Category Archives: Corona Virus

Texas Gov. Greg Abbott, pictured here in July, is not experiencing any symptoms, his office said Tuesday. Tamir Kalifa/Getty Images hide caption

Texas Gov. Greg Abbott, pictured here in July, is not experiencing any symptoms, his office said Tuesday.

Texas Gov. Greg Abbott, who has been fully vaccinated, has tested positive for the coronavirus, his office announced Tuesday. Abbott has opposed mask mandates, and his orders have drawn legal challenges.

The Republican governor is experiencing no symptoms and "has been testing daily, and today was the first positive test result," his office said.

Abbott "will isolate in the Governor's Mansion and continue to test daily. Governor Abbott is receiving Regeneron's monoclonal antibody treatment," the statement said.

Texas first lady Cecilia Abbott tested negative.

With more than 16,000 new daily cases, Texas is one of the states with the highest risk of COVID-19.

Last week, Abbott directed state officials to use staffing agencies to find additional medical personnel from outside Texas as the state's resources became overwhelmed. He also asked hospitals to postpone all elective medical procedures voluntarily.

The Biden administration is suing the state of Texas to block Abbott's order for state troopers to stop vehicles carrying migrants on grounds that the migrants may spread COVID-19. But medical experts say migrants are no more likely to have the coronavirus than any other travelers who are crossing the border, or anyone living in U.S. COVID-19 hot spots.

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Texas Gov. Greg Abbott Tests Positive For The Coronavirus - NPR

In the state of Maharashtra, one of the first places struck by Indias devastating second wave of Covid-19 earlier this year, scientists are anxiously looking for signs of a third.

New laboratories in the financial capital, Mumbai, and in the city of Pune are searching for dangerous new variants. They have stepped up testing, to over 3,600 samples per month from 134 in December last year, as they search for mutations that could make the virus even harder to stop.

India is still far short of its goal to increase genome sequencing nationwide. While Covid-19 cases and deaths have plunged, according to official numbers, the virus is continuing to spread in some parts of the country. A low vaccination rate and other factors have left India especially vulnerable to variants like Delta, the strain that helped power Indias second wave this past spring.

We need to track new variants to prepare ourselves for the next wave because waves will keep happening, much like the flu or common cold, which keep recurring because the virus mutates or recombines, said Dr. Vinod Scaria, the principal scientist at the Institute of Genomics and Integrative Biology in New Delhi. You cant really prevent that. But you can always be prepared for it.

The second wave, which exploded across the country in April and May, exposed both the Delta variants increased communicability and Indias inability to cope. Official figures show that about 430,000 people have died since the virus hit early last year, though the numbers are widely considered unreliable and experts say the true toll may be in the millions. The second wave pushed the countrys medical system past its limits and led to anger over the governments inability to handle the crisis.

For now, the disaster appears to have ebbed. Indias daily official caseload has fallen to about 40,000, compared with the more than 300,000 it saw during the worst of the crisis. The hardest-hit urban centers like New Delhi, Mumbai and Pune have had a dramatic decline in cases. Covid-19 wards in many major cities have emptied.

Some hope that the sheer contagiousness of the Delta variant means that many people have already caught it and developed a measure of protection. A recent survey by the Indian Council of Medical Research, a government agency that funds and evaluates studies, found that two-thirds of blood samples surveyed had coronavirus antibodies, compared with about one-quarter in December and January. In some states, as many as three-quarters of samples surveyed carried antibodies.

But scientists cautioned that the survey, with a small sample size of 36,000, shouldnt be read as an indication that India is out of the woods. Such tests can be prone to false positives. Also, the survey doesnt represent all areas, said Giridhara Babu, professor of epidemiology at the government-affiliated Public Health Foundation of India, though it could help Indian officials better target areas for testing and vaccinations.

Even if the numbers are accurate, they suggest that 400 million people in India remain vulnerable to Covid-19.

What is going to happen now is that areas with low sero prevalence and low vaccination will have more number of cases and more people getting hospitalized and higher deaths, Dr. Babu said, referring to serology, or antibody, testing.

The potential for new variants complicates the picture even further. Places like India with low vaccination rates and other risk factors are particularly vulnerable to new strains.

Aug. 18, 2021, 7:10 a.m. ET

After a chaotic and slow start, India has intensified its inoculation drive, regularly delivering five million doses per day. About half a billion doses have been administered so far, and more than 100 million citizens are now fully vaccinated. Indian medical experts hope the increased vaccinations will help blunt the impact of a third wave because even one shot can reduce the severity of infection.

Still, only 8.5 percent of the population is fully vaccinated. It remains to be seen whether the country can reach its goal of vaccinating all the adult population of roughly 900 million by the end of the year.

Low testing rates are another factor. India now administers an average of about 1.2 tests per thousand people per day, according to the Our World in Data project at Oxford University, well above levels at the beginning of the year. But its rate is still well below those of richer countries, coming in at a bit more than half of the level of the United States, for example.

