Category: Covid-19

MADISON, Wis. (WMTV) -- The percent of positive coronavirus tests on Sunday increased, bringing the total number of positive cases in the state to more than 10,000, according to state health officials.

Wisconsin Department of Health Services reported an additional 280 cases on Sunday, bringing the states total number of positive COVID-19 cases to 10,219.

Out of the 3,508 total tests, eight percent returned positive. Thats up from seven percent of returned cases reported on Saturday. More than 3200 tests returned negative, bringing the total to 105,163.

More than 1,800 patients are hospitalized.

DHS also reported on Sunday two additional deaths from the virus, bringing the total to 400.

There are currently 51 labs performing coronavirus testing with a total testing capacity of 13,797.

Health Care workers with COVID-19

DHS is reporting 1,251 cases, or 12-percent, of positive cases in the state are health care workers. They include: nurses, physicians, surgeons, physician assistants, health care support staff, emergency medical technicians and paramedics, dentists and other dental health workers, and pharmacists.

Group housing cases

Roughly six percent of COVID-19 cases in the state are at long-term care facilities, or 634 cases. Four percent or 362 cases are in group housing facilities. A majority of cases are not in a group housing facility.

Recovered cases

As of Saturday, 4,875 of the states COVID-19 cases have recovered. DHS defines the number of recoveries as those who have documentation of resolved symptoms or release from public health isolation. A recovery is also considered 30 days since symptoms began.

Badger Bounce Back gating criteria

According to the Badger Bounce Back Plan, two of the six gating criteria has been met to begin reopening the state.

So far, 95 percent of hospitals say they can treat all patients without crisis standards of care and 95 percent of hospitals say they can do testing for all symptomatic clinical staff treating patients at the hospital.

The following criteria has not been met:

County data

Number of cases and deaths per county, according to the DHS:

Adams : 4 / 1Brown: 1,897 / 18Columbia: 32 / 1Crawford: 17 / 0Dane: 472 / 22Dodge: 67 / 1Grant: 68 / 7Green: 33 / 0Green Lake: 8 / 0Iowa: 10 / 0Jefferson: 50 / 2Juneau: 21 / 1Lafayette: 13 / 0Marquette: 3 / 1Milwaukee: 3,952 / 225Richland: 13 / 2Rock: 354 / 13Sauk: 71 / 3Waukesha: 400 / 23

To see the latest data sets from DHS, CLICK HERE

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More than 10,000 total COVID-19 cases in Wisconsin, percent of positive tests increases - WMTV

Long dissatisfied with the doctor treating his diabetes, Reginald Relf decided to fight through whatever was causing his nagging cough. But then his temperature spiked and his breathing became so labored that he reluctantly took his sisters advice to visit a doctor.

The staff at an urgent care clinic in suburban Chicago sent him home, without testing him for Covid-19 but after advising him to quarantine.

So Mr. Relf, a 50-year-old African-American engineer, settled into his mothers basement. A week later, after he was found dead, his sister, Ami Relf, was left shaken.

When I finally get him to go to seek help, hes turned away, she said. If he was a middle-aged white woman, would they have turned her away? Those are questions that haunt me.

The coronavirus has left tens of thousands of grief-stricken American families struggling to make sense of the seemingly random terror it inflicts, sickening many but only taking some lives.

But for many black families, mourning coronavirus deaths brings an added burden as they wonder whether racial bias may have played a role.

Decades of research shows that black patients receive inferior medical care to white patients. A long history of experimentation, exploitation and mistreatment has left many African-Americans deeply suspicious of the medical establishment. Now comes Covid-19, and the fear among many families, social scientists and public health experts that racial bias might be contributing to the disproportionately high rate at which the novel coronavirus is killing African-Americans.

Americans of all races may have experienced less than ideal care in recent months in an overwhelmed health care system, and it is not uncommon to hear stories of people who visited health professionals for treatment, only to be turned away.

But African-American patients enter the health care system with distinct disadvantages, experts say. There is less access to quality health care in many black communities, research shows, and black people are more likely to suffer from diabetes, hypertension and other underlying conditions that make Covid-19 particularly fatal.

So, should providers misinterpret or ignore coronavirus symptoms in black patients, there is a higher likelihood that the results could be grave, experts say.

The countrys largest professional organization representing black doctors is calling on federal health agencies to study the role bias may have played in the testing and treatment of African-Americans for Covid-19.

I think what we will find is race is a factor, said Dr. Oliver Brooks, president of the organization, the National Medical Association.

In previous studies, doctors have been found to have downplayed African-Americans complaints of pain, given them weaker pain medication for broken bones and withheld cardiac treatments from black patients who needed them. Research suggests that the decisions are the result of ingrained assumptions, cultural ignorance and hostile attitudes toward African-Americans.

The C.D.C. said in a statement to The New York Times that it did not have data to quantify the role of implicit bias in Covid-19 deaths. But the agency added, Becoming aware of and reflecting on ones own biases to help ensure they do not impact decisions is a potentially lifesaving step for clinicians to undertake.

When Ms. Relf made an appointment for her brother at the Loyola Center for Immediate Care in River Forest, Ill., in late March, she said she was hopeful that the clinic would be able to test and treat him for the coronavirus. He had become extremely lethargic with persistent coughs and chills, she said.

Before Mr. Relf left the clinic, he called his sister complaining that the staff would not test him because he did not have a fever. He sounded defeated, Ms. Relf said.

Quarantine at home for 7 days, his discharge papers said. Infection control will contact you regarding eligibility for testing.

The clinic set up an appointment for him to see his regular doctor 11 days later. Mr. Relf never made it. One of his brothers went to check on him after he stopped answering his phone and found his lifeless body crumpled in front of a couch. A posthumous test confirmed that Mr. Relf had Covid-19.

A spokeswoman for Loyola Medicine said in an email that privacy laws prevented it from discussing Mr. Relfs case specifically, but that Loyola did not discriminate based on race, age, gender or socioeconomic status.

It is difficult to know if any individual medical decision was affected by bias.

Still, a 2003 report commissioned by Congress on racial and ethnic disparities in health care found that even controlling for income and insurance access, Racial and ethnic minorities tend to receive a lower quality of health care.

Significantly, the report added, these differences are associated with greater mortality among African-American patients.

A pilot study by Rubix Life Sciences, the biotech research firm, compared the severity of Covid-19 symptoms exhibited by more than 27,000 patients during hospital visits in seven states with the treatment they received.

