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health

Should you get a COVID-19 test before traveling? Here’s what doctors say.

As “pandemic fatigue” works its way into our lexicon and the holidays approach, more people are weighing the risks of travel. With testing more widely accessible, it makes sense that taking a test before you travel could increase your safety as well as those around you, but doctors warn it’s not that simple.

UCSF epidemiologist Dr. George Rutherford said when thinking about the safety of travel right now, no matter the mode of transportation, it’s still best not to do so at all, especially in light of new surges across the country. “The virus hasn’t changed,” Rutherford said. “Given the surging around the country, it’s probably a bad idea to go out and mix with people. The real overriding message is unless there is some really compelling reason to go, don’t.”

If you want to use testing to lower your risk, you’ll need to get more than one. Rutherford suggests taking a test, and assuming it’s negative, continue to isolate for 5-7 days and then take a second test. If that test is negative, then you’re probably truly negative before you travel. “The problem with this disease is you could be in the incubation period of 3-4 days where you don’t have a high enough level of virus to get a positive test,” Rutherford said. “They’re not false negatives, but they can be misleading. A single test doesn’t really tell you everything. It doesn’t mean they won’t turn positive the next day or day after.”

Dr. Michael Vollmer, a Kaiser Permanente infectious disease expert, said that the incubation period is key and even if those tests are negative, it also doesn’t mean you may not catch the virus while traveling or while at your destination. “That test is helpful that day … but right after it’s completed it doesn’t tell you if you’re going to be exposed to the disease. … It doesn’t tell us what’s going to happen later.”


In order to be really sure you’re negative before departure, Rutherford said you would have to self-quarantine for two weeks, but at that point, you also probably don’t need to be tested.

Once you’re at your destination, the real risks can begin. Especially if you’re going to an area where cases are high, you could encounter the virus and bring it back when you return. Additionally, when you’re around those you’re comfortable with, like friends and family, it’s easy to become lax with mask wearing and social distancing.

“With familiarity, masks come off,” Vollmer said. “Most disease is transmitted in small groupings and family gatherings.”

Hand washing, mask wearing and social distancing are still the most important ways we can prevent the spread of the virus, he said.

If you feel you may have been exposed to the virus while traveling, it’s best to isolate for at least five days upon return and then get tested again.

“Travel is risky and during a pandemic, it’s very risky,” Vollmer said. “It’s really difficult to mitigate that risk. People should put travel

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fitness

Peloton and Planet Fitness Pumped for Pandemic Workouts. Here’s Why.

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Macquarie analyst Paul Golding sees double-digit upside for upscale exercise-bike maker Peloton and low-cost gym chain Planet Fitness.


Courtesy Peloton

The Covid-19 pandemic has closed gyms, pushing consumers to work out at home. But an analyst at Macquarie is bullish on both

Peloton Interactive

and

Planet Fitness.

Peloton stock (ticker: PTON) has soared to new highs, rocketing 368% so far in 2020. With gyms were closed, Peloton sales soared as consumers poneyed up for the company’s premium exercise bike and $39-a-month connected fitness subscription. At the same time, Planet Fitness stock (PLNT) fell 15%.

Macquarie analyst Paul Golding has Outperform ratings on both stocks. On Tuesday, he raised his Peloton price target to $150, and maintained a $78 price target on Planet Fitness. That represents 13% and 23% respective upside for the stocks.

Golding thinks Peloton is a good value for consumers, at the price of about three SoulCycle classes a month. He thinks the company’s can leverage its value and bundle equipment. He also thinks it could acquire an athleisure brand or develop a strength platform either by issuing more shares or using liquidity on hand, if the company wants to own the broader fitness category.

Consumers can get a Peloton bike for about $49 a month, the Peloton Treadmill at about $64 a month, and the membership at $39 a month. He thinks an additional $8 a month for a bench and weights could help boost retention. Such a scenario highlights the trouble Peloton could spell for gyms. Golding expects membership cancellations to hit midtier and high-end gyms, boutique gyms, and studios.

