August 20 coronavirus news

As many as 60 million Americans could have been infected with coronavirus, Director of the US Centers for Disease Control and Prevention Dr. Robert Redfield told the Journal of the American Medical Association Thursday.

The CDC released a report in June, published in JAMA, showing an infection rate in the United States of about 10%. Redfield said at the time he believed testing had missed 90% or more of cases. 

Redfield said Thursday an infection rate of between 10-20% translates into as many as 60 million people who may have already been infected, but there’s not really any good data on the numbers yet.

“We’re in the process of obviously following up with the report that we did in JAMA that kind of let us understand that maybe for the 2 million cases we diagnosed, we had an estimated 20 million people infected,” Redfield said in the video interview.

“We've now expanded that throughout the country, so very large surveillance work in progress,” he said.

Redfield said he didn’t want to speculate on the number of Americans who may actually be infected with the virus, but he did offer an estimate.

“I really want to be data driven but there is enormous geographic variation. I can tell you that we have some areas that we're looking at less than 1% and we have other areas we're looking at 20%,” he said.

Confirmed cases: As of Thursday night, at least 5,573,501 coronavirus cases have been recorded across the US, according to Johns Hopkins University. The total includes at least 174,248 deaths.

In mid-March, as the coronavirus pandemic began to take hold in Europe and the United States, New Zealand's Prime Minister Jacinda Ardern presented her country with a choice.

They could let coronavirus creep into the community and brace for an onslaught, as other countries around the world had done. Or they could "go hard" by closing the border -- even if that initially hurt the island nation's hugely tourism-dependant economy.

Ardern opted for the second path. When New Zealand had only reported 28 cases, Ardern closed borders to foreigners, and when there were 102 cases, she announced a nationwide lockdown.

In effect, Ardern offered New Zealanders a deal: put up with some of the toughest rules in the world, and in return, be kept safe -- first from the deadly coronavirus, and later, from potential economic devastation.

For a while, it seemed that deal had paid off. New Zealand spent seven weeks under lockdown, five of them under strict rules that meant even takeaway food and traveling outside of their immediate neighborhood were off limits. But by June, life was basically back to normal -- and in August, New Zealand marked 100 days without any community transmission.

Then, last week, that changed.

Read the full analysis:

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Mexico reported at least 6,775 new cases of Covid-19 on Wednesday, bringing the total to approximately 543,806. 

The health ministry also reported at least 625 new deaths yesterday, bringing the total number of fatalities in the country to approximately 59,106 since the beginning of the pandemic. 

Some context: Mexico has the third-highest number of deaths from coronavirus in the world following only the US and Brazil, according to Johns Hopkins University.

Mexico is ranked third in Latin America by Johns Hopkins in terms of its number of total coronavirus cases, behind only Brazil and Peru. 

Utah Gov. Gary Herbert said people who were opposed to wearing masks in schools were "a little bit irrational."

Herbert, who said his own grandchildren would be wearing masks while at school, said the state has tried to create an environment that is safe for students to learn, and to also keep teachers who might be more susceptible to health issues safe.

Herbert said at a news conference Thursday that he understands the safety concerns and that people want zero risk when going back to school, but he said “we certainly can minimize the risk and mitigate the chances of you catching the coronavirus at school” and one of the best ways to do that is to wear a mask, he added. 

While Utah does not have a statewide mask mandate, a state public health order was issued on July 17 requiring all students, teachers, staff and visitors on school property to wear a mask.

If K-12 students, teachers, staff and visitors are not wearing a mask, they can now be charged with a class B misdemeanor that is punishable by a sentence of up to six months in jail and a fine of $1,000, according to the Utah Judiciary. The class B misdemeanor for violating the masks at school order would be the same as violating any mandate. Enforcing the mask mandate in schools is left up to local jurisdictions, Herbert said.

"The mask mandate is not intended to penalize students, parents or teachers — it's intended to create a universal standard of a safe, common sense practice. All mandates make a Class B misdemeanor the default penalty, but any enforcement of this would be on the local level," Anna Lehnardt, director of communications for Herbert, said in a statement to CNN.

Herbert also announced he issued a new state of emergency order that will take effect tonight upon the expiration of the state’s current one.

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.