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UK officials to mull north England virus steps

LONDON — Health officials are scheduled to meet Wednesday to discuss whether to add areas of northern England, including Manchester and Lancashire, to the highest-risk tier, meaning additional anti-coronavirus measures such as closing pubs could soon be imposed there. Only Liverpool was placed in the highest-risk category when the plan was unveiled Monday.

The discussions come as the regional government in Northern Ireland prepares to announce even tougher measures, including a two-week school closure. Northern Ireland has the highest infection rate among the U.K.’s four nations.

Prime Minister Boris Johnson is being criticized by all sides two days after announcing his three-tier approach to controlling the virus.


A report released Tuesday showed that the government’s science advisers have called for tougher measures, including a two- to three-week national lockdown. The opposition Labour Party has called for that advice to be followed, while members of Johnson’s Conservative Party say the measures already in place go too far and are damaging the economy,

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

— Lives Lost: Indian doctor embodied his family’s dreams

— More masks, less play: Europe tightens rules as virus surges

— Possible safety issue spurs pause of COVID-19 antibody study

— AP-NORC poll: New angst for caregivers in time of COVID-19

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

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HERE’S WHAT ELSE IS HAPPENING:

NEW DELHI — India has confirmed more than 63,000 new cases of the coronavirus, an increase of over 8,000 from the previous day but still far fewer than it was reporting a month ago, when the virus was at its peak in the country.

The Health Ministry reported 63,509 new cases on Wednesday, raising India’s total to more than 7.2 million, second in the world behind the U.S. The ministry also reported 730 fatalities in the past 24 hours, raising the death toll to 110,586. The country was seeing more than 1,000 deaths per day last month.

According to the Health Ministry, India’s average number of daily cases dropped to 72,576 last week from 92,830 during the week of Sept. 9-15, when the virus peaked. Over the last month, the country has been seeing a trend of declining cases on a week-to-week basis.

On Tuesday, India registered 55,342 new cases, its lowest single-day tally since mid-August.

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BEIJING — China says it has carried out more than 4.2 million tests in the northern port city of Qingdao, with no new cases of coronavirus found among the almost 2 million sets of results received.

The city has reported a total of 12 cases, six with symptoms and six without, since the new outbreak was first spotted over the weekend at a hospital.

China on Wednesday reported 27 new cases of coronavirus, including 13 new cases of local transmission and 14 cases brought from outside the country.

China has reported a total of 4,634 deaths among 85,611 confirmed cases of COVID-19.

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BOISE, Idaho — Idaho health care experts say coronavirus is increasing

England and Tottenham on collision course over Harry Kane’s fitness

José Mourinho is strongly against Gareth Southgate’s plan to start Harry Kane for England in the Nations League tie with Denmark on Wednesday night and has communicated his concerns to the national setup.

The Tottenham manager had urged his England counterpart to handle Kane with care during the international window, given his high workload in the season so far, and the situation became more delicate when the striker felt an issue with his thigh last week.

Related: England’s class of 2018 return favour as Southgate looks back to go forward | David Hytner

Southgate has said Kane is not injured, rather he began to suffer from “muscle fatigue” last Wednesday when he started to train with England, having been given the Monday and Tuesday off. The Football Association sent him for a scan and there has been regular dialogue between their medics and those at Spurs.

Kane was never going to feature last Thursday in the against Wales, which England won 3-0 and, because he was unable to train fully, he was used only as a 66th-minute substitute in the 2-1 Nations League victory against Belgium on Sunday.

But now club and country are on a collision course, with Southgate wanting to start Kane against Denmark. Spurs argue that the fact Kane was sent for a scan shows the FA is worried that the player is carrying something, and they also know he will always turn out when asked to do so. The club blame the FA in part for the number of games Kane has already played this season. Before Belgium he had played 10 in 29 days – eight of them as a starter.

“Medically, there’s been conversations [with Spurs],” Southgate said. “He started to train on the Wednesday, was a little unhappy with how he felt, so then worked with our medical team the next couple of days. We scanned just to be certain but it’s a muscular fatigue issue rather than an injury so it just needed a bit more confidence.