The study, which has not gone through peer review, showed that black patients were six times less likely to get treatment or testing than white patients, said Reginald Swift, the founder of Rubix.

Dr. Brooks, medical director at Watts Healthcare in Los Angeles, explained the issue this way: When we walk into an E.R., what they sometimes see is not a patient who is suffering from respiratory illness, they see a black man here who needs something.

Gary Fowlers family believes that the minimizing of his symptoms by doctors ultimately cost him his life.

Mr. Fowler, 56, who is black, had developed a deep, worrying cough, a fever and labored breathing, said one of his sons, Keith Gambrell. Over the course of five days, Mr. Fowler was sent home by three hospitals in metro Detroit, Mr. Gambrell said. A week later, Mr. Fowler died sitting in a blue recliner in his bedroom. He tested positive for the coronavirus after his death.

The three hospitals where his family said he sought care disagreed with the familys account. A spokesman from one of the hospitals, Detroit Receiving Hospital, said, there is no record of this individual coming to Detroit Receiving Hospital for any type of treatment. The other two hospitals disputed that Mr. Fowler was denied care.

Mr. Fowlers death added to the grim tally of deaths in Detroit, a city with a majority African-American population that has come to tragically symbolize the viruss devastation of black America.

Kaila Corrothers believed that her mother, Deborah Gatewood, did not have to be part of that tally.

Ms. Gatewood, 63, developed a high fever in mid March. But in four visits over six days, she was sent home with nothing more than Tylenol and cough medicine from the suburban Detroit hospital where she worked as a phlebotomist for 31 years, her daughter said.

Days after that last visit, Ms. Gatewood became so weak at home that her daughter insisted she go to the hospital again.

No, theyre not going to take me, Ms. Corrothers recalled her mother saying.

But Ms. Gatewood collapsed and an ambulance rushed her to a different hospital, where she tested positive for the coronavirus and was placed on a ventilator.

On April 17, three weeks after being admitted, her heart, kidney and lungs failed, and she died.

Ms. Corrothers said she could not say whether the fact that her mother was African-American played a role in her treatment.

In her visits to the emergency room of her employer, Beaumont Hospital in Farmington Hills, Mich., Ms. Gatewood never presented with symptoms severe enough to warrant admission, a hospital spokesman said in a statement. Given the shortage of testing supplies, patients with mild symptoms were not tested and told to quarantine at home, but return if their condition deteriorated, the statement said.

The lack of resources in some hospitals and the overwhelming number of cases likely have played more of a role than bias in the negative outcomes for African-Americans, some public health experts said.

But, in another case that has raised concern of medical bias, the family of Robert Johnson Jr. cannot help but think that doctors could have done more for him.

He seemed to embody many coronavirus risk factors: 49 and black, he had diabetes, hypertension, a low-functioning kidney and a double amputation.

The day before Easter, he woke up too weak to leave his bed, eat, or tell his mother what precisely hurt.

The next morning, Mr. Johnsons fever soared to 103.3 degrees. He was rushed to the emergency room at Yale New Haven Hospital. His mother, Gloria Johnson, 71, called the hospital hours later and was told her son had been given the green light to return home after receiving a chest X-ray that showed signs of pneumonia. The hospital did not test him for the coronavirus.

Ms. Johnson brought her son Easter dinner that night after his discharge. He had no appetite but she insisted he taste a few spoonfuls of yams. When she called the following morning to check on him, he didnt answer.

She hurried to his apartment only to find him unresponsive in his bed. Ms. Johnson watched as emergency responders tried to revive him.

I thought, Oh my God, what if they had given him the Covid-19 test or even kept him overnight for observation? What would the outcome be? she said.

The medical examiner confirmed that Mr. Johnson had died of complications from the coronavirus and diabetes, Ms. Johnson said.

A spokesman for Yale New Haven Health said in a statement that they understand the familys concern. The hospital was confident in the care provided to Mr. Johnson, but his case was under review, the spokesman said.

After Mr. Johnsons burial in a graveside service in New Haven, his mother was preparing to have his old apartment packed and cleaned when she received one last call from the Yale hospital.

They were calling, she said, to schedule Mr. Johnsons Covid-19 test.

Sheelagh McNeill contributed research.

Continued here:

Questions of Bias in Covid-19 Treatment Add to the Mourning for Black Families - The New York Times

A month ago, local health care leaders were preparing for the worst.

With some projections indicating a COVID-19 surge would hit Tennessee around mid-April, the state was racing forward in a furious effort with the U.S. Army Corps of Engineers to re-fashion and equip arenas and convention centers with medical equipment and 7,000 overflow hospital beds.

A chief concern was having enough ventilators to sustain patients in respiratory failure, a mark of severe infection in the coronavirus global pandemic.

In Chattanooga, the plan was to outfit a 400,000-square-foot building on the Alstom property with enough staff and beds to treat around 1,500 patients. Multiple loads of personal protective equipment from the Tennessee Emergency Management Agency were delivered and distributed to acute care hospitals across the region to alleviate supply shortages.

Scarce data due to a limited amount of COVID-19 testing left local decision makers largely in the dark. Chattanooga's peak in cases was expected to come a couple of weeks behind the state's based on what was happening in Nashville and Memphis which saw cases sooner and were where most of Tennessee's data was coming from.

Officials said they would rather overprepare than wind up in a situation like New York, where a Navy hospital ship was sent to relieve stress on New York City hospitals. Hospitals there are still overwhelmed with coronavirus patients, although the pandemic's trajectory in the state is steadily improving.

But Chattanooga's anticipated surge never happened a strong indicator that social distancing and stay-at-home orders slow the spread of the virus.

And while plans, including the Alstom site, are still in place, they're on hold until if and when a second wave comes.

Some experts say data on hospitalizations which generally occur a week or two after infection is the best representation of an outbreak's severity. That's because case count data is subject to how much testing is being done, and most people with coronavirus don't require hospitalization. But the more people are infected, the more people with COVID-19 wind up in hospitals.

At this point, the highest number of coronavirus patients hospitalized at the same time in Hamilton County was 14 on April 25 and May 1, according to data from the Hamilton County Health Department.

Although the county's COVID-19 cases spiked last week, the burden on local hospitals has remained small and manageable. County Mayor Jim Coppinger attributed much of the rise in cases to an increase in testing. He said during a news conference Thursday that none of the newly diagnosed residents (21 that day) were hospitalized.

