BOSTON — Once a coronavirus hot spot, Massachusetts was seen as a model for infection control this summer as coronavirus cases and deaths dwindled. Now, experts are warning the state could be headed for a bleak winter as its cases climb once again and confirmed deaths surpass 10,000.

Amid growing calls for action, Republican Gov. Charlie Baker recently tightened restrictions but has resisted taking more drastic measures such as halting indoor dining. The governor insists Massachusetts is better prepared than it was in the spring, but says if the trends continue it will only be a matter of time before the state’s hospitals are once again stressed under a flood of patients.

“We know how close we got to a completely overwhelmed health care system in the spring and we are not willing to go there again,” said Shira Doron, an infectious disease physician and hospital epidemiologist at Tufts Medical Center.

The COVID-19 Empty Chair Memorial is displayed at Campagnone Common in Lawrence, Mass., on Wednesday. Each chair represents a person from Lawrence who has died from the coronavirus. Massachusetts hit a total of 10,015 confirmed coronavirus deaths on Thursday, nearly nine months after the state’s initial case was detected. Associated Press/Elise Amendola

Massachusetts hit 10,015 confirmed coronavirus deaths on Thursday, nearly nine months after the state’s initial case was detected. Confirmed cases have topped 174,000 and the number of cities and towns designated as “high risk” nearly doubled over a two-week period last month.

Nationwide, the pandemic has killed more than 240,000, but the real toll is thought to be much higher, in part because many COVID-19 deaths were probably ascribed to other causes, especially early on, before widespread testing. Massachusetts has the sixth-highest death toll in the U.S. behind New York, Texas, California, New Jersey and Florida.

Experts are particularly concerned about data gathered from testing wastewater in the Boston area that shows a spike in the presence of coronavirus similar to that seen around April and May.

Upper Midwest faces ‘catastrophic’ lack of hospital beds

COVID’s long, dark winter has already arrived in the upper Midwest, as cases and deaths surge, snatching lives, overwhelming hospitals, exhausting health-care providers and raising fears that the region’s medical system will be completely overwhelmed in the coming days.

As coronavirus cases grow exponentially across the United States – up 70 percent on average in the past two weeks, with an average of 130,000 cases per day nationally – the situation is particularly acute now in the upper Midwest and Plains states, with North and South Dakota leading the nation in new cases and deaths per capita over the past week, according to Washington Post data.

The Stedry-Stecklein family quarantine in their home in Prairie Village, Kan., as three family members have COVID-19. Christopher Smith/The Washington Post

Experts say that cases are surging in the region as the weather has turned colder and more people are forced inside – into more poorly ventilated indoor spaces where transmission thrives – with the virus arriving even in remote areas in largely conservative states where Republican leaders have resisted mask mandates or business closures, asking their residents to rely instead on personal responsibility.

The region’s surge is a preview of what the rest of the U.S. can expect in the coming weeks as winter approaches, experts say.

The situation has become so acute that even some leaders who previously resisted restrictions have moved toward new strictures. Republican Gov. Kim Reynolds in Iowa, long an opponent of closures and mask-wearing as “feel-good” options, this week moved to prohibit maskless indoor gatherings of 25 or more and require those attending larger outdoor events to wear a mask.

In Minnesota, Gov. Tim Walz, a Democrat, has warned of more “nightmare” numbers to come, even as the state has instituted new restrictions on bars, restaurants and social gatherings in an attempt to stop the spread. On Friday, Minnesota will begin limiting social gatherings to 10 people or less and tightening restrictions on larger social receptions as the country heads into a holiday season when doctors fear multigenerational family gatherings could become superspreader events.

Read the full story here.

Chicago issues new ‘stay-at-home’ advisory, including for Thanksgiving

CHICAGO — Chicago Mayor Lori Lightfoot urged residents in the nation’s third-largest city to restrict social gatherings to 10 people, part of a renewed push announced Thursday to fight a COVID-19 surge.

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Chicago Mayor Lori Lightfoot, shown in March, said Thursday, “If we continue on the path we’re on, and you and me and others don’t step up and do more, our estimates are that we could see 1,000 more Chicagoans die from this virus by the end of the year.” Teresa Crawford/Associated Press

Lightfoot implored Chicagoans to “cancel the normal Thanksgiving plans,” saying the skyrocketing cases show no signs of slowing and urgent steps were needed immediately. She stopped short of making the limitations mandatory, calling them a progressive step: “I hope we don’t have to go any further than this.”