“He knew by then he could push on a little bit but he just needed a bit more confidence in it and so his training week really wasn’t suitable to start [against Belgium]. I think he’ll have gained more confidence from the spell he had [as a substitute] and so, all being well, we hope he’ll be good to start on Wednesday.”

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England and Tottenham on collision course over Harry Kane’s fitness | Football

José Mourinho is strongly against Gareth Southgate’s plan to start Harry Kane for England in the Nations League tie with Denmark on Wednesday night and has communicated his concerns to the national setup.

The Tottenham manager had urged his England counterpart to handle Kane with care during the international window, given his high workload in the season so far, and the situation became more delicate when the striker felt an issue with his thigh last week.

Southgate has said Kane is not injured, rather he began to suffer from “muscle fatigue” last Wednesday when he started to train with England, having been given the Monday and Tuesday off. The Football Association sent him for a scan and there has been regular dialogue between their medics and those at Spurs.

Kane was never going to feature last Thursday in the against Wales, which England won 3-0 and, because he was unable to train fully, he was used only as a 66th-minute substitute in the 2-1 Nations League victory against Belgium on Sunday.

But now club and country are on a collision course, with Southgate wanting to start Kane against Denmark. Spurs argue that the fact Kane was sent for a scan shows the FA is worried that the player is carrying something, and they also know he will always turn out when asked to do so. The club blame the FA in part for the number of games Kane has already played this season. Before Belgium he had played 10 in 29 days – eight of them as a starter.

“Medically, there’s been conversations [with Spurs],” Southgate said. “He started to train on the Wednesday, was a little unhappy with how he felt, so then worked with our medical team the next couple of days. We scanned just to be certain but it’s a muscular fatigue issue rather than an injury so it just needed a bit more confidence.

“He knew by then he could push on a little bit but he just needed a bit more confidence in it and so his training week really wasn’t suitable to start [against Belgium]. I think he’ll have gained more confidence from the spell he had [as a substitute] and so, all being well, we hope he’ll be good to start on Wednesday.”

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Boris Johnson Announces Three-tier Coronavirus Strategy for England

Tighter restrictions have been confirmed by the Government as the Prime Minister confirmed a ‘three-tier’ system for England to classify the severity of rates of COVID-19.

From Wednesday, regions will be classed as either ‘medium’, ‘high’, or ‘very high’ risk.

The details, announced in the Commons by Boris Johnson, came as the NHS said that Nightingale hospitals in Manchester, Sunderland, and Harrogate were being asked to mobilise in the next few weeks in response to growing rates of SARS-CoV-2 infections in the North West and North East.

Speaking at a Downing Street news briefing earlier, Prof Jonathan Van-Tam, England’s deputy chief medical officer, warned that additional hospital admissions and deaths were now ‘baked in’ as the virus spread from younger to older age groups.

What the Three Tiers Mean

Speaking ahead of his evening televised address to the nation, Mr Johnson said he did not believe another national lockdown was appropriate but that he was not prepared to “let the virus rip”.

The three-tier system would mean:

  • Medium: Covering most of England, national restrictions such as the ‘rule of six’ and the 10pm curfew for pubs, bars, and restaurants would apply

  • High: People in areas including Greater Manchester and Birmingham would be prevented from socialising with other households indoors

  • Very High: People would be banned from socialising with other households both indoors and in private gardens, while bars and pubs would be closed unless they were able to operate as restaurants

The Prime Minister said that agreement had been reached with leaders in Merseyside for the Liverpool city region to move into the ‘very high’ alert level. There, gyms, leisure centres, betting shops and casinos would also be told to close.

Mr Johnson said that discussions were ongoing with other leaders in the North West, North East, and Yorkshire and Humber over lockdown restrictions.

Mr Johnson told the Commons: “They, like us, like everyone in this House, are grappling with very real dilemmas, but we cannot let the NHS fall over.”