Those low test rates make charting the course of the virus difficult. Currently, a large number of positive tests are coming from southern states like Kerala, which in general conduct more tests than in other parts of the country. That state accounts for nearly half of the total active cases. Infections in areas with lower testing rates would be hard to detect.

Understandthe State of Vaccine and Mask Mandates in the U.S.

Researchers are particularly watching Kerala, which was hit later by the second wave than other parts of the country. A better-prepared health infrastructure helped reduce fatalities. But the circulation of the virus has been so steady that it gives opportunity for mutation.

It is cause for satisfaction, in a way, that the mortality is not high, said Dr. V.K. Paul, who leads the Indian governments Covid-19 task force. But when there is so much of virus replication, there are problems variants can emerge, other areas can get infected, and vulnerable population in any part of the country remains susceptible.

Kerala increased its genome sampling early, testing about 1,400 per month since December. Proactive genome sequencing has helped Kerala and Maharashtra in recent months to identify districts where a variant known as Delta Plus has emerged and immediately respond to contain the spread.

But broadly, Indias sampling effort is lagging. Under an initiative organized by the Indian SARS-CoV-2 Genomics Consortium, or Insacog, a group of national laboratories, each state was initially supposed to test 3 percent to 5 percent of samples. Currently, the country is sampling only about 0.1 percent of Covid-19 tests.

Should a third wave emerge, Indian officials say they have not let down a guard raised during the second wave. In New Delhi, which was the epicenter of the second wave, more than 95 percent of regular Covid beds as well as intensive care unit beds remain available. The states chief minister said that 27 oxygen plants had been added, and that tankers were being acquired, to avoid the oxygen shortage of the last wave. In Mumbai, about 85 percent of the regular Covid beds and nearly 70 percent of I.C.U. beds remain vacant. The number of vacant beds in Pune remains at about 77 percent.

The emergence of a third wave or another variant will ultimately depend on human behavior, said Dr. Scaria, of the Institute of Genomics and Integrative Biology. Testing may find the variant too late, as it did in the second wave, when the spread of the Delta variant did not become apparent in the countrys limited genome testing until April. Masks, vaccinations, social distancing and other precautions will be crucial to stopping new variants from emerging.

A variant by itself cannot cause a wave, because variants can be tackled if you have the information in advance, Dr. Scaria said. Human behavior is as important, if not more, in creating a wave. If the right variant reaches the right population, it will create a wave.

Hari Kumar contributed reporting.

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Indias Covid-19 Numbers Have Fallen. A Third Wave Still Looms. - The New York Times

The Philadelphia region except for Delaware County was seeing high coronavirus transmission rates as of Tuesday, according to the CDC, and local health officials said they are continuing to watch rising hospitalizations, particularly among the unvaccinated.

Throughout the pandemic, rising case counts have precipitated an increase in hospitalizations. This summer, the spread of the highly transmissible delta variant has not deviated from the sobering trend, with most patients being unvaccinated.

In Philadelphia and South Jersey, coronavirus hospitalizations have tripled since last month, spokespeople for the city and Camden County said. In the western suburbs, Bryn Mawr, Paoli, and Riddle Hospitals and Lankenau Medical Center were treating more than 50 patients for virus-related complications as of Monday, up from zero patients on July 4, said Jonathan Stallkamp, interim chief medical officer for Main Line Health.

Were definitely not at the peak of this next wave, said Stallkamp, a physician, adding that Main Line patients include seriously ill young people without preexisting conditions. Its sad to watch.

As long as the vaccination rate doesnt see a massive and sudden increase, and delta remains dominant, the virus appears primed to keep spreading across the region, erasing any early-summer hopes of the pandemic retreating, health officials warn.

Nationwide, new case counts are the highest theyve been in six months, with hospitals overwhelmed in some states. In Pennsylvania, case counts have doubled over the last two weeks, according to the New York Times, with hospitalizations increasing, too, but at a slower rate. Both metrics are rising in New Jersey, too, though less rapidly.

Michael Levy, an associate professor of epidemiology at the University of Pennsylvania, said he looks at that momentum and worries that the number of infections will continue to rise, especially as students return to their classrooms and college campuses this fall.

Dont think its not going to happen here, Levy said. We saw delta go through India, go through Britain [where 61% of the population is fully vaccinated]. I think we should be worried.

Places that have vaccination rates as high as Philly are getting hit, he added. About half of the citys total population, including children not yet eligible for shots, are fully vaccinated.

Most people getting sick and the vast majority of those being hospitalized have not had their shots, officials and physicians say, providing further evidence that vaccines are working.

Across the Philadelphia region, public health leaders said they hope enough people are vaccinated to prevent a repeat of the surge last winter, before the shots were widely available.

READ MORE: Some peoples minds are changing about the coronavirus vaccine. Heres how doctors persuade them.

If weve learned anything from this pandemic, its to not expect anything, Philadelphia spokesperson James Garrow said. Its our hope that our high vaccine rate, coupled with masking, will help flatten the curve of new cases, and keep our hospitals from being overwhelmed.

