U.S. records deadliest coronavirus day of the summer

https://www.axios.com/1485-us-coronavirus-death-record-5ee493cc-df91-4549-8c9d-43a5fee0bd87.html

U.S. records deadliest coronavirus day of the summer - Axios

The U.S. reported 1,485 deaths due to the coronavirus on Wednesday, COVID Tracking Project data shows.

Why it matters: It’s the highest single-day COVID-19 death toll since May 15, when the country reported 1,507 deaths. The U.S. has seen a total of 157,758 deaths from the virus.

The big picture: Georgia reported 109 deaths on Wednesday — its second triple-digit day in a row.

Go deeper: 5 states set single-day coronavirus case records last week

 

 

 

 

The two sides of America’s coronavirus response

https://www.axios.com/us-coronavirus-vaccine-testing-science-b656e905-67d1-4836-863e-c91f739cfd1e.html

The two sides of America's coronavirus response - Axios

America’s bungled political and social response to the coronavirus exists side-by-side with a record-breaking push to create a vaccine with U.S. companies and scientists at the center.

Why it matters: America’s two-sided response serves as an X-ray of the country itself — still capable of world-beating feats at the high end, but increasingly struggling with what should be the simple business of governing itself.

What’s happening: An index published last week by FP Analytics, an independent research division of Foreign Policy, ranked the U.S. 31st out of 36 countries in its assessment of government responses to COVID-19.

  • That puts it below developed countries like New Zealand and Denmark, and also lower than nations with fewer resources like Ghana, Kenya and South Africa.
  • The index cited America’s limited emergency health care spending, insufficient testing and hospital beds and limited debt relief.

By the numbers: As my Axios colleague Jonathan Swan pointed out in an interview with President Trump, the U.S. has one of the worst per-capita death rates from COVID-19, at 50.29 per 100,000 population.

Yes, but: Work on a COVID-19 vaccine is progressing astonishingly fast, with the Cambridge-based biotech company Moderna and the National Institutes of Health announcing at the end of July that they had begun Phase 3 of the clinical trial.

  • Their efforts are part of a global rush to a vaccine, and while companies in the U.K. and China are jockeying for the lead, U.S. companies and the NIH’s resources and expertise have been key to the effort.
  • Anthony Fauci has said he expects “tens of millions” of doses to be available by early 2021, a little over a year after the novel coronavirus was discovered.
  • If that turns out to be the case, “the Covid-19 vaccine could take a place alongside the Apollo missions as one of history’s greatest scientific achievements,” epidemiologist Michael Kinch recently wrote in STAT.

So which is the real American response to COVID-19? The bungled testing policies, the politically driven rush to reopen, the tragic racial divide seen in the sick and the dead? Or the warp-speed work to develop a vaccine in a year when most past efforts took decades?

Be smart: It’s both.

The bottom line: It can often feel as if there are two Americas, and not even a virus that has spread around the world seems capable of bridging that gap.

 

 

 

 

U.S. doing a lot less coronavirus testing

https://www.axios.com/newsletters/axios-vitals-32689a40-e409-4547-8468-b03dc589c082.html

The two sides of America's coronavirus response - Axios

The U.S. is cutting back on coronavirus testing. Nationally, the number of tests performed each day is about 17% lower than it was at the end of July, and testing is also declining in hard-hit states.

Why it matters: This big reduction in testing has helped clear away delays that undermined the response to the pandemic. But doing fewer tests can also undermine the response to the pandemic.

By the numbers: At the end of July, America was doing more than 800,000 tests a day. This week, it’s hovered around 715,000.

  • Even as states with particularly bad outbreaks pull back on their testing, the proportion of tests coming back positive is still high — which would normally be an indication that they need to be doing more tests.
  • In Texas, 19% of tests are coming back positive, according to Nephron Research. In Florida, the rate of positive tests is 18%, and in Nevada, 17%.

Yes, but: Experts have said reducing the demand for testing may be the best way to alleviate long delays, which made tests all but useless. And that appears to be working.

Driving the news: The Department of Health and Human Services estimated this week that nearly 90% of all tests are being completed within three days — a big improvement from turnaround times that had been stretching well over a week.

  • Quest Diagnostics says its expected turnaround time is now 2–3 days, and less for priority patients. LabCorp announced a similar turnaround time last week.

The bottom line: The U.S. is averaging 50,000 new cases a day, and that high caseload is ultimately why the demand for testing is more than the system can handle.

  • We can’t get our caseload under control without fast, widespread testing, but we can’t achieve fast, widespread testing with such a high caseload.

 

 

 

 

US has averaged over 1,000 coronavirus deaths per day for 16 straight days

https://www.cnn.com/2020/08/12/health/us-coronavirus-wednesday/index.html?utm_source=nl&utm_brand=wired&utm_mailing=WIR_Science_081220&utm_campaign=aud-dev&utm_medium=email&utm_term=WIR_Science&bxid=5db707423f92a422eaeaf234&cndid=54318659&esrc=bounceX&source=EDT_WIR_NEWSLETTER_0_SCIENCE_ZZ

CCR - Who'll Stop The Rain song lyrics music lyrics | Great song ...

Coronavirus continues to spread at high rates across the US South, Midwest and West, even as the total number of new Covid-19 cases has declined since a summer surge.