"We look and focus on the number of people that we have in the hospitals and also the number of beds that are available. We don't want to be caught with a surge of people in the hospital and not have capacity, and we're in great shape with all of those indicators," Coppinger said.

On Friday, there were nine coronavirus patients in Hamilton County hospitals, some of whom may be from outside counties. Six of the patients with COVID-19 were being treated in the intensive care unit.

Since April 1, the county's Emergency Operations Center has tracked how many ventilators, general hospital beds and ICU beds are available in the three major health systems: Parkridge, Memorial and Erlanger. Overall, there are 1,000 general beds, 184 intensive care unit beds and 434 adult ventilators spread across those hospitals.

Hospitals had the most open beds on April 11. At that time, all elective procedures had been placed on hold to save room for the anticipated surge. There were 79 adult ICU beds, 373 adult general beds and 354 ventilators available that day, not taking into account pediatric beds and ventilators, which the county is also tracking. In desperate times, some pediatric beds and ventilators could also be used for adults, who typically experience far more severe cases of coronavirus than children.

After weeks of watching and waiting, the governor lifted his executive order and the hospitals resumed elective procedures this week. As a result, Thursday saw the lowest number of available beds and ventilators 155 general beds, 37 ICU beds and 365 adults ventilators sat unused.

On Friday, representatives from each of the hospitals gathered to recap their first week of returning at least somewhat to normal.

"We have started on a, sort of, scaled approach, so that we are doing approximately 50% of our normal volume. That is our goal for now and not to go above that," said Dr. Matthew Kodsi, vice president of medical affairs at CHI Memorial. "We're going to watch that approach for at least a period of a few weeks, given the fact that this virus takes up to about two weeks from once you catch it to possibly showing symptoms. So we're going to watch, and we're going to see.

"We've been incredibly fortunate to avoid some of the predicted peaks that we heard about early in the disease, and we'd like to keep it that way," Kodsi said, adding that all three hospital systems have maintained strict infection control and visitation policies to ensure safety.

Even if the disease itself largely spares Chattanooga, the impact of COVID-19 on local hospitals is staggering. Aside from the financial toll, they're seeing the ramifications in their patients, many of whom have delayed care to the point that their condition significantly worsened.

Dr. Mark Freeman, an orthopedic surgeon at Erlanger Medical Center, said the hospitals never stopped treating emergency care, which is necessary to sustain life. But there's also urgent care. Although it may not be immediately life threatening, it's still significantly time dependent, Freeman said.

"Elective is still medically necessary," Freeman said. "There have been many patients who have delayed medically necessary care because they thought it was elective, and they ended up with worse outcomes out of the fear of a possible COVID infection, when in reality, they had a real, current condition that could have been treated better in a more timely fashion."

Freeman said providers are poised to help patients make those decisions about when and how to seek medical care.

"If you need a colonoscopy because you have a large family history, or a history of yourself that needs to be monitored, don't delay in getting your colonoscopy," he said. "Talk to the provider. If the provider has hesitations about the timing now, they will tell you."

And just because the data looks good today, doesn't mean that won't change tomorrow.

"From the very beginning as we started to open up, we said we're taking baby steps," Coppinger said. "I keep reinforcing that. And we've said that if we needed to pause, if the numbers were different, or if we needed to put the brakes on, or if we needed to do a reversal, we'd keep all of those things on the table. Nothing's changed.

"It's still the same virus that it has been all along," he said. "It's still extremely contagious, and we have to take every measure we can to protect ourselves and to protect others from any exposure."

Contact Elizabeth Fite at efite@timesfreepress.com.

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Chattanooga's COVID-19 patient surge never happened, but that doesn't mean it won't - Chattanooga Times Free Press

Amid Ongoing COVID-19 Pandemic, Governor Cuomo Announces New York is Notifying 49 Other States of COVID-Related Illness in Children | Governor Andrew M. Cuomo Skip to main content

State is Investigating 85 Reported Cases in New York

Governor Proposes "Americans First Law" Stating a Corporation Cannot Receive Government Funding if it Does Not Rehire the Same Number of Employees Pre-Pandemic

Issues Executive Order Mandating All Nursing Home Staff Be Tested for COVID-19 Twice Per Week

Executive Order States Hospitals Cannot Discharge a Patient to a Nursing Home Unless That Patient Tests Negative for COVID-19

Department of Health and Human Services Has Distributed New Treatment Remdesivir to New York to Help Patients Infected with COVID-19 Recover More Quickly

Confirms 2,273 Additional Coronavirus Cases in New York State - Bringing Statewide Total to 335,395; New Cases in 47 Counties

Amid the ongoing COVID-19 pandemic, Governor Andrew M. Cuomo today announced New York State is notifying 49 other states across the country of emerging cases of COVID-related illness in children. TheState is currently investigating 85 reported cases in New York where children - predominantly school-aged - are experiencing symptoms similar toan atypicalKawasaki diseaseor atoxic shock-like syndrome possibly due to COVID-19. The illness has taken the lives of three young New Yorkers and an additional two deaths are currently under investigation.

Governor Cuomo also proposed the "Americans First Law" which states that a corporation cannot be eligible to receive government funding if it does not rehire the same number of employees that the corporation had before the COVID-19 pandemic.

Audio Photos

The Governor also announced he will issue an Executive Order mandating that all nursing homes and adult care facilities test all personnel for COVID-19 two times per weekand report any positive test results to the State Department of Health by the next day. The Executive Order also mandates that hospitals cannot discharge a patient to a nursing home unless that patient tests negative for COVID-19.

All nursing home and adult care facility administrators will be required to submit a plan on how they will accomplish this testing and a certificate of compliance with this Executive Order to the State Department of Health by Friday May 15th.

Any nursing home or adult care facility found to be in violation of the Executive Order may have its operating certificate suspended or revoked or may be subject to a penalty for non-compliance of $2,000 per violation per day. Additionally, any personnel who refuse to be tested for COVID-19 will be considered to have outdated or incomplete health assessments and therefore will be prohibited from working in the nursing home or adult care facility until testing is performed.

New York has the highest population of nursing home residents of any state in the country - 101,518 residents - and yet New York's percentage of deaths in nursing homes is the 34th highest percentage of any state.

New York continues to investigate the illness and get the facts quickly so we can help prevent any more children from getting sick.

