Written by Steven Hansen
The U.S. new cases 7-day rolling average is 42.7 % HIGHER than the 7-day rolling average one week ago. U.S. deaths due to coronavirus are now 19.5 % HIGHER than the rolling average one week ago. U.S. hospitalizations due to COVID-19 are now 19.0 % HIGHER than the rolling average one week ago. Today’s posts include:
- U.S. Coronavirus New Cases are at a record 153,669
- U.S. Coronavirus deaths today significantly declined to 630
- U.S. Coronavirus hospitalizations are at a record 67,096
- Biden public health advisers reject national ‘lockdown’
- Justice Alito calls Covid restrictions ‘previously unimaginable’, cites danger to religious freedom
- How Pfizer Plans to Distribute Its Vaccine (It’s Complicated)
- Trump Administration Partners with Chain and Independent Community Pharmacies to Increase Access to Future COVID-19 Vaccines
- Immunity From Pfizer-BioNTech COVID Vaccine May Last a Year, Says Scientist Behind the Shot
- Study finds Americans would spend more this holiday if Congress can get out stimulus checks
- Nursing Students Fill Gaps as Pandemic Rages
- COVID-19 fatality rate down 30% since April, study finds
- Fed Warns Assets Face Big Declines If Virus Goes Unchecked
- West Coast states issue travel advisory ahead of Thanksgiving
The recent worsening of the trendlines for new cases should be attributed to going back to college/university, cooler weather causing more indoor activities, possible mutation of the virus, fatigue from wearing masks / social distancing, holiday activities, and continued loosening of regulations designed to slow the coronavirus spread.
My continuing advice is to continue to wash your hands (especially after using the toilet as COVID first sheds in your stool), putting down the toilet seat (as flushing the toilet releases a plume), wear masks, avoid crowds, 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 – and 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 if you can maintain social distance.
Hospitalizations (grey line) and Mortality (green line) For Week ending 07NOV2020
Coronavirus News You May Have Missed
Two public health experts advising President-elect Joe Biden on COVID-19 rejected the idea of “lockdowns” like those seen in the spring to bring down rising case numbers.
Those lockdowns also led to skyrocketing unemployment as businesses were closed down.
Celine Gounder, who sits on Biden’s COVID-19 task force, said on CNBC Friday the panel supports “targeted” closures of businesses that are actually leading to the spread of the virus, including indoor dining.
“Really the consensus is that we need a more nuanced approach. We’ve learned a lot since the spring, and we can be much more targeted geographically, and we can also be more targeted in terms of what we close,” she said.
“I think what we need to be tightening up right now is indoor dining, going to bars, indoor gyms, that sort of thing and we can really keep schools for example open much longer if we tighten up the areas where we’re most likely to see spread.”
Supreme Court Justice Samuel Alito on Thursday sounded an alarm about restrictions imposed because of the coronavirus pandemic, saying they shouldn’t become a “recurring feature after the pandemic has passed.”
“The pandemic has resulted in previously unimaginable restrictions on individual liberty,” Alito said in an address to the conservative Federalist Society, which is holding its annual convention virtually because of the pandemic.
Alito noted that he was “not diminishing the severity of the virus’ threat to public health” or saying anything about “whether any of these restrictions represent good public policy.” He cautioned against his words being “twisted or misunderstood.”
But he said it is an “indisputable statement of fact” that “we have never before seen restrictions as severe, extensive and prolonged as those experienced for most of 2020.”
“Whatever one may think about the COVID restrictions, we surely don’t want them to become a recurring feature after the pandemic has passed,” said Alito, who was nominated to the court by President George W. Bush.
With big holidays coming up at the tail end of 2020, medical experts are worried that Americans traveling for family gatherings on days like Thanksgiving or Christmas could spread COVID-19.
Nearly 40% of Americans will likely attend a gathering with 10 people, according to a new national survey by The Ohio State University Wexner Medical Center. And a third of them reportedly will not ask guests to wear masks.
The findings come as new coronavirus cases are trending up across the U.S. The Centers for Disease Control and Prevention reported more than 143,000 new cases on Wednesday alone, and the virus has so far infected more than 10.3 million Americans and killed more than 241,000.
