Category: Covid-19

WASHINGTON President-elect Bidens transition team unveiled the members of his Covid-19 task force on Monday, a whos-who of former government health officials, academics, and major figures in medicine.

The list includes Rick Bright, the former head of the vaccine-development agency BARDA ousted by the Trump administration in April; Atul Gawande, the surgeon, writer, and recently departed CEO of Haven, the joint JP Morgan Chase-Berkshire Hathaway-Amazon health care venture; and Luciana Borio, a former Food and Drug Administration official and biodefense specialist.

Biden has cast the escalating Covid-19 crisis as a priority for his incoming administration. The task force, he said, would quickly consult with state and local health officials on how to best prevent coronavirus spread, reopen schools and businesses, and address the racial disparities that have left communities of color harder hit than others by the pandemic.

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Dealing with the coronavirus pandemic is one of the most important battles our administration will face, and I will be informed by science and by experts, Biden said in a statement Monday. The advisory board will help shape my approach to managing the surge in reported infections; ensuring vaccines are safe, effective, and distributed efficiently, equitably, and free; and protecting at-risk populations.

As expected, the boards three co-chairs are Marcella Nunez-Smith, a Yale physician and researcher; Vivek Murthy, a former U.S. surgeon general; and David Kessler, a former FDA commissioner.

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Other appointees include well-known public health officials such as Julie Morita, a former Chicago health commissioner, and Eric Goosby, the founding director of the federal governments Ryan White HIV/AIDS program.

The task force also includes a variety of other well-known doctors and academics, among them Zeke Emanuel, a former Obama administration health care adviser, and Celine Gounder, a physician and medical journalist with years of experience combating HIV and tuberculosis outbreaks.

Separately, the Biden transition announced that it had appointed two health advisers who will guide the incoming administrations Covid-19 preparations but will not serve on the task force. One of those advisers, Beth Cameron, is the former director of a White House biodefense council that Trump has been criticized for closing in 2017. The other, Rebecca Katz, is a well-known Georgetown global health security professor.

Despite the task forces breadth, it does not include several figures still seen as likely to play major roles in the Biden administrations Covid-19 effort, including Joshua Sharfstein, the former deputy FDA commissioner, and Nicole Lurie, the Obama administrations assistant health secretary for preparedness and response.

Below is the full list of task force members:

David Kessler, co-chair, former FDA commissioner

Marcella Nunez-Smith, co-chair, Yale associate dean for health equity research

Vivek Murthy, co-chair, former surgeon general

Luciana Borio, former assistant FDA commissioner

Rick Bright, former BARDA director

Zeke Emanuel, former Obama administration health policy adviser

Atul Gawande, Brigham and Womens hospital professor of surgery

Celine Gounder, NYU Grossman School of Medicine assistant professor

Dr. Julie Morita, former Chicago public health commissioner

Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota

Loyce Pace, executive director of the Global Health Council

Dr. Robert Rodriguez, UCSF emergency medicine professor

Eric Goosby, former Ryan White Care Act director

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Biden transition team unveils members of Covid-19 task force - STAT

Pfizer and partner BioNTech said Monday that their vaccine against Covid-19 was strongly effective, exceeding expectations with results that are likely to be met with cautious excitement and relief in the face of the global pandemic.

The vaccine is the first to be tested in the United States to generate late-stage data. The companies said an early analysis of the results showed that individuals who received two injections of the vaccine three weeks apart experienced more than 90% fewer cases of symptomatic Covid-19 than those who received a placebo. For months, researchers have cautioned that a vaccine that might only be 60% or 70% effective.

The Phase 3 study is ongoing and additional data could affect results.

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In keeping with guidance from the Food and Drug Administration, the companies will not file for an emergency use authorization to distribute the vaccine until they reach another milestone: when half of the patients in their study have been observed for any safety issues for at least two months following their second dose. Pfizer expects to cross that threshold in the third week of November.

Ive been in vaccine development for 35 years, William Gruber, Pfizers senior vice president of vaccine clinical research and development, told STAT. Ive seen some really good things. This is extraordinary. He later added: This really bodes well for us being able to get a handle on the epidemic and get us out of this situation.

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Although it is a bright spot in the battle against the pandemic and a triumph for Pfizer and BioNTech, a German company, key information about the vaccine is not yet available. There is no information yet on whether the vaccine prevents severe cases, the type that can cause hospitalization and death.

Nor is there any information yet on whether it prevents people from carrying the virus that causes Covid-19, SARS-CoV-2, without symptoms.

Without more information, its too early to start predicting how much of an impact the vaccine could make, said Michael Osterholm, director of the University of Minnesotas Center for Infectious Diseases Research and Policy.

I dont want to dampen any enthusiasm for this vaccine. I just want us to be realistic, Osterholm said. For a vaccine to really have maximal impact, its going to have to also reduce severe illness and death. And we just dont know yet.

Because the vaccine has been studied for only a matter of months, it is impossible to say how long it will protect against infection with the virus. The vaccine does cause side effects, including aches and fevers, according to previously published data. Gruber said that he believed the side effect profile was comparable to standard adult vaccines, but probably worse than Pfizers pneumonia vaccine, Prevnar, or a flu shot.

