Category Archives: Corona Virus

Going to stay with family means exposing more than one household. Can testing in advance keep everyone safe? Noel Hendrickson/Getty Images hide caption

Going to stay with family means exposing more than one household. Can testing in advance keep everyone safe?

Let's face it, if you've been staying home a lot, you're probably pretty tired of looking at the same faces. Love them as we do, it feels like well past time to start seeing other people, to visit or host relatives and dear friends. So how can you do this without unknowingly spreading the virus or getting exposed?

Recently my husband and I debated this when our son, who lives in another state, said he'd like to come home for a visit. He lives with roommates in a city with a high rate of infection, and he works in a restaurant. We thought of having him get a diagnostic test to find out if he is infected. That way, if he got back a negative test, our problems would be solved, right?

Well, when I called up a few infectious disease specialists to ask if this all made sense, I discovered that using a diagnostic test for the coronavirus this way can be problematic. Here's what I learned.

First, which test are we talking about?

Currently the most commonly available test that can detect an active infection is the molecular or PCR test, typically collected via a swab in the nose or the back of the throat. These tests look for the virus's genetic material and are highly sensitive. Another kind of diagnostic test is an antigen test that can detect the coronavirus's proteins these are less sensitive, says Daniel Green, a pathologist at Columbia University Irving Medical Center, and can be less accurate. And finally there are tests that show if your body has developed antibodies because it fought an infection from the coronavirus. Those tell you about an infection you had in the past, not what you have right now.

If I get a negative result on a PCR diagnostic test, can I be certain I won't infect someone I want to spend time with?

Like everything with this pandemic, the answer is complicated. The infectious disease experts I spoke to told me there are two reasons why testing might not be very helpful. The first has to do with the length of time it takes to get your test results back these days up to a week or more in some places for PCR tests. By the time you get your results back, you could have unknowingly been exposed to the virus, making the original test irrelevant.

The next big reason has to do with accuracy. While the PCR test is highly accurate in a laboratory setting, out in the real world it can produce some false positives and a lot of false negatives. In fact studies show a negative diagnostic test result can be wrong between 5% and 40% of the time, depending on the circumstances.

Some of this variation has to do with how well the sample was collected whether an adequate amount of mucous made it onto the swab, for example. But it also has to do with timing. You see, the diagnostic test tells you whether or not you have the virus on the day you took it. It reflects a single "pinpoint in time," says Dr. Henry Anyimadu, an infectious disease specialist with Hartford HealthCare Medical Group at the Hospital of Central Connecticut.

"Suppose that I was exposed on the 1st of August and I didn't know it," says infectious disease specialist Dr. Aileen Marty of Florida International University. "And I took the test on the 2nd of August. My test result will probably be negative." That's because the virus typically has at least a four- to five-day incubation period, so in the first few days after exposure, there may not yet be "enough virus in the upper respiratory system to be detectable," Marty says.

Wait, up to 40% false negative sounds like a lot is there anything I can do to ensure my results are more reliable?

Yes, there are some things you can do. But first remember this, for many of us that false negative rate could be much lower than 40%, says Green, who was a coauthor on one of the studies about test reliability. He points out that many of the people in his study were sampled too early, before the diagnostic test could detect the presence of the virus. So if you want to make sure your test is as reliable as possible, wait several days from the last point you think you could have been exposed before getting the test and while you wait, self-quarantine to avoid further exposures.

Marty agrees, saying, before you take the test, "be in a bubble for at least four or five days." Don't go to bars and restaurants and scale back grocery story visits or have food delivered. Bottom line, limit your exposure as much as possible leading up to test day. And then, Marty adds, "Stay in the bubble until you get your results back." That's because if you aren't careful, you could be exposed to the virus while waiting for results, and if you do have the virus even if you don't have symptoms you could spread it to others.

So if negative results are iffy, is it ever worth getting a diagnostic test?

Yes. There are definitely times when one should get a test, Anyimadu says. "If you're worried you have COVID-19 based on symptoms, you should get a test." Or, if you think you might have been exposed for instance, if your roommate, housemate or someone close to you is infected get a test.

And you should consider a test if you've traveled to an area with a high rate of coronavirus infection, Anyimadu says. To find out if your county or one you've spent time in recently has a high rate of infection, check this county-level map. If the county has more than 10 new daily cases per 100,000 residents, that's considered high risk.

If I test positive, but I don't have any symptoms, what should I do?

If you get a positive test result, our experts say, this is not the time to expand your bubble! Even If you don't have any symptoms, you are possibly contagious, and you could still develop symptoms. Marty says you should isolate yourself for 14 days, learn the symptoms of COVID-19 and monitor yourself. If you do get sick and your symptoms are getting worse, call your health care provider. And don't forget all those folks who live with you. They too need to be tested whether they have symptoms or not, Marty says, and should self-quarantine.

