Category: Covid-19

Having to adapt to different situations throughout my life prepared me [for] a different virus, saysAkiko Iwasaki of Yale University.

By Jennifer Couzin-FrankelOct. 27, 2020 , 10:40 AM

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

Until this year, Akiko Iwasaki had never had tubes of human blood delivered to her lab. We were mostly working with mouse models, says the Yale University immunologist, who speaks precisely and thoughtfully. We used to look at the data and contemplate it. Then COVID-19 struck, and such unhurried musings flew out the window. In a matter of weeks, Iwasaki overhauled her research to launch a slew of studies on how the new virus, SARS-CoV-2, takes its toll on patients. She and her nearly two dozen lab members know their discoveries could impact people falling sick right now. Every minute counts.

In the months since, she has produced a string of high-profile papers in which she has redirected her expertise in the immune system, honed in mice, to questions such as why men are more likely than women to fare poorly if infected and how immune responses in hospitalized patients can help predict their prognosis. Now, she is turning her attention to long-haulers, people who suffer a bout with the virus and dont fully recover.

Iwasaki has had decades of practice adapting to new circumstances. As a child growing up in rural Japan, she dreamed of becoming a poet, turned off science by her physicist fathers immersion in his profession. Wed go on vacation and hed bring papers with him, she says, laughing. I thought, What kind of life is this? But when a high school teacher hooked her on math, she began to reconsider. Soon after, 9 months as an exchange student in Canada left her itching to escape the expectations for a woman in Japanese societymarry a nice man and have a family. Her mother, who worked at a local radio station, had endured jeers from co-workers for sticking with the job while raising three children. Knowing how much she stood up for always has stayed with me, Iwasaki says.

So she reimagined her future, embracing science and leaving Japan. She enrolled as an undergraduate at the University of Torontofalling hard for immunology her senior year thereand stayed on for graduate school. Twenty years ago she founded her lab at Yale, where she studies how the body responds to and combats viruses. Having to adapt to different situations throughout my life, she says, prepared me [for] a different virus.

The shift called for new science, new collaborations, and new skills. In February, Iwasakis lab joined a universitywide testing effort for SARS-CoV-2 led by Albert Ko, Nathan Grubaugh, and Anne Wyllie at Yales School of Public Health. Alice Lu-Culligan, a graduate student of Iwasakis who had been studying the immune system during pregnancy in mice, recalls the scramble. Lab members scouted for supplies such as swabs and equipment. We were going around our floor, to the neighboring labs, seeing how many PCR [polymerase chain reaction] machines they had, Lu-Culligan says. It was full-on sprint mode, collaboration and chaos.

As Iwasakis lab was helping Grubaughs group sequence viral genomes from early patients in Connecticut to mapthe spread there and across the United States, she launched a separate study to examine patients immune responses. She recruited 113 people with COVID-19 at Yale New Haven Hospital and redeployed expertise in her lab to make the project happen. Postdoctoral fellow Carolina Lucas had been studying the mosquito-borne chikungunya virus, and her project was housed in a biosafety level 3 lab at the university, the kind used for hazardous pathogens. Akiko asked me to coordinate this, says Lucas, who quickly agreed.

Every few days, the team collected samples from the nose, throat, and blood of patients. There were all these weird immune responses being engaged, Iwasaki says. In severe cases, the immune system churned out a flood of cytokine proteins. Lucas, Iwasaki, and others found four immune signatures thatappeared to correlatewith later outcomes. That paper appeared inNaturein July.

Swiftly, the scientific questions mushroomed. In mid-March, the Yale hospital treated a woman with COVID-19 who was in her second trimester of pregnancy. The woman lost her fetusand a private tragedy became interwoven with urgent questions about whether the virus could infect the placenta and pose a danger to the pregnancy. A collaborator of Iwasakis secured permission to collect the placenta, and late one night, Lu-Culligan retrieved it. Until that moment, the only placentas Lu-Culligan had seen belonged to mice. This is big and bloody, she says, and as she stared at it under a biosafety hood, Im thinking, I dont know what Im doing here.

In that case, the virus had indeed infected the placenta, and Lu-Culligan began to collaborate with Yale obstetricians to recruit women delivering at the hospital who were positive for the virus to study their placentas, too. That paper is nearing completion.

Meanwhile, Iwasaki began to investigate sex differences and found themale immune system is more likely to spark a harmful inflammatory responseto the virus, whereas in women, T cells that fight it off are activated more robustly. These distinctions, she reported in an August paper inNature, might help explain why men who are infected tend to fare worse than women.

Iwasakis juggling act impresses her colleagues. Shes made it seem so effortless, even though I know its probably not effortless at all, says Angela Rasmussen, a virologist at Columbia Universitys Mailman School of Public Health. Iwasakis husband, Ruslan Medzhitov, is also a well-known Yale immunologist (they discuss COVID-19 while walking their dog), and the pair has two daughters, ages 11and 13. Iwasaki fears the pandemic is widening the gender gap in science as women face disproportionate pressure to support their children when schools are closed. Her husband drives their daughters to in-person school each morning, but with COVID-19 cases climbing, she wonders how much longer schools will be open.

Solutions to a COVID-19fueled gender gap in science are elusive, she says, other than to really have a different mindset about evaluating progress in science during this time. Iwasaki has long advocated for female and minority scientists on Twitter, where she has 80,000 followers. In one post, she minced no words in advising female scientists who worry about pregnancy torpedoing a job interview: If they dont welcome you with open arms and offer child care options, they dont deserve you.