Nationally, over the last seven days, the US is averaging just under 53,000 new cases of Covid-19 per day, down 11% from the week prior.
As a result of all those cases, deaths from the virus have remained high. The seven-day average of daily coronavirus deaths was just over 1,000 on Tuesday, the 16th consecutive day the US averaged over 1,000 deaths per day.
Adjusting for population, states in the Southeast are seeing the most new cases. Georgia and Florida — states led by Republican governors who have not issued face mask requirements — have the highest per capita new cases over the last seven days, followed by Alabama and Mississippi.
On Wednesday, Florida reported more than 8,000 new cases and 212 new deaths, according to data released by the Florida Department of Health.
Covid-19 causes worse outcomes for older people, but young people are not immune. In Florida, people under 44 make up about 57% of the state’s 545,000 cases, 20% of the state’s 31,900 hospitalizations, and 3% of the state’s 8,765 deaths, according to state data.
Robert Ruiz, 31 and the father of a 3-year-old, was one of the 265 people under 44 who died from coronavirus in Florida.
His sister, Chenique Mills, told CNN he was overweight and had seasonal asthma but otherwise did not smoke or drink and had no underlying health conditions.
“This is all really sudden, unexpected,” she said. “I (saw) him on Friday. I (saw) him on Saturday. He was fine, to say that he was up, and he was walking and he was eating. He was functioning. So for him to be gone on Sunday? It’s just a lot to take in.
“This virus is so serious. It really really is. And I think people (won’t) understand until it hits home, because I would be one to say that I took it really lightly until it hit home.”
The virus’s ongoing spread around the country has frustrated plans to safely reopen schools, forced college football conferences to postpone the lucrative fall season, and caused vast medical and economic pain.
And it will continue to rattle American society until people more seriously adopt recommended public health measures: social distancingavoiding large indoor gatheringshand-washingmask-wearingrapid testing and quarantining the sick.
“We have to figure out how to deal with this as a whole country because as long as there are cases happening in any part, we still have transit, especially now we have students going back to college,” said Dr. Michael Mina, assistant professor of epidemiology at Harvard T.H. Chan School of Public Health. “Any cases anywhere really keep risk pretty high all across the entirety of the United States.”

 

 

 

‘A Smoking Gun’: Infectious Coronavirus Retrieved From Hospital Air

A Smoking Gun': Infectious Coronavirus Retrieved From Hospital Air ...

Airborne virus plays a significant role in community transmission, many experts believe. A new study fills in the missing piece: Floating virus can infect cells.

Skeptics of the notion that the coronavirus spreads through the air — including many expert advisers to the World Health Organization — have held out for one missing piece of evidence: proof that floating respiratory droplets called aerosols contain live virus, and not just fragments of genetic material.

Now a team of virologists and aerosol scientists has produced exactly that: confirmation of infectious virus in the air.

“This is what people have been clamoring for,” said Linsey Marr, an expert in airborne spread of viruses who was not involved in the work. “It’s unambiguous evidence that there is infectious virus in aerosols.”

A research team at the University of Florida succeeded in isolating live virus from aerosols collected at a distance of seven to 16 feet from patients hospitalized with Covid-19 — farther than the six feet recommended in social distancing guidelines.

The findings, posted online last week, have not yet been vetted by peer review, but have already caused something of a stir among scientists. “If this isn’t a smoking gun, then I don’t know what is,” Dr. Marr tweeted last week.

But some experts said it still was not clear that the amount of virus recovered was sufficient to cause infection.

The research was exacting. Aerosols are minute by definition, measuring only up to five micrometers across; evaporation can make them even smaller. Attempts to capture these delicate droplets usually damage the virus they contain.

“It’s very hard to sample biological material from the air and have it be viable,” said Shelly Miller, an environmental engineer at the University of Colorado Boulder who studies air quality and airborne diseases.

“We have to be clever about sampling biological material so that it is more similar to how you might inhale it.”

Previous attempts were stymied at one step or another in the process. For example, one team tried using a rotating drum to suspend aerosols, and showed that the virus remained infectious for up to three hours. But critics argued that those conditions were experimental and unrealistic.

Other scientists used gelatin filters or plastic or glass tubes to collect aerosols over time. But the force of the air shrank the aerosols and sheared the virus. Another group succeeded in isolating live virus, but did not show that the isolated virus could infect cells.

In the new study, researchers devised a sampler that uses pure water vapor to enlarge the aerosols enough that they can be collected easily from the air. Rather than leave these aerosols sitting, the equipment immediately transfers them into a liquid rich with salts, sugar and protein, which preserves the pathogen.

“I’m impressed,” said Robyn Schofield, an atmospheric chemist at Melbourne University in Australia, who measures aerosols over the ocean. “It’s a very clever measurement technique.”

As editor of the journal Atmospheric Measurement Techniques, Dr. Schofield is familiar with the options available, but said she had not seen any that could match the new one.

The researchers had previously used this method to sample air from hospital rooms. But in those attempts, other floating respiratory viruses grew faster, making it difficult to isolate the coronavirus.

This time, the team collected air samples from a room in a ward dedicated to Covid-19 patients at the University of Florida Health Shands Hospital. Neither patient in the room was subject to medical procedures known to generate aerosols, which the W.H.O. and others have contended are the primary source of airborne virus in a hospital setting.

The team used two samplers, one about seven feet from the patients and the other about 16 feet from them. The scientists were able to collect virus at both distances and then to show that the virus they had plucked from the air could infect cells in a lab dish.