The limitations on gatherings, which takes effect Monday for 30 days, were announced with a fresh stay-at-home advisory urging residents to venture out only for essential things, like going to work or grocery shopping. Chicago already bars indoor dining under state rules announced last month.

“If we continue on the path we’re on, and you and me and others don’t step up and do more, our estimates are that we could see 1,000 more Chicagoans die from this virus by the end of the year,” Lightfoot said at a news conference.

A month ago, Chicago was reporting 500 daily cases on average. Now, Chicago is averaging roughly 1,900 daily cases. In the same time period, the rate of positive tests has nearly tripled to 14 percent.

Gov. J.B. Pritzker has made similar pleas for Illinoisans to stay home, saying he could step up restrictions if things don’t change. State officials on Thursday reported 12,702 new COVID-19 cases, including 43 more deaths. Overall, Illinois has reported 536,542 cases and 10,477 deaths.

Chicago officials have advised against travel to states with high infection rates for months.

A revamped travel order announced earlier this week requires a two-week quarantine or negative COVID-19 test depending on the state. City residents who travel face the same rules upon return.

City officials have threatened hefty fines for those who don’t comply, but there appears to be little enforcement. WBBM-TV reported last month that no fines were issued in the first three months of the travel order.

Federal officials reach COVID-19 vaccine agreement with drug stores

WASHINGTON — Federal health officials have reached an agreement with pharmacies across the U.S. to distribute free coronavirus vaccines after they are approved and become available to the public.

The goal eventually is to make getting a COVID-19 vaccine like getting a flu shot.

Thursday’s agreement with major chain drug stores, grocery market pharmacies and other chains and networks covers about 3 in 5 pharmacies in all 50 states and U.S. territories such as Puerto Rico. It looks ahead to a time next spring when yet-to-be-approved vaccines will start to become available beyond priority groups such as health care workers and nursing home residents.

“The vast majority of Americans live within five miles of a pharmacy,” said Health and Human Services Secretary Alex Azar, calling the agreement “a critical step toward making sure all Americans have access to safe and effective COVID-19 vaccines when they are available.”

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The first patient enrolled in Pfizer’s COVID-19 coronavirus vaccine clinical trial at the University of Maryland School of Medicine in Baltimore, shown in May. On Monday, Pfizer said an early peek at its vaccine data suggests the shots may be 90% effective at preventing COVID-19. Courtesy of University of Maryland School of Medicine via Associated Press

The announcement comes as the nation is seeing its broadest virus surge of the pandemic and President Donald Trump has put the brakes on agency collaboration with President-elect Joe Biden’s transition team. New COVID-19 cases surpassed 127,000 on Wednesday, an increase of nearly 75% from two weeks ago. More than 60,000 Americans are hospitalized and deaths are rising.

A successful pandemic hand-off between the Trump and Biden administrations would rank as one of the biggest priorities for the nation. It’s on hold while Trump refuses to acknowledge Biden’s election victory, even though Biden has already appointed a coronavirus advisory panel to guide his transition team.

The list of pharmacies joining the distribution partnership include retail chains like Rite Aid and Walgreens, supermarket drug stores like Albertsons and Publix, and big box stores like Costco and Walmart.

The agreement follows a collaboration with CVS and Walgreens to deliver vaccines to nursing homes and administer shots.

Optimism about a vaccine has grown since pharmaceutical giant Pfizer announced earlier this week preliminary data showed its vaccine to be 90% effective. Pfizer is pursuing its own vaccine development process, but other manufacturers are operating within a White House-backed federal effort called “Operation Warp Speed,” which aims to deliver vaccines as soon as they are approved.

Officials say initial supplies will be limited, and distributed to states for them to allocate to priority groups such as health care workers and first responders.

Thursday’s agreement with pharmacies is intended to act as a bridge, facilitating vaccine distribution as supplies become more available but before there’s enough for the government to pull back and let the private market handle things.

Currently there are no approved vaccines for COVID-19, but officials say they anticipate one or more will be approved before the end of this year.

Schools abandon classes, states impose more restrictions as virus surges nationwide

School systems in Detroit, Indianapolis, Philadelphia and suburban Minneapolis are giving up on in-person classes, and some governors are reimposing restrictions on bars and restaurants or getting more serious about masks, as the coast-to-coast resurgence of the coronavirus sends deaths, hospitalizations and new infections soaring.

