Category: Covid-19

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Oxygen supply shortages hurt hospitals overwhelmed by COVID-19 – Los Angeles Times

December 29, 2020

One of the myriad challenges facing Southern Californias medical system, which is overwhelmed by COVID-19 patients, involves one of the most basic staples of any hospital.

Oxygen.

Officials are having problems getting the amount of oxygen needed by critically ill COVID-19 patients who are struggling to breathe as their inflamed lungs are being damaged or destroyed.

Problems on Sunday caused at least five hospitals in L.A. County to declare an internal disaster, which closed the facilities to all ambulance traffic not just certain types of ambulance patients, as is more typical.

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Its not simply a shortage of oxygen itself, county and hospital officials say. Theres a shortage of canisters, which patients need to return home, and aging hospital pipes are breaking down due to the huge amounts of oxygen needed to be distributed around the hospital.

There are two problems with the distribution of oxygen at aging hospitals.

First, there are so many patients needing a high rate of oxygen that the system cannot maintain the sufficient pressure needed in the pipes.

The second is that there is such high flow through the pipes that they freeze, and obviously, if it freezes, then you cant have good flow of oxygen, said Dr. Christina Ghaly, L.A. County health services director.

Some hospitals are forced to move patients to lower floors, because its easier to deliver oxygen there without needing the pressure to push it up to higher floors, Ghaly said.

Memorial Hospital of Gardena is one of the centers facing oxygen issues. Chief Executive Kevan Metcalfe said the hospital has run low on oxygen.

If it runs out, the hospital would be in deep, deep trouble, he said.

Doctors and nurses have learned since the early days of the pandemic to, as much as possible, avoid placing patients on ventilators, which involves sticking a breathing tube down the throat.

Many patients instead receive a high-flow oxygen treatment, in which oxygen is sent through plastic tubes placed in the nose.

While a non-COVID patient may receive six liters of oxygen per minute, COVID-19 patients need 60 to 80 liters a minute. So now, hospitals need far more oxygen than they did before.

One of the biggest concerns facing hospitals is that more patients are on the way.

The COVID-19 patients in the hospital now reflect coronavirus cases diagnosed two weeks earlier a time at which L.A. County was averaging 11,000 new cases a day. That number has swelled since then up to nearly 14,800 new cases a day for the seven-day period that ended Dec. 22 before declining slightly to 14,000 cases a day as of Monday night.

That means hospitals are still expecting to see increasing demand into the new year because of infections that took place before Christmas. About 10% of people who test positive for the coronavirus in L.A. County end up needing hospital treatment.

Barbara Ferrer, L.A. Countys public health director, said all indicators tell us that our situation may only get worse as we begin 2021. The rate of community transmission remains extraordinarily high. As cases continue to remain at these alarmingly high levels, hundreds more people are likely to die.

She added: We all need to give our hospitals a fighting chance to handle the flood of COVID-19 patients that are arriving every single day.

The pace of the fall and winter surge has been staggering. On Nov. 1, L.A. County was averaging about 1,300 coronavirus cases a day on a weekly basis; L.A. County is now averaging 14,000 cases a day. The daily rate at which coronavirus test results are coming back positive is now 17% in L.A. County, more than quadruple the comparable figure Nov. 1, when the positivity rate was less than 4%.

L.A. County is now averaging about 90 COVID-19 deaths a day over the last week, one of the highest such numbers during the pandemic. The county death toll as of Monday night was 9,564, according to an independent Times count of local health jurisdictions; Ferrer said Monday that her agency is still sorting through a reporting backlog and it expects to add 432 deaths, pushing the death toll closer to 10,000.

County Supervisor Hilda Solis urged people against thinking that nothing could be done about the pandemic, and she asked people to stay home. A coronavirus test that shows up negative can easily become meaningless as a person can be infected and contagious by the time the results come back.

I understand the futility that so many people are feeling right now the idea that some people just want to throw their hands up. But we cant think like that, Solis said. Its squarely within our control to limit how many people are infected and how many people can die.

To be more blunt, each one of us has the power to cause or prevent death and illness among our family members, our co-workers and even strangers.

It isnt just older people who can suffer from COVID-19, Solis said; a child this month died of the coronavirus-linked multisystem inflammatory syndrome in children, known as MIS-C, in L.A. County. There have been at least 51 cases of MIS-C in the county all requiring hospitalization, with half treated in intensive care units. Latino children accounted for nearly three-quarters of those cases.

Ferrer said L.A. County has run 29 coronavirus samples for a genetic analysis, and none have been positive for the potentially more contagious variant of the coronavirus identified in Britain. Although theres a high probability the variant is here, she said, it doesnt appear to be dominant.

Whether the variant is here or isnt here, the steps we need to take are exactly the same, Ferrer said.

Times staff writers Sean Greene and Colleen Shalby contributed to this report.

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Oxygen supply shortages hurt hospitals overwhelmed by COVID-19 - Los Angeles Times

COVID-19 data: Why recent drop in cases likely isn’t a sign that the coronavirus is leaving Utah – KSL.com

December 29, 2020

SALT LAKE CITY It's refreshing to see Utah's COVID-19 epidemiological curve drop in the recent weeks after months of case increases; however, there are signs that recent case counts don't show a complete picture of COVID-19 in the state.

In a conventional sense, the spread of COVID-19 can be determined by simply looking at new cases discovered through testing. But what happens when testing for the coronavirus isn't exactly consistent?

That's where other statistics help piece together how COVID-19 is currently impacting the state.

