Daily Archives: September 7, 2020

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As flu season fast approaches, public health officials have expressed concerns about further stress placed on hospital capacity. And this week, federal health officials told states to prepare for a COVID-19 vaccine to be available as early as November, raising questions about who will be able to get the vaccine and when.

Well continue to answer your questions about the coronavirus on a regular basis. What do you want to know? Tell us in the form at the bottom of this story or go here.

If all goes well, Alaskans could see a COVID-19 vaccine as soon as November, state and federal officials said this week. Initially, only small amounts of the vaccine will likely be available, and will be distributed in three phases.

FILE - This March 16, 2020 file photo shows vials used by pharmacists to prepare syringes used on the first day of a first-stage safety study clinical trial of the potential vaccine for COVID-19, the disease caused by the new coronavirus, in Seattle.

While some public health officials have expressed concern about a rushed timeline, Dr. Anne Zink, the states chief epidemiologist, said during a briefing Wednesday that the development of a vaccine for COVID-19 is building on a large body of existing science and data, and that just because theres a certain timeline doesnt mean that its unsafe.

Part of the reason for the relatively speedy timeline is also the great deal of resources, initiative and brainpower that has gone into developing a vaccine, she said.

The vaccine also doesnt have to be absolutely perfect at preventing 100% of infections, she added: It just has to be safe and effective.

Many of our vaccines help to minimize the risk of death and hospitalization, and even that alone has a tremendous impact of the number of people who die of a disease, she said.

The federal Centers for Disease Control and Prevention released documents last week that described how states should prepare for two coronavirus vaccines. Both vaccines have undergone extensive testing and are in currently in the final rounds of testing, according to the documents.

While the current trials are still determining whether the vaccines are safe and effective, neither vaccine caused serious side effects in their first human studies, and both spurred the creation of antibodies that could attack the coronavirus.

According to the CDC planning documents, the first group eligible to get the vaccines will include health care workers, essential workers (includes food service workers, teachers, librarians and others who interact with the public on a regular basis), and workers and residents of long-term care facilities like nursing homes.

Phase two will be reserved for those the CDC has classified as high risk for severe illness from the virus, which includes adults 65 years and older and those with certain preexisting health conditions.

During the final phase, which most likely wont begin until well into the new year, most other Alaskans would be able to get vaccinated. Two groups that have not yet been included in any of the clinical trials are children and youths (anyone below the age of 18) and pregnant women, which means the initial doses of vaccine that are scheduled to come out in November will not be available to them.

Of course, this timeline is based on the assumption that the final clinical trials go well, Alaska state officials said on a call Wednesday.

The state of Alaska is not currently considering mandating that people receive COVID-19 vaccinations once they are available, said Dr. Zink.

She added that her public health team would not get prioritized for the first phase of vaccinations unless they were directly caring for patients.

State employees dont have some special access to vaccines, she said.

The state has been gearing up for the coming flu season: Alaska has bought enough of the flu vaccine to immunize up to 55% of the population for free, though small administrative costs may be included. When the private-sector supply is factored in, up to two-thirds of Alaskans can get and should get covered this year, health officials say.

Christine Calderon gives a flu shot to Steve Hall of Eagle River at the Alaska Regional Hospital drive-through flu shot clinic in 2014. (Marc Lester / ADN)

Both influenza and COVID-19 are life-threatening respiratory illnesses with overlapping symptoms. Nine people in Alaska died from influenza in 2019, according to a spokesperson for the Department of Health and Social Services. Hospitals are not required to report the number of patients hospitalized with the flu, but hospital capacity in Alaska has been affected during flu season in the past.

The CDC has said that the timing of when you get the flu shot matters because of waning immunity, meaning that antibodies to influenza slowly decline in your body months after receiving a flu shot.

Later in September through the end of October is the ideal time to get your shot so that it lasts the duration of flu season in Alaska, state health officials have said. No matter when you get it, adults should only get one shot per year.

Only children ranging from 6 months old through 8 years old who have never gotten a flu shot before will need two doses.

I get the flu vaccine every year, and see how it saves lives, Zink said. I plan to do the same with a COVID vaccine based on the data I see so far.

Private-sector doses of the vaccine are already available in pharmacies around the state, and are available for free with insurance.

Because the state has so much of the vaccine this year, all adults in Alaska can get a free vaccine even without insurance through a provider that offers state-supplied vaccines.

You can visit the state health departments website to find a public health center near you thats distributing the flu vaccine.

If you have no symptoms, that test ideally should happen within seven to 14 days after exposure. But if you do have symptoms, you should get tested right away, per state guidelines.

Excerpt from:

Alaska coronavirus Q&A: Who will be able to get a vaccine once they're available? Why does the flu shot matter? - Anchorage Daily News

Seventeen new coronavirus cases have been reported in the state, health officials said Sunday.

Sundays report brings the cumulative total of coronavirus cases across the state to 4,682. Of those, 4,210 have been confirmed positive, while 472 were classified as probable cases, according to the Maine Center for Disease Control and Prevention.

No new deaths were reported on Sunday, leaving the statewide death toll at 134. Nearly all deaths have been in Mainers over age 60.