The CDC recommends precautions like wearing a mask and socially distancing at least 6 feet from people you don’t live with. But as the weather gets colder, gatherings are being forced inside, where the virus can spread more easily, officials warn.
Clinical deterioration was not seen in 80 symptomatic COVID-19 patients who received the selective serotonin reuptake inhibitor (SSRI) fluvoxamine in a randomized trial, compared with six of 72 receiving placebo.
That translated to an absolute difference in risk of 8.7 percentage points (95% CI 1.8-16.4), reported Eric Lenze, MD, of Washington University School of Medicine in St. Louis, Missouri, and colleagues.
More patients in the placebo group also experienced adverse events versus the intervention group, the authors wrote in a preliminary communication in JAMA.
Fed Warns Assets Face Big Declines If Virus Goes Unchecked – Advisor Perspectives
The Federal Reserve is warning that asset prices in key markets could still take a hit if the coronavirus pandemic’s economic impact worsens in coming months.
Most assets have maintained strong levels so far, as investor appetites increased and the government intervened to support the financial system, according to the Fed’s twice-yearly Financial Stability Report released Monday. Signs of weakness are showing in commercial real estate — which has been particularly sensitive to the pandemic — where property values have begun falling, according to the report.
The report also said that hedge fund leverage has remained elevated and that life insurers are reaching debt levels not seen since the 2008 financial crisis.
“Uncertainty remains high, and investor risk sentiment could shift swiftly should the economic recovery prove less promising or progress on containing the virus disappoint,” the Fed said in the report, which is meant to spotlight emerging threats to the financial system. “Some segments of the economy, such as energy as well as travel and hospitality, are particularly vulnerable to a prolonged pandemic.
The likelihood that a coronavirus infection will prove fatal has dropped by nearly a third since April due to improved treatment, researchers at the University of Washington’s Institute for Health Metrics and Evaluation (IHME) said on Thursday.
In the United States, COVID-19 now kills about 0.6% of people infected with the virus, compared with around 0.9% early in the pandemic, IHME Director Dr. Christopher Murray told Reuters.
He said statistics reflect that doctors have figured out better ways to care for patients, including the use of blood thinners and oxygen support. Effective treatments, such as the generic steroid dexamethasone, have also been identified.
Experts have struggled to accurately measure a crucial metric in the pandemic: the fatality rate, or percentage of people infected with the pathogen who are likely to die. The difficulty is exacerbated by the fact that many people who become infected do not experience symptoms and are never identified.
How Pfizer Plans to Distribute Its Vaccine (It’s Complicated) – New York Times
… Pfizer — like other manufacturers that may soon be authorized to roll out their vaccines — does not fully control its own destiny. The effort will hinge on collaboration among a network of companies, federal and state agencies, and on-the-ground health workers in the midst of a pandemic that is spreading faster than ever through the United States.
Before Pfizer can begin shipping its vaccine, federal and state governments must tell it where to send how many doses. McKesson, a major medical supplier, will have to provide hospitals and other distribution sites with the syringes, needles and other supplies necessary to administer the vaccine.
Employees at those locations will need to be trained to store and administer the vaccine. They will also have to ensure that, three weeks after people get the vaccine, they return for a second dose. And millions of Americans must be persuaded to get the shots in the first place.
“We have a lot of confusion at the state and the local health departments level, and a lot of concern about the nitty-gritty of deployment,” said Dr. Saad B. Omer, the director of the Yale Institute for Global Health. “Which places, where to vaccinate, how to get the vaccine there, how to identify people in various risk groups, how to document, how to call back people for the second dose.”
… The particulars of Pfizer’s vaccine will make this effort even more complex. The vaccine, developed with the German company BioNTech, has to be stored at around minus 70 degrees Celsius (minus 94 Fahrenheit) until shortly before it is injected. That is about the temperature of the South Pole on a winter day and colder than any of the other leading vaccines in development.
… Pfizer is making the vaccine at facilities in Kalamazoo, Mich., and Puurs, Belgium. The doses distributed in the United States will mostly come from Kalamazoo.
In Kalamazoo, vaccines will go into vials (five doses per vial). Vials will go into trays (195 vials per tray). Trays will go into specially designed cooler-type boxes (up to five trays per box). Pfizer plans to have about 100,000 of the coolers by the end of this month and more than double that total by March.