He warned MPs that “the weeks and months ahead will continue to be difficult and will test the mettle of this country”.

A debate and a vote on the new restrictions will take place at Westminster. The Government has promised to keep the measures under continual review.

In reply, Labour leader Keir Starmer said it was clear that the country faced a “critical moment” in efforts to contain the SARS-CoV-2 virus.

However, he added: “I’m now deeply sceptical that the Government has actually got a plan to get control of this virus, to protect jobs, or regain public trust.”

Cases of Coronavirus ‘Heating Up’

Illustrating the latest situation this morning with a series of maps and graphs, Prof Van-Tam said latest data showed COVID-19 cases were “heating up” south of the West Midlands and East Midlands.

“It has changed in a matter of just a few days, and that is clearly of concern to me,” he said.

Prof Van-Tam said that while the resurgence of cases in Northern England

Increase in COVID-19 deaths in England ‘baked in’ after infection spike, deputy CMO warns

Deputy chief medical officer Jonathan Van-Tam during a media briefing in Downing Street, London, on coronavirus
Deputy chief medical officer Jonathan Van Tam warned that COVID-19 deaths will increase in the next few weeks in England. (PA Images via Getty Images)
  • Spike in coronavirus deaths inevitable after recent wave of new cases, Jonathan Van Tam warns

  • He says deaths are “baked in” with increased infections – with more patients in hospital now than when national lockdown was enforced in March

  • It comes as Nightingale hospitals in north of England are asked to mobilise

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The recent spike in coronavirus cases will lead to an increase in deaths in a matter of weeks, England’s deputy chief medical officer has warned.

Jonathan Van Tam said further hospitalisations and deaths are “baked in” after coronavirus cases rose across the country.

He said the number of patients currently in hospital is related to infections from three weeks ago.

“As patients become ill with COVID-19 they don’t immediately go to hospital,” Van Tam told a Downing Street briefing.

“It takes some time before they become ill enough to go to hospital, and they don’t die the moment they arrive.

“The point I’m trying to make here is there is a lag between cases and when we see hospital admissions rise and when we see deaths rise.”

Deputy chief medical officer Jonathan Van Tam said COVID-19 cases were on the increase after a "flat summer" (Department for Health)
Deputy chief medical officer Jonathan Van Tam said COVID-19 cases were on the increase after a “flat summer” (Department for Health)

Van Tam was joined at the COVID-19 briefing by NHS England’s Stephen Powis, who doubled down on the stark warning as he announced Nightingale hospitals in the north of England have been asked to mobilise to deal with a rise in coronavirus patients.

Powis said there are more patients in hospital in England now than there were when the UK went into a full national lockdown on 23 March.

It means the temporary Nightingales in Manchester, Sunderland and Harrogate could be brought back into use to help with the spike in cases.

Local clinicians will decide whether they are used for COVID patients or to provide extra capacity to maintain services for people without the virus.

COVID hospital admissions are rising fastest amongst the elderly, Powis added.

At the same briefing, Dr Jane Eddleston, medical lead in Greater Manchester, urged the public to “respect” the virus due to the “extremely serious” consequences it has for some patients.

Dr Eddleston said: “I stress to you the importance of us taking this disease extremely seriously.

“We are still finding that a quarter of patients that are admitted to intensive care are still required to go on mechanical ventilator within 24 hours of admission. This is very serious.

“The condition produces a very profound inflammation of the lungs which does have serious consequences for patients and I would ask you all to respect the virus and follow the advice we’re being given.”

She added 30% of critical care beds are being taken up by COVID patients, and “this is starting to impact on the services we provide for other

England braces for more restrictions

LONDON (AP) — Millions of people in northern England are anxiously waiting to hear how much further virus restrictions will be tightened as one of the British government’s leading medical advisers warned Sunday that the country is at a crucial juncture in the second wave of the coronavirus.