Her advocacy goes beyond rhetoric. Lu-Culligan met Iwasaki at a luncheon for women in science at Yale, while struggling with bullying and harassment in another lab. Iwasaki said, We have to get you out of there, Lu-Culligan recalls. A few months later, the young scientist abandoned more than 2 years of graduate work to start over with Iwasakilater learning that she wasnt the first person her new mentor had rescued from a miserable experience elsewhere.

Nearly 9 months into the pandemic, lab life has settled downsomewhat. Iwasakis latest passion is long-haulers who cant shake symptoms like fatigue and brain fog. Volunteers find her via word of mouth. The project faces hurdles, though: Iwasaki is hunting for a facility to draw blood from her volunteers, who are still symptomatic and potentially contagious. With many competing studies, such space is at a premium and she hasnt yet been able to secure any. Shes also racing to apply for grants to fund the project.

We really want to get to the bottom of whats going on, she says impatiently. Until thenalong with so many other researchersshell be in overdrive.

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'Every minute counts.' This immunologist rapidly reshaped her lab to tackle COVID-19 - Science Magazine

Despite a new wave of COVID-19 cases across the country, President Donald Trump continues to hold frequent in-person rallies that bring together thousands of people with little regard for social distancing. His political events in Washington, D.C., already contributed to an outbreak among his aides and throughout the White House. Local public health officials and other commentators, including CNNs Sanjay Gupta, have expressed concern that Trumps political rallies could be fueling community spread of COVID-19. Dr. Anthony Fauci said that Trumps decision to hold rallies without social distancing was asking for trouble.

At least 26 individual COVID-19 cases have been linked to participation in Trump rallies since June. New analysis by the Center for American Progress finds that about half of the presidents 22 campaign rallies held between June and September were followed by a county-level increase in COVID-19 cases, suggesting the events may have led to community spread. The analysis also finds that counties that had a lower COVID-19 incidencea measure of new cases per capitaprior to the rally were more likely to have a visible increase in cases after the rally, perhaps because any uptick in cases was more likely to stand out against the pre-event level.

This column discusses how rallies without proper pandemic precautions may be endangering host communities; examines the trends in county-level case counts for cities that hosted rallies; and highlights instances in which local officials have traced cases to participation at Trump events.

Public health experts have voiced concern that Trumps rallies pose a risk not only to participants themselves but also to others in the communities in which they are held. Due to concerns about COVID-19, the Trump team suspended rallies in March. It then held two indoor rallies in June and again halted in-person events as the United States approached its second peak of COVID-19 cases. Trump resumed rallies in mid-August, appearing at multiple large events per week. In total, Trump held nearly two dozen rallies between June and September.

Attendees at ralliesincluding those held in Pennsylvania, Florida, and North Carolinatend not wear masks or socially distance, even after Trump himself contracted the virus. In addition, the majority of these events have been in violation of local or state restrictions on gatherings to limit the spread of COVID-19. Most Trump rallies during the pandemic have been outdoors in airplane hangars, which may have helped mitigate transmission relative to indoor settings.

To examine whether Trumps rallies were associated with heightened cases, the authors used county-level data on COVID-19 positive cases from The New York Times. For each of the 22 rallies Trump held between June and September, the authors looked at a chart of daily new cases and the seven-day moving average of new cases during the 21 days before and after the rally. The full set of charts is available at the end of this column as an appendix.

In 11 instances, there was a post-event increase above the pre-event trend, with an increase defined as either new case counts rising up following a pre-event decrease or plateau or new case counts accelerating above a steady, pre-event increase. The authors found unambiguous increases after rallies in Mankato, Minnesota; Bemidji, Minnesota; Henderson, Nevada; Londonderry, New Hampshire; Swanton, Ohio; Middletown, Pennsylvania; Old Forge, Pennsylvania; and Newport News, Virginia. The increase in the county case count trend was more subtle after the rallies in Vandalia, Ohio; Latrobe, Pennsylvania; and Oshkosh, Wisconsin.

In the other 11 instances, the number of new cases in the local area appeared consistent with the pre-event trend or declined after the rally. This category included rallies in Phoenix, Arizona; Yuma, Arizona; Jacksonville, Florida; Freeland, Michigan; Duluth, Minnesota; Minden, Nevada; Fayetteville, North Carolina; Winston-Salem, North Carolina; Tulsa, Oklahoma; Pittsburgh, Pennsylvania; and Mosinee, Wisconsin. Although case counts soared in Mosinee after the rally, the sharp increase that occurred prior to the rally and the next day would have been due to infections prior to the event.

A post-event increase was more common in counties that started with lower levels of COVID-19. Splitting the 22 events in two groups based on their level of per capita new case incidence in the days up to and including the rally, the authors found that only 3 of the 11 communities (27 percent) with higher pre-event incidence (19 new cases per day per 100,000 population) saw an increase. Among the communities with lower pre-event incidence (5.8 new cases per day per 100,000 population), 8 of the 11 counties (73 percent) had an increase in new COVID-19 cases following a rally.

One reason for this difference may be that a case spike from a one-time event is more visible in areas with low-baseline incidence, while an outbreak in areas with higher incidence might not stand out against other variation in case counts. Another difference between the groupswhich might make detecting an increase in spread more difficult in the high-incidence countieswas county size. Counties in the high-incidence group were larger, with an average population of nearly 1 million, compared with about 320,000 in the low-incidence group.

CAPs findings are similar to those of other recent analyses of Trump rallies. One published in Stat that found [s]pikes in Covid-19 cases occurred in seven of the 14 cities and townships where these rallies were held. Separately, USA Today found that COVID-19 cases grew at a faster rate than before after at least five of Trumps campaign rallies. While none of these analyses are causal, community-level rises in cases are not the only indication that rallies may spread COVID-19: Public health authorities have linked individual cases to Trump rallies through contact tracing.

