August 20 coronavirus news

Superspreading events – when one or a few infected people cause a cascade of transmissions – may be especially important in driving the coronavirus pandemic in rural areas, researchers reported Thursday.

Their study of five counties in Georgia also showed shelter-in-place orders worked fast to bring cases down – usually within about two weeks. And younger people were more likely to spread the virus than people over age 60.

Biostatistician Max Lau of Emory University and colleagues analyzed state health department data in more than 9,500 coronavirus cases in four metro Atlanta area counties plus Dougherty County in rural southwestern Georgia between March and May.

Health officials across the country have reported superspreading events related to birthday parties, funerals, conferences and other large gatherings.

People under 60 were almost three times as likely to spread the virus as people over 60, and tended to be responsible for superspreading, they said.

They also used location data from Facebook users to estimate how much people moved around and applied mathematical models to figure out how the reported cases fit in with behavior. 

But the data is likely skewed, the Emory team said. Early on in the pandemic, especially, older people were more likely to be reported with infections because they were more likely to have serious symptoms.

“Due to the lack of widely available testing, the underreporting rate was almost surely high during earlier phases of the pandemic,” they added.

Dr. Francis Collins, director of the National Institutes of Health, encouraged scientists to work on Covid-19 antibody treatments with the same urgency he has already seen the community bring to research during this pandemic. 

Collins’ focus in an online discussion Thursday was on the latest science behind monoclonal antibody treatments and convalescent plasma. Both are under investigation in a variety of clinical trials to treat and possible prevent Covid-19.

With monoclonal antibody treatments, scientists clone antibodies that they think will be most effective at fighting a disease and put that into a treatment.

Eli Lilly Inc., whose treatment uses one potent antibody, is currently putting its antibody treatment through a few late-stage human trials. Regeneron Inc. uses two antibodies in the treatment it’s testing in late-stage trials. Several other companies’ antibody treatments are in earlier stages of development.

In the discussion Thursday, scientists presented evidence that they think these treatments will not cause antibody-dependent enhancement – where a treatment makes a disease worse. Collins said the government will be monitoring the trials closely to see if the problem develops or if there is any evidence of viral resistance to the treatments. 

A cocktail approach reduces the risk of a treatment becoming ineffective if the virus were to mutate, studies have shown. Some companies have been reluctant to use more than one antibody in a treatment because it may slow the manufacturing process. 

Collins said if the treatment was well-designed, that may not be as much of an issue.

Dr. Janet Woodcock, therapeutic lead for Operation Warp Speed, said the government is committed to making sure these therapies work in head-to-head clinical trials.

“We hope to be testing the efficacy of a number of neutralizing monoclonal antibodies and possibly other types, so perhaps polyclonal antibodies in parallel, in randomized clinical trials,” Woodcock said. “This provides, I think, a tremendous opportunity.”

Prisons are hotspot for the spread of coronavirus, but inmates are not getting the medical attention they need, Dr. Homer Venters, former chief medical officer of New York City Correctional Health Services, said Thursday. 

Venters said his investigation of Covid-19 responses in 40 jurisdictions around the country, including federal prisons, local jails and immigration detention centers, showed “systematic racism.”

Agencies such as the US Department of Health and Human Services or the US Centers for Disease Control and Prevention, which would normally provide quality assurance in care facilities, “are all essentially AWOL when it comes to the health and health care of people who are detained and that’s not an accident. It is really one of the most poignant ongoing representations of systematic racism in our nation,” he said.

Research has shown that people of color are disproportionately represented in the US prison system.

Ohio Gov. Mike DeWine said there has been a significant decrease in coronavirus cases in urban areas, but the state has experienced an increase in cases in rural areas.

“We've seen in the urban areas that a bigger percentage of people will wear a mask for a longer period of time, and we've seen those numbers come down. Unfortunately, we're seeing the numbers go up in our rural areas,” DeWine said at a news conference Thursday.

