Virus

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Iowa doctors say virus spread risks overwhelming hospitals

DES MOINES, Iowa (AP) — Iowa’s number of coronavirus cases, deaths and hospitalizations continued to surge higher Wednesday as medical professionals have begun to express concern that hospitals could be overwhelmed with patients if no action is taken to slow the virus spread.

Iowa hospitals had 596 coronavirus patients Wednesday, by far the highest number so far in Iowa. The 113 patients admitted in the past 24 hours also was the highest seen since the virus surfaced in Iowa in March. The number of patients needing intensive care unit services has also trended upward in the past month.

Iowa doctors and hospital officials are preparing for a system overrun by COVID patients by talking about how to transfer patients between hospitals and enacting surge plans that could turn non-hospital facilities into spots to handle any overflow.

“What we know is if the last four weeks are indicative of what happens over the next four weeks we will have the system overwhelmed,” said Suresh Gunasekaran, CEO of University Hospitals and Clinics in Iowa City. “If hospitalizations continue to increase at the exact same rate they have been for weeks, the math itself tells you that you run out of beds.”

University hospitals, the state’s only academic medical center, is often where other hospitals send patients with complex intensive care needs. It is seeing a significant volume of COVID-19 patients from around the state, Gunasekaran said.


He said Iowans need to understand that the coronavirus patient surge often displaces the ability to care for patients with other complex needs stemming from problems such as heart disease, cancer or neurological conditions.

State public health officials reported 1,814 new confirmed cases Wednesday and an additional 22 deaths for a total of 1,680.

Over the past two weeks, the rolling average number of daily new cases has increased by 249, an increase of nearly 23%, according to researchers from Johns Hopkins University. Iowa has averaged about 1,400 new cases a day for the past week.

“My take away from this is that things are bad but also they can and will likely get much worse because the number of new cases is just staggering,” said Dr. Rosanna Rosa, an infectious disease doctor with UnityPoint Health.

A spokesman for the Iowa Department of Public Health said the state is in regular, often daily, contact with health systems, hospitals and regional medical coordination centers to assess hospital capacity, staffing and resources.

“At this time, hospitals are reporting that they are able to manage the increased number of patients, and are prepared to implement surge plans to expand capacity if necessary,” spokesman Alex Carfrae wrote in an email.

He said staffing shortages can occur during times of seasonal illness or viral outbreaks and hospitals have a variety of solutions to maintain adequate staffing levels.

Rosa said a better public health approach would be to make it clear to Iowans that these illnesses and deaths are preventable, a point made in a recent report from the White House Coronavirus

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South Dakota sees record virus hospitalizations, cases

SIOUX FALLS, S.D. (AP) — Hospitalizations from COVID-19 in South Dakota reached new heights for the fourth straight day on Wednesday.

The number of daily new cases also set a record, with 1,270 people testing positive for the virus. The virus has surged in the state and region, sending South Dakota to the nation’s second-worst ranking in new cases per capita over the last two weeks. Johns Hopkins researchers report that one out of roughly every 77 people in the state has tested positive in the last two weeks.

The wave of cases has resulted in 412 people who are currently hospitalized with the virus. Health officials also reported nine new deaths. October has become the state’s deadliest month of the pandemic, with 189 deaths so far.


South Dakota health officials attempted to offer some hope to the state’s virus outlook, saying they will be ready by the middle of next month to distribute coronavirus vaccinations. But it is not clear when coronavirus vaccinations will receive regulatory approval and actually arrive in the state.

Health experts are hoping that several candidates for vaccines could be ready for distribution by year’s end, maybe sooner. President Donald Trump has pushed for a faster timeline.

South Dakota Secretary of Health Kim Malsam-Rysdon said she is following federal instructions to have a vaccine distribution system in place by Nov. 15.

“If the vaccine shows up at our doorstep on that day, it will be getting out to folks immediately,” she said.

South Dakota’s plan prioritizes health care workers and people who are vulnerable to the virus before vaccines are made widely available to the public.

The Food and Drug Administration has pledged that any vaccine it approves will meet clear standards for its safety and effectiveness.

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France braces for possible lockdown as virus deaths mount | St. Louis business news

PARIS (AP) — France is bracing for a potential new lockdown as the president prepares a televised address Wednesday aimed at stopping a fast-rising tide of virus patients filling French hospitals and a growing daily death toll.

French markets opened lower on expectations that President Emmanuel Macron will announce some kind of lockdown Wednesday, though the government has not released details amid ongoing discussions about what measures would be most effective.