The Utah Department of Health reported 972 new cases of COVID-19 from tests taken on Friday and 802 on Saturday. Those figures were the lowest single-day increases reported since early October. In fact, it snapped a stretch of 1,000 or more new daily cases announced by the health department that dated back to Oct. 12. The department reported another 1,700 cases from tests Sunday, which is also well below the seven-day rolling average ahead of Christmas.

The state's COVID-19 epidemiological curve and seven-day rolling average of new cases have also been in decline since around Dec. 10.

That said, testing is another figure that's fallen off in that same time. For example, more than 15,000 people were tested for COVID-19 on Dec. 9 the most tests conducted after Thanksgiving, according to health department data. Aside from a few outliers, the state has mostly reported days with fewer than 10,000 tests conducted since then. Testing was not conducted on Christmas Day and testing sites closed early on Christmas Eve, but the downward trend is visible on a graph before the holiday.

Meanwhile, the percentage of positive tests to tests conducted, commonly referred to as positivity rate, has only increased since about the time that cases declined. As of Monday, Utah's seven-day rolling average positivity rate is 24.4% through that backdate of Dec. 22. Preliminary data from over the weekend indicated positivity rates closer to 30%, which means the number will rise in the coming days.

Experts have said that positivity rate is an important statistic because it can provide a better assessment of how prevalent a virus is in a community when testing numbers widely fluctuate and become unreliable. In this case, the positivity rate is the largest sign that COVID-19 isn't quite leaving Utah, even if case counts are falling.

"We're certainly concerned because it represents high level of community transmission," said Dr. Todd Vento, an infectious disease physician for Intermountain Healthcare. "Hence, it's why we're constantly monitoring the situation to see if there's any additional measures that we need to take to address that."

Vento said health officials don't know exactly why testing is currently down; however, they have seen trends throughout the pandemic and from illnesses different from COVID-19. On a smaller scale, some days like Sunday and Monday yield fewer testing than other days. Those are believed to be tied to when someone is expected to be out in public for any reason, such as work.

"The same sort of concept after holidays," Vento said. "We've seen in the past where the numbers were down right away. The numbers yesterday were very low, which folks kind of for a lack of better word are waking from their slumber from the holidays and maybe on, say, Tuesday or Wednesday they'll start thinking 'OK, I'm going to go get tested.' That's not unusual for other respiratory illness as well."

Since testing was down, he said the epidemiological curve and seven-day running average of case counts will be "maybe not as accurately reflecting what's out there in the community" especially when it takes into account days where testing was limited.

That's where the positivity rate comes into play.

"You can't look at just the cases and the case seven-day rolling average because it won't accurately reflect a same number of tests that were done," he added.

As for Utah's positivity rate, it's been a roller coaster over the past few weeks. After climbing to 25.4% on Nov. 10, it fell 21.8% on Nov. 22 a few days before Thanksgiving. It rose again to a current all-time high of 27.2% on Dec. 1 before it fell back down to 22.3% on Dec. 13. It's steadily climbed since then but at a much slower rate.

Of course, the biggest concern with COVID-19 is any impact it has on hospitals and deaths. Vento said that Utah hospitalizations due to the coronavirus have stabilized and even fallen a little bit. That's a welcome sign for a statewide hospital system that was on the brink of full capacity.

Hospitalizations due to COVID-19 typically lag behind new cases, so the state's current peak of 606 hospitalizations on Dec. 4 was primarily the result of climbing COVID-19 cases prior to Thanksgiving. Public health experts warned about holiday gatherings with the fear that hospitalizations would only grow.

It appears Utahns heeded the pandemic recommendations for at least Thanksgiving. While many new cases were still reported, it wasn't nearly as many as feared. As a result, the state health department reported just before Christmas fewer than 500 hospitalizations due to COVID-19 for the first time since mid-November.

"While the nation had a surge within a surge (there was) a fall surge and then a post-Thanksgiving surge for the United States we didn't see quite that level of increasing cases after Thanksgiving as we were figuring or concerned about, which is very good," he said.

He added that hospitals have also learned to shorten stays for patients who don't require ICU care by providing at-home recovery models so people are able to leave the hospital sooner.

Data might show that COVID-19 hasn't left the state even as new cases decline, but one positive sign is that new hospitalizations due to the coronavirus are on the decline.

The state health department recently began to report the seven-day rolling average of new hospitalizations per day on top of current hospitalization figures. Utah reached a seven-day average of 92.4 hospitalizations per day on Nov. 18. That was the day a record 116 new Utahns were admitted to a hospital due to COVID-19.

The average fell to 71.2 new hospitalizations per day as of Dec. 22, which is the first day beyond the department's period of incomplete new hospitalization data. These figures are still high, especially compared to numbers before November. Nevertheless, it shows that following guidelines for Thanksgiving gatherings helped not just lower the growth of new cases but also helped lessen the impact on hospitals.

The jury is still out on whether December holiday gatherings will have factored in any way as the holiday season doesn't really conclude until after New Year's Day, Friday.

All the health recommendations for Thanksgiving, Hanukkah, Christmas and Kwanzaa apply to New Year's. That means health officials advise that people celebrate the holiday at home and connect with other households virtually.

Intermountain Healthcare even promoted a do-it-yourself New Year's Eve ball drop out of a styrofoam ball and a wood dowel as one way to celebrate the holiday at home in a fun and safe way.

Looking for a fun way to celebrate New Year's Eve safely? Try creating your own ball dropping experience at home!#DIY #IMTNCovid19

Vento's colleague, Dr. Eddie Stenehjem, another infectious disease physician for Intermountain Healthcare, said last week he anticipated COVID-19 testing will increase after New Year's Day. One of the main reasons for that, he said, is that Utah colleges will begin their mass weekly testing of students who remain on campus for the spring semester.

