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COVID Cases Climbing in 36 States | Health News

By Robin Foster and E.J. Mundell
HealthDay Reporters

(HealthDay)

WEDNESDAY, Oct. 14, 2020 (HealthDay News) — Coronavirus outbreaks in the Midwest and Western United States have driven the national case count to its highest level since August, fueling fears of what the coming winter will mean for the country.

COVID-19 cases are starting to climb in 36 states, including parts of the Northeast, which is starting to backslide after months of progress, The New York Times reported. More than 820 new deaths and more than 54,500 new cases were announced across the country on Tuesday, the newspaper said. Idaho and Wisconsin set single-day records for new cases.

About 50,000 new cases are being reported each day in the United States for the week ending Monday, the Times reported. That is still less than in late July, when the country was seeing more than 66,000 cases each day.

But the trajectory is worsening, and experts fear what could happen as cold weather drives people indoors, where the virus can spread more easily, the newspaper said. The latest spike in cases shows up just before the increased mingling of people that comes with Halloween, Thanksgiving and Christmas.

Sixteen states each added more new cases in the seven-day period ending Monday than they had in any other weeklong stretch of the pandemic. North Dakota and South Dakota are reporting more new cases per person than any state has previously, the Times reported.

“A lot of the places being hit are Midwest states that were spared in the beginning,” William Hanage, a Harvard University infectious diseases researcher, told the Washington Post. “That’s of particular concern because a lot of these smaller regions don’t have the ICU beds and capacity that the urban centers had.”

COVID-19 hospitalizations have already begun rising in almost a dozen states, including Ohio and Pennsylvania, raising the probability that increasing death counts will soon follow, the Post reported.

Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, told CNN that he hopes the numbers “jolt the American public into a realization that we really can’t let this happen, because it’s on a trajectory of getting worse and worse.” He called the rising numbers “the worst possible thing that could happen as we get into the cooler months.”

It is unclear what is driving the climbing case count, but it could be the long-feared winter effect already taking place, or the reopening of businesses and schools, or just people letting down their guard on social distancing efforts, the Post reported.

Second COVID vaccine trial paused

A second coronavirus vaccine trial was paused this week after an unexplained illness surfaced in one of the trial’s volunteers.

Johnson & Johnson, which only began a phase 3 trial of its vaccine last month, did not offer any more details on the illness and did not say whether the sick participant had received the vaccine or a placebo. The trial pause was first reported by the health news website STAT

Which states had the best pandemic response?

For this story, reporters interviewed a wide range of health researchers, public officials and academic experts to ask them which states were standouts in their management of the pandemic. What we heard repeatedly were lessons culled from a handful of states that others could follow.

We’ve distilled their insights into three categories that represent the greatest challenges states are facing: fighting the virus, managing the economic fallout and reopening schools.

FIGHTING THE VIRUS

Leading the way in the rural Northeast

Few states have a record as unblemished as Vermont.

The odds could have been stacked against the state. The virus arrived in Vermont during the first wave sweeping the country. It shares borders with some of the hardest-hit states and has the third-oldest population in the country.

But Vermont swiftly flattened its initial wave and has since gone weeks at a time without any new confirmed infections. Fewer than 60 people have died, giving the state the second-fewest deaths per capita behind Alaska, which has seen surging caseloads in recent weeks. If the country as a whole had the same per capita death rate as Vermont, the nationwide death toll would be 30,000 instead of more than 215,000.

“This should be the model for the country, how you’ve done it,” Anthony Fauci, the nation’s top infectious disease expert, said during a briefing with state leaders in September. “Notwithstanding that this is a small state, it should be the model of how you get to such a low test positivity that you can actually start opening up the economy in a safe and prudent way.”

While health experts say the state has likely benefited from its rural geography, other sparsely populated areas of the country that let their guard down were overwhelmed by the virus this spring and summer. That sense of complacency never took hold in Vermont, where a moderate Republican governor and a Democratic-led Legislature helped defuse partisan tensions that hampered the response elsewhere.

“Any state that’s going to succeed against Covid has got to have the compliance of the population, because every single thing you do is telling people to alter their personal behavior,” Mark Levine, Vermont’s health commissioner, said in an interview.