In several communities, public health officials have linked COVID-19 cases to Trump rally attendance. At least 26 individual cases have been linked to Trump rallies held between the months of June and September, according to various news reports. In many of these cases, officials were unable to determine whether the case acquired the infection at a rally or was already positive for COVID-19 when they attended the event.

In addition, some local public health authorities have pointed to Trump rallies as a reason for an increase in community spread. Compared to the county-level data on COVID-19, some events with confirmed rally-linked cases were not followed by a clear increase in case counts. Conversely, for some instances where cases rose dramatically after an event the authors did not find news reports about cases among rally participants.

The following Trump rallies have been tied to individual cases of COVID-19 among staff or participants:

Despite sparse mask-wearing and lack of social distancing, other Trump campaign events have generated no reports of cases. For example, Virginia health officials have not linked any COVID-19 cases to the September 25 rally held in Newport News, even though the number of daily new cases had been falling in the city of Newport News before the rally and rose in the 21 days after. In New Jersey, Gov. Phil Murphy (D) said there are no known cases or outbreaks linked to Trumps fundraiser in Bedminster, which Trump and his staff held the day the president announced his positive test.

While data suggest that the Trump rallies are often followed by increased community spread of the coronavirus, multiple factors prevent a definitive, causal connection. First, cases may have risen for reasons independent of the political events. For example, Tulsa was already emerging as a regional hotspot for the virus prior to the Trump event. In addition, many of the late summer rallies coincide with other factors driving up cases, including school reopenings, the cooler weather sending people indoors, and pandemic fatigue with social distancing and other precautions.

Second, the lack of effective contact tracing in much of the country hampers linkages between individual cases and the source of infection. When contact tracers lack information on whom positive cases have interacted with and when, it is difficult, if not impossible, to determine how they may have contracted the virus and how it spread. A prominent example of this challenge was the outbreak in the White House, in which Trump administration officials declined to fully cooperate with contact tracers from the District of Columbia Department of Health and the federal Centers for Disease Control and Prevention.

Third, the authors examined case counts but did not have county-level data on testing or positive test rates. It could be that in the days after a rally, as after other mass gatherings, residents in the community are more likely to get tested for COVID-19 at the urging of state and local governments, which enables the detection of more cases than would otherwise be found.

Lastly, one factor that could prevent a stronger association between rallies and cases is that the authors examined only the county in which the rally took place. Events featuring the president likely attracted participants across multiple counties in each region. If the coronavirus was transmitted at an event, cases would be dispersed back to attendees home counties in the days following.

The Trump administration has flouted public health guidance throughout the pandemic, and the presidents choice to continue holding large rallies is no exception. Trumps political events have regularly violated state and local restrictions on gatherings. Both his White House and his campaign have fostered a culture that discourages commonsense mask-wearing and social distancing. By downplaying the severity and contagiousness of the viruseven after being hospitalized with the virus himselfand gathering tightly packed crowds in the nations COVID-19 hot spots, Trump jeopardizes the health of the very people who turn out to support him.

Thomas Waldrop is a policy analyst for Health Policy at the Center for American Progress. Emily Gee is the health economist for Health Policy at the Center.

To find the latest CAP resources on the coronavirus, visit ourcoronavirus resource page.

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Trump Rallies Are Often Followed by Increases in Local COVID-19 Cases - Center For American Progress

Maine reported 57 new cases of COVID-19 on Tuesday, the third day in a row the state has logged more than 50 cases.

The increase in cases is tracking with a nationwide trend of an autumn spike in COVID-19, although Maines underlying infection rate is still among the lowest in the country.

The spike we have foreshadowed is happening, Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said in a news briefing Tuesday. This is deeply concerning. The bottom line is we are in it now.

Maine also indefinitely delayed its winter high school sports season on Tuesday, making the move to allow school and health officials to develop guidelines for a season in which most sports are played inside.

The seven-day daily average of new cases was 45.8 on Tuesday, up from 32 a week ago and 29.7 a month ago. Despite the jump in cases, Maine is set to reopen bars on Monday with extra rules in place to limit the virus spread, but state health officials on Tuesday said that they are closely examining that upcoming date. Bars in other states have been associated with COVID-19 outbreaks, and in Maine they are one of the last types of businesses to reopen.

Jeanne Lambrew, Maines health and human services commissioner, said that no decisions have been made regarding bars, but we are still looking hard at the data, and circumstances have changed since we made that recommendation.

In an appearance on Good Morning America on Tuesday, Shah discussed Maines low infection rates compared to most of the country, saying Maine people believe in science and listened to advice such as wearing masks and physical distancing.

Although Maines numbers are increasing, the state is doing well relative to the rest of the United Sates. On Tuesday, Maine had the lowest seven-day average of daily new cases in the nation, at 2.8 cases per 100,000, followed by Vermont at 3.1, according to the Harvard Global Health Institute. In most of the country, cases are soaring and the spread of the disease is exponential. Twenty-one states had rates of 25 cases per 100,000 or higher, more than 10 times higher than what Maine is experiencing. Some hot spots, such as North Dakota and South Dakota, had rates higher than 90 cases per 100,000.

There were no new deaths on Tuesday. Since the pandemic began, 6,311 Mainers have been sickened by COVID-19, and 146 have died.

On Tuesday, 14 new cases were tracked in Cumberland County, 11 in York County, three in Androscoggin County and one case in Waldo County. Waldo County was the location of a recent large outbreak, with 60 cases connected to Brooks Pentecostal Church services in early October. After a rapid escalation in cases in the first three days after the Maine CDC reported the outbreak in mid-October, the growth in cases associated with the church has slowed.