Once that begins, the positivity rate will be another key factor as testing numbers may exceed previous testing norms.

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COVID-19 data: Why recent drop in cases likely isn't a sign that the coronavirus is leaving Utah - KSL.com

COVID-19 risk in 5 Oregon counties reduced from extreme to high – KGW.com

December 29, 2020

Each county's COVID-19 risk level dictates what restrictions will be in place beginning Jan. 1, 2021.

PORTLAND, Ore. Oregon Gov. Kate Brown on Tuesday announced updates to each county's COVID-19 risk level, which dictates what restrictions will be in place at the start of the new year.

Starting Friday, Jan. 1, there will be 24 counties in the Extreme Risk level, five counties in the High Risk level, zero at Moderate Risk and seven at Lower Risk.

Five counties (Clatsop, Coos, Douglas, Lincoln, Morrow) have been moved from the Extreme Risk category to the High Risk category. Lake County was also moved from Moderate Risk to Lower Risk.

"After weeks of diligent work by local leaders and public health officials to implement health and safety measures in their communities, this week's county data is a welcome sign that we are making progress in stopping the spread of COVID-19 in Oregon," Brown said.

Here's the full list of county risk levels.

Extreme Risk (24 counties)

Moderate Risk (0 counties)

Counties will remain at these risk levels from Jan. 1 to Jan. 14. The Oregon Health Authority will reassign county risk levels every two weeks based on the most recent coronavirus data available.

Here's a look at which metrics determine the risk level for each county:

In counties with extreme risk, the following activities will be allowed, with health and safety protocols in place:

High Risk is the first level in which some businesses and facilities can resume offering indoor services with health and safety measures and capacity limits in place. Here's a look at what activities will be offered under each risk category:

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COVID-19 risk in 5 Oregon counties reduced from extreme to high - KGW.com

Department of Health Dec. 13-19 Update On COVID-19 Investigations, Contact Tracing, Monitoring Efforts: Pennsylvanians Urged To Answer the Call And…

December 29, 2020

Harrisburg, PA The Department of Health today shared its weekly update on Pennsylvanias COVID-19 case investigation and contact tracing data and encouraged Pennsylvanians to download theCOVID Alert PA app, as more than 720,000 have already done, to aid in contact tracing efforts. All 67 counties have substantial COVID-19 transmission rates.

Last week we launched the Connect & Protect Form to reach many more Pennsylvanians for a digital case investigation, but that still requires residents to answer the call. We continue to ask all Pennsylvanians to answer the call answer the call when a public health professional is calling and answer the call to do your part to control the spread of COVID-19 by wearing a mask, social distancing, avoiding gatherings, downloading the COVID Alert PA, Secretary of Health Dr. Rachel Levine said. Together, by using these tools, we can stand united in the fight against COVID-19.

Contact tracing is the process of identifying, notifying, and monitoring anyone who came in close contact with an individual who has COVID-19 while that individual was infectious. Thecontact tracing processis not possible without a case investigation by a public health professional.

Across the commonwealth, there are 266 case investigators who reach out to incoming cases who are younger than 19 and older than 64 to find out where they went and who they came in contact with in order to prevent outbreaks while infectious. This case investigation typically takes between 30 and 60 minutes to complete. For those who are between 19 and 64 years old and reside in an area without their own county of municipal health department, they will be contacted by a contact tracer to complete a Connect & Protect Form as a digital case investigation.

Between Sunday, December 13 and Saturday, December 19, there were 63,870 COVID-19 cases statewide and 15 percent, or 9,581 cases, had a case investigation started within 24 hours of receiving the positive report. Public health professionals will continue calling to complete the case investigation after the 24-hour period. An additional three percent, or 1,916 cases, had a case investigation started within 48 hours.

Although public health professionals may call to start the case investigation, not all cases to obtain additional information are successful. The Department of Health leaves voicemails, texts, and sends a letter to the home requesting a return call. There were 8,303 people, or 13 percent of cases, in this reported week that were successfully contacted by a public health professional statewide.

After the initial case investigation is complete, contact tracing begins. Within the same time period of December 13 to December 19, there were 1,682contact tracing staff working with local and county health entities, partner organizations and the Regional Response Health Collaboration Program within the Department of Human Services as well as volunteers from Co-County Wellness in Berks County and Penn Medicine Lancaster General Health. These staff monitored 8,747 contacts who were identified during the case investigations.

Currently, all of the allotted 1,090 people have been hired through Insight Global. Some of these staff have been promoted to perform case investigations to meet the immediate needs of increased caseloads. There are 50 case investigators, 40 supervisors, and 10 resource coordinators who will help to refer Pennsylvanians to services during quarantine across the commonwealth.

Since the implementation of the Contact Tracing Management System in early October through December 19 in those areas of the state where Pennsylvania Department of Health is responsible for contact tracing, there have been:

On September 22, the department launchedCOVID Alert PA, a free mobile app that uses Bluetooth technology to let a person know that they have been exposed to COVID-19 without compromising the identity or location of either the person using the app, or of the person to whom they may have been exposed.

The Department of Health has made updates the COVID Alert PA app to include 13- through 17-year-old residents with parental consent to download the app and four new languages. This app is interoperable with16 other states that also utilize the same notification exposure app technology.

In addition to the traditional case investigations and contact tracing process, there have been 584 cases that confirmed their positivity and uploaded their random IDs through the app. These uploads generated 283 exposure alerts to persons who have downloaded the app on their phones and who were in close contact (six feet for 15 minutes or more) to the case. Of those who received the alerts, 44 individuals requested a call back for further assistance from a trained contact tracer.