Heres the latest on the coronavirus and its impact in Maine:

While a small number of Maine churches have been publicly fighting the states limits on large indoor gatherings, they are greatly outnumbered by the hundreds of other congregations that have chosen to follow the rules that are meant to prevent the spread of COVID-19. Charles Eichacker, BDN

Theresa Dentremont, who died from COVID-19 on Aug. 21 at the age of 88, always had a positive attitude, loved to stay creative and work with her hands, and was the anchor for her family. Thats how family members of the East Millinocket resident remembered her in an obituary published in the Bangor Daily News. Dentremont was the first of three people so far whose deaths have been linked to an outbreak of COVID-19 that stemmed from an Aug. 7 wedding in the Katahdin region. Emily Burnham, BDN

Not many county or state fairs in the U.S. are continuing on without major changes, about 80 percent have been called off or drastically scaled down by eliminating carnival rides, concerts and tractor pulls, according to the International Association of Fairs and Expositions. Some are only allowing youth livestock competitions and auctions or opening for fair food drive-thrus. The Associated Press

Normalcy has been tough to come by during the COVID-19 pandemic, particularly for school-age children whose classroom routines havent been the same in nearly six months. That loss has been compounded for Maines sports-minded youth by the loss of their after-school passions, beginning with the spring sports season and now stretching into the start of fall activities. Ernie Clark, BDN

Pandemic-induced project delays and postponements have hurt construction companies in Maine and across the nation, spotlighting the need for more federal help and additional workforce development strategies, a recent industry report found. Lori Valigra, BDN

There is a lot of angst among Maine high school athletes involved in fall sports programs. Thats because they are still awaiting word on whether they will have a season. Larry Mahoney, BDN

As of Sunday afternoon, the coronavirus had sickened 6,262,989 people in all 50 states, the District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands and the U.S. Virgin Islands, as well as caused 188,711 deaths, according to Johns Hopkins University of Medicine.

Go here to read the rest:

September 6 update: The latest on the coronavirus and Maine - Bangor Daily News

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A further 2,988 cases of coronavirus have been reported in the UK in the past 24 hours, government data showed.

It is the highest number reported on a single day since 22 May and a rise of 1,175 on Saturday, according to the UK government's coronavirus dashboard.

Health Secretary Matt Hancock said he was "concerned" about a rise in cases "predominantly among young people".

Two further deaths within 28 days of a positive test were recorded, taking the total number of UK deaths to 41,551.

Mr Hancock added: "It's so important that everybody does their bit and follows the social distancing because it doesn't matter how old you are, how affected you might be by this disease, you can pass the disease on to others."

"So don't pass the disease on to your grandparents if you're a young person, everybody needs to follow the social distancing."

Despite the sharp rise in cases, Mr Hancock said the government was right to reopen schools "because of the impact on children of not getting an education", adding that workplaces which have reopened are "Covid-secure".

Scotland recorded 208 new cases on Sunday, its highest daily increase for more than 17 weeks.

Wales recorded a further 98 cases, its highest daily rise since 30 June, and Northern Ireland recorded 106 new cases, its highest rise since 25 April.

Overall, since the start of the pandemic, 347,152 cases have been confirmed in the UK.

The number of daily reported cases has been rising steadily and some of that has been put down to an increase in the number of people being tested.

Put simply, the more you test the more new cases you will find. But the jump of more than one thousand in a day is a significant new spike.

The health secretary says the government is concerned and has renewed official calls for more vigilance on social distancing.

What Matt Hancock and health officials are worried about is that the UK might follow the same path as France and Spain, where increases in infections amongst younger adults led after a few weeks to higher numbers of admissions to hospitals for older and more vulnerable patients.

The number of people seriously ill in hospital with Covid-19 has fallen and there were just two new daily reported deaths.

Medical leaders and ministers can only hope that the spread of the virus amongst younger people does not get passed on to the elderly and those with underlying health problems.

Labour's shadow health secretary Jonathan Ashworth said ministers needed to "set out what is being done to get testing back on track and bring case numbers down".

He said the increase in cases came on top of "the ongoing testing fiasco where ill people are told to drive for miles for tests, and the poor performance of the contact tracing system".

Increased demand led bosses in charge of the coronavirus testing system to apologise after it emerged UK labs were struggling to keep up.

Screening capacity was described last week as being "maxed out" - 170,000 tests a day are being processed, up from 100,000 in mid June.

Prof Paul Hunter, an expert in outbreak response at the University of East Anglia, said some of the rise may be due to the system catching up after delays when it struggled to keep up with demand, but added it was still a "marked increase".

"Sadly it is beginning to look like we are moving into a period of exponential growth in the UK epidemic, and if so we can expect further increases over coming weeks," he said.

Birmingham had the single largest increase in cases overnight, and the majority of new cases were in the north of England, said Yvonne Doyle, Public Health England's medical director.

But she said no single area accounted for the overnight change, with broad increases in Covid-19 cases across England.

The rise in positive tests came as tougher measures limiting household contacts were introduced in Bolton in an effort to stop coronavirus cases rising and prevent a full local lockdown.

The infection rate in the area has risen to 99 cases per 100,000 people per week - the highest in England.

Commenting on Scotland's increase, First Minister Nicola Sturgeon said: "While this reflects the substantial opening up of the economy, it reminds us of the need to deploy counter measures."

She added that the "first line of defence" is to "take greater care on face coverings, hygiene and distance".

Meanwhile, speaking earlier on Sunday, Foreign Secretary Dominic Raab said the economy "needs to have people back at work".