The reusable boxes, each toting between 1,000 and 5,000 doses and stuffed with dry ice, are equipped with GPS-enabled sensors. Pfizer employees will be able to monitor the boxes’ locations and temperatures as FedEx and UPS transport them to hospitals and clinics nationwide.[editor’s note: this article has a lot of meat in it and deserves a full read]
To maximize access to COVID-19 vaccines for all Americans, the U.S. Department of Health and Human Services (HHS) today announced the U.S. government’s partnerships with large chain pharmacies and networks that represent independent pharmacies and regional chains. Through the partnership with pharmacy chains, this program covers approximately 60 percent of pharmacies throughout the 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. Through the partnerships with network administrators, independent pharmacies and regional chains will also be part of the federal pharmacy program, further increasing access to vaccine across the country—particularly in traditionally underserved areas.
Below is the list of chain and community-pharmacies networks that have signed on as of November 6
- Albertsons Companies, Inc. (incl., Osco, Jewel-Osco, Albertsons, Albertsons Market, Safeway, Tom Thumb, Star Market, Shaws, Haggen, Acme, Randalls, Carrs, Market Street, United, Vons, Pavilions, Amigos, Lucky’s, Pak n Save, Sav-On)
- Costco Wholesale Corp.
- CPESN USA, LLC
- CVS Pharmacy, Inc. (incl. Long’s)
- Good Neighbor Pharmacy and AmerisourceBergen Drug Corporation’s PSAO, Elevate Provider
- Health Mart Systems, Inc.
- H-E-B, LP
- Hy-Vee, Inc.
- LeaderNET and Medicine Shoppe, Cardinal Health’s PSAOs
- Managed Health Care Associates (MHA)
- Meijer Inc.
- Publix Super Markets, Inc.
- Retail Business Services, LLC (incl., Food Lion, Giant Food, The Giant Company, Hannaford Bros Co, Stop & Shop)
- Rite Aid Corp.
- The Kroger Co. (incl., Kroger, Harris Teeter, Fred Meyer, Frys, Ralphs, King Soopers, Smiths, City Market, Dillons, Marianos, Pick-n-Save, Copps, Metro Market)
- Topco Associates, LLC (incl. Big-Y Pharmacy and Wellness Center, Brookshire’s Pharmacy, Super One Pharmacy, FRESH by Brookshire’s Pharmacy, Coborn’s Pharmacy, Cash Wise Pharmacy, MarketPlace Pharmacy, Hartig Drug Company, King Kullen, Food City Pharmacy, Ingles Pharmacy, Raley’s, Bel Air, Nob Hill Pharmacies, Save Mart Pharmacies, Lucky Pharmacies, SpartanNash, Price Chopper, Market 32, Tops Friendly Markets, ShopRite, Wegmans, Weis Markets, Acme Fresh Markets)
- Walgreens (incl. Duane Reade)
- Walmart, Inc. (incl. Sam’s Club)
- Winn-Dixie Stores Inc. (incl. Winn-Dixie, Harveys, Fresco Y Mas)
As COVID-19 surges in the U.S., nursing students are still being encouraged to join the front lines, though some program leaders aren’t going along.
Back in June, MedPage Today reported that in official guidelines, nursing leaders encouraged students to enter clinical settings, in contrast to guidance for medical students from the Association of American Medical Colleges at that time (it now supports clinical rotations). Many in both nursing and hospital leadership continue to advocate for that plan.
But in late July, a new guidance written for the American Association of Colleges of Nursing (AACN) by Tener Goodwin Veenema, PhD, of Johns Hopkins University, was more cautious about recommending that nursing students participate in COVID-19 care.
“It may be advisable, in the interest of student safety, to limit student direct care of known or suspected cases of COVID-19 infection until better epidemiologic data are available,” the guidance states. “For now, other than limiting direct care of COVID-19 patients, clinical students should continue their roles as part of the care team.”
What has resulted is variation in policies at nursing programs and their clinical partners, and in support from nursing leadership.
“It’s a better approach for students if they get to finish their studies,” which would include clinical experience, AACN board chair Susan Bakewell-Sachs, PhD, told MedPage Today.