Shah, answering questions at the media briefing, said while its encouraging cases connected to Brooks Pentecostal Church have slowed, it can take an extra week or two for secondary outbreaks to occur, so its still possible for the outbreak to grow much larger.

Were not out of this yet, he said.

Matthew Shaw, pastor of Brooks Pentecostal Church, apologized in a Facebook video posted on Tuesday.

We regret what has happened. We ask your forgiveness, Shaw said. We apologize that the sickness came to our church. We apologize for the consequences that maybe the community is feeling.

According to the Maine CDC, 34 of the 60 cases were from primary transmission people who attended Brooks Pentecostal services in early October while the remaining 26 cases were secondary transmission, people who did not attend services but were exposed to those who did.

The Maine Department of Education changed Waldo Countys classification from green to yellow, meaning high school sports and extracurricular activities have been halted for at least two weeks.

Shah said more cases have been connected to community transmission, which is a warning sign for possible exponential growth.

Its much harder to tamp down on community transmission than an outbreak, Shah said, explaining that public health employees can more easily track cases and quarantine those who may be contagious in an outbreak.

Shah said some counties that previously had experienced very few cases are now seeing increases. For instance, in Washington County, 32 of the 48 total cases since the pandemic began happened in October.

Also on Tuesday, the Maine CDC reported two new outbreaks, four cases at Second Baptist Church in Calais and three cases at Woodland Memory Care in Rockland.

Meanwhile, Fryeburg Academy sent all students home and will switch to remote-only learning through Nov. 6 after two reported positive cases. The first, a student, tested positive on Thursday, prompting an early release on Friday for students. On Saturday, a teacher also tested positive, prompting the decision to shut down in-person learning at the private boarding school that also provides education for the areas public school students.

The decision also effectively ended the athletic season for Fryeburg Academy, although one cross-country runner will be allowed to participate in Wednesdays Western Maine Conference Class B qualifying race, to be held in Freeport, said Sue Thurston, Fryeburgs athletic director.

The Department of Corrections said Tuesday that after an employee at the Maine Correctional Center in Windham tested positive for COVID-19 last week, additional testing has confirmed the virus in two more workers. The department said it would be working with the Maine CDC on an outbreak investigation.

Statewide, hospitalizations remained low, with 12 people currently hospitalized for COVID-19, and five in intensive care.

Staff Writer Steve Craig contributed to this article.

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Maine reports 57 new cases of COVID-19, part of a 'deeply concerning' rise - Press Herald

BOSTON (CBS) Wastewater is helping to track the presence of COVID-19 in Massachusetts. COVID-19 is shed into feces which makes its way into the sewer and eventually the wastewater treatment plants, said Kyle McElroy, a research scientist at BioBot.

The Massachusetts Water Resources Authority is part of a pilot study looking at wastewater. It has a contract with Cambridge-based Biobot to process the samples.

Samples are taken at the Deer Island Treatment Plant three times a week. The wastewater tested flows in from 43 communities around Boston.

Its a very good measure of how much infection there is in the community, said Dr. Ashish Jha, the Dean at Brown Universitys School of Public Health.

He said the MWRA data showed a huge COVID spike in the spring and its showing a spike once again.

According to Jha, wastewater testing picks up the virus from people who have symptoms and from people who dont.

In that way at our population-level a much more sensitive measure for how much infection there is than the testing that were doing where we know we miss a lot of asymptomatic people, said Dr. Jha.

Gloucester is also testing its wastewater. The citys health director Karin Carroll said it helped them monitor a recent uptick in cases. They plan to use the data as they make decisions going forward.

I think as we move into the winter with cares its will be helpful in knowing should a community pull back a bit from say Phase 3 Step 2, should we go back to Step 1, said Gloucester Health Director Karin Carroll.

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Wastewater Shows Increased Presence of COVID-19 In Massachusetts - CBS Boston

The University of Miami is serving as a pilot study site for a new, rapid coronavirus test that examines air droplets from a persons breath.

Imagine blowing a few breaths into a small tube, placing the tube into a COVID-19 scanner and finding out if you are clear from the novel coronavirus within minutes.

By participating in a short clinical research study that begins this week, the University of Miami is poised to help make that possibility a reality. The University readily agreed to become the first college testing site for a quick, easy, and cost-effective Israeli-produced COVID-19 Breath Analyzer that could revolutionize coronavirus testing if approved by the U.S. Food and Drug Administration (FDA).

Its as simple as a kazooyou just blow into it. And if it works, it will be a game changer, said Roy E. Weiss, chair of the Miller School of Medicine Department of Medicine and chief medical officer for COVID-19. It would allow us to test at a fraction of the cost and time of our current nasal swab test and as frequently and wherever necessary. There could even be stations before a football game. People would blow into the tube, get their results in a minute, and then if theyre negative, go in and enjoy the game.

Starting this week at the Coral Gables Campus, upper class residential students who go to the Pavia Garage for their mandatory, regularly scheduled nasal swab test will be asked if they would also be willing to provide a breath sample. Faculty and staff members who are randomly tested in the next few weeks will also be offered the opportunity to participate. The same testing is being offered to faculty and staff members at the Medical Campus. Those who participate will have to sign a consent form. The University aims to provide about 1,000 test results to BioSafety Technologies, a subsidiary of Israel-based TeraGroup, the breath test developers who are gathering data from the University and other pilot sites across the globe. The technology is now in the evaluation process for FDA approval.

What we are trying to do is help validate the test by comparing it to the gold standard for COVID-19 detection, which remains PCR [polymerase chain reaction] via nasal swab or saliva, said Erin Kobetz, vice provost for research and scholarship, who is also leading the Universitys testing strategy. Its too soon to draw any conclusions about the effectiveness of the breath test, but we are hopeful. Research can fill the gap in understanding and keep the U on the forefront of innovation.