The Governor also announced that the Department of Health and Human Services is distributing a promising treatment called Remdesivir that has been shown to help patients infected with COVID-19 recover more quickly. The Department of Health and Human Services has sent New York enough antiviral to treat 2,900 people at 15 hospitals and will send more doses in the coming weeks to treat 500 more patients, including children, at additional New York Hospitals.

"We are learning new things about the COVID-19 virus every day, and one of the most frightening new developments has been cases of COVID-related illness in children that has already taken the lives of three young New Yorkers,"Governor Cuomo said."The State Department of Health is alerting all 49 states across the country about this evolving situation as New York continues to investigate the illness and get the facts quickly so we can help prevent any more children from getting sick."

Finally, the Governor confirmed 2,273 additional cases of novel coronavirus, bringing the statewide total to 335,395 confirmed cases in New York State. Of the 335,395 total individuals who tested positive for the virus, the geographic breakdown is as follows:

County

Total Positive

New Positive

Albany

1,432

16

Allegany

36

1

Broome

373

1

Cattaraugus

60

0

Cayuga

58

5

Chautauqua

41

1

Chemung

131

0

Chenango

109

0

Clinton

76

0

Columbia

312

8

Cortland

29

0

Delaware

64

1

Dutchess

3,359

40

Erie

4,453

116

Essex

32

1

Franklin

17

0

Fulton

107

3

Genesee

172

2

Greene

206

2

Hamilton

5

0

Herkimer

79

2

Jefferson

68

1

Lewis

11

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Amid Ongoing COVID-19 Pandemic, Governor Cuomo Announces New York is Notifying 49 Other States of COVID-Related Illness in Children - ny.gov

This story was originally published by ProPublica, a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox.

Last September, over pancakes at a diner in central Massachusetts, Molly Baldwin told her husband, Jonathan, they were going to have a baby. He cried into his coffee mug, elated and a little surprised. They had only been trying for about a week, and they had yearned for a summer baby, ideally in June, which would enable their parents to spend more time with their first grandchild.

We thought we had the best timing, she said.

But as the novel coronavirus began to spread through the country this year, Baldwin realized in early March that it was only a matter of time before the virus hit her town, Fitchburg, and the nursing home where shes a social worker. Her patients would be among the most vulnerable: Some had battled addiction, many had experienced homelessness and most were elderly. Flu seasons were always hard on her patients, and she dreaded the havoc a more lethal disease would wreak.

Baldwin also worried about her baby. She spent hours looking up the prenatal effects of COVID-19, and the lack of evidence-based research concerned her. She called her obstetrician, who cautioned that because of the unknowns, she should consider working from home to limit her exposure to the virus.

So Baldwin made a plan for when COVID-19 arrived at her nursing home: She would swap shifts with a colleague to work fewer hours and request to work from home, as many of her duties are paperwork or computer-based.

This is my first baby, and I already feel like Im doing everything wrong. Molly Baldwin

She would work from the comfort of her kitchen table. She would avoid catching the virus. She would keep visiting her doctor until it was time to deliver, her belly swelling with a baby girl she knew was healthy and safe.

None of it, not a single thing, would go according to plan.

Baldwin said her supervisor and the human resources representative from the facility verbally agreed in mid-March to let her work from home. (Baldwin spoke with ProPublica on the condition that her workplace not be named; ProPublica contacted her employers with questions for this story.)

Then, on April 16, one of the residents at her facility tested positive for the virus. Baldwin sought testing at a walk-in clinic, and the results came back negative. But when she called her obstetricians office, she got a warning: If she continued to work at the facility, potentially exposing herself to the virus, they would not allow her to enter their office for prenatal appointments unless she could prove with a test, before each visit, that she was negative for COVID-19.

She understood their caution; her job was beginning to feel at odds with her pregnancy. It was time for her work-from-home plan to go into action.

She called her employer and asked to start the accommodations she had requested the month before. But they told her that now the plan would not be feasible, she said. Other pregnant employees were continuing to work at the facilities, and she would have to as well, she said she was told.

The services provided at a nursing home do not typically allow for remote working, a company spokesperson told ProPublica. However, we have made changes to accommodate our staff whenever possible, provided there is no impact on patient care.

After finding out her request to work from home would not be granted, Baldwin panicked. Im not even a mom yet, she said. This is my first baby, and I already feel like Im doing everything wrong.

Baldwin is one of dozens of pregnant workers who ProPublica has heard from who are navigating the risks of COVID-19 while in the field of health care.

There are plenty of pregnant women across the country who are trying to figure out what to do to protect themselves, given the uncertainty, said Emily Martin, vice president for education and workplace justice at the National Womens Law Center. If you feel like you cant do your job because there arent certain accommodations and you feel like youre at risk, its difficult to see where to go next.

About half of the states have laws that allow pregnant women to request reasonable accommodations, including Massachusetts, Martin said.

According to the Massachusetts Pregnant Workers Fairness Act, signed into state law in July 2017, employers must grant reasonable accommodations to their pregnant employees that allow them to continue to do their job, unless doing so would impose an undue hardship on the employer. An employer also cannot make an employee accept a particular accommodation if another reasonable accommodation would allow the employee to perform the essential functions of the job.

Both the Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists havestated that based on the data available, pregnant women do not face a higher risk of infection or severe morbidity related to COVID-19. That said, both the CDC and ACOG have suggested that health care facilities may want to consider reducing the exposure of pregnant health care workers to patients with confirmed or suspected COVID-19, if staffing permits.

In the overwhelming majority of pregnancies, the person who is pregnant recovered well with mild illness, said Dr. Neel Shah, an obstetrician and assistant professor at Harvard Medical School, echoing the current guidance. But, he cautioned, there is a lot we still dont know about how the virus impacts bodies, let alone those that are pregnant. We cant say that its completely safe we dont know.

Baldwin and her husband went through their options.

She couldnt quit because they needed her paycheck. They had a mortgage, student loans and a new baby on the way. She also loved her job and cared deeply for her patients, whom she wanted to continue to serve. Her employer, trying to manage understaffing, had discouraged employees from taking time off, she said. She didnt want to take any additional sick days, because she needed to save them for her maternity leave.

They decided that she would have to return to work.

Her employer told her to wear a mask and gloves, use hand sanitizer and remain in her small, boxy office, which has three desks for four people. Though she didnt have contact with the residents, her office mates still did.

Even though she was scared, she tried to stay optimistic. I was grateful for what I had because I have friends that are out of work right now, she said. But she remained perplexed about why her requests had been denied. I was sitting in my office doing work that would have easily been done from a laptop on my kitchen table.