As the contact tracing program expands, the Department of Health continues to work in partnership with over 150 organizations, in addition to the county and municipal health departments, through regional partnerships to help gather and answer questions, identify problems and find solutions to improve contact tracing efforts within the region.

Each regional partnership has met at least once, and includes public health staff, health providers, academic institutions, community organizations, and other stakeholders interested in helping to coordinate and engage around contact tracing efforts.

Organizations and entities interested in partnering in these efforts should reach out toRA-DHCONTACTTRACING@pa.gov.

You can find more information on the states contact tracing efforts at the Department of Healths websitehere.

The Wolf Administration stresses the role Pennsylvanians play in helping to reduce the spread of COVID-19:

Updated Coronavirus Links: Press Releases, State Lab Photos, Graphics

MEDIA CONTACT: April Hutcheson, 717-787-1783 or ra-dhpressoffice@pa.gov

# # #

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Department of Health Dec. 13-19 Update On COVID-19 Investigations, Contact Tracing, Monitoring Efforts: Pennsylvanians Urged To Answer the Call And...

Post holiday COVID-19 testing at the Eastfield Mall – WWLP.com

December 29, 2020

SPRINGFIELD, Mass. (WWLP) Some people were looking to get tested Monday for COVID-19 after they visited families for the holidays.

22News crews went to the Eastfield Mall in Springfield to see who was getting tested after the holidays. There was a large line of cars with people waiting to get tested.

Massachusetts health officials have been urging people to avoid holiday celebrations with others from outside of their household, In efforts to not overwhelm hospitals and stop the spread of CVOID-19. One person said he quarantined for the holidays this year, but still wanted to get tested.

Yes get tested more often, just for your safety and the safety of those around you, you know? I do this about every three or two weeks just for my safety and my daughters safety as well.

The AMR testing site at the Eastfield Mall will be closed again for December 30th , New Years Eve, and New Years Day.

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Post holiday COVID-19 testing at the Eastfield Mall - WWLP.com

Pennsylvania COVID-19 Early Warning Monitoring Dashboard Update for Dec. 18 Dec. 25: Case Increases Near 46,800; Percent Positivity at 15.1% and All…

December 29, 2020

Governor Tom Wolf and Secretary of Health Dr. Rachel Levine today released a weekly status update detailing the states mitigation efforts based on the COVID-19 Early Warning Monitoring System Dashboard, highlighting a seven-day case increase of 46,777, a statewide percent positivity of 15.1% and all 67 counties with substantial transmission status.

The update includes the following:

The dashboard is designed to provide early warning signs of factors that affect the states mitigation efforts. The data available on the early warning monitoring dashboard includes week-over-week case differences, incidence rates, test percent-positivity, and rates of hospitalizations, ventilations and emergency room visits tied to COVID-19. This weeks update compares the period of December 18 December 25 to the previous seven days, December 11 December 18.

This is the second consecutive week that we see a decrease in percent positivity, providing us with data that our efforts to reduce and mitigate the spread are working, Gov. Wolf said. Although this is encouraging, we need to stay the course in our fight against COVID-19. We need Pennsylvanians to continue efforts to stay safe, stay home as much as possible, wear a mask when out of our homes, and avoid gatherings with those outside our households.

As of Thursday, December 24, the state has seen a seven-day case increase of 46,777 cases; the previous seven-day increase was 57,098 cases, indicating 10,321 fewer new cases across the state over the past week compared to the previous week.

The statewide percent-positivity went down to 15.1% from 15.82% last week. Every county in the state has a concerning percent positivity above five percent. This includes 19 counties with percent positivity at or above 20 percent.

The decisions we make over the holiday season will continue to impact the effect of COVID-19 across the state, Secretary of Health Dr. Rachel Levine said. We need to continue our efforts to practice social distancing, avoid gatherings, download the COVID Alert PA app, and answer the call when a public health professional is calling you. By using all the tools in our toolbox, we can unite to stop the spread of COVID-19 across the state and further protect our health care system.

As of Fridays data, all 67 counties were in the substantial level of community transmission, the highest level of transmission.

For the week ending December 24, 67 counties were in the substantial level of transmission.

The Department of Health is providing weekly data on the number of statewide cases of COVID-19 among 5 to 18-year-olds.

Throughout the pandemic, there have been 48,988 total cases of COVID-19 among 5 to 18-year-olds. Of that total, 4,698 cases occurred between December 18 December 25. For the week of December 11 December 17, there were 5,750 cases of COVID-19 among 5 to 18-year-olds.

Cases by demographic group is available on the DOH website.

The Department of Health is providing weekly data on the number of individuals who responded to case investigators that they spent time at business establishments (restaurants, bars, gym/fitness centers, salon/barbershops) and at mass gatherings 14 days prior to the onset of COVID-19 symptoms.

It is important to note that due to the recent number of cases, the department is prioritizing case investigations to prevent outbreak. In addition to the need for people to answer the call, the significant number of cases helps contribute to the low percentages in case investigation data. All of this reinforces the need for Pennsylvanians to take steps to prevent the spread of COVID-19.

Of the 63,870 confirmed cases reported between December 13 and December 19, 4.6 percent (2,952) provided an answer to the question as to whether they spent time at a business establishment.

Of those who did provide an answer, 0.4 percent, or 274, answered yes, they visited a business establishment 14 days prior to onset of symptoms:

Of the 63,870 confirmed cases, 4.6 percent (2,961) answered the question as to whether they attended a mass gathering or other large event. Of the 4.6 percent of cases, 7 percent (194) answered yes to whether they attended a mass gathering or other large event 14 days prior to onset of symptoms.