The genome sequence of the isolated virus was identical to that from a swab of a newly admitted symptomatic patient in the room.

The room had six air changes per hour and was fitted with efficient filters, ultraviolet irradiation and other safety measures to inactivate the virus before the air was reintroduced into the room.

That may explain why the researchers found only 74 virus particles per liter of air, said John Lednicky, the team’s lead virologist at the University of Florida. Indoor spaces without good ventilation — such as schools — might accumulate much more airborne virus, he said.

But other experts said it was difficult to extrapolate from the findings to estimate an individual’s infection risk.

“I’m just not sure that these numbers are high enough to cause an infection in somebody,” said Angela Rasmussen, a virologist at Columbia University in New York.

“The only conclusion I can take from this paper is you can culture viable virus out of the air,” she said. “But that’s not a small thing.”

Several experts noted that the distance at which the team found virus is much farther than the six feet recommended for physical distancing.

“We know that indoors, those distance rules don’t matter anymore,” Dr. Schofield said. It takes about five minutes for small aerosols to traverse the room even in still air, she added.

The six-foot minimum is “misleading, because people think they are protected indoors and they’re really not,” she said.

That recommendation was based on the notion that “large ballistic cannonball-type droplets” were the only vehicles for the virus, Dr. Marr said. The more distance people can maintain, the better, she added.

The findings should also push people to heed precautions for airborne transmission like improved ventilation, said Seema Lakdawala, a respiratory virus expert at the University of Pittsburgh.

“We all know that this virus can transmit by all these modes, but we’re only focusing on a small subset,” Dr. Lakdawala said.

She and other experts noted one strange aspect of the new study. The team reported finding just as much viral RNA as they did infectious virus, but other methods generally found about 100-fold more genetic matter.

“When you do nasal swabs or clinical samples, there is a lot more RNA than infectious virus,” Dr. Lakdawala said.

Dr. Lednicky has received emails and phone calls from researchers worldwide asking about that finding. He said he would check his numbers again to be sure.

But ultimately, he added, the exact figures may not matter. “We can grow the virus from air — I think that should be the important take-home lesson,” he said.

 

 

 

 

The Health 202: Coronavirus keeps spreading. But at least we’ve learned more about it.

https://www.washingtonpost.com/politics/2020/08/11/health-202-coronavirus-keeps-spreading-least-we-learned-more-about-it/?utm_campaign=wp_the_health_202&utm_medium=email&utm_source=newsletter&wpisrc=nl_health202

Coronavirus: FI Strategy to Stop the Spread

Coronavirus infections are swelling in the United States, which hit 5 million cases over the weekend.

But so is the body of research on how the novel coronavirus spreads and affects people.

Dozens of studies have now been published in top medical journals, providing critical information to public health officials and medical professionals attempting to get a handle on the virus. More understanding of the virus is critical, as its aggressive spread around the country confounds President Trump’s efforts toward an economic rebound and threatens to keep schools and workplaces shuttered through the fall.

There’s a lot left to learn. But some of the blanks are starting to be filled in, now that researchers around the world have had six months to study it (check out The Post’s database of questions and answers about the pandemic).

Here are some things we learned about the virus over the summer — and some questions that persist:

 

Can asymptomatic people spread the virus?

Researchers are still trying to discover whether people without visible symptoms spread the virus at similar rates as those with symptoms. There’s been a considerable amount of confusion around this question, particularly after the World Health Organization appeared to suggest the virus isn’t spread asymptomatically — and then walked back its pronouncement the next day.

It seems clear that asymptomatic transmission does occur. People with no symptoms carry the same level of virus in their nose, throat and lungs as those with symptoms, according to a South Korean study of 303 people published last week in JAMA Internal Medicine.

The study was the first to distinguish between patients who didn’t develop symptoms initially and those who did develop symptoms later on — which can cause some confusion when looking at asymptomatic spread. Based on their observations, the researchers estimated that 30 percent of infected people never develop symptoms.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said last week he thinks the figure is closer to 40 percent.

“The good news about covid-19 is that about 40 percent of the population have no symptoms when they get infected,” Fauci said, but he added that asymptomatic people “are propagating the outbreak, which means that you’re going to infect someone, who will infect someone, who then will have a serious consequence.”

Are some people immune to the virus without ever getting it?

There is some very early, tentative evidence suggesting a segment of the world’s population may have partial protection thanks to the immune system’s “memory” T cells, which are trained to recognize specific invaders.

People may derive this protection from standard childhood vaccinations or from previous infections by other coronaviruses, such as those that cause the common cold, my colleague Ariana Eunjung Cha reported.

“This might potentially explain why some people seem to fend off the virus and may be less susceptible to becoming severely ill,” National Institutes of Health Director Francis Collins remarked in a blog post last week.

“On a population level, such findings, if validated, could be far-reaching,” Ariana wrote. “ … In communities in Boston, Barcelona, Wuhan and other major cities, the proportion of people estimated to have antibodies and therefore presumably be immune has mostly been in the single digits. But if others had partial protection from T cells, that would raise a community’s immunity level much higher.”

 

How many untested Americans have already had the virus?

The head of the Centers for Disease Control and Prevention estimated in June that there were roughly 10 times more coronavirus infections in the United States than had been confirmed through testing.

