Category: Covid-19

64 higher income economies have joined the COVAX Facility, a global initiative that brings together governments and manufacturers to ensure eventual COVID-19 vaccines reach those in greatest need, whoever they are and wherever they live. These 64 economies include commitments from 35 economies as well as the European Commission which will procure doses on behalf of 27 EU member states plus Norway and Iceland.

By pooling financial and scientific resources, these participating economies will be able to insure themselves against the failure of any individual vaccine candidate and secure successful vaccines in a cost-effective, targeted way.

The 64 members of the Facility will be joined by 92 low- and middle-income economies eligible for support for the procurement of vaccines through the Gavi COVAX Advance Market Commitment (AMC), a financing instrument aimed at supporting the procurement of vaccines for these countries. This means that 156 economies, representing roughly 64% of the global population in total, are now either committed to or eligible for the COVAX Facility, with more to follow.

With the Commitment Agreements secured, the COVAX Facility will now start signing formal agreements with vaccine manufacturers and developers, which are partners in the COVAX effort, to secure the doses needed to end the acute phase of the pandemic by the end of 2021. This is in addition to an ongoing effort to raise funding for both R&D and for the procurement of vaccines for lower-income countries via the Gavi COVAX AMC.

COVAX is now in business: governments from every continent have chosen to work together, not only to secure vaccines for their own populations, but also to help ensure that vaccines are available to the most vulnerable everywhere, said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance, which is coordinating the COVAX Facility. With the commitments were announcing today for the COVAX Facility, as well as the historic partnership we are forging with industry, we now stand a far better chance of ending the acute phase of this pandemic once safe, effective vaccines become available.

The COVAX Facility is part of COVAX, the vaccines pillar of the Access to COVID-19 Tools (ACT) Accelerator, which is co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance, and the World Health Organization (WHO) working in partnership with developed and developing country vaccine manufacturers, UNICEF, the World Bank, Civil Society Organisations and others.

The allocation of vaccines, once licensed and approved, will be guided by an Allocation Framework released today by WHO following the principle of fair and equitable access, ensuring no participating economy will be left behind. Policies determining the prioritization of vaccine rollout within economies will be guided by recommendations from the WHO Strategic Advisory Group of Experts on Immunization (SAGE), which has recently released a Values Framework laying the groundwork for subsequent guidance on target populations and policies on vaccine use.

COVID-19 is an unprecedented global crisis that demands an unprecedented global response, said WHO Director-General, Dr Tedros Adhanom Ghebreyesus. Vaccine nationalism will only perpetuate the disease and prolong the global recovery. Working together through the COVAX Facility is not charity, its in every countrys own best interests to control the pandemic and accelerate the global economic recovery.

The commitment of fully self-financing economies will now unlock vital funding and the security of demand needed to scale up manufacturing and secure the doses needed for the Facility. CEPI is leading COVAX vaccine research and development work, which aims to develop at least three safe and effective vaccines which can be made available to economies participating in the COVAX Facility. Nine candidate vaccines are currently being supported by CEPI; eight of which are currently in clinical trials.

This is a landmark moment in the history of public health with the international community coming together to tackle this pandemic. The global spread of COVID-19 means that it is only through equitable and simultaneous access to new lifesaving COVID-19 vaccines that we can hope to end this pandemic, said Dr Richard Hatchett, CEO of CEPI. Countries coming together in this way shows a unity of purpose and resolve to end the acute phase of this pandemic, and we must now work closely with vaccine manufacturerswho play an integral part in the global responseto put in place the agreements needed to fulfil COVAXs core aim: to have two billion vaccine doses available by the end of 2021. Today, we have taken a great leap towards that goal, for the benefit of all.

The success of COVAX hinges not only on economies signing up to the COVAX Facility and commitments from vaccine manufacturers, but also filling key funding gaps for both COVAX research and development (R&D) work and the Gavi COVAX AMC to support participation of lower income economies in the COVAX Facility.

Governments, vaccine manufacturers (in addition to their own R&D), organisations and individuals have committed US$ 1.4 billion towards vaccine R&D so far, but a further US$ 700-800 million is urgently needed to continue to move the portfolio forward in addition to US$ 300 million to fund WHOs SOLIDARITY trial.

The Gavi COVAX AMC has raised around US$ 700 million from sovereign donors as well as philanthropy and the private sector, against an initial target of US$ 2 billion in seed funding needed by the end of 2020. Funding the Gavi COVAX AMC will be critical to ensuring ability to pay is not a barrier to accessing COVID-19 vaccines, a situation which would leave the majority of the world unprotected, with the pandemic and its impact continuing unabated.

The Commitment Agreements also commit higher income governments to provide an upfront payment to reserve doses by 9 October 2020. These funds will be used to accelerate the scale-up of vaccine manufacturing to secure two billion doses of vaccine, enough to vaccinate one billion people assuming the vaccine requires a two-dose regimen. Further details on these upfront payments are available in Gavis COVAX Facility Explainer.

As well as procuring doses for participating economies, the COVAX Facility will also maintain a buffer of doses for emergency and humanitarian use.

Participating country comments

COVID-19 poses serious health concerns to people everywhere, and thats why Canada is committed to working with partners around the world to end the pandemic, said the Rt. Hon. Justin Trudeau, Prime Minister of Canada. Equitable, timely, and affordable access to a safe and effective COVID vaccine will be critical to help protect peoples health. Canada supports the objectives and principles of the COVAX Facility as the only global pooled procurement mechanism for countries to collaborate on this monumental undertaking. Our country is a part of this important global response.

New Zealands commitment to the COVAX Facility supports access to vaccines against COVID-19 for other countries too, said Rt Hon Jacinda Ardern, Prime Minister of New Zealand.

COVAX and the idea of equal access to a COVID-19 vaccine, regardless of ability to pay, is not just a moral imperative, it is the only practical solution to this pandemic. Protecting everyone is the only way we can return our world our trade, tourism, travel, business to normal, said the Honourable Dr Edwin G. Dikoloti, Minister of Health and Wellness for Botswana. We urge those countries who have not yet signed up to do so. Let us work together to protect each other.

Immunisation saves lives. Investing in immunisation infrastructure helps strengthen health systems. We have seen this time and again through our work with Gavi and Alliance partners, said Dr Lia Tadesse, Minister of Health for Ethiopia. By being a part of the COVAX Facility and the AMC we can continue this work and protect our citizens - and the world - against the impact of COVID-19.

With COVAX, the world is joining forces and proving that together, we are stronger and together, we can defeat this pandemic, said Ekaterine Tikaradze, Minister of Health for Georgia. Georgia will be joining the COVAX Facility to give our citizens the best chance at having access to safe vaccines. By doing this, we also make sure health care workers and other high risk persons all over the world have access to these life-saving tools, helping to bring the pandemic under control and we can all recover and rebuild.

Joining the COVAX Facility was not a difficult decision not only will this give Kuwaiti citizens access to COVID-19 vaccines as they become available, it will also mean our friends and partners outside our borders also get access, said His Excellency Sheikh Dr Basel HumoudAl-Sabah, Minister of Health of the State of Kuwait. We need a global solution to this global pandemic: we believe COVAX is that solution.

We believe international cooperation a global effort is key, said Dag-Inge Ulstein, Minister of International Development for Norway. We must continue to work for equitable access to vaccines, tests and treatments. To defeat the coronavirus pandemic, well-off countries need to act swiftly and boldly to make vaccines and treatments available to those who cannot afford to pay themselves. With the commitments to the COVAX facility we are heading in the right direction.

This is a hugely important initiative, which could offer us a path out of the acute phase of this pandemic and a return to normality, said His Excellency Dr Ahmed Mohammed Obaid Al Saidi, Minister of Health of the Sultanate of Oman. I would urge every country that has not yet done so to sign up, for all our sakes. It is far better for us to work together than apart.