University administrators are interested to see whether the breath analyzer will gain emergency use authorizationa way the FDA has fast tracked many treatments to combat the spread of COVID-19.

This is probably one of the first studies in the United States to evaluate the use of breath tests to detect COVID-19, Kobetz said. If approved, this test could provide the opportunity to assess risk in real time, which may help us more effectively curb transmission.

In the meantime, the University is also exploring the possibility of integrating the saliva test into its mandatory COVID-19 testing regimen. Recently, residential students from Lakeside Village and Eaton Residential College had the opportunity to provide a saliva swab along with their normal nasal swabboth of which use the PCR technique, the most reliable tests that detect genetic material of the virus.

We are trying to determine whether a saliva-based test will enhance our capacity to screen at greater frequency or in larger numbers, Kobetz added.

The COVID-19 Breath Analyzer works similarly to the Breathalyzer devices that police use roadside to take a reading of the alcohol content in the blood of suspected drunk drivers. But instead of using one device for drivers to breathe into that also measures blood alcohol content, the COVID-19 Breath Analyzer includes two steps, said Netta Ness, senior vice president of TeraGroup. First, participants provide a sample by breathing a few puffs into a disposable, sterile TeraTube. The sample is then sealed and fed into a BioSafety station, which is a freestanding scanner that can detect the presence of COVID-19.

Your breath is not dry, Weiss explained. It contains moisture and that moisture contains droplets. And if you have COVID, the virus will be in those droplets.

TeraGroup is hopeful that once the University and other global partners help them gather more data through these pilot studies, the company will be able to sell their test in the United States. The breath tests will cost no more than a cup of coffee, and the BioSafety station can get results from a single test in one minute, Ness added.

Janette Neuwahl Tannen contributed to this report.

Originally posted here:

University tests 'game-changing' COVID-19 breath analyzer - University of Miami

There will be no scenes like this at The Beach at Arapahoe Basin this season. The Summit County ski area is forbidding Beach gatherings due to COVID-19, which is seeing increasing rates of infection this month. (Ian Zinner), provided by Arapahoe Basin)

On the same day that Arapahoe Basins COVID-19 operations plan was approved last week by public health officials the final hurdle in permitting the mountains management to open it for the season Summit County public health director Amy Wineland issued an amended public health order in response to the countys increasing number of coronavirus cases.

In recent weeks, the countys rate of cases moved it to sixth-highest in the state, causing Wineland to tighten requirements and guidelines across the county in hopes of stemming the increase with a public health order delivered Friday.

Summit County continues to see a growing trend in outbreaks in its resident population associated with gatherings, activities at restaurants and office-based business operations, Wineland wrote in her order. Theintent of this order is to minimize contact among individuals and reduce the publics exposure tothe novel coronavirus in an effort to prevent further restrictions and closures being imposed uponthe county by the state.

Related: Several Colorado ski areas receive 10 inches of snow from weekend storm

In response, Arapahoe Basin chief operating officer Alan Henceroth issued a plea on his blog, urging compliance from county residents.

If this rate doesnt go down over the next two weeks, more severe restrictions will be put in place, hampering our ability to ski, work and enjoy life, Henceroth wrote. Conventional wisdom tells us that these cases are being brought in by outside tourists. Turns out that is almost completely false. Contact tracing has told us Summit County residents are spreading COVID to other Summit County residents. Nearly all of this is happening through socialization an evening party, drinks after work, hanging too close with too many people. Many of the transmissions have occurred in the late evening, after partying, when peoples guards are down.

If we want to enjoy winter in Summit County, we are going to have to turn things around quickly, he wrote.

Related: Steamboat, northern mountains have best chance for good snow this season

In her order, Wineland asks Summit County residents to adopt six commitments of containment, including:

In addition, she ordered that public and private gatherings are limited indoors to no more than six people from no more than two households, and no more than 10 people outdoors from no more than two households. Restaurants and bars must close at 11 p.m. and alcohol sales must end at 10 p.m. Face coverings that cover the nose and mouth are required indoors. They are also required outdoors when six feet of separation cannot be maintained.

There is clear evidence that some individuals who contract COVID-19 have no symptoms orhave very mild symptoms, which means they are likely unaware they carry the virus, Wineland wrote. Asymptomatic individuals can transmit the disease, and evidence shows the disease is easilyspread, so gatherings of people facilitate transmission of COVID-19.

Summit Countys COVID-19 numbers have elevated it to high-risk since Oct. 11, moving Wineland to sound the alarm and Henceroth to plead for cooperation.

Keep your face coverings on, Henceroth wrote. Maintain your physical distances. Keep your groups small. The time to act is now.

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Could COVID-19 shut down Colorado's ski season before it even begins? - The Know

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Abbott Laboratories' BinaxNOW rapid COVID-19 nasal swab test (Abbott Laboratories via AP)

A total of 220,000 rapid-response COVID-19 tests will soon be en route to Alaska, the U.S. Department of Health and Human Services announced Monday.

The shipment is intended to facilitate the continued re-opening of Alaska schools, businesses and economy, the health department said in a written statement.

The point-in-care antigen tests, manufactured by Abbott Laboratories, are about the size of a credit card and can diagnose coronavirus infections within 15 minutes.

To use the BinaxNOW test, a healthcare worker lays the card flat, adds extraction reagent to the test card, and takes a nasal swab from the patient. The swab is then added to the test card, and the cover is folded over.

After about 15 minutes, the result will display on the card: two pink lines for positive, one for negative.

A free mobile app paired with the test allows patients to scan a QR code on the card and upload their results.