Mr Raab acknowledged there was likely to be a "bit more" remote working in future.

However, he added: "It is important to send a message that we need to get Britain back up and running, the economy motoring on all cylinders."

Mr Raab also played down suggestions that coronavirus testing at airports would help travellers avoid mandatory quarantine.

See more here:

Coronavirus: Further 2,988 cases confirmed in UK - BBC News

"The worst are the headaches and the pain in my eyes," said Paul, who lives in Kolkata, West Bengal. "I have had more panic attacks this year than in my entire life combined."

Research conducted by the Suicide Prevention in India Foundation (SPIF) in May found that nearly 65% of 159 mental health professionals surveyed reported an increase in self-harm among their patients. More than 85% of therapists surveyed said they were experiencing caregiver fatigue, and over 75% said fatigue had impacted their work.

Another survey in April, by the Indian Psychiatric Society, showed that, of 1,685 participants, 40% were suffering from common mental health disorders, such as anxiety and depression, due to the pandemic.

The lockdown may have eased, but the situation isn't improving. The report's authors told CNN in August that there's growing anxiety and uncertainty about when the pandemic will end.

Before Covid-19, India had the highest suicide rate in south-east Asia -- now medical experts say the country's mental health system is being pushed to the limit.

"The system was already creaking and overburdened, now with Covid, we are experiencing the catastrophe of increased demand, woeful supply, and fatigued frontline workers," said Nelson Moses, founder of SPIF.

India doesn't have a long history of discussing mental health.

"People think that talking about your feelings makes you weak -- there are a lot of misconceptions," said 23-year-old Baldev Singh, a volunteer counselor with the MINDS Foundation, an Indian nonprofit that aims to reduce the stigma around mental health.

Experts say the historical reluctance to address mental health in India could be partly due to a lack of terminology. None of India's 22 languages have words that mean "mental health" or "depression."

"People think that talking about your feelings makes you weak -- there are a lot of misconceptions."Baldev Singh, volunteer counselor

While there are terms for sadness (udaasi), grief (shok) or devastation (bejasi) in Urdu and other Indian languages, the specific terminology to address different mental illnesses is lacking. That's because the practice of psychiatry is largely Western, said Dr S.K. Chaturvedi, Head of department at the National Institute of Mental Health and Neurosciences (NIMHANS) in Bangalore. "It is easier for people to talk about physical symptoms and illnesses than to express to their families that they are feeling low or depressed," he said.

Growing up, Paul says her middle-class Indian family didn't talk about negative feelings.

"Ever since I was a kid it was ingrained that we don't talk about things that bother us."

Problems were pushed aside and minimized, she said. "They might just compare it with someone else's problem and make you feel guilty about it."

The stigma around mental health may prevent some people from recognizing that they need help. For those who do want treatment, facilities are limited.

According to the 2016 National Mental Health Survey, 83% of people suffering mental health problems in India did not have access to adequate mental health treatment.

The same year, India had three psychiatrists for every million people and even fewer psychologists, according to the World Health Organization (WHO). For comparison, the US had 100 psychiatrists and almost 300 psychologists for every million people.

In many cases, access to mental health treatment in India depends on where you live.

"The divide basically comes in the urban versus rural, so if I look at Mumbai, I know that today I can just get up and go to a hospital in my own area," said Pragya Lodha, the Mumbai Program Director for the MINDS Foundation.

For people in rural India, it's much harder.

Sub-district hospitals cater to roughly 30,000 people or 15 to 20 villages. However, these hospitals typically don't have mental health services, according to Amul Joshi, MINDS Foundation's program director in Gujarat.

Some villagers may have to travel up to 60 kilometers (37 miles) to get treatment, said Joshi. That takes time -- and money. "We sometimes pay for their travel to the hospital as an incentive. However, this means that treatment is usually limited to medication as people cannot keep going to the district hospital for therapy," he said.

People in rural India tend to have other priorities.

"The struggle in rural communities is often about basics so mental health tends to take a backseat," said Lodha.

India was heading into harvest season when the government announced its nationwide lockdown in March. Farmers were confused about whether they could hire migrant workers amid the ban on cross-border movement, and whether crops could be transported to market, said Singh, the volunteer counselor.

Singh said people in rural India are feeling more isolated than ever.

"In rural India, where people aren't aware of mental health issues and can't talk to their friends about their stresses, the situation is only getting worse."Baldev Singh, volunteer counselor

"In urban India, this may have led to more dialogue among family members. In rural India, where people aren't aware of mental health issues and can't talk to their friends about their stresses, the situation is only getting worse," he said.

Technology has become crucial to mental health intervention in many communities during the pandemic. However, online therapy is not often available to people in villages who don't have access to smartphones or the internet.

The MIND Foundation trains volunteers -- like Singh -- to become "community leaders" to raise awareness of mental health and encourage people to seek help when they need it.

Changing attitudes in a country of 1.3 billion people is an immense challenge. But in recent months, there have been signs of change.

Chaturvedi, from NIMHANS, is part of a central government initiative to address the mental health of migrants who were disproportionately affected by the lockdown that stretched for 68 days.

"(It's) definitely proof of the fact that there is a shift in attitudes, and that people understand the importance of mental health," Chaturvedi said.

Migrant laborers (were) displaced, forced to go back to their villages, ignored by the state machinery, treated as collateral damage," Moses said. Sometimes they were unwelcome in their own villages, he added, due to fears they were carrying the virus.