Partner comments

The history of vaccines will be defined by our response to COVID-19; the COVAX facility is at the epicenter of this response. Industry is at the forefront in vaccines development and manufacturing leading to supplies of several billion doses within the next few years, said Mr. Sai D. Prasad, President of the Developing Countries Vaccine Manufacturers Network (DCVMN). The COVAX facility will have a major impact on lives, livelihoods and accelerate the return to normalcy for countries. The DCVMN is fully engaged with its partners to enhance its mission of global public health and to leave no one behind.

It is very encouraging to see so many countries move from talk to full commitment, said Thomas Cueni, Director General of the International Federation of Pharmaceutical Manufacturers (IFPMA). The Facility can only work, and equitable access can only be achieved, if there is solidarity between rich and poorer countries. Today vaccine makers who have the unique skills and expertise to scale up manufacturing to levels never seen before, stand ready, together, to take up the challenge of providing two billion doses of yet unknown COVID-19 vaccines. This is no mean feat, as it requires doubling existing capacity in record time. Today, marks a significant step forward, and is a historic mark of solidarity which has the power to bring the acute phase of this pandemic to an end; and we are proud to be part of this unique endeavour to leave no one behind.

Uniting our efforts through COVAX must guarantee fair allocation and equitable delivery of the COVID-19 vaccine to those who need it most, and not just those who can afford it, said Jagan Chapagain, Secretary-General of the International Federation of Red Cross and Red Crescent Societies. We all have a moral and public health imperative to protect the poor in rural communities as the affluent in cities, the old in care homes as the young in refugee camps. The power of our humanity and the success of COVAX will be measured by how we collectively protect the most vulnerable among us."

"Global cooperation must be the cornerstone of our global response to COVID-19, said Kevin Watkins, Chief Executive of Save the Children. The COVAX Facility has the potential to help ensure universal and equitable access to future COVID vaccines. For this to happen, we need to ensure people in low- and middle-income countries get their fair share and can access the vaccines they need to help overcome the biggest public health and child rights crisis of our generation."

Seeing such unity in the face of the COVID-19 crisis gives us confidence that, together, we can ensure the equitable delivery of COVID vaccines globally, said Henrietta Fore, UNICEF Executive Director. With our globe-spanning supply chain and on-the-ground presence across 190 countries, UNICEF is proud to support this historic effort.

Notes to editors

A COVAX Facility Explainer document is available on the Gavi website here:, as well as a Q&A from Gavi CEO Seth Berkley here.

The full list of fully self-financing economies that have submitted both binding Commitment Agreements and non-binding Confirmations of Intent to Participate, as well as the 92 low- and middle-income countries eligible for the Gavi COVAX AMC, is available here.

About Gavi, the Vaccine Alliance

Gavi, the Vaccine Alliance is a public-private partnership that helps vaccinate half the worlds children against some of the worlds deadliest diseases. Since its inception in 2000, Gavi has helped to immunise a whole generation over 760 million children and prevented more than 13 million deaths, helping to halve child mortality in 73 developing countries. Gavi also plays a key role in improving global health security by supporting health systems as well as funding global stockpiles for Ebola, cholera, meningitis and yellow fever vaccines.After two decades of progress, Gavi is now focused on protecting the next generation andreaching the unvaccinated children still being left behind, employing innovative finance and the latest technology from drones to biometrics to save millions more lives, prevent outbreaks before they can spread and help countries on the road to self-sufficiency.Learn more atwww.gavi.organd connect with us onFacebookandTwitter.

The Vaccine Alliance brings together developing country and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry, technical agencies, civil society, the Bill & Melinda Gates Foundation and other private sector partners. View the full list of donor governments and other leading organizations that fund Gavis workhere.

About CEPI

CEPI is an innovative partnership between public, private, philanthropic, and civil organisations, launched at Davos in 2017, to develop vaccines to stop future epidemics. CEPI has moved with great urgency and in coordination with WHO in response to the emergence of COVID-19. CEPI has initiated nine partnerships to develop vaccines against the novel coronavirus. The programmes are leveraging rapid response platforms already supported by CEPI as well as new partnerships.

Before the emergence of COVID-19, CEPIs priority diseases included Ebola virus, Lassa virus, Middle East Respiratory Syndrome coronavirus, Nipah virus, Rift Valley Fever and Chikungunya virus. CEPI also invested in platform technologies that can be used for rapid vaccine and immunoprophylactic development against unknown pathogens (Disease X).

About WHO

The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable. Our goal for 2019-2023 is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and wellbeing.

For updates on COVID-19 and public health advice to protect yourself from coronavirus, visit http://www.who.int and follow WHO on Twitter, Facebook, Instagram, LinkedIn, TikTok, Pinterest, Snapchat, YouTube

About ACT-Accelerator

The Access to COVID-19 Tools ACT-Accelerator, is a new, ground-breaking global collaboration to accelerate the development, production, and equitable access to COVID-19 tests, treatments, and vaccines. It was set up in response to a call from G20 leaders in March and launched by the WHO, European Commission, France and The Bill & Melinda Gates Foundation in April 2020.

The ACT-Accelerator is not a decision-making body or a new organisation, but works to speed up collaborative efforts among existing organisations to end the pandemic. It is a framework for collaboration that has been designed to bring key players around the table with the goal of ending the pandemic as quickly as possible through the accelerated development, equitable allocation, and scaled up delivery of tests, treatments and vaccines, thereby protecting health systems and restoring societies and economies in the near term. It draws on the experience of leading global health organisations which are tackling the worlds toughest health challenges, and who, by working together, are able to unlock new and more ambitious results against COVID-19. Its members share a commitment to ensure all people have access to all the tools needed to defeat COVID-19 and to work with unprecedented levels of partnership to achieve it.

The ACT-Accelerator has four areas of work: diagnostics, therapeutics, vaccines and the health system connector. Cross-cutting all of these is the workstream on Access & Allocation. More information on the ACT Accelerator is available here.

Read more here:

Boost for global response to COVID-19 as economies worldwide formally sign up to COVAX facility - World Health Organization

Without that information, its hard to know what to make of the Frankfurt COVID-19 study or others like it. Yes, some patients have myocarditisbut what does that mean? How do the numbers compare to other respiratory viruses? Will COVID-19 patients with myocarditis recover fully, or will some have long-term problems? Is this virus doing something strange, or are researchers just studying it more intensely than other viral infections? For now, its difficult to say.

The worry is that COVID-19 is doing whatever its doing at scale. The original SARS epidemic of 2003 infected only 8,000 people, killed slightly fewer than 800, and was over in three months; its impact on the heart was lost in the historical bin of the scientific literature, says Checchia. SARS-CoV-2, by contrast, has infected at least 31 million people and killed at least 960,000. Its effects are thousands of times more obvious than its predecessors. Even if its no worse than any other viral illness, its sheer scope means that a tiny risk of severe long-term problems would still translate to a lot of failing hearts.

Reassuringly, there hasnt been an obvious influx of patients being admitted to the hospital with unexplained myocarditis, despite the huge numbers who have had COVID-19, says Venkatesh Murthy, a cardiologist at the University of Michigan. I dont find it convincing that there is a major amount of serious clinically relevant myocarditis in people who are feeling well.

Read: The empty space where normal once lived

Still, he and others say that long-term studies are important. Were still early, says Chen. I dont think theres a defined time point when wed expect to see heart failure, so we have to follow these patients for months or years down the road.

That can be unnerving for people who are currently sick. Long-haulers, who are struggling with months of debilitating COVID-19 symptoms, are responding to the medias interpretation of these studies and, to put it bluntly, are rightfully freaking out, said Kontorovich, who is part of a team that provides care for long-haulers. But for now, she sees the myocarditis issue and the long-hauler phenomenon as separate matters.

Some long-haulers have been diagnosed with dysautonomiaa group of disorders that disrupt involuntary bodily functions, including heartbeats (which can become inexplicably fast) and blood pressure (which can suddenly crash). But people who have lingering heart problems after viral myocarditis dont usually experience the chronic symptoms that long-haulers do, and they typically have measurable changes to their hearts that long-haulers dont. There may be a connection, but it hasnt been proved, Kontorovich said.

