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September 24, 2020 10:21 AM

Live updates on COVID-19: June 16-30

Modern Healthcare
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    Republicans, with exception of Trump, now push mask-wearing

    8:48 PM CT on 6/30/20

    (AP) In Republican circles--with the notable exception of the man who leads the party--the debate about masks is over: It’s time to put one on.

    As a surge of infections hammers the South and West, GOP officials are pushing back against the notion that masks are about politics, as President Donald Trump suggests, and telling Americans they can help save lives.

    Sen. Lamar Alexander, a Tennessee Republican, on Tuesday bluntly called on Trump to start wearing a mask, at least some of the time, to set a good example.

    "Unfortunately, this simple, lifesaving practice has become part of a political debate that says: If you’re for Trump, you don’t wear a mask. If you’re against Trump, you do,” Alexander said.

    Both Vice President Mike Pence and Senate Majority Leader Mitch McConnell in recent days have urged Americans to wear one when they are unable to maintain social distance. Sen. Mitt Romney, a Utah Republican, told reporters it would be “very helpful” for Trump to encourage mask usage.

    “Put on a mask--it’s not complicated," McConnell, R-Ky., urged Americans during his weekly news conference Tuesday.

    Trump aides have defended the president’s refusal to wear a mask by noting that he is regularly tested for the coronavirus, as are his aides. Those outside the administration -- including White House visitors and members of the media who are in close proximity to him and Pence -- are also tested.

    White House press secretary Kayleigh McEnany didn’t directly address Republican calls for Trump to wear a mask in public more often, but noted that the president has said in the past he has no problem wearing one when necessary.


    AMA urges Pence to take 'immediate' steps on PPE supply chain

    7:15 PM CT on 6/30/20

    The American Medical Association wants the Trump administration to take immediate action to ensure that physician practices will have adequate supply of personal protective equipment.

    In letter a to Vice President Mike Pence, the AMA said that the administration should use the "Defense Production Act to make sure there is sufficient Personal Protective Equipment (PPE) for physicians in all settings." The AMA said it continually hears from members that having enough PPE is "the biggest challenge" to resuming non-emergency procedures. 

    In a separate letter to the Federal Emergency Management Association, the AMA warned that "a significant obstacle to crafting effective solutions has been the lack of data to help us ascertain whether the central problem is in the availability of raw material, production backlogs, gaps in the distribution systems, or some combination of all three."


    Senate Republicans introduce bill to codify Trump administration hospital transparency rule

    5:36 PM CT on 6/30/20

    Several Senate Republicans introduced a bill on Tuesday that would codify the Trump administration’s rule requiring hospitals to reveal the price they negotiate with insurers.

    Senate Finance Chair Chuck Grassley (R-Iowa) was joined by Sens. Mike Braun (R-Ind.), Joni Ernst (R-Iowa), Mike Enzi (R-Wyo.), John Kennedy (R-La.) and Kelly Loeffler (R-Ga.) in introducing the bill, dubbed the PRICE Transparency Act. The purpose of the legislation is to end court battles over the Trump administration’s transparency rules. A federal judge ruled in the administration’s favor and upheld the rule on June 23. AHA said it would appeal the decision.

    There's potential for the legislation to be included in the next COVID-19 relief package, which Congress is expected to pass in July. 


    Michigan Medicine projects $3 million loss but cuts number of layoffs

    4:00 PM CT on 6/30/20

    (Crain’s Detroit Business) Michigan Medicine announced Monday that it expects to lose $3 million on $4.7 billion in revenue for fiscal year 2020, which ends today, after pre-coronavirus projections of a $175 million operating profit on $5 billion in revenue.

    As Southeast Michigan hospitals became overwhelmed with COVID-19 patients in April and May, Michigan Medicine accepted more than 800 transfers of all types of patients during the six-week height of the pandemic from such systems with hospitals in Detroit as Beaumont Health, Detroit Medical Center, Henry Ford Health System and Ascension Health.

    The financial results for Michigan Medicine's clinical operations include performance from the University of Michigan Health System's three hospitals, 125 clinics and the U-M Medical Group, as well as UM Health, which represents Michigan Medicine's affiliation with Metro Health in Grand Rapids.

    Because Michigan Medicine had to abruptly cancel surgeries and procedures and devote operations to providing care for a surge of COVID-19 patients, revenues dropped dramatically during March and April.

    The losses were offset by $136 million in government assistance along with recent efforts to reschedule and catch up on delayed appointments, surgeries and procedures. Michigan Medicine also received more than $269 million in Medicare loans that at this time must be repaid by the end of the year.

    On May 5, Michigan Medicine announced an economic recovery plan that included eliminating 1,400 job positions. Based on expense reduction, employee attrition and furloughs, the academic medicine center was able to limit the job reductions to 738 workers.

    Depending on tenure, those impacted will receive pay and benefits for varying periods of time and all will have access to career transition assistance, officials said.

    Top leaders at Michigan Medicine also have accepted compensation cuts of 5% to 15%. Marschall Runge, M.D., CEO of Michigan Medicine, dean of the U-M Medical School and executive vice president for Medical Affairs at U-M, agreed to a 20 percent compensation cut.

    Other expense savings include suspension of merit increases, employer retirement match, tuition reimbursement, and reductions to supplies, consulting and discretionary expenses.


    Research: Global COVID-19 cases, deaths much higher than official tallies

    2:34 PM CT on 6/30/20

    New research suggests the number of COVID-19 cases and deaths worldwide are much higher than official counts.

    By studying 84 countries most affected by the coronavirus, MIT Sloan School of Management researchers estimate there have been 88.5 million cases and 600,000 deaths through June 18. Those estimates are 12 times and 1.5 times higher than official reports.

    Researchers predict 249 million cases and 1.75 million deaths by spring 2021 if a vaccine or enhanced treatments haven’t been developed, and if there’s only a mild improvement in policies to control the spread.


    FDA head offers guidelines for vaccine to Senate

    1:26 PM CT on 6/30/20

    (AP) The head of the Food and Drug Administration says vaccine developers will be expected to study COVID-19 shots in racial minorities, the elderly, pregnant women and those with other health conditions.

    FDA Commissioner Stephen Hahn outlined the guidelines for potential vaccines at a Senate hearing on reopening schools and workplaces.

    Hahn says "while the FDA is committed to help expedite this work, we will not cut corners in our decision-making."

    The agency has come under criticism for granting emergency authorization to a malaria drug touted by President Donald Trump as a treatment for coronavirus. The agency revoked that designation earlier this month after studies found the drug was ineffective against the virus.

    The U.S. is set to begin a 30,000-person trial of a government-created shot starting next month. Under the Trump administration's program dubbed "Operation Warp Speed," health officials aim to have 300 million doses on hand by January.

    About 15 experimental COVID-19 vaccines are in various stages of testing worldwide. There is no guarantee that any will prove effective.


    Study: Virus can infect heart cells in lab dish

    12:06 PM CT on 6/30/20

    The virus that causes COVID-19 can infect heart cells in a lab dish, which could mean the virus can affect cells in patients too.

    In a study published in Cell Reports Medicine, researchers found heart cells produced using stem cell technology could be infected by the coronavirus. Though some COVID-19 patients have experienced heart problems, it wasn’t clear if this was caused directly by the virus or if there were other factors, like pre-existing conditions or inflammation and oxygen deprivation.

    “We not only uncovered that these stem cell-derived heart cells are susceptible to infection by novel coronavirus, but that the virus can also quickly divide within the heart muscle cells,” said Arun Sharma, an author of the study. “Even more significant, the infected heart cells showed changes in their ability to beat after 72 hours of infection.”

    The study also found an ACE2 antibody could slow viral replication on the cells, demonstrating the ACE2 receptor could be how the virus enters the heart.

    “By blocking the ACE2 protein with an antibody, the virus is not as easily able to bind to the ACE2 protein, and thus cannot easily enter the cell,” said Sharma. “This not only helps us understand the mechanisms of how this virus functions, but also suggests therapeutic approaches that could be used as a potential treatment for SARS-CoV-2 infection.”


    How risky is flying during the coronavirus pandemic? 

    9:36 AM CT on 6/30/20

    (AP) Flying can increase your risk of exposure to infection, but airlines are taking some precautions and you can too.

    Air travel means spending time in security lines and airport terminals, which puts you into close contact with other people. As travel slowly recovers, planes are becoming more crowded, which means you will likely sit close to other people, often for hours, which raises your risk.

    Once on a plane, most viruses and other germs don't spread easily because of the way air circulates, according to the U.S. Centers for Disease Control and Prevention. Airlines also say they are focusing on sanitizing the hard surfaces that passengers commonly touch.

    Some airlines like Alaska, Delta, JetBlue and Southwest are blocking middle seats or limiting capacity. But even if every middle seat is empty you will likely be closer than the recommended distance of 6 feet to another passenger now that planes are getting fuller.

    American, United and Spirit are now booking flights to full capacity  when they can. All leading U.S. airlines require passengers to wear masks. Lauren Ancel Meyers, an expert in disease outbreaks at the University of Texas, says that can help limit risk.

    For air travel, and all other types of transportation, the CDC recommends washing your hands, maintaining social distancing and wearing face coverings.

    Several airlines announced Monday that they will ask passengers about possible COVID-19 symptoms and whether they have been in contact with someone who tested positive for the virus in the previous two weeks.

    Still, Meyers said you still might consider whether you need to be on that plane. "We should all be in the mindset of 'only if necessary' and always taking the most precautions we can to protect ourselves and others," she said.


    20% of US lives in a virus hot spot

    8:11 PM CT on 6/29/2020

    (AP) It’s been a frequent Trump administration talking point on the recent spike in COVID-19 infections: Don’t worry, only a small sliver of U.S. counties is at greater risk.

    In offering this reassurance, Vice President Mike Pence and HHS Secretary Alex Azar have said that only 3% or 4% of counties in the country are seeing a surge in cases. In fact, more than 20% of Americans live in those relatively few counties.

    Azar asserted Friday only 3% of counties represent “hot spots” that are “very concerning."

    The emphasis on a percentage of counties makes for a misleading portrayal of the virus threat.

    The White House provided The Associated Press with the full list of U.S. counties that reported increases in COVID-19 cases as of Friday. It showed 137 of the 3,142 counties in the U.S. that were under a higher alert — indeed, about 4% at the time.

    But measured by population, those counties represent a vastly higher share — over 1 in 5 people in the U.S.

    Altogether there are 68.3 million people living in those 137 counties, while there is a total U.S. population of 322.9 million. That means 21.1% of U.S. residents actually live in a virus “hot spot.”

    The population figures, both county level and national, come from the Census Bureau's American Community Survey five-year estimates for 2018, the latest available.


    Arizona shuts bars, theaters, parks amid virus resurgence

    7:04 PM CT on 6/29/2020

    (AP) Arizona's Republican governor shut down bars, movie theaters, gyms and water parks Monday and leaders in several states ordered residents to wear masks in public in a dramatic course reversal amid an alarming resurgence of coronavirus cases nationwide.

    Among those implementing the face-covering orders is the city of Jacksonville, Florida, where the mask-averse President Donald Trump plans to accept the Republican nomination in August. Less than a week after Mayor Lenny Curry said there would be no mask requirement, city officials announced that coverings must be worn in “situations where individuals cannot socially distance.”

    Trump has refused to wear a mask during visits to states and businesses that require them.

    Arizona Gov. Doug Ducey's order went into effect immediately and for at least 30 days. Ducey also also ordered public schools to delay the start of the classes at least until Aug. 17.

    “Our expectation is that our numbers next week will be worse,” he said.

    Arizona health officials reported 3,858 more confirmed coronavirus cases Sunday, the most reported in a single day in the state so far and the seventh time in the last 10 days that daily cases surpassed the 3,000 mark. Since the pandemic began, 74,500 cases and 1,588 deaths stemming from the virus have been reported in Arizona.

    Most Arizona bars and nightclubs opened after Ducey’s stay-at-home and business closure orders were allowed to expire in mid-May.

    The state is not alone in its reversal. Places such as Texas, Florida and California are backtracking, closing beaches and bars in some cases amid a resurgence of the virus. Oregon and Kansas, meanwhile, announced Monday that everyone would be required to wear masks in public.


    Oregon, Kansas set to require face coverings

    5:27 PM CT on 6/29/2020

    (AP) Gov. Kate Brown announced Monday that Oregon residents must wear face coverings in indoor public spaces starting Wednesday. The guidance applies to businesses and members of the public visiting indoor public spaces.

    Brown said she did not want to close businesses again as has happened in other states that are seeing a spike in cases. She said Oregon Occupational Safety and Health (OSHA) will take the lead in enforcing face covering requirements for all covered Oregon businesses.

    Meanwhile, Kansas Gov. Laura Kelly says she will also issue a mandate to use masks in public starting Friday to stop the spread of COVID-19.

    “The evidence could not be clearer — wearing a mask is not only safe, but it is necessary to avoid another shutdown,” the Democratic governor told reporters Monday.

    Kelly’s executive order would require every Kansan to wear a mask if they are around other people. She said her administration will issue specific guidance later this week and will work with the attorney general’s office to implement the policy.

    Kansas health officials reported on Monday at least 14,443 confirmed coronavirus cases, an increase of 905 since Friday. The state also had six more deaths from COVID-19, bring the total number of deaths in the state to 270. Kansas reported that 1,152 people had been hospitalized.


    Florida site of GOP convention orders wearing of masks

    4:07 PM CT on 6/29/20

    (AP) The city of Jacksonville, Florida, where mask-averse President Donald Trump plans to accept the Republican nomination in August, ordered the wearing of face coverings Monday, joining the list of state and local governments reversing course to try to beat back a resurgence of the coronavirus.

    Less than a week after Mayor Lenny Curry said there would be no mask requirement, city officials announced that coverings must be worn in "situations where individuals cannot socially distance."

    White House spokeswoman Kayleigh McEnany responded by saying the president's advice is to "do whatever your local jurisdiction requests of you."

    Trump has refused to wear a mask during visits to states and businesses that require them.

    In recent weeks, the Republicans moved some of the convention pageantry to Jacksonville after Democratic Gov. Roy Cooper of North Carolina objected to the holding of a large gathering in Charlotte without social-distancing measures. The convention will be in late August.

    Florida Gov. Ron DeSantis, a Republican, has opposed a statewide mask requirement but said in response to Jacksonville's action that he will support local authorities who are doing what they think is appropriate.

    The Jacksonville order came on the same day that the head of the World Health Organization warned that the pandemic is "not even close to being over" and is accelerating.

    "The worst is yet to come," said Tedros Adhanom Ghebreyesu. "With this kind of environment and condition, we fear the worst."


    Senate leaders devolve to partisan bickering over drug-pricing reform

    2:25 PM CT on 6/29/20

    The top Republican and Democrat on the Senate Finance Committee publicly sniped at each other on Monday over the fate of drug-pricing reform in the next COVID-19 package.

    Senate Finance Chair Chuck Grassley (R-Iowa) published an op-ed in the Wall Street Journal accusing Democratic leadership of deciding to walk away from the negotiating table on drug pricing. He also insinuated that his successor as chairman of the Finance Committee next Congress may not be willing to work on drug pricing reform.

    “I can only assume the Democratic Party would rather use the issue of drug prices as a political hammer in November’s election than work to address it now. Perhaps they hope to pass more left-leaning legislation next year, if they win more power,” Grassley wrote.

    But Finance Committee ranking member Ron Wyden (D-Ore.) hit back at Grassley’s characterization and blamed Senate Majority Leader Mitch McConnell (R-Ky.) for failing to take up the bill. Wyden also called for bipartisan, bicameral talks including House Democrats’ drug-pricing proposal that is significantly more aggressive than the Senate Finance proposal.

    “Senate Democrats are not interested in aiding Republicans as they play political games and pretend to support lowering prescription drug prices,” Wyden said in a statement.

    The two lawmakers negotiated for months last year to craft a bipartisan drug-pricing package with reforms including capping seniors’ out-of-pocket costs in Medicare Part D, limiting Medicare’s liability for drug-price increases, and spreading seniors’ cost-sharing for drugs over the full year. The bill passed out of committee with the support of all Democrats and a few Republicans, and McConnell has since been loath to take up legislation that divides his party. Grassley has since been trying to whip Republican support for the legislation.

    Several Medicare and Medicaid program extensions that will need to be renewed expire in November, and that package is seen as a potential vehicle for drug-pricing and surprise billing legislation during the lame-duck session.


    Clinical trials test low-dose radiation to treat COVID-19

    12:02 PM CT on 6/29/20

    Two clinical trials will test whether low-dose radiation can reduce lung inflammation associated with COVID-19.

    Previous studies have shown low-dose radiation can help patients with pneumonia with few side effects. One COVID study will be conducted on patients who have difficulty breathing but are not yet on a ventilator, and another will test patients who are critically ill and need mechanical ventilation.

    “There is a substantial overlap between proinflammatory cellular reactions that occur in COVID-19 patients and those suppressed by low-dose radiation,” said Dr. Arnab Chakravarti, who will lead both studies. “Hitting that infection with low-dose radiation could be an effective anti-inflammatory therapy to reduce inflammation and improve respiratory challenges associated with COVID-19 pneumonia, providing patients with critical symptom relief and giving them a better opportunity to recover from these sometimes life-threatening infections.”


    Study: COVID-19 patients with HIV didn’t have worse outcomes

    10:21 AM CT on 6/29/20

    Patients with HIV who were hospitalized for COVID-19 did not have worse outcomes than those without HIV,  according to a study published in Clinical Infectious Diseases.

    Researchers compared 88 patients with HIV who had tested positive for COVID-19 with control groups of patients with similar demographic characteristics, like age, sex and race. Patients with HIV didn’t have more severe symptoms or worse outcomes compared to those without HIV.