"Thanks to Covid, everyone is in the same boat of despair and despondency."Nelson Moses, founder of the Suicide Prevention in India Foundation

Under the direction of the Ministry of Health and Family Welfare, NIMHANS set up a helpline that refers prospective patients to mental health professionals. Separately, the government released guidelines on addressing the mental health issues of migrants and health care workers, and advice on identifying patients whose mental health had suffered during the pandemic. And the Health Ministry shared posters stressing the importance of wellness practices, such as yoga to improve mental health.

However, some mental health practitioners say these initiatives are insufficient. "These are helpful but seem to be reductive and appear to pay mere lip service," said Moses.

Mental health experts say what's needed is more funding. Of India's total 2020-2021 budget, just 2% has been set aside for healthcare. And of that figure, less than 1% has been allocated to mental health.

Moses believes now is the time for the Indian government to start prioritizing mental health services.

"Never before have we witnessed more engagement surrounding mental health. Thanks to Covid, everyone is in the same boat of despair and despondency," said Moses. "It has gone from (being) swept under the carpet to hitting the ceiling."

Paul chose to speak about her panic attacks to raise awareness of a problem that often is ignored in India. "It is no longer acceptable to label mental health as "taboo," and move on without addressing the issue," she said.

"There needs to be a lot more communication ... we need to start from ground zero in schools and colleges and rope in parents and make them comfortable with it, so that their children can be comfortable talking to them about their issues."

See original here:

India didn't prioritize mental health before Covid-19. Now it's paying the price - CNN

New estimates released this week suggest the global impact of the coronavirus pandemic will reach even greater levels of awfulness before 2020 is over: A prominent forecasting team projects that between now and Jan. 1, the virus will kill an additional 1.9 million people worldwide, pushing the total death toll by year's end to above 2.8 million.

But other disease specialists are highly skeptical of that forecast, which comes from the University of Washington's Institute for Health Metrics and Evaluation or IHME. NPR spoke with the head of IHME's team, Chris Murray, as well as two researchers who are not involved with IHME's work: Ashish Jha of Brown University and Kalipso Chalkidou of the Imperial College School of Public Health in London. Here are five takeaways from those interviews:

1. The United States could continue to rank among the hardest hit countries.

According to IHME, by year's end the death toll in the United States will top 410,000 second only to India's death total, which is projected to reach nearly 660,000, and well ahead of Brazil's projected 174,000 dead. Similarly, when it comes to deaths as a share of population, the U.S. is projected to rank eighth. (The top five in that group are the U.S. Virgin Islands, the Netherlands, Spain, Belgium and Peru.) And Murray expects that Americans will help fuel that trend by easing up on precautions in response to the decline in daily new cases since mid-July. "Rather than celebrating, we should be planning for what is coming up in the fall," he says. "By December we can get up to 30,000 deaths a day at the global level. So it's so important for governments to be anticipating this."

2. Colder weather in northern regions will largely drive the coming surge.

Relaxed vigilance won't be the only factor behind the autumn upswing in cases, says Murray. The major driver will be colder weather in the northern hemisphere. He says the team compared the rates of coronavirus transmission to date in countries in the southern hemisphere, where June through August coincide with winter, and those in the Northern hemisphere, where those months bring summer weather. "When you look at the huge epidemics that unfolded in Argentina, despite considerable efforts at lockdowns, the big epidemics that occurred in Chile, the epidemics in Southern Brazil and South Africa" he says, "and contrast them with what was happening in the Northern hemisphere, in places with similar social distancing mandates, where things were actually on average, improving that's where in the statistical analysis, we see a very strong correlation with seasonality."

This analysis doesn't speak to why colder weather correlates with greater transmission for instance, it could be that people spend more time indoors or that the virus survives better in cold air or some combination of those explanations. Regardless of the reason, says Murray, because far more people in the world live in the northern hemisphere, the arrival of cold weather there will dramatically increase the number of daily global infections overall.

3. These projections could be substantially off.

Ashish Jha, dean of Brown University's School of Public Health, says he finds IHME's forecast highly implausible particularly when it comes to the projected 410,000 death toll in the U.S. by Jan. 1. "I think that's completely unrealistic. I see no basis for that," says Jha.

Among his critiques is that IHME's team assumes that people who are infected with coronavirus in the coming months will die at the same rates as those who were infected earlier on in the pandemic. Murray says this is based on the team's finding that death rates have failed to improve even after advancements in various therapies and treatments.

Jha disagrees. "We have gotten so much better at taking care of sick patients, I think mortality has probably fallen by about 50%," says Jha. "The idea that everything we have learned in the last six months, we will have forgotten and that none of the new therapies will make a difference I don't know any public health person who can look at this and think this is a credible estimate."

4. It's not even clear how many people have already died of COVID-19.

A related challenge is that many countries lack reliable health statistics. This is particularly true of low- income countries, says Imperial College's Kalipso Chalkidou who also directs global health policy at the thinktank, Center for Global Development and is leading an international effort to quantify the wider health impacts of the pandemic.

"In most countries around the world we really don't know what people die from," says Chalkidou. And she adds, this means it's likely that vast numbers of COVID-19 deaths are going uncounted.