The company spokesperson did not respond to a question about whether it had originally given Baldwin verbal approval to work from home. When asked why she couldnt have done the same work remotely, he said, Based on your questions, our HR and Risk Management are anticipating action and would prefer to not comment at all.

The next day, the Massachusetts National Guard delivered testing kits to the nursing home, and every resident was checked for the virus. When the results came back, at least 22 residents and 20 other staff members tested positive.

We are conducting cleanings and infection control measures multiple times per day, with extra focus on high touch areas, the company spokesperson said. We screen and take the temperature of anyone entering our building, and we have increased monitoring of our residents.

Public data shows the facility has more than 30 cases among residents and staff, the maximum number that the state reports publicly.

I thought if I just keep working, stay in my office, use hand sanitizer, wear my mask, go home and shower right away, disinfect my clothes, then I will be fine, and I can keep my baby safe, and I can shed all this guilt, she said.

Then on April 24, two of her office mates texted to tell her they had the virus.

And that morning, shed felt a tickle in her throat.

I thought if I just keep working, stay in my office, use hand sanitizer, wear my mask, go home and shower right away, disinfect my clothes, then I will be fine, and I can keep my baby safe, and I can shed all this guilt. Molly Baldwin

I know Im positive, she thought to herself, as she left work midday and drove to a CVS drugstore testing site an hour away that was offering free rapid tests for front-line and health care workers. Hundreds of cars were already lined up.

She waited alone in her Jeep Wrangler for three hours, wearing her mask as required, which muffled her nagging cough. She shifted around constantly, to keep blood from pooling in her swelling feet. At the front of the line, she received a 6-inch cotton swab, wedged it deep in her nasal cavity, and returned it to the technicians. They directed her into a side parking lot, and 30 minutes later, she got a phone call with her results.

Were sorry to tell you that youre positive, the voice on the line told her. Baldwins mind stalled, engulfed in a wave of anxiety, which gave way to seething frustration.

This was so preventable, she said. Now here I am, 33 weeks pregnant and positive. My most important job is to keep the baby safe, and my actual job wasnt making that happen.

When she called her co-workers and supervisor to tell them she tested positive, she said they were all very caring and compassionate. They told her to stay home for at least a week, or until her symptoms subsided. The Families First Coronavirus Response Act requires most employers to provide their workers with two weeks of paid leave if the employee is quarantined or experiencing COVID-19 symptoms. Baldwin said she would have to exhaust her sick days first; shed been saving them for her maternity leave. Her husband, who works as a correctional officer at a county jail, was allowed to take 14 days of paid leave to tend to his wife, without using his own sick days.

She could no longer go to her normal obstetrician for in-person appointments, and instead, she would have to rely on telemedicine. Her doctor connected her with an obstetrician specializing in COVID-19 cases, with whom she planned to meet this week.

Last Saturday, Baldwins mother had planned to throw her daughter a baby shower. She had invited 50 of their closest friends to celebrate at a new restaurant and had ordered dozens of pink favors from Etsy.

Because of the stay-at-home order, her shower morphed into a drive-by celebration, where her friends and family passed by her house, honking their horns and holding celebratory signs, balloons and streamers. They dropped gifts in front of her house, including first aid kits and a handsewn pink mask for an infant.

Her symptoms have, so far, been relatively mild, similar to a normal flu: headaches, a stuffy nose, a sore throat and muscle pains. Shes spent most of the past week resting in bed and taking baths to soothe her body aches. While taking care of Baldwin, her husband has also contracted the virus and is experiencing severe body aches as well.

In addition to her disappointment that the hypnobirthing and breastfeeding classes she had signed up for are canceled, her time in quarantine is now filled with anxious questions about how the disease may impact her baby.

Will the stress of this experience damage her baby neurologically? Will her baby be born early? Will she have to deliver by cesarean section to relieve pressure on her body and lungs, like so many stories she had read? Will she have to be secluded from her baby for days or weeks after birth? And what if her own symptoms worsen?

This is our first baby, and it was so planned and wanted, she said. But had we known this awful thing would happen, would we have tried when we did?

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She made every effort to avoid COVID-19 while pregnant. Not a single thing went according to plan - The CT Mirror

In just a few short weeks, weve all made the collective journey from pandemic ignoramuses to budding armchair virologists with a decent grasp of once-arcane terms like personal protective equipment, social distancing and "flatten the curve".

But theres one phrase that might still leave a few justifiably scratching their heads: the R number. The coronavirus has one, and governments around the world are keen to see it shrink as much as possible. But what is it?

R refers to the effective reproduction number and, basically put, its a way of measuring an infectious diseases capacity to spread. The R number signifies the average number of people that one infected person will pass the virus to.

The R number isnt fixed, but can be affected by a range of factors, including not just how infectious a disease is but how it develops over time, how a population behaves, and any immunity already possessed thanks to infection or vaccination. Location is also important: a densely populated city is likely to have a higher R than a sparsely peopled rural area.

Because Sars-CoV-2 to give the novel coronavirus its full honorific is a new pathogen, scientists at the start of the outbreak were scrambling to calculate its R0, or R nought: the viruss transmission among a population that has no immunity. Studies on early cases in China indicated it was between 2 and 2.5; more recent estimates have placed it as high as 6.6.

To put these figure in context, says Wired science editor Matt Reynolds, they're worse than seasonal flu, which has an R0 of 1.3, but miles better than measles, whose R0 is between 12 and 18. The kicker, though, is that for each of those diseases we have a vaccine, and so the effective reproduction number the R is way below 1.

This threshold an R of 1 will become increasingly crucial over the next few months. As the UK government explained in the video that accompanied its press briefing on 30 April, an R figure that is even slightly over 1 can lead quickly to a large number of cases thanks to exponential growth.

Here's how that works. Say a disease has an R of 1.5. This may seem like a manageable figure, but a glance at the figures quickly proves that isn't the case. An R of 1.5 would see 100 people infect 150, who would in turn infect 225, who would infect 338. In three rounds of infection, the number of people with the virus would have more than quadrupled to 438. As worldwide cases now exceed 3.5 million, this helps explain why the novel coronavirus was able to rip so quickly among a global population with no previous immunity.