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Custodial workers clean a classroom at Richard A. Simpson Elementary School in Arnold, Mo., this month. The school went to fully virtual learning on Nov. 2, after more than 5 percent of the staff and students tested positive for COVID-19. They will stay virtual at least until Nov. 16. Colter Peterson/St. Louis Post-Dispatch via Associated Press

The crisis deepened at hospitals, with the situation so bad in North Dakota that the governor this week said nurses who test positive but have no symptoms can still work. Idaho clinics struggled to handle the deluge of phone calls from patients.

The virus is blamed for more than 240,000 deaths and over 10.4 million confirmed infections in the U.S., with the country facing what health experts say will be a dark winter because of disregard for mask-wearing and other precautions, the onset of cold weather and crowded holiday gatherings.

“It should frighten all of us,” Dr. David Peterman, CEO of Idaho’s Primary Health Medical Group, said of the virus numbers. “It’s easy to look at TV, and say, ‘I’m not in the intensive care unit, my grandmother’s not in the intensive care unit.’ But if I say to you your doctor cannot treat your child with an ear infection because I cannot answer your phone call, or your doctor is on quarantine, or our clinics are full with people with coronavirus?”

Deaths per day in the U.S. have soared more than 40 percent over the past two weeks, from an average of about 790 to more than 1,100 as of Wednesday, the highest level in three months.

That is still well below the peak of about 2,200 deaths per day in late April, in what may reflect the availability of better treatments and the increased share of cases among young people, who are more likely than older ones to survive a bout with COVID-19.

But newly confirmed cases per day in the U.S. have rocketed more than 70 percent over the past two weeks, reaching an average of about 127,000 — the highest on record. And the number of people currently hospitalized with the virus hit an all-time high of more than 65,000.

Amid the staggering numbers, some state leaders continued to take a hands-off approach, pushing “personal responsibility” rather than government-imposed restrictions such as mandatory mask-wearing.

Read the full story here.

Trump adviser Corey Lewandowski positive for virus

Trump adviser Corey Lewandowski has tested positive for the coronavirus.

Lewandowski recently traveled to Pennsylvania to assist Trump’s efforts to contest the state’s election results. He said Thursday he believes he was infected in Philadelphia and he’s not experiencing any symptoms.

Lewandowski appeared with Trump lawyer Rudy Giuliani at an event last Saturday outside a landscaping company and lobbed unfounded accusations of voter fraud as the race was called for Trump’s challenger, now-President-elect Joe Biden.

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President Trump’s campaign adviser Corey Lewandowski, center, outside the Pennsylvania Convention Center where votes were being counted, on Nov. 5 in Philadelphia. At left is former Florida Attorney General Pam Bondi. Associated Press/Matt Slocum

Lewandowski was also at the election night party at the White House last week linked to several virus cases.

Numerous White House and campaign officials have tested positive in this latest wave of infections, including Trump chief of staff Mark Meadows.

Republican and Democratic election officials nationwide have said publicly the election went well. International observers confirm there were no serious irregularities.

Read the full story here.

Fauci: ‘The cavalry is coming’

Around the United States, new cases are soaring, hospital beds are filling up and some areas are mulling a return of restrictions not seen since the spring, but Anthony S. Fauci, the nation’s leading infectious-disease expert, reassured pandemic-weary Americans the outlook isn’t entirely bleak.

“Help is really on the way. If you think of it metaphorically, the cavalry is coming here,” Fauci said during a Thursday morning appearance on ABC’s “Good Morning America.” “Vaccines are going to have a major positive impact.”

It was an optimistic tone amid days of grim reports that infections continue to hit record levels: More than 145,000 new cases were reported on a single day Wednesday.

Cases have risen in nearly every part of the United States, prompting some governors and municipalities to consider reactivating stay-at-home orders; already, many states have reinstated restrictions on restaurant and bar service and indoor crowd size at businesses.

Asked if the United States is headed for a possible national lockdown, Fauci said it’s still possible to avert such drastic measures if people take every precaution seriously.

“The best opposite strategy to locking down is to intensify the public health measures short of locking down,” he said, noting that lockdowns are hard on people both psychologically and economically.

“If we can just hang in there, do the public health measures that we’re talking about, we are going to get this under control, I promise you,” he said.

CDC says preventing lockdowns means wearing masks to protect others – and yourself

When the White House coronavirus task force first recommended mask-wearing April 3, officials emphasized this was not about you. It was about others. Your mom, dad, other family members. Friends. The older woman who always smiles at you at the grocery store, the immunocompromised dad coaching your kid’s basketball team.

Now, a growing body of science suggests that by wearing a mask to prevent spreading the virus, you may be protecting yourself, too. It is further evidence that knowledge about masks, and their benefits, continues to evolve – much like understanding of the pandemic more broadly.