    “Throughout the pandemic, we've suspected that immunocompromised patients, such as those with HIV, could be at a higher risk for infection and suffer more severe outcomes, but without data on how COVID-19 affects patients with HIV specifically, clinical guidance for managing and advising these patients has been lacking,” said Dr. Keith Sigel, a study author.  “This study sets the foundation for future studies in larger cohorts so we can appropriately address treating COVID-19 in patients with HIV.”


    Texas Medical Center deleted ICU data on coronavirus

    7:32 PM CT on 6/28/2020

    The Texas Medical Center, a group of hospitals and healthcare research facilities in Houston that make up most of the area's intensive care Sunday removed all previously published admission numbers from its website, according to Newsweek.

    The data was collected from at least seven hospitals affiliated with the TMC's medical network.

    The TMC also published data that showed ongoing changes to Houston's overall ICU capacity, which reached 100% late last week. On Wednesday, the data found that 900 additional emergency beds could be added to local hospitals.

    Confirmed cases of the coronavirus in Texas have continued to surge on Saturday with the state reporting 5,747 new cases. A day earlier, Gov. Greg Abbott shut down bars again and scaled back restaurant dining as cases climbed to record levels after the state embarked on one of America’s fastest reopenings. The Texas Department of State Health Services said the new number of cases reported Saturday brought the state’s total to 143,371 confirmed cases. Also Saturday, health officials said 42 more deaths were reported from the virus, bringing the state’s total to 2,366.


    Worldwide coronavirus death toll exceeds 500,000

    4:55 PM CT on 6/28/2020

    (AP) Another tragic milestone was passed Sunday in the coronavirus pandemic: 500,000 deaths worldwide.

    The reported tally comes from Johns Hopkins University researchers.

    About 1 in 4 of those deaths – more than 125,000 – have been reported in the U.S. The country with the next highest death toll is Brazil, with more than 57,000, or about 1 in 9.

    The true death toll from the virus, which first emerged in China late last year, is widely believed to be significantly higher. Experts say that especially early on, many victims died of COVID-19 without being tested for it.

    To date, more than 10 million confirmed cases have been reported globally. About a quarter of them have been reported in the U.S.


    Experts see no proof of child-abuse surge amid pandemic

    4:21PM CT on 6/28/2020

    (AP) When the coronavirus pandemic took hold across the U.S. in mid-March, forcing schools to close and many children to be locked down in households buffeted by job losses and other forms of stress, many child-welfare experts warned of a likely surge of child abuse.

    Fifteen weeks later, the worries persist. Yet some experts on the front lines, including pediatricians who helped sound the alarm, say they have seen no evidence of a marked increase.

    Among them is Dr. Lori Frasier, who heads the child-protection program at Penn State’s Hershey Medical Center and is president of a national society of pediatricians specializing in child abuse prevention and treatment.

    Frasier said she got input in recent days from 18 of her colleagues across the country and “no one has experienced the surge of abuse they were expecting.”

    A similar assessment came from Jerry Milner, who communicates with child-protection agencies nationwide as head of the Children’s Bureau at the federal Department of Health and Human Services. “I’m not aware of any data that would substantiate that children are being abused at a higher rate during the pandemic,” he told The Associated Press.

    Still, some experts believe the actual level of abuse during the pandemic is being hidden from view because many children are seeing neither teachers nor doctors, and many child-protection agencies have cut back on home visits by caseworkers.

    “There’s no question children are more at risk — and we won’t be able to see those children until school reopens,” said Marci Hamilton, a University of Pennsylvania professor who heads CHILD USA, a think tank seeking to prevent child abuse and neglect.

    Several states said calls to their child-abuse hotlines dropped by 40% or more, which they attributed to the fact that teachers and school nurses, who are required to report suspected abuse, no longer had direct contact with students.

    “While calls have gone down, that doesn’t mean abuse has stopped,” said Gov. Chris Sununu of New Hampshire, which reported a 50% drop in hotline calls.

    Comprehensive data on abuse during the pandemic won’t be available for many months, according to Milner.


    Arizona reports record number of cases

    2:32PM CT on 6/28/2020

    (AP) Arizona health officials reported 3,858 more confirmed coronavirus cases on Sunday, the most reported in a single day in the state so far.

    It was also the seventh time in the last 10 days that daily cases surpassed the 3,000 mark.

    The Arizona Department of Health Services also reported nine additional deaths. That pushes Arizona’s documented COVID-19 totals to nearly 74,000 cases and 1,588 known deaths.

    Some Arizona hospitals have begun activating surge plans to increase their capacity to treat COVID-19 patients as confirmed cases rise and more people seek treatment.

    Arizona became a coronavirus hot spot following Gov. Doug Ducey’s lifting of stay-home orders last month.


    South Korea still coping with new virus clusters

    12:15 PM CT on 6/28/2020

    (AP) South Korea has confirmed 62 additional cases of the coronavirus over a 24-hour period as the Asian country continues to face new clusters of infections amid eased social distancing rules.

    The additional cases reported Sunday took the country’s total to 12,715, with 282 deaths.

    The Korea Centers for Disease Control and Prevention says 40 of the newly reported cases were domestically infected, while the other 22 came from overseas. It says 26 of the 40 domestic cases were detected in the densely populated Seoul metropolitan area.

    South Korea has been struggling to suppress a spike in new cases since it eased up on its rigid social distancing rules in early May. Those new cases have been linked to nightclubs, church services, a huge e-commerce warehouse and low-income workers.


    Confirmed virus cases hit 10 million as Poland, France vote

    10:02 AM CT on 6/28/2020

    Worldwide confirmed coronavirus infections hit the 10 million mark Sunday.

    New clusters of cases at a Swiss nightclub and in the central English city of Leicester showed that the virus was still circulating widely in Europe, though not with the rapidly growing infection rate seen in parts of the U.S., Latin America and India.

    While concern in the U.S. has focused on big states like Texas, Arizona and Florida reporting thousands of new cases a day, rural states are also seeing infection surges, including in Kansas, where livestock outnumber people.

    The U.S. handling of the outbreak has drawn concern from abroad. The European Union seems almost certain to bar Americans from traveling to the bloc in the short term as it draws up new travel rules to be announced shortly.

    The infection surges prompted Vice President Mike Pence to call off campaign events in Florida and Arizona, although he will still travel to those states and to Texas this week to meet with their Republican governors. Those three governors have come under criticism for aggressively reopening their economies after virus lockdowns despite increasing infections in their states.

    After confirmed daily infections in the U.S. hit an all-time high of 40,000 on Friday, Texas and Florida reversed course and closed down bars in their states again. Arizona Republican Gov. Doug Ducey reversed himself and allowed cities and counties to require face masks in public even though he hasn’t been seen wearing one.

    “This is not a sprint, this is a marathon,” said Dr. Lisa Goldberg, director of the emergency department of Tucson Medical Center in Arizona. “In fact, it’s an ultra-marathon.”

    U.S. Health and Human Services Secretary Alex Azar stressed that “the window is closing” for the U.S. to take action to effectively curb the coronavirus.

    Azar pointed to a recent spike in infections, particularly in the South. He says people have “to act responsibly” by social distancing and wearing face masks, especially “in these hot zones.”

    Speaking on NBC and CNN, Azar argued that the U.S. is in a better position than two months ago in fighting the virus because it is conducting more testing and has therapeutics available to treat COVID-19.

    But he acknowledged that hospitalizations and deaths could increase in the next few weeks.

    Globally, confirmed COVID-19 cases passed the 10 million mark and confirmed deaths neared half a million, according to a tally by the Johns Hopkins University, with the U.S., Brazil, Russia and India having the most cases. The U.S. also has the highest virus death toll in the world at over 125,000.

    Experts say all those figures significantly undercount the true toll of the pandemic, due to limited testing and missed mild cases. U.S. government experts last week estimated the U.S. alone could have had 20 million cases.

    Lower-income California areas more likely to be hit by virus

    7:17 PM CT on 6/27/20

    (AP) Data show hundreds of new infections in densely populated neighborhoods that are more likely home to low-income residents in one California county.

    Orange County health officials say residents living certain parts of Anaheim and Santa Ana are more likely to live in multi-generational or multifamily households and many of them hold jobs in stores and restaurants.

    Cases and hospitalizations in the county have grown significantly in the last couple weeks, reflecting a statewide trend that prompted Gov. Gavin Newsom this week to sound renewed alarm bells. He urged Imperial County to reimpose a stay-at-home order to deal with a high rate of positive cases and hospitalizations.


    California governor steps up urgency of virus messaging

    4:55 PM CT on 6/27/20

    (AP) California Gov. Gavin Newsom issued his sharpest warning yet on the rising coronavirus threat, announcing for the first time the state wanted a county to shut down again, pleading with residents to wear masks and reminding them that dozens of people are dying each day — 79 more reported Friday.

    "Please, even if you don't feel sick, you may be transmitting this disease," he said. "Please, please, practice common sense, common decency. Protect yourself, but also protect others. ... What more evidence do we need?"

    His tone marked a shift from his policy-wonk style on display at three press conferences earlier in the week, where he talked about data modeling and delivered a trove of statistics, but offered assurances that the state's hospitals were prepared to deal with patients.

    The emotional appeal came as Newsom was pressed repeatedly on whether California's messages about the virus were clear. While California has allowed most counties to open everything from restaurants to gyms, Newsom and other officials have warned about the risks of private gatherings, particularly inside. As caseloads and hospitalizations rise, Newsom has stated that a broad shutdown isn't necessary because of hospital capacity.


    As cases surge in US, rural areas seeing increases as well

    3:11 PM CT on 6/27/20

    For many states and counties in the U.S., the dark days of the coronavirus pandemic in April unfolded on their television screens, not on their doorsteps. But now, some places that appeared to have avoided the worst are seeing surges of infections, as worries shift from major cities to rural areas.

    While much of the focus of concerns that the United States is entering a dangerous new phase has been on big Sunbelt states that are reporting thousands of new cases a day — like Texas and Florida — the worrying trend is also happening in places like Kansas, where livestock outnumber people.

    In early June, Kansas looked to be bringing its outbreak under control, but its daily reported case numbers have more than doubled in recent weeks. On June 5, the seven-day average for daily new cases hovered at around 96; by Friday, that figure was 211. As cases rise, the U.S. Army commander at Fort Riley in the state's northeast ordered his soldiers to stay out of a popular nearby restaurant and bar district after 10 p.m.

    Idaho and Oklahoma have seen similarly large percentage increases over the same three-week period, albeit from low starting points. In Oklahoma, the seven-day average for daily new cases climbed from about 81 to 376; Idaho's jumped from around 40 to 160.

    Many rural counties in states including California, Arkansas, Missouri, Kansas, Texas and Florida have seen their confirmed cases more than double in a week, from June 19 to Friday, according to data compiled by Johns Hopkins University. Lassen County, California, went from just nine cases to 172, and Hot Spring County, Arkansas, went from 46 cases to 415; both spikes were attributed to outbreaks at prisons. Cases in McDonald County, Missouri, more than tripled after Tyson Foods conducted facility-wide testing at a chicken plant there.


    Coronavirus task force briefs — but not at White House

    1:01 PM CT on 6/27/20

    (AP) There was no presidential appearance and no White House backdrop when the government's coronavirus task force briefed the public for the first time since April — in keeping with an administration effort to show it is paying attention to the latest spike in cases but is not on a wartime footing that should keep the country from reopening the economy.

    The Friday briefing at HHS was held as the number of confirmed new coronavirus infections per day in the U.S. soared to an all-time high of 40,000 — higher even than during the deadliest stretch in April and May. In light of the new surge, task force briefers chose their words carefully to update the public about COVID-19, which has become both a public health and political issue.

    Vice President Mike Pence had the most delicate line to walk. He acknowledged a surge in new cases across the South and West, while backing the president's desire to get the economy up and running without mentioning that it will also help the prospects for reelection.

    "As we see new cases rising, and we're tracking them very carefully, there may be a tendency among the American people to think that we are back to the place that we were two months ago — in a time of great losses and a great hardship on the American people," Pence said.

    But the vice president also took note of positive job numbers and added: "The reality is we're in a much better place."


    What to wear: Feds' mixed messages on masks sow confusion

    11:18 AM CT on 6/27/20

    Forgive the American people if they're in a fog about face masks. President Donald Trump and the federal government have done a number on them.

    First there was the don't-do-it phase. Then the nice-but-not-for-me dissonance. Followed by the local-rules-don't-apply exceptions. Topped off by Trump's stated suspicion that some people wear masks just to troll him.
    It has all added up to a murky message about one of the critical tools in the fight against the coronavirus pandemic.

    To be clear: The Centers for Disease Control and Prevention recommends that people wear cloth face coverings in public settings where other social distancing measures are difficult to maintain. Some states and local communities require them.

    But the messaging disconnect from Washington was evident as recently as Friday, when Vice President Mike Pence defended Trump's decision to stage two big mask-scarce gatherings in the past week in states with big surges in infections and, in one case, local rules requiring masks.


    Virus visitor bans renew interest in nursing home cameras

    9:12 AM CT on 6/27/20

    (AP) Visitation bans at nursing homes have renewed interest in legislation that would allow families to put remote cameras inside the facilities to help see how loved ones are doing.

    Before the pandemic, cameras were seen as a way to identify elder abuse and neglect. But now, many hope they could bring comfort after visitation bans imposed to stem the devastating tide of COVID-19 inside nursing homes left many families struggling to get information.

    "That visitation ban, it was really, really upsetting to people. And I think understandably, Some facilities aren't great about sharing information about what's going on," said Anna Doroghazi, the associate state director for AARP in Connecticut.

    About a dozen states already have laws or regulations in place allowing residents and their families to install video cameras, subject to certain rules.

    Last month, Missouri lawmakers passed legislation allowing families to request cameras to connect with loved ones in a nursing home. The state's governor is reviewing the legislation. Camera bills have also gained new life in other states, including Ohio and Connecticut.


    Trump administration to give Congress full virus loan data

    8:20 PM CT on 6/26/20

    (AP) After prodding from Democratic lawmakers, the Trump administration has agreed to give Congress — but not the public — complete data on the millions of small businesses that received loans from a $600 billion-plus coronavirus aid program. 

    Senior administration officials told lawmakers they will provide full details on the roughly 4.7 million taxpayer-funded loans worth $515 billion awarded under the Small Business Administration’s Paycheck Protection Program. Their concession came with a warning to lawmakers not to divulge “confidential” loan information to the wider public.

    The administration’s move is “a step in the right direction,” said Erin Hatch, spokesperson for Rep. Richard Neal, D-Mass., chair of the House Ways and Means Committee, though Neal believes the names of all recipients should be made public. 

    Rep. Nydia Velazquez, D-N.Y., told The Associated Press in an email that while it’s unfortunate it took so much pressure from Congress, “this is a valuable step, and we will be carefully reviewing the data to ensure that taxpayers and small businesses are being properly served by the program.” Velazquez heads the House Small Business Committee. 

    Last week, the Treasury Department and SBA relented to pressure from lawmakers and watchdogs and agreed to publicly disclose details on which businesses received loans under the program. Up to now, SBA has only provided summary information about the beneficiaries of its loans, such as the industry the businesses are in and the state in which they are located.

    But it will be only a partial disclosure: For loans of less than $150,000, the agencies will not publicly name the recipients, revealing only loan amounts and summary information broken down by ZIP code, industry and demographics, and the number of jobs they helped protect.

    The SBA has processed 4.7 million loans worth about $515 billion. Nearly 75% of the total money approved so far has gone to businesses borrowing more than $150,000. But 86% of the loans have gone to businesses borrowing less than $150,000.

    Under the new agreement, the agencies will provide the complete data on loans of all sizes to the congressional oversight panels. Data on loans under $150,000 will only be provided to Congress, not the public. And Mnuchin and Carranza told Neal, Velazquez and Rep. Maxine Waters, D-Calif., head of the House Financial Services Committee, in a letter that it will be given “with the understanding that nonpublic, personally identifiable and commercially sensitive business information will be treated as confidential.”


    Georgia lawmakers: Block COVID-19 lawsuits against business

    7:15 PM CT on 6/26/20

    (AP) Georgia lawmakers want to protect businesses and other from being sued if someone blames them for contracting COVID-19, but House members voted Friday for less-extensive protections than the business community sought.

    House members voted 104-56 to approve Senate Bill 359, sending it back to the Senate for more debate in the closing hours of the 2020 legislative session.

    “People need to be able to get back to work, and the way people get back to work is businesses feeling comfortable opening themselves up,” said House Majority Whip Trey Kelley, a Cedartown Republican.

    The bill is the result of weeks of haggling among lawmakers, business groups and plaintiff's lawyers. The Senate on Tuesday approved a bill that would have made it even harder to sue, adopting the business community's preferred language.

    Democrats argued that the bill is overly broad and should, at most, protect health care institutions. House Minority Leader Bob Trammell, a Luthersville Democrat, said the bill risked letting businesses off the hook for safety.

    “Let me tell you something: businesses don’t get COVID, people get COVID," Trammell said. "This bill doesn’t seek to protect people against COVID, it seeks to protect businesses against people.”

    Trammell argued lawmakers should instead be seeking to provide better protections for frontline workers.

    “We need to be legislating about public health measures that will keep people safe,” Trammell said.

    Under the language approved Friday, a business, health care provider or protected entity would have to display gross negligence, “willful and wanton misconduct” or reckless or intentional infliction of harm to lose a lawsuit.

    That’s higher than the regular standard of negligence, but the Senate had removed even gross negligence, leading opponents to argue that it would be almost impossible to win a lawsuit.

    The Georgia Chamber of Commerce and others have called for a lawsuit shield.

    “These are things we have to do to get our lives moving again,” Kelley said.

    Gov. Brian Kemp already exempted hospitals and medical professionals from liability by executive order, but protections run out when Kemp’s emergency powers expire.

    But some Democratic critics said even health care institutions shouldn't be protected.

    Rep. Al Williams, a Midway Democrat, noted that nursing home residents have disproportionately died, and said lawmakers shouldn’t cut off lawsuits against nursing homes that may have poor records of caring for residents.