Marty also suggests people "connect with their department of health to assist with contact tracing," and help health workers reach out to anyone else who might have been exposed to you.

If you develop any symptoms, keep track of when they kick in so that you will know when you're no longer contagious. According to the Centers for Disease Control and Prevention, you should isolate yourself for at least 10 days after your first symptom appears. At that point, as long as you haven't had a fever for at least 24 hours and you're feeling better, you should be able to mix with others.

If I can't rely on negative test results, what do I do instead to visit someone safely or merge social bubbles?

The safest and simplest thing to do if you want complete peace of mind is to quarantine yourself for 14 days before the visit this is especially important if you're hoping to visit someone who is older or has an underlying condition.

But short of that, experts say testing can play a role in your decision-making as long as you "don't treat a negative test as a get-out-of-jail free card," Green says.

Think of it as one more piece of imperfect information that you can add together with the most important factor, your own behavior. Have you been able to isolate as much as possible before the potential visit with a friend? If you have gone out, did you carefully socially distance and wear a mask? Have you been avoiding bars and restaurants and indoor gatherings?

If the answer to these questions is yes, and if you are certain you haven't been around someone with a possible or confirmed case of COVID-19, then a negative test could be helpful. "If you aren't sick or don't have any particular reason to believe you're infectious," says epidemiologist Justin Lessler from Johns Hopkins University, "then getting that negative test should increase your confidence."

And remember, before you head off on your trip or join friends for an indoor gathering, ask the people you're visiting about their own behaviors and whether or not they've also gotten a test. Remember, you can spread the virus, but you can receive it as well.

"There's no way to bring your risk down to zero," Anyimadu says. But the recommended measures of mask-wearing, social distancing and thorough hand washing are still the most important defense against the virus. And that is true whether you've had a negative test, a positive test or not even gotten a test at all.

Rob Stein and Carmel Wroth contributed to this report.

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Should You Get Tested For Coronavirus Before You Travel To Visit Family? : Shots - Health News - NPR

ZURICH Like many parents in the United States, I am nervous about what will happen when schools reopen on Monday. The only difference is that here, in Switzerland, we already experienced what it was like to send our children back to school, in the spring.

Is the coronavirus gone? my 5-year-old son asked when we found out on April 29 that schools were reopening in May.

Well, not exactly, I said.

Can you go first to see that there are no coronaviruses in my kindergarten?

Sure, but Im pretty sure there are none in there right now, I answered, pulling his soft pajama-clad body closer to mine.

Hearing his 5-year-olds fears, I started to panic a bit. Emilio and I can both get bronchitis easily. The smallest cold virus hits us directly in the lungs. Although I am considered to be at high risk for Covid-19, Emilio is not because he is a child. The Swiss Society of Pediatrics stance is that children are not at high risk and are also not primary vectors of transmission. Never mind the troubling news of the rare condition, called pediatric multisystem inflammatory syndrome, that affects children exposed to the coronavirus.

In Switzerland, the federal governments Covid-19 response wasnt so much a political issue but one most people accepted as a public health one. The government is cautious when it comes to infringing upon civil liberties. For example, it recommended but never mandated that people stay at home during shutdown, and for the most part, the Swiss listened.

By the time Swiss schools reopened on May 11, the number of new daily infections had dropped to 46. At the height of the Covid-19 pandemic, Switzerland, with a population of 8.6 million, roughly the same as New York City, was among the countries with the highest number of infections per capita in the world after Italy.

Before my sons school reopened, I called his kindergarten teacher, who assured me there would only be eight children in the classroom at a time and that two additional teachers would assist in maintaining hygiene and social distancing rules. The learning environment with fewer kids would be ideal for him, she told me. Emilio is sensitive to noise. She was right. When he returned to in-class instruction, Emilio began to make huge strides both academically and socially.

My 9-year old daughter, Liliana, is a motivated self-learner and loved having more control of her time when schools were closed. There were certainly struggles at home to complete required school assignments, but with time at her disposal she also discovered gardening, insects and volcanoes. She spent hours reading piles of books. She drew, painted and practiced a lot of violin. She didnt necessarily feel like she needed to return to school, but she was happy to see her friends again. She even performed in the end-of-the-year talent show.

Teachers in both my childrens classes made a concerted effort to put students and their friends in the same groups. At first, each group attended school two full days while continuing with long-distance learning for the remainder of the week. By June, as infection numbers continued their steady decline in Switzerland, schools returned to normal scheduling and classes were adjusted back to pre-Covid-19 sizes.

Throughout this, my childrens school provided us with a comprehensive contact-tracing plan. Children exhibiting the slightest of coughs were sent home to get tested before being allowed back in the classroom.