The CDC publicly acknowledged that for the first time, writing in a scientific bulletin posted to its website this week, “the benefit of masking is derived from the combination of source control and personal protection for the mask wearer.” Masks are neither completely selfless nor selfish – they help everyone.

John Brooks, chief medical officer for the CDC’s coronavirus response, told The Washington Post there was an urgency to explain this clearly, because the widespread wearing of face coverings can help avoid a return to lockdowns.

The CDC published this scientific brief to fix what the agency saw as the lack of “a concise summary of the powerful scientific evidence demonstrating the benefit of masking,” he said. The bulletin marks the start of the agency’s renewed push to bolster public messaging as infections surge to highest-ever levels in many U.S. regions.

Because the CDC cannot impose mandates, the agency wants the public to understand masks are “good for them,” Brooks said.

The new document attempts to dangle a persuasive carrot of information before the public: A “likely complementary and possibly synergistic” relationship exists between controlling the source of infection for others and being protected yourself, the agency said. Put another way, the more people wearing masks in the community, the greater the individual benefit.

“Wearing a mask blocks you from inhaling potential virus-containing particles in the air,” Brooks said. “But most of the benefit to a mask is to block particles coming out of people who don’t know they are infected from exposing others.”

Masks create a barrier that stops some of the droplets from flying outward when someone breathes, talks, sings or coughs. A study released last week showed that, in experimental conditions, simple fabric masks blocked about three-fourths of the particles expelled by coughing volunteers.

But it was a logical hypothesis for researchers to investigate, too, whether masks might also block incoming particles. And laboratory tests in recent months indicated that masks can filter out the types of incoming particles able to carry virus, Brooks said.

The CDC official added that personal protection for the mask-wearer is not absolute. “The real benefit is when all of us do it, that’s how we bring down the viral load of covid-19 in communities,” Brooks said.

Read the full story here.

With COVID and Trump both raging, governors are left to face pandemic alone

With a COVID vaccine months away and a distracted, lame-duck president, governors are stirring as America’s first line of defense against the pandemic’s winter onslaught.

The pending departure of President Donald Trump, who has scoffed at the disease’s potency, could provide cover for strict new measures. The Republican leaders of Nebraska, Maryland, Utah, Ohio and Iowa tightened virus restrictions for their states this week, and Democrats warned residents of difficult months ahead. Many have little choice but to act, as the virus sets daily records and reality sets in among constituents.

“We may see governors that haven’t been as aggressive forced to take actions they haven’t wanted to,” said Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials. “The big thing that’s going to come up is when hospital systems begin to reach capacity. That’s a very dangerous situation that no one wants to find themselves in.”

Governors face wrenching choices in gathering and apportioning supplies and an eventual vaccine, keeping economies on life support and cajoling voters to wear masks and stay home — again. Public-health experts and some state officials said President-elect Joe Biden could take some of the burden when he assumes office Jan. 20, having made a strong national response his main issue.

On Wednesday night, Ohio Gov. Mike DeWine, R, who has drawn praise for his aggressive response to the pandemic, toughened the state’s mask mandate. Store owners will be held responsible for ensuring that all customers and employees wear them, he said. The governor also banned dancing, games and congregating at events like wedding receptions.

“I’m tired of all this COVID. I know you’re tired,” DeWine said in a statewide address. “This pandemic gives each of us a chance to serve a higher cause, a more noble purpose than just ourselves.”

 

The Trump administration has been widely criticized for shirking a leading role in combating the pandemic, leaving states fighting for resources and formulating different policies for a national crisis. But about 72 million people voted for Trump’s reelection, to Biden’s 77 million, and the path ahead is fraught. Some hard-liners, however, are softening.

Iowa Gov. Kim Reynolds, R, who has opposed a statewide mask requirement, told citizens Tuesday that their health-care system was on the brink of collapse. More than 22,700 Iowans were diagnosed with COVID-19 in the past week and nearly half of its daily tests return positive, a rate second only to South Dakota, according to Johns Hopkins University.

Reynolds set mask and social-distancing rules for indoor gatherings of more than 25 people, large outdoor gatherings and salons and tattoo parlors, and said she would put more in place if needed.

“Iowa is open for business and we intend to keep it that way,” she said. “That’s why it’s time for these additional mitigation measures.”

Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials, said that taking the politics out of public health is essential because the disease won’t wait for the inauguration.