There were just 2.4 million confirmed cases when CDC Director Robert Redfield made that estimate — which, if accurate, would have translated to 24 million cases at the time. Confirmed cases have since doubled, to more than 5 million — meaning the virus may have swept through tens of millions of people.

Redfield based his estimate on the results of antibody tests, which examine a person’s blood for indicators that the body fought off an infection, Lena H. Sun and Joel Achenbach wrote.

 

How does the virus travel?

Scientists initially thought the virus easily spread on surfaces, similar to how other viruses operate. That’s why much of the initial public health advice centered around hand-washing and disinfecting surfaces.

Now public health experts think SARS-CoV-2 is primarily spread through person-to-person contact.

In May, the CDC updated guidance on its “How COVID-19 Spreads” website to say that “the virus spreads easily between people.” The agency also acknowledged the virus may spread other ways, such as through touching contaminated objects or surfaces, but clarified “this is not thought to be the main way the virus spreads.”

“The virus travels through the droplets a person produces when talking or coughing,” Ben Guarino and Joel wrote. “An individual does not need to feel sick or show symptoms to spread the submicroscopic virus. Close contact means within about six feet, the distance at which a sneeze flings heavy droplets. Example after example have shown the microbe’s affinity for density. The virus has spread easily in nursing homes, prisons, cruise ships and meatpacking plants — places where many people are living or working in proximity.”

 

Do children spread it?

Children only rarely get seriously ill or die of covid-19, the disease the virus causes; data on hospitalizations and deaths make that clear. But whether — and to what extent — they can spread the virus to others asymptomatically is still murky.

Studies are also conflicting on whether the age of children affects their likelihood of spreading the virus. One study conducted at a Chicago hospital found children younger than 5 with mild to moderate cases of covid-19 had much higher levels of virus in their noses than older children and adults — suggesting they could be more infectious, Ariana, Haisten Willis and Chelsea Janes reported.

But a study out of South Korea examining household transmission seemed to reach an opposite conclusion. It found children under age 10 did not appear to pass on the virus readily, while those between 10 and 19 appeared to transmit the virus almost as much as adults did, my colleagues wrote.

 

Which organs does Covid-19 attack?

The lungs appear most susceptible to the virus. Researchers have also found the pathogen in parts of the brain, kidneys, liver, gastrointestinal tract, spleen and in the endothelial cells that line blood vessels, along with widespread clotting in many organsAriana and Lenny Bernstein reported.

But researchers have been surprised to discover little inflammation on the brain, despite previous reports about neurological symptoms related to the coronavirus. The same goes for the heart. While physicians warned for months about a cardiac complication they suspected was myocarditis, autopsy investigators found no evidence of the condition.

 

97,000 children reportedly test positive for coronavirus in two weeks as schools gear up for instruction

https://www.cbsnews.com/news/covid-19-kids-school-children-positive-tests-coronavirus-reopening/?utm_source=nl&utm_brand=wired&utm_mailing=WIR_Science_081020&utm_campaign=aud-dev&utm_medium=email&utm_term=WIR_Science&bxid=5db707423f92a422eaeaf234&cndid=&esrc=bounceX&source=EDT_WIR_NEWSLETTER_0_SCIENCE_ZZ

97,000 children reportedly test positive for coronavirus in two ...

Nearly 100,000 children tested positive for the coronavirus in the last two weeks of July, a new report from the American Academy of Pediatrics finds. Just over 97,000 children tested positive for the coronavirus from July 16 to July 30, according to the association.

Out of almost 5 million reported COVID-19 cases in the U.S., CBS News’ Michael George reports that the group found that more than 338,000 were children.

Vanderbilt University’s Dr. Tina Hartert hopes increased testing of children will help determine what role they play in transmission, as school districts around the country return to some form of school. She is leading a government-funded study that saw DIY testing kits sent to some 2,000 families.

“The kits are shipped to the families, they are taught how to collect these samples, and then the samples are sent back by the families to a central repository,” she said.

In New York City, home to the nation’s largest school district, Mayor Bill de Blasio announced a return to in-person schooling in the fall and pledged officials “have worked incessantly to get this right.”

“They’ve looked at examples from all over the world of what will keep the school community safe, and they’ve made a series of choices of how to do things from the health and safety lens first, while also making sure we can educate our kids,” he said in a Friday press conference.

De Blasio gave parents until Friday night to register students for in-person instruction, remote learning or a hybrid.

More than 25 children died of the coronavirus in July alone. Pressure to get kids back into the classroom has left superintendents in more than 13,000 different school districts across the country to figure out how to keep children safe amid a myriad of public health advisories, and handle learning differences.

Niles, Michigan Superintendent Dan Applegate is hoping Plexiglas could be a solution for children with speech impediments to be able to participate in class.

He demonstrated by speaking behind a transparent slate at a press conference.

“As I’m sitting here and I can articulate,” Applegate said. “The student on the other side will be wearing a mask. Then I can put my mask on, and that student can drop their mask and articulate as well.”

Indiana’s Lawrence Township is cleaning school buses with a hospital-grade disinfectant spray for students still needing rides to school.

“You’re going to see a very clean and disinfected bus,” Transportation Director Matt Miles said. “We actually have fogging machines.”

However, they are not expecting many students to get on the bus — 35% of children in the area are expected to learn remotely, while other school districts in the U.S. will not open at all.