One result is that estimates on the global coronavirus death toll to date already vary substantially. For instance, IHME estimates that about 910,000 people have died worldwide. That's about 44,000 more than is estimated by another prominent team, led by researchers at Johns Hopkins University. Murray says the difference comes down to adjustments IHME's team has made to make up for what appears to be a significant undercounting of COVID-19 deaths in two countries where the outbreaks have been particularly severe: Ecuador and Peru.

Chalkidou notes that, "we also don't have good data on comorbidities [that increase people's chances of dying of COVID-19] how many people suffer from chronic conditions such as diabetes for instance in Africa." That further complicates efforts to accurately predict the course of the pandemic in the region.

5. Getting the forecast right could have political implications.

Jha says his disagreement with IHME's methodology amounts to much more than a technical debate. "The problem here is if we come in at 250,000 or 300,000 dead [by year's end in the United States] which is still just enormously awful political leaders are going to be able to do a victory dance and say, 'Look, we were supposed to have 400,000 deaths. And because of all the great stuff we did, only 300,000 Americans died.'" says Jha.

"It's just setting a bar that's so easy to beat, it makes us somehow numb to the actual horrendous outcomes that the United States has had so far."

Read the original here:

Controversial Forecast Of COVID-19 Death Toll Worldwide : Goats and Soda - NPR

COVID-19 widespread testing is crucial to fighting the pandemic, but is there enough testing? The answer is in the positivity rates. USA TODAY

President Donald Trump urged the nation"to be careful" over Labor Day weekend as health experts worryholiday gatheringsincluding a state fair in the virus hotspot of South Dakota will fuel thespread of the virus.

In the weeks following the previous two summer holiday weekends Memorial Day and the Fourth of July positive tests climbed in the nation, according toJohns Hopkins University data. After peaking in mid-July, positive tests have been on a slow downward trend in the nation. Deaths peaked in the spring and have been slightly falling from a smaller second spike over the summer.

Hours after mocking Democratic opponent Joe Biden for wearing a mask, Trump asked Americans to keep their distance from each other as they celebrated the holiday, "wearing a mask whenever the distancing is not possible."

The pivotal weekend comes amid more grim projections for the death toll of the virus. The Institute for Health Metrics and Evaluation at the University of Washington's School of Medicine saysmore than 410,000 deaths are predictedby January if mask usage stays at current rates. If governments continue relaxing social distancing requirements, that number could increase.

Some significant developments:

Today's numbers:A USA TODAY analysis of Johns Hopkins data through late Friday shows Montana and North Dakota set records for new cases in a week while West Virginia reported a record number of deaths. The U.S. has 6.2million confirmed cases and over 188,000 deaths. Globally, there are 26million cases and more than 876,000 people have died.

What we're reading:Schools play a pivotal role in U.S. vaccination efforts since laws require children to have certain immunizations to enroll and attend classes. But with schools increasingly starting online amid COVID-19, are many needed vaccinations are getting skipped?

This file will be updated throughout the day. For updates in your inbox,subscribe to theDaily Briefing.

San Diego State University on Saturday announced a stay at home order for students living on-campus after San Diego County announced120 new virus cases connected with the campus.

The move comes days after SDSU halted in-person classes for a month but kept on-campus housing open. The university, the third-largest in the state, has more than 35,000 students but as many as 2,600 students have been living on campus since the fall semester began Aug. 24.

Since the beginning of the semester, there have been 184 cases at the university, according to San Diego County.

Among Californias 10 most populous counties, San Diego is the only one with virus cases low enough to meet state standards for reopening theaters, museums and gyms, and resuming indoor dining all with limited capacity to provide for physical distancing. But on Friday, county health officials warned of a concerning of rise cases in the county which could not be entirely attributed to SDSU cases.

A Polk County judge upheld Iowa Gov. Kim Reynolds'new round of bar closures Friday, refusing to issue a temporary injunction that would have allowed some Des Moines metro bars to reopen.

Judge William Kelly said in his decision that Reynolds'Aug. 27 order was "not in violation of Iowa law and the statutes under which she issued it. Echoing the states argument in a Wednesday hearing on the injunction request, Kelly emphasized the importance of public health in his explanation of the ruling.

"The worst (bar owners) could expect is losing revenues, possibly bankruptcy and going out of business, while the worst (the state of Iowa) could expect is widespread transmission of COVID-19 across the state, high numbers of deaths and long-term health consequences," he wrote.

Earlier this week, White House health experts warned Iowa leaders that the state has the country's steepest outbreak and suggested the state should close bars in 61 counties and test all returning college students.

Katie Akin and Tony Leys, Des Moines Register

The members of nine fraternities and sororities at the University of Wisconsin-Madison have been directed to quarantine after 38 students tested positive for COVID-19, the university confirmed Friday.

UW-Madison and Dane County health officials told about 420 Greek life students to quarantine for at least 14 days. Violation of isolation and quarantine orders could result in a court order requiring the students to quarantine or a fine of up to $10,000, the university warned in a statement.

UW-Madison is also requiring every student who lives in one of the campus' 38 chapter houses to be tested for COVID-19. There are about 1,500 students who live in such houses, out of 5,000 total members of Greek life organizations at the university.To date, 440 UW-Madison students have tested positive for COVID-19 at on or off-campus testing sites.

Devi Shastri, Milwaukee Journal Sentinel

The coronavirus pandemic has hit Mexico so hard that the governments of several states have runout of death certificates.