    “The legislation protects those who don't deserve protection because they were lousy at business before the pandemic and they will be lousy at business after the pandemic,” Williams said.


    Stocks sink as virus cases jump, forcing states to backtrack

    5:19 PM CT on 6/26/20

    (AP) Stocks on Wall Street fell sharply Friday as confirmed new coronavirus infections in the U.S. hit an all-time high, prompting Texas and Florida to reverse course on the reopening of businesses.

    The combination injected new jitters into a market that's been mostly riding high since April on hopes that the economy will recover from a deep recession as businesses open doors and Americans begin to feel more confident that they can leave their homes again.

    The S&P 500 dropped 2.4%, giving up all of its gains after a rally the day before. The sell-off capped a choppy week of trading that erased the benchmark index's gains for the month. Even so, the S&P 500 is still on pace for its best quarter since 1998.

    The surge in the number of confirmed new coronavirus cases prompted Texas and Florida to reverse course and clamp down on bars again. The two states join a small but growing list of those that are either backtracking or putting any further reopenings of their economies on hold because of a resurgence of the virus.

    “That certainly calls into question how vigorous this recovery will be,” said Bill Northey, senior investment director at U.S. Bank Wealth Management. “We have to acknowledge there’s a high degree of uncertainty about how this is going to progress for the balance of the year.”

    The S&P 500 fell 74.71 points to 3,009.05. The Dow Jones Industrial Average had its worst day in two weeks, losing 730.05 points, or 2.8%, to 25,015.55. The Nasdaq, which hit an all-time high earlier this week, dropped 259.78 points, or 2.6%, to 9,757.22.

    Markets have been mostly rallying since April on hopes that U.S. states and regions around the world could continue to lift the spring lockdowns put in place to slow the spread of the coronavirus. The increase in cases casts doubt on expectations that the economy will continue to reopen and things can get back to normal sooner, rather than later.

    The stock market is likely to remain volatile as traders weigh the ups and downs in the trajectory of the pandemic.

    “In large part, we’re going to see some of these fits and starts,” said Charlie Ripley, senior investment strategist for Allianz Investment Management. “It’s going to weigh on sentiment to some extent, but overall we think the economy is on the mend and the recovery is on its the way."

    Major indexes in Europe closed mostly lower, and Asian markets finished mostly higher.


    Trump administration extending support for Texas COVID-19 test sites

    4:34 PM CT on 6/26/20

    The Trump administration is extending by 14 days the cutoff date of federal support for five COVID-19 test sites in Texas.

    In its announcement Friday, HHS said it was making the extension in respond to a request from the state of Texas, which has seven Community-Based Testing Sites in total. The federal government had previously planned to end funding for 13 such sites in five states on June 30, in accordance with an agreement from May.

    Dr. Brett Giroir, HHS' assistant secretary for health, said in a statement his office received an extension request from Texas’ health department on Thursday.

    That wasn’t the first extension request the agency received. Rep. Sylvia Garcia (D-Texas), whose district covers the eastern portion the Houston metro area, sent the head of HHS a letter on Tuesday asking for funding to continue through August 30.

    Officials in Illinois told Modern Healthcare on Thursday they had also submitted an extension request, but it had been denied.

    “We will continue to closely monitor COVID-19 diagnoses and assess the need for further federal support of these sites as we approach the extension date,” Giroir said.

    As part of the extension, HHS said it will provide additional resources to help Texas to prepare for the sites to become state run.


    U.S. officials change virus risk groups, add pregnant women

    2:55 PM CT on 6/26/20

    (AP) The nation's top public health agency on Thursday revamped its list of which Americans are at higher risk for severe COVID-19 illness, adding pregnant women and removing age alone as a factor.

    The Centers for Disease Control and Prevention also changed the list of underlying conditions that make someone more susceptible to suffering and death. Sickle cell disease joined the list, for example. And the threshold for risky levels of obesity was lowered.

    The changes didn't include adding race as a risk factor for serious illness, despite accumulating evidence that Black people, Hispanics and Native Americans have higher rates of infection, hospitalization and death.

    Agency officials said the update was prompted by medical studies published since CDC first started listing high-risk groups. They sought to publicize the information before Independence Day weekend, when many people may be tempted to go out and socialize.

    "For those at higher risk, we recommend limiting contact with others as much as possible, or restricting contacts to a small number of people who are willing to take measures to reduce the risk of (you) becoming infected," said CDC Director Dr. Robert Redfield.

    The same advice holds for people who live with or care for people at higher risk, Redfield added.

    Previously, the CDC said those at high risk of serious illness included people aged 65 years and older; those who live in a nursing home or long-term care facility; and people with serious heart conditions, obesity, diabetes, liver disease, chronic kidney disease, chronic lung disease, and conditions that leave them with weakened immune systems.

    In the changes, CDC created categories of people who are at high risk and people who might be at high risk.

    Those who are at high risk include people with chronic kidney disease, chronic inflammatory lung disease, obesity, serious heart conditions, sickle cell disease, Type 2 diabetes, and weakened immune systems because of organ transplants. The threshold for obesity concern was lowered from a body mass index of 40 down to 30.

    The CDC said people are at increasing risk as they get older, but it removed people 65 and older as a high risk group.

    The list of people who might be at high risk includes pregnant women, smokers and those with asthma, diseases that affect blood flow to the brain, cystic fibrosis, high blood pressure, dementia, liver disease, scarred or damaged lungs, Type 1 diabetes, a rare blood disorder called thalassemia, and people who have weakened immune systems due to HIV or other reasons.


    COVID-19 positivity rates vary by senior living facility

    1:29 PM CT on 6/26/20

    Nursing home residents are most susceptible to COVID-19 compared to their peers in other types of senior living facilities, a new report shows.

    More than 4% of nursing home residents tested positive for COVID-19, according to a National Investment Center for Seniors Housing & Care analysis of May 31 data from 105 senior home operators. Memory care facilities had the next highest positivity rates at 3.7%, followed by assisted living at 1.2% and independent living at 0.2%. Nursing home operators also had the most tests.

    Each type of facility offers different levels of care and serves different populations, requiring a tailored approach to mitigation efforts, said Brian Jurutka, NIC president and CEO.

    “These facilities changed procedures dramatically since the pandemic began, as testing and treatment guidelines became available,” he said in prepared remarks. “The more that is known about COVID-19 in senior care facilities over time, the more informed decisions can be about how to keep residents healthy and safe.”


    Vizient: Demand for dexamethasone increases 610%

    11:31 AM CT on 6/26/20

    Demand for dexamethasone has increased 610% after a study found the drug may reduce mortality for patients who are severely ill with COVID-19.

    The U.K. study, which has not yet been peer-reviewed, found the drug reduced mortality by one-third for patients on ventilators. Dexamethasone has been used since the 1960s to reduce inflammation caused by a variety of conditions.

    Vizient found the fill rate for the drug has dropped to 54% at member hospitals. But Dan Kistner, group senior vice president of pharmacy solutions for Vizient, said the supply chain could adapt to the increase in demand.

    “Dexamethasone is a workhorse drug for hospitals and it is good that there are several manufacturers in the supply chain,” Kistner said.  “Vizient is in communications with both manufacturers and distributors about the increase in demand and will be monitoring availability and supply of various presentations of dexamethasone as we continue to see the increase in demand.”


    Confirmed new virus cases hit a new high in the U.S.

    9:38 AM CT on 6/26/20

    (AP) The number of confirmed new coronavirus cases per day in the U.S. hit an all-time high of 40,000 Friday — eclipsing the mark set during one of the deadliest stretches in late April — in a resurgence that has led some governors to backtrack or at least pause the reopening of their states.

    While the increase is believed to reflect, in part, greatly expanded testing, experts say there is ample evidence the virus is making a comeback, including rising deaths and hospitalizations in parts of the country, especially in the South and West. Arizona, Texas, Florida and Arkansas are among the states that have been hit hard.

    The number of confirmed new infections soared past the previous high set on April 24 of 36,400, according to the count kept by Johns Hopkins University.

    Deaths from the coronavirus in the U.S. are down to around 600 per day, compared with about 2,200 in mid-April. Some experts have expressed doubt that deaths will return to that level, in part because of advances in treatment and prevention but also because a large share of the new infections are in younger adults, who are more likely than older ones to survive.

    The virus is blamed for 124,000 deaths in the U.S. and 2.4 million confirmed infections nationwide, by Johns Hopkins' count. But U.S. health officials said the true number of Americans infected is about 20 million, or almost 10 times higher. Worldwide, the virus has claimed close to a half-million lives, according to Johns Hopkins.


    AMA updates CPT codes for COVID-19 antigen tests

    7:55 PM CT on 6/25/20

    The American Medical Association added a new code to report COVID-19 antigen testing. These tests can be done at point of care and the association believes they could help with testing shortages across the country. 

    The new code was approved Wednesday by the Current Procedural Terminology (CPT) Editorial Panel. The tests use immunofluorescent or immunochromatographic techniques to detect the virus.

    “The new CPT code for antigen testing to detect the coronavirus is the latest in a series of CPT codes developed in rapid response to the pandemic,” AMA President Dr. Susan R. Bailey said in a statement. “Moving quickly during this crisis to meet the medical coding needs of the health care industry has enhanced the reporting of innovative tools now available to advance medicine's overarching goals of reducing the COVID-19 disease burden, improving health outcomes and reducing long-term care costs.”


    Some states pause reopening as virus cases near record high

    7:02 PM CT on 6/25/20

    (AP) The coronavirus crisis deepened in Arizona on Thursday, and the governor of Texas began to backtrack after making one of the most aggressive pushes in the nation to reopen, as the daily number of confirmed cases across the U.S. closed in on the peak reached during the dark days of late April.

    While greatly expanded testing probably accounts for some of the increase, experts say other measures indicate the virus is making a comeback. Daily deaths, hospitalizations and the percentage of tests that are coming back positive also have been rising over the past few weeks in parts of the country, mostly in the South and West.

    In Arizona, 23% of tests conducted over the past seven days have been positive, nearly triple the national average, and a record 415 patients were on ventilators. Mississippi saw its daily count of confirmed cases reach record highs twice this week.

    “It's not a joke. Really bad things are going to happen,” said Dr. Thomas Dobbs, Mississippi's health officer.

    Republican Gov. Greg Abbott of Texas, whose state was among the first to reopen, put off lifting any more restrictions and reimposed a ban on elective surgeries in some places to preserve hospital space after the number of patients statewide more than doubled in two weeks. Some Arizona hospitals also halted elective surgeries. Nevada’s governor ordered face masks be worn in public, Las Vegas casinos included.

    “The last thing we want to do as a state is go backwards and close down businesses,” Abbott said.


    FCC closes applications for COVID-19 Telehealth Program

    5:36 PM CT on 6/25/20

    The Federal Communications Commission's Wireline Competition Bureau is no longer accepting applications for the COVID-19 Telehealth Program, the agency said Thursday.

    The FCC as of June 24 has approved a collective $157.64 million in funding for 444 healthcare organizations as part of the COVID-19 Telehealth Program. That's more than 75% of the $200 million that Congress allocated for the program as part of the Coronavirus Aid, Relief, and Economic Security Act.

    Congress under the CARES Act authorized $200 million for the FCC to set up a program to provide healthcare organizations with funds to purchase telecommunications equipment, broadband connectivity and devices needed to offer telehealth services during the COVID-19 pandemic. The FCC opened the program in April.

    FCC officials expect to exhaust the remaining COVID-19 Telehealth Program funds as they continue to evaluate applications already submitted to the agency.

    "Based on the applications received to date, demand for funding exceeds available program funds," reads a public notice posted by the FCC. "As a result, the public interest is not served by imposing burdens on healthcare providers who may prepare new applications that cannot be funded under the current appropriation."

    Healthcare organizations receive funding after submitting an invoice and supporting documentation for eligible services, as a form of reimbursement. That means the $157.64 million in funding the agency has announced to date, while approved, has not necessarily been distributed to designated healthcare organizations yet.


    California uses funding as threat over virus measures

    4:49 PM CT on 6/25/20

    (AP) As California sees a worrisome rise in the number of coronavirus cases and hospitalizations, Gov. Newsom threatened Wednesday to withhold up to $2.5 billion in the upcoming state budget from local governments that fail to comply with state mandates on wearing masks, testing and other measures meant to slow the spread of the virus.

    "There are some that have made rhetorical comments about not giving a damn," Newsom said in some of his most strident comments to date. "That's exactly why I look forward to signing this budget that will afford me a little bit of leverage in that conversation."

    The money is intended to help local governments pay for services needed because of the pandemic. But it is contingent upon counties following emergency orders to enforce the safety measures as they gradually reopen the economy.

    Newsom's warning came as the state recorded a 69% increase in new cases this week, and set several daily records for new cases. Officials reported corresponding increases in the rate of people testing positive and hospitalizations. Still, Newsom said the state is prepared to handle the trends.

    The governor said he views the $2.5 billion in the budget lawmakers are expected to approve this week as a reward, not a punishment for local government.

    "When people simply thumb their nose and do not come with a collaborative spirit ... then by all means the state of California has a responsibility, an obligation — legally and otherwise — to enforce those laws and to utilize the tools that are afforded us," he said.

    Newsom said he plans to hand out the money monthly, based on counties' compliance. However, the budget bill before lawmakers leaves it up to local governments to certify to the state that they are complying.

    Orange County Board of Supervisors Chairwoman Michelle Steel called the budget measure "an act of extortion, and an arbitrary exercise of power."

    Assemblyman James Gallagher, a Republican who is fighting the Democratic governor in court over his orders, said Newsom "is instituting a one-size-fits-all mandate, this time with major financial consequences if, in his sole discretion, we haven't complied."

    "And now in our time of greatest need, our federal funds are being held hostage," he added.


    Report: 'Baffling' errors at vets home amid deadly outbreak

    2:35 PM CT on 6/25/20

    (AP) The leadership of a home for aging veterans in Massachusetts where nearly 80 residents sickened with the coronavirus have died packed dementia patients into a crowded unit as the virus spread, one of several "utterly baffling" decisions that helped the disease run rampant, investigators said in a report released Wednesday.

    The superintendent of the Holyoke Soldiers' Home was not qualified to run a long-term care facility and "substantial errors and failures" he and his team made likely contributed to the high death toll there, investigators found. Among them was a decision prompted by staffing shortages to combine two locked dementia units, both of which already housed some residents with the virus.

    "Rather than isolating those with the disease from those who were asymptomatic — a basic tenet of infection control — the consolidation of these two units resulted in more than 40 veterans crowded into a space designed to hold 25. This overcrowding was the opposite of infection control; instead, it put those who were asymptomatic at even greater risk of contracting COVID-19," the report said.

    When a social worker raised concerns about the move, the chief nursing officer said "it didn't matter because (the veterans) were all exposed anyway and there was not enough staff to cover both units," the report said. One staffer who helped move the dementia patients told investigators she felt like she was "walking (the veterans) to their death." A nurse said the packed dementia unit looked "like a battlefield tent where the cots are all next to each other."

    As the virus took hold, leadership shifted from trying to prevent its spread, "to preparing for the deaths of scores of residents," the report said. On the day the veterans were moved, more than a dozen additional body bags were sent to the combined dementia unit, investigators said. The next day, a refrigerated truck to hold bodies that wouldn't fit in the home's morgue arrived, the report said.

    Since March 1, 76 veterans who contracted COVID-19 at the home have died, officials said. Another 84 veterans and more than 80 staff have also tested positive.

    The first veteran tested positive March 17. Even though he had been showing symptoms for weeks, staff "did nothing to isolate" him until his test came back positive, allowing him to remain with three roommates, wander the unit and spend time in a common room, investigators said.

    An attorney for the superintendent, Bennett Walsh, said they dispute many of the investigation's findings and are "disappointed that the report contains many baseless accusations that are immaterial to the issues under consideration." The lawyer said in an emailed statement that "Walsh reached out for help when the crisis erupted" and sought National Guard assistance.

    "The failure of the Commonwealth to affirmatively respond to that request contributed to many of the problems outlined in the report," the attorney, William Bennett, said.


    Mich. Senate: Send patients to new facilities—not nursing homes 

    1:40 PM CT on 6/25/20

    (AP) Michigan would have to create dedicated facilities for coronavirus-infected patients who are not sick enough to be hospitalized or placed in nursing homes under Senate-passed legislation billed as an alternative to a state policy that has come under criticism from lawmakers.

    The Republican-sponsored measure, approved 24-13 Wednesday and sent to the GOP-led House, is a response to Democratic Gov. Gretchen Whitmer's order that lets people with the COVID-19 virus be transferred and isolated in nursing homes that also have non-infected residents. Critics worry the practice has led to infections among vulnerable, elderly residents — though there is no direct evidence.

    Senators said they want to ensure that non-residents of nursing homes who test positive but are medically stable are treated in facilities designated solely for coronavirus patients — not nursing homes — starting Sept. 15. The bill would still let nursing homes admit or retain infected residents if they provide state-approved designated areas with adequate staffing and personal protective equipment.

    "We want to save lives," said the sponsor, Republican Sen. Peter Lucido of Macomb County's Shelby Township. He said the current policy "has failed" and criticized the administration for rejecting the nursing home industry's early suggestion, in March, to use empty facilities as quarantine centers.

    Michigan's Department of Health and Human Services has defended its decision to turn 21 nursing homes into regional "hubs" to care for coronavirus patients in isolated wings at a time some hospitals were at capacity. It has cited limitations with federal field hospitals in the Detroit area and the timely process of creating new facilities.

    The hub homes were given $5,000 per virus patient to help with costs. "They sweetened the deal," Lucido said.

    Many Democrats voted against the legislation. Sen. Curtis Hertel Jr. of East Lansing said it's important to review the policy to make sure "outside people aren't being moved into nursing homes," but "I cannot vote for a bill that violates an individual's basic civil rights." Democrats unsuccessfully tried amending the bill to require a doctor's written permission to transfer someone to one of the dedicated facilities, to ensure notice is given to the individual and his or her family and to establish an appeals process.