 

 

 

 

2005 chloroquine study had nothing to do with COVID-19 and the drug wasn’t given to humans

https://www.politifact.com/factchecks/2020/jul/29/facebook-posts/2005-chloroquine-study-had-nothing-do-covid-19-and/?fbclid=IwAR2e4j_lb10FWa5Cyuokzo3pbjlty_ffvwsEfVT_2iQ6ki8a9z-TpzDm9DQ

PolitiFact | 2005 chloroquine study had nothing to do with COVID ...

IF YOUR TIME IS SHORT

  • The 2005 study wasn’t published by the NIH and didn’t prove chloroquine was effective against “COVID-1” because that’s not a real disease.
  • The study found that chloroquine could inhibit the spread of Severe Acute Respiratory Syndrome in animal cell culture, and the authors said more research was needed.
  • There are currently no approved medications or treatments for COVID-19.

 

Chloroquine is back.

The anti-malarial drug first showed up as a possible COVID-19 treatment around May 2020, when President Donald Trump said he had been taking its chemical cousin, hydroxychloroquine, to prevent getting infected with the virus.

Since then, some studies have found that the drugs could help alleviate symptoms associated with COVID-19, but the research is not conclusive. There are currently no FDA-approved medicines specifically for COVID-19. (Chloroquine is chemically similar to hydroxychloroquine, but it is a different drug that’s primarily used to treat malaria. Both carry a particular risk for people with heart problems, plus other possible side effects.)

Now, hydroxychloroquine and chloroquine have been thrust back into the spotlight as misinformation about the drugs’ effectiveness and safety recently reappeared online.

One such post on Facebook falsely claims that Americans have been deceived because health officials at the National Institutes of Health have known all along that chloroquine is effective against “COVID.”

The post reads:

“N.I.H. 15 years ago published a study on chloroquine. It is effective against COVID-(1). We are being lied to America!”

The post was flagged as part of Facebook’s efforts to combat false news and misinformation on its News Feed. (Read more about our partnership with Facebook.) 

 

This is flawed. 

First, there’s no such thing as “COVID-1.” COVID-19 was named for the year it was discovered, not because it’s the 19th iteration. 

Second, the 2005 study found that chloroquine was effective on primate cells infected with severe acute respiratory syndrome, known as SARS, which is caused by a coronavirus. But while the two share similarities, SARS-CoV and COVID-19 are different diseases, and primate cells are far from human patients.

Third, the study was indexed by the NIH’s National Library of Medicine, but the NIH was not involved. It was published in the peer-reviewed Virology Journal and conducted by researchers from the Centers for Disease Control and Prevention and the Montreal Clinical Research Institute.

 

What the study says

The study was published in August 2005 and found that chloroquine has “strong antiviral effects on SARS-CoV infection of primate cells” and that it was effective on cells treated with the drug before and after exposure to the virus.

The drug was not administered to actual SARS patients, and the study’s authors wrote that more research was needed on how the drug interacts with SARS in animal test subjects.

“Cell culture testing of an antiviral drug against the virus is only the first step, of many steps, necessary to develop an antiviral drug,” Kate Fowlie, a spokesperson for the CDC previously told PolitiFact in an email. “It is important to realize that most antivirals that pass this cell culture test hurdle fail at later steps in the development process.”

Dr. Alex Greninger, assistant director of clinical virology at the University of Washington School of Medicine, told us that a problem in virology is trying to determine the difference of how drugs work in cell culture in comparison to humans.

“Data on chloroquine is largely taken from these cell culture studies, but we now have trials in people on hydroxychloroquine that show it’s not as effective,” Greninger said, “and there’s new data out in the last week that suggests that some of the reasons could be because of the cell types that SARS coronaviruses grow in, and this original experiment was done on African green monkey kidney cells, which is not the tissue we are really worried about.”

 

What officials say about the drugs now

The Food and Drug Administration granted emergency use authorizations for some medicines to be used for certain patients hospitalized with COVID-19, but it revoked the authorization for hydroxychloroquine and chloroquine in mid-June due to concerns over the drugs’ serious side effects. There are currently no FDA-approved medicines for COVID-19.

“It is no longer reasonable to believe that oral formulations of HCQ and CQ may be effective in treating COVID-19, nor is it reasonable to believe that the known and potential benefits of these products outweigh their known and potential risks,” FDA Chief Scientist Denise M. Hinton wrote.

The NIH’s COVID-19 treatment guidelines, which were developed to inform clinicians on how to care for patients with COVID-19, also currently recommend against the use of chloroquine or hydroxychloroquine for COVID-19 treatment, except in a clinical trial.

But even those trials have been halted. The World Health Organization and the NIH announced in mid-June that they would stop hydroxychloroquine patient trials, citing safety concerns that include serious heart rhythm problems, blood and lymph system disorders, kidney injuries, and liver problems and failure.

 

Our ruling

A Facebook post says that the NIH published a study 15 years ago that showed chloroquine was effective against “COVID-(1)” and that health officials have been lying to the American people.

This is wrong. There’s no such thing as “COVID-1” and the study cited was not published by the NIH and had to do with animal cells infected with SARS, not COVID-19. The drug was not given to human patients and the study’s authors said more research was needed.

Health officials caution against the use of chloroquine or hydroxychloroquine to treat COVID-19 patients, citing the possibility of serious side effects. There are currently no approved treatments for the virus.

We rate this False. 

