Written by Steven Hansen

The U.S. new cases 7-day rolling average is 10.5 % HIGHER than the 7-day rolling average one week ago. U.S. deaths due to coronavirus are now 8.4 % HIGHER than the rolling average one week ago. At the end of this post is a set of interactive graphs and tables for the world and individual States – as well as today’s headlines which include;

• Global daily new coronavirus cases continue at record levels
• The U.S. reported its second-highest daily case total since the start of the pandemic.
• Universal mask wearing could save 130,000 lives by spring
• FDA OKs Remdesivir, First Drug for COVID-19
• Moderna’s coronavirus vaccine trial is fully enrolled, 37 percent of participants are minorities
• Schoolchildren Seem Unlikely to Fuel Coronavirus Surges, Scientists Say
• Explaining declines in death rates from COVID-19
• Where Europe’s Second Wave Is Filling Up Hospitals
• For Covid-19 vaccine recipients, CDC to roll out cell phone-based monitoring system
• A new culprit for severe COVID-19 cases
• Hospital Bills For Uninsured COVID-19 Patients Are Covered, But No One Tells Them
• COVID-19 Plus Cancer Proves Deadly

The recent worsening of the trendlines for new cases should be attributed to going back to college/university, cooler weather causing more indoor activities, holiday activities, and continued loosening of regulations designed to slow the coronavirus spread.

My continuing advice is to continue to wash your hands, wear masks, and maintain social distancing. No handwashing, mask, or social distancing will guarantee you do not get infected – but it sure as hell lowers the risk in all situations – as the evidence to-date shows a lower severity of COVID-19. In addition, certain activities are believed to carry a higher risk – like being inside in air conditioning and removing your mask (such as restaurants, around your children/grandchildren, bars, and gyms). It is all about viral load – and outdoor activities are generally safe.

The daily number of new cases in the U.S. is remaining stubbornly and embarrassedly high – and is currently increasing.

The following graphs show the 7-day rolling average for new coronavirus cases and deaths have been updated through 23 October 2020:

z coronavirus.png​

Hospitalizations (grey line) and Mortality (green line) For Week ending 17OCT2020

source: https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html

Source: EU CDC – The data insignificantly varies from the data produced by Johns Hopkins

* as of 20 Oct 2020

** evidently several States included “probable” deaths today in the number

*** red color indicates record number

Tracking Covid at U.S. Colleges and Universities

Coronavirus News You May Have Missed

Study: Universal mask wearing could save 130,000 lives by spring – Newsweek

Universal mask wearing could prevent nearly 130,000 deaths from COVID-19 through the end of February, according to new research released Friday.

The analysis, published in the journal Nature Medicine, found that even if only 85 percent of the population wore masks in public, nearly 96,000 lives could be saved.

But without universal masking, which the study defined as 95 percent compliance, more than a half a million lives could be lost to COVID-19, researchers at the Institute for Health Metrics and Evaluation (IHME) projected.

The most optimistic scientists do not predict the availability of new coronavirus treatments before 2021, and a vaccine might not be widely available until April at the earliest.

That means until there is a vaccine, masks and other non-pharmaceutical measures such as physical distancing are the only real ways to reduce transmission of the virus.

The findings match what public health officials have been saying for months, but mask wearing is still controversial. Only 49 percent of Americans said they always wear a mask in public.

FDA OKs Remdesivir, First Drug for COVID-19 – MedPage

The FDA approved remdesivir (Veklury) on Thursday for treating hospitalized COVID-19 patients, a first for the disease that started a global pandemic.

Remdesivir, an antiviral that works by limiting SARS-CoV-2 replication, is indicated for hospitalized patients age 12 and up (and at least 40 kg [88.2 lbs]). Previously, the intravenous drug was solely available under an emergency use authorization (EUA) from the agency.

FDA also announced a new EUA for remdesivir in hospitalized kids age 12 and older weighing at least 3.5 kg (7.7 lbs) but less than 40 kg, and in kids under age 12 weighing at least 3.5 kg.

The news comes exactly a week after a major international trial led by the World Health Organization (WHO) found no survival improvement for hospitalized COVID-19 patients treated with the drug, and no improvement in time to recovery.

