health and safety of our community, said Santa Cruz County Health Officer Dr. Gail Newel said in a statement.

Santa Cruz County, located along the coast south of San Francisco, has a per capita infection rate only slightly above the state average. Of Californias 58 counties, the ones with the highest rates are nearly all rural and have lower vaccination rates.

Fresno County, an agricultural powerhouse of nearly 1 million people located in the Central Valley, is the most populated county among those in the top 10 for infections per 100,000 people. Los Angeles County, with its more than 10 million residents making up about a quarter of the states population, has an infection rate that falls in the bottom third.

Los Angeles became the nations epicenter for the outbreak last winter when California saw its worst surge. Things got so bad that the National Guard had to bring in refrigerated trucks to store bodies at overwhelmed hospitals.

But all of that happened before a coronavirus vaccine was available. Now, more than 75% of people 5 and older in California have gotten at least one dose. For adults 18 and older, more than 91% have received at least one dose. Nearly 5 million people have gotten a booster shot.

Newsom continued to urge parents to get their children vaccinated. While speaking to reporters at the vaccine clinic he was interrupted by a child crying after receiving a shot. He joked that scene wouldnt lead a public service announcement but it is a very human moment. He then turned to applaud the child.

California plans to require all students in public and private schools to receive the coronavirus vaccine as a requirement for attending in-person classes. But that mandate wont take effect until the federal government gives final approval to the vaccine for children 5 and older.

In the meantime, California requires all public school staff and students to wear masks while indoors. Newsom said state officials might lift that rule once more children are vaccinated.

The virus will dictate those terms, he said.

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Californias COVID-19 case rate is among nations lowest, but threat remains into holidays - KTLA

When guests arrive at Jeanne Sauvages home in Seattle for Thanksgiving dinner this year, they will have to take a rapid Covid-19 test on her front porch before entering.

My husband and I have asthma and I have an autoimmune disorder, and so we just figured, why take the risk? says Ms. Sauvage, who got her booster shot in early November and is concerned about breakthrough infections.

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A New Part of Thanksgiving Dinner: Bring Your Negative Covid-19 Test - The Wall Street Journal

CASPER, Wyo. TheWyoming Department of Health (WDH) reported355 new confirmed COVID-19 cases in the state during its 3 p.m. Monday, November 22 update.Updates are not provided over the weekend.

There have now been 87,144 confirmed cases in Wyoming since the pandemic began. 131 new probable cases were also added Monday, bringing the total to 22,658.

Wyoming has been adding an average of 159.1 new confirmed cases per day over the last 14 days. There are 1,290 active confirmed cases in the state, 208 fewer than on Friday.

30 new lab confirmed cases were reported in Natrona County on Monday, bringing the pandemic total to 10,052. Probable cases rose by 14 to a total of 6,013.

Hospitalization data from the WDH has not been updated since Friday, when there were 147 COVID-19 hospitalizations in the state. Peak hospitalizations in Wyoming reached 249 on October 21.

No additional COVID-19-related deaths were reported Monday. There have been 1,347 COVID-19-related deaths among Wyoming residents since the pandemic began. These are deaths that have COVID-19 listed as either the underlying or primary cause of death or as a contributing cause of death, theWDH explains.

The number of COVID-19 casesidentified as variant casesstands at 6,777. Variant cases involve a mutated form of the virus and some may spread more easily or result in more serious illness.

The WDHsaysits variant dashboard may underestimate the number of variant cases in Wyoming: Not all positive tests are sequenced to identify which variation of COVID-19 caused illness.

There had been 84,803 recoveries from lab confirmed cases as of Monday as well as 21,857 recoveries from probable cases.

A lab confirmed or probable case is defined as recovered when there is resolution of fever without the use of fever-reducing medications and there is improvement in respiratory symptoms (e.g. cough, shortness of breath) for 24 hours AND at least 10 days have passed since symptoms first appeared, the WDH says. Cases with laboratory-confirmed COVID-19 who have not had any symptoms are considered recovered when at least 10 days have passed since the date of their first positive test and have had no subsequent illness provided they remain asymptomatic.

WDH Public Information Officer Kim Deti explained that the department marks people as recovered once their isolation order date has expired. People who test positive are asked to remain in isolation until 10 days after their first symptoms, 10 days after their test was taken, or longer if they are still showing symptoms.

If people need to be isolated longer than their initial isolation period, they can contact the WDH, who can extend their isolation order. Deti said that in some cases, contact tracing informs whether a case is considered recovered while in others, the department counts someone as recovered after their isolation period ends.

County-specific COVID-19 information is available from the Wyoming Department of Health.Confirmed cases by county are as follows (probable cases in parentheses):

The Wyoming Department of Health provides COVID-19 case, variant, death, testing, hospital and vaccine data online. The department also shares information about how the data can be interpreted. COVID-19 safety recommendations are available from the CDC.

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Wyomings active confirmed COVID-19 case count drops by 208 to 1,290 on Monday - Oil City News

In a new study from Greece, people with systemic rheumatic diseases, such as lupus, who received the COVID-19 vaccine experience better outcomes than unvaccinated people with similar disease.

Researchers examined a group of 195 people who contracted the virus, comprised of 147 who were unvaccinated and 48 who received at least one vaccine dose.

Differences in terms of COVID-19 outcomes were evident. Those who were unvaccinated (27.9%) required oxygen supplementation compared to one dose (14.6%) and fully vaccinated (10.3%) people. No vaccinated people required invasive ventilation versus 2.7% of unvaccinated individuals. Additionally, 29.3% of unvaccinated people required hospitalization, while only 21% of partially and 10.3% of fully vaccinated people needed hospital-based care. Six unvaccinated people died and there were no deaths among vaccinated people.