Since schools ended on July 10, there has been a steady increase of infections in Switzerland, rising above 200 new cases per day. When schools reopen on Monday, our biggest concern is whether families who travel to high-risk areas during the summer will bring new infections back to their communities. There are financial penalties for people traveling to high-risk countries who do not factor in the mandatory 10-days self-quarantine upon returning to jobs and schools in Switzerland. Whether this is enough to curb new outbreaks is still unclear.

These days, my husband and I track daily infection numbers. We will likely send our children back to school and we trust that the government will close schools again, if necessary.

Mommy, if a lot more coronaviruses come back, we wont go back to school, right? Emilio asked me recently.

We are watching carefully to make sure it is safe, I tell him. Nevertheless, it is difficult not to be fearful or overthink possible consequences. I cant help but wonder, if a common cold sent my child to the intensive care unit, is he really safe from Covid-19?

Sharon Kim Soldati is a writer and violin teacher at the Musikschule Konservatorium Zrich. Originally from New York, she lives with her husband and two children in Switzerland.

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Is the Coronavirus Gone? a 5-Year-Old in Switzerland Asks - The New York Times

With Washington talks on emergency coronavirus aid having stalled, both sides are playing the blame game Thursday. House Speaker Nancy Pelosi blasted Republicans for not giving "a damn." (Aug. 13) AP Domestic

The United States Postal Service has warned almost every statethat deadlines for early voting may meansome ballots cannotbe delivered in time to be counted.

Many states have put new emphasis on early voting by mail because many voters may not want to go to the polls in person because of the pandemic. The warning, blamed by the USPS on changes to limit overtime and increase efficiency,has prompted charges that the move by the Trump administration is politically motivated.

Though President Donald Trump has unleasheda barrage of attacks on "universal" mail voting,few states are actually planning that in November: Only nine states and the District of Columbia so far plan to automatically send ballots to all voters. Even in these states, in-person voting will remain an option.

Meanwhile, the Centers for Disease Control and Prevention now says people who have had COVID-19 within the past three months and comein close contact with someone who is actively infected do not need to quarantine or be tested again.

Here are some significant developments:

Today's numbers:The U.S. has5.3million confirmed infections and more than 168,000deaths. Worldwide, there have been more than 766,000 deaths and more than million cases, according toJohn Hopkins University data.

What we're reading: Some people are listening to health experts, while others ignore them. What does that mean for the future of COVID-19 in America? The psychology behind following rules, explained.

The U.S. Postal Service is warning that it may not be able to meet many state deadlines for returning early voting ballots for the November election.The issue is arising asstates gear up for an expected avalanche of early ballotrequests byvoters fearful of going to the polls in person because of the pandemic.

The warnings, blamed on USPS changes this summer to limit overtime and increase efficiency, have gone out to almost every state, notably including such as Ohio, Florida, Pennsylvania, Michigan and Arizona.

The warning lettersto state election officials,first reported by The Washington Post, prompted immediate questions from the League of Women Voters and suspicion from the American Postal Workers Union that the warnings were politically motivated.

Kevin McCoy, Donovan Slack and Katie Wedell

Achild returning to school this fallmight go throughthe following morning routine: their parent checks them for COVID-19 symptoms, they take a socially distanced bus ride, and a faculty member, like a school nurse, conducts a final screening at the school entrance before letting them through the door.

As students return to class, many school districts have introduced routine symptom screenings into their reopening plans. But their effectiveness and feasibility in stopping the spread of COVID-19 in schools remain unclear.

Screenings are limited for a variety of reasons, including that the novel coronavirus shares many symptoms with common illnesses like the fluand not everyone with COVID-19 will have symptoms, saidAdam Karcz,director of infection prevention at Indiana University'sRiley Hospital for Children.The Centers for Disease Control and Preventiondoesn't recommend universal health screenings or COVID-19 testingat schools because of theselimitations.

Tiana Woodard,Indianapolis Star

People who have had COVID-19 within the past three months and comein close contact with someone who is actively infected do not need to quarantine, according to updated guidance from the Centers for Disease Control and Prevention.

"People who have tested positive for COVID-19 do not need to quarantine or get tested again for up to 3 months as long as they do not develop symptoms again," the new guidance says. "People who develop symptoms again within 3 months of their first bout of COVID-19 may need to be tested again if there is no other cause identified for their symptoms."

But antibodies may begin to decline sooner than that. A June study in the journal Naturefound that antibodies may begin to decrease within 2 to 3 months after infection.

"This science does not imply a person is immune to reinfection with SARS-CoV-2, the virus that causes COVID-19, in the 3 months following infection," CDC spokesperson Jason McDonald said in a statement. "The latest data simply suggests that retesting someone in the 3 months following initial infection is not necessary unless that person is exhibiting the symptoms of COVID-19 and the symptoms cannot be associated with another illness."