The results have not been peer-reviewed by outside scientists or published in a medical journal, and even Pfizer and BioNTech have been given no other details about how the vaccine performed by the independent monitors overseeing the study.

Initial supplies of the vaccine, if authorized, will be limited. Pfizer says up to 50 million doses could be available globally. by the end of the year, with 1.3 billion available in 2021. There are also expected to be distribution challenges. The vaccine must be stored at super-cold temperatures, which could make it extremely difficult to deliver to many places. Pfizer has said it is confident those issues can be managed.

Although the estimate of the efficacy of the vaccine could change as the study is completed, it is close to a best-case scenario. That also bodes well for other vaccines in the late stages of testing, including those developed by Moderna, AstraZeneca, and Johnson & Johnson.

If that headline really number really holds up, that is huge. That is much better than I was expecting and it will make a huge difference, said Ashish Jha, the dean of the School of Public Health at Brown University. He cautioned, however, that it is always difficult to evaluate science via press release and that researchers will need to see the full results. He noted that side effects are something to watch, because even if there are no serious long-term complications, people feeling sick for a day or two could lead some to be hesitant to take a vaccine.

This really bodes well for us being able to get a handle on the epidemic and get us out of this situation.

William Gruber, Pfizer senior vice president of vaccine clinical research and development

Both Pfizers vaccine and Modernas use messenger-RNA, or mRNA, technology, which uses genetic material to cause the body to create a protein from the virus; the immune system then recognizes the virus and learns to attack. Other vaccines in the late stages of development use genetically engineered viruses for a similar purpose, or pieces of protein that are directly injected. No mRNA product has ever been approved by regulators.

The story of how the data have been analyzed seems to include no small amount of drama. Pfizer, seeing an opportunity to both help battle a pandemic and demonstrate its research prowess, made decisions that were always likely to make its study the first of a Covid-19 vaccine to produce data including its decision to have an independent group of researchers, known as a data safety and monitoring board, take an early look at the data in the 44,000-volunteer study before its completion.

The first analysis was to occur after 32 volunteers both those who received the vaccine and those on placebo had contracted Covid-19. If fewer than six volunteers in the group who received the vaccine had developed Covid-19, the companies would make an announcement that the vaccine appeared to be effective. The study would continue until at least 164 cases of Covid-19 individuals with at least one symptom and a positive test result had been reported.

That study design, as well as those of other drug makers, came under fire from experts who worried that, even if it was statistically valid, these interim analyses would not provide enough data when a vaccine could be given to billions of people.

In their announcement of the results, Pfizer and BioNTech revealed a surprise. The companies said they had decided not to conduct the 32-case analysis after a discussion with the FDA. Instead, they planned to conduct the analysis after 62 cases. But by the time the plan had been formalized, there had been 94 cases of Covid-19 in the study. Its not known how many were in the vaccine arm, but it would have to be nine or fewer.

Gruber said that Pfizer and BioNTech had decided in late October that they wanted to drop the 32-case interim analysis. At that time, the companies decided to stop having their lab confirm cases of Covid-19 in the study, instead leaving samples in storage. The FDA was aware of this decision. Discussions between the agency and the companies concluded, and testing began this past Wednesday. When the samples were tested, there were 94 cases of Covid in the trial. The DSMB met on Sunday.

This means that the statistical strength of the result is likely far stronger than was initially expected. It also means that if Pfizer had held to the original plan, the data would likely have been available in October, as its CEO, Albert Bourla, had initially predicted.

Gruber said that there will not be another interim analysis conducted in the study. He also said that Pfizers estimate that it could file for authorization of the vaccine by the third week of November was based on the assumption that the FDA would be willing to accept two-month safety data on half the volunteers in the study as initially planned, when it was to include 30,000 volunteers, not more than 44,000, as is now the case. Those discussions are ongoing.

But Gruber said he now expects that by the time of the planned meeting of the FDAs vaccine advisory committee in December, the studys efficacy portion could be completed, having reached 164 cases of Covid-19.

He also emphasized that although there will only be a few months of data from this study, results from earlier studies make him optimistic that immunity from the vaccine will not wane rapidly.

The study has enrolled 43,538 volunteers the companies said, and 38,955 have received their second dose. About 42% of global participants and 30% of U.S. participants have racially and ethnically diverse backgrounds.

Bourla, Pfizers CEO, said the results mark a great day for science and humanity, in a statement, saying they provide initial evidence of our vaccines ability to prevent Covid-19. He added: We look forward to sharing additional efficacy and safety data generated from thousands of participants in the coming weeks.

Helen Branswell contributed reporting.

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Covid-19 vaccine from Pfizer and BioNTech is strongly effective, data show - STAT

Until we get a vaccine, all of us will have to sacrifice some pleasures in our lives, says K. K. Shailaja, health minister of Indias Kerala state.