Many French doctors are urging a new nationwide lockdown, noting that 58% of the country’s intensive care units are now occupied by COVID patients and medical staff are under increasing strain.

“The government didn’t take into account what the first wave was and didn’t learn all its lessons,” Frederic Valletoux, president of the French Hospital Federation, said Wednesday on France-Inter radio.

He called for full, monthlong lockdown, saying “this wave will

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South Korea’s conscripted doctors feel like ‘human shields’ in virus battle

By Ju-min Park

OKCHEON, South Korea (Reuters) – As the coronavirus pandemic began sweeping through South Korea late in February, doctor Nam Ha-jong received an order to report overnight to Daegu, a city that was to become the epicentre of infections.

With little formal training in treating virus victims and just two hours of instruction in the use of personal protective gear, the 30-year-old was sent to track down likely patients.

As fear of the new disease gripped the country, Nam went door to door from dawn to dusk each day, wearing full protective gear to perform the testing of members of an obscure religious group at the centre of the outbreak.

“We were exhausted, scared, and felt like being thrown in as a shield to fight against an enemy that no one knew about,” said Nam, who spent three weeks working in Daegu, a city of about 2.4 million southeast of the capital, Seoul.

A nurse and driver helped him run tests at the homes of suspected victims. Many in the religious group wanted to keep secret even the fact of having been tested, so Nam had to shoo away curious neighbours.

Nam was one of 1,900 young men conscripted from medical school to serve a term of 36 months as a public health doctor instead of regular military service.

That is compulsory in South Korea, which is technically still at war with the North, since the neighbours ended the Korean War with only a truce, instead of a peace treaty.

After eight months on the frontlines of the virus battle, the young doctors are credited with pulling off the strategy to target hotspots with rapid, mass testing and contact tracing.

As in the military, they were given no choice, often feeling their efforts went unrecognised, even as South Korea eventually flattened the curve of infections and won global praise for its response.

“Now I feel some people are taking us for granted,” Nam, who now works at a test centre in Okcheon county, a two-hour drive south of Seoul, said in an interview.

Refusing to serve would have brought punishment in the form of a service extension of five times the length of the hotspot deployment, which typically lasts several weeks.

Experts say the doctors’ efforts were responsible for more than 2.5 million tests among a population of 50 million, as well as a programme of stringent contact tracing.

The doctors are “indispensable”, said Park Yoon-hyung, a specialist in preventive medicine at Soonchunhyang University.

However, he added, “The general public don’t usually appreciate their work, because they think of their service as something obvious.”

As many as 1,000 of the doctors rotated through Daegu in March to fight an outbreak that racked up the largest number of infections outside China.

That deployment paved the way for a four-fold increase in daily virus tests, said Sejin Choi of the Korean Association of Public Health Doctors.

UNHERALDED

In normal times, the routine of a public health doctor can

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India Near 8 Million Cases; Europe Wave Resurgence: Virus Update

(Bloomberg) — India’s confirmed cases reached just under 8 million as virus infections spread across the country. Europe’s resurgent coronavirus outbreak intensified, with Italy’s new cases reaching a record and France reporting the most deaths since April as stricter measures are weighed on the continent.

Japan passes a bill to offer a free vaccine. In a rare admission, U.S. President Donald Trump acknowledged that coronavirus cases are rising in “certain areas” of the Midwest. Covid-19 hospitalizations have risen at least 10% in the past week in 32 states and the nation’s capital as the month-old viral surge increasingly weighs on America’s health-care system.

Pfizer Inc. CEO Albert Bourla said the company may know by the end of October whether its vaccine is effective. Russia has begun production of a second vaccine that hasn’t completed trials.

Key Developments:

Global Tracker: Cases top 43.9 million; deaths exceed 1.16 millionEast Europe fights for its life against virus it thought crushedCity locked down for three months has bleak lesson for the worldCan you get Covid twice? What reinfection cases mean: QuickTakeSlow Covid recovery stalks health industry as new cases surgeEuropean governments running out of options to avoid lockdownsVaccine Tracker: Vaccine trials restart, providing hope

Subscribe to a daily update on the virus from Bloomberg’s Prognosis team here. Click CVID on the terminal for global data on coronavirus cases and deaths.



chart, histogram: Seven-day average of U.S. death toll is at 800 again


© Bloomberg
Seven-day average of U.S. death toll is at 800 again

India Virus Cases Reach Almost 8 Million (12:22 p.m. HK)

India’s total confirmed virus cases reached 7.99 million on Wednesday, according to government data. The nation added 43,893 cases in a day. Coronavirus-related deaths rose to 120,010.