Mayo Clinic researchers reported a strong hint that blood plasma from COVID-19 survivors helps other patients recover, but its not proof and some experts worry if, amid clamor for the treatment, they'll ever get a clear answer.

More than 64,000 patients in the U.S. have been given convalescent plasma, a century-old approach to fend off flu and measles before vaccines. It's a go-to tactic when new diseases come along, and history suggests it works against some, but not all, infections.

Theres no solid evidence yet that it fights the coronavirus and, if so, how best to use it. But preliminary data from 35,000 coronavirus patients treated with plasma offers what Mayo lead researcher Dr. Michael Joyner on Friday called signals of efficacy.

After bitter battles with municipalities over mandatory mask ordinances, Georgia Gov. Brian Kemp has yielded to local citys demands.Kemp isexpected to sign an executive order on Saturday that allows cities like Savannah, Atlanta, Augusta and Athens to enforce the mask mandates that the governor had previously insisted had no power.

Until Friday, Kemp had strongly encouraged people to wear masks. Hed filed a lawsuit against Atlanta Mayor Kesha Lance Bottoms to drop her local mandate, but earlier this week Kemp dropped that suit.

Under the order, first reported by The Atlanta Journal-Constitution, the ordinances for businesses will only be applicable if the owner agrees to it. Kemp also said people must be given a warning before being issued a citation. Kemp has not gone as far as making masks a statewide mandate.

Rana L. Cash, Savannah Morning News

Bowling alleys, gyms, museums and other low-risk indoor cultural venues will soon be allowed to open in New York with strict COVID-19 rules, Gov. Andrew Cuomo said Friday.

Bowling alleys will be allowed to open Monday, being limited to 50% of occupancy capacity and forced to follow other rules, such as bowlers must have a face covering and every other lane will remain closed. Food and alcohol service will also be limited to wait service, reports USA TODAY Network's New York State Team.

Museums, aquariums and other low-risk indoor cultural venues will be allowed to open in New York City on Aug. 24 with various COVID-19 restrictions, including operating at 25% occupancy capacity. In upstate communities, museums and other indoor venues opened previously.

The opening date and rules for gyms will be revealed on Monday, Cuomo said.

David Robinson, New York State Team

The Canada-U.S. border will remain closed to nonessential travel for at least another month, Public Safety Minister Bill Blair said in a statement Friday, a day after Mexico announced a similar measure for its border with the United States. The land border restrictions aimed at controlling the coronavirus pandemic were first announced in March and have been renewed monthly.

Essential cross-border workers such as health care professionals, airline crews and truck drivers are still permitted to cross. Americans and Canadians returning to their respective countries are exempted from the border closure.

The Associated Press

Communities of color are dying at higher rates from the novel coronavirus than white Americans. Here's how structural inequities play a role. USA TODAY

On Facebook:There's still a lot unknown about the coronavirus. But what we do know, we're sharing with you.Join our Facebook group,Coronavirus Watch,to receive daily updates in your feed and chat with others in the community about COVID-19.

In your inbox:Stay up-to-date with the latest news on the coronavirus pandemic from the USA TODAY Network.Sign up for thedailyCoronavirus Watchnewsletter here.

Tips for coping:Every Saturday and Tuesday we'll be in your inbox, offering you a virtual hug and a little bit of solace in these difficult times.Sign up forStaying Apart, Togetherhere.

Contributing: The Associated Press

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Coronavirus updates: USPS says some absentee ballots may not arrive in time; it's the final weekend for massive Sturgis bike rally - USA TODAY

Pennsylvania added 829 new coronavirus cases on Friday, bringing the statewide case count to 122,950.

The Pa. COVID-19 death toll rose to 7,445 as 36 more deaths were reported in the daily update from the Pennsylvania Department of Health.

(Cant see the map? Click here.)

Meanwhile, the state has identified 15 counties with concerning rates of positive tests, including Berks County near the Lehigh Valley.

And schools are reopening, but when might they have to close again? New guidance from the state education department shows how many COVID-19 infections are allowable before a building shutdown is recommended, and for how long.

Pennsylvania coronavirus updates for Aug. 14, 2020.

(Cant see the chart? Click here.)

With 147 new COVID-19 cases, Philadelphia alone accounted for almost one-fifth of Fridays statewide case count. Pittsburghs Allegheny County had 90 new cases.

Pennsylvania closes out the week with its case rate again on the rise, averaging 810 new cases a day over the last seven days. Thats up from 747 at this time last week but still below the 925 case average from two weeks ago.

(Cant see the chart? Click here.)