By Vaishnavi ChandrashekharNov. 9, 2020 , 1:55 PM

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

When the World Health Organization (WHO) issued its first statement on the spread of a novel coronavirus in Wuhan, China, on 18 January, few local governments in India paid close attention. But K. K. Shailaja, the diminutive woman running the health ministry in the southern state of Kerala, immediately perked up her ears.

Shailaja knew many students from Kerala were studying at Wuhan University; some had asked her for internships the previous year. She also knew firsthand the havoc an outbreak could cause. In 2018, during her first stint as a minister, she faced an outbreak of Nipah virus, another deadly pathogen spread from animals to people. We knew anything could happen at any time, she says.

By 24 January, Shailaja had called a meeting of her rapid response team, set up a control room, and mobilized surveillance teams. On 27 January, the first group of students flew back from Wuhan. Three days later, one of them tested positive for COVID-19, becoming Indias first confirmed case.

Kerala was ripe for the spread of the virus, with its large urban population, many residents living abroad (and traveling back and forth), and high influx of migrant laborers from other states. Yet with targeted testing, contact tracing, and isolation measures, the leftist state government brought the number of daily new cases down to almost zero in the first few months, flattening the curve far better than the rest of India. As national lockdown measures eased, infections have risen again, but the state seems prepared to keep things from going out of control. Only 0.36% of those confirmed cases have died, a mortality rate among the lowest in the world. (Like the rest of India, Kerala has the advantage of a young population, but many observers attribute its low death rate to the quality of its health care and hospitals that have not yet reached capacity.)

In many ways, [Kerala] got it right, says virologist Shahid Jameel, director of Ashoka Universitys Trivedi School of Biosciences. They possibly got it right the most of any Indian state.

Much of the credit goes to Keralas calm and cheerful health minister, often called Shailaja Teacher because of her old job as a high school teacher. Although Kerala benefited from historical advantages including the countrys highest literacy rates and arguably its best primary health care system, experts say Shailajas leadership has been critical to the battle. She listens to people, she visits hospitals privately, she talks to doctors, says K. Srinath Reddy, director of the Public Health Foundation of India. She comes across as a person who is blessed both in ability and humility.

Shailaja is not a scientist, but she has a passion for science that goes back to her time as a physics and biology teacher in the late 1970s. She and her students would read the science section of local newspapers in class, she recalls. We would have the most interesting discussions about space, the Moon landing, so many things not on the syllabus, she says. Politics, however, eventually drew her in. In the 1950s, members of her family joined the growing communist movement and the struggle against caste oppression.

Her grandmother took part in local movements against untouchability (the persecution of caste groups seen as lesser or impure), sometimes taking young Shailaja along to tumultuous protests. Shailaja says her grandmother taught her to be brave, and not only in politics. Smallpox was once widespread in Kerala, and the sick were often shunned or abandoned to die; many people believed patients were cursed by a goddess. But not her grandmother. She would visit patients in their homes and offer them clean water, good food, and traditional herbal remedies. She was very bold, Shailaja says. Everybody should have such a grandmother.

After working her way up to leadership positions in one of the states communist parties, Shailaja was appointed minister of health and social welfare when a left-led alliance was elected to power in 2016. Memories of smallpox may have been in her mind in 2018 as she was grappling with the states first outbreak of Nipah, a bat-borne virus with a case fatality rate in people of 50% to 75%. Ignoring everyones advice, Shailaja visited the worst hit village to calm residents and explain that, although low person-to-person transmission can occur with Nipah, especially in hospitals, the risk is low in everyday life. That ultimately prevented a mass flight from the area.

India had seen only two Nipah outbreaks before, in 2001 and 2007, both in the state of West Bengal. WHO later concluded that Keralas early response was improvised and health personnel were inadequately trained. The outbreak was contained, however, by isolating patients and tracing and quarantining more than 2000 contacts. In the end there were 19 confirmed cases and 17 deaths. And Shailaja and her team resolved to be better prepared for the next outbreak. They put in place a raft of measures, including improved surveillance and contact tracing systems, standard operating procedures, and hospital protocols. Jameel notes that not every state has remembered the lessons of past outbreaks. Its important to build capacity in peacetime, he says, adding, Theyve done well in that.

Shailaja also learned how to deal with the thorny social aspects of an epidemic. In the Nipah outbreak, the government initially cremated the deadwhich was unacceptable to Keralas many Muslims. One relative called Shailaja in tears, and she, in turn, asked her team to find a solution. Finally, they settled on a technique of deep burial, in which a body is wrapped in airtight plastic and buried 3 meters underground. We understood that we have to make our own protocols sometimes, she says.

Keralas traditionally strong social services have helped fight the new pandemic. During the national lockdown early this year, it provided migrant laborers with shelter and generous food stocks to keep them from fleeing back to their home statesand potentially spreading the virus. The state started with some of the best health indicators in the country, including infant mortality rates comparable to those in many wealthier countries. Devolution of power has also strengthened citizens participation and public communication, Reddy notes. Despite political polarities, at the [village council] level, there is a great deal of social solidarity, especially in the support for the primary health system, he says.