Compared to data reported on December 21, this weeks data saw an increase for people who reported going to a restaurant (41 percent vs. 37 percent last week) and going to a gym (12 percent vs. 10 percent last week). The data saw an decrease for people who reported going to a some other business (34 percent vs. 38 percent last week), going to a bar (13 percent vs. 14 percent last week) and going to a salon/barbershop (7 percent vs. 8 percent last week). The number of those who attended a mass gathering or other large event decreased to 7 percent from 8 percent last week.

The numbers above highlight business settings and mass gatherings as possible sites for transmission. With less than half of those asked about what types of businesses they visited or if they attended a mass gathering responding to the question, the department is reminding Pennsylvanians that it is essential that people answer the phone when case investigators call and to provide full and complete information to these clinical professionals.

In November, the Department of Health provided an updated travel order requiring anyone over the age of 11 who visits from another state to provide evidence of a negative COVID-19 test or place themselves in a travel quarantine for 14 days upon entering Pennsylvania. Travel quarantine guidance was changed to 10 days on Dec. 5 based on new CDC guidance.

This order does not apply to people who commute to and from another state for work or medical treatment, those who left the state for less than 24 hours, and those complying with a court order, including child custody.

It is important that people understand that this Order is in place to prevent the spread of COVID-19 in Pennsylvania. A concerning number of recent cases have been linked to travel, and if people are going to travel, we need them to take steps to protect themselves, their loved ones and their community, and that involves having either a negative test, or placing themselves in a quarantine.

Gov. Wolf continues to prioritize the health and safety of all Pennsylvanians through the COVID-19 pandemic. Pennsylvanians should continue to take actions to prevent the spread of COVID-19, regardless of in what county they live. This includes wearing a mask or face covering anytime they are in public. COVID-19 has been shown to spread easily in the air and contagious carriers can be asymptomatic. Pennsylvanians are encouraged to wash their hands, social distance, avoid gatherings and download COVID Alert PA.

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Pennsylvania COVID-19 Early Warning Monitoring Dashboard Update for Dec. 18 Dec. 25: Case Increases Near 46,800; Percent Positivity at 15.1% and All...

December is the deadliest month in the US since the coronavirus pandemic began — and projections for January are ‘nightmarish,’ expert says – CNN

December 28, 2020

In comparison, the entire month of November saw about 36,964 deaths.

The death toll comes on the heels of several brutal months, with Covid-19 ravaging communities from coast to coast, crippling hospital systems and prompting new widespread restrictions.

"We very well might see a post-seasonal -- in the sense of Christmas, New Years -- surge," Dr. Anthony Fauci said on CNN's "State of the Union" Sunday morning, pointing to holiday travel and private gatherings taking place despite the advice of health experts.

The nation's top infectious disease expert described the potential rise in cases as a "surge upon a surge," telling CNN's Dana Bash, "If you look at the slope, the incline of cases that we've experienced as we've gone into the late fall and soon to be early winter, it is really quite troubling."

This is the 26th consecutive day that the US has remained above 100,000 current hospitalizations.

All of the five highest days for hospitalizations have been in the last week.

Another surge of cases and hospitalizations will, inevitably, mean more deaths -- on top of an already devastating death toll.

"When you're dealing with a baseline of 200,000 new cases a day and about 2,000 deaths per day, with the hospitalizations over 120,000, we are really at a very critical point," Fauci said.

"As we get into the next few weeks," he added, "it might actually get worse."

Fauci's comments Sunday came as the US surpassed 19.1 million coronavirus cases, yet another milestone for the pandemic, coming just over 11 months after the first case was recorded in the US in late January.

As of 8 p.m. ET Sunday, Johns Hopkins University has reported 125,041 new cases and 1,160 reported deaths.

"The projections are just nightmarish," said Dr. Peter Hotez, an infectious disease specialist at the Baylor College of Medicine. "People can still save the lives of their loved ones by practicing that social distancing and masks. And remember, vaccines are around the corner."

Vaccine rollout slow in some places, expert says

Nearly 2 million Covid-19 vaccine doses have been administered in the US, according to the Centers for Disease Control and Prevention, and more than 9.5 million doses have been distributed.

Asked about the apparent slow rollout of vaccines, Fauci told CNN Sunday that large, comprehensive vaccine programs with a new vaccine start slow before gaining momentum.

"I'm pretty confident that as we gain more and more momentum, as we transition from December to January and then February to March, I believe we will catch up with the projection," he said.

Dr. Esther Choo, a professor of emergency medicine at Oregon Health & Science University, explained that vaccine distribution is "just a very complicated thing."

"At every step, there's complexity and there's possibility for delay, whether it's individual state planning, allocation, training, supply of vaccine, storage... there (are) just so many factors at this stage," Choo said.

"We need to be prepared for the fact that it is going to be a slow rollout in many places and that it will not change our behaviors or necessarily the trajectory of the pandemic in this country in the short term," Choo said.

A number of experts have warned Americans not to let their guard down as vaccinations begin and to continue wearing masks, social distancing, avoiding crowds and gatherings, and regularly washing their hands.

It likely won't be until summer that vaccines are widely available and begin to make a meaningful impact on the pandemic's course, officials have said. Fauci estimates about 70% to 85% of the population needs to get vaccinated against Covid-19 for the country to achieve herd immunity.