The rate of hospitalizations has fallen after a small surge in July. However, the rate of statewide deaths is climbing. In the last seven days, on average, 21 Pennsylvanians died daily from COVID-19, up from 15 a week ago and 13 two weeks ago.

The health department estimates that 78% of Pennsylvania patients have recovered so far.

MORE: How to understand Pa. COVID-19 data with interactive charts

Each week, the health department updates its online early warning monitoring system and identifies counties with a concerning percentage of positive cases, above the World Health Organizations recommended threshold of 5%. This measurement factors into decisions on school reopenings.

(The state calculates percent positivity based on total tests, including duplicates. This method puts Pennsylvanias percent-positivity at 4% over the last week. Another way, used by lehighvalleylive.com and Johns Hopkins University, calculates percent positivity based on individuals tested, eliminating duplicate tests that method shows statewide positivity at 5.1% over the last seven days.)

(Cant see the chart? Click here.)

This week, 15 counties, many in rural central and western Pennsylvania, were above 5% positivity, by the states calculation. They are:

Last week, there were 17 counties above 5% positivity.

The lower the positivity rate, the more likely that testing is capturing the full spread of the virus in a community. On the other hand, high positivity rates show that only the sickest people are being tested which means that people with few or no symptoms may be unknowingly spreading the virus.

As of Friday, state data puts the Lehigh Valley at total 9,038 cases with 635 deaths, an increase of 20 cases and one death from the day before. That breaks down to:

(Cant see the chart? Click here.)

According to the health departments early warning dashboard, Lehigh County had 128 confirmed cases over the last week, up from 104 the previous week. The countys positivity rate (per the states calculation) rose to 4% this week, from 3.1% a week ago. Average daily hospitalizations, as reported by the health department, were cut in half, from 41.1 last week to 19.6 this week.

By the same metrics, Northampton County had 80 cases in the last week, down from 84 the previous week. The countys positivity rate dropped to 2.7% this week, down from 2.9% last week. Few residents are reportedly hospitalized in Northampton: The average daily hospitalizations dropped from 2.6 last week to 1.4 this week.

Here is how bordering Pennsylvania counties compare in cases and deaths:

(Cant see the table? Click here.)

Schools are reopening, but when will they need to close again? New guidelines from the Pennsylvania Department of Education lay out a policy based on the number of infections within the school and how widespread COVID-19 is in the county. (The state described its process for determining county transmission earlier this week.)

In counties with low and moderate spread, schools will not need to close if just one student or staff member contracts COVID-19, but the building will need to be disinfected.

If two to four people fall ill, the school should close for up to a week for cleaning. If five or more infections are reported, schools could close for up to two weeks.

In all cases, if there is substantial county spread, schools will be advised to go fully virtual. The departments recommendations can be found here.

MORE: How many COVID-19 infections until a school must close? Pa. offers more guidelines.

(Cant see the table? Click here.)

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Steve Novak may be reached at snovak@lehighvalleylive.com.

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Pa. coronavirus updates: 829 new cases; 15 concerning counties; when will schools have to close from infect - lehighvalleylive.com

SEOUL, South Korea North Koreas leader, Kim Jong-un, says the nation is facing two crises at the same time fighting the spread of the coronavirus and coping with extensive flood damage. But Mr. Kim has ordered his country not to accept any international aid for fear that outside help might bring in Covid-19, the state news media reported on Friday.

Mr. Kim, who spoke during a meeting of the ruling Workers Party Politburo on Thursday, said that he sympathized with the great pain of families who had lost their homes to the floods and were living in temporary shelters.

But he said the situation, in which the spread of the worldwide malignant virus has become worse, requires us not to allow any outside aid for the flood damage but shut the border tighter and carry out strict anti-epidemic work, according to the Norths official Korean Central News Agency.

The double-whammy calamities of the pandemic and floods have exacerbated Mr. Kims economic troubles. The Norths economy, already hamstrung by the sanctions imposed by the United Nations for its nuclear weapons development, has gone into a tailspin this year as fear of coronavirus infections cut deeply into its exports and imports with China, the countrys primary trading partner.

An unusually long monsoon season, as well as torrential rains this month, has set off floods and landslides in both North and South Korea. But the North said the natural disaster had damaged 96,300 acres of farmland and 16,680 homes, as well as roads, embankments and rail lines. Most of the damage was reported in southern and western provinces, a breadbasket for North Korea, which has suffered chronic food shortages even during normal years.

North Korea has also taken drastic actions against the coronavirus, sealing its borders in late January and quarantining all diplomats in Pyongyang for a month. It locked down the border city of Kaesong last month, suspecting a defector who crossed back over the border from South Korea of bringing the virus with him.