Shailaja built on those advantages, Reddy says, by engaging scientific advice, generating support across ministries, and communicating with the public. With a fairly educated and politically agile population, so much depends on gaining citizen trust and cooperation, and she has been able to do that effectively, he says.

Still, she has met with resistance from political rivals seemingly resentful of her success as a woman. One sarcastically called her Nipah Princess, especially after a feature film calledViruswas made about the outbreak with a well-known actor playing Shailaja heroically taking charge. More recently, a politician called her the COVID Queen. Opposition seems likely to increase with the recent surge in cases.

As Indias economy reopened and travel increased, clusters of cases cropped up in parts of Kerala, growing into a surge after the harvest festival in late August. By October, the state was seeing some of the countrys largest daily increases in cases. Some observers say the government became lax and did not test enough. Others point to the influx of migrant labor. A lot of people also returned from the Gulf [countries] after the lockdown lifted, Jameel notes.

Fatigue with the early strict measures may have set in, especially among health workers, and the states governor, a federal appointee, suggested the good health care and low death rates made people unafraid of the virus. When Shailaja spoke withSciencein August, she said she was preparing for a possible second wave with an expansion in the number of beds and recommendations to renew some lockdown measures. Her goal, she said, was to keep the death toll as low as possible and protect the elderly. Until we get a vaccine, all of us will have to sacrifice some pleasures in our lives, she said.

Recently she acknowledged that festival gatherings and political protests had contributed to the recent surge, and recommended stricter restrictions on travel. Now, more than ever, Keralas hard-working health minister will need to draw on all her abilitiesand her grandmothers plucky spirit-to find new strategies against the virus.

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How a communist physics teacher flattened the COVID-19 curve in southern India - Science Magazine

Updated: 3:26 p.m.

Gov. Tim Walz said Monday that he plans to announce new restrictions that target active spreaders of COVID-19 in an effort to bring the coronavirus under control as cases have surged to dangerous levels in recent weeks.

The governor plans to unveil at least some of his restrictions on Tuesday, hinting that they would be more surgically, much more aggressively targeted than the 51-day stay-at-home order from the spring. Walz said the shutdown order which he imposed earlier this year was necessary, but was a blunt instrument.

Walz appeared at the Minneapolis Convention Center Monday after the state registered nearly 14,000 new cases over the past three days. The convention center is the site of the states latest saliva testing facility.

The governor said hes looking at data, which show people between 18 and 35 who are infected but asymptomatic are helping push the spread of the virus to other parts of the population. Health officials are studying how members of this cohort may be contracting and spreading the virus in places like bars and restaurants, he added.

"The infection rates increase after a set time in the evening, he said. That before 10 o'clock, we seem to see that's at least what we're extrapolating from some of the data."

Walz didnt say specifically that hell make bars and restaurants close early but hes already restricted the number of patrons these businesses can allow inside their buildings. Bars and restaurants have been linked to 117 COVID-19 clusters, resulting in 2,400 individual cases.

Liz Rammer, president and CEO of Hospitality Minnesota, a business association for lodging, restaurants, resorts and campgrounds, said Monday afternoon that shutting down bars and restaurants would only serve to push more people to home gatherings where the data shows increased case spread.

The state has repeatedly told us they do not intend to shut down restaurants and bars, and we have not been told any different today, Rammer said. We would hope that any targeted restrictions being contemplated would take into account that restaurants and bars are affiliated with only 2 percent of the cases, and not unfairly single out these businesses.

Walzs announcement came as Minnesota doctors called on the governor to issue new coronavirus restrictions in the state. More than 400 health care workers, represented by eight organizations around the state, signed a letter asking Walz to issue new restrictions on bars, restaurants, gyms and other nonessential services while preserving access to schools.

As of Monday, more than 1,000 Minnesotans are in the hospital with COVID-19 a record for the state.

Walzs new plans also include mobile device tracking that would alert people when they have been exposed to the virus, theStar Tribunereported.

At this point in time, weve learned we can do retail, we can do education, some of it in person, if were able to test, contain and contact trace those folks to get [their infections] isolated, he said.

Walz and Lt. Gov. Peggy Flanagan also said Monday that the state is adding more than a dozen free COVID-19 testing sites around the state over the next two weeks, including 10 in armories around the state and several locations at Minneapolis-St. Paul International Airport.

Testing at the sites will be free and available to anyone, whether symptomatic or not.

Over the last week, Minnesotans saw our COVID-19 positivity rate climb higher than ever before. We have entered a dangerous phase of this pandemic, and our testing strategy is key to controlling the spread, Walz said in a statement. So many people are spreading the virus before they know they have it ... todays announcement brings us closer to getting the virus under control.

Health officials say increased testing is needed to help people find out if they have COVID-19 and to help the department track, trace and find asymptomatic people to prevent more spreading.

The rate of case growth we are seeing is very concerning. Ultimately, our goal is to get out there, do as much testing as we can with case investigation, contact tracing, and the necessary isolation to stop this disease from spreading, said Minnesota Department of Health Commissioner Jan Malcolm.

Tom Weaver is one person who took a saliva test. He toldKSTP-TVthat it was quick and easy.