Image: BBC

Conversely, an R of less than 1 means that the virus will eventually peter out the lower the R, the more quickly this will happen. An R of 0.5 means that 100 people would infect only 50, who would infect 25, who would infect 13. As the number of cases drops and ill people either die or recover, the virus will be brought under control as long as the R can be kept low.

So an R of 1 and above tends towards exponential growth. An R of below 1 tends towards the end of the outbreak. All we need to do is keep the R below 1. Simple, right?

Not so fast. As stated above, the R value is ever-changing. Thanks to lockdown measures, many governments have been able to push R to below 1. In the UK, chief scientific officer Patrick Vallence said that the nations R number is currently thought to be between 0.6 and 0.9, though it varies regionally and in London could be as low as 0.5 to 0.7.

This was only achieved, however, thanks to a heroic, unprecedented series of adjustments which have brought our lives and our economies to a juddering halt and all of this to produce an R of 0.6 to 0.9. This doesnt give us a huge amount of leeway.

Lockdown helped drop Germanys R down to about 0.7 in early April, but researchers at the Robert Koch Institute in Berlin said it had recently increased back to 0.9, before sinking again to 0.75. Even within lockdown, if people start losing patience with restrictions or need to go out to work, R could quickly rise again.

Another difficulty that scientists and policymakers are facing is that its still not entirely clear how much of a role each measure plays. Is shutting schools doing the heavy lifting, or restricting access to shops? How much of a boost could wearing masks provide?

As governments tentatively ease lockdown restrictions around the world, they will be monitoring R very carefully for signs of a sudden jump. If R sneaks above 1 even a fraction, it could trigger a damaging second wave of the virus.

Once R is consistently low and the number of cases is manageable, governments can implement more precise measures to restrict R, such as contact-tracing and location-tracking apps approaches that paid dividends when introduced early on in nations such as South Korea and Singapore.

A couple kisses at Duomo Square, Catania, Sicily, as Italy begins a staged end to a nationwide lockdown, 4 May 2020.

Image: Reuters/Antonio Parrinello

There are a number of ways to calculate R, as Wired notes. One is by monitoring hospitalisation and death figures to get a sense of how many people have the virus but the problem with this is that, since the viruss incubation period is so long, it only gives an accurate picture of a few weeks ago. To check transmission rates in a more accurate way, scientists at Imperial College London in the UK have started testing randomised 25,000 groups of the population to see how many are ill.

Its important to note that R isnt the only key measure in assessing the impact of this pathogen, says the BBC. Another crucial yardstick is the number of cases of COVID-19, the disease caused by Sars-CoV-2. If we have a large number of cases and an R of 1 or just below, that still equates to a large number of infections so ideally we need to restrict both R and bring down the number of cases at the same time.

An additional key measure to look out for is the number of ICU beds available in any given country, since this will have a big effect on mortality rate.

Ultimately, the best weapon in the fight to reduce R is a vaccine. But exactly when this will be available or indeed if it will ever happen at all is currently unclear.

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What is COVID-19's R number and why does it matter? - World Economic Forum

After dropping throughout March and into early April, the transmission rate of COVID-19 is no longer falling and could be rising again in western Washington, according to the latest report from Bellevue-based Institute for Disease Modeling (IDM).

A previous report issued last week found that the effective reproductive numberthe number of new cases stemming from each COVID-19 infectionhad dropped below the critical threshold of 1.0 in King County between March 29 and April 15.

However, updated case and mortality data from the Washington Disease Reporting System revised that estimate upward, showing the reproductive number had no longer been falling and likely has been inching up again since roughly April 6.

Heres more from Public Health Seattle & King County:

As of April 22, the number of new cases from each COVID-19 infection in King County was between 0.47 and 1.32 (best estimate 0.89). Overall in western Washington, the reproductive number on April 22 was between 0.61 and 1.39 (best estimate 1.0).

No longer definitely below 1.0, cases in western Washington can be expected to plateau or increase, if the trend continues.

Physical distancing remains the best tool for reducing COVID-19 transmission. Because most of the population remains susceptible across the state, relaxing distancing policies will likely result in increased transmission. However, researchers ability to measure these increases are retrospective, delayed by weeks because of the time until symptom onset and delays in case reporting.

This report once again reminds us that our position is precarious and COVID-19 transmission and new cases remain unacceptably high, said Dr. Jeff Duchin, Health Officer for Public Health Seattle & King County. We need to double down on distancing and other prevention steps at home, in the community, and in workplaces and we must see these numbers improve before relaxing our current restrictions.

Its clear that the course of the epidemic in Washington remains sensitive to changes in social distancing, said Dr. Mike Famulare, Principal Research Scientist at IDM. We allscientists, policymakers, everyone in Washingtonface a difficult challenge in the coming weeks as our day-to-day lives will be in flux as we are forced to respond quickly to slow transmission and save lives.

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New report shows COVID-19 transmission rate could be rising in King County - The B-Town (Burien) Blog - The B-Town Blog

The novel coronavirus causing COVID-19 seems to hit some people harder than others, with some people experiencing only mild symptoms and others being hospitalized and requiring ventilation. Though scientists at first thought age was the dominant factor, with young people avoiding the worst outcomes, new research has revealed a suite of features impacting disease severity. These influences could explain why some perfectly healthy 20-year-old with the disease is in dire straits, while an older 70-year-old dodges the need for critical interventions.

These risk factors include:AgeDiabetes (type 1 and type 2)Heart disease and hypertensionSmokingBlood typeObesityGenetic factors

About 8 out of 10 deaths associated with COVID-19 in the U.S. have occurred in adults ages 65 and older, according to the U.S. Centers for Disease Control and Prevention (CDC). The risk of dying from the infection, and the likelihood of requiring hospitalization or intensive medical care, increases significantly with age. For instance, adults ages 65-84 make up an estimated 4-11% of COVID-19 deaths in the U.S, while adults ages 85 and above make up 10-27%.

The trend may be due, in part, to the fact that many elderly people have chronic medical conditions, such as heart disease and diabetes, that can exacerbate the symptoms of COVID-19, according to the CDC. The ability of the immune system to fight off pathogens also declines with age, leaving elderly people vulnerable to severe viral infections, Stat News reported.

Related: Coronavirus in the US: Latest COVID-19 news and case counts

Diabetes mellitus a group of diseases that result in harmful high blood sugar levels also seems to be linked to risk of more severe COVID-19 infections.