What works:

— Vermont reopened slowly. The lockdown it put in place in late March is still gradually being lifted, restaurants and bars are still limited to 50 percent indoor capacity and even outdoor gatherings are still subject to a 150-person limit.

— Local governments have authority to set their own stricter rules. Burlington, the state’s most populous city, reduced its outdoor gathering limit to 25 in late August when college students began returning to nearby campuses.

— The state is also strict about visitors, requiring a two-week quarantine for people arriving from places with higher infection rates. And it invested early in testing and contact tracing and implemented a state-wide mask mandate early on.

“They took action early, they let science lead, and they were consistent

LA Could Soon Escape State’s Most Restrictive Shutdown Tier

LOS ANGELES, CA — In a sign of the light at the end of the tunnel, Los Angeles County health officials said the region is on track to emerge from the most restrictive tier of the state’s coronavirus economic-reopening roadmap within the next few weeks.

Angelenos just have a little more work to do to help get the number of new coronavirus cases a little lower, Los Angeles County’s public health director said.

“My hope is that in the next few weeks we get to Tier 2” of the state’s reopening matrix, Barbara Ferrer told the county Board of Supervisors.

It will depend on whether the county can reduce its average rate of new cases per 100,000 residents from 7.6 to below 7. If the county can get there, it can advance out of the restrictive “purple” Tier 1 and into the slightly more liberal “red” Tier 2. As always seems to be the case, there are events and holidays on the horizon that could prove to be hurdles. On Tuesday, the state followed the county’s lead in advising against trick or treating on Halloween this year. Ongoing protests, demonstrations and postseason NBA and MLB gatherings could lead to an uptick in new cases.

Ferrer told the board that reducing the number of new cases will take continued action from residents, some of whom have contributed to recent upticks thanks to large gatherings held in spite of public health orders barring them. She reiterated earlier guidance from health officials suggesting that residents balance their daily risk of exposure by limiting their activities outside the home. She suggested, as an example, that if a person goes to a grocery store during the day, that person should consider staying home for dinner instead of visiting a restaurant that same day.

Large gatherings, however, have continued to vex efforts to control the spread of the virus. Health officials on Monday said the tens of thousands of people who attended a pro-Armenian march in the Mid City area on Sunday may have been exposed to the virus, and should now be avoiding others for the next 14 days and get tested for COVID-19. The same applies to the hundreds of people who flocked to downtown Los Angeles Sunday night to celebrate the Lakers’ NBA championship.

Ferrer also told the board that businesses must continue to adhere to health protocols as they welcome back customers, noting that the county has generally seen good compliance.

On Tuesday, the county reported another 18 coronavirus deaths, while health officials in Long Beach announced three additional fatalities. The new deaths increased the countywide total since the start of the pandemic to 6,793.

The county also announced 790 newly confirmed cases of the virus, while Long Beach added 40 and Pasadena reported three. Those cases lifted the overall cumulative total since the pandemic began to 283,793.

The county Department of Public Health noted that Tuesday’s number of new cases was likely artificially low due to reporting lags from

13-Year-Old Gave COVID To 11 Relatives Across 4 States During Family Vacation: CDC

Getty

Nearly a dozen people across four states were infected with the novel coronavirus by a 13-year-old girl during a three-week family vacation over the summer, according to a report from the Centers for Disease Control and Prevention.

The teenager, whose identity remains anonymous, was exposed to COVID-19 during a “large outbreak” in June, leading her to take a coronavirus test four days later. She tested negative and was not showing symptoms at the time, the report states.

But two days later, the teen began experiencing nasal congestion, a symptom of COVID-19, on the same day she, her parents and two brothers traveled to a family gathering at an unconfirmed location, where 14 of them stayed in a five-bedroom, two-bathroom house for between eight and 25 days.

The attendees ranged in age from 9 to 72 and belonged to five households in four states: Rhode Island, Illinois, Georgia and Massachusetts, according to the CDC report.

Six additional relatives (an aunt, an uncle, and four cousins) visited for 13 hours during the trip but maintained social distance and stayed outdoors. None of them tested positive for the virus.