England’s deputy chief medical officer, Professor Jonathan Van-Tam, said the U.K. is at a “tipping point similar to where we were in March” following a sharp increase in new coronavirus cases.

“But we can prevent history repeating itself if we all act now,” he said. “Now we know where it is and how to tackle it — let’s grasp this opportunity and prevent history from repeating itself.”


All across Europe including the U.K., the pandemic has found fresh legs over the past few weeks following the reopening of large sectors of the economy, as well as schools and universities. Infection levels — and deaths — in the U.K. are rising at their fastest rates in months.

Without quick action, there are fears that U.K. hospitals will be overwhelmed in the coming weeks at a time of year when they are already at their busiest with winter-related afflictions like the flu. So far the U.K. has experienced Europe’s deadliest virus outbreak, with over 42,750 confirmed deaths.

Although new coronavirus infections are rising throughout England, cities in the north — Liverpool, Manchester, Newcastle — have seen a disproportionate increase in new cases. While some rural areas in eastern England have less than 20 cases per 100,000 people, major metropolitan areas such as Manchester are recording levels above 500 per 100,000, nearly as bad as Madrid or Brussels.

As a result, national restrictions such as a 10 p.m. curfew on pubs and restaurants have been supplemented by local actions, including in some cases banning contacts between households. In Scotland’s two biggest cities, Glasgow and Edinburgh, pubs have already closed for 16 days to suppress the outbreak.

In response to the virus’ resurgence, Prime Minister Boris Johnson is expected to announce a new three-tier local lockdown system Monday, which could temporarily close pubs and restaurants in the virus hotspots. The speculation is that those areas put under the tightest restrictions would forbid all household mixing, indoors or out.

Local leaders in northern England have vented their fury at the Conservative government over what they see as an “inadequate” wage support scheme that it announced Friday and for not properly telling them about the upcoming restrictions. The wage plan aims to help employees in companies that are forced to close due to virus restrictions but mayors say it’s not generous enough in paying only two-thirds of employees’ wages and doesn’t compensate those indirectly hit by any business closures, such as drink suppliers to pubs.

Communities Secretary Robert Jenrick on Sunday sought to assuage concerns that the government was being overly top-down in its approach.

“We are trying to work very closely with mayors, with council leaders, with chief executives to design these measures with them,” he told

The New England Journal of Politics, Part II

The entrance to the editorial offices of the New England Journal of Medicine in Boston.



Photo:

AP

The New England Journal of Medicine (NEJM) his week published an editorial denouncing “dangerously incompetent” leadership in Washington on the pandemic and all but endorsing Joe Biden for President. This will go down well in all the right precincts. But then please don’t complain if half of America suspects that science is increasingly politicized.

The editorial recites the government’s well-known failures in managing the coronavirus, such as the initial struggles to roll out testing and hand out enough protective equipment. We can’t disagree with that, but the editors go on to extol China’s virus management, conveniently ignoring its early cover-up and manipulation of the World Health Organization. Why are American elites so enamored of authoritarian command and control? The editors then hit the U.S. for late and inconsistent quarantines, without taking into account the public-health and economic costs of lockdowns.

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You might say “the New England Journal is joining the ranks of academic publications risking their reputations as non-partisan arbiters of good science in order to rumble in the political tarpits.” That’s a line from our 2006 editorial “New England Journal of Politics” describing how the NEJM had waded into a legal dispute over Merck’s painkiller Vioxx. The NEJM also appeared in these pages in 2007 for working to tank a diabetes drug and help Democrats in Congress to regulate treatment approvals more tightly.

Our contributor Scott Gottlieb noted at the time that medical journals have “historically played a special role in helping to define medical practice standards. Even decisions they make on how prominently to place a study, let alone how they editorialize about it, are seen as strong signals to clinicians on how doctors should weigh the evidence. So when editors pursue a political agenda, it’s public health that pays a price.”

Another prominent medical journal, The Lancet, has its own history of political incursions, such as a study on Iraq war casualties funded by anti-George W. Bush partisans. The NEJM’s latest editorial laments that “current leaders” have “undercut trust in science.” The irony is that much of the public distrust of expertise derives from years of scientists behaving like politicians.

