COVID-19 Update

World

• New Cases:   490,021 (⬆︎ 1.16%)
• New Deaths:      6,531 (⬆︎   .57%)

USA

• New Cases:   81,210 (⬆︎ .94%)
• New Deaths:       903 (⬆︎ .40%)

WaPo:

America on Friday hit its highest daily number of coronavirus cases since the pandemic began, recording at least 82,600 new infections and surpassing the previous record set during the summertime surge of cases across the Sun Belt.

The rising numbers put the nation on the precipice of what could be its worst stretch to date in the pandemic with some hospitals in the West and Midwest already overwhelmed and death counts beginning to rise.

The current surge is considerably more widespread than the waves from last summer and spring. The unprecedented geographic spread of the current surge makes it more dangerous, with experts warning it could lead to dire shortages of medical staff and supplies. Already, hospitals are reporting shortfalls of basic drugs needed to treat covid-19, the disease caused by the novel coronavirus.

And it’s not simply a matter of increased testing identifying more cases. Covid-19 hospitalizations increased in 38 states over the past week. The number of deaths nationally has crested above 1,000 in recent days.

The last time the country hit a new daily record for coronavirus cases — 76,533 on July 17 — just four states accounted for more than 40,000 of those cases: Arizona, California, Florida and Texas, according to a Washington Post analysis.

On Friday, 11 states accounted for that same lion’s share of cases. And in the past two weeks, 24 states have broken their records for single-day highs of cases.

More than 170 counties across 36 states were designated rapidly rising hotspots, according to an internal federal report produced Thursday for officials at the Department of Health and Human Services and obtained by The Post.

“One key way we got through previous waves was by moving health-care workers around. That’s just not possible when the virus is surging everywhere,” said Eleanor J. Murray, an epidemiologist at Boston University.

Equally alarming, Murray said, is that no one knows how high this wave will grow before peaking.

“We are starting this wave much higher than either of the previous waves,” she said. “And it will simply keep going up until people and officials decide to do something about it.”

More than 8.3 million Americans so far have been infected with the coronavirus, and at least 222,000 have died, according to a database maintained by The Post.

The high case numbers of recent days have stoked concerns because the country has not even hit the stretch of holidays and cold weather, which experts have long warned will send cases soaring even higher. More interactions could mean more transmission during celebrations of Halloween, Christmas and the New Year. The winter’s cold, dry air will also help the virus stay stable longer, even as it drives people to hunker down together indoors.

On Thursday, Chicago Mayor Lori E. Lightfoot (D) announced new restrictions on businesses. Hours later, White House coronavirus response coordinator Deborah Birx warned that closing public spaces may not be enough.

“It won’t be as simple as closing public spaces,” Birx said, pointing to increased gatherings in people’s homes. “What has happened in the last three to four weeks is that people have moved their social gatherings indoors.”

In some areas of Wisconsin, 90 percent of hospital intensive care unit beds are full, the office of Gov. Tony Evers (D) said. The first patient was admitted Wednesday to a makeshift field hospital erected at a state fairgrounds.

Hospitals from Missouri to Idaho are starting to reach capacity. On Thursday and Friday, America had more than 40,000 current covid-19 hospitalizations — the first time that level has been reached since August. In the past three weeks, 37 states saw sizable increases in hospitalizations, and the number has more than doubled in Connecticut, Montana, New Mexico and Wyoming.

In Utah, leaders are trying to open a field hospital at an exposition center. State epidemiologist Angela Dunn warned that the health-care system is at capacity, hospital staff are exhausted, and Utahans are getting scared.

“You know, I just, I don’t know what to do anymore,” Dunn said at a Thursday news conference, pleading for residents to be more cautious. “I’m really not trying to scare anyone. I’m just trying to inform you of what’s going on.”

Experts said the problem facing many hospitals this winter won’t be finding enough beds. It will be ensuring that hospitals have sufficient specialized staffing.

“Creating beds is relatively easy, but what do you do when you outstrip ICU nurses, doctors and teams?” said Michael T. Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy.

In recent months, health-care workers have been able to lower mortality rates — the ratio of patients who die once infected. Much of that progress has come through hard-earned expertise by ICU staff — new approaches and knowledge about how to combat the virus, such as when to use ventilators, the adoption of treatments such as steroids and proning patients, which helps with breathing by shifting them onto their abdomens.

But the hard-won battle to lower mortality rates could be imperiled as hospitals are overwhelmed and staffing gets stretched, Osterholm said. And as the pandemic has seeped into rural swatches of the Midwest, skeleton staffs at smaller hospitals are shrinking further as doctors and nurses fall ill.

A report this week by Osterholm’s center showed shortages in 29 of the 40 basic but critical drugs often used for covid-19 patients. That includes antibiotics, sedatives like propofol that are used to calm patients during intubation and heart medication such as norepinephrine. And because of the widespread nature of the infections, hospitals are finding it harder to draw from excess supplies of such drugs elsewhere.

The nation’s growing fatigue with the pandemic will likely make it even harder to contain a wintertime wave, specialists fear.