Expert: Testing requirements won't help control Covid-19 variant spread

Passengers must have had a negative PCR or antigen test within 72 hours of boarding a flight from the UK to the US, along with documentation of their laboratory results. Airlines will be required to confirm the test prior to the flight.

The third case of the variant first identified in the UK has been detected in Ottawa, Canada, a press release from the Ontario government said Sunday.

The case is a person who recently traveled from the UK, according to the release. That individual is now in self-isolation.

The two previous cases that were reported on Saturday have since been found to have had contact with a recent traveler from the UK, the release said.

One expert says the new testing requirements for travelers into the US have not been implemented quickly enough to be effective against a reported variant.

"It makes sense that for any place that's experiencing a regional spike in cases that we put new measures in place," emergency medicine physician Dr. Richina Bicette told CNN. "But if they're trying to make sure that the virus isn't imported to the United States, these measures are going to have no effect on that whatsoever."

CNN's Virginia Langmaid, Pete Muntean and Hollie Silverman contributed to this report.

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December is the deadliest month in the US since the coronavirus pandemic began -- and projections for January are 'nightmarish,' expert says - CNN

Two studies find that COVID-19 antibodies last 8 months – CIDRAP

December 28, 2020

Two studies published yesterday demonstrate that COVID-19 immune responses last as long as 8 months, although the authors focus on different reasons.

The first study, published in Science Immunology, followed a small cohort of Australians from day 4 to day 242 after infection. All patients demonstrated the presence of memory B cellsimmune cells that "remember" viral proteins and can trigger rapid production of antibodies when re-exposed to the virusas long as 8 months after initial infection.

The second study investigated antibody responses in 58 confirmed COVID-19 patients in South Korea 8 months after asymptomatic or mild SARS-CoV-2 infection, finding high rates of serum antibodies. These results, published in Emerging Infectious Diseases, are contradictory to both the first study's antibody data and previous research that showed antibodies waning after 20 days, but the authors suggest that variations in immunoassay test characteristics and manufacturing may be responsible for the difference.

For the Australian study, researchers obtained blood samples from 25 confirmed COVID-19 patients with a range of disease severities and 36 healthy control patients from March to September, evaluating each patient's antibody status and levels of virus-specific immune cells.

The study authors found that by day 6 post-infection, all patients showed immunoglobulin (Ig) G antibodies for the viral receptor-binding domaina protein on the viral surface that binds to cell receptors, allowing entry and infectionand the nucleocapsid protein, the protective protein shell of the virus. Patient IgG levels began declining 20 days after symptom onset.

In contrast, the study authors found that memory B cell levels continued to rise up to 150 days post-infection and remained detectable 240 days post-symptom onset, suggesting that patient immune systems were primed to respond to reinfection. Because of their extended presence, the cells may be a better indicator of long-term immune response than serum antibodies, the authors say.

The study results provide hope that vaccines will generate a similar duration of protection, and the authors say cellular immunity may explain why there are few documented cases of reinfection with SARS-CoV-2.

"These results are important because they show, definitively, that patients infected with the COVID-19 virus do in fact retain immunity against the virus and the disease," said senior author Menno van Zelm, PhD, in a Monash University news release yesterday.

"This has been a black cloud hanging over the potential protection that could be provided by any COVID-19 vaccine and gives real hope that, once a vaccine or vaccines are developed, they will provide long-term protection."

In the second study, the researchers measured SARS-CoV-2specific antibodies using four commercial immunoassay tests in isolated patients at a Seoul National University Hospital community treatment center from Mar 5 to Apr 9. Three of the four assays showed high seropositivity rates (69% to 91.4%; P < 0.01), in contrast to yet another earlier study showing that asymptomatic patients become seronegative by 2 to 3 months post-infection.

"Rates differed according to immunoassay methods or manufacturers, thereby explaining differences in rates between the studies," the authors wrote. For instance, they said, a July BMJ study reported chemiluminescent immunoassay tests had 97.8% IgG or IgM sensitivity, whereas enzyme-linked immunosorbent assay tests only had 84.3%.

Virus neutralizing activityessential for protection from reinfectionwas detected in only 53.4% of study participants at 8 months post-infection, considerably lower than the rate of positivity for immunoassays.

"Despite concerns of waning immunity, appropriate immunoassays can detect antibodies against SARS-CoV-2 at 8 months after infection in most asymptomatic or mildly symptomatic persons," the authors concluded.

Read more:

Two studies find that COVID-19 antibodies last 8 months - CIDRAP

The Treasured Diners and Hidden Haunts That Covid-19 Closed for Good – The New York Times

December 28, 2020

We gather today to mourn the 150-year-old restaurant that served up platters of fried chicken and creamed corn to Abilene, Kan. To bid farewell to the New Orleans cafe that was a destination for huge crab omelets and endless conversation. To raise one last glass to the tavern in Cambridge, Mass., where the regulars arrived at 8 a.m. and the Austin diner where Janis Joplin nearly sang the neon lights off the walls.

They were local landmarks watering holes, shops and haunts that weathered recessions and gentrification, world wars and the Great Depression, only to succumb this year to the economic ravages of the coronavirus. This is their obituary.

Thousands of businesses have closed during the pandemic, but the demise of so many beloved hangouts cuts especially deep. They were woven into the identity of big cities and small towns, their walls lined with celebrity photos and Best Of awards. Some had been around a century. Others, like the Maam Sir Filipino restaurant in Los Angeles, needed just a few years to win the hearts of their neighborhoods.

Their closures have left blank spaces across the country as owners liquidate their memorabilia and wistful customers leave social-media tributes recalling first dates and marriage proposals. And there are new worries: If these institutions could not survive, what can? And who will be left standing, to hold our memories and knit our communities together, when this pandemic is over?