But if consumers combine Peloton’s at-home instruction with a low-cost gym membership, Planet Fitness could actually stand out, according to Golding.

“Enter Planet Fitness—with its almost 2,100 stores and Black Card reciprocity, and with a 50% gym membership rate across Peloton subscribers as an example across in-home platforms, we think Planet Fitness is poised to become the de facto bricks-and-mortar gym for many looking to diversify their fitness offerings,” Golding wrote. “And of course, reciprocity comes by virtue of being open and well capitalized.”

Pointing to industrywide struggles, Golding thinks Planet Fitness can benefit from consolidation.

“We think certain swaths of the competitive landscape like midtier gyms as well as boutiques and studios are likely to be affected by the secular shifts toward virtual fitness, leaving fewer brick -and-mortar alternatives to Planet domestically (especially at these price-points), and leaving more real estate available for Planet franchisees to take advantage of,” he wrote.

In Tuesday morning trading, Peloton stock is down about 1% to $131.90, while Planet Fitness stock is flat.

Write to Connor Smith at connor.smith@barrons.com

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health

Obamacare Open Enrollment Starts Nov 1. Here’s What’s Changing This Year : Shots

Open enrollment is about to start for those buying private insurance off state or federal exchanges.

PhotoAlto/Frederic Cirou/Getty Images/PhotoAlto


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PhotoAlto/Frederic Cirou/Getty Images/PhotoAlto

Open enrollment is about to start for those buying private insurance off state or federal exchanges.

PhotoAlto/Frederic Cirou/Getty Images/PhotoAlto

Facing a pandemic, record unemployment and unknown future costs for COVID-19 treatments, health insurers selling Affordable Care Act plans to individuals reacted by lowering rates in some areas and, overall, issuing only modest premium increases for 2021.

“What’s been fascinating is that carriers in general are not projecting much impact from the pandemic for their 2021 premium rates,” said Sabrina Corlette, a research professor at the Center on Health Insurance Reforms at Georgetown University in Washington, D.C.

Although final rates have yet to be analyzed in all states, those who study the market say the premium increases they have seen to date will be in the low single digits — and decreases are not uncommon.

That’s good news for the more than 10 million Americans who purchase their own ACA health insurance through federal and state marketplaces. The federal market, which serves 36 states, opens for 2021 enrollment Nov. 1, with sign-up season ending Dec. 15. Some of the 14 states and the District of Columbia that operate their own markets have longer enrollment periods.

The flip side of flat or declining premiums is that some consumers who qualify for subsidies to help them purchase coverage may also see a reduction in that aid. Subsidies are determined by a mix of a consumer’s income and the cost of a benchmark plan.

Here are a few things to know about 2021 coverage:

It might cost about the same this year — or even less.

Despite the ongoing debate about the ACA — compounded by a Supreme Court challenge brought by 20 Republican states and supported by the Trump administration — enrollment and premium prices are not forecast to shift much.

“It’s the third year in a row with premiums staying pretty stable,” said Louise Norris, an insurance broker in Colorado who follows rates nationwide and writes about insurance trends. “We’ve seen modest rate changes and influx of new insurers.”

That relative stability followed ups and downs, with the last big increases coming in 2018, partly in response to the Trump administration cutting some payments to insurers.

Those increases priced out some enrollees, particularly people who don’t qualify for subsidies, which are tied both to income and the cost of premiums. ACA enrollment has fallen since its peak in 2016.

Charles Gaba, a web developer who has since late 2013 tracked enrollment data in the ACA on his ACASignups.net website, follows premium changes based on filings with state regulators. Each summer, insurers must file their proposed rates for the following year with states, which have varying oversight powers.

Gaba said the average requested increase next year nationwide is 2.1%. When he looked at 18 states for which regulators have approved insurers’ requested rates, the percentage is lower

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health

Coronavirus in Illinois updates: Here’s what happened Oct. 16 with COVID-19 in the Chicago area

The state also said the seven day-average of coronavirus tests coming back as positive has climbed to 5.1%, surpassing a threshold recommended by the World Health Organization for safely reopening economies.