Getty Coronavirus

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Including the teenage girl, 12 of the 14 relatives staying at the home – none of whom social distanced or wore masks — began exhibiting COVID-19-related symptoms and were subsequently found to have been infected with the virus.

One of the family members was hospitalized, according to the CDC, while another was treated at an emergency department care for respiratory symptoms. They have both recovered.

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Adeline Fagan, who was in her second year of residency, tested positive for COVID-19 in July

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After the CDC investigated the cases throughout July and August, the 13-year-old girl was determined to be the “index patient” given that she began showing symptoms prior to any other family member that was infected.

The teen’s initial COVID-19 test, done before the trip, was likely a false negative, according to the CDC report, “because it was performed before symptom onset.”

The CDC said that the outbreak further proves that children and adolescents can serve as the source of COVID-19 spreading, even when their symptoms are mild. In addition, it shows that lack of social distancing will likely result in further spreading of the virus, per the CDC.

As of Tuesday, there are over 7.8 million confirmed cases of COVID-19 in the United States, while at least 214,900 people have died, according to the New York Times’ database.

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Teen infected relatives in four states during family vacation, CDC says

In a recent Morbidity and Mortality Weekly Report released by the CDC, 11 separate coronavirus cases across four states were traced back to one 13-year-old child.



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Exposure to the virus occurred during a three-week family gathering at which five families met. The age of the attendees ranged from 9-72 years-old. The families shared a five-bedroom, two-bathroom house and the CDC report points out that the family members did not wear masks or practice social distancing.

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It should be noted that although several states began requiring masks to be worn in public in April, data confirming their effectiveness in combating the spread of the coronavirus was not known until late June and the shared house would not necessarily classify as a public space. Six relatives who later joined the event remained outdoors and practiced social distancing without staying at the house.

Of the 14 people who stayed inside the house, 12 were later diagnosed with COVID-19 after experiencing symptoms. None of the six people who stayed outdoors were diagnosed with the coronavirus.

The report used this incident to highlight that children and teens can be the source of COVID-19 outbreaks in their families even if their symptoms are mild and show the demonstrated benefit of social distancing.

The necessity to quarantine after possible exposure, even with a negative test, is also indicated in the report.

These recommendations come as President Trump recently held a rally in Florida on Monday less than 20 days after experiencing severe coronavirus symptoms. Trump’s doctor reported on Monday that he had tested negative for the virus on consecutive tests using the Abbott antigen test.

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Thirteen States Set Seven-Day Record for New Coronavirus Cases

Thirteen states reported Sunday that they had broken their previous seven-day coronavirus case records.

The states that beat their own records for the most new cases in the seven-day period ending Sunday evening are Alaska, Colorado, Indiana, Minnesota, Montana, Nebraska, New Mexico, North Dakota, Ohio, Oklahoma, Oregon, South Dakota, and Wisconsin, according to a USA Today analysis of data from Johns Hopkins University.

Many of those states are now seeing more than 25 daily new coronavirus cases per 100,000 people.

In Oklahoma, there have been an average of 1,172 new cases per day over the past week, a jump of 13 percent from the average two weeks ago. Wisconsin has experienced a particularly steep spike with an average of 2,696 new cases per day, 20 percent higher than the average new cases the state logged two weeks earlier.

While metropolitan areas were the first to become hotspots for the coronavirus, midwestern states that fared better during the initial wave of the virus have seen their cases spike in recent months.

Meanwhile, a 25-year-old man from Nevada became the first known American to be infected a second time with the coronavirus, raising concerns about immunity in those who have already had the virus. Several different strains of the coronavirus exist in the U.S.

Trump administration officials have expressed confidence that a coronavirus vaccine will be available to the public by the end of the year. So far, four drugmakers have vaccine trials that have reached late-stage testing under the administration’s coronavirus vaccine program, Operation Warp Speed.

In June, Dr. Anthony Fauci, chief medical advisor for the Trump administration’s coronavirus task force, said that he is “cautiously optimistic” that a vaccine for the coronavirus will be available to the American public by the end of the year or early 2021.