The latest numbers: The governor says 22 more people died and 86 were hospitalized in the last 24 hours. That brings the current total of confirmed cases to at least 106,063 and at least 3,650 people have died in the state so far. Mercer County has the highest number of cases in Ohio with at least 718, two times what the Centers for Disease Control and Prevention considers high incidence.

DeWine announced that he is issuing an order for all 765 assisted living facilities in the state. The order requires participation in a rapid saliva test for all residents and staff at no cost. The self-performed test will offer results within 48 hours of lab receipt. 

“The value in this initiative is tied to four things, the accuracy and sensitivity of the test, how quickly you get test results, consistent to repeat testing and high-risk settings and modifying behavior based on the results data," he said. "Our focus has been and remains, protecting Ohio and navigating through this pandemic. To achieve this, we must have 100% participation of all assisted living facilities in Ohio,” he added.

Connecticut is currently trending at a 0.8% positivity rate for Covid-19 and is well within the self-imposed metrics to reopen schools in two weeks, Gov. Ned Lamont said Thursday.

In a news conference, Lamont said the seven-day average per 100,000 people is the key metric he is using to evaluate safely reopening schools. As of Thursday, that statewide percentage stood at 2.1 new cases per 100,000 population.

The “breakpoint” for positivity would be 10 new cases per 100,000, Lamont said, at which point the state would have to reconsider reopening.

Part of the state’s phase three plan for reopening includes schools and colleges, but Lamont said there are “no plans” for implementing the other portion, which includes increasing capacity in restaurants and bars.

Connecticut will extend its eviction freeze until Oct. 1 and will increase rent relief for landlords to negotiate with tenants, Lamont said.

Brazil’s health ministry on Thursday reported at least 45,323 new Covid-19 cases in the past 24 hours, bringing the total to approximately 3,501,975.

The ministry also reported at least 1,204 new Covid-19 fatalities, raising the country’s death toll to approximately 112,304.

The White House has formally declared that teachers are essential workers as part of its effort to encourage schools around the country to reopen for in-person learning.

The move is just the latest in the administration’s campaign to pressure districts into bringing back students this fall. The essential worker designation provides guidance for educators that is only voluntary; it calls on teachers to return to the classroom even after potential exposure. 

Some context: Vice President Mike Pence announced the decision to governors on a call earlier this week, a person familiar with the decision said.

Under Department of Homeland Security guidance issued this week, teachers are now considered “critical infrastructure workers,” and are subject to the same kinds of advisories as other workers who have born that label – such as doctors and law enforcement officers.

The guidance for essential workers states that they can continue to work even after exposure to a confirmed case of Covid-19, provided they remain asymptomatic. Schools’ contribution to community spread has already been a top concern for districts making the decision to open or close, so pushing teachers to continue working after potential exposure could prove controversial.

White House officials made the move in part to convey how seriously its believes the schools question should be taken, the person said, but also to try to stabilize the teaching workforce and streamline guidance at a time of confusion about the future of classrooms.

East Carolina University has paused football activities indefinitely after evaluating results from the latest rounds of Covid-19 testing, according to news release citing director of athletics Jon Gilbert.

Separately, a news alert on the university's website Thursday said the school has identified a cluster of Covid-19 cases within the university’s football team and Clement Hall, which is a university residence hall. There are currently seven positives related to Clement Hall and 10 positives associated with the football team, the alert stated.

“Learning pods” may help families pool resources while keeping kids safe, but not every family has the means to take part, one expert said Thursday. 

Some parents are even sharing resources to hire tutors, but it’s something not many families can do, Anderson told a briefing sponsored by Johns Hopkins.

She urged parents to carefully consider plans for their children this upcoming school year.

“They need to really think about how they're going to balance the academic needs but also some of the social emotional learning needs to students, so that they can make sure that it's fair and balanced for everyone,” Anderson said.

Anderson also noted concerns that some people may have trouble getting the supplies and equipment their kids need for online learning.

“Despite the redoubling of efforts in districts to try to get devices to children, there's still a backlog in the number of devices and hotspots that are available to some of our students, so we need to make sure that we are being more consistent and bringing everyone up to the same level if we're going to deliver online content this fall,” she said.