In Bucks County, where 29 people were hospitalized with the virus as of Tuesday, officials said they were heartened to see that neither hospitalizations nor deaths have increased in proportion to the increase in cases.

While we may see an increase as the weather turns colder, we do not anticipate anything on the scale of last winter, county officials said, nor do we expect to see the level of hospitalizations and deaths that we encountered a year ago.

Chester Countys vaccination rate, the regions highest, should help it weather a surge, said county health director Jeanne Franklin. As of Tuesday, it was the only county in the region not seeing high transmission.

If a surge increases excluding the introduction of another variant we anticipate [the surge] to last for a shorter time, Franklin said in a statement. But really the crystal ball is still nowhere to be found!

About 54% of Pennsylvanians, including children under 12 who arent yet eligible for shots, are fully vaccinated, according to the New York Times, as are 60% of New Jerseyans. In Philadelphia and its collar counties, the rate ranges from about 50% in the city to 63% in Chester County, according to state and city data.

READ MORE: Swag bags and a coronavirus Cupid: How the region hopes to persuade millennials to get their shots

Even more people have received one dose of a two-dose vaccine, and the number of first doses has recently ticked up in some places. But experts say both shots are needed for the most protection.

Health experts say this is especially important in the face of the delta variant, which is more transmissible than earlier forms of the virus, and it sometimes spreads through vaccinated people, even if they dont feel sick, and can occasionally make the immunized mildly ill.

Its rise has led to a bevy of new mitigation measures: Days after Philadelphia brought back its indoor mask mandate, Montgomery County on Monday formally recommended that people mask up indoors. The move echoed the Centers for Disease and Control and Preventions universal masking recommendation for any counties experiencing high or substantial spread, which was announced last month.

Because of the delta variant, Montgomery County has seen increases in our key COVID-19 indicators for the past several weeks. However, I want to be very clear that the vast majority of the new cases are occurring in unvaccinated individuals, Montgomery County Commissioner Chair Val Arkoosh said Monday at a briefing. The quickest way to get this pandemic under control is to get vaccinated.

READ MORE: Pa., N.J., and Del. leaders weigh vaccine-verification options, but largely hold off on mandates

As it sees a growing proportion of cases in children and teenagers, Camden County is focusing on increasing vaccinations among those age groups before the school year starts.

Vaccinations and social behavior will dictate what this winter looks like, said county spokesperson Dan Keashen. It will be incumbent upon us to do everything we can to avoid another surge like we had last winter.

Levy, the Penn epidemiologist, said any increase in vaccinations would be hugely important, and hed like to see an even greater, on-the-ground push at this critical juncture.

While its unclear whether vaccines can stop the spread of delta, vaccines slow the spread, he said. And that means everything because this thing is just [about] momentum. Everything we can do to slow it down is going to lead to fewer people getting infected before they get protected. "

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Coronavirus spread is high and hospitalizations are rising across the Philadelphia region - The Philadelphia Inquirer

In most cases, they found, the chain of transmission stopped with the infected child, but in 27.3 percent of households, children passed the virus along to at least one other resident.

Aug. 18, 2021, 7:10 a.m. ET

Adolescents were most likely to bring the virus into the home: Children from 14 to 17 made up 38 percent of all the index cases. Children who were 3 or younger were the first to get sick in just 12 percent of households but they were the most likely to spread the virus to others in their homes. The odds of household transmission were roughly 40 percent higher when the infected child was 3 or younger than when they were between 14 and 17.

The findings may be the result of behavioral differences between toddlers and teenagers, medical experts said.

When we think about whats teen social behavior outside of the house, theyre spending a lot of time together, theyre often in quite close quarters, theyre often touching or sharing a drink, said Dr. Susan E. Coffin, an infectious disease specialist at Childrens Hospital of Philadelphia, who was not involved in the study.

Those behaviors could make teens more likely to contract the virus and bring it home, she said.

On the other hand, while very young children probably have less social interaction outside the home, they tend to be in close physical contact with others in their households, in addition to frequently putting their hands and other objects in their mouths, which could help spread the virus. Once they bring it into the household, it can be spread easily, Dr. Coffin said.

It is also possible that the youngest children may carry higher levels of virus, or have higher rates of viral shedding, than teenagers, the researchers noted. Some studies have found that even though young children rarely get seriously ill, they may carry similar, or even higher, levels of virus than adults do. Although viral load is not a perfect predictor of infectiousness, the data suggest that children could potentially be as contagious as adults.

But the dynamics of disease transmission are complicated, and the precise role that children play in spreading the virus remains uncertain.

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Babies and Toddlers Spread Coronavirus in Homes More Easily Than Teens, Study Finds - The New York Times

Pope Francis appealed to people to get vaccinated against COVID-19 in what he called "an act of love," in a video message published on his Twitter account on Wednesday.

In the message, recorded in Spanish, Francis said that "thanks to God's grace and the work of many we now have vaccines to protect us from COVID-19."