The state will decide how the tests are distributed. They are to support testing K-12 students, teachers, nursing home patients and staff, higher education, critical infrastructure, first responders, and other priorities as (the governor) sees fit," the department said.

The states testing priority right now is congregate settings, and people with symptoms, said Coleman Cutchins, a pharmacist with Alaska Department of Health and Social Services who is helping coordinate the states coronavirus response.

The department said it has already sent over 58,000 of the rapid-response tests to Alaska to places like nursing homes and assisted living facilities. It said the state indicated that the incoming tests could go to marine trade schools, oil work camps and school districts. Long-term care facilities can also request the tests, the department said.

The announcement comes in the midst of a second surge in virus cases in Alaska that shows no signs of slowing.

Widespread testing with quick turnarounds has long been lauded by public health experts as a key tool for getting the pandemic under control.

This spring and summer, Alaska implemented a testing strategy more extensive than most.

But in recent weeks, the states average test positivity rate has climbed above 5%, a metric that health experts say could indicate not enough testing is being done and that widespread community transmission continues.

As of Monday afternoon, the average turnaround time for tests processed by the Alaska State Public Health Laboratories was just under three days, according to the states coronavirus testing dashboard.

According to their packaging, the rapid-response tests are intended for people with virus symptoms early on in their illness.

While antigen tests can be a useful diagnostic tool, they are generally less sensitive than the viral PCR tests, and perform best when a persons viral load is the greatest, according to the U.S. Centers for Disease Control and Prevention.

Testing is not substitute for avoiding crowded indoor spaces, washing ones hands, or wearing a mask when not able to physically distance," U.S. Assistant Secretary for Health Brett Giroir said in the written statement announcing the shipment.

Excerpt from:

Hundreds of thousands of rapid-response COVID-19 tests headed to Alaska - Anchorage Daily News

CHICAGO (CBS) Mayor Lori Lightfoot on Tuesday appeared blindsided by Gov. JB Pritzkers order banning indoor dining in the city of Chicago.

The mayor said she was very concerned about Pritzkers decision, which was made due to a surge in coronavirus cases. On the PBS News Hour, the mayor emphasized that gatherings at peoples homes seem to be the main driver of infection in Chicago, and many restaurants are already on the brink as it is.

Theres a number of restrictions, and were very concerned about them. Our restaurant industry, our bars, our gyms, indoor spaces if the governors order goes into effect, its really effectively shutting down a significant portion of our economy at a time when those same businesses are really hanging on by a thread, Lightfoot told PBS News Hour host Judy Woodruff. So were going to continue our engagement with the governor and his team, but its not looking good, and if we cant convince them that some other metrics should apply, then the shutdown, unfortunately, is going to take effect starting on Friday by state order.

Mayor Lightfoot reiterated a statement she made last week that two thirds of people who have tested positive in Chicago recently have said they got the virus from someone they knew.

I think that weve got to look at what our metrics are. No question, were seeing an uptick in cases. Were also seeing percent positivity go up. But hospitalizations are not at the breaking point like we feared back in the spring, and I think thats an important metric that needs to have some really significant rank, and also, weve got to be very surgical in the way the we impose these new restrictions. The truth is that where were the greatest challenges is in peoples homes in social settings that are not public, the mayor said.

Given that, the mayor said, Im not sure that were reaching the right people with the restrictions that are going to be imposed by the state, and thats my concern.

Gov. JB Pritzker announced Tuesday that indoor dining and bar service will be suspended in Chicago on Friday due to rising COVID-19 cases.

That came just a day after Mayor Lightfoot talked with CBS 2 about the timetable for tightening restrictions.

In a wide-ranging interview, Kozlov asked the mayor, Youre not like 24 hours away from, for instance, banning indoor dining again in the city?

No, we would give a lot more notice if we were going to do something like that, Lightfoot said on Monday.

But that was, in fact, about 24 hours away from an announcement that tighter mitigation efforts will go into effect for the city of Chicago effective Friday.

Region 11 is now averaging more than twice as many COVID-related hospital admissions per day as it was a month ago, with a positivity rate that has almost doubled since the beginning of October, Pritzker said Tuesday. So, starting on Friday the city, too, will begin operating under our resurgence metrics, with a closure of indoor restaurant and bar service and a restrained gathering cap limit of 25 people. We cant ignore what is happening around us because without action, this could look worse than anything we saw in the spring. So please, no matter where you live, what your politics are, where you work or who you love: Illinois: mask up! And well get through this together.

Chicago Department of Public Health Commissioner Dr. Allison Arwady earlier said, while she would support the governor if he did move forward with enhanced mitigations for Chicago, she said, obviously, Im concerned.

As CBS 2s Jermont Terry reported, bar and restaurant owners across the city were stunned by the new orders, and hoped the governor and mayor could come to some understanding that would keep people dining in.

Under the governors order, clocks are ticking for just how many meals can be served at Sayat Nova, off Michigan Avenue and Ohio Street.

Expenses are high, said Sayat Novas Roupen Demirdjian. Were living one day at time.

There is plenty of uncertainty for the Armenian restaurant at 157 E. Ohio St.

Somehow, we survived 51 years, Demirdjian said. I guess well try to make it to 52.

That is especially the case since the governors latest ban is days away and will keep people from sitting at the tables.

When they said the second surge was coming, I knew it was only a matter of time, Demirdjian said.

In the Morgan Park neighborhood on the citys Southwest Side, the owner of Manzos Burger relies on his dine-in customers.

We already had to cut back hours, said Manzos Burger owner Josue Manzo.

He only wants to flip burgers, not see the mayor and governor cooking up steam about his livelihood.