The U.S. has seen more than 7.7 million cases and 215,000 deaths from the coronavirus. Worldwide, more than 37.6 million people have contracted the virus, and more than 1 million have died after being infected.

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CDC says teen gave COVID-19 to 11 relatives across 4 states during a family vacation. Experts see a cautionary tale for holidays

A COVID-19 outbreak that infected 11 people across four states began with a 13-year-old girl who transmitted the virus during a three-week family vacation over the summer, according to a Centers for Disease Control report.

In Illinois — one of the states involved — a Cook County Department of Public Health spokeswoman said that the community where some of the family members live is not currently at risk from this particular outbreak, which occurred months ago.

But the case shows that kids and teens can contract and spread the virus, public health experts say. It also serves as a cautionary tale before the holiday season, a traditional time for many large family get-togethers.

“(The) outbreak highlights several important issues that are good to review before the holidays., a Cook County Department of Public Health spokeswoman said in an email.

The CDC noted that the case underscores the risk of exposure during gatherings, as well as the benefits of social distancing.

“SARS-CoV-2 (the virus that causes COVID-19) can spread efficiently during gathering, especially with prolonged, close contact,” the CDC report said. “Physical distancing, face mask use and hand hygiene reduce transmission; gatherings should be avoided when physical distancing and face mask use are not possible.”

The three-week family gathering involved five households from four states, according to the CDC report, which was released earlier this month. The report in a footnote mentioned public health departments in Rhode Island, Massachusetts, Illinois and Georgia; it did not give any other information about where the family gathering took place or the states where various relatives lived.

The report said the initial patient, a 13-year-old girl, was exposed to COVID-19 during a large outbreak in June. A rapid antigen test four days after her exposure came back negative, before her symptoms began. Two days later she had some nasal congestion, her only symptom. That day she traveled with her parents and two brothers to attend a large family gathering, which began the following day, according to the CDC report.

She was one of 14 relatives ranging in age from 9 to 72 who shared a five-bedroom, two-bathroom home for eight to 25 days, the report said. The relatives did not wear face masks or practice physical distancing, according to the report.

Eleven other family members contracted the virus; one was hospitalized and another went to the emergency room for treatment of respiratory symptoms, but both recovered, according to the report.

“This outbreak highlights several important issues,” the report said. “First, children and adolescents can serve as the source for COVID-19 outbreaks within families, even when their symptoms are mild. Better understanding of transmission by children and adolescents in different settings is needed to refine public health guidance.”

Six additional family members did not stay at the home but did visit on different occasions, maintaining physical distance from relatives from other households. None of those individuals developed symptoms, and four tested negative for the virus, the CDC found.

“None of the six family members

31 states have growing rates of new Covid-19 cases, and ‘we know what’s coming next’

Once again, most of the country is in trouble.



a person standing in front of a car: A man performs a self-swab at a drive-through COVID-19 testing site at Eastern Florida State College on October 9, 2020 in Palm Bay, Florida. The Florida Department of Health reports that COVID-19 cases, deaths, and hospitalizations are on the rise while U.S President Donald Trump plans to hold a rally in Sanford, Florida after contracting the disease. (Photo by Paul Hennessy/NurPhoto via Getty Images)


© Paul Hennessy/NurPhoto/Getty Images
A man performs a self-swab at a drive-through COVID-19 testing site at Eastern Florida State College on October 9, 2020 in Palm Bay, Florida. The Florida Department of Health reports that COVID-19 cases, deaths, and hospitalizations are on the rise while U.S President Donald Trump plans to hold a rally in Sanford, Florida after contracting the disease. (Photo by Paul Hennessy/NurPhoto via Getty Images)

As of Monday, 31 states have reported more new Covid-19 cases this past week compared to the previous week, according to data from Johns Hopkins University.

And nine states reported record-high Covid-19 hospitalizations on Sunday, according to the Covid Tracking Project: Arkansas, Kansas, Missouri, Montana, Nebraska, North Dakota, Oklahoma, Wisconsin and Wyoming.

“These are extremely alarming trends, and there should be warning bells going off around the country,” emergency medicine physician Dr. Leana Wen said.