The religious leader, who wields significant political and moral authority among the 1.3 billion Catholics in the world, appealed that shots be made widely available amid stark disparities in vaccination rates between the developed and the developing world.

"They bring us hope that the pandemic may end, but only if they are available to all and if we collaborate with one another," Francis said.

The message comes amid ongoing debate, especially in more conservative or religious communities, over the efficacy and safety of vaccines. In Poland, an overwhelmingly Catholic-majority country, local church authorities have sent mixed signals over vaccines and government public health efforts.

In North America, the U.S. Conference of Catholic Bishops which represents the church in the country, said in March that Catholics should avoid the Johnson & Johnson vaccine over concerns about the use of fetal tissues.

Francis, who already in previous occasions had come out in favor of making coronavirus vaccines more widely available, reiterated his support for the jabs.

"Getting the vaccines that are authorized by the respective authorities is an act of love... Love to oneself, and love for one's family and friends," he said.

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Pope urges world to get vaccinated against coronavirus - POLITICO Europe

Minnesota recorded more than 3,000 new coronavirus cases Tuesday from over 57,000 tests, the most cases and test results reported in a single day since April.

The Minnesota Department of Health no longer reports coronavirus numbers on weekends so Tuesdays statistics are actually from more than one day from Saturday through 4 a.m. Monday. Nevertheless, the 3,054 cases reported Tuesday was an increase of 45 percent over a week ago using the same reporting structure.

The more contagious delta variant is the cause of nearly all new infections in Minnesota. More than 99 percent of new cases, hospitalizations and deaths are residents who are not fully vaccinated.

The U.S. Centers for Disease Control and Prevention says community transmission of the coronavirus is widespread enough that masks are recommended in 80 of the states 87 counties. Seven are in the moderate transmission category and there are none where spread is considered low.

Meanwhile, the test-positivity rate in the state has again exceeded the 5 percent caution threshold.

Masks are important, but health officials maintain that vaccination is the best way to avoid contracting and spreading the coronavirus. Breakthrough infections are rare and much less likely to be severe.

Jan Malcolm, the state health commissioner, said this years summer surge is shaping up to be worse than a year ago, before there were vaccines to protect against the coronavirus.

Even more striking, compared to last year at this time our case rates are 54 percent higher than they were, Malcolm said.

Three more COVID-19 deaths were also reported Thursday. They ranged in age from their 50s to their 70s and all resided in Hennepin County with two in private homes and one in a behavioral health facility.

There have been 7,737 COVID-19 fatalities, including 4,533 deaths in long-term care. About 88 percent of deaths have been seniors.

Hospitalizations continue to rise, with 434 patients requiring care and 115 in critical condition. Fewer than 3 percent of Twin Cities hospital beds are currently available, according to state data.

Since the pandemic began, more than 11 million samples from 4.8 million residents have been screened for the coronavirus. There have been 629,354 infections diagnosed, and of those who tested positive 612,681 have recovered enough they no longer need to be isolated.

There are an estimated 8,500 people with active cases who are recovering at home, roughly double the number just two weeks ago.

Minnesota has administered more than 6 million doses of vaccine and 3.2 million have gotten at least one dose. There are 3 million Minnesotans whove completed their vaccination series.

Vaccinations have climbed considerably in recent weeks, thanks to a combination of concern over the delta variant and a $100 reward being paid by the state to the newly vaccinated. New vaccinations of 12- to 17-year-olds since have increased by about 20,000 doses since a back-to-school vaccination push began earlier this month.

Roughly 70 percent of residents 16 and older have gotten at least one shot.

For more information about vaccines visit:VaccineConnector.mn.gov. Apply for the $100 vaccine reward at mn.gov/covid19/100.

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3K COVID-19 cases reported in Minnesota, highest level since April. See a map of where transmission is high. - TwinCities.com-Pioneer Press

A nasal swab being placed into vial at a free COVID-19 community test site in Anchorage. (Bill Roth / ADN archive)

The Department of the Interior is complying with White House guidance that federal employees and contractors will be asked to show theyre fully vaccinated against COVID-19 or be regularly tested if they are not.

In Alaska, there are more than 2,500 employees at Interior, including at agencies like the National Park Service, the U.S. Geological Survey, the Bureau of Land Management and the U.S. Fish and Wildlife Service.

The agency is strongly encouraging all employees and contractors to receive a COVID-19 vaccine and is working on a way to determine employee and contractor vaccination status that fits with recent White House guidance, according to the Interiors website.

That guidance, released by Democratic President Joe Biden in late July, says that any onsite contractor or employee who is not vaccinated will have to wear a mask, physically distance and comply with a weekly or twice weekly screening testing requirement, and be subject to restrictions on official travel.

An Aug. 6 email to agency employees from Interior Secretary Deb Haaland, obtained by the Daily News, described the departments updated guidelines, saying the new process will be implemented in the coming days and weeks.

Employees who arent fully vaccinated also will soon be required to go through COVID-19 testing in order to enter federal buildings, according to the email.