The LFA remains committed to providing resources and support regarding the COVID-19 pandemic. Learn about up-to-date health information on the virus and people with lupus.

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Study Shows Better COVID-19 Outcomes Among Vaccinated People with Rheumatic Diseases, Lupus - Lupus Foundation of America

Significance

Plastic waste causes harm to marine life and has become a major global environmental concern. The recent COVID-19 pandemic has led to an increased demand for single-use plastic, intensifying pressure on this already out-of-control problem. This work shows that more than eight million tons of pandemic-associated plastic waste have been generated globally, with more than 25,000 tons entering the global ocean. Most of the plastic is from medical waste generated by hospitals that dwarfs the contribution from personal protection equipment and online-shopping package material. This poses a long-lasting problem for the ocean environment and is mainly accumulated on beaches and coastal sediments. We call for better medical waste management in pandemic epicenters, especially in developing countries.

The COVID-19 pandemic has led to an increased demand for single-use plastics that intensifies pressure on an already out-of-control global plastic waste problem. While it is suspected to be large, the magnitude and fate of this pandemic-associated mismanaged plastic waste are unknown. Here, we use our MITgcm ocean plastic model to quantify the impact of the pandemic on plastic discharge. We show that 8.4 1.4 million tons of pandemic-associated plastic waste have been generated from 193 countries as of August 23, 2021, with 25.9 3.8 thousand tons released into the global ocean representing 1.5 0.2% of the global total riverine plastic discharge. The model projects that the spatial distribution of the discharge changes rapidly in the global ocean within 3 y, with a significant portion of plastic debris landing on the beach and seabed later and a circumpolar plastic accumulation zone will be formed in the Arctic. We find hospital waste represents the bulk of the global discharge (73%), and most of the global discharge is from Asia (72%), which calls for better management of medical waste in developing countries.

Plastics have an excellent strength to weight ratio, and they are durable and inexpensive, making them the material of choice for most disposable medical tools, equipment, and packaging (1, 2). The COVID-19 pandemic has demonstrated the indispensable role of plastic in the healthcare sector and public health safety (2). As of August 23, 2021, about 212 million people worldwide have been infected with the COVID-19 virus with the most confirmed cases in the Americas (47.6%) and Asia (31.22%) followed by Europe (17.26%) (3). The surging number of inpatients and virus testing substantially increase the amount of plastic medical waste (4). To sustain the enormous demand for personal protective equipment (PPE, including face masks, gloves, and face shields), many single-use plastic (SUP) legislations have been withdrawn or postponed (2). In addition, lockdowns, social distancing, and restrictions on public gathering increase the dependency on online shopping at an unprecedented speed, the packaging material of which often contains plastics (5, 6).

Unfortunately, the treatment of plastic waste is not keeping up with the increased demand for plastic products. Pandemic epicenters in particular struggle to process the waste (7), and not all the used PPEs and packaging materials are handled or recycled (8, 9). This mismanaged plastic waste (MMPW) is then discharged into the environment, and a portion reaches the ocean (10). The released plastics can be transported over long distances in the ocean, encounter marine wildlife, and potentially lead to injury or even death (1114). For example, a recent report estimated that 1.56 million face masks entered the oceans in 2020 (15). Earlier studies have also raised the potential problem of COVID-19 plastic pollution and its impact on marine life (1618). Some cases of entanglement, entrapment, and ingestion of COVID-19 waste by marine organisms, even leading to death, have been reported (19, 20). The plastic debris could also facilitate species invasion and transport of contaminants including the COVID-19 virus (2123). Despite the potential impacts, the total amount of pandemic-associated plastic waste and its environmental and health impacts are largely unknown. Here, we estimate the amount of excess plastic released during the pandemic that enters the global ocean and its long-term fate and potential ecological risk.

As of August 23, 2021, the total excess MMPW generated during the pandemic is calculated as 4.4 to 15.1 million tons (Fig. 1). We use the average of scenarios with different assumptions as our best estimate (Methods), which is about 8.4 1.4 million tons. A dominant fraction (87.4%) of this excess waste is from hospitals, which is estimated based on the number of COVID-19 inpatients (24) and per-patient medical waste generation for each country (25). PPE usage by individuals contributes only 7.6% of the total excess wastes. Interestingly, we find that the surge in online shopping results in an increased demand for packaging material. However, we find that packaging and test kits are minor sources of plastic waste and only account for 4.7% and 0.3%, respectively.

Global generation of mismanaged plastics from different sources (hospital medical waste, test kits, PPE, and online packaging) attributable to the COVID-19 pandemic. High- and low-yield scenarios are considered for each source (Methods).

Table 1 shows the distribution of COVID-19 cases across different continents (Asia, Europe, North America, South America, Oceania, and Africa). About 70% of COVID-19 cases are found in North and South America and Asia (Table 1). We find that MMPW generation does not follow the case distribution, as most MMPW is produced in Asia (46%), followed by Europe (24%), and finally in North and South America (22%) (Table 1 and Fig. 2E). This reflects the lower treatment level of medical waste in many developing countries such as India, Brazil, and China (range between 11.5 and 76% as the low- and high-end estimates) compared with developed countries with large numbers of cases in North America and Europe (e.g., the United States and Spain) (0 to 5%) (Fig. 2A). The MMPW generated from individual PPE is even more skewed toward Asia (Fig. 2C and SI Appendix, Table S1) because of the large mask-wearing population (26). Similarly, the MMPW generated from online-shopping packaging is the highest in Asia (Fig. 2D). For instance, the top three countries in the express-delivery industry of global share are China (58%), United States (14.9%), and Japan (10.3%) followed by the United Kingdom (4%) and Germany (4%) (27).