College athletes are also facing immediate decisions. In just the past two months, the 27-year-old basketball player Michael Ojo died from a heart attack during a practice, while the 20-year-old football player Jamain Stephens Jr. died from a blood clot in his heart. Both had previously contracted COVID-19.

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What COVID-19 Does to the Heart - The Atlantic

TheWest Virginia Department of Health and Human Resources (DHHR) reports as of 10:00 a.m., September 21,2020, there have been 519,175 total confirmatorylaboratory results received for COVID-19, with 14,171 totalcases and 312 deaths.

DHHR has confirmed the deaths of an80-year old female from Kanawha County and a 75-year old male from KanawhaCounty. We send our sympathy to these families and urge all WestVirginians to continue to protect our residents, saidBill J. Crouch, DHHR Cabinet Secretary.

CASESPER COUNTY: Barbour(46), Berkeley (947), Boone (198), Braxton (10), Brooke (107), Cabell (724),Calhoun (24), Clay (34), Doddridge (18), Fayette (569), Gilmer (29), Grant(152), Greenbrier (120), Hampshire (100), Hancock (141), Hardy (82), Harrison(341), Jackson (247), Jefferson (419), Kanawha (2,317), Lewis (38), Lincoln(156), Logan (582), Marion (255), Marshall (159), Mason (136), McDowell (80),Mercer (401), Mineral (164), Mingo (356), Monongalia (1,902), Monroe (148),Morgan (52), Nicholas (88), Ohio (356), Pendleton (52), Pleasants (17),Pocahontas (59), Preston (149), Putnam (509), Raleigh (473), Randolph (236),Ritchie (10), Roane (49), Summers (42), Taylor (116), Tucker (15), Tyler (15),Upshur (60), Wayne (356), Webster (7), Wetzel (49), Wirt (10), Wood (348),Wyoming (101).

Pleasenote that delays may be experienced with the reporting of information from thelocal health department to DHHR. As case surveillance continues at the localhealth department level, it may reveal that those tested in a certain countymay not be a resident of that county, or even the state as an individual inquestion may have crossed the state border to be tested.Suchis the case of Clay and Taylor counties in this report.

Pleasevisit the dashboard located at http://www.coronavirus.wv.gov for more information.

Free COVID-19 testing locations areavailable today in Boone, Kanawha, Lincoln, Mingo and Ohio counties:

Boone County, September21, 10:00 AM - 3:00 PM, Boone County Health Department, 213 Kenmore Drive, Danville,WV

Kanawha County, September21, 9:00 AM - 3:00 PM, Nitro High School, 1300 Park Avenue, Nitro, WV (flushots offered)

Lincoln County, September21, 9:00 AM - 2:00 PM, Lincoln County Health Department, 8008 Court Avenue,Hamlin, WV

Mingo County, September21, 2020, 1:00 PM 4:00 PM, Parking lot across from Giovannis Pizza, US 52, Kermit,WV

Ohio County, September21, 9:00 AM - 4:00 PM, The Highlands (Power Center - lower parking lot), 565Cabela Drive, Triadelphia, WV

Testing is available to everyone,including asymptomatic individuals. Formore testing locations this week, visit https://dhhr.wv.gov/COVID-19/pages/testing.aspx.

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COVID-19 Daily Update 9-21-2020 - West Virginia Department of Health and Human Resources

The Navy last week released a fresh tranche of records from the investigation into the COVID-19 outbreak aboard the aircraft carrier Theodore Roosevelt this spring.

Those records include statements from leadership, emails and other materials offering further insight into those harried days.

Among the new revelations:

Several members of the ships medical department including the carriers senior medical officer considered leaking a letter to the media about the dire conditions on the ship by late March, around the time that a similar call for help was sent to higher-ups by then-commanding officer Capt. Brett Crozier, correspondence that leaked to the media and led to his firing.

In their letter, the (medical department) signatories outlined their concerns over the situation on TR, detailed the possibility of 50 fatalities onboard the TR based on their assessment of published COVID-19 mortality rates at the time, and threatened to release their letter to the media, a timeline of events states.

Crozier asked them not to send the letter to the media because he had sent his email, with the attached letter, up the chain of command and thought it would address their concerns, according to the timeline.

In the end, Chief Aviation Ordnanceman Charles R. Thacker, 41, was the lone TR sailor to die of COVID-19 complications, but roughly a quarter of the ships 5,000 crewmembers were infected.

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As the Navy scrambled to figure out housing for TR sailors in Guam, "human suffering was the order of the day in an aft section of the ship set up to isolate sailors who had been in contact with shipmates who tested positive, the ships executive officer told investigators.

Sailors are not dumb, they knew they were all in close contact, Capt. Daniel Keeler said in a May statement. We were as open and honest about the situation as we could be.

The new records indicate that feeding the crew out of the ship became challenging as an increasing number of cooks tested positive for the coronavirus.

Meals and conditions were spartan and grew increasingly crowded, Keeler said of the aft isolation section. Sailors had nothing to do except sit in crowded and unpleasant berthing/lounges with other Sailors who might be sick.

Keeler, who came aboard as XO in early March, called the aft berthing quarantine plan a failure that he regretted attempting.

Sailors in aft berthing had anxiety when a rack neighbor would test positive, he told investigators. They knew they had been sleeping next to that Sailor for at least a few days. It was obvious to (the senior medical officer), (command master chief) and I that the entire ship was in close contact and we all needed to go into proper quarantine.

While the investigation has chided TR leadership for not following social distancing protocols as the carrier headed for Guam, Keeler noted that such distance isnt really possible on a carrier.

With 4800 onboard, there was no way to draw a 6-foot circle around every Sailor and still operate, he said in his statement.

Croziers April 2 firing was like dropping a nuclear bomb in the middle of an ongoing crisis, Keeler said. His relief took over everything for two or three days. It was difficult to focus on the real problem fighting a COVID outbreak on a CVN.

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Fresh insights into Theodore Roosevelt's COVID-19 outbreak provided in newly released records - NavyTimes.com

TheWest Virginia Department of Health and Human Resources (DHHR) reportsas of 10:00 a.m., September 20, 2020, there have been 513,967 total confirmatory laboratory results receivedfor COVID-19, with 14,054 total cases and 310 deaths.

DHHR hasconfirmed the deaths of a 79-year old male from KanawhaCounty and an 81-year old female from Putnam County. I ask all West Virginians to do theirpart to diminish the spread of this virus and prevent further loss of life,said Bill J. Crouch, DHHR Cabinet Secretary.

CASESPER COUNTY: Barbour(44), Berkeley (944), Boone (197), Braxton (10), Brooke (107), Cabell (718),Calhoun (24), Clay (35), Doddridge (18), Fayette (564), Gilmer (27), Grant(152), Greenbrier (120), Hampshire (100), Hancock (141), Hardy (81), Harrison(339), Jackson (247), Jefferson (419), Kanawha (2,297), Lewis (38), Lincoln(155), Logan (572), Marion (254), Marshall (158), Mason (136), McDowell (80),Mercer (399), Mineral (164), Mingo (354), Monongalia (1,876), Monroe (148),Morgan (51), Nicholas (87), Ohio (351), Pendleton (52), Pleasants (17),Pocahontas (59), Preston (149), Putnam (496), Raleigh (472), Randolph (234),Ritchie (10), Roane (49), Summers (41), Taylor (117), Tucker (15), Tyler (15),Upshur (60), Wayne (346), Webster (7), Wetzel (49), Wirt (10), Wood (348),Wyoming (101).

Pleasenote that delays may be experienced with the reporting of information from thelocal health department to DHHR. As case surveillance continues at the localhealth department level, it may reveal that those tested in a certain countymay not be a resident of that county, or even the state as an individual inquestion may have crossed the state border to be tested.