Officials said Friday that at least three states Baja California, the State of Mexico and Mexico City started running out about15 to 20 days ago.

Authorities say a million new forms have been printed and are being distributed. The certificates are printed with special characteristics because falsification has been a problem in the past.

Mexico has suffered the fourth-highest leof COVID-19 deaths in the world. On Friday, the number of confirmed cases rose by 6,196 to 623,090, while deaths rose by 522 to 66,851. Cases in Mexico now appear to have plateaued and are no longer decreasing.

The Associated Press

Northeastern University dismissed 11 first-year students after they were discovered together in a room at the Westin Hotel in Boston on Wednesday night, in violation of university and public health protocols that prohibit crowded gatherings, the school announced Friday. They will not receive refunds on their payments for the semester.

The students were part of a study-abroad experience for first-year studentsthat had been modifieddue to COVID-19 and was, instead, hosting more than 800 students in two-person rooms at the Westin, less than one mile from campus. The gathering was discovered Wednesday night.

"Cooperation and compliance with public health guidelines is absolutely essential. Those people who do not follow the guidelines including wearing masks, avoiding parties and other gatherings, practicing healthy distancing, washing your hands, and getting tested are putting everyone else at risk,"Madeleine Estabrook, senior vice chancellor for student affairs at Northeastern, said in a statement.

Russian scientists have belatedly published first results from early trials into the experimental Sputnik V vaccine, which received government approval last month but drew considerable criticism from experts, as the shots had only been tested on several dozen people before being more widely administered.

In a report published in the journal Lancet on Friday, developers of the vaccine said it appeared to be safe and to prompt an antibody response in all 40 people tested in the second phase of the study within three weeks. However, the authors noted that participants were only followed for 42 days, the study sample was small and there was no placebo or control vaccine used.

One part of the safety trial included only men and the study mostly involved people in their 20s and 30s, so it is unclear how the vaccine might work in older populations most at risk of the more severe complications of COVID-19.

The Associated Press

Many months into the pandemic, Google is making Friday a one-time paid holiday for "collective wellbeing" and encouraging employees to enjoy a four-day holiday weekend, the company confirmed.

Google announced in July that employees would continue to work from home until summer of 2021.

Thousands of Black and Hispanic Americans could go uncounted in the nations census this year because of the coronavirus pandemic and other disruptions that discouraged households in poor and heavily minority neighborhoods from filling out their forms.

In 63% of census tracts, fewer people provided initial responses this year than in 2010, a USA TODAY analysis found. Response rates fell particularly in tracts with high concentrations of Black or Latino residents, large percentages of families qualifying for government benefits, or low levels of access to broadband internet.

People of color and poor families are undercounted every census. But COVID-19 delayed delivery of Census questionnaires for hard-to-reach populations during the spring quarantine and delayed operations since then to reach households that failed to respond.

Theresa Diffendal

The U.S. economy added 1.4 million jobs in August as businesses shuttered by the COVID-19 pandemic continued to reopen and bring back workers, more than offsetting a fresh wave of layoffs by firms that have exhausted their federal loans.

The unemployment rate fell sharply to 8.4% from 10.2% in July, the Labor Department said Friday.

Augusts payroll gains were healthy but mark the second straight monthly slowdown in hiring after employers added a record 4.8 million positions in June and 1.8 million in July. Thats a troubling sign considering the nation has recouped slightly less than half the unprecedented 22 million jobs wiped out in early spring as states closed down nonessential businesses such as restaurants, malls and movie theaters.

Paul Davidson

At least 7,000 health workers worldwide have diedafter contracting COVID-19, human rights organization Amnesty International said Thursday.

"For over seven thousand people to die while trying to save others is a crisis on a staggering scale. Every health worker has the right to be safe at work, and it is a scandal that so many are paying the ultimate price," Steve Cockburn, Head of Economic and Social Justice at Amnesty International, said in a statement.

At least 1,320 health workers are confirmed to have died in Mexico alone, the highest known figure for any country, the group said. The U.S. has seen the second-highest number of health care worker deaths, Amnesty International said, with morethan 1,000 deaths.

More than 410,000 Americans will die of COVID-19 by Jan. 1, according to a model cited by top health officials and once used by the White House.

The Institute for Health Metrics and Evaluation at the University of Washington's School of Medicine predicts that number could exceed 620,000if mask usage stays at current rates and governments continue relaxing social distancing requirements. Global deaths couldreach4million by the end of the year in a worst case scenario, with a "most likely" scenario of 2.8 million.

Daily deaths in December could be as highas 30,000.

"Looking at the staggering COVID-19 estimates, it's easy to get lost in the enormity of the numbers," said IHME Director Dr. Christopher Murray."The number of deaths exceeds the capacity of the world's 50 largest stadiums, a sobering image of the people who have lost their lives and livelihoods."

Murray said more lives could be saved if mask usage is near-universal and governments implement social distancing requirements.

Contributing: The Associated Press

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Coronavirus live updates: Thousands of college students ordered to stay in dorms; cases spiked after other holidays - USA TODAY

Chin up, the security planner tells herself. Fortunately, Americansas individuals, institutions, states and groups of states, cities, corporationshavent been completely paralyzed by the White Houses failures. On our own initiative, we are taking steps that buy ourselves a certain amount of freedom: testing and tracing; developing better treatments; practicing smarter social distancing; masking; working from home; protecting vulnerable groups; masking; limiting contact intensity; minimizing contact numbers; masking; practicing better hygiene; promoting healthy buildings; being quiet in indoor spaces; and masking.