The record comes as the state also reports the highest number of test results returned in a 24-hour period. The 87,759 results reported Friday outstrips the previous high of 74,286 on Sept. 19. There were 2,529 newly confirmed cases that day.

There also were 38 more fatalities reported Friday, bringing the statewide death toll to 9,165 since the pandemic began. In all, there have been 336,174 known cases of COVID-19 in Illinois.

Meanwhile, Chicago Public Schools announced Friday that all students will continue with remote learning when the second quarter starts in November but that some of the district’s “most vulnerable” children will have the option to begin returning to schools before the end of the calendar year.

In explaining their rational for offering in-person classes first to pre-kindergarten and some special education students, CPS officials cited enrollment figures they released Friday that show a drop of 34% in total preschool enrollment from last year.

Here’s what’s happening Friday with COVID-19 in the Chicago area and Illinois:

5:40 p.m.: Lake County moved off COVID-19 warning status, but officials warn return to all-remote schooling is a possibility

Lake County was removed from orange COVID-19 warning status by the Illinois Department of Public Health Friday, and is now the only county along the Wisconsin state line not so situated, according to department’s website.

While the reclassification may give residents a temporary sigh of relief, Hannah Goering, the marketing and communications manager for the Lake County Health Department, said it could be short-lived.

5:25 p.m.: COVID-19 numbers are rising in Illinois. How worried should the Chicago area be?

Illinois just announced a record number of new COVID-19 cases. Positivity rates for coronavirus testing are up too. So are hospitalizations and deaths.

But a deeper look at the data can soften the sense of alarm somewhat — at least for the Chicago area, where many pandemic metrics have remained steady for months until some recent upticks. And the state as a whole is still in better shape than its neighbors on most of those same statistics.

As a pandemic-weary public braces for winter, the latest Illinois figures have prompted researchers and public health officials to offer a mix of warnings and reassurance. They worry a second surge may be starting in Illinois while also noting that the shifting pandemic threatens some areas more than others.

3:45 p.m.: Kane, Will counties back on state COVID-19 warning list; Kane health director outlines ‘concerning’ trends

Kane and Will counties have returned to the state’s list of those showing “warning signs” of increased coronavirus risk.

They were among 34 counties statewide on the list Friday, based on measures of the virus’ spread. Their addition to the warning list came the same day Illinois public health officials announced a record-high number of new COVID-19 cases for the second

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health

She was suffering on the streets of Santa Monica. Here’s what it took to rescue her

VENICE, CA - OCTOBER 14: Dr. Coley King, director of homeless health care at Venice Family Clinic, right, visits Suzanna, left, one of his clients on Wednesday, Oct. 14, 2020 in Venice, CA. Dr. King helped treat Suzanna when she was living on the street and now she is housed. (Francine Orr / Los Angeles Times)
Dr. Coley King, director of homeless health care at Venice Family Clinic, right, visits his client Suzanna, who now has temporary housing and will be moving into an apartment soon. (Francine Orr / Los Angeles Times)

Coley King, who practices street medicine for the Venice Family Clinic, wasn’t frightened by the angry and disoriented woman at Wilshire and Lincoln boulevards in Santa Monica, who was chucking her belongings in all directions.

“My usual approach is to give some distance,” said King, who studied the homeless woman’s behavior from afar before approaching.

She was limping badly and teetering on the curb, and King feared she might tumble into the path of speeding cars. The doctor conferred with his traveling companion, outreach worker Katie Holz, and moved closer. He recalls the woman continuing “to throw a fit” for a while, tossing a flashlight and backpack in his direction, but then the anger began to melt away.

“At some point I said, ‘Hey, can I buy you a cup of coffee?’ and she said yes,” said King.

Her name was Suzanna, and she was in her mid-50s, living on the streets with a combination of mental health and addiction issues. Over coffee and doughnuts, Suzanna told King about the hip surgery she’d recently had and a bit about her mental health history.