I wish that the mayor and governor could go back when they were first in this pandemic, where they were both communicating and they knew what was going at the same time, Manzo said.

Earlier Tuesday afternoon, Mayor Lightfoot issued the following statement:

Communication is the key to navigating through this crisis. We will continue our efforts to engage with the Governor and his team to better understand their metrics so that we can forge targeted solutions to address the public health challenges here in Chicago and across the state. The Governor and I are aligned that we need residents to mask-up and follow the City and States health guidance in order to reverse these recent troubling trends, but we must remain in lockstep when it comes to the rollout of new restrictions. Even amid the pandemic, I urge residents to continue to find ways to support our small businesses and their local communities.

CBS 2s Jermont Terry contributed to this report.

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Mayor Lightfoot Very Concerned About Ban On Indoor Dining, Other COVID-19 Restrictions Imposed By Gov. Pritzkers Office In Chicago - CBS Chicago

Past research has attributed income-based inequalities in young childrens academic achievement and educational attainment in part to differences in the home environment; that is, to differences in what parents do and the goals that drive their behavior. However, in our studies using data on parenting behavior and parental goals over the past 30 years, we found that income-based differences in parenting have been steadily decreasing. For instance, since the mid-1980s, low income parents have greatly increased the time they spend in enrichment with young children, such as reading to them, telling them stories, and taking them to the library. And, when we look at parents goals for children, we see a complete convergence in trends over time, such that high and low income parents today are equally likely to value childrens thinking for themselves and working hard over being obedient, a trait low-income parents consistently rated as more important than higher income parents throughout the 20th Century.

Consequently, economically advantaged and disadvantaged parents of young children share more similar parenting behaviors and goals today than ever before.There is some evidence these changes are benefitting young children too Reardon and Portilla find that test score gaps between kindergartners at the top and bottom of the income distribution narrowed in the first 20 years of the 21st century after increasing from the 1970s to 2000.

The COVID-19 crisis, and the economic and social restrictions that followed it, threaten that progress. The pandemic has exacerbated inequalities in families economic, health and educational resources that will tax low-income parents ability to pursue and realize their goals. Decades of research describes the toll taken by job loss, income instability, and material hardship on parent mental health, parent-child interaction, and childrens development and we can see in emerging data from the pandemic that these phenomena remain true today.

Our respective research teams have been following hundreds of low-income families with young children from before the onset of the pandemic through this spring after its onset. One of these longitudinal studies is of 272 predominantly Latinx families of elementary school children in rural Pennsylvania, and the other is of 314 predominantly Black and Latinx families of preschoolers in Chicago. Despite the differences in demographics, emerging evidence from families surveyed between April and June of this year shows striking similarities in the ways in which three pillars of parenting economic stability, parental mental health, and support for childrens learning have been shaken. In rural Pennsylvania, for example, we found a substantial increase in the share of parents who worried they would run out of food before they could afford to buy more, just as parents reports of daily worry and depression increased steadily from February to May 2020. In Chicago, we similarly found that the share of families who reported struggling to make ends meet nearly doubled, from 13% to 23% from last fall to this spring. Not surprisingly, these same parents reported a substantial increase in their levels of stress. Disruptions in parent-child interaction are also apparent: Among parents in Pennsylvania, the share of parents who reported losing their temper with their children on any given day increased by 60 percent from February to May. In Chicago, the share of parents who agreed with the statement I feel overwhelmed by the responsibility of being a parentrose significantly from 8.9% last fall to 14.3% this spring.

Furthermore, given the ongoing economic crisis and move to online learning in many school districts, there is reason to believe that support for young childrens skill development has also diminished during the pandemic, particularly for low-income families who are experiencing high levels of stress and few resources for at-home.The challenges posed by the digital divide, which impedes schools and teachers abilities to support parental engagement in their childrens learning, exacerbate this problem. In Chicago, we found that the share of parents who reported not reading to their preschool age child at all in the prior week nearly doubled, rising from 4.7% to 8.2% between last fall (when preschools were open) and this spring when preschools schools were closed. The increase in not reading at all was accompanied by a decrease in the number of parents who reported daily reading.

This reduction in time spent supporting childrens learning is despite the fact that about three-quarters of parents of preschoolers report being somewhat or very worried about their childrens learning and social skills as a consequence of the pandemic-related school closures. These changes in parent support for learning are a particular problem for low income preschool-age children because evidence shows that the preschool years are crucial for future success and are a source of increasing disparities later in life.

Numerous policy proposals to support low income families are on the table, from federal efforts to pass another stimulus bill and expand federal food assistance to local efforts to connect low income families with high speed internet access and functioning digital devices. Our research suggests all of these options should be pursued vigorously and simultaneously so that the pandemic does not break the three pillars of parenting and wipe out decades of progress for low income families and children.

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COVID-19 could erase parenting gains of the last 30 years - Brookings Institution

The Covid-19 pandemic has swept across our nation and robbed the lives of over 200,000 individuals in the United States, with what feels like no end in sight. Infecting our universities, workplaces, and communities at mounting rates, not even the highest level of federal leadership has been spared. It is even more heartbreaking to know that minority communities have been among the hardest hit throughout the pandemic, bearing the highest burden of job loss, infection, and death.

Covid-19 has magnified systemic health inequities that have long been perpetuated by barriers in access to care, physician bias, and financial disincentives. Many minority communities are experiencing difficulties in accessing Covid-19 testing due to unequal site distribution, lack of transportation, and limited hours of operation. Compounding matters further, minorities are more likely to work in frontline jobs considered essential and live in densely populated neighborhoods and residences, both of which dramatically increase the risk of infection. While CMS and payers have worked to mitigate barriers for lower income individuals (e.g., waiving cost-sharing), minorities often fall into coverage gaps with 22% still lacking coverage compared to 8% of white individuals.