North Koreas swift actions were driven by fears that a Covid-19 outbreak could seriously test its woefully underequipped public health system and its economy, already struggling under international sanctions, analysts said.

On Friday, however, North Korea lifted the lockdown, based on the scientific verification and guarantee by a professional anti-epidemic organization.

The North Korean state news media has long insisted that there are no coronavirus cases in the country, although outside experts question the claim. The North did not reveal whether the defector who crossed back from South Korea had tested positive for the virus, and officials in the South have said there is no proof that he had it.

The global pandemic and creeping flood damage come as Mr. Kim has failed to get United Nations sanctions lifted through his stalled diplomatic relations with President Trump.

By precluding outside aid, Mr. Kim appeared to have denied Seoul and Washington a chance to thaw relations with the North through humanitarian shipments.

North Koreas rejection of flood relief is ostensibly to prevent transmission of Covid-19 into the country, said Leif-Eric Easley, a professor of international studies at Ewha Womans University in Seoul. But humanitarian assistance is heavily politicized by the Kim regime, as it does not want to show weakness to the domestic population or international rivals.

North Korea shut down business with neighboring China, which accounts for nine-tenths of its external trade, and clamped down on smugglers who keep its thriving unofficial markets functioning. The countrys exports to China, hit hard by the border shutdown, plummeted to $27 million in the first half of this year, a 75 percent drop from a year ago, according to the Korea Institute for National Unification in Seoul. Imports from China dropped 67 percent, to $380 million.

Updated August 12, 2020

About 60 percent of North Koreas population face food insecurity this year, according to the United States Department of Agricultures Economic Research Service.

The floods and coronavirus fears have also complicated Mr. Kims plan to celebrate the 75th anniversary of the ruling Workers Party on Oct. 10 with pomp and spectacle.

We cannot make the flood-affected people celebrate the 75th anniversary of the party homeless, Mr. Kim said during the Politburo meeting, urging his government to bring the lives of the people back to normal as soon as possible.

The Norths leader has been visiting the flood-affected areas in recent weeks, sometimes photographed driving his own car, and has ordered the release of reserve grains for the hard-hit towns, in an apparent effort to demonstrate what the state news media has called his people-loving leadership.

During the Politburo meeting, Mr. Kim replaced Premier Kim Jae-ryong, who was in charge of the cabinet and the economy, with Kim Tok-hun, a senior official in the Workers Party. The departing premier was given a senior post within the party.

Mr. Kim also elevated Ri Pyong-chol, an official in charge of North Koreas missile and nuclear weapons development, to the top leadership committee of the Politburo, along with the new premier.

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North Korea, Fighting Coronavirus and Floods, Rejects Outside Aid - The New York Times

Government is in need of financial resources on an emergency basis with a view to mitigate the effects of Covid-19, Albert Kawana, the minister of Fisheries and Marine Resources, said in a statement. We do not produce medicines in Namibia nor do we manufacture medical equipment. In order to obtain these items, we have to buy them with foreign currency.

After mining and agriculture, fishing is the biggest foreign currency earner for Namibia, bringing in some $10 billion Namibian dollars ($565 million U.S.) annually.

Last month, the government ordered the closure of schools for 28 days as part of a new set of restrictions aimed at curbing rising virus cases.

Reporting was contributed by Sarah Almukhtar, Nicholas Bogel-Burroughs, Luke Broadwater, Nick Bruce, Damien Cave, Troy Closson, Emily Cochrane, Lindsey Rogers Cook, Shaila Dewan, Caitlin Dickerson, John Eligon, Sheri Fink, Kimiko de Freytas-Tamura, Robert Gebeloff, Matthew Haag, Mike Ives, Danielle Ivory, Sarah Kliff, Andrew E. Kramer, Isabella Kwai, Mark Landler, Apoorva Mandavilli, Patrick McGeehan, Sarah Mervosh, David Montgomery, Alan Rappeport, Emily Rhyne, Frances Robles, Amy Qin, Erin Schaff, Ed Shanahan, Julie Shaver, Michael D. Shear, Karan Deep Singh, Mitch Smith, Kaly Soto, Eileen Sullivan, Lucy Tompkins, Julie Turkewitz, Noah Weiland, Will Wright, Katherine J. Wu, Jin Wu, Elaine Yu, Mihir Zaveri, Carl Zimmer and Karen Zraick.

An earlier version of this briefing mistakenly attributed the falling rate of hospitalizations in Texas; the figure came from the Texas Department of State Health Services. It also included an incorrect figure for current hospitalizations in the state, which is 7,200.

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Texas Has Too Many Cases to Reopen, Governor Warns - The New York Times

Dr. Carlos Vallejo, 57, and his father, Dr. Jorge Vallejo, 89, were hospitalized during the early morning hours of Father's Day. They died five weeks apart, said Carlos' son, Charlie Vallejo.