Hospitalized COVID-19 patients receiving SNG001, inhaled nebulized interferon beta-1a, were more likely to show clinical improvement than those receiving placebo, a small pilot study in the U.K. found.
Patients randomized to receive SNG001 for 14 days had greater odds of improvement on the World Health Organization (WHO) ordinal scale for clinical improvement (OSCI; OR 2.32, 95% CI 1.07-5.04, P=0.033) on day 15 or 16 compared with those receiving placebo, reported Tom Wilkinson, PhD, of University of Southampton in England, and colleagues.
Moreover, patients in the intervention group were more likely to revert to an OSCI score of 1, or no limitation of activities, on day 15 or 16 (HR 2.19, 95% CI 1.03-4.69, P=0.043), the authors wrote in the Lancet Respiratory Medicine.
Type 1 interferon is “one of the first cytokines induced by viral infection of a cell and is a primary driver of innate immune responses in the human lung,” the researchers noted. They explained that SNG001 is a formulation of recombinant interferon beta “for inhaled delivery by [nebulizer],” which has been well tolerated in clinical studies among patients with asthma or chronic obstructive pulmonary disease.
West Coast states are jointly asking anyone who arrives from out of state to self-quarantine for 14 days.
The new advisories in California, Washington and Oregon are meant to discourage nonessential travel and apply to both residents and nonresidents.
The travel advisories recommend individuals limit their interactions to their immediate household, defining essential travel as travel for work and study, critical infrastructure support, economic services and supply chains, health, immediate medical care and safety and security.
Uğur Şahin, one of the scientists behind the experimental Pfizer-BioNTech vaccine against COVID, says he hopes it will provide immunity for at least a year, by giving the virus a “bash” on the head.
German biotechnology firm BioNTech and American pharmaceutical giant Pfizer announced in a press release on Monday that their COVID vaccine is 90 percent effective in preventing COVID-19, marking an important milestone in the pandemic that has killed over 1.2 million people worldwide, and seen over 52.8 million infected.
The companies did not release data on the vaccine, and their findings have not been peer-reviewed. If the vaccine meets certain safety criteria, they plan to submit a request for an emergency use authorization to the U.S. Food and Drug Administration. This is expected to happen in the third week of November.[editor’s note: I am a little wary of this post as the only way one can say immunity lasts for a year is to have a year’s worth of data – other than that, it is only extrapolation of data]
A fresh round of stimulus checks in Americans’ bank accounts before the end of the year could provide a welcomed boost to retailers this holiday season, according to a new study.
Assuming no additional government stimulus, 37% of consumers said they are likely to spend less money during the holidays, while only 16% plan to spend more on gifts, the Franklin Templeton-Gallup Economics of Recovery study found.
However, assuming there is a $1,200 stimulus payment, the percentage of people planning to spend less falls to 30%, while those planning to dole out more cash on gifts jumps to 22%, according to the poll, which is based on the online responses of 5,002 people from Oct. 1 to Oct. 9.
After the government issued millions of checks to consumers as part of a historic $2 trillion relief package Congress passed in March, consumers were able to shift away from buying only necessities such as groceries and toiletries to splurging on new technology and home improvement items.
The following are foreign headlines with hyperlinks to the posts
The surge of coronavirus cases appears to be slowing in Germany and France, generating hopes that the two European heavyweights are beginning to regain control over the pandemic. But authorities said hospitals are still crowded and are likely to face further strains in the coming weeks,
In Greece, dozens of medical workers protested at hospitals, demanding more staff be hired as the country struggles to contain a spike of infections that has led to a new lockdown,
India Festival: The crowds filling shopping areas ahead of the Diwali festival of lights are raising hopes of India’s distressed businesses after months of lockdown losses.
In China, people are already lining up to receive investigational vaccines not yet approved but nevertheless made available for limited distribution.
Canada’s Ontario province is also considering suspending non-essential surgeries again.
The following are additional national and state headlines with hyperlinks to the posts
Once a coronavirus hot spot, Massachusetts was seen as a model for infection control this summer as cases and deaths dwindled.
With the recent steady incline in cases, Chicago’s mayor announced a month-long stay-at-home advisory on Thursday and asked residents to cancel Thanksgiving gatherings.
Today’s Posts On Econintersect Showing Impact Of The Pandemic With Hyperlinks