Suzanna also told King that he appeared to her to be spinning about, as if trapped in a tornado.

King is a physician, not a psychiatrist, but more than a decade of visiting homeless encampments offers an education you can’t get in school, and he has learned that it’s often better to provide help as soon as someone agrees to it than to write a prescription that may never get filled. He carries anti-psychotic drugs with him, and after a series of questions about her medical history, he asked Suzanna if she’d like him to administer an injection, right then and there, that might help relieve her hallucinations and other symptoms.

Suzanna said yes.

That was in late June. A week later, he returned with another, longer-lasting dose of the same medication, and again she agreed to the treatment.

When I met with Suzanna a few days ago, it was at a Venice hotel, where she has been given temporary housing. She is living a new life, filled with dreams rather than despair. She said she feels “immensely” better and would be moving soon into her own apartment.

I’m sharing Suzanna’s story because in a county with 60,000 homeless people, three or four of whom die each day on average, it’s just so good to hear about a successful intervention.

Last week I wrote about a homeless woman after Silver Lake residents alerted me that she was often naked and disoriented, and that she had been seen crawling across Sunset Boulevard, in grave danger. After the column ran, I heard from readers, as I often do on this topic, who said that if she was known to be using

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health

From the pandemic declaration to the fall surge, here’s a timeline of Covid-19 in the USd

Experts say the fall Covid-19 surge is here. Infections and hospitalizations are rising across the country. And one leading health official says daily Covid-19 deaths could soon begin climbing, too.



a man wearing a costume: Medics transfer a patient on a stretcher from an ambulance outside of Emergency at Coral Gables Hospital where Coronavirus patients are treated in Coral Gables near Miami, on July 30, 2020. (Photo by Chandan Khanna/AFP/Getty Images)


© Chandan Khanna/AFP/Getty Images
Medics transfer a patient on a stretcher from an ambulance outside of Emergency at Coral Gables Hospital where Coronavirus patients are treated in Coral Gables near Miami, on July 30, 2020. (Photo by Chandan Khanna/AFP/Getty Images)

The alarming trends come ahead of a season that will likely be especially challenging. Students across the country have returned to class and college students — some of whom live in campuses that reported Covid-19 outbreaks — will soon return to visit their families and could unknowingly bring the virus back with them. And Covid-19 will also be stacked up against the flu season and could create what doctors call a “twin-demic.”

What happens next is unclear. But here’s how we got here:

On April 10, about a month after Covid-19 was declared a pandemic by the World Health Organization, the US hit its first high point during the pandemic, peaking at an average of a little more than 31,800 daily cases, according to data from Johns Hopkins University.

The country also eclipsed more than half a million Covid-19 infections.

Cases were clustered mostly in New York, with other, smaller outbreaks in places such as Washington state, Louisiana and Illinois. Around that time, New York state had more infections than any other country in the world, with more than 160,000 cases. As of October 16, the state has reported more than 481,000 infections.

By June 9, the US had flattened the curve and was averaging about 20,340 new cases daily, Johns Hopkins data showed. States were opening back up after weekslong lockdowns that were put in place to help curb the spread of the virus.

With the easing of measures, more Americans began to venture outside and images and videos emerged of parties and other gatherings with no social distancing and few masks in sight.

By July 22, the nation reached its highest peak of the pandemic, to date, averaging more than 67,000 cases daily. The US was seeing huge spikes in cases in the West and South.

The case surges came weeks after crowds celebrated the July 4 holiday. Across the country, local officials warned more young people were testing positive and helping drive the increase in infections.

Arizona, Florida, California, Texas and Georgia were adding thousands of cases per day. Experts called Florida the epicenter of the pandemic and by the end of the month, more than four dozen hospitals across the state were reporting full ICUs.

By September 12, the summer peak had slipped down to a little more than 34,300 average new cases daily, according to data from Johns Hopkins. That baseline was higher than what it was in the spring and experts warned Americans should work to lower it as the nation was heading into the colder fall and winter months.

Now hotspots

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