COVID-19 Compilation

September 28, 2020

Iowa At 10 a.m. Monday, the state was reporting 1,317 COVID-19-related deaths, an increase of two deaths since the state's tally at 10 a.m. Sunday, according to the state's Coronavirus.Iowa.gov website. The state was reporting at 10 a.m. Monday that there are 86,840 confirmed cases of coronavirus, an increase of 611 since 10 a.m. Sunday. The state has been changing how it reports testing data, which has caused spikes in the rate of positive data. Before the changes, the state was consistently reporting a positivity rate, that is, the percentage of tests that were positive, below 10%. Iowa also is now counting the results of antigen tests, a relatively rapid type of coronavirus tests, that will increase the reported rates of infection in some counties.

On Monday, the state was reporting 11.0% positive since the pandemic started. Of the tests the state has reported since 10 a.m. Sunday, 8.3% were positive, according to a Des Moines Register analysis. Iowa's 14-day average was 9.0% positive, according to the state. These were the Iowa counties that had 14-day averages above 15%:

Sioux (29.6%); Lyon (26.0%); Henry (24.5%); Osceola (24.4%); Crawford (19.0%); Plymouth (18.0%); Fremont (18.0%); Delaware (17.2%); Sac (16.8%); Dubuque (16.3%); Woodbury (15.5%); Palo Alto (15.4%) O'Brien (15.4%); Winnebago (15.1%).

Gov. Kim Reynolds has ordered that at least 50% of instruction at Iowa schools must be held in person. For K-12 schools to be considered for a state waiver allowing for online-only instruction, districts must have an 10% absentee rate and the county they are located in must have a 14-day coronavirus average of at least 15%. Of the 86,840 people who have tested positive, 66,191 have recovered, according to the state. The total number of people tested is 786,014, including 7,315 on Sunday. On Monday, the state was reporting 353 hospitalizations, up from 343 on Sunday. In the past 24 hours, 51 patients have been admitted. Also, there are 96 patients in the ICU, up/ from 89 on Sunday.

Washington, D.C.

 House Democrats released an updated version of the Heroes Act, their $2.2 trillion COVID-19 relief bill. The text of revised version of The Heroes Act is here. A one-pager on the legislation is here. A section-by- section summary is here. Additional information on the state and local relief provisions is here.  President Trump announced today that the federal government will ship 100 million rapid coronavirus tests to states by the end of the year. The first shipment of around 6.5 million tests will be divided and sent this week. The amount each state receives will be based on population data. President Trump and HHS testing czar Brett Giroir are encouraging state leaders to use the tests to help schools reopen, but governors will ultimately be in charge of deciding how to use the rapid tests they receive.  Tomorrow at 12:00 PM, the FDA, NIOSH, and OSHA will host a webinar on Respirators and Other PPE for Health Care Personnel Use during the COVID-19 Pandemic.  The FDA has announced a clinical hold on INOVIO's COVID-19 vaccine trials as the Agency has additional questions about the CELLECTRA® 2000 delivery device used in the trial. The hold is not the result of any adverse outcomes during the ongoing Phase 1 portion of INOVIO's study, and INOVIO and its partners are continuing to prepare for a planned Phase 2/3 trial of INO-4800.  The FDA will host the last in their series of virtual Town Halls for clinical laboratories and commercial manufacturers that are developing or have developed diagnostic tests for SARS-CoV-2. The purpose of this Town Hall is to help answer technical questions about the development and validation of tests for SARS- CoV-2. The FDA will also hold virtual Town Halls for clinical laboratories and commercial manufacturers to help answer questions on: o September 30, 12:15 PM  The CDC updated their guidance today on how to select, wear, and clean your mask.  CDC's MMWR published an early release new article COVID-19 Trends Among School-Aged Children — United States, March 1–September 19, 2020. The findings indicate that children with underlying conditions are more likely to experience severe effects of COVID-19, but also that teens are more likely to contract COVID-19 than younger children.  The House Committee on Energy and Commerce will hold a hearing on Wednesday titled, "Pathway to a Vaccine: Ensuring a Safe and Effective Vaccine People Will Trust.” You can view the witness panel here. A memo will be available upon request.  Friday, the Select Subcommittee on the Coronavirus Crisis will hold a hybrid hearing with HHS Sec. Alex Azar on the Department’s response to the coronavirus pandemic. A memo will also be available upon request for this hearing. Updates from the States