Wonder Land: Leading epidemiologists have come together to write “The Great Barrington Declaration,” which urges a “Focused Protection” strategy in managing the coronavirus, and has already been signed by thousands of scientists. Images: Getty Composite: Mark Kelly

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‘Alarming’ study suggest 45,000 people are catching COVID every day in England

45,000 people are catching COVID every day in England, an 'alarming' study has reported, despite mass movements still casting skepticism on the scale of the virus (Hasan Esen/Anadolu Agency via Getty Images)
45,000 people are catching COVID every day in England, an ‘alarming’ study has reported, despite mass movements still casting skepticism on the scale of the virus (Hasan Esen/Anadolu Agency via Getty Images)

The largest home testing study for coronavirus suggests that new infections have reached 45,000 every day in England.

An analysis of swab tests taken by 175,000 people between 18 September and 5 October found that one in every 170 tests was returning a positive result.

The research, led by Imperial College London, reports that 0.60% of the population, or 60 per 10,000, had the SARS-CoV-2 virus, compared to 0.13% in the previous round of testing.

Professor Paul Elliott, from the School of Public Health, and director of the REACT programme which conducted the research, said: “Our robust findings paint a concerning picture of the growing epidemic across England. While certain areas are worse affected, if left unabated then infection trends will follow nation-wide and could lead to high levels of unnecessary death and illness from the disease.”

On 21 September two of Boris Johnson’s top advisers warned the UK could see 49,000 new cases of coronavirus by mid-October unless action was taken to slow the spread of coronavirus.

Chief Medical Officer for England Chris Whitty (left) and Chief Scientific Adviser Sir Patrick Vallance (right) warned in September that the UK was at a "critical point" in the pandemic (REUTERS/Peter Nicholls)
Chief Medical Officer for England Chris Whitty (left) and Chief Scientific Adviser Sir Patrick Vallance (right) warned in September that the UK was at a “critical point” in the pandemic (REUTERS/Peter Nicholls)

Chief scientific adviser Sir Patrick Vallance said such a scenario could see 200 daily deaths by November as hospitalisation figures increase, while England’s chief medical officer Professor Chris Whitty said too little action risked the virus becoming “out of control”.

The pair said the UK was at a “critical point” in the pandemic.

Vallance told a Downing Street briefing: “At the moment we think the epidemic is doubling roughly every seven days.

“If, and that’s quite a big if, but if that continues unabated and this grows doubling every seven days… if that continued you would end up with something like 50,000 cases in the middle of October per day.

“50,000 cases per day would be expected to lead a month later, so the middle of November, say, to 200-plus deaths per day

“The challenge therefore is to make sure the doubling time does not stay at seven days.”

Watch: What is long COVID?

The REACT-5 research suggesting 45,000 cases per day came as the Office for National Statistics confirmed a huge leap in case numbers.

ONS figures, published Friday, suggested there were 224,400 people with COVID-19 between between 25 September and 1 October, the latest dates for which data is available.

This was nearly double the 116,600 people with COVID the week before, despite lockdown measures and the stark warnings from Valance and Whitty.

Professor James Naismith, director of the Rosalind Franklin Institute, and University of Oxford, said: “The virus has not changed.

“The ONS survey is grim reading and in conjunction with the REACT-5 study alarming. The two surveys report rather different absolute numbers,

New England Journal of Medicine Says US Leaders Turned the COVID-19 Crisis Into a Tragedy

“Dying in a Leadership Vacuum” – that’s the title of a new editorial published by editors from the prestigious medical journal New England Journal of Medicine (NEJM) on Oct. 8, less than a month before the general election. With Election Day fast approaching, the journal, which has been nonpartisan for over 200 years since its inception, took an opportunity to change course and urged Americans to vote our current administration out of office due to what they describe as our leaders’ failure of a response to COVID-19.