“We have to turn this corner on public trust,” she said. “We have to do that like, yesterday, because that is what is holding us back.” America’s COVID-19 cases have climbed steadily since September. About 123,000 were recorded each day over the past week, on track to double summer highs. Almost 62,000 patients were hospitalized Wednesday, a record that represents a 40% increase from two weeks ago, according to the COVID Tracking Project.

Read the full story here.

One large place in the world is free from coronavirus – but it is hard to get to

There has been perhaps no place on Earth where people have been more vigilant in keeping out the virus than Antarctica, the only continent which remains virus-free. That’s because any outbreak would be difficult to control in a place where people live in close quarters and where medical capabilities are limited. People who do get gravely ill on Antarctica typically must be evacuated, a process that can take days, or even weeks, due to the extreme weather conditions, which can delay flights.

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Directional signpost on King George Island, Antarctica. Associated Press

While most countries have been reducing the number of scientists and staff they are sending to Antarctica this Southern Hemisphere summer, hundreds of people still have been arriving to ensure bases are maintained and long-term scientific programs continue to tick over.

Michelle Rogan-Finnemore, the executive secretary of the Council of Managers of National Antarctic Programs, says people planning to travel to Antarctica are typically tested in their home countries before leaving and then quarantined for at least two weeks in their final gateway country before flying to Antarctica. Once there, she says, people are typically tested again and are required at first to remain socially distanced and wear masks.

Rogan-Finnemore says they’re making every effort to keep the virus out. “We’re doing our best in a global pandemic,” she says.

Screenings failed to detect infections among Marine recruits

Checking temperatures and screening for symptoms failed to identify coronavirus infections and prevent outbreaks among Marine recruits, according to a study published Wednesday in the New England Journal of Medicine.

The findings suggest that the safety measures introduced at many workplaces, businesses and schools may not be particularly effective, especially when compared with routine testing. Over 90 percent of the positive test results came from recruits who were asymptomatic and were identified through surveillance testing.

Led by scientists at the Naval Medical Research Center and Icahn School of Medicine at Mount Sinai, the study tracked 1,848 recruits, most of them young men. All were ordered to self-quarantine at home for two weeks before arriving at a college campus where they would begin another two-week quarantine period, this one with strict supervision.

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Marine recruits line up at Parris Island Recruit Depot, S.C., in May. A study published on Wednesday found that despite temperature and COVID-19 symptom checks and strict quarantines, new Marine recruits spread the virus to others even though hardly any of them had symptoms. Lolita Baldor/Associated Press Lolita Baldor/Associated Press

During the second quarantine, recruits underwent daily screenings when their temperatures were taken and they were asked whether they had experienced any coronavirus symptoms. Anyone displaying possible symptoms was tested, but no positive cases were identified through this process, the researchers found.

Instead, all 51 cases detected during the two-week quarantine were found through mandatory scheduled testing for all recruits, with 16 testing positive within two days of arriving on campus, and an additional 35 testing positive on day seven or day 14. Forty-six of the infected participants were asymptomatic, and the study doesn’t make clear why the screening process failed to catch the remaining five.

Genome sequencing showed that a number of the asymptomatic recruits infected their roommates or members of their platoons before testing positive. Researchers identified six separate clusters, including three involving pairs of roommates.

Read the full story.

New Zealand reports infection with no link to quarantine facilities for the first time since August

For the first time since August, New Zealand has identified a mystery coronavirus infection with no known link to government-supervised quarantine facilities, suggesting possible community transmission.

Authorities said Thursday that the case involves a young woman who lives alone and attends the Auckland University of Technology, but who has not been on campus since the middle of October. The woman “appears to have had limited community outings recently,” health director Ashley Bloomfield said, but did go to work at a clothing store in Auckland’s business district this week. People who work in the downtown district, where life has essentially returned to normal, were warned to stay home on Friday as a precaution while contact tracing is happening.

“This is a very important reminder of why anyone with any symptoms of a cold or flu get tested,” Bloomfield said.

Residents of the sick woman’s apartment building offered one possible theory for the mystery case: Earlier this week, a fire alarm went off at a neighboring building that houses an isolation facility, forcing people in quarantine to leave the premises. But officials have rejected that explanation, saying that quarantined guests were “continuously monitored ” and contained in designated areas where they couldn’t mix and mingle with the public, according to the New Zealand Herald.

After a cluster of coronavirus cases with an unknown source were detected in Auckland in August, the city entered lockdown for the second time this year. That approach proved successful, and all restrictions were lifted by early October. Officials said Thursday that they have yet to determine if there will be a need to bring back some restrictions or enter lockdown again.


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