“Some will say, ‘Well look, we are having increasing numbers of cases because we’re testing more.’ But we also know that in more than 15 states, the test positivity rate is over 10% — which means that we’re not doing nearly enough testing.”

On top of that, many people have no idea where they caught the virus.

“Many parts of the country are reporting that 50% or more of their cases cannot be traced back to any single infectious source — which also means that there is a high level of community spread,” Wen said.

“We know what’s coming next … we’re going to get increasing numbers of hospitalizations,” she said.

“Hospitals could again become overwhelmed. And then we’re not just talking about patients with coronavirus who might be in trouble. It’s also about other patients who might be coming in for heart attacks and strokes and car accidents who may find a situation that’s really untenable.”

The states headed in the wrong direction

Five states are grappling with a 50% increase in new cases this past week compared to the previous week: Montana, New Mexico, Tennessee, North Carolina and Vermont.

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Another 26 states had increases between 10% and 50%: Arkansas, Oregon, Idaho, Utah, Arizona, Colorado, Wyoming, North Dakota, South Dakota, Nebraska, Oklahoma, Minnesota, Iowa, Missouri, Illinois, Indiana, Michigan, Ohio, Kentucky, Mississippi, Florida, Virginia, West Virginia, Pennsylvania, New Jersey and Rhode Island.

Only three states — Maine, Texas and Washington — had fewer new cases compared to the previous week. The remaining 16 states are relatively steady.

No one is off the hook — not even states that have improved

Several states, especially in the Northeast, have enjoyed much better success at fighting coronavirus after implementing strict and innovative ways to limit the virus’ spread.

But those residents can’t let their guard down, White House coronavirus task force coordinator Dr. Deborah Birx said.

“We’re seeing those early suggestions here in the Northeast and what we wanted

As COVID-19 cases rise again, how will the US respond? Here’s what states have learned so far

<span class="caption">States have tried shutting down bars and limiting restaurants to outdoor seating to slow the coronavirus's spread.</span> <span class="attribution"><a class="link rapid-noclick-resp" href="http://gettyimages.com/detail/news-photo/patrons-dine-at-an-outdoor-restaurant-along-5th-avenue-in-news-photo/1227674724" rel="nofollow noopener" target="_blank" data-ylk="slk:Sandy Huffaker/Getty Images">Sandy Huffaker/Getty Images</a></span>
States have tried shutting down bars and limiting restaurants to outdoor seating to slow the coronavirus’s spread. Sandy Huffaker/Getty Images

When COVID-19 began spreading in the U.S. in early spring, governors in hard-hit states took drastic steps to reduce the threat and avoid overloading their health care systems. By shutting down nonessential businesses and schools and ordering people to stay home, they slowed the virus’s spread, but several million people lost jobs.

Since then, we’ve witnessed a series of ad hoc experiments with more targeted approaches. As states started to reopen, they tested different levels of restrictions, such as face mask mandates and capacity constraints on restaurants. Some closed bars when cases rose again but left other businesses open. Others set restrictions that would be triggered only for hot spots when a county’s positive case numbers passed a certain threshold.

Now, as cooler weather moves more people indoors and daily case numbers rise, states and communities are looking to those successes and failures as they consider what future strategies should look like. Could more targeted closures and restrictions be effective, or will a return to statewide stay-at-home orders be needed again?

As public health researchers, we’ve been following the strategies as they evolve, and we see lessons those experiments hold for the country.

Better testing and treatment, but a long way to go

The nation’s ability to respond to the virus has improved since COVID-19 first reached U.S. cities.

Testing capacity has expanded and results are available faster. That means people who become infected can be isolated faster. Treatment methods have also improved. For the most severe cases, innovative use of low-cost steroids and repositioning patients to support breathing have helped seriously ill patients recover faster.

However, there is still no vaccine, a lot of questions remain about new therapies, and shortages are predicted for personal protective equipment as a new flu season approaches.