These practices have been adopted to varying degrees, just not widely enough to keep the coronavirus from ricocheting around the country. Trump helped encourage a culture war around masking. Fortunately, he lost. Today, more than 75 percent of Americansincluding in red states such as Mississippi and South Carolinaare living under statewide masking policies, and 74 percent of Americans favor a mandatory national one. Biden has embraced such a policy. If Trump had done so months ago, efforts to reopen the economy would be much further along.

Derek Thompson: Mask up and shut up

Instead, get your head around it: Rules and regulations controlling our movement and masking could well be in place for another year. The dilemmas facing retailers, airlines, and many other private-sector companies, such as how strict to be with customers who dont wear masks, are not passing problems that time will solve. Whether a crisis lasts a few weeks or 18 months inevitably affects your own personal risk calculations. Some normal activities, including seeing family in a faraway state, making new friends, or going to the gym, are easy to put off for a few months, but avoiding them forever carries a cost. The bad habits that you might have formed in the springsmoking or drinking as a form of stress reliefno longer look like short-term vices.

Everyone will need coping strategies. On my morning runs, Ive been playing Luther Vandross, hoping a sultry groove might distract me from the discomfort of wearing a mask and break through the numbness of pandemic life.

Eventually, the weather will warm again, and Americans will learn to go to work and school together again. Still, the U.S. has no excuse for being ravaged by a virus that more focus and discipline could have defeated. Unlike Asian and European countries now resuming a normal life with modest precautions, Americans squandered our first opportunity to beat the virus in early 2020. The calendar shows the consequence: Well pay for our mistake well into the new year.

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The Emotionally Challenging Next Phase of the Pandemic - The Atlantic

This negative-stained transmission electron micrograph depicts the ultrastructural details of an influenza virus particle, or virion. Frederick Murphy/CDC hide caption

This negative-stained transmission electron micrograph depicts the ultrastructural details of an influenza virus particle, or virion.

With the annual flu season about to start, it's still unclear exactly how influenza virus will interact with the coronavirus if a person has both viruses.

Doctors around the world have seen some patients who tested positive for both influenza virus and the coronavirus that causes COVID-19. At least a couple of dozen cases have been reported although that's not a lot, given that over 26 million people have tested positive for SARS-CoV-2, the virus that causes COVID-19.

Still, "it is quite possible and likely that the two viruses could infect a patient at the same time or, for that matter, sequentially: one month, one virus, and the next month, the other virus," says Michael Matthay, a professor of medicine at the University of California, San Francisco.

Both viruses can cause dangerous inflammation in the lungs that can fill the airspaces with fluid, making it difficult to breathe, he notes.

"It's likely with both viruses at the same time, the severity of respiratory failure would be greater," says Matthay. "Or, of course, having two illnesses in a row that affected the lungs would make the respiratory failure more severe."

COVID-19 is so new, though, that scientists just don't have enough research to know for sure.

Generally speaking, co-infections are common when it comes to respiratory diseases. Helen Chu, an associate professor of medicine at the University of Washington in Seattle, has done studies to screen people with respiratory symptoms for a variety of viruses.

"We often find the presence of more than one virus at a time," says Chu, but that doesn't necessarily mean that there's actually more than one active infection. "You could be at the end of your illness, so you are no longer symptomatic from it, but you can still detect nonviable virus."

One study looked at people who tested positive for SARS-CoV-2 and found that about 20% tested positive for at least one other respiratory virus, such as rhinovirus which is a common cold virus or respiratory syncytial virus (RSV), which can be serious in infants and older adults.

Past research suggests that viruses can have complicated interactions when two are present. An extra virus can do nothing at all, can make an illness more severe or possibly even have some kind of short-term protective effect.

For example, it's unclear if rhinovirus can make a bout with flu worse, says Chu.

"But for a lot of the other viruses that are known causes of disease like parainfluenza virus and human metapneumovirus and human coronavirus, those can work with flu and cause you to have more severe disease," says Chu.

Not everyone agrees on that. "There are many studies all over the map," says Sarah Meskill, assistant professor of pediatrics and emergency medicine at Baylor College of Medicine in Houston.

"The studies looking at previous coronavirus infection with influenza are so sparse it's really hard to know," adds Meskill, saying that her gut reaction is that "we're going to see co-infections, we are going to see patients positive for both" flu virus and the coronavirus.

Some epidemiological research shows that respiratory viruses can compete with each other in a way that means one virus can suppress the spread of another.

RSV and influenza virus are a good example of that, says Meskill, explaining that when both try to infect the same cell, one will win. What's more, when RSV levels in a population tend to be high, levels of flu tend to be low, and vice versa.

Tanya Miura, a virologist at the University of Idaho, says that when a new pandemic flu virus swept through in 2009, "it was delayed in certain populations that were having ongoing outbreaks of other respiratory viruses at the time."

Her work with lab animals shows that getting a mild respiratory virus can seem to offer some protection against getting a different, more severe one a couple of days later.

In the Southern Hemisphere, where the flu season is just coming to an end, doctors saw very little flu at all this year, probably mostly because of travel restrictions, the wearing of masks and social distancing.