    A Whitmer spokeswoman said the office was reviewing the legislation.

    More than 2,000, or about 35%, of Michigan's coronavirus-related deaths are linked to nursing homes.

    Meanwhile, the state health department reported 323 new cases statewide Wednesday, the highest daily figure in June, and four deaths.


    Manufacturers group unveils COVID-19 Product Exchange site

    11:40 AM CT on 6/25/20

    The Healthcare Manufacturers Management Council announced the launch of a website in which potential sellers and buyers of COVID-19 related products can connect, according to a news release.

    Buyers and sellers can list their needs or wares, respectively, said the trade association for U.S. manufacturers of healthcare products.

    “Healthcare providers, government agencies and medical supply chain participants across the nation are now searching for supply sources outside of their normal supply chain and partner relationships, and in many cases don’t know where to turn,” said Janis Dezso, president of the council, in the release.


    Nevada to require masks after rise in new virus cases

    9:43 AM CT on 6/25/20

    (AP) Gov. Steve Sisolak announced Wednesday that Nevada will mandate the use of face coverings in public places in an effort to stem an increase of coronavirus cases that has hit the state as casinos, restaurants and other businesses began reopening.

    "No shirt, no shoes, no mask, no service," Sisolak said, distilling the policy down to a tagline.

    Nevada has reported more than 14,300 virus cases and 494 deaths since the onset of the pandemic. A downward trend in cases previously led Sisolak and health officials to move the state to a second phase of reopening before new cases began to rise.

    "For Nevada to stay safe and stay open, we must make face coverings a routine part of our daily life," the first-term Democratic governor said at a news conference.

    When the mandate takes effect Thursday at midnight, Nevada will join California, North Carolina and Washington in requiring face-coverings, after those states' Democratic governors implemented similar mandates.

    Sisolak emphasized his intentions with the new rule weren't partisan and only intended to contain the spread of the virus to protect residents and allow Nevada to reopen as quickly as possible.

    "If back in March, before we shut down our economy, I said to you: we can keep our economy open if everyone agrees to wear masks and maintain 6 feet in person-to-person distance, who would have not accepted that offer?" Sisolak said.

    The face-covering mandate will apply to all indoor and outdoor spaces where people convene. Individuals with medical conditions and disabilities, and children 2 to 9 will be exempt from the mandate, Sisolak said.

    Businesses not following the mandate will be cited by licensing and regulatory authorities as well as Nevada's Occupational Safety and Health Administration. Sisolak said he hoped individuals would abide by the mandate so penalties for not doing so wouldn't be necessary.

    "This is a mandate so enforcement language is necessary. However, ideally there won't be any criminal or civil sanctions against individuals," he said.


    'Coming back and biting us': US sees virus resurgence

    8:47 PM CT on 6/24/20

    (AP) A coronavirus resurgence is wiping out two months of progress in the U.S. and sending infections to dire new levels across the South and West, with hospital administrators and health experts warning Wednesday that politicians and a tired-of-being-cooped-up public are letting a disaster unfold.

    The U.S. recorded a one-day total of 34,700 new confirmed COVID-19 cases, the highest level since late April, when the number peaked at 36,400, according to a count kept by Johns Hopkins University.

    While newly confirmed infections have been declining steadily in early hot spots such as New York and New Jersey, several other states set single-day records this week, including Arizona, California, Mississippi, Nevada, Texas and Oklahoma. Some of them also broke hospitalization records, as did North Carolina and South Carolina.

    "People got complacent," said Dr. Marc Boom, CEO of the Houston Methodist hospital system. "And it's coming back and biting us, quite frankly."


    Miami creates COVID-19 surge teams

    5:57 PM CT on 6/24/20

    (AP) Miami-Dade Mayor Carlos Gimenez said Wednesday at a virtual press conference that “surge teams” will be sent this weekend to areas where doctors are noticing an increase in new COVID-19 infections.

    About 100 people will go into such hot spots as Little Havana and Homestead, an agricultural area with vegetable farms and nurseries. The teams will be knocking on doors and handing out kits with masks and hand sanitizers.

    Gimenez says officials are noticing an increase of cases among farm workers and will be offering hotel rooms to those who are ill and live in small homes with several people so they don’t infect others.

    Gimenez says the county still has an availability of beds, but certain hospitals are out of ICU beds and have had to transfer patients to other centers.


    COVID-19 cases climbing in Ohio after reopening 

    4:39 PM CT on 6/24/20

    (Crain’s Cleveland Business) Cases of COVID-19 in Ohio increased by 590 in the last 24 hours and 729 in the 24 hours before that, continuing an upward trend in the state since most of the economy began reopening in May.

    "The numbers are going up," Gov. Mike DeWine admitted during his Tuesday, June 23, coronavirus update, adding that it was expected after the state lifted many restrictions.

    DeWine also acknowledged that the median age of COVID-19 cases is trending downward, now standing at 47 for all cases. He posited that might reflect more young adults being tested or more younger people becoming infected due to "moving around more."

    The state is set to release a series of three public service announcements for broadcast and social media platforms stressing the need to wear masks, socially distance and get tested. The PSAs were paid for by the Ohio Bureau of Workers' Compensation.

    In an attempt to encourage more testing as capacity has been expanded, DeWine, Ohio First Lady Fran DeWine and Lt. Gov. Jon Husted all took a coronavirus test live during the press conference.

    According to the latest report from the Ohio Department of Health, the state has 42,767 confirmed and 3,360 probable cases of COVID 19, for a total of 46,127. Of those, 7,379 people have been hospitalized, 1,876 of them in intensive care. To date, there have been 2,497 confirmed deaths and 238 probable related deaths, for a total of 2,735 fatalities statewide. A total of 667,077 people have been tested in the state.


    Utah governor: No shutdown plan despite spread of virus

    2:31 PM CT on 6/24/20

    (AP) Gov. Gary Herbert says he has no plans to shutdown the economy and appears unwilling to bow to mounting pressure to make face masks mandatory despite a warning from the state's epidemiologist that a complete shutdown might be imminent if Utah can't stop a prolonged spike of coronavirus cases.

    Herbert tweeted  Monday night that he appreciated the analysis by epidemiologist Angela Dunn that outlined the severity of the surge in COVID-19, but made clear he's not considering going backwards from a plan he rolled out in early May that gradually allowed businesses, gyms, salons and pools to reopen.

    "We will work to stem this tide, but I have no plans to shut down Utah's economy," tweeted the Republican governor, who isn't seeking reelection after holding the post since 2009.

    Utah is one of nearly two dozen states dealing with rising case rates following reopenings. The infection rate and daily case count has doubled in the last month, state figures show.

    Dunn recommended that the state reimpose some restrictions on businesses and group gatherings unless it lowers it's weekly average to 200 cases per day by July 1. The state has averaged 478 cases per day over the last week following a steady increase in positive rates over the last month, state figures show.

    Dunn also recommended mandating face coverings in her memo, which was made public Monday.

    On Tuesday, the Democratic mayors of Utah's largest city and county urged Herbert to implement a statewide requirement while a coalition of the state's largest health care providers launched a new campaign touting the necessity to use face masks to slow the spread of the virus.

    Salt Lake County Mayor Jenny Wilson formally asked Herbert to grant her authority to make face coverings mandatory in the county at retail and commercial establishments, restaurants while waiting to be seated and served and at community gatherings.

    In response, the governor's office said in a statement sent by spokeswoman Brooke Scheffler that Herbert thinks a mask requirement could create "divisive enforcement issues," but said county health departments can send data and analysis to the state health department to make their case.

    "Gov. Herbert strongly supports mask wearing in public when social distancing is not possible because it is a sign of respect for the health and well being of others," the statement said.


    Related Article
    Utah state epidemiologist warns of dangerous COVID-19 spread

    Fauci: Next few weeks critical to tamping down virus spikes

    12:21 PM CT on 6/24/20

    (AP) The next few weeks are critical to tamping down a disturbing coronavirus surge, Dr. Anthony Fauci told Congress on Tuesday — issuing a plea for people to avoid crowds and wear masks just hours before mask-shunning President Donald Trump was set to address a crowd of his young supporters in one hot spot.

    Fauci and other top health officials also said they have not been asked to slow down virus testing, in contrast to Trump's claim last weekend that he had ordered fewer tests be performed because they were uncovering too many infections. Trump said earlier Tuesday that he wasn't kidding when he made that remark.

    "We will be doing more testing," Fauci, infectious disease chief at the National Institutes of Health, pledged to a House committee conducting oversight of the Trump administration's response to the pandemic.

    Fauci told lawmakers he understands the pent-up desire to get back to normal as the U.S. begins emerging from months of stay-at-home orders and business shutdowns. But that has "to be a gradual step-by-step process and not throwing caution to the wind," he said.

    "Plan A, don't go in a crowd. Plan B, if you do, make sure you wear a mask," Fauci said.

    Troubling surges worsened Tuesday in several states, with Arizona, California, Mississippi, Nevada and Texas setting single-day records for new coronavirus cases, and some governors saying they'll consider reinstating restrictions or delaying plans to ease up in order to help slow the spread of the virus.

    Arizona, where Trump was headed for a speech at a Phoenix megachurch, reported a new daily record of nearly 3,600 additional coronavirus infections Tuesday. Arizona emerged as a COVID-19 hot spot after Republican Gov. Doug Ducey lifted his stay-home orders in mid-May. Last week he allowed cities and counties to require masks in public places and many have done so.

    Texas surpassed 5,000 new cases for a single day for the first time — just days after it eclipsed 4,000 new cases for the first time — as America's largest pediatric hospital began taking adult patients to free up bed space in Houston. The infection rate in Texas has doubled since late May. And Nevada surpassed a record one-day increase for the fourth time in the past eight days. Other states also were experiencing worrisome surges, including Louisiana, Utah and South Carolina.

    Another worrisome trend: an increase in infections among young adults. Fauci said while COVID-19 tends to be less severe in younger people, some of them do get very sick and even die. And younger people also may be more likely to show no symptoms yet still spread the virus.

    If people say, "'I'm young, I'm healthy, who cares' — you should care, not only for yourself but for the impact you might have" on sickening someone more vulnerable, Fauci said.


    Scarce medical oxygen worldwide leaves many gasping for life

    10:42 AM CT on 6/24/20

    As the coronavirus spreads, soaring demand for oxygen is bringing out a stark global truth: Even the right to breathe depends on money. In much of the world, oxygen is expensive and hard to get — a basic marker of inequality both between and within countries.

    In wealthy Europe and North America, hospitals treat oxygen as a fundamental need, much like water or electricity. It is delivered in liquid form by tanker truck and piped directly to the beds of coronavirus patients. Running short is all but unthinkable for a resource that literally can be pulled from the air. But in poor countries, from Peru to Bangladesh, it is in lethally short supply.

    For many severe COVID patients, hypoxia — radically low blood-oxygen levels — is the main danger. Only pure oxygen in large quantities buys the time they need to recover. Oxygen is also used for the treatment of respiratory diseases such as pneumonia, the single largest cause of death in children worldwide.

    Yet until 2017, oxygen wasn’t even on the World Health Organization’s list of essential medicines. In vast parts of sub-Saharan Africa, Latin America and Asia, that meant there was little money from international donors and little pressure on governments to invest in oxygen knowledge, access or infrastructure.

    “Oxygen has been missing on the global agenda for decades,” said Leith Greenslade, a global health activist with the coalition Every Breath Counts.

    The issue got more attention after British Prime Minister Boris Johnson narrowly survived a bout of coronavirus, crediting his recovery to the National Health Service and “liters and liters of oxygen.” But Johnson is a prominent figure in one of the world’s richest countries.

    Unlike for vaccines, clean water, contraception or HIV medication, there are no global studies to show how many people lack oxygen treatment — only broad estimates that suggest at least half of the world’s population does not have access to it.


    U.S. virus cases surge to highest level in 2 months

    9:37 AM CT on 6/24/20

    (AP) New coronavirus cases in the U.S. have surged to their highest level in two months and are now back to where they were at the peak of the outbreak.

    The U.S. on Tuesday reported 34,700 new cases of the virus, according to a tally compiled by Johns Hopkins University that was published Wednesday. There have been only two previous days that the U.S. has reported more cases: April 9 and April 24, when a record 36,400 cases were logged.

    New cases in the U.S. have been surging for more than a week after trending down for more than six weeks. While early hot spots like New York and New Jersey have seen cases steadily decrease, the virus has been hitting the south and west. Several states on Tuesday set single-day records, including Arizona, California, Mississippi, Nevada and Texas.

    Cases were also surging in other parts of the world. India reported a record daily increase of nearly 16,000 new cases. Mexico, where testing rates have been low, also set a record with more than 6,200 new cases.

    But China appears to have tamed a new outbreak of the virus in Beijing, once again demonstrating its ability to quickly mobilize vast resources by testing nearly 2.5 million people in 11 days.


    Health officers sound alarm as California economy reopens

    9:24 PM CT on 6/23/20

    (AP)  Health officials in a San Francisco Bay Area county that was among the most aggressive in the nation in shutting down its economy to slow the spread of the coronavirus are warning of “worrisome” growing infections as California on Tuesday reported its highest daily infection rate to date and hospitalizations from the virus increase.

    The state Department of Public Health recorded more than 5,000 new cases Tuesday, putting the total number of positive cases at more than 183,000. The state has seen more than 5,500 deaths related to COVID-19.

    The record-setting numbers and warnings come as more businesses reopen statewide, spurred by antsy residents weary over stay-at-home and social distancing orders. San Francisco, which was part of the Bay Area's strict order in mid-March, plans to allow outdoor bars, nail and hair salons and tattoo shops to open next week.

    Health officers say they always expected case numbers to creep up as the economy reopens, but they worry the trend may be getting out of hand.

    “The question of how we’re doing as a nation is: We’re not doing so well. How are we doing as a state? Not doing so well. How are we doing as a region? Not doing so well,” said Santa Clara County Executive Jeffrey Smith Tuesday. Smith, a doctor, said one widely cited model projects 15,000 Californians could die by October 1.

    Gov. Gavin Newsom last week ordered Californians to wear face coverings when out in public, sparking more resistance from residents who say they believe the emergency is over. 


    Washington issues statewide facial covering requirement

    8:10 PM CT on 6/23/20

    (AP) Citing ongoing coronavirus-related health risks, Washington Gov. Jay Inslee on Tuesday announced a statewide requirement for people to wear facial coverings in public settings.

    The public health order, issued by Secretary of Health John Wiesman, takes effect Friday. The order requires face coverings when people are indoors in a public area, and outdoors in a public area when six feet of physical distancing can't be maintained.

    Washington joins several other states that already have statewide mask orders in place, including California, which issued its order last week.

    Inslee said the decision was made following an uptick in transmission rates of COVID-19 activity in the state.

    “Until a vaccine or cure is developed, this is really going to be our best defense," Inslee said at a news conference.

    Yakima County, which has been among the areas hardest hit by the outbreak, has even more stringent requirements under a separate proclamation issued by Inslee that also takes effect Friday. In addition to being covered by the statewide mandate on masks in public that prohibits people from entering a place of business — either indoors or outdoors — without first donning a mask, businesses in the central Washington county are prohibited from allowing a customer to enter a business, or conduct business with a customer in any public space unless the customer is wearing a face covering.

    There are exemptions for people who are deaf or have hearing loss and those who have medical conditions that preclude them from wearing a mask. Children age 5 and younger are also exempt, though the order recommends facial coverings for children between the ages of 3 and 5.

    People engaged in recreation alone or with household members and those eating out at restaurants wouldn’t have to wear masks as long as they are properly distanced from others.

    The statewide order builds on a previous one from Inslee that — since June 8 — has required workers to wear facial coverings unless they don’t interact with others on the job.


    Mississippi sees highest-ever daily increase of COVID cases

    6:41 PM CT on 6/23/20

    (AP) As Mississippi saw its highest single-day increase in coronavirus cases Tuesday, the state health officer said he is not “remotely surprised” and expressed concern for the future.

    The announcement came as the Mississippi Senate is working to limit lawsuits by customers who say they were exposed to COVID-19 at businesses or medical offices.

    “We’ve been seeing this trend evolving over weeks," Dr. Thomas Dobbs said in an interview with The Associated Press on Tuesday evening. " As people have tried to embrace normal, but unsafe normal, it is permitting the virus to spread. We’re really going to end up paying the price for it.”

    The Mississippi Department of Health reported 611 new cases and 11 deaths Tuesday. Dobbs said the uptick is driven by community transmission of the virus from younger, asymptomatic people to their older relatives.

    “If you drive around and look at how younger people are having social gatherings, they’re crowding into bars, it’s just not safe," Dobbs said. “People are not complying, people are not wearing masks. It’s not a joke. Really bad things are going to happen.”

    Dobbs said a big concern of his is the stress the new cases are putting on Mississippi's heath care system. He said it's already testing the state's hospital bed capacity.

    Meanwhile, a group of mostly Republican legislators are working to pass Senate Bill 3049 and before the end of the legislative session in July. The bill would shield businesses, health care providers, religious organizations and other entities from lawsuits related to COVID-19 if they show a “good faith” effort to follow public health guidelines.

    Republican Gov. Tate Reeves has pushed for the bill at his regular coronavirus press briefings. If it lands on his desk and he signs it, the bill would take effect retroactively to March 14.


    Africa's 1st COVID-19 vaccine trial starting

    4:27 PM CT on 6/23/20

    (AP) Researchers in South Africa say the first COVID-19 vaccine trial on the African continent is set to get underway on Wednesday.

    The University of the Witwatersrand says the vaccine developed by University of Oxford researchers is already being evaluated in a large trial in the UK and a similar trial is beginning in Brazil.

    The announcement came hours after South Africa reported that total coronavirus cases in the country surpassed 100,000 as of Tuesday. South Africa accounts for almost one-third of the infections on the African continent.