 Out of the cases under investigation detected by U.S. surveillance, there are 7,095,422 total cases and 204,328 deaths The CDC data closes out the day before reporting.  State officials in Minnesota have reported that a public health survey on the impact of COVID-19 has been halted after several incidents in which surveyors of color were intimidated or called racial slurs. The surveyors, who are conducting this work in person, have faced armed threats, verbal harassment, and have even been followed or videotaped. CDC's Community Assessment for Public Health Emergency Response survey, or CASPER survey, was scheduled to run between Sept. 14 and Sept. 30 and was meant to help public health officials understand the spread of COVID-19 in Minnesota.  Almost half of U.S. states are reporting increased numbers of new COVID-19 cases as health experts warn of a potential coronavirus surge in the fall and winter. According to the latest Johns Hopkins University data: 21 states are showing an upward trend in cases compared to the previous week, 19 states are showing steady trends, and 10 states are showing downward trends.  After months of promising signs in its fight against the coronavirus, New York State today reported a spike in its rate of new cases, including a rise in New York City and in its northern suburbs. The rate of positive test results in the city reached 1.93 percent, according to Mayor, an increase from the 1.5 percent rate reported by the city a week ago.  Authorities in North Dakota are trying to ease concerns over hospital capacity as the state grapples with the country’s steepest current surge in coronavirus cases.  Wisconsin reported 2,817 new cases on Saturday, the state's highest single-day increase in cases. The previous record was set Sept. 18 with 2,533 cases.  Missouri again reported record-high COVID-19 hospitalizations. There were 1,125 patients hospitalized due to COVID-19 across Missouri on Sunday, the highest number the state has reported since the start of the pandemic.  Florida Education Commissioner Richard Corcoran has ordered Miami-Dade County Public Schools to fully open its buildings five days a week by Oct. 5. That’s more than two weeks earlier than the system, the fourth-largest in the country, had decided to do after a marathon 29-hour meeting last week.  New Jersey Gov. Phil Murphy (D) signed an EO extending the state’s public health emergency.  Michigan Gov. Gretchen Whitmer (D) signed an EO requiring face coverings for students in grades K-5 and also signed an EO amending the MI Safe Start order to reopen movie theaters and performance venues.  Washington Gov. Jay Inslee (D) extended a proclamation related to the Washington residency requirement for public university tuition waivers in response to the COVID-19 pandemic.  The Illinois Department of Public Health reported 17 counties in Illinois are considered to be at a warning level for COVID-19.  Citing "sufficient progress in the fight against COVID-19," Chicago Mayor Lori Lightfoot announced the easing of phase four guidelines for businesses starting Oct. 1.  A Maryland man was sentenced to a year in jail for holding two large parties and violating the state's order against large gatherings, according to the Charles County state's attorney's office.  Useful state data: o Use Johns Hopkins University’s COVID-19 U.S. map as a resource for media, policymakers, and communities to view a collection of critical public health data in one online destination and better understand and track the COVID-19 pandemic in populations both large and small across the country. o NASHP has developed a COVID-19 State Action Center which serves as a state-level policy dashboard. Governing is also keeping a running tally of coronavirus news and impacts at the intersection of the health and economic crises in the states and localities. o This site from the Kaiser Family Foundation provides state-level information on cases/deaths, social distancing measures, health policy actions, and more. o This series of maps shows how states are responding to COVID-19, and this tracker, created and maintained by MultiState Associates, has an up-to-date list of executive orders and various travel restrictions.

Military/Defense

 Last week, SOUTHCOM donated a field hospital to Jamaica to support its response to COVID-19. Overall, the U.S. has provided Jamaica $2 million and the whole region $17 million in supplies and other resource to assist in COVID-19 response.  Military suicides are up 20 percent in 2020 compared to the same period in 2019. While officials can't attribute this increase to COVID-19, there is a direct correlation from when the COVID-19 pandemic began.  Despite calls from some House Democrats, Congress announced that they will not be investigating how the Pentagon spent its CARES Act funds and stated that the Pentagon did not misuse its funds because they addressed COVID-related impacts in the industrial base.  According to data released Monday, an eighth U.S. service member has died from COVID-19, the first since late August.