Additionally, employees, contractors and visitors who arent fully vaccinated must wear masks indoors and continue to physically distance themselves.

Federal employees, contractors and visitors regardless of vaccination status must wear masks in areas where COVID-19 transmission is high, according to the email.

In the email, Haaland said 35 Interior employees agency-wide have died from COVID-19.

Link:

Interior Department employees will soon need to be regularly tested for coronavirus if they don't get vaccinated - Anchorage Daily News

This is an updated version of an article first published on Nov. 13, 2020.

The Delta-variant-driven wave of coronavirus infections is driving a new surge in testing and that could mean more surprise medical bills.

Congress wrote rules last spring to make most coronavirus testing free for all Americans. But patients, with or without insurance, have found holes in those new coverage programs.

Federal law does not, for example, require insurers to cover the routine testing that a growing number of workplaces and schools are mandating. Some doctors and hospitals have tacked unexpected fees onto coronavirus testing bills, leaving patients with surprise charges ranging from a few dollars to over $1,000.

In the past year, Ive collected patients bills related to coronavirus. As part of that project, Ive read through more than 100 patient stories about coronavirus tests. Many patients are happy to report no charge at all, while others have been billed large unexpected fees or denied claims related to coronavirus tests.

[Have a bill you want to share? Submit it here.]

The surprise bills have hit uninsured Americans as well as those with robust coverage. The health data firm Castlight estimates that 2.4 percent of coronavirus test bills leave some share of the charge to consumers, which means there could be millions of patients facing fees they did not expect.

These are some simple steps you can take to lower your chances of becoming one of them.

Many states, counties and cities/towns now have public testing facilities. Very few patients have reported surprise medical bills from those testing sites (although its not impossible). You can typically use your state health department website to find public testing options.

If a public test site isnt an option where you live, you might consider your primary care doctor or a federally qualified health clinic. The largest surprise coronavirus test bills Ive reviewed tend to come from patients who are tested in hospitals and free-standing emergency rooms. Those places often bill patients for something called a facility fee, which is the charge for stepping into the room and seeking service.

Patients are finding that these fees can pop up even when they dont actually set foot in the facility. Multiple patients at one Texas emergency room had $1,684 facility fees tacked onto their drive-through coronavirus tests. A patient in New York faced a $1,394 charge for her test at a tent outside a hospital. The majority of the bill was the facility fee. The investigative news site ProPublica has reported on how facility fees can sometimes cost as much as 10 times the coronavirus test itself.

If you get your test at a primary care provider, or at a public test site, you shouldnt have to worry about that type of billing. They typically do not charge facility fees for coronavirus tests or any other types of care.

When patients receive a surprise medical bill related to a coronavirus test, often the charges they face are not for the test itself, but instead for other services that the patient may not have known about.

Some of these make sense: Many bills for coronavirus tests have fees for the doctor visit that went along with it. Others make less sense, like the bills that include screenings for sexually transmitted diseases. Those extra fees appear to be a bit more common in emergency rooms, or when health providers send their samples to outside laboratories. But they can happen at public testing sites, too: One Connecticut doctor regularly tested patients for dozens of illnesses at a town drive-through. The patients thought they were simply getting coronavirus tests.

To avoid those extra charges, ask your provider what diseases they will screen for. It can be as simple as saying: I understand Im having a coronavirus test. Are there any other services youll bill me for? Having a better understanding of that up front can save you a headache later, and you can make an informed decision about what care is actually needed. If your providers cant tell you what theyll bill for, that may be a signal you want to seek care elsewhere.

Uninsured patients have faced coronavirus bills upward of $1,000, according to billing documents reviewed by The New York Times.

That type of billing is legal: Health care providers are not required to provide free coronavirus tests to Americans who lack health insurance. But they do not necessarily have to bill patients directly. The federal government has set up a provider relief fund: Health providers can seek reimbursement for coronavirus testing and treatment provided to those without coverage. Once again, it pays to ask ahead of time how providers handle uninsured patients and whether they submit to the fund. Unfortunately, they are not required to do so and could continue to pursue the debt.

You should also be aware that 17 states have authorized their state Medicaid plans to cover coronavirus test costs for uninsured Americans. This means your state government can pay the bill instead of you. You can find out if you live in one of these states here.

New federal laws regulate how health providers and insurers can bill patients for coronavirus tests. Understanding how they work can help you push back on charges that may not be allowed.

The new laws state that health insurers must cover coronavirus tests ordered by a doctor without any cost to the patients. This means that standard deductibles and co-payments youd face for other services do not apply.

There is one important exception in those laws: Insurers do not have to cover routine coronavirus testing ordered by a school or workplace. If your job mandates that you get tested each week, for example, it is up to your health plan whether it wants to pay those bills.

For that type of testing, youll want to be especially careful about where you get tested, and ask more questions about the fees you may have to pay. Some employers are already directing their workers to be tested at public sites, in part to reduce the possibility of surprise charges.