Even as hundreds of people are dying each day, “there’s this false sense of calm right now,” said Tom Inglesby, director of the Johns Hopkins Center for Health Security. “We have the president saying, ‘We’re rounding the corner.’ We have state leaders openly defying public health guidances.”

Inglesby pointed to plans and metrics many states laid out last spring for reopening. “That’s been completely disregarded in many places,” he said.

In North Dakota — among the hardest-hit states — Gov. Doug Burgum (R) put the onus on individuals to wear masks and avoid gatherings.

“It’s not a job for government,” Burgum recently declared.

At Thursday night’s final presidential debate, President Trump claimed the virus was “going away” and “we’re learning to live with it.” His Democratic rival, former vice president Joe Biden, responded, “We’re learning to die with it."

Experts say rapid action is needed by leaders and residents to tamp down virus transmission.

“It’s been framed as this false choice between full shutdowns and doing nothing, but that’s not the case,” said Inglesby, who urged people to wear masks and avoid large gatherings.

Politicians also need to stop minimizing the risk posed by the virus and start discussing openly with the public the hard decisions and trade-offs that lie ahead, Murray said. Is it, for example, worth keeping bars open if it means having to close schools?

“I worry sometimes about being too pessimistic,” she said. “We are not making predictions and saying this dark winter is somehow inevitable. We’re trying to warn people this is how it will be if we don’t do something about it.

“But it doesn’t have to be that way.”

COVID-19 Update

World

New Cases:   478,057 (⬆︎ 1.15%)

New Deaths:      6,477 (⬆︎   .57%)

USA

New Cases:   74,307 (⬆︎ .87%)

New Deaths:       973 (⬆︎.43%)

We damned near hit a record high for New Cases yesterday. Fortunately, as the thing mutates, and as the contagion spreads, and as the medicos learn more, treatments are getting better and no so many are dying - right now.

That could change.

And as the emergency level rises across a dozen or more states, we prob'ly won't be able to mobilize the caregivers and concentrate their efforts the way it was done in New York (eg) in the early phases.

NYT:

‘At Capacity’: Covid-19 Patients Push U.S. Hospitals to Brink

Utah officials issued urgent pleas and said they were planning to open a field hospital, which Wisconsin has already done

At least 14 states have a record number of coronavirus hospitalizations

WEST ALLIS, Wis. — A hospital in Idaho is 99 percent full and warning that it may have to transfer coronavirus patients to hospitals in Seattle and Portland, Ore. Medical centers in Kansas City, Mo., turned away ambulances on a recent day because they had no room for more patients. And in West Allis, just outside Milwaukee, an emergency field hospital erected on the grounds of the Wisconsin State Fair admitted its first virus patient this week.

More than 41,000 people are currently hospitalized with the coronavirus in the United States, a 40 percent rise in the past month, and cooler weather that pushes more people indoors is threatening to expand the outbreak still more. At least 14 states saw more people hospitalized for the virus on a day in the past week than on any other day in the pandemic, according to the Covid Tracking Project. Seven more states are nearing their peaks.

The nation has seen more people hospitalized at earlier points — during an onslaught of cases in New York City in April and in the Sun Belt in July — but the sharply rising numbers now are deeply worrisome, in part, because they are testing the limits of smaller hospital systems.

Patients are now spread more broadly across the country, with troubling hot spots from North Dakota to Kentucky. More people than ever are falling critically ill in rural areas, particularly in the Midwest and the Mountain West, where they must rely on hospitals that may have only a handful of beds. And experts worry that the growing numbers in need of hospital care will only get worse if cases continue to mount.

“I don’t really see any signs that things are slowing down and that concerns me a lot,” Caitlin M. Rivers, an epidemiologist at Johns Hopkins University, said. “It has to be our starting premise that it’s not going to slow down unless we force it to slow down.”

Even as hospitalizations and known cases of the virus have grown, daily deaths across the country have remained fairly steady at around 760 in recent days. But some experts fear that the rate of deaths is beginning to rise again. Upticks in deaths usually lag behind rises in cases and hospitalizations because of the time it takes for the virus to progress.

For families around the country, the mounting hospitalizations were frightening — and personal. Among the thousands of patients, there was a retired Air Force lieutenant colonel who had trouble catching her breath in Missouri, grandparents being treated in separate hospitals in Utah and a beloved uncle whose niece said he had been on a ventilator for five weeks in Wisconsin.

Amy Stadler, the niece, sat in a black minivan outside of the Milwaukee Brewers’ stadium this week as she waited for a nurse to swab her nose. She said relatives had collected messages for her uncle — who is gravely ill — to be shared if his condition were to grow even more dire. Ms. Stadler, 49, said she sent hers: “That I love him, and that it’s OK to go.”

In recent days, Ms. Stadler, who works as a teaching assistant, began coughing and registered a fever. “I’m careful, but there’s a lot of people that aren’t,” she said softly from behind her face mask as she waited for her test.

The signs of a crunch for hospital space were painfully clear across several states.