International Affairs

 The WHO's Weekly Epidemiological Update can be found here.  A new arrangement will allow for around 120 million rapid coronavirus tests to be distributed to low- and middle-income countries over the next six months, WHO Director-General Tedros Adhanom Ghebreyesus announced today.  Greece on Sunday confirmed the first COVID-19 fatality in one of the country’s increasingly overburdened migrant and refugee camps.  People who do not self-isolate in England will now face fines of up to 10,000 pounds, or almost $13,000 USD, as the nation battles a second coronavirus wave.  Government officials in Marseille and Aix-en-Provence ordered bars, cafes, and restaurants to close for 15 days starting last evening. They are currently the only two cities in France under the new order.  India’s coronavirus caseload has surpassed six million.  A cruise ship carrying more than 1,500 people was turned back from the Greek island of Milos in the Aegean Sea after 12 crew members tested positive for COVID-19. The Mein Schiff 6, which sails under the flag of Malta, left Crete on Sunday and was off the coast of Milos early on Monday when the test results were released.  The municipal government in Beijing announced new procedures to allow medical personnel to bypass their bosses in reporting health emergencies directly to hotlines and government agencies. The rules are supposed to protect whistle-blowers’ identities and shield them from any retaliation.  The next Group of 20 summit meeting, which was scheduled to be held in Riyadh, Saudi Arabia, will take place virtually on Nov. 21 and 22.  With Zimbabwe’s coronavirus infections on the decline, schools are reopening, along with churches, bars, restaurants, airports and tourist attractions. Strict lockdowns designed to curb transmission are being replaced by a return to relatively normal life.  A recent surge in infections in Morocco has led authorities to reinstitute strict lockdown measures. Marrakech is at a standstill, while police checks are part of the scenery in hard-hit Casablanca. In the northern city of Tangiers, military vehicles were deployed last month to help enforce measures there. Movement between the city and others was stopped, barring exceptional authorizations.  Beijing’s Municipal Commerce Bureau called on frozen food importers to avoid importing goods from COVID-19 hotspots.  A definitive count of coronavirus-related fatalities in Mexico will probably not be available for “a couple of years,” the country’s top health official predicted Sunday. As in most countries, Mexico’s official death toll — over 76,000 as of late last night, the fourth-highest total worldwide — is widely understood to be an undercount.  Melbourne, the epicenter of the Australia’s largest coronavirus outbreak, will no longer be subject to a curfew after today.  Kenya will extend its nightly COVID-19 curfew for another 60 days with shortened hours from 11 PM to 4 AM local time, but bars and the sale of alcohol in ordinary eateries will be permitted effective Tuesday.  Global Cases: 33,034,598 Total Deaths: 996,342 deaths (reports now confirm this number has exceeded 1,000,000)

Lifestyle, Science, and Economy

 A recent poll conducted by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health, surveyed around 3,500 respondents nationwide in July and early August and found that nearly half of American households faced lost jobs or pay cuts during the pandemic (figure below). According to the survey results, the share of households that had a member fall ill with COVID-19 and that subsequently have lost work is up to 64 percent. Of those that have had a sick household member, 63 percent report facing serious financial problems during the coronavirus outbreak. Of households that include someone who has a disability, 63 percent reported facing serious financial hardship, and 37 percent report using up all or most of their savings.  Researchers are increasingly concerned about the long-lasting mental health impacts of the pandemic and virus-related lockdowns. This concern is particularly acute for those with substance use disorder or related behavioral health issues. A University of Houston researcher, Michael Zvolensky said, "The impact of COVID-19 on psychological symptoms and disorders, addiction and health behavior is substantial and ongoing and will negatively impact people's mental health and put them at greater risk for chronic illness and drug addiction."  Early results from Johnson & Johnson's Phase 1/2a COVID-19 vaccine clinical trial found that 99 percent of the participants age 18 to 55 in both dose groups had developed antibodies against the virus 29 days after getting vaccinated. The analysis found that most of the side effects, like fever, headache, fatigue, body aches and injection-site pain, were mild and resolved after a couple of days. Phase 3 trials, which will involve around 60,000 individuals, will examine the safety and effectiveness of a single dose against a placebo to prevent symptomatic COVID-19.  A new study has identified 2,085 excess deaths in England and Wales due to heart disease and stroke during the peak of the COVID-19 pandemic. On average, that is 17 deaths each day over four months that probably could have been prevented. The study's authors believe the excess deaths were caused by people not seeking emergency hospital treatment for a heart attack or other acute cardiovascular illness requiring urgent medical attention, either because they were afraid of contracting COVID-19 or were not referred for treatment.  Findings from a new literature review about the association between flu vaccines and the risk of severe COVID-19 illness suggest that measures aimed at raising influenza vaccination coverage in the coming months would be beneficial.  A recent study estimates that only around 9 percent of Americans had been infected with COVID-19 by July - a far cry from what would be needed to achieve herd immunity.  The airline industry is about to take another large hit as airlines prepare to cut a combined 35,000 jobs this week.  There are now 8 clinical trials in Phase 3 of testing. The WHO keeps a running list of COVID-19 vaccine candidates, which you can view here. STAT News also has a resource tracking COVID-19 drugs and vaccines. The New York Times has a very helpful vaccine tracker as well, which you can view here.  The Johns Hopkins Center for Health Security has an extensive list of commercial and lab-developed tests.  Continue to look at the NIH Office of Portfolio Analysis’s (OPA) expert-curated portfolio of COVID-19 publications and preprints. The portfolio includes peer-reviewed articles from PubMed and preprints from medRxiv, bioRxiv, ChemRxiv, and arXiv. It is updated daily with the latest available data and enables users to explore and analyze the rapidly growing set of advances in COVID-19 research.