For the coronavirus tests that insurers do have to cover, there is still a bit of a gray area. The law requires insurers to cover any other services that are necessary to get the coronavirus test, but doesnt define what makes the cut. Most experts agree that a doctor visit fee is a pretty clear example of a service that ought to qualify, and that patients facing those types of bills ought to appeal to their insurer for coverage. Other services, like a flu test or even an X-ray conducted alongside a coronavirus test, present a murkier situation. If youre facing fees like those, you might want to enlist your doctor to tell the insurer why the additional care was needed.

One last thing to know about the federal laws is that they require insurers to fully cover out-of-network coronavirus tests. This can be especially important for patients who go to an in-network doctor but unknowingly have their sample sent to an out-of-network laboratory, a situation Ive seen many times. Your health plans typical rules for out-of-network care should not apply to the coronavirus test. They can, however, be applied to other parts of the test experience (the doctor visit fee, for example), so it is safer to stick with in-network providers whenever possible.

One other issue to look for is what billing codes your doctor used for the test visit. Many of the surprise bills Ive reviewed involve a doctor charging a visit fee, then sending the test to an outside laboratory that submits its own claim. The health plan might apply a co-pay to the doctors visit because its not clearly linked in billing records to the coronavirus test. In this case, you may need to work with your health provider to get your visit recoded to show a coronavirus test occurred.

Nearly everything I know about coronavirus test billing comes from reading the bills that hundreds of Times readers have sent describing their experiences. If you receive a bill related to coronavirus testing and treatment, we ask that you take a moment to submit it here. It will help me continue to report on the types of fees patients face, and can help identify areas of the country where patients are facing unusually high fees.

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Will You Have to Pay for a Coronavirus Test? Here's How to Avoid a Surprise Bill - The New York Times

The Oregon Health Authority on Monday announced 4,396 new coronavirus cases from the preceding three days, pushing the weekly total to a pandemic record.

Oregon reported 12,740 cases in the past week, or an average of 1,820 a day, setting a new high. Cases are up 53% from the previous week, marking the sixth consecutive week of gains.

The Oregon Health Authority in July stopped reporting cases on the weekends, leading to high three-day totals announced on Mondays. The new cases included 2,027 for Friday, 1,533 Saturday and 836 Sunday.

Hospitalizations also climbed over the weekend, although the trajectory slowed. Oregon reported 752 people with COVID-19 are hospitalized, up 19 since the last public report. The number of people in intensive care stands at 206, up 21 since Fridays figures.

Its too early to tell if that slower growth will continue, and some metrics suggest it wont, as hospitalizations typically lag new positive cases.

The states test positivity rate for the cases reported Monday is alarmingly high, at 13.6%, exceeding the daily rates reported last week.

Meanwhile, the states previous high for weekly cases had been 10,355, set for the week ending Dec. 6.

Vaccines:

Oregon reported 3,013 newly administered doses, which includes 751 on Sunday and the remainder from previous days.

Where the new cases are by county: The new confirmed and presumptive COVID-19 cases reported today are in the following counties: Baker (18), Benton (54), Clackamas (296), Clatsop (73), Columbia (19), Coos (66), Crook (19), Curry (136), Deschutes (355), Douglas (350), Harney (11), Hood River (10), Jackson (542), Jefferson (30), Josephine (363), Klamath (15), Lane (567), Lincoln (35), Linn (178), Malheur (17), Marion (163), Morrow (13), Multnomah (504), Polk (46), Tillamook (66), Umatilla (109), Union (39), Wallowa (11), Wasco (22), Washington (166), Yamhill (103).

Who died: Oregons 2,936th death linked to COVID-19 is a 54-year-old Douglas County who tested positive Aug.7 and died on Aug. 14 at Mercy Medical Center.

The 2,937th fatality is a 27-year-old Douglas County woman who tested positive Aug. 6 and died Aug. 14 at Mercy Medical Center.

Oregons 2,938th death is a 79-year-old Douglas County man who tested positive July 29 and died Aug. 12 at Mercy Medical Center.

The 2,939th fatality is an 80-year-old Crook County woman who tested positive Aug. 6 and died Aug. 12 at her residence.

Oregons 2,940th death is a 69-year-old Coos County woman who tested positive Aug. 3 and died Aug. 11 at a location still being confirmed.

The 2,941st fatality is a 90-year-old Jackson County woman who tested positive July 27 and died Aug. 11 at Asante Rogue Regional Medical Center.

Oregons 2,942nd death is an 88-year-old Jackson County man who tested positive July 13 and died Aug. 13 at his residence.

The 2,943rd fatality is a 69-year-old Lane County man who tested positive July 30 and died Aug. 12 at his residence.

Oregons 2,944th death is a 47-year-old Jefferson County woman who tested positive July 23 and died Aug. 12 at St. Charles Bend Hospital.

The 2,945th fatality is a 47-year-old Washington County man who tested positive Aug. 9 and died on Aug.13 at his residence.