The most common form in the U.S. is type 2 diabetes, which occurs when the body's cells don't respond to the hormone insulin. As a result, the sugar that would otherwise move from the bloodstream into cells to be used as energy just builds up in the bloodstream. (When the pancreas makes little to no insulin in the first place, the condition is called type 1 diabetes.)

In a review of 13 relevant studies, scientists found that people with diabetes were nearly 3.7 times more likely to have a critical case of COVID-19 or to die from the disease compared with COVID-19 patients without any underlying health conditions (including diabetes, hypertension, heart disease or respiratory disease), they reported online April 23 in the Journal of Infection.

Even so, scientists don't know whether diabetes is directly increasing severity or whether other health conditions that seem to tag along with diabetes, including cardiovascular and kidney conditions, are to blame.

That fits with what researchers have seen with other infections and diabetes. For instance, flu and pneumonia are more common and more serious in older individuals with type 2 diabetes, scientists reported online April 9 in the journal Diabetes Research and Clinical Practice. In a literature search of relevant studies looking at the link between COVID-19 and diabetes, the authors of that paper found a few possible mechanisms to explain why a person with diabetes might fare worse when infected with COVID-19. These mechanisms include: "Chronic inflammation, increased coagulation activity, immune response impairment and potential direct pancreatic damage by SARS-CoV-2."

Related: 13 coronavirus myths busted by science

Mounting research has shown the progression of type 2 diabetes is tied to changes in the body's immune system. This link could also play a role in poorer outcomes in a person with diabetes exposed to SARS-CoV-2, the virus that causes COVID-19.

No research has looked at this particular virus and immune response in patients with diabetes; however, in a study published in 2018 in the Journal of Diabetes Research, scientists found through a review of past research that patients with obesity or diabetes showed immune systems that were out of whack, with an impairment of white blood cells called Natural Killer (NK) cells and B cells, both of which help the body fight off infections. The research also showed that these patients had an increase in the production of inflammatory molecules called cytokines. When the immune system secretes too many cytokines,a so-called "cytokine storm" can erupt and damage the body's organs. Some research has suggested that cytokine storms may be responsible for causing serious complications in people with COVID-19, Live Science previously reported. Overall, type 2 diabetes has been linked with impairment of the very system in the body that helps to fight off infections like COVID-19 and could explain why a person with diabetes is at high risk for a severe infection.

Not all people with type 2 diabetes are at the same risk, though: A study published May 1 in the journal Cell Metabolism found that people with diabetes who keep their blood sugar levels in a tighter range were much less likely to have a severe disease course than those with more fluctuations in their blood sugar levels.

Scientists aren't sure whether this elevated risk of a severe COVID-19 infection also applies to people with type 1 diabetes (T1D). A study coordinated by T1D Exchange a nonprofit research organization focused on therapies for those with type 1 diabetes launched in April to study the outcomes of T1D patients infected with COVID-19. When a person with T1D gets an infection, their blood sugar levels tend to spike to dangerous levels and they can have a buildup of acid in the blood, something called diabetic ketoacidosis. As such, any infection can be dangerous for someone with type 1 diabetes.

People with conditions that affect the cardiovascular system, such as heart disease and hypertension, generally suffer worse complications from COVID-19 than those with no preexisting conditions, according to the American Heart Association. That said, historically healthy people can also suffer heart damage from the viral infection.

The first reported coronavirus death in the U.S., for instance, occurred when the virus somehow damaged a woman's heart muscle, eventually causing it to burst, Live Science reported. The 57-year-old maintained good health and exercised regularly before becoming infected, and she reportedly had a healthy heart of "normal size and weight." A study of COVID-19 patients in Wuhan, China, found that more than 1 in 5 patients developed heart damage some of the sampled patients had existing heart conditions, and some did not.

In seeing these patterns emerge, scientists developed several theories as to why COVID-19 might hurt both damaged hearts and healthy ones, according to a Live Science report.

In one scenario, by attacking the lungs directly, the virus might deplete the body's supply of oxygen to the point that the heart must work harder to pump oxygenated blood through the body. The virus might also attack the heart directly, as cardiac tissue contains angiotensin-converting enzyme 2 (ACE2) a molecule that the virus plugs into to infect cells. In some individuals, COVID-19 can also kickstart an overblown immune response known as a cytokine storm, wherein the body becomes severely inflamed and the heart could suffer damage as a result.

People who smoke cigarettes may be prone to severe COVID-19 infections, meaning they face a heightened risk of developing pneumonia, suffering organ damage and requiring breathing support. A study of more than 1,000 patients in China, published in the New England Journal of Medicine, illustrates this trend: 12.3% of current smokers included in the study were admitted to an ICU, were placed on a ventilator or died, as compared with 4.7% of nonsmokers.

Cigarette smoke might render the body vulnerable to the coronavirus in several ways, according to a recent Live Science report. At baseline, smokers may be vulnerable to catching viral infections because smoke exposure dampens the immune system over time, damages tissues of the respiratory tract and triggers chronic inflammation. Smoking is also associated with a multitude of medical conditions, such as emphysema and atherosclerosis, which could exacerbate the symptoms of COVID-19.

A recent study, posted March 31 to the preprint database bioRxiv, proposed a more speculative explanation as to why COVID-19 hits smokers harder. The preliminary research has not yet been peer-reviewed, but early interpretations of the data suggest that smoke exposure increases the number of ACE2 receptors in the lungs the receptor that SARS-CoV-2 plugs into to infect cells.

Many of the receptors appear on so-called goblet and club cells, which secrete a mucus-like fluid to protect respiratory tissues from pathogens, debris and toxins. It's well-established that these cells grow in number the longer a person smokes, but scientists don't know whether the subsequent boost in ACE2 receptors directly translates to worse COVID-19 symptoms. What's more, it's unknown whether high ACE2 levels are relatively unique to smokers, or common among people with chronic lung conditions.

Several early studies have suggested a link between obesity and more severe COVID-19 disease in people. One study, which analyzed a group of COVID-19 patients who were younger than the age of 60 in New York City, found that those who were obese were twice as likely as non-obese individuals to be hospitalized and were 1.8 times as likely to be admitted into critical care.

"This has important and practical implications" in a country like the U.S. where nearly 40% of adults are obese, the authors wrote in the study, which was accepted into the journal Clinical Infectious Diseases but not yet peer-reviewed or published. Similarly, another preliminary study that hasn't yet been peer-reviewed found that the two biggest risk factors for being hospitalized from the coronavirus are age and obesity. This study, published in medRxiv looked at data from thousands of COVID-19 patients in New York City, but studies from other cities around the world found similar results, as reported by The New York Times.