Percentage of the confirmed COVID-19 cases (as of August 23, 2021), the generated mass of pandemic-associated MMPW ending up in the environment, and the pandemic-associated MMPW that is transported to river mouths for different continents

Accumulated riverine discharge of pandemic-associated mismanaged plastics to the global ocean. Panels are for the discharges caused by (A) hospital medical waste, (B) COVID-19 virus test kits, (C) PPE, (D) online-shopping packaging material, and (E) the total of them. The background color represents the generated MMPW in each watershed, while the sizes of the blue circles are for the discharges at river mouths.

Based on the MMPW production from each country and a hydrological model (28), we calculate a total discharge of 25.9 3.8 (12.3 as microplastics [< 5 mm] and 13.6 as macroplastics [> 5 mm]) thousand tons of pandemic-associated plastics to the global ocean from 369 major rivers and their watersheds (Fig. 2E). We believe that the 369 rivers (account for 91% of the global riverine plastic discharge to the sea) considered here include a vast majority of the global pandemic-associated plastic discharge. The top three rivers for pandemic-associated plastic waste discharge are Shatt al Arab (5.2 thousand tons, in Asia), Indus (4.0 thousand tons, in Asia), and Yangtze River (3.7 thousand tons, in Asia) followed by Ganges Brahmaputra (2.4 thousand tons, in Asia), Danube (1.7 thousand tons, in Europe), and Amur (1.2 thousand tons, in Asia). These findings highlight the hotspot rivers and watersheds that require special attention in plastic waste management.

Overall, the top 10 rivers account for 79% of pandemic plastic discharge, top 20 for 91%, and top 100 for 99%. About 73% of the discharge is from Asian rivers followed by Europe (11%), with minor contributions from other continents (Table 1). This pattern is different from that of the generation of MMPW (Table 1) because of the different ability of rivers to export plastic load to the ocean, which is measured as the yield ratio (defined as the ratio between the plastic discharges at the river mouth and the total MMPW generation in the watershed). The yield ratio is influenced by factors such as the distribution of plastic release along rivers and the physical conditions of rivers (e.g., water runoff and velocity) (28). The top five rivers with the highest yield ratios are the Yangtze River (0.9%), Indus (0.5%), Yellow River (0.5%), Nile (0.4%), and Ganges Brahmaputra (0.4%). These rivers have either high population density near the river mouth, large runoff, fast water velocity, or a combination of them. The combination of high pandemic-associated MMPW generations and yield ratio for Asian rivers results in their high discharge of MMPW to the ocean.

We simulate the transport and fate of the 25,900 3,800 tons of pandemic-associated plastic waste by the Nanjing University MITgcm-Plastic model (NJU-MP) to evaluate its impact on the marine environment. The model considers the primary processes that plastics undergo in seawater: beaching, drifting, settling, biofouling/defouling, abrasion, and fragmentation (29). The model reveals that a large fraction of the river discharged plastics are transferred from the surface ocean to the beach and seabed within 3 y (Fig. 3). At the end of 2021, the mass fraction of plastics in seawater, seabed, and beach are modeled as 13%, 16%, and 71% respectively. About 3.8% of the plastics are in the surface ocean with a global mean concentration of 9.1 kg/km2. Our model also suggests that the discharged pandemic-associated plastics are mainly distributed in ocean regions relatively close to their sources, for example, middle- and low-latitude rivers distributed in East and South Asia, South Africa, and the Caribbean (Fig. 4 and SI Appendix, Fig. S2). The beaching and sedimentation fluxes are mainly distributed near major river mouths (Fig. 4 and SI Appendix, Fig. S2). This suggests that the short-term impact of pandemic-associated plastics is rather confined in the coastal environment.

Projection of the fate of discharged pandemic-associated plastics (including both microplastics and macroplastics) in the global ocean. (A) The mass fractions and average concentrations in the surface ocean. (B) The mass fractions in the seawater, seabed, and beaches.

Modeled spatial distribution of mass concentrations of COVID-19-associated plastics in the surface ocean (AC, JL), on the beaches (DF, MO), and the seabed (GI, PR) in 2021, 2025, and 2100, respectively. The black boxes on the Top panel indicate the five subtropical ocean gyres (North Pacific Gyre, North Atlantic Gyre, South Pacific Gyre, South Atlantic Gyre, and Indian Gyre). Panels AI are for the microplastics, while JR are for the macroplastics.

The model suggests the impact could expand to the open ocean in 3 to 4 y. The mass fraction of plastics in the seawater is predicted to decrease in the future while those in seabed and beach are modeled to gradually increase. At the end of 2022, the fractions of riverine discharged, pandemic-associated MMPW in seawater, seabed, and beach are modeled as 5%, 19%, and 76%, respectively, and the mean surface ocean concentration sharply decreases to 3.1kg/km2. In 2025, five garbage patches in the center of subtropic gyres merge, including the four in North and South Atlantic and Pacific and the one in the Indian Ocean (Fig. 4 and SI Appendix, Fig. S2). Hot spots for sedimentation fluxes are also modeled in the high-latitude North Atlantic and the Arctic Ocean in 2025 (Fig. 4 and SI Appendix, Fig. S2), reflecting the large-scale vertical movement of the seawaters (SI Appendix, Fig. S3).