 

 

 

 

Covid-19 Data in the US Is an ‘Information Catastrophe’

https://www.wired.com/story/covid-19-data-in-the-us-is-an-information-catastrophe/#intcid=recommendations_wired-bottom-recirc-personalized_31e95638-88d6-439c-85a2-db8f6235da26_text2vec1-mab

Covid-19 Data in the US Is an 'Information Catastrophe' | WIRED

The order to reroute CDC hospitalization figures raised accuracy concerns. But that’s just one of the problems with how the country collects health data.

TWO WEEKS AGO, the Department of Health and Human Services stripped the Centers for Disease Control and Prevention of control of national data on Covid-19 infections in hospitalized patients. Instead of sending the data to the CDC’s public National Healthcare Safety Network (NHSN), the department ordered hospitals to send it to a new data system, run for the agency by a little-known firm in Tennessee.

The change took effect immediately. First, the hospitalization data collected up until July 13 vanished from the CDC’s site. One day later, it was republished—but topped by a note that the NHSN Covid-19 dashboard would no longer be updated.

Fury over the move was immediate. All the major organizations that represent US public health professionals objected vociferously. A quickly written protest letter addressed to Vice President Mike Pence, HHS secretary Alex Azar, and Deborah Birx, the coordinator of the White House’s Coronavirus Task Force, garnered signatures from more than 100 health associations and research groups. The reactions made visible the groups’ concerns that data could be lost or duplicated, and underlined their continual worry that the CDC is being undercut and sidelined. But it had no other effect. The new HHS portal, called HHS Protect, is up and running.

Behind the crisis lies a difficult reality: Covid-19 data in the US—in fact, almost all public health data—is chaotic: not one pipe, but a tangle. If the nation had a single, seamless system for collecting, storing, and analyzing health data, HHS and the Coronavirus Task Force would have had a much harder time prying the CDC’s Covid-19 data loose. Not having a comprehensive system made the HHS move possible, and however well or badly the department handles the data it will now receive, the lack of a comprehensive data system is harming the US coronavirus response.

“Every health system, every public health department, every jurisdiction really has their own ways of going about things,” says Caitlin Rivers, a senior scholar at the Johns Hopkins Center for Health Security. “It’s very difficult to get an accurate and timely and geographically resolved picture of what’s happening in the US, because there’s such a jumble of data.”

Data systems are wonky objects, so it may help to step back and explain a little history. First, there’s a reason why hospitalization data is important: Knowing whether the demand for beds is rising or falling can help illuminate how hard-hit any area is, and whether reopening in that region is safe.

Second, what the NHSN does is important too. It’s a 15-year-old database, organized in 2005 out of several streams of information that were already flowing to the CDC, which receives data from hospitals and other health care facilities about anything that affects the occurrence of infections once someone is admitted. That includes rates of pneumonia from use of ventilators, infections after surgery, and urinary tract infections from catheters, for instance—but also statistics about usage of antibiotics, adherence to hand hygiene, complications from dialysis, occurrence of the ravaging intestinal infection C. difficile, and rates of health care workers getting flu shots. Broadly, it assembles a portrait of the safety of hospitals, nursing homes, and chronic care institutions in the US, and it shares that data with researchers and with other statistical dashboards published by other HHS agencies such as the Center for Medicare and Medicaid Services.

Because NHSN only collects institutional data, and Covid-19 infections occur both inside institutions such as nursing homes and hospitals, and in the outside world, HHS officials claimed the database was a bad fit for the coronavirus pandemic. But people who have worked with it argue that since the network had already devised channels for receiving all that data from health care systems, it ought to continue to do so—especially since that data isn’t easy to abstract.

“If you are lucky enough to work in a large health care system that has a sophisticated electronic medical record, then possibly you can push one button and have all the data flow up to NHSN,” says Angela Vassallo, an epidemiologist who formerly worked at HHS and is now chief clinical adviser to the infection-prevention firm Covid Smart. “But that’s a rare experience. Most hospitals have an infection preventionist, usually an entire team, responsible for transferring that data by hand.”

There lies the core problem. Despite big efforts back during the Obama administration to funnel all US health care data into one large-bore pipeline, what exists now resembles what you’d find behind the walls of an old house: pipes going everywhere, patched at improbable angles, some of them leaky, and some of them dead ends. To take some examples from the coronavirus response: Covid-19 hospital admissions were measured by the NHSN (before HHS intervened), but cases coming to emergency departments were reported in a different database, and test results were reported first to local or state health departments, and then sent up to the CDC.

Covid-19 data in particular has been so messy that volunteer efforts have sprung up to fix it. These include the COVID Tracking Project—compiled from multiple sources and currently the most comprehensive set of statistics, used by media organizations and apparently by the White House—and Covid Exit Strategy, which uses data from the COVID Tracking Project and the CDC.

Last week, the American Public Health Association, the Johns Hopkins Center, and Resolve to Save Lives, a nonprofit led by former CDC director Tom Frieden, released a comprehensive report on Covid-19 data collection. Pulling no punches, they called the current situation an “information catastrophe.”

The US, they found, does not have national-, state-, county-, or city-level standards for Covid-19 data. Every state maintains some form of coronavirus dashboard (and some have several), but every dashboard is different; no two states present the same data categories, nor visualize them the same way. The data presented by states is “inconsistent, incomplete, and inaccessible,” the group found: Out of 15 key pieces of data that each state should be presenting—things such as new confirmed and probable cases, new tests performed, and percentage of tests that are positive—only 38 percent of the indicators are reported in some way, with limitations, and 60 percent are not reported at all.