    The South Africa vaccine trial aims to enroll 2,000 participants. The first are to get vaccinated this week in Gauteng province, home of economic hub Johannesburg and the capital, Pretoria.

    Others will be vaccinated in the hot spot of Western Cape province. Shabir Madhi, who leads the trial, said it begins as South Africa enters winter and the flu season and as pressure increases on hospitals.


    R.I. Blues insurer to return premiums to customers

    3:46 PM CT on 6/23/20

    Blue Cross and Blue Shield of Rhode Island said it has requested approval from regulators to issue $13.8 million in premium credits to its fully insured customers.

    The Blues insurer said it will provide a 10% premium credit for two months to individual customers and large and small employers.

    “COVID-19 has had an unprecedented impact on healthcare delivery this year. Our members have not been able to access the volume of care we anticipated when setting their monthly premiums,” said Kim Keck, president and CEO of the insurer.


    Governor urges masks but no new steps as cases rise in Texas

    2:03 PM CT on 6/23/20

    (AP) Texas' surging coronavirus numbers will not slow the state's reopening as Republican Gov. Greg Abbott on Monday instead prescribed an emphasis on face coverings and social distancing to curtail sobering trends, including hospitalization rates that have doubled since Memorial Day.

    Abbott did not announce any new measures to reverse what he called "unacceptable" trends as Texas reached an 11th consecutive day of record COVID-19 hospitalizations. And while he didn't rule out reimposing lockdown orders in Texas — describing it as a last resort — he said the virus did not require choosing "between jobs and health." He instead emphasized long-established voluntary measures, such as staying at home if possible.

    Wearing a mask has become a political statement during the pandemic throughout the U.S., and Abbott is not requiring them in public, even as big cities last week began racing to impose mask mandates on businesses. On Monday, Nueces County, home to Corpus Christi, became the latest Texas county to order that businesses require employees and customers to wear masks. The order was to take effect on Friday.

    But Abbott nodded to the resistance that has flared particularly from within his party. Ahead of next month's Texas GOP Convention in Houston, party leaders have said masks won't be required.

    "I know that some people feel that wearing a mask is inconvenient or that it is like an infringement of freedom," Abbott said in a televised briefing outside his office in the Texas Capitol. "But I also know that wearing a mask will help us to keep Texas open."

    House Democrats quickly blasted Abbott's reaction to surging cases as insufficient.

    "He set the stage to finally take much-needed strong and decisive action — and then, predictably, backed away without doing anything," Democratic state Rep. Chris Turner said in a statement.

    On Monday, state health officials reported 3,711 hospitalizations, setting a record for the 11th consecutive day with a single-day jump of 302 new patients.

    Texas also reported 3,280 new cases, the fifth-highest total since the state began keeping records and the highest yet reported on a Monday, which is typically the lowest day of the week for reported new cases. The state's seven-day positivity rate rose again to 9.5%, its highest since April 20.

    The 10 new fatalities reported Monday were the fewest reported in a week.


    Strike won't affect delivery of machines to swab maker

    12:07 PM CT on 6/23/20

    A strike at Bath Iron Works won't affect the company's delivery of machines needed to ramp up production of specialized swabs used for tests for the coronavirus, officials say.

    Bath Iron Works completed the delivery Monday of 22 machines that Puritan Medical Products needs to expand production. The remaining eight machines will be delivered next month, the shipyard's spokesman David Hench said.

    Bath Iron Works and Cianbro Corp. have partnered with Puritan to open a second facility to double production.

    Puritan is one of only two companies that make the specialized swabs for coronavirus tests. The other is in Italy.

    "Recognizing how essential COVID-19 testing is to keeping people safe and fully reopening the economy, BIW does not anticipate the current work stoppage will affect delivery of the machinery to Puritan so that the healthcare products company can fulfill its vital mission," Hench said.

    More than 4,000 production workers went on strike Monday against the Navy shipbuilder.


    Fauci to testify at a fraught time for U.S. pandemic response

    9:51 AM CT on 6/23/20

    (AP) With coronavirus cases rising in about half the states and political polarization competing for attention with public health recommendations, Dr. Anthony Fauci returns to Capitol Hill on Tuesday at a fraught moment in the nation's pandemic response.

    The government's top infectious disease expert will testify before a House committee, along with the heads of the Centers for Disease Control and Prevention, the Food and Drug Administration, and a top official at the Department of Health and Human Services.

    In prepared testimony submitted for all four witnesses, HHS told lawmakers that "the rigorous clinical testing required to establish vaccine safety and efficacy means that it might take some time for a licensed (coronavirus) vaccine to be available to the general public."

    The statement added that, "the COVID-19 response currently is focused on the proven public health practices of containment and mitigation." Translation: keeping outbreaks under control is the best tool in the public health arsenal for now.

    Fauci remains optimistic that a vaccine will be found, noting that patients develop antibodies to the virus — a sign that the human immune system is able to battle back. However, he shies away from promising results by the end of the year, as President Donald Trump has done.


    Hospitals might need twice as much money than current federal emergency funds

    8:10 PM CT on 6/22/2020

    Canceled elective procedures have wrecked financial havoc on safety-net hospitals that often have razor-thin financial margins. The plan to distribute COVID-19 emergency funds based on hospitals’ historic net revenue from Medicare and other payers could disadvantage safety-net hospitals with large Medicaid-covered patient populations. Based on these factors and the American Hospital Association’s estimates for March through June 2020, the authors of a Health Affairs study think that US hospitals may require funding of up to two times what is currently appropriated.

    Stimulus legislation should include incentives such as bonus payments for hospitals providing care to low-income and disadvantaged patients. A simple allocation could target funds to hospitals that qualify for Medicaid disproportionate-share hospital (DSH) payments. Alternatively, the government could use hospital census data to more equitably distribute payments to facilities that primarily treat uninsured and Medicaid patients (and not Medicare patients). These facilities could be identified based on definitions of “safety-net hospital” that incorporate data on hospitals’ bad debt or uncompensated care; such data are publicly available in Medicare annual cost reports. In addition, the allocation formula should reflect national data on emergency services use and eligibility for the 340B program.

    The authors suggest several steps to help aid the hospitals. 

    • Reducing regulatory burdens also could bolster provider revenue. 
    • Federal efforts could include loan forgiveness to incentivize new clinicians to accept positions in safety-net hospitals.
    • The Trump administration should create a special enrollment period in the federally facilitated ACA Marketplace used by a majority of states.

    Trump: US doing 'too good a job' on testing

    5:43 PM CT on 6/22/2020

    (AP) President Donald Trump said Monday the U.S. has done “too good a job” on testing for cases of COVID-19, even as his staff insisted the president was only joking when he said over the weekend that he had instructed aides to “slow the testing down, please.”

    The president’s comments at a campaign rally in Tulsa, Oklahoma, on Saturday brought quick rebukes. In an interview with Scripps for its local TV stations, Trump was asked Monday whether he did indeed tell aides to “slow it down.” He did not directly answer the question.

    “If it did slow down, frankly, I think we’re way ahead of ourselves, if you want to know the truth,” Trump said. “We’ve done too good a job,” adding that the reason the U.S. has more coronavirus cases is that it does more testing.

    White House press secretary Kayleigh McEnany said any suggestion that testing has been curtailed is not rooted in fact, saying Trump made the slow-it-down comment “in jest.”

    She said that Trump’s comments were an effort to criticize the media for its coverage of the coronavirus and its “failure” to understand that “when you test more, you also find more cases.”

    However, the U.S. is seeing disturbing trends in several benchmarks, including the percentage of tests that prove positive for the virus.

    Health officials say that testing in the U.S. early on was insufficient for optimal containment. In early March, Dr. Anthony Fauci, a member of the White House coronavirus task force, testified that the nation's testing system was “not really geared to what we need right now” and added, “it is a failing. Let’s admit it.”

    But now, about a half-million people per day are being tested, and the president and his aides have been repeatedly touting the U.S. as leading the world in testing.

    The United States has confirmed nearly 2.3 million COVID-19 cases, which represents about a quarter of the world’s cases. More than 120,000 people in the U.S. with COVID-19 have died. The next closest nation is Brazil, with 50,600 deaths.


    South Carolina city considers state's 1st mask requirement

    4:01 PM CT on 6/22/20

    (AP) A South Carolina city is considering whether to become the first in the state to require people to wear masks in grocery stores and pharmacies to help fight COVID-19.

    The Greenville City Council will hold an emergency meeting Monday evening to consider the mask requirements.

    All employees in restaurants, retail stores, salons, grocery stores and pharmacies would have to wear masks. Customers in grocery stores and pharmacies would need coverings over their noses and faces, and anyone who can't wear a mask because of age or underlying illness is excluded.

    Greenville has had some of the highest COVID-19 rates in the state in recent weeks.

    South Carolina Gov. Henry McMaster again said Monday that he isn't considering a statewide mask requirement because it might violate people's rights. He has emphasized making the right choice and wearing face coverings voluntarily to slow a rise in cases that have the state in the top five in the nation for new infections.

    "It's time to take it very, very seriously. We've said that from the beginning. There is very little other than that we can do," McMaster said at a Monday media appearance. He wore a mask, which he rarely has in public before.

    The rapid spike in COVID-19 cases in South Carolina continues, with more than 1,000 cases reported Monday, the Department of Health and Environmental Control said.


    Virus outbreak could spin 'out of control' in South Sudan

    2:02 PM CT on 6/22/20

    (AP) It began with a dry cough, weakness and back pain. For Reagan Taban Augustino, part of South Sudan's small corps of health workers trained in treating COVID-19 patients, there was little doubt what he had.

    Days later, hardly able to breathe, the 33-year-old doctor discovered just how poorly equipped his country is for the coronavirus pandemic: None of the public facilities he tried in the capital, Juba, had oxygen supplies available until he reached South Sudan's only permanent infectious disease unit, which has fewer than 100 beds for a country of 12 million people.

    It took more than an hour to admit him. "I was almost dying at the gate," he told The Associated Press from the unit last week.

    The pandemic is now accelerating in Africa, the World Health Organization says. While the continent had more time than Europe and the United States to prepare before its first case was confirmed on Feb. 14, experts feared many of its health systems would eventually become overwhelmed.

    South Sudan, a nation with more military generals than doctors, never had a fighting chance. Five years of civil war and corruption stripped away much of its health system, and today nongovernmental organizations provide the majority of care. Nearly half of the population was hungry before the pandemic. Deadly insecurity  continues, and a locust outbreak  arrived just weeks before the virus.

    The United Nations says the country's outbreak is growing rapidly, with nearly 1,900 cases, including more than 50 health workers infected, more than 30 deaths and no way to know the true number of infections. At one point several members of the COVID-19 task force tested positive, including Vice President Riek Machar.

    "It can be out of control at any time," said David Gai Zakayo, a doctor with the aid group Action Against Hunger.

    "The groups we are treating are malnourished," Zakayo said. "My big worry is if the virus begins spreading to those groups we are treating, it will be a disaster."

    At South Sudan's only laboratory that tests for the virus, supervisor Simon Deng Nyichar said the team of 16 works up to 16-hour days slogging through a backlog of more than 5,000 tests. Around 9,000 samples have been tested since early April, when the country became one of the last in Africa to confirm a coronavirus case.

    With materials in short supply, testing is largely limited to people with symptoms of COVID-19. It can take weeks to receive results, "creating mistrust in communities and resentment toward contact tracers," the Health Ministry said last week.

    Meanwhile "our hospitals are full," Wolde-Gabriel Saugeron, who leads the International Committee of the Red Cross' team in Bor, wrote last week. "COVID-19 means that we need to create more space between our hospital beds, which has reduced the number of people we can accommodate in our wards by 30%."


    Chicago set for phase 4 reopening this week

    12:12 PM CT on 6/22/20

    (Crain’s Chicago Business) Mayor Lori Lightfoot announced the city is on track to join the state in moving into Phase 4 of its opening guidelines this Friday.

    The news follows Lightfoot’s announcement last week that indoor seating in bars and restaurants would resume Friday. The next phase of reopening allows for gatherings of 50 or less indoors, 100 or less outdoors, and openings of several industries closed since late March: museums and zoos, performance venues, summer camps and youth activities.

    The transition to the city’s fourth phase, “Gradually Resume,” was possible because of a continued decline in newly diagnosed COVID-19 cases, the city said in a release, with declines since a peak in early May. Testing has also increased. Hospitalizations, deaths and emergency department visits are down. The percentage of people testing positive is also down to approximately 5 percent.

    Chicago Department of Public Health Commissioner Allison Arwady said in the release that Chicago still has a lot of cases and “we’re just now moving from a high-risk to a medium-high-risk city for COVID-19 spread, based on our numbers, and we need to move ahead cautiously. I can’t emphasize enough the need for people and businesses to continue to abide by the public health guidance so we can avoid the spike in cases we’re seeing in other cities and states that reopened before us.”


    WHO chief warns world leaders not to 'politicize' pandemic

    9:52 AM CT on 6/22/20

    (AP) World leaders must not politicize the coronavirus pandemic but unite to fight it, the head of the World Health Organization warned Monday, reminding all that the pandemic is still accelerating and producing record daily increases in infections.

    The comments by Tedros Adhanom Ghebreyesus, who has faced criticism from U.S. President Donald Trump, came as the number of reported infections soared in Brazil, Iraq, India and southern and western U.S. states, straining local hospitals.

    It took over three months for the world to see 1 million virus infections, but the last 1 million cases have come in just eight days, Tedros said during a videoconference for the Dubai-based World Government Summit.

    Tedros never mentioned Trump's name or the fact that he is determined to pull the United States out of the U.N. health agency but warned against "politicizing" the pandemic.

    "The greatest threat we face now is not the virus itself, it's the lack of global solidarity and global leadership," he said. "We cannot defeat this pandemic with a divided world."

    Trump has criticized the WHO for its early response to the outbreak and what he considers its excessive praise of China, where the outbreak began, as his administration's response in the U.S. has come under scrutiny. In response, Trump has threatened to end all U.S. funding for the WHO.

    Nearly 9 million people have been infected by the virus worldwide and more than 468,000 have died, according to figures compiled by Johns Hopkins University. Experts say the actual numbers are much higher, due to limited testing and asymptomatic cases.

    "The COVID-19 pandemic has demonstrated that, indeed, the world was not prepared," Tedros said. "Globally, the pandemic is still accelerating."


    WHO reports largest single-day increase in coronavirus cases

    8:15 PM CT on 6/21/20

    (AP) The World Health Organization on Sunday reported the largest single-day increase in coronavirus cases by its count, at more than 183,000 new cases in the latest 24 hours. The UN health agency said Brazil led the way with 54,771 cases tallied and the U.S. next at 36,617. Over 15,400 came in in India.

    Experts said rising case counts can reflect multiple factors including more widespread testing as well as broader infection. Overall in the pandemic, WHO reported 8,708,008 cases — 183,020 in the last 24 hours — with 461,715 deaths worldwide, with a daily increase of 4,743.

    More than two-thirds of those new deaths were reported in the Americas.

    At a campaign rally in Tulsa, Oklahoma, Trump said Saturday the U.S. has tested 25 million people, but the “bad part” is that it found more cases.

    “When you do testing to that extent, you’re going to find more people, you’re going to find more cases,” Trump said. “So I said to my people, ‘Slow the testing down, please.’″

    White House trade adviser Peter Navarro said on CNN that Trump was being “tongue-in-cheek” and made the comment in a “light mood.” Democratic rival Joe Biden’s campaign accused Trump of “putting politics ahead of the safety and economic well-being of the American people.”

    The U.S. has the world's highest number of reported infections, over 2.2 million, and the highest death toll, at about 120,000, according to Johns Hopkins. Health officials say robust testing is vital for tracking outbreaks and keeping the virus in check.

    In the U.S., the virus appears to be spreading across the West and South. Arizona reported over 3,100 new infections, just short of Friday’s record, and 26 deaths. Nevada also reported a new high of 445 cases.

    In Europe, a single meatpacking plant in Germany has had over 1,000 cases, so the regional government issued a quarantine for all 6,500 workers, managers and family members.

    In Asia, China and South Korea reported new coronavirus cases Sunday in outbreaks that threatened to set back their recoveries.

    Chinese authorities recorded 25 new confirmed cases — 22 in Beijing. In the past week, Beijing tightened travel controls by requiring anyone who wants to leave the Chinese capital, a city of 20 million people, to show proof they tested negative for the virus.

    In South Korea, nearly 200 infections have been traced to employees at a door-to-door sales company in Seoul, and at least 70 other infections are tied to a table tennis club there. But South Korean officials are reluctant to enforce stronger social distancing to avoid hurting the economy.


    Study gauges efficacy of community use of face masks

    6:32 PM CT on 6/21/20

    State policies mandating public or community use of face masks or covers to curb COVID-19 is associated with a decline in the daily COVID-19 growth rate by 0.9, 1.1, 1.4, 1.7, and 2.0 percentage-points in 1–5, 6–10, 11–15, 16–20, and 21+ days after issuing mandates to wear face masks or covers. The findings suggest that requiring face mask use in public might help in mitigating COVID-19 spread, according to a preprint in Health Affairs.

    Mandated face coverings have been implemented in 15 states plus D.C. between April 8 and May 15. The research studies the cases reported between March 31 and May 22.

    While face masks have now become political, there is now substantial evidence of asymptomatic transmission of COVID-19.For example, a recent study of antibodies in a sample of customers in grocery stores in New York State reported an infection rate of 14% by March 29 (projected to represent nearly 2.1 million cases), which substantially exceeds the number of confirmed COVID-19 cases, according to the study.

    On April 3, 2020, the Centers for Disease Control and Prevention issued new guidance advising all individuals to wear cloth facial covers in public areas where close contact with others is unavoidable, citing new evidence on virus transmission from asymptomatic or pre-symptomatic individuals.


    Louisiana health officials probe COVID-19 clusters

    4:50 PM CT on 6/21/20

    (AP) Louisiana health regulators have tied at least 100 cases of the new coronavirus to bars near LSU in Baton Rouge and report a new cluster of the illness in the Orleans Parish area.