India trails only the U.S. as the nation with the most number of cases. The U.S. has 8.77 million cases, according to data collected by Johns Hopkins University.

Iran’s Parliament Speaker Tests Positive (11.26 a.m. HK)

Iranian parliament speaker Mohammad Baqer Qalibaf has tested positive for coronavirus and is currently in self-isolation, the state-run Islamic Republic News Agency reported. Earlier this month, IRNA reported the country’s nuclear energy chief Ali Akbar Salehi as well as Mohammad Bagher Nobakht, a deputy president and top aide to President Hassan Rouhani, had also tested positive for the virus.

Trump Says Midwest ‘Heated Up’ With Cases (10:41 a.m. HK)

President Donald Trump on Tuesday night acknowledged that coronavirus cases are rising in “certain areas” of the Midwest, a rare admission during the final week of the presidential campaign.

“Certain areas that are heated up right now,” Trump said at a rally in Omaha, Nebraska. “They’ll go down. They’ll go down very quickly. They’ll be down within two weeks, they’re figuring.”

Trump has routinely downplayed the virus while making his closing argument to voters, who have rated his pandemic response poorly, according to opinion polls. The president said again on Tuesday that the country is “turning that corner.”

South Korea’s Moon Says Virus Contained, Seeks to Revive Economy (9:34 a.m. HK)

Video: Health panel proposes colon cancer tests start

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Britain’s Health Workers Face 2nd Virus Wave, but This Time With Less Support

People have also begun complaining about long wait times.

“There is some disbelief that you’ve had six months to prepare for this and why haven’t you been training more nurses,” said Dr. Tamás Szakmany, an intensive care doctor in Newport, Wales. But, he said, “it’s not just like you’ve got a car factory and you suddenly need more transmissions, so you train the factory workers to build more transmissions. It’s just not that simple.”

Among doctors and nurses, a sense of battle fatigue has set in. Extra weekend shifts that were intended to be temporary have lasted through the summer, especially in northern cities where coronavirus wards remained busy even as a national lockdown was lifted in the summer. Health workers are calling in sick, many of them with anxiety and depression.

Rapid testing remains scarce for doctors and nurses. And health workers on coronavirus wards are supplied only with basic surgical masks, not the heavier-duty N-95 masks reserved for intensive care units.

“The first time around, it’s almost like a once-in-a-lifetime kind of medical challenge,” said Paul Whitaker, a respiratory doctor in Bradford, in northern England, where the number of coronavirus patients has returned to its early May peak.

“The hospital provided packed lunches for us all,” Dr. Whitaker added. “People were sending good luck messages. But the prospect of going into another six months, which is almost certainly what it’s going to be, is relatively frightening. How are you going to maintain the morale, the focus and the energy of all these people?”

In the ex-mining and manufacturing towns in England’s north that have been hit hardest by the latest surge of infections, doctors are especially harried. Nearly 40 percent of critically ill patients are now classified as the country’s most deprived, compared to a quarter of such patients in the spring and early summer.

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U.N. cancels meetings after reported virus cases

SEOUL, South Korea — South Korea has reported 103 new confirmed cases of coronavirus infections, continuing a steady spread as people increasingly venture out in the public amid eased social distancing measures.

The figures released by the Korea Centers for Disease Control and Prevention on Wednesday brought the national caseload to 26,146, including 461 deaths.

Sixty-six of the new cases were reported in the densely populated Seoul metropolitan region. At least 31 patients have been linked to a golf gathering in Yongin, which emerged as the country’s latest cluster of infections.

Officials have also been testing thousands of workers at hospitals and nursing homes in the capital area following outbreaks that sickened hundreds at a number of these facilities.

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HERE’S WHAT YOU NEED TO KNOW ABOUT THE VIRUS OUTBREAK:

— United Nations cancels in-person meetings after virus cases at New York headquarters

— Russian issues nationwide mask mandate; foreign minister Lavrov in quarantine

— Italy registers nearly 22,000 confirmed daily coronavirus cases

— Mask-less Pope Francis noticed by Vatican virus commission

— Iowa elections officials concerned over surge in coronavirus cases, with possible illnesses or absences among key workers and volunteers a hindrance through Election Day.

— World Series played at a neutral site in front of smallest crowds in a century, but Dodgers and Rays are just happy that some fans are there

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— Follow AP’s coronavirus pandemic coverage at http://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak

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HERE’S WHAT ELSE IS HAPPENING:

SPRINGFIELD, Ill. — Surging coronavirus infections in Chicago have prompted Illinois Gov. J.B. Pritzker to ban indoor dining and bar services in the city and limit the number of people gathering in one place.