Helpful Articles/Media

 How will COVID-19 change global development? 5 experts weigh in  Read the CDC's September 25 Science Update here. As a reminder, the Science Update series provides brief summaries of new COVID-19-related studies on many topics, including epidemiology, clinical treatment and management, laboratory science, and modeling.  Here is last week’s COVIDView from CDC, a weekly summary and interpretation of key indicators that have been adapted to track the COVID-19 pandemic in the U.S.  Nearly Two-Thirds Of U.S. Households Struck By COVID-19 Face Financial Trouble  Convalescent Plasma for the Treatment of COVID-19: Perspectives of the National Institutes of Health COVID-19 Treatment Guidelines Panel  How the Pandemic Transformed This Songbird’s Call  It’s Time to Put Children and Young People First During the Global COVID-19 Pandemic  COVID-19 data on Native Americans is ‘a national disgrace.’ This scientist is fighting to be counted  Reimagining Nursing Homes in the Wake of COVID-19  Advances In ICU Care Are Saving More Patients Who Have COVID-19  Structural Racism, Social Risk Factors, and Covid-19 — A Dangerous Convergence for Black Americans  Transmission of SARS-CoV-2: A Review of Viral, Host, and Environmental Factors  Covid-19: Do many people have pre-existing immunity?  Disinfection dangers: How to avoid viruses without exposing yourself to toxics  The AstraZeneca/Oxford University Phase 3 COVID-19 Vaccine Trial – Why Was It Paused?  Join a Facebook Live Q&A on reopening schools and workplaces with Joseph Allen, Director of the Healthy Buildings Program, Harvard T.H. Chan School of Public Health on Tuesday, September 22 at 12 PM.  Assessing a novel, lab-free, point-of-care test for SARS-CoV-2 (CovidNudge): a diagnostic accuracy study  Urban Hospitals of Last Resort Cling to Life in Time of COVID  Some Urban Hospitals Face Closure Or Cutbacks As The Pandemic Adds To Fiscal Woes  As COVID-19 Vaccine Trials Move At Warp Speed, Recruiting Black Volunteers Takes Time  How a new way of parsing COVID-19 data began to show the breadth of health gaps between Blacks and whites  Emergence of Kawasaki disease related to SARS-CoV-2 infection in an epicentre of the French COVID-19 epidemic: a time-series analysis  Potential COVID-19 drug azithromycin may increase risk for cardiac events  SARS-CoV-2 Viral Load Predicts Mortality in Patients with and Without Cancer Who Are Hospitalized with COVID-19  Emory University Epidemiologist On The Future Of COVID-19  Trump officials rush to introduce untested vaccine tracking system  Prolonged low-dose methylprednisolone in patients with severe COVID-19 pneumonia  Public trust in CDC, Fauci, and other top health officials is evaporating, poll finds  The Great Vaccine Race: Inside the Unprecedented Scramble to Immunize the World Against COVID-19  Update Alert: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers  First COVID-19 Global Forecast: IHME Projects Three-Quarters of a Million Lives Could be Saved by January 1  UNC researchers publish striking images of SARS-CoV-2 infected cells  Hospital COVID-19 risk lowest among intensive care staff  Not just conspiracy theories: vaccine opponents and pro-ponents add to the COVID-19 ‘infodemic’ on Twitter  In the latest kid-friendly pandemic video published by BrainPOP, the director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci, explains to students of all ages the role they can play in controlling the spread of coronavirus.  Creative school plans could counter inequities exposed by COVID-19  Why COVID-19 is more deadly in people with obesity—even if they're young  Comparison of Clinical Features of COVID-19 vs Seasonal Influenza A and B in US Children  Clinical Outcomes in Young US Adults Hospitalized With COVID-19  Trans-ethnic analysis reveals genetic and non-genetic associations with COVID-19 susceptibility and severity  COVID-19 sparks 12-fold increase in remote delivery of mental health care across the US  Rapid isothermal amplification and portable detection system for SARS-CoV-2  Pandemic Vaccine Program Distribution, Tracking, and Monitoring  Viewpoint of a WHO Advisory Group Tasked to Consider Establishing a Closely-Monitored Challenge Model of COVID-19 in Healthy Volunteers  CDC director attempts to clarify controversial Covid-19 testing guidelines  Internet Searches for Acute Anxiety During the Early Stages of the COVID-19 Pandemic  How COVID-19 Could Aggravate the Homelessness Crisis?  From Resolve to Save Lives- Promoting mask-wearing during the COVID-19 pandemic: A POLICYMAKER’S GUIDE  Duration of SARS-CoV-2 Infectivity: When is it Safe to Discontinue Isolation?  Risk for Severe COVID-19 Illness Among Teachers and Adults Living With School-Aged Children  Pediatric SARS-CoV-2: Clinical Presentation, Infectivity, and Immune Responses  Dust can spread influenza among guinea pigs, raising coronavirus questions  Long-Haulers Are Redefining COVID-19  Seven months later, what we know about Covid-19 — and the pressing questions that remain  Coronavirus saliva tests could be cheaper and faster. Here’s how they work.  Widespread testing, case isolation and contact tracing may allow safe school reopening with continued moderate physical distancing: a modeling analysis of King County, WA data  Dozens of public health officials are quitting during pandemic  For health care ‘heroes,’ death toll keeps rising  ‘We’re losing an entire generation of scientists.’ COVID-19’s economic toll hits Latin America hard  Viable SARS-CoV-2 in the air of a hospital room with COVID-19 patients  Antibody therapies could be a bridge to a coronavirus vaccine — but will the world benefit?  Companies test antibody drugs to treat, prevent COVID-19  Treatment of COVID-19 Patients with Convalescent Plasma Reveals a Signal of Significantly Decreased Mortality  Winter is coming: Why America’s window of opportunity to beat back Covid-19 is closing  Clinical Course and Molecular Viral Shedding Among Asymptomatic and Symptomatic Patients With SARS- CoV-2 Infection in a Community Treatment Center in the Republic of Korea  Operational Considerations for Maintaining Essential Services for and Providing Maternal, Newborn, and Child Healthcare in Low-Resource Countries  Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network — United States, March–June 2020  MMWR Weekly COVID-19 Briefing is a weekly podcast to update readers on the latest scientific information from CDC’s COVID-19 response. In each episode, MMWR’s Editor-in-Chief, Dr. Charlotte Kent provides an overview of the latest scientific information published in MMWR. New episodes are posted every Monday. Listen to episodes here.  Infographic: Early Cases of MIS-C: Multi-System Inflammatory Syndrome in U.S. Children  Safe Pregnancy As COVID-19 Surges: What's Best For Mom And Baby?  Listen to the Kaiser Health News podcast ‘What The Health?’: ‘Open The Schools, Close The Bars’  Update: COVID-19 Among Workers in Meat and Poultry Processing Facilities ― United States, April–May 2020  The Fullest Look Yet at the Racial Inequity of Coronavirus  Principal Deputy Director of the CDC, Dr. Anne Schuchat, participated in an interview with the Editor in Chief of JAMA. You can view it here.  Covid-19 vaccine research must involve Black and Latinx participants. Here are 4 ways to make that happen  Vaccine Access and Hesitancy: The Public Health Importance of Vaccines  Johns Hopkins data capture.  Other tracking data here.