a woman standing in front of a building: New England Journal of Medicine Says US Leaders Turned the COVID-19 Crisis Into a Tragedy


© Getty / MarioGuti
New England Journal of Medicine Says US Leaders Turned the COVID-19 Crisis Into a Tragedy

The editorial was the only one in NEJM’s history that was signed by all of its editors, and it begins by stating that the COVID-19 pandemic, a worldwide crisis, tested leadership across the globe. “With no good options to combat a novel pathogen, countries were forced to make hard choices about how to respond. Here in the United States, our leaders have failed that test. They have taken a crisis and turned it into a tragedy,” the editors, who are all doctors, wrote.

They pointed to the fact that the US leads the world in COVID-19 cases and deaths – over 211,000 have died and seven million have contracted the virus – and that we did not behave aggressively or adequately enough; we have behaved “poorly” for a number of reasons (other countries have outperformed us, they said). Those reasons include lack of testing early on and distribution of PPE to healthcare workers and the public despite having “ample warning” when the disease first arrived.

And, while the editors said testing has increased substantially, “the more useful metric is the number of tests performed per infected person,” and our numbers are far below that of other countries. “Moreover, a lack of emphasis on developing capacity has meant that U.S. test results are often long delayed, rendering the results useless for disease control,” they wrote.

Another big misstep for the US, according to the editors? Lack of universal guidelines and enforcement when it comes to lockdown measures, which they call inconsistent (doctors POPSUGAR has spoken to in the past have talked about this as well). “Our rules on social distancing have in many places been lackadaisical at best, with loosening of restrictions long before adequate disease control had been achieved,” the NEJM editors explained. “And in much of the country, people simply don’t wear masks, largely because our leaders have stated outright that masks are political tools rather than effective infection control measures.”

“Our current leaders have undercut trust in science and in government, causing damage that will certainly outlast them.”

What’s more, the editors blamed this administration for politicizing vaccines and ignoring public

New England Journal Of Medicine Takes Stance On Presidential Election For First Time

If you had a nickel for every time you’ve heard the phrase “unprecedented times” this year, you’d probably have a lot of nickels. Well, here’s another thing that’s truly been unprecedented: major scientific journals telling you to not vote for one of the major candidates in an upcoming U.S. Presidential election. For the first times in their long histories, The Lancet and Scientific American have clearly urged people to not re-elect current U.S. President Donald Trump this November 3. Scientific American went one step further by endorsing Democratic challenger and former Vice President Joe Biden for President, as Tommy Beer described for Forbes. And now a third prestigious scientific journal, The New England Journal of Medicine (NEJM), has taken a stance with an editorial entitled, “Dying in a Leadership Vacuum.” Take a wild guess from the title as to what they may think of the Trump administration.

Yep, “Dying in a Leadership Vacuum,” may sound like the life and times of a dust ball and how an encounter with a vacuum cleaner really sucks. But in this case, it summarized what the Editors for NEJM wrote about the Trump administration’s continuing response to the current Covid-19 coronavirus pandemic. And spoiler alert, it was not positive, unless you count positively scathing as positive. They described the pandemic as a “test of leadership” and “here in the United States, our leaders have failed that test. They have taken a crisis and turned it into a tragedy.”

In the immortal words of Tag Team, whoomp! There it is. It’s really the first time since since its founding in 1812 that the esteemed medical journal has taken a clear position on a U.S. presidential election. That was a streak of about 208 years, which is approximately 7592 Scaramuccis, that has now been broken. This is by no means small news in the scientific and medical communities. Some scientists and physicians avoid discussing Presidential politics like a radioactive piece of Shoofly pie covered in sludge. But as many prominent scientists have recently point out, the upcoming election is no longer about “partisanship.” When major scientific journals have to take such a stance, you know the upcoming election is not your typical election.

The editorial went on to state that “the magnitude of this failure is astonishing,” and point out how the U.S. “had ample warning,” but was “incapable of testing effectively and couldn’t provide even the most basic personal protective equipment to health care