The rules taking effect Friday will force diners and bar patrons outdoors and shut down service at 11 p.m. No more than 25 people may gather at one time. Occupancy may not exceed 25% capacity.

The governor said that “without action, this could look worse than anything we saw in the spring.”

Chicago joins six other regions in Illinois that are subject to what the Pritzker administration calls “resurgence mitigations.” A day earlier, Pritzker imposed the restrictions on Cook County areas outside Chicago and Lake County to the north.

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UNITED NATIONS — The United Nations canceled all in-person meetings after a U.N. member nation reported five coronavirus cases among its staff.

General Assembly President Volkan Bozkir sent a letter to the 193 U.N. member nations announcing Tuesday’s cancellation on the advice of the U.N. Medical Unit.

He didn’t identify the country. Diplomats, speaking on condition of anonymity because there hasn’t been a public announcement, say it was the African nation of Niger. Niger’s U.N. Ambassador Abdou Abarry has a staff of 17, according to the latest U.N. directory.

Assembly spokesman Brenden Varma says contact tracing is expected “to be done quickly and efficiently.”

U.N. spokesman Stephane Dujarric says in recent weeks, between 1,300 and 1,400 people swiped their passes every day to enter the U.N. building in New York.

–Edith Lederer

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ROME

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Virus pushes twin cities El Paso and Juarez to the brink

A record surge in coronavirus cases is pushing hospitals to the brink in the border cities of El Paso and Ciudad Juarez, confronting health officials in Texas and Mexico with twin disasters in the tightly knit metropolitan area of 3 million people.

Health officials are blaming the spike on family gatherings, multiple generations living in the same household and younger people going out to shop or conduct business.

The crisis — part of a deadly comeback by the virus across nearly the entire U.S. — has created one of the most desperate hot spots in North America and underscored how intricately connected the two cities are economically, geographically and culturally, with lots of people routinely going back and forth across the border to shop or visit with family.

“We are like Siamese cities,” said Juarez resident Roberto Melgoza Ramos, whose son recovered from a bout of COVID-19 after taking a cocktail of homemade remedies and prescription drugs. “You can’t cut El Paso without cutting Juarez, and you can’t cut Juarez without cutting El Paso.”


In other developments Tuesday, Illinois Gov. J.B. Pritzker, a Democrat, banned indoor dining and drinking in Chicago in one of the biggest retreats yet in the face of the latest surge. And Wisconsin’s governor pleaded with residents to voluntarily stay home as the state shattered records for daily cases and deaths. Democratic Gov. Tony Evers issued a stay-at-home order in March, but the conservative-leaning state Supreme Court struck it down two months later.

In El Paso, authorities have instructed residents to stay home for two weeks and imposed a 10 p.m. curfew, and they are setting up dozens of hospital beds at a convention center.

Also, the University Medical Center of El Paso erected heated isolation tents to treat coronavirus patients. As of Tuesday, Ryan Mielke, director of public affairs, said the hospital had 195 COVID-19 patients, compared with fewer than three dozen less than a month ago, and “it continues to grow by the day, by the hour.”

In Juarez, the Mexican government is sending mobile hospitals, ventilators and doctors, nurses and respiratory specialists. A hospital is being set up inside the gymnasium of the local university to help with the overflow.

Juarez has reported more than 12,000 infections and over 1,100 deaths, but the real numbers are believed to be far higher, because COVID-19 testing is extremely limited. El Paso County recorded about 1,400 new cases Tuesday, just short of the previous day’s record of 1,443. The county had 853 patients hospitalized for the virus on Monday, up from 786 a day earlier.

Even the mayor of Juarez hasn’t been spared. Armando Cabada was first diagnosed in May and appeared to have recovered, but then landed in the hospital last week with inflamed lungs.

Last week, Chihuahua, which includes Juarez, became the only state in Mexico to return to its highest level health alert, or red, under which most nonessential services are shut down and people are encouraged to stay home.

A curfew is

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Governor bans indoor dining in Chicago as virus cases surge

SPRINGFIELD, Ill. (AP) — Surging COVID-19 cases in Chicago prompted Gov. J.B. Pritzker on Tuesday to ban indoor dining and bar services and limit the number of people gathering in one place.

The rules taking effect Friday will force diners and bar patrons outdoors and shut down service at 11 p.m. No more than 25 people may gather at one time, or fewer if that number would exceed 25% of room capacity.

