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Coronavirus updates: Birx warns of ‘troubling signs’ in Northeast amid ‘very different’ spread of COVID-19

“What we did in the spring is not going to work in the fall,” Birx said.

A pandemic of the novel coronavirus has now killed more than 1 million people worldwide.

Over 36.7 million people across the globe have been diagnosed with COVID-19, the disease caused by the new respiratory virus, according to data compiled by the Center for Systems Science and Engineering at Johns Hopkins University. The criteria for diagnosis — through clinical means or a lab test — has varied from country-to-country. Still, the actual numbers are believed to be much higher due to testing shortages, many unreported cases and suspicions that some national governments are hiding or downplaying the scope of their outbreaks.

The United States is the worst-affected country, with more than 7.6 million diagnosed cases and at least 213,570 deaths.

California has the most cases of any U.S. state, with more than 847,000 people diagnosed, according to Johns Hopkins data. California is followed by Texas and Florida, with over 811,000 cases and over 728,000 cases, respectively.

More than 190 vaccine candidates for COVID-19 are being tracked by the World Health Organization, at least 10 of which are in crucial phase three studies. Of those 10 potential vaccines in late-stage trials, there are currently five that will be available in the United States if approved.

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New York Worries Over 20 Coronavirus Hot Spots, Wisconsin Sees Troubling Trends | Top News

By Jonathan Allen and Lisa Shumaker

NEW YORK (Reuters) – New York state reported an uptick of positive coronavirus tests in 20 “hot spots” on Thursday, while Midwest states also reported rising caseloads led by Wisconsin, where U.S. President Donald Tramp will hold rallies over the weekend.

New cases of COVID-19 rose in 27 out of 50 U.S. states in September compared with August, with an increase of 111% in Wisconsin, according to a Reuters analysis.

Wisconsin is also dealing with a troubling rise in serious COVID-19 cases that threaten to overwhelm hospitals.

“Our emergency department has had several instances in the past week where it was past capacity and needed to place patients in beds in the hallways,” Bellin Health, which runs a hospital in Green Bay, said in a statement. “Our ICU (intensive care unit) beds have also been full, or nearly full, during the past week.”

Dr. Ryan Westergaard, chief medical officer at the Wisconsin department of Health Services, said the state’s outbreak started in younger people and has now spread throughout the community.

“Public gatherings of any kind are dangerous right now, more so than they have been at any time during this epidemic,” he told CNN on Thursday.

In New York, which grappled with the world’s most rampant outbreak earlier this the year, officials said they were worried about clusters of cases in 20 ZIP code areas across the state, where the average rate of positive tests rose to 6.5% from 5.5% the day before.

New York Governor Andrew Cuomo and New Jersey Governor Phil Murphy encouraged residents to download onto their smartphones a new voluntary contact-tracing app, COVID Alert, they launched on Thursday. The app uses Bluetooth technology to alert users if they have recently been near someone who later tested positive for the novel coronavirus.

Many of New York’s 20 hot spots — half of which are in New York City — include Orthodox Jewish communities. Cuomo said he talked to community leaders about enforcing social distancing measures.

“A cluster today can become community spread tomorrow,” Cuomo said on a briefing call with reporters. “These ZIP codes are not hermetically sealed.”

He implored local authorities to increase enforcement measures. “If they’re not wearing masks, they should be fined,” Cuomo said.

Wisconsin health officials are urging residents to stay home and avoid large gatherings ahead of Trump’s weekend rallies in La Crosse and Green Bay in the run up to the Nov. 3 election.

An indoor Trump rally in Tulsa, Oklahoma, in July likely contributed to a subsequent rise in cases there, city health officials said.

“This spike we’re seeing in Brown County, Wisconsin should be a wakeup call to anyone who lives here that our community is facing a crisis,” Dr. Paul Casey, medical director of the emergency department at Bellin Hospital, told CNN.

Cases, hospitalizations, positive test rates and deaths are all climbing in Wisconsin, according to a Reuters analysis.

Over the past week, 21% of coronavirus tests on average came back

COVID Treatment’s Positive Test Results Contain Troubling Wrinkles Upon Examination

KEY POINTS

  • Regeneron’s COVID-19 monoclonal antibody cocktail performed well on safety and reduction of viral load
  • It was not, however, tested on hospitalized patients, and limitations on pricing and the production of monoclonal antibody treatments suggest it’s no panacea for the pandemic
  • Also concerning were its effects on actual symptom reduction, for which none of the groups produced a statistically significant effect

Positive results from trials are a hopeful step for a COVID-19 monoclonal antibody cocktail, but some elements of the data cast doubt on the efficacy and practicality of the treatment. The results, announced Tuesday by pharmaceutical company Regeneron, did suggest that their drug reduced viral loads and performed well on safety metrics.