Pleasevisit the dashboard located at http://www.coronavirus.wv.gov for more information.

Free COVID-19 testing locations areavailable today in Kanawha County and tomorrow in Kanawha, Lincoln, and Ohiocounties:

Kanawha County, September20, 1:00 PM - 5:00 PM, Kanawha-Charleston Health Department, 108 Lee Street,East, (Use Reynolds Street Entrance) Charleston, WV

Kanawha County, September21, 9:00 AM - 3:00 PM, Nitro High School, 1300 Park Avenue, Nitro, WV (flushots offered)

Lincoln County, September21, 9:00 AM - 2:00 PM, Lincoln County Health Department, 8008 Court Avenue, Hamlin,WV

Ohio County, September 21,9:00 AM - 4:00 PM, The Highlands (Power Center - lower parking lot), 565 CabelaDrive, Triadelphia, WV

Additional sites will be open this week inBoone, Cabell, Fayette, Jackson, Kanawha, Marion, Mingo, Putnam and Waynecounties. Testing is available to everyone, including asymptomatic individuals.For testing locations, visit https://dhhr.wv.gov/COVID-19/pages/testing.aspx.

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COVID-19 Daily Update 9-20-2020 - West Virginia Department of Health and Human Resources

Niticia Mpanga, a registered respiratory therapist, checks on an ICU patient at Oakbend Medical Center in Richmond, Texas. The mortality rates from COVID-19 in ICUs have been decreasing worldwide, doctors say, at least partly because of recent advances in treatment. Mark Felix/AFP via Getty Images hide caption

Niticia Mpanga, a registered respiratory therapist, checks on an ICU patient at Oakbend Medical Center in Richmond, Texas. The mortality rates from COVID-19 in ICUs have been decreasing worldwide, doctors say, at least partly because of recent advances in treatment.

If you think all the coronavirus news is bad, consider the uplifting story of Don Ramsayer.

The 59-year-old man from Cumming, Ga., is living evidence that doctors in intensive care units quickly figured out how to help more patients survive.

In early August, Ramsayer was helping his son pack up the car for his freshman year at The Citadel, the Military College of South Carolina. Ramsayer had been having night sweats and wasn't feeling that well, but he tried to play it down.

"We got the last box packed and it was ready to go in the car, and I finally succumbed to my sister and kids, who said 'Dad, something's wrong. Go to the hospital.'"

Ramsayer, a software designer and self-described gym rat, had been diagnosed in November with a slow-moving form of leukemia. But the doctors at Emory Johns Creek Hospital, northeast of Atlanta, ran a few tests and concluded that his new symptoms were actually from COVID-19.

He was admitted to the hospital and got sicker and sicker over the weekend. Ramsayer recalls the doctors phoned his sister and told her to prepare for the worst, "because they did not think I was going to make it."

As his health declined, doctors "basically threw everything in the kitchen sink at me," he says. "Almost like Sherlock Holmes. 'What can we try here? What can we try there to get in front of these things?' "

Doctors gave him a newly available antiviral drug, remdesivir, as well as an experimental treatment called convalescent plasma. That involves transfusions of blood plasma from people who have recovered from COVID-19 and carry antibodies that might help fight the virus.

He also ended up on a ventilator for nine days, under heavy sedation.

Don Ramsayer and his sister Melanie Ramsayer speak over FaceTime on August 30. He'd been off the ventilator for 10 days and was finally recovered enough from COVID-19 to be moved out of the ICU. Don and Melanie Ramsayer hide caption

Ramsayer himself rather unexpectedly ended that phase of his treatment.

"Somehow I got out of the straps," he says in an interview from his hospital bed. "I completely unhooked myself ... and pulled the breathing tube out. And here's the really funny thing. I'm obviously pretty doped up. They had me on all kinds of stuff and how I was even conscious, they aren't even sure of that. The first thing I do is I say, 'Can I have a Coke?' "

He says doctors at first considered reinserting the breathing tube, but they saw he could breathe on this own well enough.

"I continued to improve from that point forward," he says.

Ramsayer's story is remarkable, considering his cancer and the complications of his case. But this story is far from unique.

"We have very much replicated what's been seen worldwide, which is over time the mortality in ICUs have decreased," says Dr. Craig Coopersmith, director of the Emory Critical Care Center. He oversees ICUs at five hospitals in the Emory system, including Johns Creek.

The decline in mortality related to COVID-19 varies month to month. At Emory it has been in the range of 20% to 50%. Coopersmith says there are lots of reasons for that.

A big one is that, when the first wave of Covid-19 hit Atlanta's hospitals in April, doctors had no experience with the disease. Medical management of these patients is now, by comparison, routine.

"There's certainly nothing routine about the pandemic," Coopersmith says, "but in terms of how we're managing it, once you have taken care of something for the tenth time, it is normal."

Doctors can better handle common and serious complications like blood clots. They realized that patients do better if they aren't lying on their backs all the time. Patients in Emory hospitals are encouraged to spend some time lying on their stomachs. That simple effort sometimes is enough to keep them out of the intensive-care unit.

A poster filled with photographs in Don Ramsayer's hospital room a reminder of those at home cheering him on. Don and Melanie Ramsayer hide caption

Ramsayer found it uncomfortable to sleep on his stomach he says he has a couple of blown disks as a result of his days as a powerlifter but he did sleep on his side when he could.

And while no medicine can cure COVID-19, a series of studies showed that steroids can benefit the sickest patients.

Emory, like many medical centers, had not been using steroids such as dexamethasone routinely to treat COVID-19 until a major study from the United Kingdom showed that these drugs reduce the risk of death among seriously ill patients.

"So that's a tremendous success story," Coopersmith says. "In just a few months we have a drug which is easily available everywhere and quite cheap, and which improves survival significantly in the ICU patient population."

Indeed, steroids were part of Ramsayer's treatment.

The trend in improving survival has been documented in intensive care units around the world. Even so, people treated in the ICU for COVID-19 are at higher risk of death than is the case for other viral lung diseases. Across the United States, hundreds of people still die daily from COVID-19.

Coopersmith credits some of the improvements in treatment to scientific advances, as was the case for steroids. He says it also helped that, for the past six months, all the attending physicians shared their observations and ideas with one another on a daily text chat, "and in that we find the art of medicine."

Ramsayer also credits his own deep faith in God for getting him through the ordeal. When we spoke, he was getting ready to be discharged after more than five weeks in the hospital.

"I'm walking, sitting, I can get around. My only limitation is just my oxygen requirement," he says. He considers that a mere inconvenience.

He's eager to return to his work as a software designer, and to keep working with his doctors to figure out the right treatment for his leukemia.

"That's something we'll tackle once I get back on my feet."

You can contact NPR Science Correspondent Richard Harris at rharris@npr.org.

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COVID-19 Survival Improved By Better ICU Care : Shots - Health News - NPR

ENID, Okla. Oklahoma gained 1,101 new COVID-19 cases on Monday, with more than a third of those in Fort Supply in Woodward County, where an outbreak of the virus has occurred in William S. Key Correctional Center, a minimum security facility with an open-dorm environment.

The Department of Corrections had not yet updated its website early Monday afternoon to reflect the latest count of COVID-19 in the state's facilities. As of Friday, Sept. 18, 2020, William Key had 221 inmates who had tested positive for the virus, with seven employees also with confirmed cases.

Monday morning figures released by the Oklahoma State Department of Health show the cases in Fort Supply, a town of about 330, according to the last census, had risen to 827. The last census count for the prison on the DOC website was 1,007, but the count can fluctuate. A spokesman with the DOC said he would gather information about the outbreak but had not yet returned a phone call with that data as of Monday evening.

Rob Crissinger, communications and media relations manager with the OSDH, referred questions toSaxum, a local PR agency, who did not respond to queries on Monday.

Some Oklahoma prisons have been struggling lately with a rise in COVID-19 cases, prompting the state Corrections Department to announce Friday it will deploy rapid response teams to facilities declared COVID-19 hot spots. A team will meet with the facility warden and walk him through every step of the agencys COVID-19 Hot Spot Action Plan, according to a DOC release.