Its just a peace of mind kind of thing, Weaver said. You can go about your life letting people know, that way everybody is in the know, the best information is available, and they can make decisions appropriately."

The Minnesota Department of Health reported 3,930 new cases on Monday, lower than the single-day record of 5,924 set just a day earlier. The update lifted the total number of cases in Minnesota to 184,788 since the start of the pandemic.

Health officials confirmed additional 19 deaths Monday, for a total number of 2,675 fatalities.

Walz said he is grateful for the partnerships that made the expanded testing possible.

We need all Minnesotans to come together and remain vigilant in the fight against COVID-19 as we prepare for a long winter ahead," he said.

MPR News reporter Brian Bakst contributed to this story.

You make MPR News possible. Individual donations are behind the clarity in coverage from our reporters across the state, stories that connect us, and conversations that provide perspectives. Help ensure MPR remains a resource that brings Minnesotans together.

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Walz hints at targeted restrictions to curb COVID-19 spread - Minnesota Public Radio News

COVID-19 treatments and pathogenesis including anosmia in K18-hACE2 mice  Nature.com

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COVID-19 treatments and pathogenesis including anosmia in K18-hACE2 mice - Nature.com

On March 16, Patricia Frieson, a 61-year-old retired nurse from Auburn Gresham and described as the rock of her family, was the first person in Illinois to die from COVID-19. Her sister, 63-year-old Wanda Bailey, a medical coder living in south suburban Crete, was hospitalized with the virus at the time; she died nine days later.

Six and a half months later, Illinois has surpassed 10,000 deaths, according to the Illinois Department of Public Health. The sisters deaths prefigured who would be most vulnerable to the disease: They were Black Chicagoans, over 55, with significant underlying conditions like hypertension or diabetes.

A lot has changed since. Encouragingly, the response from the medical community, businesses, and regular citizens has reduced the mortality rate even as the state has been unable to check its spread. And, as cases and deaths show signs of the predicted seasonal resurgence, all those lessons can be used to help the sick recover and prevent transmission in the first place.

We all want to be with our friends and family for the holidays. Perhaps on this holiday, as we have already done for most of 2020, were going to have to do it COVID-style, Illinois Department of Public Health Director Dr. Ngozi Ezike said on the Thursday when the state passed its grim milestone. And that means virtual. Well have to stay at home and forego the large gatherings so we can be with our friends and family.

To see where patterns may emerge in the next six months, we looked for clues in data on the road to 10,000 deaths starting with Cook County, which was hit hard first.

Of the first thousand people to die of COVID-19 in Cook County which took until April 18, almost exactly a month after the first death 49.9% were Black and 31.2% were white, in a county thats about one-quarter Black and about half white, according to data from the medical examiner. (Seventy of the first 100 victims were black, as WBEZ discovered on Apr. 5; ProPublica did a deeply reported look at the public-health implications of that figure in May.) Cook County reached 2,000 deaths by May 2, and the ratio of victims by race reversed but was still disproportionately Black: 35.1% Black and 41.5% white. Less than two weeks later, on May 15, Cook County hit 3,000 deaths; of this cohort, 27.6% were Black and 43.9% were white.

As of Nov. 1, there have been 5,539 deaths in the county, of whom 32% are Black and 40% are white. As the virus passed through the county, the demographics of its victims evolved closer to those of the county itself after hitting Black residents hardest at first, though the numbers are still disproportionately high for Blacks and low for whites.

A comparable pattern can be seen among Cook County Latinos. Of the first 1,000 deaths, 13.5% were Latino. That rose slowly, then quickly: 16.5% in the next cohort, then 21.3%, then 26.3%. Out of all 5,539 deaths, 1,177 are Latino, or 21%. The share of Latinos in Cook County is 29% overall, according to American Community Survey data.

Both Black and Latino residents suffered early from the virus. According to IDPH data, the test positivity rate among Blacks peaked at 48% on Mar. 30 and among Latinos at 55% on Apr. 7. Testing was much less common at the beginning of the pandemic and more likely to be sought by high-risk populations. But those are still very high numbers and much higher than among Cook Countys white population, where the positivity rate has not exceeded 24% to date.

Theres very clear evidence that individuals in Black and brown communities, in poor communities, do worse with COVID than people who arent in that demographic. And its incredibly multifactorial, said Emily Landon, an associate professor and hospital epidemiologist at the University of Chicago School of Medicine, whos served as an adviser to Gov. J.B. Pritzker and a regular source for news coverage of the pandemic. And its a burden of everything from not having great access to get care for your asthma to the long-term physical effects of being discriminated against for many years and many generations.

Concentration of Black and Latino residents in service-sector and front-line health-care jobs, which cannot be done from home, likely played a role in the virus spread. Interestingly, the death rate among Latino residents is disproportionately low 21%, compared to 29% share of the population. This may be explained by the fact that their median age in Cook County is comparatively young: 31, versus 37 for Blacks and 43 for whites. In other words, despite high test positivity rates (evidence of more frequent exposure to the virus), Latinos had better chance for survival.