Approval was based on three randomized trials, including the National Institutes of Health-led ACTT-1 trial, a phase III trial that showed that patients with mild, moderate, and severe disease who were treated with up to 10 days of remdesivir recovered a median 5 days quicker than those on placebo (10 vs 15 days; rate ratio [RR] 1.29, 95% CI 1.12-1.49, P<0.001), and a median 7 days quicker in those requiring oxygen at baseline (11 vs 18 days; RR 1.31, 95% CI 1.12-1.52).

Fewer patients on oxygen at baseline progressed to mechanical ventilation or extracorporeal membrane oxygenation with remdesivir (13% vs 23%), and a trend toward lower day-29 mortality was observed with the drug (11.4% vs 15.2%; HR 0.73, 95% CI 0.52-1.03).

Moderna’s coronavirus vaccine trial is fully enrolled, 37 percent of participants are minorities – Washington Post

Moderna, the biotechnology firm partnering with the National Institutes of Health to develop a coronavirus vaccine, announced Thursday that it has fully enrolled its trial, with 30,000 participants — more than a third of whom are minorities.

The coronavirus vaccine trials have been closely watched to ensure they reflect the diversity of the U.S. population at a minimum, and Moderna’s enrollment was slowed in September to recruit more minorities. A fifth of the participants are Hispanic and 10 percent are Black, according to data released by the company. People over 65, a population also at high risk for coronavirus, make up 25 percent of the study population.

“I think that we have done quite well — I think the demographics of the Moderna trial have markedly changed,” Larry Corey, a virologist at Fred Hutchinson Cancer Research Center said in an interview last week. Corey is heading up the clinical trials under Operation Warp Speed, the federal effort to speed vaccine development.

… Pharmaceutical giant Pfizer’s coronavirus vaccine trial is also nearing completion. Pfizer’s trial, which is not part of Operation Warp Speed, has enrolled 39,862 of its planned 44,000 participants. Of those, 34,601 have received their second, booster dose.

Half the participants in both trials receive the study vaccine and half receive a placebo, and more than 25,000 of Moderna’s participants have already received their second dose.

More than half of the volunteers in Moderna’s trial are healthy and not at high risk of severe covid-19, the disease caused by coronavirus. But 25 percent are at elevated risk due to age and 17 percent are younger, but have conditions such as diabetes or obesity that put them in a high risk group.

[editor’s note: also read Pfizer is including teens in its vaccine trials — a strategy some consider risky.]

For Covid-19 vaccine recipients, CDC to roll out cell phone-based monitoring system – CNN

Once a Covid-19 vaccine becomes available in the United States, the Centers for Disease Control and Prevention plans to monitor vaccine recipients for any health problems through text messages and online surveys, as part of a new program called V-SAFE.

“V-SAFE is a new smartphone-based active surveillance program for Covid-19,” Dr. Tom Shimabukuro, deputy director of the CDC’s Immunization Safety Office, said during a meeting of the US Food and Drug Administration’s Vaccines and Related Biological Products Advisory Committee on Thursday.

During the early phase of distributing a Covid-19 vaccine, initial doses may be given to specific groups, such as healthcare personnel and other essential workers, and so they likely would be the first to use V-SAFE. CNN has contacted the CDC for comment.

Through V-SAFE, which stands for “vaccine safety assessment for essential workers,” health checks can be conducted via text messages and email daily in the first week after a person receives the vaccine and then weekly thereafter for six weeks, according to the CDC’s website.

If a vaccine recipient reports any adverse events, the program will help submit a report to the US Department of Health and Human Services’ Vaccine Adverse Event Reporting System or VAERS.

“It includes active telephone follow-up,” Shimabukuro said. It’s a more active way to monitor for adverse events, instead of merely waiting for patients to report them.

Where Europe’s Second Wave Is Filling Up Hospitals – New York Times

… a second wave of serious illness is here, new data released on Thursday shows, making it clear that the pandemic is still dangerous and that adherence to control measures over the next few weeks will be crucial in preventing hospitals from becoming overrun for a second time this year.

Where People Are Sick From the Coronavirus

	Patients in hospital per 100,000	Spring peak	% of spring peak
Czech Republic	35	4	882%
Spain	29
Belgium	22	50	43%
Bulgaria	21	6	381%
Poland	21	9	230%
Hungary	18	7	249%
France	16	48	34%
21 European countries	14	31	45%
Italy	13	55	24%
Slovenia	13	6	226%
Croatia	12	9	136%
Slovakia	12	4	285%
United States	11	18	61%
Portugal	11	13	83%
United Kingdom	10	30	33%
Austria	8	12	68%
Ireland	6	18	31%
Luxembourg	5	35	15%
Latvia	4	2	163%
Estonia	3	12	23%
Denmark	2	9	23%
Finland	1	4	23%
Norway	1	6	10%
Iceland	0.3	12	2%

Source: European Centre for Disease Prevention and Control. Hospital data for Europe includes 21 countries that report daily hospital occupancy data to the ECDC. Germany, the Netherlands and others are omitted. Spring peak is the highest value from March and April, except for Hungary where data collection began in May. Current patients in hospitals reflect the most recent available data.