“We are highly encouraged by the robust and consistent nature of these initial data, as well as the emerging well-tolerated safety profile, and we have begun discussing our findings with regulatory authorities while continuing our ongoing trials. In addition to having positive implications for REGN-COV2 trials and those of other antibody therapies, these data also support the promise of vaccines targeting the SARS-CoV-2 spike protein,” said George D. Yancopoulos, Regeneron’s president and chief scientific officer. 

Even their most positive test group, however, did not reach the standard benchmark for statistical significance when measuring symptom alleviation. Their results for the reduction of viral load did meet or exceed the level of statistical significance. The drug also lacked a linear relationship between dosage and reduced recovery time, with high dose patients taking longer to recover than low dose patients. A press release aimed at investors said with equal certainty that REGN-COV2 both reduced viral load and alleviated symptoms.

Monoclonal antibody treatments like Regeneron’s REGN-COV2 can be “eye-wateringly expensive,” especially given that they were tested on non-hospitalized patients who would likely recover fine on their own. Some investors were already commenting on this on public trading forums. 

Regeneron A comment on Regenron’s finance.yahoo.com board Photo: Cullen Paradis

Antibody infusions are intended to be administered to patients already infected with the disease and help the body recover faster, as opposed to vaccines, which help the immune system prevent patients from becoming infected in the first place.

The drug was especially promising in patients whose immune systems had not mounted a response to the disease. Without treatment, those patients have a higher viral load to start with and almost double the average recovery time of their counterparts.

Regeneron elected to only measure the results in non-hospitalized populations, meaning that the gravest COVID-19 cases were not measured in the trial. Patients that do not need hospitalization typically recover well at home over a period of one to two weeks. Jefferies analyst Michael Yee speculated in a research note that “it is unclear, though possible, that the Regeneron cocktail could work in a hospital setting where the patient is already severely ill and has a high viral load,” Reuters reports.

Of the 2,000 patients that participated, four ‘infusion reactions’ were recorded, with three of them labeled as ‘serious adverse events.’ Two of those serious

Troubling Sleep Disorder in Athletes a Sign of CTE?

Rapid eye movement sleep behavior disorder (RBD) is surprisingly common in athletes and may signal chronic traumatic encephalopathy (CTE) caused by brainstem tau and Lewy body pathologies, new research suggests.

CTE is a neurodegenerative disorder linked to years of repetitive head impacts from playing professional football and other contact sports.

“Repetitive head impacts may damage sleep-relevant brainstem nuclei and lead to REM sleep behavior disorder,” senior author Thor Stein, MD, PhD, neuropathologist at VA Boston Healthcare in Massachusetts, said in a webinar hosted by the Concussion Legacy Foundation.

“This is something both athletes and their doctors need to be aware of,” added Stein, who is an assistant professor of pathology and laboratory medicine at Boston University School of Medicine.

The findings were published online September 17 in Acta Neuropathologica.

Surprising Findings

In RBD, the paralysis that normally occurs during REM sleep is incomplete or absent, causing people to act out their dreams by talking, flailing their arms and legs, punching, kicking and other behaviors while asleep. 

“The disorder often comes to medical attention when there is an injury or potential for injury to the individual or the individual’s bed partner,” Stein noted.

To investigate ties between CTE and RBD, the researchers analyzed the brains of 247 deceased male athletes who played contact sports; the brains were donated to the Veterans Affairs-Boston University-Concussion Legacy Foundation (VA-BU-CLF) Brain Bank.

The athletes died at a mean age of 63 years. They all had a neuropathological diagnosis of CTE. Their relatives provided information on sleep.

Nearly one third of these athletes (n = 80, 32%) with CTE displayed symptoms characteristic of RBD when they were alive. “That really surprised us,” said Stein. “This is about 30 times more than what’s reported in the general population, where it has been estimated to be present in about 1% of people,” he noted.

In addition, there was a clear dose-response effect. Athletes with CTE and RBD had played contact sports for significantly more years than their peers without RBD (18.3 vs 15.1 years; P = .02). 

“The odds of reporting RBD symptoms increased about 4% per year of play,” first author Jason Adams, an MD/PhD student now at the University of California San Diego, said in a statement.

New Insight

The results also point to a potential cause for RBD.

Compared with athletes who had CTE and no RBD, those with CTE and RBD were four times more likely to have tau pathology within brainstem nuclei involved in REM sleep (odds ratio [OR], 3.96; 95% CI, 1.43 – 10.96; P = .008). Athletes with CTE and RBD were also more likely to have Lewy body pathology (OR, 2.36; 95% CI, 1.18 – 4.72; P = .02).

“Contrary to our expectations, tau pathology in the raphe nuclei was more strongly associated with RBD than Lewy body pathology, suggesting that tau pathology is more likely to lead to sleep dysfunction in CTE,” Stein said.

Christopher John Nowinski, PhD, cofounder and CEO of the Concussion Legacy Foundation, said this study