Woodward Emergency Manager Mattsaid during a Woodward County commissioner meeting Monday a team has been sent to W.S. Key, according to a story in the Woodward News.

Overall on Monday, Oklahoma's 1.4% increase in cases brought the cumulative total to 77,908 since March, when the first case was confirmed in the state. It is the fifth day more than 1,000 cases were gained, but officials expected those numbers to rise with the recent shift in the way cases are now reported.

"There is no difference anymore between testing positive from PCR (deep nasal) test or rapid antigen test, theyre both just considered 'cases' now with the recent shift in reporting to include both 'confirmed' and 'probable' cases in the case total, based on CDC guidance," Crissinger said.

Of those cases on Monday, 12,019 were active, a single-day gain of 625, and 64,941, or 83.4%, have recovered, OSDH data shows.

There have been 948 who have died because of or due to complications from the virus, with two of those reported Monday, a Oklahoma County woman in the 50-54 age range and a Rogers County man in the 65 and older age range.

The number of hospitalizations increased in the state, with 5,896 reported by the OSDH Monday, up from 5,755 reported on Friday by the OSDH. St. Mary's Regional Medical Center reported Monday it has 14 inpatients who have tested positive for the virus, and there was a death of a COVID-19-positive patient from another county over the weekend. Integris Bass Baptist Health Center had eight patients hospitalized who had tested positive for COVID-19 as of Monday.

Garfield County saw a single-day increase of 28 cases on Monday, taking the cumulative total to 1,504, with 312 active and 1,174 recovered, according to theOSDH COVID-19 website. Enid saw an increase of 22 cases for an overall 1,418, with 293 active and 1,107 recovered.

Other Northwest Oklahoma county case increases on Monday were six in Major, three each in Blaine and Woods, two in Kingfisher and one each in Grant and Noble. Case increases in cities and towns included five in Woodward, two each in Ames, Meno and Okeene and one each in Cherokee, Dover, Hunter, Kremlin, Okeene, Pond Creek, Mooreland, Watonga and Waukomis. Alva and Hennessey each saw a reduction of one case.

The 18-35 age group continues to lead the increase in cases, with 427 on Monday, according to the OSDH website. The age group made up 36.6% of all cases in the state, according to OSDH data. Other new case gains were 306 in the 36-49 age group, 172 in the 50-64 age group, 118 in the 65 and older age group, 64 in the 5-17 age group and 12 in the 0-4 group.

Cumulative totals of confirmed cases as of Monday were 1,576 in the 0-4 age group, 7,225 in the 5-17 age group, 28,546 in the 18-35 age group, 16,612 in the 36-49 age group, 13,519 in the 50-64 age group and 10,426 in the 65 and older age group. There were six listed as unknown age. The average age of those who have tested positive for COVID-19 is 39.1.

Of those Oklahomans testing positive, 40,536 have been women and 37,324 have been men. There were 48 listed as unknown gender, according to OSDH data on Monday.

Of the overall 948 deaths in the state in which the virus was the cause or a contributor, 760 have been 65 and older and 149 have been ages 50-64, making up a combined 95.9% of the total. There have been 28 deaths in the 36-49 age group, 10 in the 18-35 age group and one in the 5-17 age group. More men, 517, than women, 431, have succumbed to the virus, according to OSDH on Monday.The average age of those who have died is 74.7.

Data shows deaths in 65 of Oklahoma's 77 counties, with 183 in Oklahoma County; 152 in Tulsa County; 68 in Cleveland County; 48 in Rogers County; 40 in Washington County; 33 in McCurtain County; 30 in Creek County; 24 in Wagoner County; 23 in Delaware County; 21 in Muskogee; 20 in Caddo County; 19 in Pittsburg County; 18 in Garfield County; 17 inLeFlore County; 16 in Canadian County; 13 each in Kay and Osage counties; 12 in Comanche County; 11 in Sequoyah County; 10 each in Adair, Grady, Jackson, Lincoln and Mayes counties; nine in Pottawatomie County; eight each in Carter, Greer, and Texas counties; seven in Cherokee County; six each in McClain and Payne counties; five each in Garvin, Okmulgee, Seminole and Stephens counties; four each in Bryan, Haskell, Hughes, Johnston, McIntosh, Okfuskee and Ottawa counties; three each in Cotton, Nowata, Pawnee and Pontotoc counties; two each in Choctaw, Kingfisher, Kiowa, Latimer, Noble and Tillman counties; and one each in Atoka, Beckham, Blaine, Craig, Dewey, Harper, Logan, Love, Major, Marshall, Murray, Pushmataha and Roger Mills counties.

COVID-19 data per county released Monday by OSDH shows Garfield with 1,476 cases, 1,504 recovered, 312 active and 18 deaths, all in Enid, reportedSept. 17,Sept. 12,Sept. 11,10,4,Aug. 29,27,26,18,15,14,13, and6,July 28and23,June 21andApril 10; Woodward with 961 cases, 140 recovered and 821 active; Kingfisher with 323 cases, 293 recovered, 28 active and two deaths, both in Hennessey, reportedSept. 1andAug. 27; Noble with 141 cases, 116 recovered, 23 active and two deaths, including aBillings man in the 65 and older age range; Blaine with 113 cases, 89 recovered, 23 active and one death, a Canton man, reportedAug. 28; Woods with 96 cases, 32 recovered and 64 active; Major with 76 cases, 61 recovered, 14 active and one death, awoman in18-35 age groupin April; Alfalfa with 59 cases, 22 recovered and 37 active; Grant with 40 cases, 30 recovered and 10 active.

CumulativeCOVID-19 cases by city or townin Northwest Oklahoma include 1,418 in Enid (293 active); Fort Supply 827 (814 active); 146 in Hennessey (nine active); 136 in Woodward (43 active); 112 in Kingfisher (nine active); 34 in Alva (57 active); 52 in Watonga (12 active); 44 in Helena (29 active); 38 in Okarche (three active); 34 in Fairview (four active); 31 in Mooreland (one active); 21 in Canton (three active); 20 in Garber (two active); 19 in Cashion (four active) 17 in Ringwood (three active); 14 each in Dover (three active), Seiling (two active) and Waukomis (three active); 12 in Medford (one active); 11 in Lahoma; 10 in Cherokee (seven active); nine each in Billings (two active), Okeene (three active) and Pond Creek (three active); eight in Longdale (two active); seven each in Ames (three active), Fairmont (two active), Lamont and Orlando (one active); six each in Kremlin (one active), Meno (three active) and Nash (four active); five in Covington; four each in Drummond (one active), Freedom, Hitchcock and Mulhall; three each in Cleo Springs, Jet, Marshall, Wakita and Waynoka (three active); two each in Deer Creek (one active) and Hillsdale; and one each in Burlington (one active), Carmen (one active), Goltry and Hunter (one active), according to data released by OSDH on Monday. Residents living in areas with under 100 in population or those with unknown addresses may be recorded as "other."

In Enid, there have been 767 cases, with 586 recovered and nine deaths from the 73701 ZIP code, primarily the eastern half of the city, and 643 cases, with 514 recovered and nine deaths from 73703, or the western half, according to OSDH data on Monday. There also has been one recovered case in the 73705 ZIPcode, which is listed as Vance Air Force Base athttps://www.unitedstateszipcodes.org/.

State Health Department officials areencouraging Oklahomans to get testedfor COVID-19, saying recently that due to adequate supplies, residents no longer need to exhibit symptoms or report exposure to someone with the virus to get in line for testing.