We find a long-lasting impact of the pandemic-associated waste release in the global ocean. At the end of this century, the model suggests that almost all the pandemic-associated plastics end up in either the seabed (28.8%) or beaches (70.5%), potentially hurting the benthic ecosystems. The global mean pandemic-associated plastic concentrations in the surface ocean are predicted to decrease to 0.3 kg/km2 in 2100, accounting for 0.03% of the total discharged plastic mass. However, two garbage patches are still modeled over the northeast Pacific and the southeast Indian Ocean, exerting persistent risk for ecosystems over there. The fate of microplastics and macroplastics are similar but with a higher fraction of macroplastics ending up in the beaches due to their lower mobility (Fig. 4 and SI Appendix, Fig. S1).

The Arctic Ocean appears to be a dead-end for plastic debris transport due to the northern branch of the thermohaline circulation (30). About 80% of the plastic debris discharged into the Arctic Ocean will sink quickly, and a circumpolar plastic accumulation zone is modeled to form by 2025. In this year, the Arctic seabed accounts for 13% of the global plastic sedimentation flux, but this fraction will increase to 17% in 2100. The Arctic ecosystem is considered to be particularly vulnerable due to the harsh environment and high sensitivity to climate change (31, 32), which makes the potential ecological impact of exposure to the projected accumulated Arctic plastics of special concern.

It is speculated that the pandemic will not be completely controlled in a couple of years, and many of the containing policies will continue to be implemented (33). By the end of 2021, it is conservatively estimated that the number of confirmed cases will reach 280 million (34). The generated pandemic-associated MMPW will reach a total of 11 million tons, resulting in a global riverine discharge of 34,000 tons to the ocean. The MMPW generation and discharge are expected to be more skewed toward Asia due to record-breaking confirmed cases in India (3). Given the linearity between the discharge and ocean plastic mass, the fate and transport of the newly generated plastic discharge can be deduced from our current results.

There are substantial uncertainties associated with our estimate of pandemic-associated MMPW release due to the lack of accurate data (e.g., the number of used masks and online-shopping packages and the fraction of mismanaged waste under the over-capacity conditions). For example, our estimate for the discharge from face mask usage is much lower than that of Chowdhury etal. (35), which assumes that a person uses a single mask daily while we assume a mask lasts for 6 d based on survey data (Methods). We thus consider multiple scenarios to cap the actual situations (Methods). The estimated MMPW as hospital medical waste varies by 53%, while that from packaging and PPE vary by 25% and a factor of 3.5, respectively. The estimated amounts of riverine MMPW discharge to the ocean have also uncertainty as they are based on a coarse resolution (i.e., watershed-wise) hydrological model (28). In addition, factors such as the fragmentation, abrasion, and beaching rate of plastics in NJU-MP also have a substantial influence on the simulation results (29). Despite these uncertainties, the spatial pattern of the pandemic-associated releases and their relative fate in different compartments of the ocean is more robust.

The pandemic-associated plastic discharge to the ocean accounts for 1.5 0.2% of the total riverine plastic discharges (28, 36). A large portion of the discharge is medical waste that also elevates the potential ecological and health risk (37) or even the spreading of the COVID-19 virus (38). This offers lessons that waste management requires structural changes. The revoking or delaying of the bans on SUPs may complicate plastic waste control after the pandemic. Globally public awareness of the environmental impact of PPE and other plastic products needs to be increased. Innovative technologies need to be promoted for better plastic waste collection, classification, treatment, and recycling, as well as the development of more environmentally friendly materials (15, 39). Better management of medical waste in epicenters, especially in developing countries, is necessary.

We develop an inventory for the excess plastic waste generated due to the COVID-19 pandemic. We consider four categories of sources: hospital-generated medical waste, virus testing kits, PPE used by residents, and online-shopping packages.

For hospital-generated medical waste, we estimate the amount by the number of hospitalization patients (nH) and per-patient healthcare waste generation rates (HCWGR). The nH is estimated based on the number of COVID-19 infections (nI) and the global average hospitalization rate (HR) of this disease:nH=nIHR.[1]

The nI and HR data are based on the statistics of the World Health Organization (3). The HCWGR of COVID-19 patients is approximately two times higher than that of general patients (40), which is calculated as a function of life expectancy (LE) and CO2 emissions (CDE) based on Minoglou etal. (25):HCWGR=2(0.014LE+0.31CDE).[2]

This relationship was developed based on the statistical data from 42 countries worldwide and can explain 85% of the variability of the HCWGR data (25). The LE data are from Roser etal. (41), and the CDE data are from Worldometer (42).

The virus testing kitsgenerated medical waste is estimated based on the number of conducted tests and the amount of waste generated per test. The former data are from Ritchie etal. (43) while the latter is from Cheon (44) and ShineGene (45). Depending on the specifications of the testing kits, the waste generated per test ranges 21 to 28 g/test.

For the PPE used by residents, we consider only face masks, as other items such as gloves and face shields are less commonly used. We use two ways to estimate the number of used masks: consumption-based and production-based. For the former way, we first assume an ideal condition that each person uses a new mask every 6 d (46), and we assume that the actual mask usage lies 25 to 75% of this situation. The population data are from United Nations (26). For the latter way, we assume that all masks produced are used up. The global production (PW) is estimated based on the mask production in China (PC), which is the largest mask producing country (54 to 72%) in the world (47):PW=PCp,[3]where p is the share of Chinese-produced masks (47). We also consider two scenarios for the mass of waste generated by each mask (for surgical masks or N95 masks).