    The state Department of Public Health said Friday that bars in an area near the campus called Tigerland are believed to be a major contributor to the outbreak. Anyone who visited bars in that area recently should consider themselves exposed and should self-quarantine for 14 days. People should monitor for symptoms including fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, loss of taste or smell, sore throat, congestion or runny nose, nausea and diarrhea, the health department said.

    At least three bars — JL's Place, Reggie's and Fred's — have employees who have tested positive for COVID-19, the businesses' owners told WAFB-TV Friday.

    Louisiana Department of Health spokeswoman Mindy Faciane confirmed an outbreak investigation is underway involving JL's Place and Reggie's Bar.

    Meanwhile, the owner of Fred’s confirms two of his employees have tested positive for the virus. He said each is recovering at home.

    In New Orleans, health officials are investigating a new cluster of COVID-19 that is likely linked to a high school graduation party.

    “By and large teenagers do well with COVID. On average, they don’t get very sick. That doesn’t mean they always do well. It is still possible, if you’re a young adult, to get very sick with COVID and we have seen cases,” Dr. Eric Kanter, with the Louisiana Department of Health told WVUE-TV.

    But, health officials noted that young people also risk unknowingly exposing their parents or grandparents to the disease.

    “Those individuals might not do as well with COVID. It’s serious. We are in the middle of a pandemic. It is not a game. An outbreak like we’re seeing now, based on events that happened over the last two weeks, can have a far-reaching and serious ramifications,” Kanter said.


    Maine has widest virus racial disparity gap in the country

    2:55 PM CT on 6/21/20

    (AP) The widest racial disparity in the U.S. stemming from the coronavirus pandemic is in Maine, where Black residents are contracting the virus at 20 times the rate of their white neighbors, according to a report in the Portland Press Herald.

    Maine has the highest percentage of white residents of any state and it also has a low rate of coronavirus infection, with less than 3,000 cases in total. But the Portland Press Herald reports Black Maine residents, who make up 1.4% of the state’s population, account for nearly a quarter of the state's coronavirus cases.

    The Maine Immigrants' Rights Coalition called the disparity “enormous and growing” and told the newspaper the state's Black community has suffered from compromised access to health services during the pandemic.

    “We are making strides and we are attempting to do better in partnership with members of those communities. But … I will be the first to acknowledge that we have more to do there," the Maine Center for Disease Control and Prevention's director Nirav Shah said recently.


    Nurses sue Ga. hospital over alleged COVID-19 test manipulation

    12:37 PM CT on 6/21/20

    Four nurses at Landmark Hospital in Athens, Ga. sued the provider over allegedly manipulating its COVID-19 test results to hide an outbreak, according to local news reports.

    The nurses told local news station WXIA that the hospital would retest people who tested positive to get a subsequent negative COVID-19 result, and claim the original test was a false positive. The nurses claimed the throat samples were sent to Piedmont Hospital, which only runs nasal swabs.

    Landmark Hospital CEO Marie Saylor told WXIA the hospital would investigate the allegations and defend against "misleading and false claims."


    Spain ends COVID-19 state of emergency

    11:04 AM CT on 6/21/20

    (AP) Spain’s national state of emergency has ended after three months of restrictions on movement to rein in its COVID-19 outbreak.

    As of Sunday, 47 million Spaniards will be able to freely move around the entire country for the first time since the government declared a state of emergency on March 14. The lockdown measures have been rolled back gradually over recent weeks.

    “This freedom that we now have, that we don’t have to justify our journey to see our family and friend, this was something that we were really looking forward to,” 23-year-old Pedro Delgado said at Madrid’s airport.

    Travelers from European countries, including Britain, can also enter Spain now without having to quarantine for 14 days. That quarantine rule still applies to non-Schengen countries, except for the U.K. Spain is hoping it can save part of its summer tourist season, which provides a huge part of its economic activity.

    Spaniards are still obliged to wear face masks both indoors and outside when in public spaces where it is impossible to guarantee a distance of 1.5 meters (5 feet) from others. Regional governments are now in complete charge of putting limits on attendance in public places, from theaters, to weddings, to classrooms.

    Spain’s lockdown succeeded in stopping the uncontrolled spread of the coronavirus, which authorities say has claimed at least 28,000 lives in the country.


    Rise in coronavirus cases brings new concerns in Alabama

    9:26 AM CT on 6/21/20

    (AP) Alabama and much of the Deep South are seeing a spike in coronavirus cases as some have stopped heeding warnings of the virus, alarming public health officials and people who have lost loved ones because of COVID-19. Over the past two weeks, Alabama had the second highest number of new cases per capita in the nation. South Carolina was fourth. Louisiana and Mississippi were also in the top 10.

    “We are extremely concerned about these numbers. We know if they continue, we will see more hospitalizations and more deaths,” Alabama State Health Officer Scott Harris said.

    As of Saturday, Alabama had more than 29,000 confirmed cases of COVID-19, with more than a quarter of the cases reported in the last two weeks.

    The combination of preexisting health conditions and limited health care access in the region, along with pockets of public skepticism about health officials' advice on the illness, complicate attempts to manage the virus.

    Dr. Selwyn Vickers, dean of the UAB School of Medicine, said the South has high rates of diabetes, kidney disease, heart disease and high blood pressure — all illnesses that put people at risk for poorer outcomes with COVID-19.

    But Vickers said human behavior is the most difficult aspect of fighting the disease.

    “When you open the doors and you look at the beaches, you look at the restaurants and you look at cities that choose not to do masks, or individuals who don't, ... I would say our behaviors create the biggest challenge for us," Vickers said.


    Trump suggests he urged slowing of virus testing

    8:53 PM CT on 6/20/20

    (AP) President Donald Trump is suggesting to supporters that he has told members of his administration to slow the rate of coronavirus testing.

    Speaking at a campaign rally Saturday night in Oklahoma, Trump said the U.S. has tested 25 million people, and far more than any other country. He said that more testing leads to finding more cases of people who test positive.

    Trump said that “so I said to my people slow the testing down, please.”


    Arizona COVID-19 case surge continues, setting care records

    7:45 PM CT on 6/20/20

    (AP) Arizona total of COVID-19 cases neared 50,000 on Saturday as the state's surge in additional cases continued to set daily records for hospitalizations, ventilator use and use of intensive care beds for coronavirus patients.

    The state Department of Health Services reported 3,109 additional, increasing the statewide total to 49,798 along with 1,338 deaths, including 26 reported on Saturday.

    The number of in-patient hospitalizations for COVID-19 as of Friday reached 1,938, with 368 COVID-19 patients on ventilators and 546 in ICU beds, the department reported. Friday's count of 1,164 emergency room visits for COVID-19 also set a record.

    Earlier in the week, Arizona set daily new-case records with 3,246 on Friday, 2,519 cases on Thursday and 2,392 on Tuesday.

    Arizona has emerged as a national hot spot for the coronavirus since Republican Gov. Doug Ducey lifted his stay-home orders in mid-May.

    Health officials have attributed the new cases to increased testing and to community spread of the coronavirus.

    Saying that data trends were headed in the wrong direction, Ducey on Wednesday reversed himself and allowed local governments to impose requirements for people to wear masks in public to curtail spread of the virus.

    Tucson and Flagstaff quickly adopted mask rules and Phoenix and multiple suburbs followed suit on Friday.

    Counties that include most of metro Phoenix and metro Tucson also imposed mask requirements.

    For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia, and death.


    Gaps in paid sick leave for healthcare workers

    5:40 PM CT on 6/20/20

    At least 69.4 million adult American workers are not guaranteed access to the emergency #PaidSickLeave benefits in the Coronavirus Families First Response Act.

    39% of excluded or exempted healthcare workers are people of color. https://t.co/p4vu7W67az pic.twitter.com/RKWWGzObDo

    — KFF (Kaiser Family Foundation) (@KFF) June 20, 2020

    Nevada again sets single-day record rise in COVID-19 cases

    4:05 PM CT on 6/20/20

    (AP) Nevada reported 445 additional new COVID-19 cases on Saturday, the second straight day the state recorded its largest single-day jump in new cases since the start of the pandemic.

    The state 's case total rose to 12,931 with 486 deaths, including 8 reported Saturday, according to the state Department of Health and Human Services.

    Clark County, which includes Las Vegas, accounts for fourth-fifths of the cases and deaths.

    The state reported 410 new cases on Friday, surpassing the previously largest single-day jump of 379 positive tests reported Monday.

    The number of new cases has climbed as Nevada has expanded testing capacity and reopened casinos, restaurants and other businesses in a limited fashion.

    The rise in new cases prompted Gov. Steve Sisolak to say Friday he'd consider enhanced policies on face coverings.

    Nevada already requires employees of businesses that have reopened to wear face coverings, but does not require consumers to do so.

    For most people, the new coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia and death.


    6 staffers setting up for Trump rally positive for COVID-19

    2:19 PM CT on 6/20/20

    (AP) President Donald Trump's campaign says six staff members helping set up for his Saturday night rally in Tulsa, Oklahoma, have tested positive for coronavirus.

    The campaign's communications director, Tim Murtaugh, said in a statement that “quarantine procedures” were immediately initiated and no staff member who tested positive would attend the event. He said no one who had immediate contact with those staffers would attend, either.

    Murtaugh said campaign staff members are tested for COVID-19 as part of the campaign's safety protocols.

    Campaign officials say everyone who is attending the rally will be given temperature checks before they pass through security. They will also be given masks to wear, if they want, and hand sanitizer at the 19,000-seat BOK Center.

    The rally was expected to be the largest indoor gathering in the world during the pandemic.

    Tulsa has seen cases of COVID-19 spike in the past week, and the local health department director asked that the rally be postponed. But Republican Gov. Kevin Stitt said it would be safe. The Oklahoma Supreme Court on Friday denied a request that everyone attending the indoor rally wear a mask, and few in the crowd outside Saturday were wearing them.


    South Carolina sees more cases, hospitalizations

    1:21 PM CT on 6/20/20

    (AP) The coronavirus continues to spread and set daily records in South Carolina, one of the new outbreak hot spots in the United States.

    Health officials said Saturday that South Carolina again saw more new cases, more people in the hospital with the virus and the highest percentage of positive tests in a day.

    The Department of Health and Environmental Control reported more than 1,150 new confirmed cases, for a total of more than 23,750 in South Carolina since the outbreak began in March.

    More than 16% of the people tested had the virus, compared to just over 9% two weeks ago. Health officials said when that figure rises, it is one of the strongest indicators the virus is spreading.

    Health officials reported five additional deaths in the state, bringing South Carolina's COVID-19 death toll to 644 people.

    Another trend bothering health officials is an increase in young people with the virus. About 18% of all cases in the state involve people ages 21 to 30, and 7% involve teenagers, the Department of Health and Environmental Control said.


    Volunteer sleuths track down Hawaii's quarantine scofflaws

    11:18 AM CT on 6/20/20

    (AP) Former longtime television reporter Angela Keen knows how to track people down.

    During the coronavirus pandemic, she’s putting her skills to use finding tourists who defy Hawaii's mandatory two-week quarantine on arriving travelers.

    When members of her Facebook group spot tourists posting about their beach trips on social media, Keen zeroes in on photos for clues like license plate numbers she can run down and distinctive furnishings she can match up with vacation rental listings.

    Armed with a violator's name, she scours the internet for information, from criminal records to previous addresses.

    “I start doing a deeper search with my reporter skills and try to dig things up to say, ‘Are they a risk? ... Do they come from a hot spot?'” said Keen, who was recently working in communications.

    So far, volunteer sleuths with her group Hawaii Quarantine Kapu Breakers — “kapu” can mean “rules” in Hawaiian — has helped find about 13 people on Oahu and 22 people on the Big Island who were later arrested by police, Keen said. Members on other islands assisted with other cases that led to arrests, she said.

    Keen said group members are told not to approach potential violators and not to profile people because they look like outsiders. Lawmakers have credited the group with passing along information to authorities and not taking matters into their own hands.

    Residents helping bring violators to justice is a unique approach to enforcing a quarantine requirement meant to contain the coronavirus, which could spread quickly on the islands if travelers bring it in and pose a threat to Hawaii's limited medical resources. While cases are surging in some states, the quarantine has helped Hawaii maintain some of the nation's lowest COVID-19 infection and mortality rates.

    As of Friday, Hawaii reported nearly 800 confirmed infections. There have been 17 deaths.

    Lawmakers are grappling with how to police hundreds of visitors who continue to arrive daily, even after Gov. David Ige extended the quarantine order through July. Ige has lifted a similar mandate for those traveling between islands and started to allow many businesses to reopen, but officials are still figuring out how to safely welcome back tourists who have long driven Hawaii's economy.

    “I think when you have these instances of individuals blatantly violating the quarantine, you’re naturally going to get this kind of response from the community," said Sen. Jarrett Keohokalole, who's on the Senate Special Committee on COVID-19. “It’s been a challenge tracking down handfuls of quarantine violators. If that ramps up to hundreds or thousands, we’re going to have to change strategy.”

    Community members on the lookout are helpful to law enforcement, said Lt. Audra Sellers, a Maui police spokeswoman.

    “As a small community here in Hawaii, it takes everybody to be able to keep everybody safe,” she said. “You know, some people say, ‘Oh, you’re snitching on people,' but that’s not how you see it. It’s seen it as the fact that you want to keep the community safe.”

    When travelers land, officials at airports verify their arrangements by contacting hotels directly and letting them know a visitor has arrived, the state said. Workers from Hawaii tourism agencies follow up numerous times to verify travelers are in quarantine. When workers can’t contact someone, they alert law enforcement.

    While in quarantine in a hotel room or home, visitors and residents aren’t allowed to leave except for medical emergencies.


    AHA asks HHS to extend emergency declaration

    9:56AM CT on 6/20/20

    Health systems want HHS to extend the public health emergency past its July 25 expiration date, the American Hospital Association said Friday in a letter to HHS Secretary Alex Azar.

    According to the AHA, HHS should extend the public health emergency until supply chains can meet the need for more personal protective equipment, and the U.S. administers more than 500,000 COVID-19 lab tests per day with 5,000 or less positive results for two weeks. Hospitals also want to ensure less than 5,000 patients are in intensive care unit beds on a daily basis for 14 days, with no greater than 10% of those patients in any one region or city. In addition, the number of daily COVID-19 deaths should fall below 500 throughout a two-week period.

    “While not all areas of the country are seeing large numbers of COVID-19 patients, every hospital and health system is operating in a COVID-19 environment, requiring continued assistance from the federal government,” AHA said. “Now is not the time to pull back.”


    COVID hot spot in Washington exceeding hospital capacity

    7:42 PM CT on 6/19/20

    (AP) Hospitals in Yakima County — which has the highest rate of COVID-19 infection in Washington state — are beyond capacity with sick patients.

    Virginia Mason Memorial hospital in Yakima, which holds more than 200 beds, had none available as of Thursday night, intensive care or otherwise, the Yakima Health District said in a statement late Friday. The Seattle Times reports at least 17 patients had already been transferred out of the county. That leaves a total of 61 individuals in hospital beds with positive COVID-19 diagnoses, the county's highest to date.

    And "all hospitals" are experiencing severe staffing shortages — many due to COVID-19 cases within hospital staff, symptoms of the coronavirus, or proximity to a quarantined patient.

    Nearby Benton and Franklin counties are also feeling the strain on their health care systems, but Yakima County remains Washington state's hot spot for the virus. The county now represents 22% of all hospitalized COVID-19 patients in Washington (61 of 242 cases), a higher tally than King County, which is nearly 10 times larger than Yakima County.


    Saliva test for COVID-19 to be adopted by university

    5:48 PM CT on 6/19/20

    (Crain's Chicago Business) When students return to the University of Illinois Urbana-Champaign in the fall, they'll likely be tested for COVID-19 with a new saliva test developed by the university's researchers.

    In a pre-print version of a research manuscript, which has yet to be peer-reviewed, a UIUC research team proposes using saliva to test for COVID-19, rather than the more invasive nasal swab. The manuscript describes how the team is bypassing the RNA extraction step in testing, making it faster and less susceptible to shortages of scarce testing materials.

    School researchers were looking for a way to mass-produce a test to accommodate the more than 47,000 students who would be returning to campus. Saliva is “easy to collect and therefore easy to scale,” said Martin Burke, associated dean of research for UIUC’s Carle Illinois College of Medicine.

    The university plans to pursue FDA Emergency Use Authorization for the saliva testing procedure, according to a UIUC statement. The statement said the emergency use authorization is not necessary for the UIUC lab to use the test, but will help enable the use of the test by other labs.


    Montana records most virus cases in a day since March 28

    4:10 PM CT on 6/19/20

    (AP) Montana on Thursday reported 25 new confirmed cases of the coronavirus, the most in a day since late March as health officials in one county recommended a return to more stringent restrictions on activities.

    The new cases came from every region of the state and reflect an emerging upward trend of infections since restrictions on social movements were eased in recent weeks.

    No new deaths were reported Thursday, leaving the number of fatalities at 20.

    State officials have attributed the increase in confirmed cases over the past several weeks to moves to reopen the economy and increased testing for the virus.

    The trend will likely worsen as the reopening progresses, the officials said.

    The state has only had so many infections on two other days — March 26, when 35 cases were recorded, and March 28, when 25 cases were registered.

    In Custer County, health officials recommended that businesses revert back to restrictions that had been eased last month when virus cases statewide were in decline.

    The county that includes Miles City has recorded 19 infections since its first case appeared less than a week ago.

    The recommendations would have bars and restaurants operate at 50% capacity and limit gatherings to 10 or fewer people.

    "We're a tiny little town, and we have almost as many cases as Great Falls or Helena," county health officer Michael Kecskes told the Billings Gazette.