Free testing for COVID-19 is ongoing at the Garfield County and other state Health Departments. Testing is by appointment only for Blaine County, 521 W. 4th, Watonga, (580) 623-7977; Garfield County, 2501 S. Mercer, Enid, (580) 233-0650; Grant County, 115 N. Main, Medford, (580) 395-2906; Kingfisher County, 124 E. Sheridan, courthouse annex room #101, Kingfisher, (405) 375-3008; Major County, 501 E. Broadway, Fairview, (580) 227-3362; Noble County, 300 Fir St., Perry, (580) 336-2257; Woods County, 511 Barnes St., Alva, (580) 327-3192; and Woodward County, 1631 Texas Ave., Woodward, (580) 256-6416. For a full list of county drive-through testing, go tohttps://coronavirus.health.ok.gov/drive-thru-testing. Some health department also advise the public to check their Facebook pages for more information regarding testing.

Emergency warning signs for COVID-19 are trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse, bluish lips or face, according to the CDC. More information can be found athttps://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html.

Those with symptoms of COVID-19 should call ahead to local emergency rooms. Those with minor symptoms should contact their regular physicians.

Resources and information on COVID-19 can be obtained by calling 211 or going tohttps://covidresources.ok.gov/.

BREAKING NEWSon the COVID-19 threat and its impact is available athttps://www.enidnews.com/virusand isfree for all readers. That includes information on closings and cancellations.

Get full-access breaking news via text alerts at https://enidnews.com/textalerts.

For more local, state, national and global COVID-19 pandemic news, go tohttps://enidnews.com/news/covid19.

All breaking news is fully accessible on theEnid News & Eaglewebsite.

Information also can be found athttps://coronavirus.health.ok.gov/andhttps://www.cdc.gov/.

We are making critical coverage of the coronavirus available for free. Please consider subscribing so we can continue to bring you the latest news and information on this developing story.

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Oklahoma gains 1101 COVID-19 cases, a third of those in Fort Supply as outbreak continues at prison - Enid News & Eagle

Twelve days after his wife died of the coronavirus, increasing the enormous toll in the United States by one, Michael Davis, dazed and grieving, went back to work.

He hoped that his job, at an assembly plant in Louisville, Ky., would keep his hands busy, which might then occupy his mind, too. Maybe it would ease his longing for Dana, 51, a nurse with blond hair and a bright smile. They were just shy of their seventh wedding anniversary when the coronavirus took her life.

But at work, it felt like the pandemic was the only thing people could think about, the center of conversation at his sprawling factory. And on the news, every story seemed to be about the coronavirus.

Everythings corona, everythings corona thats all you hear about all the time, Mr. Davis said. You dont want that reminder all the time of why shes gone.

The coronavirus crisis in the United States has claimed nearly 200,000 lives, the young and the old, those living in dense cities and tiny towns, people who spent their days as nursing home attendants, teachers, farm laborers and retirees.

The loved ones left behind are trapped in an extraordinary state of torment. They have seen their spouses, parents and siblings fall ill from the virus. They have endured the deaths from a distance, through cellphone connections or shaky FaceTime feeds. Now they are left to grieve, in a country still firmly gripped by the coronavirus pandemic, where everywhere they turn is a reminder of their pain.

That aftermath has been uniquely complicated, and cruel. In dozens of conversations, people across the United States who have lost family members to the coronavirus described a maelstrom of unsettled frustration, anger and isolation, all of it intensified by the feeling that the pandemic is impossible to shut out.

Many are bitter over the governments handling of the pandemic, which has brought bleak milestones since the first announcement of a coronavirus death in the United States in late February. By May 27, more than 100,000 people in the country had died from the virus. Less than four months later, nearly 100,000 more people are dead, losses captured in the flags, crosses and photographs at memorials that are popping up around the country.

Some survivors have felt a stigma attached to their loved ones deaths, a faint suggestion by acquaintances that their relatives were somehow to blame for being infected. And they have been particularly distraught by the constant mentions of it in conversations and in the news, inescapable reminders that resurface their own losses like a pinprick.

Unless youre one of the people who has lost somebody to this, said Corinthia Ford of Detroit, whose father, a beloved pastor, died from the coronavirus in April, you dont understand.

In Louisville, Mr. Davis ultimately went on short-term leave, realizing that he needed to step away from a job that demanded a focus he had temporarily lost.

But staying home brought a different misery.

In the evenings, he began skipping the news in favor of Netflix, where he hoped he might avoid mentions of the coronavirus. Scrolling through Facebook, it was a constant topic. He read posts from people who were cavalier about its risks, dismissing it as a minor affliction that killed a small fraction of people who caught it.

One of those people, he thought, was his Dana.

For Teresa DiMezza, a high school guidance counselor in New Jersey, September brought a new academic year and a busy schedule. But there was no respite from the virus, or from the questions that have been left unanswered since her father, Samuel Fuoco, 71, died from the coronavirus in April.

She wonders how her father, a military veteran who was so strong, could have died so quickly. How was he infected in the first place?

This is a mystery that will never be solved, and we have to learn to live with this, Ms. DiMezza said. We will never know and that is sickening.

She and her family members have been plagued by guilt, reliving the scramble to manage his medical care, which had to happen entirely over the phone because of hospital restrictions.

What if we were there? she said. What if we hadnt had him intubated? Is he disappointed with us? Did he realize we werent there? Could he hear our voices on the phone?

Families who endured their spouses and relatives hospital stays recounted a whiplash of hopes and disappointments. Joe Takash of suburban Chicago believes he knows how his parents both became infected with the coronavirus in May.

They had been so cautious, following all the rules, staying inside and away from other people. Then one day, his mother, Kathleen Takash, wanted to drop off some clothes at her seamstresss house. They hugged and chatted for a bit. It turned out that the seamstress was infected with the virus but did not know it. Soon, both of his parents were sick.

But Mr. Takash does not know why his father, 87, recovered from the virus quickly while his mother, 82, succumbed in a hospital in June.

On two different occasions, the family thought she was going to be discharged. Then she would take a turn for the worse.

Even when I realized the writing was probably on the wall, youre still hoping for a miracle, Mr. Takash said. If she had terminal cancer or something, you know theres no chance.

Shane Peoples, 41, has had plenty of grief since his parents were taken by the coronavirus this month. It has frequently been interrupted by outrage.

He tells their story like the storybook romance it was: Darlene and Johnny Peoples, native North Carolinians, were happily married for nearly half a century, and were exceptionally close and devoted to their children. But that lifetime together ended abruptly when the couple, both of them stricken by the coronavirus, died four minutes apart while holding hands in a hospital room in Salisbury, N.C.

They went to the hospital on the same day. They entered the intensive care unit on the same day. And they died on the same day.

They held each others hands for 50 years, Mr. Peoples said. They held them as they left this earth and they are still holding them in heaven.

He and others who lost relatives to the virus said they could not stop thinking about what they considered the mishandling of the pandemic by President Trump and politicians of both parties closer to home.

Personally, losing my parents brought out a lot of anger for me, said Mr. Peoples, who lives in China Grove, N.C., near Charlotte. They were stolen from us by a virus that should have been contained months ago.

Mr. Peoples, a Democrat whose parents were longtime Republicans, expressed fury at Mr. Trump, who downplayed the virus in the spring and continues to hold large indoor rallies and largely shrug off masks and social distancing.

Fiana Garza Tulip, 40, who lives in Brooklyn, has found it difficult to grieve her mother with her anger so fierce.

She blames state and national political leaders for the death of her mother, Isabelle Odette Papadimitriou, who was 64 when she died of the virus in Dallas in July. And she is furious at people who do not wear masks, who spread misinformation and who are in denial about how lethal the virus can be.

I cant cry and I wish I could, she said. I want to feel all the things you should when a loved one dies so tragically because it helps you get through it. But the anger gets in the way.

Conversations about mask-wearing can cut deep to those who have lost relatives to the virus. Gary Werito Jr., of Tuba City, Ariz., gets angry when he hears the issue framed as a choice that could infringe on personal freedom. What about the freedoms of his mother and aunt, who died from the virus in April?

For some mourners, cutting people out of their lives at least on social media has been the only solution.