The online-shopping packaging (np) in this study refers to the excess part that is caused by lifestyle changes during the pandemic compared to the normal situation (no COVID-19 pandemic) (nno-covid):np=nactualnnocovid,[4]where nactual is the actual online package usages from 2020 to the first quarter of 2021 and is estimated based on the financial report of the top six e-commerce companies worldwide (Taobao, Tmall, Amazon, Jingdong, eBay, and Walmart) (4852). The nno-covid is calculated based on the package numbers in 2019 and an average annual growth rate in recent years (53). The mass of generated plastic waste (m) is then estimated based on the average mass of plastics in the packaging material (mp) (54):m=npmp.[5]

The amount of MMPW for each source (i) can be calculated based on the waste generation rate of the above four sources (Rw), the fraction of plastic waste in the total waste (Pp), and the fraction of mismanagement waste in the total waste (Pm):MMPW=i=14RwiPpiPmi.[6]

We consider the former two source categories as medical waste while the latter two as municipal waste. The Pm for each country is specified according to the waste type. The Pm of municipal waste is based on Schmidt etal. (28). There is no solid data for the Pm of medical waste, and we use the data of Caniato etal. (55) as a function of the economic status (56) and the level of treatment and disposal of waste for individual countries. The dataset includes two scenarios, and we consider an additional scenario that is 50% lower than the lower one to account for the uncertainty of this fraction.

We estimate the river discharge of pandemic-associated MMPW to the ocean based on the watershed model developed by Schmidt etal. (28), which calculates the yield ratio of plastic discharge at the river mouth to the total MMPW generated in the entire corresponding watershed. We assume this ratio is the same for pandemic-associated plastic waste and other wastes. We consider a total of 369 major rivers and their watersheds in this study. We split the country-specific, pandemic-associated MMPW data to each watershed based on the amount of regular MMPW (28).

The NJU-MP model has a resolution of 2 latitude 2.5 longitude horizontally with 22 vertical levels and is driven by ocean physics from the Integrated Global Systems Model with 4-h time step (29). The model considers five categories of plastics with different chemical composition, and the density of each category is predetermined: polyethylene (PE, 950 kg/m3), polypropylene (PP, 900 kg/m3), polyvinyl chloride (PVC, 1,410 kg/m3), polyurethane (PU, 550 kg/m3), and others (1,050 kg m3). The plastics densities are modeled to increase when biofouled but decrease when defouled (57). The densities determine their buoyancy as low-density polymers float, whereas high-density polymers sink to the sediment (58, 59). Each category has six size bins: four belong to microplastics: <0.0781 mm, 0.0781 to 0.3125 mm, 0.3125 to 1.25 mm, and 1.25 to 5 mm, and two belong to macroplastics: 5 to 50 mm and >50 mm. There is thus a total of 60 plastic tracers in the model. We assume all the plastic debris as spheres for simplicity. The pandemic-associated MMPW discharge from rivers are released as half 5 to 10 mm and half >50 mm for macroplastics, while the largest size bin (i.e., 1.25 to 5 mm) for microplastics. After their discharge into the ocean, the plastics undergo removal by beach interception (57) and sinking to the deeper ocean and eventually on the seafloor. Biofouling of light plastic types (PE and PP) is modeled following Kooi etal. (60) but adjusted for more realistic scenarios. Three types of plastics with different degrees of biological attachment are considered. In addition, the model considers the removal processes including ultraviolet degradation, fragmentation, and abrasion.

The MMPW generation and river discharge datafor all the countries are provided in the Environmental Biogeochemistry Modeling Group (EBMG), https://www.ebmg.online/plastics (61). All study data are included in the article and/or SI Appendix.

This research was funded by the National Natural Science Foundation of China (Grant Nos. 42177349 and 41875148), the Fundamental Research Funds for the Central Universities (Grant No. 0207-14380168), Frontiers Science Center for Critical Earth Material Cycling, Jiangsu Innovative and Entrepreneurial Talents Plan, and the Collaborative Innovation Center of Climate Change, Jiangsu Province. We are grateful to the High Performance Computing Center of Nanjing University for doing the numerical calculations in this paper on its blade cluster system.

Author contributions: A.T.S. and Y.Z. designed research; Y.P. and P.W. performed research; Y.P. and P.W. analyzed data; and Y.P., A.T.S., and Y.Z. wrote the paper.

The authors declare no competing interest.

This article is a PNAS Direct Submission.

This article contains supporting information online at https://www.pnas.org/lookup/suppl/doi:10.1073/pnas.2111530118/-/DCSupplemental.

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Plastic waste release caused by COVID-19 and its fate in the global ocean - pnas.org

We need to embrace normalcy at this point, but we need to be smart about it, Dr. Ulysses Wu, an infectious disease specialist at Hartford HealthCare, said Friday. Who are the people you are going to be hanging out with, how many people are going to be coming, and what is their vaccination status?

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Daily coronavirus updates: COVID-19 cases now rising ...

Three more Mainers have died and another 848 coronavirus cases have been detected across the state, health officials said on Saturday.

Saturdays report brings the total number of coronavirus cases in Maine to 115,857,according to the Maine Center for Disease Control and Prevention. Thats up from 115,009 on Friday.

Of those, 82,675have been confirmed positive, while 33,182were classified as probable cases, the Maine CDC reported.

Three new deaths were reported Saturday, raising the statewide death toll to 1,271.

As of Friday, the number of coronavirus cases diagnosed in the past 14 days statewide is 7,935. This is an estimation of the current number of active cases in the state, as the Maine CDC is no longer tracking recoveries for all patients. Thats up from 7,592 on Thursday.

The new case rate statewide Saturday was 6.34 cases per 10,000 residents, and the total case rate statewide was 865.6 on Saturday.

The most cases have been detected in Mainers younger than 20, while Mainers over 80 years old make up the majority of deaths. More cases have been recorded in women and more deaths in men.

So far, 3,027Mainers have been hospitalized at some point with COVID-19, the illness caused by the new coronavirus. Of those, 281 are currently hospitalized, with 74 in critical care and 35 on a ventilator.