Similar trends have played out statewide. According to data from the COVID Tracking Project (a site launched by The Atlantic to monitor COVID-19 data in the US; the author of this story is a contributor), Blacks make up 14% of the state, 16% of cases for which racial and ethnic data is available, and 24% of deaths. For Latinos, the breakdown is 17% of the state population, 31% of COVID-19 cases and 19% of deaths. For whites, its 62% of the population, 45% of cases and 52% of deaths.

Racial disparities in cases and deaths are common across states by the COVID Tracking Projects definitions. But a 10-point difference between the share of the population and the share of deaths as is the case with Blacks in Illinois is high. Only Maryland (11 points), Missouri (11 points), Alabama (12 points), Michigan (12 points), South Carolina (12 points), Louisiana (13 points) and the District of Columbia (29 points) also cross that threshold.

By contrast, the share of deaths among long-term care residents in the state is more in line with national numbers. In Illinois, the death toll is astonishingly high about 5,000 or almost half of all COVID deaths statewide. Nationally, such deaths account for 40% of those across the U.S. as of Oct. 29, according to the COVID Tracking Project. But 40% is almost certainly low due to inconsistency in ways these deaths are counted.

The state of New York, for instance, only counts deaths that occurred within long-term care (LTC) facilities, not deaths that are connected to such facilities. So, if a resident contracted COVID-19 in a long-term care facility then later died in a hospital, that person wouldnt be counted as a long-term care facility death. Most states include those deaths in their LTC data; if that method of counting was consistent across the board, the share would be higher nationwide and closer to Illinois 50%.

One bright spot in the states LTC data is that the fatality rate has decreased. This is a bloodbath, one worker told WBEZ seven months ago in April. I feel like my heart is breaking. It took less than two months for deaths in long-term care facilities to double from 2,000 to 4,000, from late May to late July. It took three months from late July to late October to increase by half as many deaths, from 4,000 to 5,000. Illinois was one of the first states with a major outbreak, and the poorly understood virus devastated unprepared facilities which struggled with staffing and the effort to obtain personal protective equipment.

As conditions have improved, death rates have dropped for a variety of reasons.

There were a lot of challenges in the beginning in how to control the spread of disease in congregate living facilities, Landon said. And that came down to inadequate testing, inadequate PPE, and inadequate space and facilities to separate individuals that were in different risk groups. Now space obviously hasnt changed, but the PPE and the testing has changed dramatically.

These improvements in the medical response manifested in a slowdown of fatalities across the state and across demographic groups: For each set of 1,000 deaths, the number of days to reach each increment peaked early at 12 days and stayed below 30 until mid-August. Finally, the velocity slowed considerably: Getting from 8,000 to 9,000 deaths took 47 days from Aug. 17 to Oct. 3, according to the COVID Tracking Projects count.

The reduction in the case-fatality rate has been aided by our growing understanding of a novel virus. There is definitely an art to taking care of really ill patients, Landon explained. And once you get a feel for the clinical syndrome, and you get a feel for what works and what doesnt work, and you can make much better granular, small decisions early on in the course of the care that can really influence the outcome.

Recent studies also suggest that wearing masks not only reduces the spread of the disease, but also results in less severe cases in those who do acquire COVID-19. This is true for many other infectious diseases. You know, the proverbial church picnic, where everybody who ate the potato salad ends up with diarrhea, and the people who ate more potato salad were worse off than the people who ate less, Landon said. This is the dose effect.

On Thursday, Nov. 5, the state set a new record, with nearly 10,000 cases reported in a single day then broke it the next day with 11,356 cases. Illinois also recorded the most new cases in nursing homes in one week since early May, with more than 2,000. Falguni Dave, a nurse and union representative at Stroger Hospital, told WBEZ that the hospital has expanded its ICU unit in preparation, but shes concerned about a potential shortage of PPE supplies and insufficient staffing levels. Dr. Zaher Sahloul, a pulmonologist at Saint Anthony Hospital, said that hes seeing mostly minority patients as part of this new wave, as it was at the beginning of the pandemic.

The message? To keep things from worsening further, the state and its residents will have to commit to lessons learned and carry them through the dark winter, like masking, social distancing and caution about gatherings during the cold months.

I think that we need a mindset shift. People need to understand the kind of exposure that you have in a household where you dont have adequate ventilation. People think, its fine, because you had a barbecue outside in the summer, Well just do the same thing well just come inside, well just say six feet apart. And indoor ventilation is not adequate for that, Landon said. The only way to safely be able to get together with your family for Thanksgiving is either to do it virtually or to have everybody quarantine quarantine before getting together, regardless of exposure.

Whet Moser is a freelance writer in Chicago.

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The First COVID-19 Death In Illinois Foretold The 10,000 Today - WBEZ

A coronavirus test is administered by a health care worker in Arlington, Va., on June 19. Andrew Harrer/Bloomberg via Getty Images hide caption

A coronavirus test is administered by a health care worker in Arlington, Va., on June 19.

Dr. Taison Bell, the director of the medical intensive care unit at the University of Virginia in Charlottesville, was doing rounds in the COVID-19 ICU, caring for about 20 patients, when he noticed that his unit was full almost entirely of Black and Latinx people, despite the fact that Charlottesville is 70% white.