People stand in line at a clinic offering quick coronavirus testing near Long Beach, California.
Rapid tests and more testing supplies at clinics have helped pinpoint coronavirus hotspots. Brittany Murray/MediaNews Group/Long Beach Press-Telegram via Getty Images

With colder weather now arriving, the nation faces a greater potential for virus outbreaks to spread. More person-to-person contact will be inevitable with more indoor activities and in-person classes in schools and colleges.

The upcoming holidays will also mean more inside gatherings and travel. Throughout the pandemic, data have revealed a pattern of increased cases within two weeks of holidays and other events that increase contact and related exposures. For example, an uptick in cases in the Midwest was linked to late summer gatherings around Labor Day and the reopening of colleges. State and local leaders need to be prepared.

So what works?

From the nationally reported and global case data, it seems clear that requirements for social distancing and mask-wearing combined with stay-at-home orders and business closures can effectively reduce virus transmission.

New Jersey and New York initially implemented strict, prolonged measures and were able to keep case rates lower through the summer, while several states that quickly lifted restrictions saw their

New cases are up by at least 50% in 5 states

More than half of US states are seeing an increase in new Covid-19 cases, with five states — Montana, New Mexico, North Carolina, Tennessee and Vermont — reporting a jump of more than 50% in one week.



a person standing in front of a car: A man performs a self-swab at a drive-through COVID-19 testing site at Eastern Florida State College on October 9, 2020 in Palm Bay, Florida. The Florida Department of Health reports that COVID-19 cases, deaths, and hospitalizations are on the rise while U.S President Donald Trump plans to hold a rally in Sanford, Florida after contracting the disease. (Photo by Paul Hennessy/NurPhoto via Getty Images)


© Paul Hennessy/NurPhoto/Getty Images
A man performs a self-swab at a drive-through COVID-19 testing site at Eastern Florida State College on October 9, 2020 in Palm Bay, Florida. The Florida Department of Health reports that COVID-19 cases, deaths, and hospitalizations are on the rise while U.S President Donald Trump plans to hold a rally in Sanford, Florida after contracting the disease. (Photo by Paul Hennessy/NurPhoto via Getty Images)

Health experts warned over the weekend that the US could have a surge in coronavirus cases and deaths in the coming months, adding to the more than 7.7 million cases and 214,764 deaths on record.

Only Maine, Texas and Washington are reporting fewer new daily cases on average from last week. The number of new cases is holding steady in 16 states: Alabama, Arkansas, California, Connecticut, Delaware, Georgia, Hawaii, Kansas, Louisiana, Maryland, Massachusetts, Nevada, New Hampshire, New York, South Carolina and Wisconsin.

Everywhere else, 31 states in all, new cases have climbed compared with the week before.

Montana, one of the states reporting a steep uptick over the week, has reported 5,000 coronavirus cases in the last 11 days. That’s a stark contract to the beginning of the pandemic when it took the state almost five months to chart its first 5,000 cases.

The state recorded its first coronavirus case on March 13 and on August 10 reported having 5,017 cases across the state. Then from September 30 through October 10, Montana reported 5,046 coronavirus cases, according to data from Johns Hopkins University.

Public health experts have warned that the fall and winter could bring an explosion of new Covid-19 cases as Americans exercise less caution and spend more time indoors, where there is a greater likelihood of transmission.

20,000 deaths ‘inevitable’ this month

An additional 20,000 Covid-19 deaths by the end of the month are “inevitable,” according to a former director of the US Centers for Disease Control and Prevention.

The estimate is based on the number of infections “that have already occurred,” Dr. Tom Frieden said Saturday, during CNN’s “Coronavirus: Facts and Fears” town hall.

The United States reported 57,420 new coronavirus cases on Friday, the highest number of new daily cases since August. That number fell to 44,614 on Sunday.

“Anytime we ignore, minimize or underestimate this virus, we do so at our peril and the peril of people whose lives depend on us,” Frieden said.

By February, the coronavirus death toll in the US could double to about 400,000, a model from the Institute for Health Metrics and Evaluation at the University of Washington School of Medicine projected. Daily deaths will peak at about 2,300 in mid-January, the model predicted.

New Covid-19 cases continue to grow across the country. Florida health officials reported 5,570 new case on Sunday after there