    Mich. governor extends coronavirus emergency through July 16

    12:01 PM CT on 6/19/20

    (AP) Gov. Gretchen Whitmer on Thursday extended Michigan's coronavirus emergency declaration through July 16, enabling her to keep intact certain business closures, longer unemployment benefits and other changes after she previously lifted a stay-at-home order.

    The Democratic governor — who has been gradually reopening the state — hopes to let gyms, movie theaters and bowling alleys restart by July 4. They currently are operating only in northern Michigan.

    The state of emergency, first declared more than three months ago, is the underpinning for a slew of orders. They include a pause on residential evictions, caps on crowd sizes, an additional six weeks of jobless payments, requirements to wear masks and socially distance, delayed tax deadlines and new workplace infection-control rules.

    "Now is not the time to get complacent," Whitmer said in a statement. "We must continue to stay vigilant and flexible in order to reduce the chance of a second wave."

    She said nearly every state in the country is maintaining a state of emergency to cope with COVID-19. Though the Republican-led Legislature earlier refused to extend the emergency and sued Whitmer, a judge said she can lengthen it on her own under a 1945 law.

    GOP lawmakers have appealed the ruling. Separately, Unlock Michigan — a group with ties to Republicans — is in the early stages of a ballot drive to place before the Legislature veto-proof legislation to repeal the 1945 law.

    "The 1945 law would literally allow a governor to declare a state of emergency to exist from their first day in office, and then issue a stream of orders for four full years," said spokesman Fred Wszolek. "We intend to wipe this law from the books, and force a governor and a legislature to work together with proper checks and balances as intended."

    Whitmer on Wednesday called attempts to strip her powers "irresponsible and dangerous."

    The state health department on Thursday reported 26 additional coronavirus deaths and 225 more cases. There were more than 6,000 deaths — sixth-highest in the U.S. — and 66,000 cases overall.

    As of Wednesday, Michigan had seen 28.4 new cases per 100,000 residents over the previous 14 days, which was lower than all but five states.


    Decline in new U.S. virus deaths may be temporary reprieve

    9:55 AM CT on 6/19/20

    (AP) The number of deaths per day from the coronavirus in the U.S. has fallen in recent weeks to the lowest level since late March, even as states increasingly reopen for business. But scientists are deeply afraid the trend may be about to reverse itself.

    "For now, it's too soon to be reassured that deaths are going down and everything's OK," said Dr. Cyrus Shahpar of Resolve to Save Lives, a nonprofit organization that works to prevent epidemics.

    Deaths from COVID-19 across the country are down to about 680 a day, compared with around 960 two weeks ago, according to an Associated Press analysis of data compiled by Johns Hopkins University. The analysis looked at a seven-day rolling average of deaths through Wednesday.

    A multitude of reasons are believed to be at play, including the advent of effective treatments and improved efforts at hospitals and nursing homes to prevent infections and save lives.

    But already there are warning signs.

    For one thing, the number of newly confirmed cases per day has risen from about 21,400 two weeks ago to 23,200, the AP analysis found.

    And in Florida, Georgia, Texas and Arizona — states that loosened their stay-at-home restrictions early — daily deaths have been quietly rising since early June, said Ali Mokdad, professor of health metrics sciences at the University of Washington in Seattle.

    Experts note that a rise in deaths could take awhile to show up in the U.S. statistics. Stay-at-home orders imposed in March, combined with the use of face masks and other social-distancing measures, have been bringing down the daily death toll since mid-April, and the U.S. as a whole is still seeing the positive effects, even though people are starting to work, shop and eat out again.

    Doctors watching for an uptick in deaths will be on the alert for certain signals to emerge in a specific order, Shahpar said.

    First, cellphone data will show people moving around more. Next, doctors will report more flu-like illnesses, and the proportion of people testing positive for the virus will rise. Hospitalizations will then go up and, finally, so will deaths.

    Several factors are believed to be pushing the curves for deaths and cases in opposite directions.

    Rising case numbers can partially be explained by the wider availability of testing. Mild cases, previously undetected because of limits on who could be tested, are now showing up in the numbers.

    As for the drop in deaths, "it is probably several things happening at once," said Dr. Shmuel Shoham, a professor of medicine at Johns Hopkins University School of Medicine. Lessons learned from the "awful early days" are now benefiting the severely sick and people in nursing homes, Shoham said.


    Nursing homes represent more than 1 in 4 COVID-19 deaths

    8:18 PM CT on 6/18/20

    (AP) Nursing home residents account for nearly 1 in 10 of all the coronavirus cases in the United States and more than a quarter of the deaths, according to an Associated Press analysis of government data released Thursday.

    As federal data collection becomes more robust, a clearer picture is emerging of the ravages of COVID-19 in nursing homes. About 1.4 million older and medically frail people live in such facilities, a tiny share of the American population that has borne a crushing burden from the pandemic. Most residents have been in lockdown since early March, isolated from families and friends, even in death.

    AP's analysis of data from the Centers for Medicare and Medicaid Services found that nearly half of the more than 15,000 nursing homes have reported suspected or confirmed cases of COVID-19 as of June 7. About 1 in 5 facilities — or 21% — have reported deaths.

    Nationwide, nursing homes reported nearly 179,000 suspected or confirmed cases among residents and 29,497 deaths. The latest figures include about 95% of nursing homes.

    Lawmakers are concerned “that lax oversight by the Centers for Medicare and Medicaid Services and the federal government’s failure to provide testing supplies and personal protective equipment to nursing homes and long-term care facilities may have contributed to the spread of the coronavirus," said committee Chairman James Clyburn, D-S.C. “Despite CMS’s broad legal authority, the agency has largely deferred to states, local governments, and for-profit nursing homes to respond to the coronavirus crisis.”

    But CMS chief Seema Verma has said that “trying to finger-point and blame the federal government is absolutely ridiculous.” She says nursing homes with poor ratings on infection control are more likely to have high numbers of cases, a claim that academic researchers say they have not been able to substantiate.


    California orders people to wear masks in most indoor spaces

    7:04 PM CT on 6/18/20

    (AP) California on Thursday started requiring people throughout the state to wear masks in most indoor settings and outdoors when distancing isn't possible as the coronavirus continues to spread.

    “Science shows that face coverings and masks work,” Gov. Gavin Newsom said in a statement about the new order. “They are critical to keeping those who are around you safe, keeping businesses open and restarting our economy.”

    States including Michigan, New York, Maine, Delaware and Maryland already have statewide mask orders in place.

    The order came as California broadly reopens its economy. In most counties, people can now shop, dine in at restaurants, get their hair done and go to church, among other things. As restrictions relax, coronavirus cases are increasing, something the state says was expected as more people get tested. More than 3,400 infected people were hospitalized as of Wednesday, the most since April.

    The order requires people to wear masks when inside or in line for any indoor public spaces, in healthcare settings like hospitals and pharmacies, while waiting for or riding public transportation and in outdoor spaces where it's not possible to stay six feet (1.8 meters) apart from others.

    Until now, the Democratic governor had allowed local governments decide whether to mandate masks, an issue that has become politically fraught as some Americans resist orders to wear them. Newsom said he issued the order because too many people are going out in public without face coverings as businesses, restaurants and other sectors of the economy reopen.


    UN seeks urgent funding for virus aid transport

    5:42 PM CT on 6/18/20

    (AP) The United Nations’ food agency says ít needs immediate funding to prevent a shutdown in late July of the global transport system that has been delivering tons of masks, gloves and other critical equipment for the coronavirus pandemic in 132 nations.

    The World Food Program’s director of operations said Thursday that the agency also would have to ground aircraft that have transported 2,600 humanitarian and health workers free of charge to 40 destinations across Africa, Asia and the Middle East since the pandemic began.

    Amer Daoudi says the WFP requested $965 million to sustain its transport services through 2020 but so far has received only $132 million even though “the entire humanitarian and health community is relying on WFP’s logistic services now more than ever.”


    Arizona governor says mayors allowed to require face masks

    4:21 PM CT on 6/18/20

    (AP) Arizona mayors are free to make wearing face masks mandatory to slow the spread of coronavirus, Gov. Doug Ducey said Wednesday, a turnabout amid pressure as the state became a national virus hotspot.

    The Republican governor, who entered his weekly virus news conference for the first time wearing a face mask but took it off to speak, said allowing cities to decide would work better than a statewide mandate.

    The governor had as recently as last week resisted allowing cities to do more than the state allows to slow the virus spread, saying statewide directives avoid a patchwork of regulations. But he pointed to vastly different county rates of COVID-19 cases and alluded to pushback that some more conservative counties may have a mandate.

    "For some things, a statewide directive or executive order works very well," Ducey said. "If you have 12 or 13 counties that say 'pound sand' on an executive order ... it's a self-defeating executive order."

    Mayors in Phoenix, Tucson and Flagstaff said they would move quickly to require masks. Mesa Mayor John Giles tweeted that he will issue a proclamation mandating masks in the city.

    Pressure has been mounting for Ducey to act amid the state's alarming rise in cases. Hundreds of Arizona medical professionals urged him to take steps like requiring face masks in public, top Democratic politicians urged him to act and the state's biggest newspaper, The Arizona Republic, also called for action.

    Since Ducey allowed the state's stay-at-home and most business-closure orders to expire in mid-May, the second-term governor had taken no new steps to rein in activities like raging bar scenes and the lack of mask-wearing by many in public.

    The rising numbers may have forced his hand. Arizona hospitals were treating a record number of coronavirus patients Tuesday amid a surge of new cases. The state's Health Services Department reported a record number of emergency room visits for the virus as well.

    The health agency confirmed 1,827 new cases and 20 new deaths Wednesday. That brings the total confirmed cases to 40,924 and deaths to 1,239.

    Hospitals were treating 1,582 patients on Tuesday, an increase of more than 500 from two weeks earlier. Emergency room visits for patients with virus symptoms soared to nearly 1,100. On June 3, hospitals reported seeing 638 patients in emergency rooms.

    Statewide Tuesday, hospitals were at 85% of capacity. That's well above the 80% rate where Ducey said they would have to halt elective surgeries to preserve space.


    More than 50 provider groups ask Congress to avert pay cuts

    2:56 PM CT on 6/18/20

    Dozens of healthcare provider groups on Thursday asked congressional leaders to waive budget neutrality requirements for the 2020 Medicare Physician Fee Schedule final rule to avert pay cuts.

    “We are deeply concerned that adhering to existing budget neutrality requirements for implementing the new policy will generate sizable cuts for various sections of the provider community,” the signatories wrote.

    Groups that signed the letter included the American Medical Association, the American Health Care Association, and a new coalition of 12 surgical groups called the Surgical Care Coalition.

    The cuts are currently scheduled to go into effect on January 1, 2021.


    Race for virus vaccine could leave some countries behind

    2:09 PM CT on 6/18/20

    (AP) As the race intensifies for a vaccine against the new coronavirus, rich countries are rushing to place advance orders for the inevitably limited supply to guarantee their citizens get immunized first — leaving significant questions about whether developing countries will get any vaccines in time to save lives before the pandemic ends.

    Earlier this month, the United Nations, the International Red Cross and Red Crescent, and others said it was a "moral imperative" that everyone have access to a "people's vaccine." But such grand declarations are unenforceable, and without a detailed strategy, the allocation of vaccines could be inequitable and extremely messy, said health experts.

    "We have this beautiful picture of everyone getting the vaccine, but there is no road map on how to do it," said Yuan Qiong Hu, a senior legal and policy adviser at Doctors Without Borders in Geneva. Few measures have been taken to resolve numerous problems to achieve fair distribution, she said.

    At a summit with African leaders on Wednesday, Chinese President Xi Jinping said countries in Africa would be "among the first to benefit" once a COVID-19 vaccine is developed and deployed in China, but no deals were announced to back up his promise.

    Worldwide, about a dozen potential COVID-19 vaccines are in early stages of testing. While some could move into late-stage testing later this year if all goes well, it's unlikely any would be licensed before early next year at the earliest. Still, numerous rich countries have already ordered some of these experimental shots and expect delivery even before they are granted marketing approval.

    Among several global efforts underway to try to ensure developing countries don't get left behind is an "advance market commitment" from the vaccines alliance GAVI, whose CEO has warned countries about the dangers of vaccines not being available globally.

    "Even if a few countries go ahead and have vaccines, if there are raging outbreaks in other places ... that is going to continue to threaten the world and the return to normality," said Seth Berkley, the GAVI CEO.

    GAVI and partners have inked a $750 million deal with AstraZeneca to supply 400 million doses by the end of 2020. The Anglo-Swedish pharma giant has also agreed to license its vaccine to India's Serum Institute for the production of 1 billion doses.

    Johnson & Johnson plans to make its coronavirus shot for poor countries at a not-for-profit price, because of the complexity of the technology and expertise needed, said the company's chief scientific officer, Dr. Paul Stoffels. Likewise, AstraZeneca has pledged to make the vaccine available at no profit during the pandemic.

    The World Health Organization and others have called for a COVID-19 "patents pool," where intellectual property rights would be surrendered so pharmaceuticals could freely share data and technical knowledge. Numerous countries including Australia, Brazil, Canada and Germany have already begun revising their licensing laws to allow them to suspend intellectual property rights if authorities decide there is an overwhelming need given the pandemic.

    But the response from the industry has been lukewarm.

    Executives at Pfizer and some other major drug makers say they oppose suspending patent rights for potential COVID-19 vaccines.

    Health officials worry what that might mean for divvying up supplies of a vaccine arguably needed by every country on the planet.

    "We can't just rely on goodwill to ensure access," said Arzoo Ahmed, of Britain's Nuffield Council on Bioethics, noting that precedents of how innovative drugs have been distributed are not encouraging. "With HIV/AIDS, it took 10 years for the drugs to reach people in lower-income countries."


    Texas county orders use of face masks to fight COVID-19

    11:50 AM CT on 6/18/20

    (AP) Texas Gov. Greg Abbott said Wednesday local governments can require businesses to mandate customers and workers to wear face masks after one the state's most populous counties ordered such a measure amid record numbers of new cases of coronavirus and hospitalizations.

    The order for Bexar County, which includes the San Antonio area, takes effect Monday and businesses could face fines up to $1,000 for failing to comply.

    Abbott, a Republican, has refused to order individuals to wear masks as part of his statewide orders, but said other local governments are free to do the same as Bexar County. The mayor of Austin said his city would.

    In an interview with Waco television station KWTX, Abbott said his previous state order would have allowed the move long ago, adding county officials had "finally figured that out."

    "We want to make sure individual liberty is not infringed upon by government and hence government cannot require individuals to wear masks," Abbott said.

    "Local governments can require stores and businesses to require masks .... They've always had the opportunity and ability. Just like they can require people to wear shoes and shirts, these businesses can require people to wear face masks," Abbott said.

    Abbott said under his statewide orders, no person can be jailed for not wearing a mask and local governments can't force individuals to wear one.


    Test maker targeted by FDA says it responded to concerns

    9:46 AM CT on 6/18/20

    (AP) A company targeted by the Food and Drug Administration for selling unauthorized coronavirus antibody tests says it has responded to regulators' concerns, though it has no business operations in the U.S.

    The Food and Drug Administration announced Wednesday it had sent warning letters to three companies selling at-home blood tests, none of which have been reviewed or authorized by the agency. At-home testing can carry extra risks for patients due to the risk of faulty results. The FDA has not authorized any COVID-19 test to be used completely at home

    A representative for Hong Kong-based Medakit Ltd. said Wednesday via email it responded to the agency's letter with a series of steps, including blocking U.S. purchases from its website and adding a disclaimer that its products have not been reviewed or approved by the FDA. Additionally the company said it is reviewing the promotional language it uses for the test, which it said is only intended for use by health professionals, not consumers.

    The company said it mostly operates in Europe and has no business presence in the U.S.

    The warning letters come as FDA tries to police dozens of antibody tests that the agency allowed onto the market earlier this year without evidence that they worked. After coming under fire from experts and members of Congress, the FDA changed course last month, telling companies to submit testing data to remain on the market.

    Antibody tests are different from the nasal swab tests used to diagnose most active infections. The tests instead look for blood proteins called antibodies, which indicate someone had a previous infection. Most of the tests use a finger-prick of blood on a test strip.


    Michigan Legislature approves $220M for frontline pandemic healthcare workers

    7:06 PM CT on 6/17/20

    (AP) The Michigan Legislature on Wednesday unanimously approved spending $880 million in federal relief aid in response to the coronavirus pandemic, setting aside funding for frontline workers, municipalities and child care providers.

    Democratic Gov. Gretchen Whitmer, whose administration was involved in negotiations, will sign it.

    The legislation includes $220 million to give pay raises to certain health workers ($2 an hour) and first responders (up to $1,000), $200 million to reimburse local governments for virus-related spending and $125 million to reduce child care costs.


    NASA's next Mars rover honors medical teams fighting virus

    5:20 PM CT on 6/17/20

    (AP) NASA's next Mars rover is honoring all the medical workers on the front lines of the coronavirus battle around the world.

    With just another month until liftoff, the space agency on Wednesday revealed a commemorative plate attached to the rover, aptly named Perseverance.

    The rover team calls it the COVID-19 Perseverance plate, designed in the last couple months.The black and white aluminum plate — 3-by-5 inches (8-by-13 centimeters) — shows planet Earth atop a staff entwined with a serpent, a symbol of the medical community. The path of the spacecraft also is depicted, with its origin from Cape Canaveral.

    Health care workers were "on front lines keeping us safe" during launch preparations, said deputy project manager Matt Wallace of NASA's Jet Propulsion Laboratory in Pasadena, California. "They really inspired us, I think, through this period, and we hope that this plate and we hope that this mission in some small way can inspire them in return," Wallace told reporters.


    Nevada reports single largest day increase of virus cases

    4:08 PM CT on 6/17/20

    (AP) Nevada is reporting its single largest daily increase of new cases of the coronavirus after the governor announced he would hold off on easing any more restrictions.

    Health officials reported Tuesday that 379 new cases were reported statewide Monday. Before that, the largest one-day increase was 295 cases on May 22.