The number of Covid-19 patients in hospitals across the continent is still less than half of the peak in March and April, but it is rising steadily each week, according to data from the European Centre for Disease Prevention and Control. People across much of Europe — including larger countries like France, Italy, Poland and Spain — are now more likely to be hospitalized with Covid-19 than those in the United States.

A new culprit for severe COVID-19 cases – DDN

More than 10 percent of people who develop severe COVID-19 have misguided antibodies that attack not the virus, but the immune system itself, new research shows. Another 3.5 percent, at least, carry a specific kind of genetic mutation.

In both groups, the upshot is basically the same: The patients lack type I interferon, a set of 17 proteins crucial for protecting cells and the body from viruses. Whether the proteins have been neutralized by so-called auto-antibodies, or were not produced in sufficient amounts in the first place due to a faulty gene, their missing-in-action appears to be a common theme among a subgroup of COVID-19 sufferers whose disease has thus far been a mystery.

Published in two papers in Science, the findings help explain why some people develop a disease much more severe than others in their age group—including, for example, individuals who required admission to the ICU despite being in their 20s and free of underlying conditions. They may also provide the first molecular explanation for why more men than women die from the disease.

“These findings provide compelling evidence that the disruption of type I interferon is often the cause of life-threatening COVID-19,” said Jean-Laurent Casanova, head of the St. Giles Laboratory of Human Genetics of Infectious Diseases at The Rockefeller University and a Howard Hughes Medical Institute investigator. “And at least in theory, such interferon problems could be treated with existing medications and interventions.”

The findings are the first results being published out of the COVID Human Genetic Effort, an ongoing international project spanning over 50 sequencing hubs and hundreds of hospitals around the world, co-led by Casanova and Helen Su at the National Institute of Allergy and Infectious Diseases. The study participants included various nationalities from Asia, Europe, Latin America, and the Middle East.

Study helps explain declines in death rates from COVID-19 – Medical Xpress

Fewer New Yorkers are dying from the coronavirus than health experts had anticipated, a new study shows. Regional death rates have dropped from the highs seen at the start of the outbreak, partially due to a shift in the population contracting the disease toward those who are more resilient.

After New York became the epicenter for the pandemic in early March, with tens of thousands dying from COVID-19, experts had expected that the infection would remain as deadly in the following months.

Instead, a new investigation showed that by mid-August the death rate in those hospitalized with coronavirus-related illness had dropped from 27 percentage points to about 3 percentage points. Led by researchers at NYU Grossman School of Medicine, the study showed that a younger, healthier group of people were getting infected and were arriving at the hospital with less-severe symptoms than those infected in the spring.

However, the researchers’ analysis showed that these factors accounted for only part of the improvement in survival. The rest, they suspect, resulted from health care providers‘ growing experience with the coronavirus. For example, physicians learned that resting COVID-19 patients on their stomachs rather than their backs and delaying the use of ventilators as long as possible were more effective practices, say the study authors. Drugs likely helped as well. In addition, other factors such as decreasing hospital volumes, less exposure to infection, and earlier testing and treatment, may have played a role.

“Our findings suggest that while COVID-19 remains a terrible disease, our efforts to improve treatment are probably working,” says study lead author Leora Horwitz, MD, an associate professor in the Department of Population Health at NYU Langone Health. “Even in the absence of a silver-bullet treatment or vaccine, we are protecting more of our patients through a host of small changes,” says Horwitz, who is also director of the Center for Healthcare Innovation and Delivery Science at NYU Langone.

Schoolchildren Seem Unlikely to Fuel Coronavirus Surges, Scientists Say – New York Times

So far, schools do not seem to be stoking community transmission of the coronavirus, according to data emerging from random testing in the United States and Britain. Elementary schools especially seem to seed remarkably few infections.

The evidence is far from conclusive, and much of the research has been tarnished by flaws in data collection and analysis. School reopenings are very much a work in progress. Still, many experts are encouraged by the results to date.