If you ever went to the Cantab Lounge at 8 in the morning, you would meet regulars named Hoopy or Ralphie Moneybags or Growling John or Illinois, guys who showed up every morning, as if they had a time clock to punch.

This was before Cambridge, Mass., became a tech boomtown, home to a 300,000-square-foot Google satellite office complete with decorative canoes and a miniature indoor putting green.

Back then this stretch of Massachusetts Avenue was genuinely grungy. The Cantab took only cash. The bar was always sticky, and you wouldnt want to use the bathroom. In a 1996 Senate debate, the Republican candidate, Bill Weld, held up the establishment as an argument against public assistance, saying, They get the check, go down to the Cantab in the morning, and drink it away. (The competition groused that his comment had been good for the Cantabs business.)

But if you wandered in there on the right night, you could find a poetry slam or bluegrass night or Little Joe Cook and the Thrillers. Ben Afflecks father used to work there, serving Budweisers to off-duty postal workers. Even the barflies were somehow uniquely Cambridge; Hoopy, for example, carried crossword puzzles in his inside pocket, and gave his profession as solipsist.

In July, when the Cantabs owner, Richard Fitzgerald, announced he was putting it up for sale after 50 years, a howl of distress went up from that old, scruffy bohemian Cambridge. Mr. Fitzgerald, known as Fitzy, is hoping to find a new buyer to reopen the place in the summer lets hope in its old, sticky style.

Ellen Barry

New Orleans

The bars and nightclubs that have shut down across New Orleans this year account for an infinity of lost time: gabbing over beers and the remains of a banh mi at the Lost Love Lounge, lingering after the friend of a friends band played at the Saturn Bar, giving up a further pub crawl for the siren song of the Circle Bar.

Still, as one ages, the places that were once just for mornings after become the hangouts themselves. Such was the case with Cake Cafe and Bakery, which sat on a bright yellow corner in the Marigny neighborhood.

On Saturday and Sunday mornings the line ran out the door, people waiting for French toast, biscuits and gravy and crab omelets the size of phone books; you could add a cupcake for a dollar.

The staff knew most of the customers on sight, except during carnival season when the tourists flocked. By that time those in the know had already ordered a king cake, in competition with the best in the city. It closed in June.

My young children will never know the pleasure of a long night of aimless conversation at the Lost Love Lounge. But they did know long mornings at Cake Cafe, which may be the first hangout they loved and lost.

Campbell Robertson

There was an adage everyone knew in Spokane, Wash.: If you cant find it anywhere else, the White Elephant will have it.

As superstores and Amazon devoured the landscape of American retail, the White Elephant hung on, a stubbornly independent small-box store. Founded in 1946, the prices were still marked in black Sharpie, and shoppers paid a dime to ride the mechanical elephant out front. It was a go-to retail destination for toys, camping tents and fishing lures. People lined up for Cabbage Patch dolls and Teddy Ruxpin bears. Children zoomed Matchbox cars around the aisles.

No more. The White Elephant, a place woven into many childhoods across eastern Washington State, was a casualty of 2020.

When the Covid hit, that just made it a definite thing we thought we ought to just go ahead and call it, said Mary Conley, whose husband, John R. Conley Sr., started the business as a war-surplus store. He died in 2017.

In June, shoppers strapped on face masks and lined up for one final day of bargain-hunting as the Conleys liquidated their inventory and got ready to sell their two storefronts.

Jack Healy

The warnings about the fries were as legendary as the fries themselves.

The large is huge!

Order it with friends.

Seriously, you cant eat it by yourself.

The Original Hot Dog Shop had hot dog right there in the name, but it was the fries perfectly cut, fried twice in peanut oil to extra crispness, served in a massive pile in a paper basket, with side cups of beef gravy or cheese product that everyone talked about.

No one actually called it by its full name. Maybe the Original. But it was usually just the O. Or especially among my high school friends and the University of Pittsburgh students in the citys Oakland neighborhood the Dirty O.

Dec. 28, 2020, 1:38 a.m. ET

The place was a favorite of Michael Chabon, a Pitt grad whose first two novels are set in the city. In his memories, he told me, its 2 a.m. and Ive been hanging out with friends and drinking, and were all stumbling through Oakland, which is completely dark, and nothing is open except this one shining beacon of the O.

Decades later, he can still hear the chirping video games and picture the late-night security guard glowering at a diverse cross-section of Pittsburgh. In my memory its always freezing cold outside and really hot inside, and this sort of miasma of grease from the frying baskets is just hanging over everything.

The Pitt student newspaper reported that when the O closed in April, the owners served up one more giant order of fries, donating 35,000 pounds of potatoes to charity.

Scott Dodd

Los Angeles

When Charles Olalia decided to open a Filipino restaurant in Los Angeless hip Silver Lake district, he wished to showcase my countrys food and vibe: beautiful, boisterous, loving to a wide audience, he said.

It was the full dining experience of what Filipino culture is, said Mr. Olalia, 37, who immigrated to the United States when he was 20.

Maam Sir opened in 2018 to rave reviews for its creative renditions of signature Filipino dishes, like sizzling pork sisig and oxtail kare-kare.

Its tropical dcor and festive atmosphere drew crowds of Filipino-Americans like Cheryl Balolong, 41, who grew up visiting traditional Filipino cafeteria-style joints in strip malls, picking dishes from display cases, eating and leaving.

Maam Sir was different, she said. It was a place where we felt proud to bring friends who werent from our culture. When Ms. Balolong got married, her bachelorette party was held at Maam Sir.

