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Region 9 Hospitalizations Rise, Coronavirus Positivity Up To 5.8%

WAUKEGAN, IL — New regional COVID-19 mitigations were lifted on one area of Illinois this week and imposed on another, as rising coronavirus positivity rates in neighboring regions risk triggering additional restrictions.

In the Lake-McHenry County region, Region 9, the coronavirus positivity rate rose by nearly a full percentage point in the week ending Tuesday, the most recent data available from the Illinois Department of Public Health. The positivity rate of 5.8 percent was the highest in the past three weeks and among the highest in the state.

During that same period, daily new hospitalizations of patients with “COVID-like illnesses,” or CLI, more than doubled, rising from a rounded rolling average of four people a day on Sept. 14 to nine people a day on Oct. 6.

In Lake County, increases in the percentage of emergency department visits of patients with coronavirus symptoms and the per capita number of new cases detected led state public health officials to declare the state at warning level — “orange” on the county-level risk metrics map.

The target for new cases per 100,000 people is less than 50, but Lake County has 90 — and the percentage of emergency room visits consisting of people with CLI increased to 4.3 percent. In McHenry County, which is not at a warning level, there were 63 new cases per 100,000 people and only 1.8 percent of ER visits were for CLI.

Only one region is currently subject to increased restrictions to limit the spread of coronavirus as part of the 11-region Restore Illinois COVID-19 resurgence plan, as of Friday. It is the third region where public health officials have tightened limits on gatherings and businesses due to high positivity rates.

In Region 1, the Rockford emergency medical services region, the seven-day rolling average coronavirus positivity rate has remained above 8 percent for more than two weeks. Three days above the threshold leads to mandatory mitigation measures. Restrictions on indoor service at bars and restaurants will be in effect in the nine-county region until its rate stays below 6.5 percent for three consecutive days.

That happened this week in Region 4, where the “tier 2” restrictions on businesses and gatherings were first imposed on Aug. 18. The Metro East region hit a high of 10.5 percent positivity in late August before coming down to 5.8 by Friday, when public health officials announced the restrictions had been lifted. Mitigations were placed on Region 7, Will and Kankakee counties, from Aug. 27 and lifted Sept. 18.

The region with the highest coronavirus positivity rate outside of the Rockford region is Region 5 in Southern Illinois. The Marion emergency medical services region saw its positivity rate spike from 5.6 percent to 7 percent this week. If the rolling average continues to rise at that rate, the region could be on pace for additional restrictions as soon as next week.

The next highest rate was in Region 6 excluding Champaign County. Public health officials have begun calculating the region’s positivity

Midwest Latest Region to be Hit Hard by COVID Spread | Health News

By Robin Foster and E.J. Mundell
HealthDay Reporters

(HealthDay)

THURSDAY, Oct. 1, 2020 (HealthDay News) — Coronavirus infections are surging in the American heartland, with Wisconsin bearing the brunt of COVID-19’s relentless spread.

Many Midwestern states are seeing some of the nation’s highest per capita rates of infection, and while federal health officials have again urged some governors in the region to require masks statewide, some Republican governors have resisted, the Associated Press reported.

Wisconsin appeared to be in the worst shape: A record number of people with COVID-19 were hospitalized in that state as of Wednesday. Of 737 patients, 205 were in intensive care, with spikes in cases in northern parts of the state driving up the numbers, the AP reported. Wisconsin health officials reported 2,319 new infections, bringing the total number to 122,274.

The state also reported its highest single-day number of deaths — 27 — pushing the overall death toll to 1,327.

“Over the course of the past two to three weeks we have noticed a marked rise in COVID patients coming into our hospitals in Green Bay,” said Dr. Paul Casey, medical director of the emergency department at Bellin Hospital in Wisconsin, told CNN. “And this comes in the wake of what we thought we were doing well.”

“For the first time in 17 years that I’ve been here, we’ve had to put patients in hallway beds,” Casey told CNN. “I never envisioned having to do that in a small community like Green Bay, but we’ve done it not twice, but three times, in the last 10 days.”

In North Dakota, hospitals are adding extra space amid worries about capacity, the AP reported. Nearly 678 COVID-19 infections per 100,000 people have been diagnosed over the past two weeks, leading the country for new cases per capita, according to the COVID Tracking Project. Overall, there have been 21,846 infections and 247 deaths.

The surge has been seen throughout the Midwest. Iowa also reported a spike in people hospitalized with the virus, to 390, the AP reported. Last week, the state had the nation’s sixth-highest rate of coronavirus infections per 100,000 people, according to a recent White House coronavirus task force report. It again recommended Iowa require masks statewide, which Republican Gov. Kim Reynolds has said is unnecessary.

Similarly, Oklahoma Gov. Kevin Stitt, a Republican, has said he won’t impose such a requirement. The task force report found his state is among the worst in the United States for positive coronavirus tests per 100,000 people, up 15% from a week ago.

The Midwest has now overtaken the South for the country’s highest seven-day average of new daily cases per 1 million residents, CNN reported. The Midwest averaged 156 cases per 1 million people, against 124 in the South, 88 in the West and 51 in the Northeast, Johns Hopkins data shows.

Globally, COVID death toll passes 1 million

The global coronavirus pandemic reached a grim new milestone this week: One million dead.