“We can’t ignore what is happening around us, because without action, this could look worse than anything we saw in the spring,” Pritzker said, referring to the start of the pandemic, when health care resources were pushed to the limit because of the overwhelming number of COVID-19 cases.


Chicago, which comprises Region 11 of the state’s 11 COVID-19 monitoring regions, joins six other regions subject to what the Pritzker administration calls “resurgence mitigations.” A day earlier, Pritzker imposed the restrictions on Region 10, Cook County outside of Chicago and Lake County to the north.

After a summer of declining case numbers — Illinois fared better than many other states, particularly in the South and West — they began climbing again in August and jumped precipitously this month. There were 4,000 new infections and 46 additional deaths Tuesday, bringing total cases to 382,985 with 9,568 deaths.

There were 2,758 hospitalized, an 86% increase from a month ago, and both intensive care patients at 595 and the 241 on ventilators represented increases in the 70% range.

Other regions which hit the mitigation bar did so when positive rates of COVD-19 test results topped 8% for three consecutive days. Dr. Ngozi Ezike, the state public health director, said the latest additions, Cook County on Monday and Chicago on Tuesday, have seen the troubling rise in numbers of sick people requiring inpatient treatment as well as a jump in positive test results.

“Based on current trends, we soon could face reduced hospital bed availability and overwhelming our health care systems,” Ezike said.

Earlier Tuesday, Dr. Allison Arwady, commissioner of the Chicago Department of Public Health, predicted the action taken by the governor, pointing out that while COVID-19 is not as prevalent in Chicago as during the pandemic’s early days in March, the number of confirmed cases is doubling every nine days.

“COVID is widespread here in Chicago, and we need you to double down on the things that you know work,” Arwady said. “Please as much as you can, if there are interactions you’re having that are not essential, back off on those.”

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Associated Press writer Kathleen Foody contributed from Chicago.

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Follow Political Writer John O’Connor at https://twitter.com/apoconnor

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Surge in new virus cases driven by people under 30

BOSTON (AP) — The recent surge in confirmed coronavirus cases in Massachusetts is being driven in large part by an increase among younger people, Gov. Charlie Baker said Tuesday.

Whereas 15% of new cases in April were among people under age 30, now 37% of the new confirmed cases are people in that age group, the Republican governor said at a news conference at which he urged people to stop partying.

“According to our most recent data, about 300 people per day under 30 have contracted COVID-19, have tested positive for it, with about 38,000 people in this age group diagnosed since March,” he said.


More than half the new cases have been traced to social gatherings and household transmission, and there have been more reports of indoor parties as the weather has turned cooler, Baker said. He reminded people that outdoor trick-or-treating on Halloween is safer than an indoor party.

“To keep case rates down, and help us not only keep people healthy, but also ensure that our hospitals continue to have the capacity they need to serve their patients, our young people need to be serious about dealing with COVID,” he said.

Baker also urged people to limit Thanksgiving gatherings to members of the same household, or if mixing households, limit the number of guests to as few as possible.

He also shed new light on the state’s decision last week to close indoor skating rinks for two weeks in response to an increase in cases linked to youth hockey games.

He blamed the closures on “irresponsible” parents and coaches who didn’t cooperate with state contact tracers, including some who refused to supply team rosters.

“Youth hockey needs to make some changes,” he said.

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VIRUS BY THE NUMBERS

The state Department of Public Health reported more than 1,000 new confirmed coronavirus cases for the fourth consecutive day on Tuesday, as the 7-day rolling average of the positivity rate and daily new cases in the state continued to rise.

The state reported 1,025 new confirmed cases and seven deaths Tuesday.

The 7-day rolling average of the positivity rate in Massachusetts has now risen over the past two weeks from 0.95% on Oct. 12 to more than 1.5% on Monday, according to the Johns Hopkins University Center for Systems Science and Engineering.

The 7-day rolling average of daily new cases in Massachusetts has also risen over the past two weeks from more than 600 on Oct. 12 to more than 1,041 on Monday, according to Johns Hopkins.

The number of people in the state’s hospitals with the disease rose to 567, up from 550 the previous day. The number of patients in intensive care rose to 109 from 105.

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UNEMPLOYMENT HELP

About 17,000 Massachusetts residents who have lost their jobs during the coronavirus pandemic but were ineligible for additional federal benefits are getting an additional $1,800 from the state.

The bill providing the extra cash was passed by the Legislature on Monday and signed into law by Baker

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