“This is not the fault of the states—there was no federal leadership,” Frieden emphasized in an interview with WIRED. “And this is legitimately difficult. But it’s not impossible. It just requires commitment.”

But the problem of incomplete, messy data is older and deeper than this pandemic. Four scholars from the health-policy think tank the Commonwealth Fund called out the broader problem just last week in an essay in The New England Journal of Medicine, naming health data as one of four interlocking health care crises exposed by Covid-19. (The others were reliance on employer-provided health care, financial losses in rural and primary-care practices, and the effect of the pandemic on racial and ethinic minorities.)

“There is no national public health information system—electronic or otherwise—that enables authorities to identify regional variation in the demand for, and supply of, resources critical to managing Covid-19,” they wrote. The fix they recommended: a national public health information system that would record diagnoses in real time, monitor the materials hospitals need, and link hospitals and outpatient care, state and local health departments, and laboratories and manufacturers to maintain real-time reporting on disease occurrence, preventive measures, and equipment production.

They are not the first to say this is needed. In February, 2019, the Council of State and Territorial Epidemiologists launched a campaign to get Congress to appropriate $1 billion in new federal funding over 10 years specifically to improve data flows. “The nation’s public health data systems are antiquated, rely on obsolete surveillance methods, and are in dire need of security upgrades,” the group wrote in its launch statement. “Sluggish, manual processes—paper records, spreadsheets, faxes, and phone calls—still in widespread use, have consequences, most notably delayed detection and response to public health threats.”

Defenders of the HHS decision to switch data away from the CDC say that improving problems like that is what the department was aiming for. (“The CDC’s old hospital data-gathering operation once worked well monitoring hospital information across the country, but it’s an inadequate system today,” HHS assistant secretary for public affairs Michael Caputo told CNN.) If that’s an accurate claim, during a global pandemic is a challenging time to do it.

“We were opposed to this, because trying to do this in the middle of a disaster is not the time,” says Georges Benjamin, a physician and executive director of the American Public Health Association, which was a signatory to the letter protesting moving data from the NHSN. “It was just clearly done without a lot of foresight. I don’t think they understand the way data moves into and through the system.”

The past week has shown how correct that concern was. Immediately after the switch, according to CNBC, states were blacked out from receiving data on their own hospitals, because the hospitals were not able to manage the changeover from the CDC to the HHS system. On Tuesday, Ryan Panchadsaram, cofounder of Covid Exit Strategy and former deputy chief technology officer for the US, highlighted on Twitter that data on the HHS dashboard, advertised as updating daily, was five days old. And Tuesday night, the COVID Tracking Project staff warned in a long analysis: “Hospitalization data from states that was highly stable a few weeks ago is currently fragmented, and appears to be a significant undercount.”

When the Covid-19 crisis is over, as everyone hopes it will be someday, the US will still have to wrestle with the questions it raised. One of those will be how the richest country on the planet, with some of the best clinical care in the world, was content with a health information system that left it so uninformed about a disease affecting so many of its citizens. The answer could involve tearing the public-health data system down and building it again from scratch.

“This is a deeply entrenched problem, where there is no single person who has not done their job,” Rivers says. “Our systems are old. They were not updated. We haven’t invested in them. If you’re trying to imagine a system where everyone reports the same information in the same way and we can push a button and have all the information we might want, that will take a complete overhaul of what we have.”

 

 

 

 

Winter is coming: Why America’s window of opportunity to beat back Covid-19 is closing

Winter is coming: Why America’s window of opportunity to beat back Covid-19 is closing

Winter is coming: Why America's window of opportunity to beat back ...

The good news: The United States has a window of opportunity to beat back Covid-19 before things get much, much worse.

The bad news: That window is rapidly closing. And the country seems unwilling or unable to seize the moment.

Winter is coming. Winter means cold and flu season, which is all but sure to complicate the task of figuring out who is sick with Covid-19 and who is suffering from a less threatening respiratory tract infection. It also means that cherished outdoor freedoms that link us to pre-Covid life — pop-up restaurant patios, picnics in parks, trips to the beach — will soon be out of reach, at least in northern parts of the country.

Unless Americans use the dwindling weeks between now and the onset of “indoor weather” to tamp down transmission in the country, this winter could be Dickensianly bleak, public health experts warn.

“I think November, December, January, February are going to be tough months in this country without a vaccine,” said Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota.

It is possible, of course, that some vaccines could be approved by then, thanks to historically rapid scientific work. But there is little prospect that vast numbers of Americans will be vaccinated in time to forestall the grim winter Osterholm and others foresee.

Human coronaviruses, the distant cold-causing cousins of the virus that causes Covid-19, circulate year-round. Now is typically the low season for transmission. But in this summer of America’s failed Covid-19 response, the SARS-CoV-2 virus is widespread across the country, and pandemic-weary Americans seem more interested in resuming pre-Covid lifestyles than in suppressing the virus to the point where schools can be reopened, and stay open, and restaurants, movie theaters, and gyms can function with some restrictions.

“We should be aiming for no transmission before we open the schools and we put kids in harm’s way — kids and teachers and their caregivers. And so, if that means no gym, no movie theaters, so be it,” said Caroline Buckee, associate director of the Center for Communicable Disease Dynamics at Harvard’s T.H. Chan School of Public Health.