Cases have been reported in Androscoggin (12,342), Aroostook (4,820), Cumberland (23,732), Franklin (2,817), Hancock (3,432), Kennebec (11,200), Knox (2,331), Lincoln (2,059), Oxford (5,999), Penobscot (13,3375), Piscataquis (1,493), Sagadahoc (2,326), Somerset (5,170), Waldo (2,748), Washington (2,278) and York (19,355) counties.

As of Saturday, 916,698 Mainers are fully vaccinated, or about 71.58 percent of eligible Mainers, according to the Maine CDC.

As of Saturday morning, the coronavirus had sickened 47,660,379people 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 770,691deaths, according to the Johns Hopkins University of Medicine.

Correction: A previous version of this article state an incorrect number of COVID-19 cases reported by the Maine CDC on Saturday.

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3 deaths and 850 new COVID-19 cases reported across the state - Bangor Daily News

Theres a world of difference between this Thanksgiving and last. A year ago, Oregon was deep into its third COVID-19 surge, vaccinations hadnt yet started and Gov. Kate Brown limited celebratory gatherings to no more than six people, warning that violators could be fined up to $1,250.

This Thanksgiving, Oregonians age 12 and older have had ample opportunity to get vaccinated, and first shots for children ages 5 to 11 started earlier this month. About 62% of the population is fully vaccinated. The governor also has placed no limits on the size of gatherings between family and friends.

Were in a completely different spot than we were last year, said Carlos Crespo, professor at the Oregon Health & Science University and Portland State University School of Public Health.

But Crespo and other experts in Oregon and across the nation caution: Now is not the time to be complacent, given that COVID-19 cases have been climbing in at least three dozen states and infections are up 33% nationwide over the past two weeks, as of Friday.

Will Oregon be next?

Although the states infection rates have dropped 10% in the past two weeks, some experts worry another surge is likely as people gather to celebrate the holidays with multiple families and spend more time indoors in the colder weather. Waning immunity only adds to the problem. Crespo is among public health experts, epidemiologists and other scientists who say theres still lots that people can do to try to lessen the severity of the next surge, if there indeed is one.

What precautions should I take?

One of the most important actions you can take is asking everyone at your gathering to be fully vaccinated and, if eligible, to have gotten a booster shot.

That should give you a sense of relief that you didnt have last year, Crespo said.

Even though vaccinated people can still spread the SARS-CoV-2, data shows unvaccinated people are five to six times more likely to be infected by the virus than vaccinated people.

Getting everyone vaccinated might be impossible for families with younger children, because children under 5 have yet to receive the green light for shots. And although the federal government authorized the Pfizer-BioNTech vaccine for 5- to 11-year-olds in early November, no one in that age group has had enough time to become fully inoculated. Research shows Pfizer-BioNTechs vaccine doesnt offer robust protection against the delta variant until two weeks after the second shot.

With the support of her mother, Becca, Cora Thompson, 9, readies herself for her first COVID-19 vaccination at the Sellwood Medical Clinic drive-thru vaccination site at Oaks Park in Southeast Portland. November 5, 2021 (Beth Nakamura/Staff)The Oregonian

Among other recommended safety measures, even for get-togethers of fully vaccinated people:

Limit exposure: Consider asking guests to avoid contact with others outside their households in the three -- but ideally five to seven days -- leading up to the gathering. If you must be around others you dont live with, be extra careful by wearing a well-fitted, high-quality mask. These steps will limit exposure to the virus.

If you go to a really crowded gathering just a few days before you go off to visit Grandma -- not great, said Dr. Tom Jeanne, deputy state epidemiologist at the Oregon Health Authority.

If you travel by air: Remember the importance of properly wearing a quality mask not just on the airplane, where air filtration tends to be good, but on public ground transportation to and from or in packed airports and in lines.

If possible, try to avoid eating or drinking, especially in crowded situations, so you dont have to remove your mask. The same goes for train and bus travel.

Rapid tests: Add an extra layer of protection by asking attendees to take a home rapid antigen test just before attending the gathering. The tests typically cost $10 to $12 each at pharmacies, grocery stores and online. But be warned, they might be in short supply due to increasing demand over the holiday season.

Ventilation: The World Health Organization has recommended a benchmark of six air changes per hour. But many homes dont accomplish even one air change in an hour. So its smart to open a window or crack the door, which can make a difference. Turning on kitchen and bathroom fans, which suck indoor air out also can improve the flow.

HEPA air purifiers: If youve got them, use them. They can do wonders in helping to sift virus out of the air.

Gather outdoors: This isnt a particularly comfortable option in late November in many parts of Oregon, given the cool, wet temperatures. But even if you dont dine out on the back deck, you dont need to spend all your time indoors. Getting out for a walk and some fresh air is a good way to spend time together.

Bow out if sick: No one should attend a holiday get-together if they have cold-like symptoms, feel fatigued or otherwise are feeling unwell.

Get your flu shot: Were talking about COVID-19 here, right? But getting your flu shot lessens the likelihood that youll get the flu and have to skip the get-together. While its too late for a flu vaccination to take full effect by Thanksgiving, its not too late for holiday gatherings later in the season.

Masks and social distancing: While these might seem like a real holiday downer, these two measures can significantly reduce transmission. Thats particularly true if there are unvaccinated people at your gathering. Some experts say wearing masks and physical distancing isnt necessary for the fully vaccinated, especially if everyone is younger with no underlying medical conditions.

Keep it small: The smaller the gathering, the less risk.

I think its important to understand there is some risk of transmission from vaccinated people, Jeanne said. If youre at a small private gathering, the risk is very low.