Bell, who grew up just an hour away from the hospital, says he "just couldn't escape the thought of this virus disproportionately killing people in my community."

As he tells NPR's Michel Martin on All Things Considered, he had to pause rounds and "acknowledge how tough emotionally it was for me just to see what we were seeing."

"I didn't know what to do about it," he says. "I didn't know how to deal with that emotion, but I had to get it out there because if I was feeling that way, I knew that several other of my team members were feeling the same way, too."

The United States has been experiencing a massive surge of COVID-19 cases. Last week the new record was more than 120,000 confirmed cases a day, three days in a row, according to the Johns Hopkins Coronavirus Resource Center.

Bell, who is also an assistant professor of medicine at UVA, notes that those numbers represent real people.

"At the end of the day, we're tracking a lot of numbers because the metrics are important," Bell says. "But we have to remember that behind that number is a story, a story of a life that either may not make it. And even if they do make it, their life may be completely different from now."

It's a pandemic that has infected nearly 10 million people in the country and killed more than 230,000, and it disproportionately affects Black and Latinx people in the U.S. Black Americans are dying of COVID-19 at a rate of nearly twice their share of the population. Latinx people made up a greater share of confirmed cases and deaths than their share of the population as well, according to data analyzed by NPR.

Bell says the Trump administration didn't adequately emphasize the virus's disproportionate impact on minority communities.

"There was an opportunity lost there to communicate the urgency, the necessity and the basic public health measures that we could take and the fact that even if it's not in your community now, it's likely to be in your community later," Bell says, "so we all need to take the same sort of safety measures."

Bell says one of the problems at play was the messaging from the Trump White House, which he says led "large segments of the country" to not take the virus seriously.

"You have to connect it to the top where in the White House, they may have been holding events outside, but very tight," he said. "No mask, no social distancing, not setting an example of how we should be proceeding in society to control the spread of COVID-19."

Bell says the virus has changed the nation dramatically, and that the death toll is almost impossible to fathom.

"In the minority community, it's exposed a lot of issues in our society," he says. "But just to think about the individuals that we're losing and the weddings that are being missed, the barbecues, the hugs, the reunions and all of these opportunities and moments that are going to be lost because of this virus. It's just really hard to think about."

Jeffrey Pierre and William Troop produced and edited the audio version of this story.

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ICU Doctor Stresses COVID-19 Severity In Communities Of Color, Faults White House - NPR

GOVERNOR CELEBRATES REPORTED SUCCESS OF POTENTIAL COVID-19 VACCINEAlso on Monday, Gov. Justice took time to celebrate that early reports on a COVID-19 vaccine, currently being developed by pharmaceutical company Pfizer, indicate that the vaccine may be performing better than expected.

According to Pfizer, the vaccine proved to be effective in more than 90% of the first 94 test subjects who were infected with the coronavirus, vastly exceeding the U.S. Food and Drug Administrations minimum expectation of 50% efficacy for a COVID-19 vaccine.

Lets just hope and pray that this is the right news, because this could be the biggest announcement that we have ever had in our lifetime, Gov. Justice said. If we have a vaccine that will work at a level greater than 90%, it is unbelievable to think that has been pulled off in the timespan it has taken to make this a reality.

If this is above 90%, this will enable us to eradicate COVID-19, just like we did with smallpox, Gov. Justice continued. This is an incredible announcement. It has the stock market going crazy to the upside. They think they will have this vaccine very soon, especially for our most vulnerable.

Weve got to be absolutely thankful to God above if its a reality, and everybody seems to think its just that. Its a testament to great American ingenuity, science, and all the goodness that we have.

In apress release announcing the early results, Pfizer said that the clinical trial will continue through to final analysis at 164 confirmed cases in order to collect further data and characterize the vaccine candidates performance against other study endpoints. The release added that Submission for Emergency Use Authorization to the FDA is planned for soon after the required safety milestone is achieved, which is currently expected to occur in the third week of November.

How do we bridge the gap between now and, hopefully, when this vaccine becomes a reality? Weve got to get tested, we absolutely have to wear our masks, and we have to continue to practice proper social distancing, Gov. Justice said. Its really tough and frustrating. But, for crying out loud, were so close now. Please, West Virginia, youve got to buckle up, youve got to try really hard.

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COVID-19 UPDATE: Gov. Justice announces $43 million to help thousands of businesses with cost of providing healthcare; celebrates progress on vaccine...

Most of the research on how COVID-19 spreads has focused on communities. But its also happening in homes.

A new study involving families in Wisconsin and Tennessee suggests COVID-19 infections get passed to other household members more frequently than previously indicated in other reports and that fewer than half of the family members showed symptoms when they tested positive for the disease.

Both children and adults transmitted the virus to other family members, resulting in a secondary infection rate of 53 percent, according to the study, funded by the Centers for Disease Control and Prevention.

The studys initial results come as cold weather sets in, and people spend more time indoors.