    The state Department of Health and Human Services said the increase can be partially attributed to delayed reporting from the weekend but also is part of an upward trend of new cases the state has seen in the last three weeks.

    Nevada's casinos reopened almost two weeks ago after being shuttered for 11 weeks, but Democratic Gov. Steve Sisolak announced Monday that current limits on customer capacity in businesses, social distancing guidance and limits on gatherings of more than 50 people would remain at least until the end of June, so health officials can evaluate.

    The state health department said Nevada had expected an increase as a result of reopening and more testing but would continue to review the health data and encourage people to wear face masks and keep their distance from those who are not in their household.

    Nevada has reported 467 deaths from COVID-19 and more than 11,600 people testing positive for the disease.
    Sisolak said Monday that while there's been a recent increase in daily cases, the seven-day average of the percentage of positive cases has held steady or continued to decline, dropping to 5.2% on Monday.

    He said hospitalizations have consistently increased since June 5 but remain within a "plateau" of between 340 and 372 statewide.

    "This indicates the increased number of cases in the community has not manifested in a serious disease that requires hospitalization. However, this must be very closely monitored," he said Monday night.


    House COVID-19 watchdog committee launches investigation into nursing homes

    2:37 PM CT on 6/17/20

    The chairman of the House’s panel created to address the COVID-19 crisis announced Tuesday that he is launching an investigation into skilled nursing facilities’ handling of the coronavirus pandemic.

    Rep. James Clyburn (D-S.C.), the House Majority Whip and chair of the House Select Subcommittee on the Coronavirus Crisis, sent letters to CMS and the nation’s five largest for-profit nursing home companies. The investigation will look into the availability of testing and personal protective equipment, the Trump administration’s oversight, and skilled nursing facilities’ staffing practices.

    Genesis HealthCare, Life Care Centers of America, Ensign Group, SavaSeniorCare, and Consulate Health Care received letters from Clyburn. The letters request documents and information related to COVID-19 cases, deaths, testing, PPE, staffing levels and pay, legal violations, and efforts to prevent future infections.


    Florida governor says COVID spike will not slow economy

    11:59 AM CT on 6/17/20

    (AP) Gov. Ron DeSantis said Tuesday he has no intention of reclosing Florida's economy as the state's daily reported coronavirus cases rose sharply to a record level, saying many of the newly detected are young and healthy and unlikely to suffer serious illness or death.
     

    DeSantis said much of the two-week spike in confirmed infections that pushed the daily total past 2,700 Tuesday can be traced to hot spots such as farm labor camps or particular businesses where a few positive cases lead to widespread testing that uncovers high percentages of asymptomatic or barely symptomatic cases.

    Given those circumstances, DeSantis said it makes no sense to again severely restrict the state's economy as it was from late March into May.

    "We are not shutting down, we are going to go forward and we are going to continue to protect the most vulnerable," DeSantis said at a news conference in Tallahassee.

    But Agriculture Commissioner Nikki Fried, the only Democrat elected statewide, blasted DeSantis, saying in a statement he "has lost control of Florida's COVID-19 response."

    "His policies are simply not working, and he's recklessly reopening Florida despite the data screaming for caution," she said. "Refusing to acknowledge the alarming patterns in cases, hospitalizations, and positivity is not only arrogant, but will cost lives."

    DeSantis' appearance came hours after the state Department of Health reported 2,783 new confirmed cases, pushing the total since March 1 to 80,109. The figure broke the one-day record of 2,581 just set on Friday. Both days are well above the previous high of 1,601 set in mid-May. The state now has reported 2,993 deaths, a one-day jump of 55. The daily average for the past week has been about 35, down from 60 in early May — a fact DeSantis pointed to as proof that the newly infected are less likely to be elderly or sick.

    He also said the number of COVID-19 patients in intensive care units has been halved along with the number requiring ventilators.

    After a period of decline, the state's confirmed cases again began rising June 3, with more than 1,000 cases reported on 13 of the last 14 days. The number of tests given daily has been in the 27,000 range. On average this past week, more than 1,700 new cases have been reported daily.


    COVID-19 hospitalizations in Tennessee reach highest level

    10:04 AM CT on 6/17/20

    (AP) The number of COVID-19 patients in Tennessee hospitals has hit a grim new record at more than 400, and more than twice that number could need beds in the weeks ahead as the state grapples with a new spike in its coronavirus caseload, Vanderbilt University researchers reported Tuesday.

    The rolling weekly caseload of hospitalizations jumped nearly 30% between June 7 and June 13, researchers said, with more people in their 20s and 30s who lack pre-existing medical conditions needing treatment. More 31,000 have now been infected in the state.

    Rises in new coronavirus cases and hospitalizations in recent days have led Memphis and Nashville to delay plans to reopen more businesses and increase capacities for restaurants and retail stores. Health experts also stressed that people should keep wearing face masks in public to reduce the spread of infection.

    "If current transmission trends continue, the state may reach 1,000 concurrent hospitalizations in mid to late July or early August," the Nashville-based university's hospital and medical school said in a news release.

    The rise in hospitalizations has not yet put stress on the state's hospital system, said John Graves, associate professor of Health Policy and director of the Center for Health Economic Modeling at Vanderbilt.

    Republican Gov. Bill Lee and city and county officials have been easing restrictions on businesses during a gradual reopening of the state's economy in recent weeks, despite concerns that Tennessee could worsen local outbreaks by moving too quickly.

    Nashville, for example, is reopening in four phases, and last week, delayed moving to its third phase due to the increased caseload.

    Meanwhile, Shelby County's health department reported hundreds of new infections on Monday and Tuesday, increasing its caseload to more than 7,090. About 200 of these patients are being treated in Memphis-area hospitals, up from 192 on Friday, according to the city and county's virus task force.

    Officials had said Memphis and Shelby County could move on Monday into phase three of their reopening, allowing restaurants and other businesses to expand to 75% capacity, but those plans were delayed due to the "disconcerting" upward trend, county health director Alisa Haushalter said.

    "We have hit the pause button so that we don't have to hit the rewind button," Dr. Manoj Jain, a member of the county's COVID-19 task force, said Tuesday.


    Arizona sees nearly 2,400 new virus cases, a daily high

    8:49 PM CT on 6/16/20

    (AP) The number of new coronavirus cases in Arizona has hit an alarming new daily high of nearly 2,400 — almost double the previous record, health officials said Tuesday.

    The state Department of Health Services reported 2,392 new cases and 25 additional deaths. Hospital intensive care units were hovering around 80% capacity with 1,307 people with the virus as of Monday.

    A day earlier the state recorded 1,104 new cases and eight additional deaths. The number of hospitalizations was slightly higher with 1,449 patients. The number of hospitalizations each day has been at least 1,000 for more than two weeks straight.

    Arizona has seen 39,097 cases and 1,219 deaths. It’s unclear how many of the new cases are due to expanded testing.

    Gov. Doug Ducey has said hospitals would possibly forego elective surgeries if capacity was 80% or greater to save space for a COVID-19 surge. So far, though, there have been no indications that elective surgeries will be delayed.

    The St. Vincent de Paul Society, in a joint effort with CVS Health, has started offering rapid, free virus testing for uninsured people by appointment at the nonprofit's clinic in Phoenix. The goal is to allow people from low-income and other disproportionately affected communities to be tested, with results provided on the spot.

    Licensed health care providers who work for CVS are staffing the testing operation. CVS also announced last week it added 14 more retail drive-thru testing locations to 35 others already open in Arizona.

    The number of new cases has leaped over the past two weeks. Ducey's stay-at-home order expired more than a month ago.

    Arizona has drawn national attention as one of several emerging virus hot spots. Some experts have criticized Ducey and his administration for not doing more to stop the spread such as enforcing face masks and increasing contact tracing.

    For most people, the new coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia and death.


    Bill limiting coronavirus liability advances in Tennessee

    7:21 PM CT on 6/16/20

    (AP) Tennessee would become the latest state to provide health care providers, schools and businesses broad protections against coronavirus lawsuits under a proposal gaining traction inside the GOP-dominant Statehouse.

    House Republicans approved such a measure Tuesday despite objections from Democrats, who argued the bill was unnecessary.

    A separate bill had already passed the Senate last week. However, the House's version tweaked the proposal, which means now the two chambers must negotiate on a final version.

    However, the concept is widely embraced by Republican Gov. Bill Lee and GOP lawmakers.

    So far, a handful of states — including Arkansas, Louisiana and Utah — have adopted such limits through legislation or executive orders. Several more states are considering them as the Chamber of Commerce lobbies for national liability protections.

    Supporters argue employers need assurance they can open their doors without facing a wave of litigation. Critics counter that employees already face a high barrier to receiving restitution from businesses that may place them at risk.

    According to the House's bill, qualifying businesses would not be liable for any “damages, injury or death” from allegedly contracting the coronavirus at their establishment unless the claimant can prove “gross negligence or willful misconduct” that the businesses did not properly comply with public health guidelines.

    The bill also stipulates that anyone seeking to file a lawsuit must include a statement from at least one coronavirus expert who agrees there is a “good faith basis” to submit the claim

    But unlike the Senate version, the bill would only take effect once signed into law. The Senate had included a retroactive element, but House members argued that doing so might not hold up in court.

    For most people, the new coronavirus causes mild or moderate symptoms, such as fever and cough that clear up within weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness and be fatal.


    Texas governor says state can handle spike in COVID-19 cases

    5:46 PM CT on 6/16/20

    (AP) Gov. Greg Abbott insisted Tuesday that Texas' health care system can handle the record-high number of new coronavirus cases and hospitalizations as the state aggressively pushes to reopen its economy.

    At a news conference, Abbott acknowledged that many Texans have become lax about wearing masks and social distancing as coronavirus restrictions have been lifted, and urged them to take greater responsibility for stopping the spread of the virus and to stay home as much as possible.

    “It does raise concerns, but there is no reason right now to be alarmed,” Abbott said of the recent spike in cases.

    Tuesday marked the eighth time in nine days that the state set a new high for hospitalizations of COVID-19 patients, with 2,518, which was an increase of nearly 200 since Monday. That exceeded the number of hospitalized patients on Memorial Day, which at the time was the lowest in more than a month, by more than 1,000.

    In the past week, Abbott allowed retailers, restaurants and amusement parks to increase capacity, even as local officials in some of the hardest hit areas such as Dallas, Houston and Austin urged residents and businesses to remain vigilant about social distancing and wearing face masks. On Friday, amusement parks in counties with more than 1,000 cases will be allowed to operate at 50% capacity.

    Abbott and health officials said the state has enough equipment and available hospital beds to handle the spike — nearly 15,000 open beds, including nearly 1,700 in intensive care units.


    Verma: Some nonemergency care should resume

    4:21 PM CT on 6/16/20

    CMS Administrator Seema Verma said the Trump administration made the right decision to halt nonemergency care during its initial response to the COVID-19 pandemic, but the U.S. will suffer if people continue to delay needed care like childhood vaccinations. Some areas of the country should resume in-person care for necessary operations, procedures, preventive care or evaluation for chronic conditions, according to her op-ed.

    “If we fail to resume the vaccination of our children, we run the risk of a resurgence -- but this time, of long-vanquished conditions such as measles or mumps,” Verma said.

    CMS recently published guidelines to help state and local governments reopen facilities for nonemergency, non-COVID healthcare. But many providers and state and local officials say the guidance isn’t useful because it’s too vague.

    Providers have taken a huge financial hit during the pandemic because people have deferred care at an alarming rate.


    AMGA survey finds medical groups, systems expect lower revenue for some time

    2:46 PM CT on 6/16/20

    A group of independent medical practices and health systems reported in a new survey that revenue likely won’t return to pre-COVID-19 pandemic levels until the end of the year.  

    The findings were released Tuesday by the physician association AMGA as it continues to advocate for continued financial relief for healthcare providers. Just last week AMGA, which represents more than 440 multispecialty medical groups and integrated delivery systems, sent a letter to Senate leaders asking for additional aid. Since mid-March, Congress has passed two relief packages providing about $275 billion in relief for providers but AMGA argues that’s not enough as some practices remain at risk of closure.

    The new AMGA survey involved leaders from 59 integrated health systems and 36 independent group practices. Responses were gathered from May 26 to June 1. Of those, 32% of health systems and 31% of medical groups expect revenue won’t return to pre-COVID levels until the end of 2020. Additionally, 28% of health systems and nearly 26% of medical group practices responded they don’t expect revenue to return until the second quarter of 2021.

    Providers tie declines in revenue to temporary suspension of non-essential services and rising costs of personal protective equipment and telehealth infrastructure.

    In a statement, AMGA CEO Dr. Jerry Penso said, “This pandemic has changed the expense makeup for providers, who are now funding new PPE and telehealth infrastructure costs while simultaneously dealing with significant revenue losses.”


    Mich. nursing homes, tied to one-third of deaths, ordered to test for COVID-19

    1:48 PM CT on 6/16/20

    (AP) Michigan's health department on Monday mandated coronavirus testing of all nursing home residents and staff after reporting the deaths of nearly 2,000 residents tied to the facilities — about a third of all COVID-19 deaths across the state.

    Director Robert Gordon's order requires initial universal testing. Also, all new or returning residents have to be tested, and there must be weekly testing of all residents and staff in a home with any cases until 14 days after the last positive result.

    The state for the first time released a firm overall death count for nursing home residents — 1,947, which is more than 400 more than previously estimated — and listed them by facility. Places with the deadliest outbreaks are largely located in the Detroit area, Michigan's epicenter of the virus.

    "We are not in a position to vouch for data from other states, but such a figure is generally consistent with the figures we have seen elsewhere," said Gordon, who announced penalties for nursing homes that do not comply with reporting requirements.

    Democratic Gov. Gretchen Whitmer, who has faced criticism from Republicans and some Democrats for letting recovering COVID-19 patients go to dedicated virus units in their nursing home or to a "hub" nursing home as long as they are isolated from non-infected residents, extended the policy through July 12. It had been set to expire on Wednesday. Some of the hubs will be decommissioned due to reduced demand.

    Michigan on Monday reported 74 additional coronavirus cases overall and just two more deaths, bringing the respective totals to roughly 66,000 and 6,000.

    While many nursing homes have been testing residents and staff to adhere to clear federal guidance, Gordon said, the state held off on requiring it because "we wanted to wait until we had adequate supply and adequate ability to ensure access to that."

    There have been 7,163 COVID-19 cases among nursing home residents — 11% of all confirmed and probable cases — and 3,133 among staff, including 20 staff deaths. About one in five of all 32,000-plus nursing home residents have tested positive.


    R.I. nursing home visits may resume

    11:48 AM CT on 6/16/20

    (AP) Rhode Islanders may be allowed to make drive-up visits to nursing homes for the upcoming Father's Day weekend.

    State Department of Health Director Nicole Alexander-Scott said Monday that her agency is working on possibly easing restrictions at nursing homes, where the majority of the state's fatal cases of COVID-19 have occurred.

    She said visitors would have to stay in their car with masks on while the nursing home resident would be kept several feet away and also have to wear a mask.

    She also warned that visits may not be possible at all long-term care facilities and that they would be by appointment only.

    Visits have been banned at long-term care facilities since the pandemic started in March.


    UK begins coronavirus vaccine trial; France pledges funding 

    10:00 AM CT on 6/16/20

    (AP) Scientists at Imperial College London will start immunizing people in Britain this week with their experimental coronavirus shot, while pharmaceutical company Sanofi and the French government announced more than 800 million euros ($890 million) in investment Tuesday as part of the worldwide race to find an effective vaccine.

    About a dozen vaccine candidates are currently in early stages of testing in thousands of people. There are no guarantees any will work but there's increasing hope that at least some could be ready by the end of the year.
    Many scientists have warned that the pandemic that has already infected at least 8 million people and killed over 437,000 worldwide might only be stopped with an effective vaccine, which typically takes years to develop.

    In a statement, the British government said 300 healthy people will be immunized with two doses of the COVID-19 vaccine candidate developed at Imperial, which has been backed by 41 million pounds ($51 million) in government funding.

    Robin Shattock, who is leading the vaccine research at Imperial, said the advantage of their vaccine is the small amount required: their dose is one hundredth of the dose being tested by the NIH and Moderna Inc. That means millions of doses could be relatively quickly manufactured.

    "If the U.K. government wants to purchase enough vaccine for the U.K. population, we already have that infrastructure in place to deliver that in the first two quarters of next year," he said.

    Sanofi, meanwhile, is working on a vaccine that it hopes to test on humans later this year and win approval next year.

    The company pledged Tuesday to invest 610 million euros ($680 million) in a vaccine production site and a new vaccine research center in France, to be able to produce in greater scale and "quickly respond to future pandemic risks."

    French President Emmanuel Macron visited a Sanofi lab Tuesday alongside CEO Paul Hudson, and announced 200 million euros in government investments to reduce France's dependence on other countries for vaccines and other medicines.

    Macron said France will "relocalize" production of some drugs as part of broader government efforts to revive the virus-battered economy and bring more manufacturing production back to France.

    Last month, Sanofi prompted outrage in France by promising to give the United States first access to the company's eventual vaccine, because the U.S. had invested more in its research. Sanofi later backtracked and said it would be available in all countries.

    Macron has pushed for vaccines to be considered a "common good" for humanity that must not be subject to market pressures.

    The Imperial vaccine uses synthetic strands of genetic code based on the virus. Once injected into the muscle, the body's own cells are instructed to make copies of a spiky protein on the coronavirus. That should in turn trigger an immune response so the body can fight off any future COVID-19 infection.

    Dr. Doug Brown, chief executive of the British Society for Immunology, said the technology used by Imperial College London should theoretically lead to long-term immunity against the coronavirus but now needs to go through rigorous testing. He was not linked to the trial.

    Oxford University recently began an advanced study involving 10,000 volunteers, and the U.S. is preparing for even larger studies in July that involve 30,000 people each testing different candidates, including Oxford's and one made by the National Institutes of Health and Moderna Inc.


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