“The more and more data that I see, the more comfortable I am that children are not, in fact, driving transmission, especially in school settings,” said Brooke Nichols, an infectious disease modeler at the Boston University School of Public Health.

That is not to say that younger children do not become infected — they do. On Wednesday, Dr. Michael Beach, a senior scientist at the Centers for Disease Control and Prevention, acknowledged that the agency’s guidance on school reopenings does not reflect the latest research showing that children can become infected with the coronavirus and transmit it to others.

“It does appear that children can become infected” and that children “clearly can transmit,” Dr. Beach, the agency’s deputy incident manager for Covid-19 response, told the House Select Subcommittee on the Coronavirus Crisis.

… Weighed against the substantial harms to children and parents from keeping schools closed, elementary schools should at least offer in-person learning, said Dr. David Rubin, a pediatrician and infectious disease expert at the University of Pennsylvania.

How helpful is convalescent plasma, really? – BMJ

[editor’s note: A randomized trial in India found no benefit in slowing progression to severe COVID-19 or in all-cause mortality. This post was written in scientific style.]

Although the use of convalescent plasma seemed to improve resolution of shortness of breath and fatigue in patients with moderate covid-19 and led to higher negative conversion of SARS-CoV-2 RNA on day 7 post-enrolment, this did not translate into a reduction in 28 day mortality or progression to severe disease. Areas of future research could include effectiveness of convalescent plasma among neutralising antibody negative patients and the use of convalescent plasma with high neutralising antibody titres. The challenge will be to find both suitable patients and suitable plasma donors. Additionally, this challenge could limit the use of convalescent plasma to a small subset of patients.

Hospital Bills For Uninsured COVID-19 Patients Are Covered, But No One Tells Them – NPR

The CARES Act provides funds to pay medical bills for uninsured COVID-19 patients. But a young man’s death in Nashville, Tenn., shows people often don’t know about the program until it’s too late.

TriStar, like most major health systems, participates in a program through the Centers for Medicare and Medicaid Services in which uninsured patients with COVID-19 have their bills covered. It was set up through the pandemic relief legislation known as the CARES Act.

But TriStar doesn’t tell its patients that upfront. Neither do other hospitals or national health systems contacted by WPLN News. There’s no requirement to, which is one of the program’s shortcomings, says Jennifer Tolbert of the Kaiser Family Foundation who studies uninsured patients. (KHN is an editorially independent program of the foundation.)

“This is obviously a great concern to most uninsured patients,” Tolbert says. Her research finds that people without insurance often avoid care because of the bill or the threat of the bill, even though they might qualify for any number of programs if they asked enough questions.

Tolbert says the problem with the COVID-19 uninsured program is that even doctors don’t always know how it works or that the program exists.

COVID-19 Plus Cancer Proves Deadly – MedPage

Patients with cancer and COVID-19 have a higher risk of severe disease and mortality, researchers reported.

Of 89 cancer patients admitted to the intensive care unit (ICU) due to COVID-19, 32 died, a mortality rate of 36%, reported Michael Dang, MD, a critical care fellow at Memorial Sloan Kettering Cancer Center in New York City, at the virtual CHEST conference, the annual meeting of the American College of Chest Physicians.

… Mortality rates appeared to be higher among the patients with hematologic cancers, he said. Of the 51 patients with solid tumors, most commonly non-small cell lung cancer and breast cancer, 14 died, for a mortality rate of 27%; of the 38 patients with hematologic cancers, most commonly leukemia and lymphoma, 18 died, for a mortality rate of 47%.

Of the 59 patients requiring mechanical ventilation, 32 died, a 54% mortality rate. If the patient was neutropenic, the mortality was very high — six of nine died.

In the study, Dang and colleagues included critically ill patients who were being treated for cancer and COVID-19 from March 16 through June 30, 2020 in two ICUs. The patients had a mean age of 64, 58% were men, 66% were white, 18% were Black, and 10% were Asian/Indian. COVID-19 cases were confirmed via reverse-transcriptase polymerase chain reaction assays performed on nasopharyngeal swab specimens.

COVID Causes People to Lose Their Sense of Smell Because of Changes in the Brain, Study Suggests – Newsweek

The sudden loss of smell in some COVID-19 patients may be explained by changes to the brain, according to a study.