"A lot of people dont have immunity to the virus. Think about household dynamics. Youre in close contact with your family members it's likely youll get the virus," said one of the studys authors, Huong McLean, a scientist at the Wisconsin's Marshfield Clinic Research Institute.

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The study involved 101 households in the two states. After the first person in a family tested positive at a medical clinic, their family was recruited for a two-week follow up to see if other members of the household became sick. Participants tested themselves daily for COVID-19 using nasal and saliva samples. They also kept track of any symptoms of illness.

The ongoing research is designed to provide critical data regarding the recommended timing and frequency of testing. Results suggest transmission among household members is high and occurs quickly. Roughly 75 percent of secondary COVID-19 infections came within five days of the original patients illness.

Researchers recommend people isolate as soon as they have COVID-like symptoms, or before a test following exposure to the virus. They also advise everyone to wear masks within shared spaces in the home.

Thats what Lane Manning did after returning to Wisconsin after visiting Florida in mid-September where he was visiting his sister. One of her friends, which she saw before Manning visited, later tested positive for COVID-19. So Manning, 46, isolated himself in the basement of his Dane County home for 12 days.

Meals were left at the top of the stairs, and he wore a face mask in the house if he went upstairs. Neither his spouse nor his 10-year-old son became infected. But his teenage daughter, Reese, did, and she temporarily lost her sense of smell.

"I mean, we passed maybe once in the garage on my way outside to get some air," he said. "But we were both wearing masks and 7 to 8 feet apart. She was on one side of the garage, I was on the other. We still dont know to this day how she contracted (COVID-19)."

Manning said his 13-year-old daughter played soccer but with a mask on. Both father and daughter recovered from COVID-19.

Manning was not involved in the Marshfield study, which notes that although living in the same household with someone infected with COVID-19 increases risk, it can be difficult to determine whether family members gave it to each other or contracted the virus elsewhere.

Originally posted here:

Study: Once Someone In Your Household Has COVID-19, Risk Of Secondary Infection Is 'High' - Wisconsin Public Radio News

As America grapples with record-breaking surges in Covid-19 infections and no meaningful federal response, some state and local governments are implementing new restrictions to combat the surging virus.

Other hard-hit areas, however, are taking little to no action against a pandemic that has claimed more than 200,000 lives and sent the US economy into a tailspin.

Oregon, which saw a state record-breaking 805 new cases on Thursday and 769 on Friday, will implement new restrictions in at least five counties to stop Covid-19 from spreading. These regulations halt visits to care homes, and limit indoor dining at restaurants to 50 people, according to the Associated Press.

Authorities are also urging businesses to require work-from-home. Officials are also asking Oregon residents not to gather with people they dont live with, but to limit any non-household gathering to six people, the AP reported.

In New York, Andrew Cuomo, the governor, said on Friday that officials were weighing additional restrictions to combat the surge in western and central New York and would announce details on Monday. Cuomo also said that officials would ramp up enforcement of new quarantine requirements for out-of-state travelers.

Those coming to New York from states other than New Jersey, Connecticut, Pennsylvania and Massachusetts must take a Covid-19 test within three days of arriving, show proof that it is negative, and then have another negative test the fourth day after arrival.

Were going to be increasing enforcement personnel at the New York airports. You should not land if you do not have proof of a negative test upon landing, Cuomo said. Im increasing the national guard. I spoke to New York City Mayor Bill de Blasio about increasing the New York police department at the airports, but I want people to know were serious.

New Jersey is poised to see new restrictions after Covid-19 hospitalizations tripled over the last seven weeks, governor Phil Murphy said on Thursday. The states daily case data is also nearing the levels seen in early May. Connecticut has also limited some reopening initiatives due to a recent spike in cases, NBC New York reported.

Elsewhere, the response was not as aggressive despite the virus now raging through vast swaths of America, and especially the midwest and Great Plains states.

On Friday, health authorities in Kansas reported 5,418 new coronavirus cases over two days. A top health authority said that people are ignoring masks and social distancing initiatives indoors and at public events and claimed many local officials havent done anything to stop the spread, AP said.

North Dakota and South Dakota, which do not have full or partial mask requirements, are seeing soaring rates. In Wisconsin, which is also seeing rising case numbers, Governor Tony Everss health emergency order was made virtually irrelevant because of legal challenges, the Milwaukee Journal Sentinel reported.

Although Iowa is seeing record Covid-19 infection and hospitalization rates, the Republican governor, Kim Reynolds, has not announced any new actions to stop the disease from spreading. She urged Iowa residents to do their part and said authorities would launch an awareness campaign promoting hygiene and social distancing, the Des Moines Register reported.

This patchwork approach has boded poorly for countrywide disease rates.

The US broke its record for the highest number of Covid-19 cases in a single day on Friday, with 128,000 additional new infections, according to the Washington Post. Deaths were over 1,000 for the fourth day in a row. About 53,000 people were hospitalized because of coronavirus on Thursday.

In total, the US has marked more than 9.7m Covid-19 cases and 235,000 deaths since the pandemic started more than any other country, according to Johns Hopkins University data.

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New restrictions announced in US states seeing Covid-19 surges - The Guardian