Americans made up more

Coronavirus cases hit multiweek lows in D.C. region, but experts fear cold weather could reverse trend

But health experts cautioned that there’s no guarantee the numbers will continue to fall, as chillier October weather begins to usher outdoor activities indoors.

Taison Bell, an assistant professor of medicine specializing in infectious diseases and critical care at the University of Virginia in Charlottesville, said the greater Washington region is “in a bit of a steady state” in its number of reported coronavirus cases. The region’s caseload had held steady for several weeks before starting to tick downward about 10 days ago.

He also cautioned that the arrival of cooler weather could increase the spread of the virus as people increasingly decide to congregate indoors.

Neil J. Sehgal, an assistant professor of health policy and management at the University of Maryland School of Public Health, urged residents to consider the pandemic as they make plans for the holidays. They should remember that this is “not the normal holiday season,” he said.

Sehgal said progress in some jurisdictions while battling the virus has started to slow, singling out Prince George’s County, where outbreaks have been reported at the University of Maryland. He said other college towns in the region, including Virginia’s Blacksburg and Charlottesville, also have seen caseloads rise as students go back to school.

“We haven’t controlled transmissions,” Sehgal said. “We’re still riding our first wave of the outbreak. We saw a summer dip, but we never stamped it out. There are still chains of transmission in the community.”

Short of a vaccine, Sehgal said, recent days are probably “as safe as it’s going to be” in terms of a lowered number of cases in the Washington region, also noting the likelihood of increased spread as the weather turns colder.

Still, D.C., Maryland and Virginia have made progress in battling the virus in recent days.

The seven-day rolling average of new cases in Washington’s Northern Virginia suburbs stood at 190 on Wednesday, with the region this week notching its lowest average caseloads since early August. Statewide, the number of new daily cases is the lowest since mid-July.

In D.C., the seven-day average dropped to 39 on Wednesday, the lowest in the city since early July.

Maryland’s seven-day average stood at 490 on Wednesday, up slightly in recent days but about half the number of daily cases as early August. Caseloads have held mostly steady in Montgomery and Prince George’s counties in recent weeks.

Montgomery County officials said Wednesday that they are continuing to accumulate supplies in preparation for a possible increase in coronavirus cases this fall or winter.

“We are in a lot better position than we were in the spring,” County Executive Marc Elrich (D) said at a news conference. “We made a decision in the beginning that we would accumulate enough supplies for a second surge.”

Among the supplies are 50 new ventilators that arrived this summer, officials said.

The seven-day rolling average of new cases in the county stood at 83 on Wednesday, with a test positivity rate of 2.6 percent. County health officer Travis Gayles

Nursing Home Inspectors In The D.C. Region Aren’t Required To Take COVID-19 Tests : NPR

Staff and vendors in nursing homes have to get regular COVID-19 tests. State nursing home inspectors don’t.

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Maryland, D.C. and Virginia are not mandating COVID-19 tests for the inspectors examining conditions in local nursing homes, public health spokespeople from all three jurisdictions confirmed. The lack of testing for the inspectors, nursing home leaders say, stands in contrast to state and federal testing requirements for nearly anyone entering a nursing home these days.

For the past several months, inspectors were focused on completing federally mandated infection control surveys to evaluate long term care facilities’ responses to the coronavirus pandemic. Some of the inspectors’ findings have resulted in citations and fines for nursing homes found to have inadequate screening, social distancing or sanitizing practices.

Nursing home leaders are worried that inspectors are entering facilities without knowing their COVID-19 status, said Allison Ciborowski, the president of LeadingAge Maryland, a long-term care industry group.

The inspectors work on behalf of the federal government’s Centers for Medicare and Medicaid Services but are employed by state jurisdictions. Ciborowski said CMS hasn’t required or recommended that inspectors be tested. Maryland, Virginia and the District have chosen to follow that lead.

“It’s a concern for our members just because they are really trying to carefully track the spread of the virus,” she told WAMU/DCist. “It seems strange that the agency that is citing nursing homes if they’re not appropriately testing staff is not testing the surveyors that are going in to fight those kinds of things.”

Inspectors may not be required to undergo coronavirus testing, but almost everyone else going in and out of nursing homes is. CMS and state governments regulate how frequently long-term care facilities should be testing staff, residents and regular outside visitors. For much of the summer, CMS required nursing home staff to be tested for COVID-19 every week (in Maryland, weekly testing is still the case).

When inspectors enter facilities, they are expected to comply with temperature checks, answer screening questions, and wear masks, gloves and gowns. Once inside, they walk around the facility, but do not enter sick resident rooms.

Last month, CMS revised its testing guidance, tying the frequency of staff testing to the positivity rate of the county where the nursing home is located. The definition of who counts as staff is still broad: it includes “employees, consultants, contractors, volunteers and caregivers who provide care and services to residents on behalf of the facility, and students in the facility’s nurse aide training programs or from affiliated academic institutions,” according to the guidance.

Missing from that long cast of characters: inspectors. And while fewer than half of all states are requiring inspectors to get tested despite the omission in CMS guidelines, Maryland, Virginia and D.C. are not.

Spokespeople for the Maryland Department of Health, Virginia Department of Health and D.C. Health pointed to a number of reasons for not requiring tests. Virginia Department of Health spokeswoman Tammie Smith emailed the following