A preliminary study from Shenzhen, China, which also hasn't been peer-reviewed, found that obese COVID-19 patients were more than twice as likely to develop severe pneumonia as compared with patients who were normal weight, according to the report published as a preprint online in the journal The Lancet Infectious Diseases. Those who were overweight, but not obese, had an 86% higher risk of developing severe pneumonia than did people of "normal" weight, the authors reported. Another study, accepted into the journal Obesity and peer-reviewed, found that nearly half of 124 COVID-19 patients admitted to an intensive care unit in Lille, France, were obese.

It's not clear why obesity is linked to more hospitalizations and more severe COVID-19 disease, but there are several possibilities, the authors wrote in the study. Obesity is generally thought of as a risk factor for severe infection. For example, those who are obese had longer and more severe disease during the swine flu epidemic, the authors wrote. Obese patients might also have reduced lung capacity or increased inflammation in the body. A greater number of inflammatory molecules circulating in the body might cause harmful immune responses and lead to severe disease.

Blood type seems to be a predictor of how susceptible a person is to contracting SARS-CoV-2, though scientists haven't found a link between blood type per se and severity of disease.

Jiao Zhao, of The Southern University of Science and Technology, Shenzhen, and colleagues looked at blood types of 2,173 patients with COVID-19 in three hospitals in Wuhan, China, as well as blood types of more than 23,000 non-COVID-19 individuals in Wuhan and Shenzhen. They found that individuals with blood types in the A group (A-positive, A-negative and AB-positive, AB-negative) were at a higher risk of contracting the disease compared with non-A-group types. People with O blood types (O-negative and O-positive) had a lower risk of getting the infection compared with non-O blood types, the scientists wrote in the preprint database medRxiv on March 27; the study has yet to be reviewed by peers in the field.

In a more recent study of blood type and COVID-19, published online April 11 to medRxiv, scientists looked at 1,559 people tested for SARS-CoV-2 at New York Presbyterian hospital; of those, 682 tested positive. Individuals with A blood types (A-positive and A-negative) were 33% more likely to test positive than other blood types and both O-negative and O-positive blood types were less likely to test positive than other blood groups. (There's a 95% chance that the increase in risk ranges from 7% to 67% more likely.) Though only 68 individuals with an AB blood type were included, the results showed this group was also less likely than others to test positive for COVID-19.

The researchers considered associations between blood type and risk factors for COVID-19, including age, sex, whether a person was overweight, other underlying health conditions such as diabetes mellitus, hypertension, pulmonary diseases and cardiovascular diseases. Some of these factors are linked to blood type, they found, with a link between diabetes and B and A-negative blood types, between overweight status and O-positive blood groups, for instance, among others. When they accounted for these links, the researchers still found an association between blood type and COVID-19 susceptibility. When the researchers pooled their data with the research by Zhao and colleagues out of China, they found similar results as well as a significant drop in positive COVID-19 cases among blood type B individuals.

Why blood type might increase or decrease a person's risk of getting SARS-CoV-2 is not known. A person's blood type indicates what kind of certain antigens cover the surfaces of their blood cells; These antigens produce certain antibodies to help fight off a pathogen. Past research has suggested that at least in the SARS coronavirus (SARS-CoV), anti-A antibodies helped to inhibit the virus; that could be the same mechanism with SARS-CoV-2, helping blood group O individuals to keep out the virus, according to Zhao's team.

Many medical conditions can worsen the symptoms of COVID-19, but why do historically healthy people sometimes fall dangerously ill or die from the virus? Scientists suspect that certain genetic factors may leave some people especially susceptible to the disease, and many research groups aim to pinpoint exactly where those vulnerabilities lie in our genetic code.

In one scenario, the genes that instruct cells to build ACE2 receptors may differ between people who contract severe infections and those who hardly develop any symptoms at all, Science magazine reported. Alternatively, differences may lie in genes that help rally the immune system against invasive pathogens, according to a recent Live Science report.

For instance, a study published April 17 in the Journal of Virology suggests that specific combinations of human leukocyte antigen (HLA) genes, which train immune cells to recognize germs, may be protective against SARS-CoV-2, while other combinations leave the body open to attack. HLAs represent just one cog in our immune system machinery, though, so their relative influence over COVID-19 infection remains unclear. Additionally, the Journal of Virology study only used computer models to simulate HLA activity against the coronavirus; clinical and genetic data from COVID-19 patients would be needed to flesh out the role of HLAs in real-life immune responses.

Originally published on Live Science.

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Why COVID-19 kills some people and spares others. Here's what scientists are finding. - Livescience.com

CHICAGO (CBS) A Chicago postal worker who died from COVID-19 was remembered with a balloon release by her coworkers Saturday morning.

Union leaders, friends, and coworkers met outside of the post office in Kilbourn Park wearing face masks and practicing social distancing in order to take part in the balloon release.

The medical examiner identified the postal worker as 31-year-old Unique Clay, who died earlier this week from complications of the coronavirus.

According to the National Association of Letter Carriers, Clay worked as a letter carrier with USPS for two years.

She was a mother of three and had a baby just a week before she died.

Her union says 30 letter carriers in Chicago have tested positive for COVID-19.

The balloon release also falls on the same day the union was supposed to have its 28th annual food drive, but that has been postponed due to the pandemic.

According to the union, Clay is the first active letter carrier in Chicago to die from the virus.

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Chicago Postal Worker And Mother Of 3 Dies Of COVID-19 One Week After Giving Birth - CBS Chicago

The Spokane Regional Health District confirmed three new cases of COVID-19 on Sunday, bringing the countys total to 386. No new deaths were reported.

Statewide, 217 new cases were reported Sunday, bringing the total to 16,674. The states COVID-19 death toll was 931, with 10 new deaths reported Sunday.

Five counties in Eastern Washington got the OK to move to Phase 2 of Gov. Jay Inslees reopening plan last week.

Pend Oreille and Ferry counties were able to move forward, but Stevens County could not because it hasnt gone three weeks without a new case.

Stevens County stayed on track to reopen, however, with no new cases over the weekend.

Nationwide, there were more than 1.3 million cases and more than 78,000 deaths as of Sunday, according to the Centers for Disease Control and Prevention.

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Three new COVID-19 cases confirmed in Spokane County on Sunday, bringing total to 386 - The Spokesman-Review