Over the last eight months, the realities in health disparities have been well-publicized, leading some cities to implement stop-gap solutions through initiatives like pop-up community-based testing in underserved areas. Building on these initiatives and the momentum of our countrys racial justice reckoning, we are entering the next phase of the pandemic and face a critical decisionhow will we ensure equitable distribution of a vaccine while maintaining equitable access to testing?

Learning from our mistakes: how historical vaccine distribution has exacerbated health disparities

While Covid-19 is distinct from any health crisis the country has previously faced, there are still many parallels. As such, assessing U.S. public health strategies during past crises can provide insight into what has contributed to a more or less equitable response.

The mid-1900s polio pandemic highlighted the ubiquity of the U.S. healthcare systems racial segregation. Leading up to this pandemic, the U.S. Public Health Service was conducting the infamous Tuskegee Study, in which Black men of Alabama were lied to, mistreated, and denied treatment. This study reinforced long-standing mistrust which, combined with the lack of public education in communities of color and a decentralized vaccine distribution effort, led to an uptick in polio cases primarily in low-income Black communities.

As for a more recent case study, the approach to vaccine distribution for the H1N1 virus differed significantly from that of the polio pandemic. The CDC initially prioritized distribution to high-risk individuals and healthcare professionals. Health authorities then leveraged targeted strategies to narrow the gap between white and minority vaccination coverage with interventions such as localized action plans, partnerships with minority-focused health organizations, and free vaccinations. However, vaccination rates among Black individuals still lagged behind, suggesting that even targeted strategies may not be sufficient for fully addressing these racial disparities.

History has shown that one of the largest challenges in vaccine distribution is convincing the public of a vaccines safety and efficacy. This is especially concerning as public distrust of a vaccine is higher than ever due to the politicization of healthcare, and is especially high among Black Americans. While 58% of white people surveyed indicated they would be willing to be vaccinated this year, that figure is much lower at 43% among Black Americans.

An effective strategy for supporting vaccination efforts in minority communities will require a thoughtful approach that builds upon lessons from our past.

Prioritizing vaccine distribution for vulnerable populationsTo date, several policies have been introduced that consider race, socioeconomic status, and broader vulnerability in the distribution strategy of a Covid-19 vaccine. The CDC, advised by the National Academies, recently proposed a framework for equitable allocation. First, prioritize healthcare workers and first responders, followed by nursing home residents and individuals with underlying conditions. Next, prioritize teachers, childcare workers, and essential workers, with vaccines only available to the general population once supply increases sufficiently. Most notably, the framework suggests that the CDC hold back 10% of the vaccine supply for hot spots identified using the Social Vulnerability Index, which incorporates measures of race, poverty, and housing density among other factors.

Beyond decisions around population prioritization, there are still structural shortfalls that must be addressed to ensure equitable distribution. For example, many minority individuals have not been formally diagnosed with high-risk conditions, and thus would not surface as high priority vaccine candidates in population data. Even for individuals who are appropriately identified, many lack access to transportation or reside in rural areas with inaccessible vaccine distribution sites.

Strategies to narrow vaccination inequities a playbook for payers and providersPartnerships between payers, providers, digital health solutions, and the government will be essential in expanding awareness, deploying up-to-date health education, increasing vaccine access, and confirming dosing completion to ensure population-wide immunization.

Adopt digital solutions to expand awareness and education

Payers and providers will be critical actors for driving vaccine awareness by meeting hard-to-reach individuals through a combination of technology and human touch. By partnering with local community leaders, advocacy groups, and faith-based organizations, providers can equip on-the-ground advocates with resources about vaccine safety and availability. San Joaquin General Hospital leveraged this strategy by partnering with Verilys Covid-19 pathfinder to guide patients to relevant information and local resources. Communication of information in multiple languages will be vital for closing the education gaps for multicultural communities of color in particular.

Reduce access barriers with creative localized approachesAddressing access barriers will likely be an operationally challenging, but an essential step in closing care gaps. Payers can be a critical partner by leveraging existing social determinants data to uncover challenges that may inhibit vaccination and provide tailored solutions in target communities, such as providing transportation and directing members to care sites with flexible hours. BCBS of Oklahoma tackled transportation barriers by collaborating with local city governments to send vans equipped with Covid-19 testing capabilities into vulnerable communities, a strategy which can be repurposed for vaccine distribution.

Closing vaccine completion gaps through digital interventions

Lastly, as most late-stage vaccine candidates will likely require a series of doses, clear education on dosing requirements and data-driven interventions to encourage completion will be essential. Equipped with access to population data, payers and providers can leverage multi-modal communication strategies to deploy both the preferred and most effective intervention tactics. Such a strategy was previously applied in inner-city primary care practices for HPV vaccine communication and intervention, ultimately increasing completion rates of the vaccine series. Digital solutions will be a critical component for reaching populations and driving vaccine completion at scale.

While the resources that have been devoted to removing cost barriers are encouraging, this is just one piece of a broader solution. Effective strategies for supporting vulnerable populations will require more coordinated involvement from payers, providers, communities, and government agencies to holistically identify unmet needs at the local level, close access barriers, and deliver tailored education. But coordination efforts will only go so far; such strategies must be amplified by equipping consumers with information and empowering them to become stewards of their own health. At this critical juncture in the pandemic, we as a society have a moral and social responsibility to support the individuals that have historically fallen victim to systemic care gaps. It is time to finally tackle the hard problem of healthcare inequity.

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Why prioritizing health equity in the Covid-19 vaccine distribution is not just right, but necessary - MedCity News