But keeping it small is likely a piece of advice many wont heed. Nationwide, a Kaiser Family Foundation survey found that nearly half of adults said they plan to attend a holiday gathering with 10 or more people.

How do I know Im taking enough precautions?

That really depends on your circumstances.

People ask me about their gatherings, whether they should do this or that, said Peter Graven, a data scientist at Oregon Health & Science University. He puts out a weekly COVID-19 forecast. Unfortunately, none of this stuff is certain. So you want to minimize your risk as much as you can. But there again, you can have a good bit of faith in the science of the vaccine.

For some extra help determining how safe your get-together will be, try The New York Times interactive questionnaire: Were Having a Holiday Gathering. Are We Nuts?

Experts say when mulling the precautions youll employ, prioritize your most vulnerable family members and friends. Even if they are vaccinated, their bodies might not have produced the same immune response as younger, healthier people.

Also, consider your communitys transmission rates or the rates in areas where your guests live. A transmission tracker created by the Centers for Disease Control and Prevention shows COVID-19 is spreading at substantial or high rates in 34 of Oregons 36 counties, including the entire Portland area. Even so, rates in some parts of the U.S. such as Michigan, New Mexico and New Hampshire are more than triple what they are in Oregon.

Patrick Allen, director of the Oregon Health Authority, told a legislative committee this week that hes concerned Oregonians are letting their guard down. Daily reported infections and hospitalizations still are higher than any time during the states spring surge.

Its dangerous to start thinking and acting like the pandemic is over or is ending, Allen said. Were still at very, very high caseloads. Our hospitals continue to be at 90% or more of capacity. One in five Oregonians is completely unprotected from the virus, having neither been exposed nor vaccinated.

How are our experts celebrating Thanksgiving?

Crespo, the OHSU-PSU professor, said hes planning to get together with some local relatives who will all travel by car. Including himself, he expects about eight people, all fully vaccinated, at the table. Theyll probably open some windows and have the nice dinner we couldnt have last year.

Later, he plans to travel to Arecibo, Puerto Rico, where hell visit his mother, whos fully vaccinated with a booster. Crespo said hell be careful with a good mask while in the airport and on the plane. He said feels comfortable with his destination because virtually every eligible adult in the city is inoculated.

Thats had a noticeable benefit. Crespo said his mother had to recently visit the hospital for a non-COVID-19 ailment, and his brother asked staff about isolating her away from the coronavirus patients.

The answer from the doctor was We have zero COVID-19 cases here in the hospital, Crespo said.

Jeanne, the deputy state epidemiologist, said hell celebrate Thanksgiving with a very small get-together with friends. Theyll open a window and fire up an HEPA air purifier.

Itll be all vaccinated people, Jeanne said. Nobody with symptoms.

Graven, the OHSU data scientist, said hes still hashing out plans. But hes thinking of sharing the holiday with one other family. Only one person, a school-aged child, will be partially vaccinated. Everyone else has had a full course of shots.

Our normal Thanksgiving would probably be like 30 people, Graven said, and this is going to be like eight.

-- Aimee Green; agreen@oregonian.com; @o_aimee

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Will Thanksgiving fuel a new COVID-19 surge in Oregon? Heres how to have a safer gathering amid rising U.S. - oregonlive.com

BALTIMORE (WJZ) Maryland reported 1,017 new COVID-19 cases and nine new deaths, according to state health department data released Saturday morning.

The percentage of people testing positive increased by .08% to 3.51%.

Hospitalizations increased by two to 556. Of those hospitalized, 418 adults are in acute care and 133 adults are in intensive care. Two children are in acute care and one is in intensive care.

Doctors say the new cases are fueled by dangerous strains targeting the unvaccinated. In an August press conference, Gov. Larry Hogan said the Delta variant, a strain that is reportedly two to four times more contagious than the original virus strain, accounts for nearly every new confirmed case in Maryland.

The vaccines are without a doubt our single most effective tool to mitigate the threat of COVID-19 and the surging Delta variant, and Marylands vaccination rate continues to outpace the nation, Hogan said.

Since the pandemic began, there have been 577,013 total confirmed cases and 10,878 deaths.

There are 4,056,511 Marylanders fully vaccinated. The state has administered 9,105,357 doses. Of those, 4,219,679 are first doses with 9,799 administered in the past 24 hours. They have given out 3,738,727 second doses, 3,268 in the last day.

Thanks to the millions of people who have rolled up their sleeves, Maryland continues to be one of the most vaccinated states in America, said Governor Hogan of the eight million milestone mark. We have achieved these numbers with strong public health outreach, innovative lottery and scholarship promotions, and a relentless focus on equity.

Governor Hogan also announced earlier this month that 99% of Maryland seniors are now vaccinated and more than 50,000 children ages 5-11 years old have received a vaccination shot.

The state began to administer the Johnson & Johnson vaccine again in April after the CDC and FDA lifted their pause on the vaccine due to a rare blood clot found in some women.

A total of 317,784 Marylanders have received the Johnson & Johnson vaccine, 392 in the last day.

On September 24, after the CDC granted final approval for Pfizers booster, Gov. Hogan announced the immediate authorization of the booster shot for Marylanders who have received their second Pfizer shot at least six months ago. Hogan had already approved use for vulnerable populations in early September.

The state has administered 829,167 additional or booster vaccine doses, 26,180 in the last day.

The state reported 87.9% of all adults in Maryland have received at least one dose of the vaccine.

In August, the state launched a post-vaccination infections dashboard that is updated every Wednesday. There have been 34,450 total cases among fully vaccinated Marylanders as of Nov. 14.