Common Acronyms Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), National Institutes of Health (NIH), Personal Protective Equipment (PPE), Department of Health and Human Services (HHS), Department of Defense (DoD), Department of Homeland Security (DHS), U.S. Department of Agriculture (USDA), Central Command (CENTCOM), Department of Housing and Urban Development (HUD), Centers for Medicare and Medicaid Services (CMS), Transportation Security Administration (TSA), Department of Veterans Affairs (VA), Assistant Secretary for Preparedness and Response (ASPR), Biomedical Advanced Research and Development Authority (BARDA), U.S. Trade Representative (USTR), Childrens Health Insurance Program (CHIP), Supplemental Nutrition Assistance Program (SNAP), Emergency Use Authorization (EUA), Executive Order (EO), Morbidity and Mortality Weekly Report (MMWR)

Source: NPR/Robert Wood Johnson Foundation/Harvard T.H. Chan School of Public Health poll of 3,454 U.S. adults, including 155 adults living with anyone who has been diagnosed with COVID-19, conducted July 1-Aug. 3.

Cumulative totals of COVID-19 cases, hospitalizations, recovered, and deaths within the DoD. Source: https://www.defense.gov/explore/spotlight/coronavirus/

WHO, 9.28.20.

(Updated 9.28.20 from CDC's platform.) For more information, visit CDC’s Novel Coronavirus 2019 website or the WHO's dashboard.

David R. Adelman Principal & Director | Government Affairs