“We seem to be choosing leisure activities now over children’s safety in a month’s time. And I cannot understand that tradeoff.”

While many countries managed to suppress spread of SARS-CoV-2, the United States has failed miserably. Countries in Europe and Asia are worrying about a second wave. Here, the first wave rages on, engulfing rural as well as urban parts of the country. Though there’s been a slight decline in cases in the past couple of weeks, more than 50,000 Americans a day are being diagnosed with Covid-19. And those are just the confirmed cases.

To put that in perspective, at this rate the U.S. is racking up more cases in a week than Britain has accumulated since the start of the pandemic.

Public health officials had hoped transmission of the virus would abate with the warm temperatures of summer and the tendency — heightened this year — of people to take their recreational activities outdoors. Experts do believe people are less likely to transmit the virus outside, especially if they are wearing face coverings and keeping a safe distance apart.

But in some places, people have been throwing Covid cautions to the wind, flouting public health orders in the process. Kristen Ehresmann, director of infectious disease epidemiology, prevention, and control for the Minnesota Department of Health, points to a large, three-day rodeo that was held recently in her state. Organizers knew they were supposed to limit the number of attendees to 250 but refused; thousands attended. In Sturgis, S.D., an estimated quarter of a million motorcyclists were expected to descend on the city this past weekend for an annual rally that spans 10 days.

Even on smaller scales, public health authorities know some people are letting down their guard. Others have never embraced the need to try to prevent spread of the virus. Ehresmann’s father was recently invited to visit some friends; he went, she said, but wore his mask, elbow bumping instead of shaking proffered hands. “And the people kind of acted like, … ‘Oh, you drank that Kool-Aid,’ rather than, ‘We all need to be doing this.’”

Ehresmann and others in public health are flummoxed by the phenomenon of people refusing to acknowledge the risk the virus poses.

“Just this idea of, ‘I just don’t want to believe it so therefore it’s not going to be true’ — honestly, I have not really dealt with that as it relates to disease before,” she said.

Buckee, the Harvard expert, wonders if the magical thinking that seems to have infected swaths of the country is due to the fact many of the people who have died were elderly. For many Americans, she said, the disease has not yet touched their lives — but the movement restrictions and other response measures have.

“I think if children were dying, this would be … a different situation, quite honestly,” she said.

Epidemiologist Michael Mina despairs that an important chance to wrestle the virus under control is being lost, as Americans ignore the realities of the pandemic in favor of trying to resume pre-Covid life.

“We just continue to squander every bit of opportunity we get with this epidemic to get it under control,’’ said Mina, an assistant professor in Harvard’s T.H. Chan School of Public Health and associate medical director of clinical microbiology at Boston’s Brigham and Women’s Hospital.

“The best time to squash a pandemic is when the environmental characteristics slow transmission. It’s your one opportunity in the year, really, to leverage that extra assistance and get transmission under control,” he said, his frustration audible.

Driving back transmission would require people to continue to make sacrifices, to accept the fact that life post-Covid cannot proceed as normal, not while so many people remain vulnerable to the virus. Instead, people are giddily throwing off the shackles of coronavirus suppression efforts, seemingly convinced that a few weeks of sacrifice during the spring was a one-time solution.

Osterholm has for months warned that people were being misled about how long the restrictions on daily life would need to be in place. He now thinks the time has come for another lockdown. “What we did before and more,” he said.

The country has fallen into a dangerous pattern, Osterholm said, where a spike in cases in a location leads to some temporary restraint from people who eventually become alarmed enough to start to take precautions. But as soon as cases start to plateau or decline a little, victory over the virus is declared and people think it’s safe to resume normal life.

“It’s like an all or nothing phenomenon, right?” said Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases. “You all locked down or you get so discouraged with being lockdown that you decide you’re going to be in crowded bars … you can have indoor parties with no masks. You can do all the things that are going to get you in trouble.”

Osterholm said with the K-12 school year resuming in some parts of the country or set to start — along with universities — in a few weeks, transmission will take off and cases will start to climb again. He predicted the next peaks will “exceed by far the peak we have just experienced. Winter is only going to reinforce that. Indoor air,” he said.

Buckee thinks that if the country doesn’t alter the trajectory it is on, more shutdowns are inevitable. “I can’t see a way that we’re going to have restaurants and bars open in the winter, frankly. We’ll have resurgence. Everything will get shut down again.”

Fauci favors a reset of the reopening measures, with a strong messaging component aimed at explaining to people why driving down transmission now will pay off later. Young people in particular need to understand that even if they are less likely to die from Covid-19, statistically speaking, transmission among 20-somethings will eventually lead to infections among their parents and grandparents, where the risk of severe infections and fatal outcomes is higher. (Young people can also develop long-term health problems as a result of the virus.)

“It’s not them alone in a vacuum,” Fauci said. “They are spreading it to the people who are going to wind up in the hospital.”

Everyone has to work together to get cases down to more manageable levels, if the country hopes to avoid “a disastrous winter,” he said.

“I think we can get it under much better control, between now and the mid-to-late fall when we get influenza or we get whatever it is we get in the fall and the winter. I’m not giving up,” said Fauci.

But without an all-in effort “the cases are not going to come down,” he warned. “They’re not. They’re just not.”