Oregons 2,946th death is a 93-year-old Washington County man who tested positive July 23 and died on Aug. 5 at his residence.

The 2,947th fatality is a 54-year-old Multnomah County man who tested positive Aug. 9 and died Aug. 11 at Adventist Health Portland.

Oregons 2,948th death is a 93-year-old Wasco County man who tested positive Aug. 5 and died Aug. 11 at his residence.

The 2,949th fatality is a 63-year-old Jackson County man who tested positive June 10 and died on Aug. 12 at Providence Medford Medical Center.

Each person had underlying health conditions or officials were determining if underlying conditions were present.

Hospitalizations: 752 people with confirmed cases of COVID-19 are hospitalized, up 19 from Friday, a record during the pandemic. That includes 206 people in intensive care, 21 more than Friday and a new high point since the beginning of the pandemic.

Since it began: Oregon has reported 242,843 confirmed or presumed infections and 2,949 deaths. To date, the state has reported 4,723,999 doses administered, fully vaccinating 2,351,758 people and partially vaccinating 201,626 people.

To see more data and trends, visit https://projects.oregonlive.com/coronavirus/

-- Ted Sickinger; tsickinger@oregonian.com; 503-221-8505; @tedsickinger

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Today is Tuesday.Welcome to Equilibrium, a newsletter that tracks the growing global battle over the future of sustainability. Subscribe here: thehill.com/newsletter-signup.

The British government has touted this falls United Nations climate summit in Glasgow as the most inclusive ever but an inability to access coronavirus vaccinations, coupled with international travel bans, may prevent some delegates from attending, The Washington Post reported.

Prime Minister Boris Johnson promised that his country and its allies would provide full vaccination to each negotiator, observer and accredited journalist who could not get a vaccine in their home country, according to the Post. But the time to get inoculated before Novembers U.N. Climate Change Conference is rapidly running out and those vaccines have yet to materialize.

That means the least-developed nations face a double-bind. They are forecast to shoulder an outsize burden in a warming world, the Post reported. However, their vaccination rates hover below 2 percent, jeopardizing their attendance at a summitwhose decisions will disproportionately impact them.

Today well turn again to the warming West, where the U.S. Bureau of Reclamation declared the Colorado Rivers first-ever federal shortage on Monday. Then well travel to the U.K., where the government is wading into one of the biggest battles in clean energy: hydrogen versus electricity.

For Equilibrium, we are Saul Elbein and Sharon Udasin. Please send tips or comments to Saul at selbein@thehill.com or Sharon at sudasin@thehill.com. Follow us on Twitter: @saul_elbein and @sharonudasin.

Lets get to it.

Historic water cuts hit a thirsty West

The U.S. Bureau of Reclamation has announced a water shortage for the drought-stricken Colorado River for the first time in history meaning hard times for Central Arizonas farmers.

The U.S. Bureau of Reclamation announced future cutbacks on Monday after an unusually dry spring left the total Colorado River basin storage at 40 percent capacity a decline of 49 percent from this time last year, Zack Budryk reported for The Hill.

Like much of the West, and across our connected basins, the Colorado River is facing unprecedented and accelerating challenges, Assistant Secretary for Water and Science Tanya Trujillo said in a Bureau of Reclamation news release.

How bad are things? Pretty bad. Spring runoff into the Lake Powell storage reservoir from the Upper Basin states Colorado, New Mexico, Utah and Wyoming amounted to just 26 percent of the average, the Bureau of Reclamation said. The amount that would have flowed to Lake Mead, which stores water for the Lower Basin states Arizona, Nevada and California is about 32 percent of the annual average.

So what is actually going to happen, and when? Lake Powell will release just 7.48 million acre-feet in water year 2022 (Oct. 1, 2021 through Sept. 30, 2022) a 9 percent drop from this years 8.23 million acre feet.

Lake Mead, meanwhile, will adjust to its first-ever Level 1 Shortage Condition for calendar year 2022 (Jan. 1, 2022 through Dec. 31, 2022). Three places will face hefty cuts, as per domestic and international agreements that stem back to the 1944 Water Treaty with Mexico.

Those cuts are:

Arizona is hit hardest,losing just less than 8 percent of its state water supply, the Arizona Department of Water Resources said in a news release.

In addition, the shortage will also eliminate about 30 percent of the Colorado River supply to the critically important Central Arizona Project (CAP), the Arizona Department of Water Resources news release said.

CAP is the 336-mile conduit system that conveys water to central and southern Arizona where the brunt of desert agriculture occurs.

DRY TIMES IN ARIZONA

For farmers, the cuts could be dire. The reductions will eliminate about 60 percent of current CAP supplies in Pinal County, the Arizona Daily Star reported, citing Paul Orme, a Phoenix attorney who represents four central Arizona irrigation districts.

That could drastically reduce water available to farmers. And assuming drought conditions persist, an inter-state deal called the 2019 Lower Basin Drought Contingency Plan could lead these same farmers to lose their entire CAP supply by 2023.