Since her uncle and cousin died in Rhode Island after battling the coronavirus, Tammy Chevrette has been tortured by hurtful and inaccurate comments from friends and acquaintances.

I have been mad, but not at God, she said. Some people are so insensitive with the comments they make, like this is fearmongering, and saying this isnt real, its a conspiracy to affect the election and this only affects sickly or old people.

She is coping in the modern way: deleting friends from her Facebook account. I told people off, she said. It was so painful to hear what they were saying.

At the car dealership in Salt Lake City where Cesar Hernandez works, he explained to a co-worker this summer that his father had just died from complications caused by the coronavirus.

It is all fake, Mr. Hernandezs co-worker responded.

He said it was a conspiracy made up by the government and said, Youll see after the November election, the talk about it will disappear, he said. He didnt think the coronavirus was real. Mr. Hernandez was left in shock. I thought to myself, People are not going to change their mentality until it happens to them or a close family member.

Through it all, the mourners are still living through a pandemic.

In her Charleston, S.C., home, Petrice Brown was walking from one room to another this month when a black-and-white Time magazine cover flashed on the television screen. Nearly 200,000 people had died of the coronavirus in the United States, the headline told her.

I stopped in my tracks, she said. And I was like, Wow. My husband is in there.

After that, she stopped watching the news.

It is a common refrain from families who have lost loved ones to the virus: There is no way to turn the world off.

The pandemic dominates social media, newspapers, radio and television. Stopping at the grocery store requires standing on floor markings in the checkout line. Even the simple act of slipping on a mask can be a reminder of a relative who died from the virus.

Ivette Marquez, of Brooklyn, said the numbers the deaths, the cases that continue to flash across television screens and on the internet are seared into her mind. She knows that about 800 others in New York City died of the coronavirus on the same day as her father.

Another woman whose father died from the virus said that hearing the word Covid is like getting punched. One widow said she listened to people talk about a vaccine and could only think of one thing: Whenever it comes will be too late for her husband.

Yesterday was the first time I watched the news in five months, said Denise Chandler of Detroit, who lost both her father and husband to the coronavirus in a matter of weeks this summer. Everywhere you turn, its Covid this, Covid that. Im just tired of hearing about Covid.

In Charleston, Ms. Brown has been receiving some visitors at her home while keeping strict coronavirus guidelines in place. She placed signs at her front door asking people to wear masks and socially distance. Bottles of hand sanitizer are everywhere. All of it is needed, she says, and yet all of it is a painful reminder of what killed her husband, Keith, this month.

She has even been treated by visitors as if she could be contagious. One friend, arriving with a platter of food in her hands, backed away quickly when Ms. Brown, keeping a safe distance of six feet, tried to greet her with a hello.

She said, No, no, Im just dropping this off, Ms. Brown said. It really hurt me.

Perhaps the most difficult part to process, many survivors said, has been losing a family member to a ubiquitous pandemic but being robbed of the ability to publicly mourn.

Families were not allowed to hold their loved ones hands when they died in hospitals. They cannot receive hugs of comfort from friends. They have been forced to curtail gatherings with groups in living rooms, in the pews of churches or at crowded pubs and restaurants in the rituals that guide families through loss.

Even the tradition of a funeral procession dozens of cars in a line, halting traffic around them, making their mourning visible to the community has been painfully disrupted, as funerals have been limited to a small handful of family members at most.

The pandemic has proved an old saying familiar in the funeral trade: Grief shared is grief diminished.

There is some consolation, though, in fellow coronavirus survivors.

Robb Hickey, who lost his 45-year-old wife to the coronavirus in Idaho, said he had been comforted by talking with a woman he grew up with in Burns, Ore., who reached out to him not long ago from her home in North Carolina.

She told me that her husband was one of the first Covid deaths in that area, said Mr. Hickey, who had lived with his wife, Samantha, a nurse practitioner, in Caldwell. Weve talked a couple times now and shared some thoughts and feelings. Talking to other widows and widowers has helped me cope with death.

Others have connected on social media, where groups for mourners have sprung up, and hundreds of people share aching stories of loss.

Ms. Chandler, a mother of eight in Detroit, has had little time for grieving as she raises her children and keeps most visitors away, too worried about exposing her family to the virus.

She took one day last month to let herself be immersed in sadness. She went to a public memorial in Detroit a long, driving tour of photographs of the citys dead, arranged in alphabetical order with her children.

Immediately upon entering, you see the first person that starts in A, and you see how long the line is, Ms. Chandler said. Tears immediately started coming down my face. It took my breath away just to see all of the families that were affected by this virus.

Nicholas Bogel-Burroughs and Steven Moity contributed reporting. Susan C. Beachy contributed research.

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Covid-19 Deaths: With Flags, Crosses and Photos, Mourning 200,000 Dead - The New York Times

Editors note: The Salt Lake Tribune is providing free access to critical stories about the coronavirus. Sign up for our Top Stories newsletter, sent to your inbox every weekday morning. To support journalism like this, please donate or become a subscriber.

As Utahs rate of new coronavirus cases continued to rise on Monday, Gov. Gary Herbert said he would wait at least another day before enacting any new restrictions.

But pressure to step up prevention efforts grew, with one Republican lawmaker calling for Herbert to require masks.

"If we have county leaders that continue to abdicate their responsibilities, then I dont really see any other option but to go ahead and do a statewide mandate, said state Sen. Deidre Henderson, the Republican candidate for lieutenant governor, running with current Lt. Gov. Spencer Cox. The latest spike is maybe testament that we need to maybe do a little bit more as a government, unfortunately.

With 622 new coronavirus cases reported by the Utah Department of Health on Monday, the state has averaged 847 new positive test results per day for the past week far exceeding Julys top weeklong average of 671 new daily cases.

Herbert had said he would meet with other state officials on Monday to determine what, if any, new restrictions might be undertaken in response to the recent surge in new cases but his spokeswoman said he would announce no policy changes until Tuesday.

When asked what proposals Herbert was considering, his spokeswoman Anna Lehnardt said: Everything is on the table," repeating his description from last week.

Although the state had not updated its coronavirus response scoreboard for more than a week, it appears that some of the health measures have strayed farther from the goals set in Herberts latest accountability plan. The goals include keeping weeklong averages to fewer than 400 new cases per day a target Utah met in mid-August but surpassed again on Sept. 3 as cases among young adults exploded.

But the states key metric under Herberts plan a coronavirus death rate of less than 1% stayed at 0.7% on Monday, and younger patients continued to drive new cases. Since late August, the weeklong rates of new cases among patients ages 15 to 24 have more than tripled, from 98 new cases per day to 336 new cases per day as of Monday. During the first week of September, the age group overtook 25- to 44-year-olds as Utahs biggest contributor of new cases, despite comprising a far smaller portion of the states population.

Utahs death toll from the coronavirus rose to 441 on Monday, with one fatality reported since Sunday: a Salt Lake County man, older than 85, who died in a hospital.

The virus continued to spread quickly in Utah County, which recorded 227 new cases Monday down from recent days, but still the most per capita of any county in the state. For the past seven days, Utah County has averaged more than 56 new cases a day per 100,000 residents, more than double the statewide average of 26. By comparison, Salt Lake Countys average per 100,000 residents was 27 new cases per day, and the Bear River Health District in northern Utah was at 21 per 100,000.

Brigham Young University, which has experienced the worst campus outbreak since fall term began, reported 927 cases as of Sunday, up 165 cases in two days.

As of Monday afternoon, neither Utah County officials nor Provos mayor had responded to inquiries made by The Salt Lake Tribune Monday morning. The county, which is at the yellow or low restriction level, had not updated local case numbers on its website since Friday. At that time, Provo, Mapleton, Lindon, Orem, Cedar Hills, Highland, Alpine and Saratoga Springs all had averaged more than 40 new daily cases per 100,000 residents for the previous week.

Henderson said Monday that Utah County, where shes from, needs to have a mask mandate, for sure.