After the coronavirus that causes COVID-19 first emerged late last year, losing one’s sense of smell and taste quickly emerged as a possible symptoms of the disease. The U.S. Centers for Disease Control and Prevention lists these alongside other symptoms such as a fever or chills, cough, shortness of breath, and fatigue.

Study Co-author Maxime Niesen of the Functional Brain Mapping Laboratory at Belgium’s ULB university and colleagues set out to explore the hypothesis that some COVID-19 patients lose their sense of smell because the infection affects cells that support certain neurons that are key for this sense working.

It is also thought that inflammation stops certain receptors from picking up smells, and a person’s sense of smell is restored when this subsides, Professor Barry Smith, director of the Centre for the Study of the Senses at the U.K’s University of London who did not work on the paper, told Newsweek via email. If a person loses their sense of smell totally or partially for a longer period of time, this may be due to the overreaction of the immune system blocking receptors, he said.

After studying 12 COVID-19 patients, the authors of the paper suggested there are a number of reasons why they lost their sense of smell. Parts of the brain involved in processing smells, including what are known as the olfactory cleft, olfactory bulbs, and surrounding neural tissue were affected in some patients.

The team found that the infection appears to affect how parts of the brain involved in this sense metabolize sugar. And the connections of nerve cells that pass on information about smells may also be interrupted by the coronavirus infection.

The following are foreign headlines with hyperlinks to the posts

France’s Prime Minister Jean Castex grimly announced “the second wave is here” while implementing a new curfew.

India has reported below 60,000 new coronavirus cases for a fifth day as the promise of a free vaccine turned into a key state election issue.

The U.K. Treasury has announced increased help for bars, pubs and restaurants that have seen business collapse because of virus controls

Colombian pro cyclist Fernando Gaviria is confirmed to be among the emerging cases of re-infection — his second case asymptomatic after spending a month hospitalized last winter.

Poland limits gatherings, shutters bars and restaurants amid COVID-19 surge

COVID Cases Are Still Rising in These 80 Countries

Trump’s Harsh Sanctions on COVID-Stricken Iran Leave Diplomatic Wreckage

Lack of Antidotes Adds to Ethical Dilemmas for UK COVID-19 Challenge Trials

Nepal suspends access to Mount Everest after a local virus case is detected.

North Korea warns that dust storms from China may carry the virus.

Istanbul has 40 percent of Turkey’s virus cases, a top official reports.

Trudeau announces $214M for potential made-in-Canada COVID-19 vaccines

Uruguay will close its borders during summer season to prevent Covid-19 spread

‘It’s time for partying in nightclubs to stop’: Sweden limits clubs to 50 people

Russia records more than 17,000 cases for the first time

The following are additional national and state headlines with hyperlinks to the posts

Moments after hearing an Idaho hospital was overwhelmed by virus patients and looking at sending people as far away as Seattle

Social distancing in Major League Baseball, without the hard bubble used in pro basketball and hockey, was largely successful in mitigating COVID spread.

New England ice rinks shut down after coronavirus case clusters emerge linked to hockey

Researchers Find Doubts About COVID-19 Vaccine Among People Of Color

Trumps to host Halloween at White House despite coronavirus

COVID Outbreak At North Carolina Church Kills 3, Infects Nearly 100 People

California Gov. Newsom’s Thanksgiving Rules, Severe Restrictions in Place

Florida Will Investigate All COVID-19 Deaths

Britain Authorises Temporary Use of Flu Vaccine to Help Meet Demand

The U.S. reported its second-highest daily case total since the start of the pandemic.

One rural state continues to do a fabulous job keeping the virus away: Vermont.

Chicago Mayor announced a 10 p.m. curfew for all nonessential businesses and ordered bars and breweries without food licenses to shut down indoor service.

West Point to Host Army-Navy Game for First Time Since World War II

More than 19,000 new Covid-19 cases recorded in Italy

Down syndrome tied to 10 times the risk of COVID-19 death

Today’s Posts On Econintersect Showing Impact Of The Pandemic With Hyperlinks

16 October 2020 ECRI’s WLI Marginally Continues To Improve

Rail Week Ending 17 October 2020 – Improvement Continues

A No-Deal Brexit Could Damage The UK’s Ability To Cope With Pandemics

Contact-tracing Apps: There’s No Evidence They’re Helping To Stop COVID-19

Coronavirus INTERACTIVE Charts

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Human coronaviruses ‘inactivated’ by mouthwash, oral rinses

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