Less than 0.93% of fully vaccinated Marylanders have later tested positive.

Of those cases, 2,471 vaccinated Marylanders were hospitalized, representing 13.02% of all COVID cases hospitalized in the state. 357 fully vaccinated Marylanders have died, representing 14.17% of lab-confirmed COVID deaths in the state.

CORONAVIRUS RESOURCES:

Heres a breakdown of the numbers:

By County

By Age Range and Gender

By Race and Ethnicity

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COVID-19 In Maryland: More Than 1K New Cases & 9 Deaths Reported Saturday - CBS Baltimore

At Long Island Jewish Medical Center, a loudspeaker announces an emergency in one of the rooms.It is March 2020, and the Covid-19 pandemic has just begun to take hold in the U.S. Ateamof nurses and doctors in the hospital is preparing a patient for intubation. A doctor leans over the patient, whose name is Patrick George.

George, the doctor shouts, do you want to be put on a respirator?

Put me on, George responds weakly.

Well let your family know, OK? the doctor says.

George is struggling to breatheand knows its his last hope.

Put me on now, he says.

If you have survived the pandemic without going inside a Covid ward, you will likely be stunned by the grim intimacy of this scene and the fact that you are witnessing it, with real-time urgency, in Matthew Heinemans new documentary, The First Wave. The scene offersthe kind of life-and-death drama that medical staffs have staggered through every daywhile the rest of us rarely or never saw it. We were and are isolated from the traumatic realities inside U.S. hospitals as more than 750,000 souls perished from the virus.

Thisopening scene, not yet 30 seconds long, twists in ways you cannot forget.

A nurse puts a phone, encased in a plastic bag, in front of Georges face. On the other end, seeing him via FaceTime, is Georges wife.

I love you, baby, she cries out.

I love you too, George responds.

OK, be strong.

Bye, George says.

I love you, she repeats.

Bye bye, George says. Bye bye bye bye bye bye.

Thisscene is not done with us but I wont say what happens next. What I can say is that The First Wave is necessary to watch. Unless you have already seen and heard the kinds of events it shows, you have an incomplete understanding of the pandemic and of what three-quarters of a million deaths mean when instead of astatisticin a news story, the casualtiesare a man on his back, his wife on the phone, and the nurses and doctors doing everything they can to save his life.

The saving grace of this film, if thats the right way to put it, is that it journeys aroundthe epidemiological trenches at this New York City hospital and brings back a variety of stories, some of them uplifting, and they thread into an effective narrative. There are patients who seem on the verge of death and struggle back, there are family members urging them along on those plastic-encased phones, and there are medical staffers whose trauma-filled work is getting the attention it deserves in our less troubled lives.

It sounds strange to say, but there is art in this film too. The way the camera lingers just long enough at the right moments and not too long at others, the way the lifted brow of a nurse speaks louder than words, the way the film breaks out ofLong Island Jewish and moves into the streets of New York City, taking us from the gasps of Covid patients to the I Cant Breathe chants of the Black Lives Matter movement this is masterful work.

Heineman is no stranger to documentaries. He directed the Academy Award-nominated Cartel Land, about the drug trade on the U.S.-Mexico border. He also directed City of Ghosts, an award-winning film about citizen journalists in Raqqa, Syria. Those films demonstrated a willingness and ability to work in dangerous areas and gain the confidence of people who otherwise might not let an outsider into their worlds. Those talents are what went into the making of The First Wave.

Heineman used his experience and contacts to gain unparalleled access to Long Island Jewish. Across the U.S., hospitalswere shutting their doors to journalists as the pandemic began. Only a handful gained entry, and their visits were short, usually just a few hours or a few days at most. Heinemans team was at Long Island Jewish for months. Hospital administrators have cited safety and privacy concerns for keeping journalists out, but as Heinemans experience showed, they could work insideCovid wards without getting in anyones way or spreading the virus.

Thats what makes the footage in his documentary so extraordinary. I worked for months on an investigative article that delved into the way hospitals cracked down onreporters in the U.S., and I spent a lot of that time scouring through theimagery that was published by journalists, including filmmakers,and bymedical staffers (some hospitals even threatened doctors and nurses who shared photos or videos). Ive seen nothing that comes close to Heinemans graphic portrayal of Covid victims.

The onlyvisual documentation of the pandemic thats in the same league comes from far away. Thedirector Hao Wu, working with Chinese journalists in early 2020, got relatively unfettered access to four hospitals in Wuhan, where thevirus originated. His powerful documentary, 76 Days, came out last year and won an Emmy. Until the emergence of Heinemans film, which opened Friday, Americans who wanted a visceral look inside a Covidward had to watch a film shot in China.

It is hard to categorize The First Wave because it crosses boundaries: It is a documentary thatalso feels like a horror film, an expos of social injustice, and a love letter. In its review of The First Wave, the Washington Post has a line that manages to be insightful and off-kilter at the same time. The film feels like a viscerally effective time capsule from the recent past, wrote Michael OSullivan, yet one whose arrival in theaters may still be too soon for many.

A time capsule is filled with the familiar objects of a civilization. But whats in The First Wave is unfamiliar to most of us; we have not seen it before and perhaps have been unable to imagine it. There is the anguish ofpatients as theylaborto breathe, themedicalinstruments warning of hearts no longer beating, the body bags zipped up and hauled away, and the moments of silence beforenurses rush to the next room to try to save another life. Stumbling onto this time capsule, we arevisitors from another world who are seeing for the first time whatthe Covid pandemic really meant.

This film has not come too soon. It has come too late.

Excerpt from:

The First Wave Shows What We Haven't Seen of Covid-19 - The Intercept