They would still be allowed to drill new wells, but those wells would only generate about 28 percent of what they received from CAP, Orme said, according to the Daily Star.

It will be interesting to see what materializes in terms of investments in irrigation technologies that use less water, changes in cropping patterns, and/or fallowing lands, Sharon Megdal, director of the University of Arizonas Water Resources Research Center, told Equilibrium.

What does this mean for the future? The Bureau of Reclamations declaration is a stark reminder that the over-allocation of the Colorado River System must be reckoned with, Megdal said.

While the Central Arizona farming sector will bear the brunt of these initial reductions, models indicate high probabilities that further cutbacks will occur in a few years affecting municipal, industrial and tribal users as well, according to Megdal.

Both water managers and users will need to prepare for these more adverse eventualities, with continued adaptation efforts occurring on both the supply and demand sides of the equation, she said.

Last words: It will not be easy, especially with all the uncertainty, but I do think that the region will demonstrate its resilience through what I will call innovative adaptability, Megdal added.

For a deep dive into one such innovation, please read Sharons new story in Ensia, on how desalination might play a role in revitalizing a parched Colorado River Delta mirroring lessons learned by unlikely partners in the Middle East.

Clean energy cold war: Hydrogen versus electricity

A new hydrogen power plan from the U.K. government has avoided two treacherous pitfalls in one of green energys most contested grudge matches: Hydrogen versus electric power.

But as the U.S. prepares to spend $9 billion on hydrogen research under the bipartisan infrastructure plan, its worth paying attention to both.

First steps: The British government wants the country to produce 5 gigawatts of low-carbon hydrogen by 2030, according to a strategy document released on Tuesday approximately equivalent to the energy needs of 3 million households, The Guardian reported.

That fuel would largely be dispatched to the sectors most difficult to fully electrify: Industry, the power grid and some forms of heavy transport.

Tiptoeing around controversy: That neatly avoids some of hydrogens most controversial applications, said Jan Rosenow, Europe Director of the International Regulatory Assistance Project, which works to decarbonize the worlds largest economies.

A bad strategy would have been: hydrogen used everywhere, to heat homes, in personal transport that it is a panacea, Rosenow told Equilibrium,

A blocking act by fossil fuels? Using hydrogen for those two applications only makes senseif you're an oil and gas company, analyst Michael Liebreich told clean energy trade journal Recharge in June.

If it works, then you're embedded in the hydrogen industry but if it doesn't work, you've delayed the transition to the thing you don't make, which is electricity.

FIGHTS OVER ENERGY SOURCES

A contest over heating: In Britain, natural gas producers like the idea of subbing in hydrogen for the existing gas infrastructure. But this is more complicated than it sounds: hydrogen molecules are far smaller than natural gas molecules, Rosenow said meaning the existing infrastructure risks leaking what the U.S. Department of Labor described as a highly flammable gas.

Also, producing zero-emission hydrogen for home heating costs 2.7 times more than electric heating, according to a study by University College London.

And a contest over cars: In the U.S., car manufacturer Toyota has pushed back on electric car mandates that it sees as a risk to its hydrogen business, as we covered in July.

What is clear is that urban transport buses that operate the same routes in the city, and can be charged in a depot at night, or personal vehicles will most likely not be serviced by hydrogen, Rosenow said.

At current prices, a kilogram of hydrogen delivers slightly more energy than a kilogram of diesel, but costs four times more, The Associated Press reported.

So what should hydrogen be used for? Only the unavoidable, according to Liebreich.

His office has put out the Hydrogen Ladder, which ascends from industries he calls uncompetitive metro trains, domestic heating to those he calls unavoidable, like long-haul aviation and fertilizer production.

First in line for greening, Rosenow said: The around 75 million tons of industrial hydrogen (according to the AP) currently produced from fossil fuels like gas and coal. And barring a huge breakthrough in battery technology, hydrogen could also be what gas and oil are now: A stable store of dispatchable power that can be held for seasons or even years, he added.

A looming problem: The U.K. largely restricted its hydrogen strategy to the unavoidable side of Liebreichs ladder.

But another big question looms where will that hydrogen come from? Will it be truly green, produced from water via wind or solar energy? Or will it be blue, generated from ammonia or natural gas, with leakage at a minimum and emissions somehow captured and stored?

The U.K. government currently plans a twin track approach that will include both four parts blue to one part green, according to Reuters. Thats a second-rate solution to the climate emergency, Juliet Philips of climate think-tank E3G told the Times.

Takeaway: Expect all these fights to be mirrored in the U.S. the moment the bipartisan infrastructure bill passes.

And whatever future breakthroughs hydrogen tech may hold, the current U.K. strategy, as described by Rosenow, is a prod to get started with what we know works building far more clean electricity capacity.

Tech Tuesday

Administration: Solar could provide up to 40 percent of U.S. power by 2035

Airlines turn to tech solutions for climate uncertainty

Please visit The Hills sustainability section online for the web version of this newsletter and more stories. Well see you on Wednesday.

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