Dr. Jorge Vallejo was a retired obstetrician and gynecologist who practiced for more than 45 years in the Miami area and treated celebrities, like salsa singer Celia Cruz. He was known for delivering one of the smallest babies in the world, a 22-week-old who weighed 15 ounces.

He moved his family, including a 2-year-old Carlos, to Miami from Guantanamo, Cuba, in 1965. All three of his sons studied medicine, too.

Dr. Carlos Vallejo was on the frontlines of the pandemic, suiting up in full personal protective equipment and treating dozens of Covid-19 patients at any point in time.

Charlie Vallejo told CNN his father treated his patients like family.

"He cared too much," Charlie Vallejo said. "He died a hero."

They died weeks apart

Jorge died on June 27 while Carlos battled Covid-19 from a hospital room. His family delivered the devastating news of his father's death over FaceTime.

"(He was) surrounded by machines and no human contact so I think that kind of broke him," said Charlie Vallejo.

After three weeks in the ICU, including two weeks on a ventilator, Carlos Vallejo died on August 1. Charlie said his dad didn't have any preexisting conditions.

"He felt like a champion, you know. He was a warrior to the very end," Charlie Vallejo said.

Five members of the Vallejo family contracted coronavirus, including Carlos's wife. The family believes Carlos Vallejo was very cautious, but became infected by treating patients.

Carlos is one of over 900 US health care workers who've died from the very disease they're trying to save others from.

CNN's Scottie Andrew contributed to this report.

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Father and son doctors die of coronavirus weeks apart after being hospitalized on Father's Day - CNN

Syracuse, N.Y. People attending services at four Syracuse area churches may have been exposed to the coronavirus by infected congregants, some of whom were not wearing face masks.

The Onondaga County Health Department said the potential exposures occurred at:

First Ukrainian Pentecostal Church, 3875 Warners Road, Syracuse on Sunday, Aug. 2 at the 9 a.m. and noon services;

St. Patricks Church, 216 North Lowell Ave., Syracuse on Saturday, Aug. 8 at the 4 p.m. service.

Blessed Virgin Mary Church, 2656 Warner Road, Warners on Sunday, Aug. 9 at the 9 a.m. service;

Herald of Joy Evangelical Church, 3994 Split Rock Road, Camillus on Sunday, Aug. 9 at the 10 a.m. service.

The infected individual at Herald of Joy was wearing a mask, but the infected individuals at the three other churches did not have masks on, the department said.

Health Department investigators are in the process of identifying all close contacts of the individuals and notifying them. Members of the public who attended the services may have been exposed and should monitor themselves for symptoms of coronavirus for 14 days from the date of the service.

If symptoms do develop, stay home, and call your doctor for further guidance. If you are elderly, have underlying medical conditions, or are immunocompromised, call your doctor early even if your illness is mild. In an emergency, call 911. Testing is also widely available, and anyone can get tested for COVID-19 by calling their healthcare provider or visiting the drive-thru clinic at Syracuse Community Health Center.

Attendees of services must be required to wear face coverings at all times and maintain a distance of at least six feet between individuals unless they are members of the same household. It is recommended that all services have a sign-in sheet for attendees to provide contact information including name, address and phone number for the purpose of notification and contact tracing if there is a potential exposure of coronavirus.

The health department said it is critical that congregants stay home if they are sick.

James T. Mulder covers health news. Have a news tip? Contact him at (315) 470-2245 or jmulder@syracuse.com

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People at 4 Syracuse area churches may have been exposed to coronavirus - syracuse.com

Members of the American Red Cross remove influenza victims in 1918.

St. Louis Post-Dispatch | Tribune News Service via Getty Images

The coronavirus is at least as deadly as the 1918 flu pandemic and thedeath toll could even be worse if world leaders and public health officials fail to adequately contain it, researchers warned in a study publishedThursday in the medical journal JAMA Network Open.

"What we want people to know is that this has 1918 potential," lead author Dr. Jeremy Faust said in an interview, adding that the outbreak in New York was at least 70% as bad as the one in 1918 when doctors didn't have ventilators or other advances to help save lives like they do today. "This is not something to just shrug off like the flu."

Researchers comparedexcess deaths in New York City during the peak of the 1918 pandemic with those during the first few months of the Covid-19 outbreak. They used public data from the Centers for Disease Control and Prevention, the New York City Department of Health and Mental Hygiene, and the U.S. Census Bureau to conduct their analysis.

The increase in deaths during the 1918 flu pandemic was higher overall, but comparable to that observed in the first two months of the coronavirus outbreak in New York City, the researchers found. But when taking into account improvements in hygiene, modern medicine and public health,the increase during the early coronavirus outbreak was "substantially greater" than during the peak of the 1918 pandemic, the researchers wrote.