Speaking in a Zoom interview with The Tribune for supporters of the papers Report From America positions, Henderson said she prefers the local government approach," but would support state-imposed restrictions to slow the spread of the virus.

Henderson who represents Spanish Fork in the Legislature announced in August that she was diagnosed with COVID-19, and told The Tribune Monday that she just recently recovered, after spending three weeks on oxygen.

I know that its not a cold. Its not a flu. Its very different from anything Ive ever experienced, she said. Ive been a little bit disappointed lately at the division thats been happening and the rancor and just the polarization and the politicization of wearing a mask.

"Wearing a mask is not about the person wearing the mask. It is about the person wearing the mask not potentially spreading their disease to someone else, Henderson said.

Hospitalizations continued to rise on Monday, with 144 Utah patients concurrently admitted, UDOH reported. On average, 131 patients have been receiving treatment in Utah hospitals each day for the past week up from a week ago, but below the peak average of 211 patients hospitalized each day at the end of July.

In total, 3,520 patients have been hospitalized in Utah for COVID-19, up 26 from Sunday.

Utahs intensive care units were 67.7% occupied as of Monday; the states goal is to keep the level below 85%.

There were 3,886 new test results reported on Monday, far below the weeklong average of 5,767 new tests per day. Testing demand had risen precipitously in the past week but generally remained below its peak in mid-July, when the state was reporting more than 7,000 new test results per day, on average.

Since public schools began opening on Aug. 13, there have been 66 outbreaks in schools, affecting 461 patients, with 2 new outbreaks and 41 new cases reported in the past day.

Since the beginning of the pandemic, there have been 506 patients infected in 77 school outbreaks, with a median age of 16. Twelve of those patients have been hospitalized; none have died.

The virus is spreading particularly rapidly in the Canyons School District of southeast Salt Lake County, where cases jumped from 156 to 194 in two days, and three of the districts six high schools have surpassed 15 cases in the past two weeks the threshold at which the state recommends stopping in-person classes.

Brighton High School also has more than 15 active cases, but remains open for classes, and Alta High School on Monday surpassed 15 active cases, according to county data.

Draper Park Middle School was at 13 active cases on Friday, according to the district, but it the count remained under 15 as of Monday, the county reported.

Meanwhile, Riverton High School in the Jordan School District also remained open on Monday despite identifying at least 15 active cases, Salt Lake County reported. The school board last week voted to close the school for a two-day cleaning and then reopen, in opposition to the states recommendation to move to online-only classes.

Of 64,394 Utahns who have tested positive for COVID-19, 51,660 are considered recovered that is, they have survived for at least three weeks after being diagnosed.

Reporters Bethany Rodgers and Becky Jacobs contributed to this story.

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Another 622 cases of COVID-19 in Utah; Gov. Herbert weighing options for regulations - Salt Lake Tribune

Its unusual that a virus would be less severe in children than it is in adults. But when it comes to COVID-19, kids make up just a small percentage of severe cases. Yale researchers are working to understand why that is.

Their discoveries can help guide understanding of the virus and possible treatment options.

Ina paper published recently in Proceedings of the National Academy of Sciences(PNAS),Dr. Naftali Kaminski, theBoehringer-Ingelheim Endowed Professor of Internal Medicine and chief of Pulmonary, Critical Care and Sleep Medicine, and colleagues shared findings related tochildrens surprising immunity to the virus. They detailed how factors including allergies, asthma, the common cold, and existing vaccines may be having a protective effect.

Meanwhile,Carrie Lucas, assistant professor of immunobiology at Yale, is looking at blood samples from the small percentage of children who develop the rare condition known as Multi-Inflammatory Syndrome in Children, or MIS-C, in response to COVID-19. Her lab is analyzing blood samples for molecular and genetic clues to figure out why a certain subset of kids are most at risk.

Findings just published in the journal Science Translational Medicine led byKevan Herold, the C.N.H. Long Professor of Immunology and Internal Medicine at Yale, revealed that children diagnosed with COVID-19 express higher levels of two specific immune system molecules, a factor that might be leading to better health outcomes.

Related story:Childrens immune response more effective against COVID-19

Understanding why children appear to be better protected from severe cases than adults could provide important clues on how the novel coronavirus spreads, who is at greatest risk, and how to treat it.

This is different from other viruses that affect kids more seriously, Kaminski said. Its an interesting conundrum and could provide implications for therapeutics.

In the PNAS paper, researchers point to the possibility that allergies and asthma in children has a protective effect. When the body responds to an allergy or asthma trigger, the immune system releases Th2 cells, which in turn increases a type of cell called the eosinophil in the blood and tissues. This allergic inflammation has been shown to dramatically reduce the levels of a key receptor to the COVID-19 molecule, known as ACE2. They added that astudy of 85 older adultswho died of COVID-19 in China showed that they had very low levels of blood eosinophils.

Initially, there was a concern about the impact of COVID-19 on children with asthma, said Kaminski. Some 7.5% of U.S. children under 18, or 5.5 million kids, have asthma, according to the Centers for Disease Control and Prevention. But, in fact, it seems that compared to other chronic lung diseases, people with asthma are infected less, and, when they are infected, asthma is not a risk factor.

Instead, risk factors known to drive worse COVID-19 outcomes include age, obesity, hypertension, and cardiac diseases.

The greater exposure children have to the common cold may also offer protection. Coronaviruses are a large family of viruses so named for their crown-like shape under a microscope, of which the common cold is one. SARS-CoV-2, which causes COVID-19, is another.

It is thought that exposure to colds may cause viral interference, when one virus interferes with the replication of a second virus. Exposure to common colds, and more severe illnesses like croup, more common in children, are associated with decreased expression of the ACE2 COVID-19 receptor. Studies have found that children symptomatic with COVID-19 may have high viral loads in their noses but, because they have lower levels of ACE2, their lungs are less likely to become infected. In other words, they can still easily spread the virus, but are less likely to develop serious symptoms.

Kaminski added that there is even evidence that vaccines can provide protection. Astudyof Department of Defense personnel found that the 2017-2018 seasonal flu vaccine produced a statistically significant number of individuals who tested positive for common cold-related coronaviruses. If future flu vaccines are designed to increase common coronaviruses, he said, this phenomenon may actually provide some protection to SARS-CoV-2 through cross-reactive immunity.

Of course, not all children are protected from the worst effects of COVID-19. Lucas and her team of pediatric immune disease researchers at Yale are looking at the rare cases of children who have been seriously affected by the virus. Specifically, they looked at children who were asymptomatic during SARS-CoV-2 infection, but weeks later developed a high fever, vomiting, abdominal pain, and sometimes shock, a condition known as MIS-C.As of Sept. 17, there were 935 confirmed cases of MIS-C in the U.S., and 19 deaths.

Lucas lab, which has enrolled 16 pediatric MIS-C patients, is analyzing immune cells in their blood at the single-cell level, as well as thousands of blood proteins, to understand what is happening.

Mostly, right now, our data are showing what the syndrome isnot, she said. For instance, we have found no sign of an active viral or bacterial infection during acute MIS-C.

They are also collecting saliva samples from parents to compare to childrens samples, which might reveal information about genetic variants. Were looking for the needle in the haystack that could be causing this rare manifestation, Lucas said. So far, theres no evidence that this is something that runs in families. I dont know of any cases where two children in a family developed MIS-C.

What they do know, she said, is that inflammatory markers are high, and most patients respond well to immunosuppressive therapies such as steroids. Additional findings will be published in the coming weeks on MedRxiv, a preprint server founded by Yale scientists which publishes studies before they have been peer-reviewed.

While children largely seem to be protected from the immediate effects of COVID-19, there are still long-term concerns, Kaminski and the authors caution. The pandemic and social distancing, they note, affect maturation of the immune system, psychological health, education, and childhood obesity.

We know that the health of children is strongly affected by socioeconomic downturns, Kaminski said, and this potential adverse outcome should not be overlooked.

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What we know about COVID-19 and kids - Yale News