And the number of circulating respiratory viruses does seem to be lower up north, too, says Chu, who has been searching for them in her city: "There's really no transmission of these other viruses going on in the community right now. That is what we are seeing in Seattle."

The flu isn't completely absent, though. "I can tell you that we're starting to find flu," says Chu. "It's very important to get vaccinated."

Getting vaccinated against seasonal flu would both protect people against a double whammy from the flu and COVID-19 and reduce the total number of flu cases. That would help a health care system that is struggling to cope with one serious respiratory illness already.

It's worth noting that the symptoms of the flu fever, muscle aches, cough can be very similar to those of COVID-19.

"Just because you test positive for the flu doesn't mean you don't have coronavirus," says Meskill. "You should still be doing your social distancing and quarantining."

And some researchers are getting ready to look at people who have mostly recovered from the flu and then get COVID-19. "Is it going to make it worse? Is it going to limit the virus or the transmission?" wonders Stacey Schultz-Cherry, an infectious diseases researcher at St. Jude Children's Research Hospital in Memphis, Tenn. "We're actually starting those studies soon."

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Dual Infections: When Coronavirus And Flu Virus Compete : Shots - Health News - NPR

We all know that if someone with the coronavirus coughs or sneezes on you, you're at risk of catching it.

But even when we speak or laugh or breathe, particles come out of our noses and mouths. Big bits of spittle can fly out when you're shouting and singing, along with respiratory droplets and tiny aerosolized particles that come out in clouds that may linger in the air. And if we're infected with the coronavirus even if we don't have any symptoms those excretions could contain live, contagious SARS-COV-2 that can make others sick.

In some settings especially poorly ventilated indoor rooms where many people are gathering researchers increasingly believe that clouds of the virus expelled when someone speaks are able to stay aloft in the air and potentially infect people farther away than the recommended 6 feet of social distance.

In these settings, an infectious person shouting or laughing or coughing can release clouds containing the virus that can build up, linger and waft in the air and then be inhaled by passersby and settle in their lungs.

What's the evidence, you ask?

There was that time in late January, when 10 people were infected in a windowless restaurant in Guangzhou, China. More than 80 people had shared the dining room during the lunch period but the 10 who got sick were all sitting in the path of one air conditioning vent that may have sucked in viral particles from someone in the room who was later confirmed to have COVID-19.

Another classic example scientists bring up is a choir practice, back in March in Washington state. Fifty-three out of 61 people who attended came down with COVID-19. The act of singing, where you're breathing deeply and projecting your voice, can spews tiny virus particles from deep inside the lungs that can then stay aloft in the air.

Researchers think those clouds of airborne coronavirus exhaled by infectious people may be a key factor in superspreading events one gathering that results in a number of new cases.

Clusters of infections have also emerged among students returning to college dormitories in North Carolina, musicians and revelers in a nightclub district in Hong Kong, guests at a wedding reception in rural Maine, residents in a nursing home in The Netherlands, worshippers at a church in South Korea, staff and inmates at a prison in Ohio.

"We see this over and over and over again," said Maria Van Kerkhove, technical lead for the World Health Organization's emergencies program, on Aug. 21, "This virus is being driven by outbreaks in clusters."

What's still unclear is how long the virus lingers in the air, how far it travels through a room, how much you need to breathe in to get infected and how commonly it spreads this way.

But scientists say it's become increasingly clear that airborne virus particles help the coronavirus superspread.

So if a friend invites you over for drinks and you want to say yes, what can you do to protect yourself?

Make the indoors more like the outdoors

That's what researchers recommend, because it seems that airflow is a factor in transmission. "You limit aerosol transmission by increasing ventilation and increasing air circulation," says Seema Lakdawala, a flu researcher at University of Pittsburgh, which means opening the windows that surround you and putting fans in them. Ventilation experts generally suggest that the fans should face outward to pull air from the room. That would help remove any clouds of virus that might exist. But some say an inward-facing fan, to draw outside air in, will also be effective in diluting the indoor air.

When you can, move your get-together outside to a location where fresh air is all around you a backyard, for example. Lakdawala's neighborhood hosts happy hours, "where everybody brings a lawn chair and we sit on someone's lawn. Everyone is spatially distanced and brings their own drink."

Clean the air

Researchers recommend that you consider an air purifier if you periodically have guests over or if some members of your household work outside the home. "You wouldn't drink water downstream from another town without treating it. But we breathe air from other people without treating it," says Donald Milton, an infectious disease aerobiologist at the University of Maryland.

Effective air purifiers range from $100-$600, depending on technology, energy efficiency and the recommended room size, according to an analysis by Wirecutter.

And keep your distance

Much of this is common knowledge by now, but make sure you wear your mask correctly making sure that it fits snugly over your nose and mouth while not obstructing your ability to breathe and that you keep a personal space bubble of at least 6 feet between you and other people.

The mask will catch a lot of the droplets that come out when you speak or laugh or cough and also block some of other people's droplets from getting into your nose and mouth.

Greet your friend with a wave or an air hug from 6 feet away. That personal space bubble between you and others means there's more air passing between you to dilute any virus clouds that might be expelled.

Ultimately, health officials say, there is no such thing as zero risk. But by keeping the air around you moving you'll minimize your chances of inhaling a big, infectious whiff of virus.

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VIDEO: How To Protect Yourself From Coronavirus That Can Linger In The Air - NPR