Then the pandemic struck. By August, Mr. Olalia shut the place down. Day after day putting food in a box and seeing an empty dining room, I was getting farther and farther away from what the restaurant really was and why I built it, he recalled.

Miriam Jordan

Austin, Texas

For generations of University of Texas students, a stick-to-your ribs meal at Threadgills was about as close to moms kitchen as one could get. And with live music most nights, every dining experience also felt like a party.

The place had been a fixture in Austin since Franklin Roosevelt was in the White House. Its original owner, Kenneth Threadgill, a former bootlegger and well-known yodeler, was the first post-Prohibition licensed seller of beer in the county.

Threadgills began hosting live music in the 1940s, with local hillbilly blues artists paid in rounds of beer. U.T. students flocked there, including a rebellious undergrad named Janis Joplin, who made regular open-mic appearances.

By the time Eddie Wilson bought Threadgills in 1977, it had been closed for a few years and fallen into disrepair. It reopened in 1981, and became home to the Waller Creek Boys, Jimmy Dale Gilmore and other Austin musical legends.

Threadgills was the spot where you wooed a first date with chicken-fried steak and pecan pie. It was where you celebrated Longhorn victories and mourned losses.

Sandra Wilson said she and her husband were heartbroken over the closure in April, which left 50 employees without jobs. But after years of rising rents, Covid-19 made it nearly impossible to go on.

Jamie Stockwell

Pikeville, Ky.

In rural America, far from airports and skyscrapers and rush hours, certain types of restaurants are hard to come by, which makes them all the more delightful when you discover them.

The Blue Raven, in Pikeville, Ky., was one of those. It would have been a great restaurant anywhere, but in Pikeville, people knew they were especially lucky to have it.

The Blue Raven was effortlessly classy. It was the kind of place you could take a third date without seeming like you were trying too hard. And it somehow managed to combine eastern Kentuckys small-town charm with a modern, fusion menu that rotated with the whims of its workers.

One of its last dishes before it closed in May: miso chicken pot pie with hot sauce whipped cream.

Will Wright

Coral Gables, Fla.

Ortanique on the Mile was where locals took their out-of-town relatives to try someplace that tasted like Miami. The walls were bright. The mojitos were among the best in town. The food was the cuisine of the sun, Cindy Hutson, the chef and co-owner, liked to say.

West Indian-style bouillabaisse. Mussels steamed in a spicy broth of Red Stripe beer. A beef tenderloin that Delius Shirley, Ms. Hutsons partner and co-owner, recommended to customers like this: If you dont like this steak, Ill buy it for you. (They liked it.)

Their first restaurant, Normas on the Beach named after Mr. Shirleys mother, Norma Shirley, the Julia Child of Jamaica was on Miami Beachs touristy Lincoln Road. They moved the restaurant to Coral Gables 21 years ago and renamed it.

We did parties for a kids First Communion and then when they graduated high school, Ms. Hutson said. Then we did a party for that same kid when they graduated college. And then we did a party when they got engaged.

All that came to an end this year. I cried and cried at first, Ms. Hutson said. But it turned into a happy cry from the outpouring of response from the neighborhood.

Patricia Mazzei

Abilene, Kan.

The Brookville Hotel looked like a relic from Kansas dusty frontier days the white clapboard facade with black lettering, blue-and-white china, charming old patterned wallpaper and curved bistro chairs in the dining room. The food hardly changed in decades, either: fried chicken, sweet-and-sour coleslaw, creamed corn, biscuits and bowls of vanilla ice cream, family-style platters that materialized on the table in generous portions, as if by magic.

But the pandemic was too much for the hotel, which was really a restaurant and a 150-year-old institution along the interstate in the tiny city of Abilene, Kan. Drop-in customers had dwindled, along with buses packed with tourists headed to the Dwight D. Eisenhower Presidential Library and Museum nearby. By early October, the Martin family, proprietors since the 1890s, called it quits.

It is with a very heavy heart that we must announce that the Covid, and the lack of traffic, has forced us to close, the owners wrote on Facebook.

Julie Bosman

The Kansas City, Mo., culinary scene is most often associated with barbecue, but another place caught my eye that was more fine dining than smoked meats.

The Rieger, housed in an early 20th-century hotel of the same name, produced delightful plates of Midwestern favorites with a chefs flair.

There was chicken with barbecue sauce, but the chicken was done in the French ballotine style. The pork tenderloin sandwich was fried in a light batter and brightened with red onions pickled with habaneros. There was an ode to French onion soup that was packed with pork confit and topped with crispy pork skin.

The basement housed a speakeasy, Manifesto, that took reservations through text messages and served craft cocktails.

The Rieger opened in 2010 and quickly became a local staple. But the pandemic would prove too much, and the restaurant announced its closure on Oct. 16 in an Instagram post.

Before that happened, Howard Hanna, who was the chef and owner, turned the Rieger into a community kitchen that served more than 85,000 free meals.

John Eligon

More:

The Treasured Diners and Hidden Haunts That Covid-19 Closed for Good - The New York Times

New strain of COVID-19 in Canda, first found in the UK – ABC27

December 28, 2020

BEIJING (AP) Police in Shanghai say they have detained a suspect in the case of the death by possible poisoning of the billionaire founder of a Chinese video game company that makes films based on the popular science fiction novel The Three-Body Problem.

Lin Qi, 39, died on Christmas Day after being hospitalized, according to his company, Yoozoo Games Co., also known as Youzu Interactive.

See the original post:

New strain of COVID-19 in Canda, first found in the UK - ABC27

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