"If insufficiently treated, SARS-CoV-2 infection may have comparable or greater mortality than 1918 H1N1 influenza virus infection," Faust wrote in the paper. He's a physician at Brigham and Women's Hospital and an instructor at Harvard Medical School.

The study's authors noted that their research had limitations. The researchers said it's unknown how many Covid-19 deaths have been prevented since the outbreak began because of modern improvements in health care that weren't available a century ago, such as supplemental oxygen and ventilators.

The new study comes as the coronavirus continues to rapidly spread across the United States and worldwide. The virus has infected more than 20 million people worldwide and killed at least 749,700, according to data compiled by Johns Hopkins University. The U.S. has the worst outbreak in the world with more than 5 million infections and at least 166,000 deaths, Johns Hopkins data shows.

The U.S. recorded more than 1,500 deaths caused by Covid-19 on Wednesday, marking the deadliest day for the country since the end of May.

A separatestudy published July 1 inJAMA Internal Medicinefound the number of confirmed U.S. deaths due to the coronavirus is substantially lower than the true tally.

Those researchers found that the excess number of deaths over normal levels also exceeded those attributed to Covid-19, leading them to conclude that many of those fatalities were likely caused by the coronavirus but not confirmed. State reporting discrepancies and a sharp increase in U.S. deaths amid a pandemic suggest the number of Covid-19 fatalities is undercounted, they said.

The World Health Organization says there is no "silver bullet" for the virus and health-care workers will likely need an array of treatments to help patients fight the disease. Currently, many hospitals in the U.S. are using antiviral drug remdesvir, which has been shown to help shorten the recovery time of some hospitalized patients. There are also numerous vaccines in development with at least 26 already in human trials, according to the WHO.

Public health officials and infectious disease experts have often compared Covid-19 to the 1918 flu, which is estimated to have killed 50 million people worldwide from 1918 through 1919, including 675,000 Americans, according to the CDC. More than 20 million people died in World War I, by comparison.

Dr. Anthony Fauci, the nation's leading infectious disease expert, has said the coronavirus is a "pandemic of historic proportions" and history books will likely compare it to 1918.He has mentioned the "extreme" range of symptoms people can experience after contracting the virus, includingpediatric multisystem inflammatory syndrome. PMIS is a rare inflammatory condition found in children with Covid-19 that's similar to Kawasaki syndrome and has caused neurological damage in some kids.

"We learn things every week," he said July 13.

The researchers of the new study said their findings may help officials contextualize the unusual magnitude of the Covid-19 pandemic and "lead to more prudent policies that may help decrease transmission."

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Scientists say the coronavirus is at least as deadly as the 1918 flu pandemic - CNBC

A study in 26 nursing homes in the Netherlands, demonstrating that families can visit without causing new Covid infections, has encouraged advocates. Perhaps, they say, in areas with low community infection rates, when facilities have sufficient protective equipment and testing capacity, family caregivers can be cautiously reintroduced.

But many long-term-care facilities still cant meet those conditions. Dr. Bergman, whose group expects to publish its recommendations next month, pointed out that some still report shortages of protective equipment, particularly N95 masks in appropriate sizes. In many regions, bottlenecks in testing have so delayed results that they are useless for screening visitors.

Moreover, Dr. Karlawish said, one thing that haunts long-term care is fear of litigation.

Medicare vowed last month to send a rapid testing kit to each of the nations 15,000 nursing homes, prioritizing those with outbreaks or in Covid hot spots; so far it has allocated about 2,400. But these antigen tests produce more false negative than the slower but more reliable P.C.R. tests, experts said; facility administrators also worry about the cost of supplies the kits require.

Providers are eager but cautious to welcome visitors and volunteers back into their buildings, the American Health Care Association/National Center for Assisted Living said in an email. That is why we need public health officials to direct resources testing, PPE and funding to long-term care on an ongoing basis.

Theres always a reason to delay, and facilities where residents and staff members have already suffered and died from Covid-19 understandably fear a recurrence. But they could exercise judgment, Dr. Karlawish said, and at least allow visitors for residents who clearly struggling with the isolation. Nursing homes care for a group of people for whom high-stakes ethical decisions are part of life, he said.

Almost by definition, long-term care residents have limited life spans; nursing home residents are particularly fragile. Do they so value safety over quality of life that they want to spend their last months or years separated from their loved ones? Has anyone asked them?

Ms. Baum keeps visiting her mother and mother-in-law from a distance, but she is haunted by the idea that one of them might pass, without one of us next to them, she said. I dont know what I would do.

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Coronavirus: When Will Long-Term Care Facilities Reopen to Visitors? - The New York Times