“Make no mistake about this, this is an urgent crisis,” Gov. Tony Evers of Wisconsin said on Thursday of the state’s outbreak.

In months past, field hospitals have opened in several cities, including Seattle and New York. Some closed after seeing only small numbers of patients, or none at all. But in Wisconsin, the health secretary-designee, Andrea Palm, said hospital officials had sounded an “urgent call” as more and more patients arrived at their doors.

The 530-bed field hospital in West Allis, she said, is the state’s “ultimate insurance policy.” The hospital was built inside the Exposition Center, a brick building the size of three football fields where the fair, in most years, is a widely attended event. Inside the hospital, hundreds of white cubicles are lined up one after the next, each with little more than a bed, a waste bin and a curtain for privacy.

In Utah, officials sounded frustrated on Thursday as they issued urgent pleas.

“Our health care system is at capacity, our health care providers are overwhelmed and exhausted, our public health system is stressed,” Dr. Angela Dunn, the state epidemiologist, said.

“I don’t know what to do anymore,” Dr. Dunn added. “I’m really not trying to scare anyone, I’m just trying to inform you of what’s going on.”

Gov. Gary Herbert said the state was preparing to open a field hospital of its own at an exposition center south of Salt Lake City. One out of five patients in intensive care units across the state are Covid-19 patients, he said.

In separate hospitals in Utah — about 20 miles apart — Rebecca Hannett’s grandmother, a 79-year-old retired bus driver, is feeling better, but her grandfather, who is 85, is not, Ms. Hannett said. The isolation and separation of being hospitalized with Covid-19 has added to their struggle with the illness.

“My grandma called us yesterday because she’s worried about our grandpa,” Ms. Hannett, 22, said. “He’s kind of decided that if this is the end, this is the end. And my grandmother is just worried that they won’t be able to say their goodbyes to each other.”

In some rural parts of the nation, hospital officials are having to act “almost like air traffic control,” moving around patients to open up beds, said Dr. David Basel, a vice president at the Avera Medical Group, which is based in South Dakota and runs about three dozen hospitals in the Midwest.

“Our regional hospitals are all running at or near capacity on a daily basis,” Dr. Basel said.

One in four of the patients now being admitted to the group’s hospitals are Covid-19 patients, Dr. Basel said, a proportion that could rise if the infection rate remains high. As more patients arrive from rural parts of the region, he said, he feared that hospitals might have to cancel cancer screenings, back operations and other nonemergency procedures to make room.

As the pandemic wears on, hospital officials said they were most worried about a shortage in workers, rather than physical supplies. Unlike when the virus was largely concentrated in New York and the Northeast, when medical workers arrived to assist from across the country, the virus is now more widespread, meaning there are few nurses or doctors arriving to help.

“It feels more like a slog that we’re getting through, rather than something we can rally together and defeat rapidly,” said Nancy Foster, a vice president at the American Hospital Association. “There are not as many folks who can leave their community to help out in another one because they’re struggling to keep up in their own community.”

Karina Brown, a nurse, has been helping to treat virus patients at the Aurora Sinai Medical Center in Milwaukee since the pandemic began. Even though she felt prepared for the influx of patients, it was still a shock when they came.

“We had a plan, but once you really saw it and it was go time, that’s kind of different,” Ms. Brown said.

Now she is assigned to more patients and they are, on average, much sicker, meaning she has to monitor and care for them more often. She and other nurses have also become, in many cases, one of the few connections between patients and relatives who are not allowed to visit. It has brought her closer to her patients, but also makes it more painful if they succumb to the illness.

“We’re their person while they’re here,” Ms. Brown said. “Because they’re all alone.”

She added: “You get to know people, and you have to sit at the bedside with them and hold their hand because their family might not be able to come.”

Today's Tweet

Brilliant as usual

I don’t know why Leslie Stahl even gives Trump the time of day pic.twitter.com/X6MPM5uyYJ

— Sarah Cooper (@sarahcpr) October 22, 2020

It's The Lies, Stupid

Bullshit works because those who don't spend much time thinking in general aren't going to stop and think about much of anything in the specific.

To be fair - an awful lot of us were never taught to think - have never felt the need to learn much about it - while some have developed a Dunning-Kruger thing where they honestly believe they think really well &/or that there's nothing more to it than applying a little common sense cuz they're a very stable genius (or something else that excuses them from doing the actual work).

Many of us just don't have the time or the inclination to "delve into it" and do the navel-gazing thing or whatever.

There's a gullibility factor that grows out of a willingness to believe what we're told because we believe people are generally OK, or that there's some magical mechanism in place that protects us automatically without our having to do much for it all to work out in the end, pass the biscuits please, and how 'bout them Red Sox, eh?

Since we think of ourselves as mostly honest people, we tend to project that onto others, even as we learn they've been lying to us all along - which makes for some really harsh cognitive dissonance, which can resolve itself in very dangerous and even explosive ways as we become selective about who we believe and who we don't, which is the opportunity unscrupulous assholes look for so they can condition us to believe bullshit and reject reality.

NYT:

I Spoke to a Scholar of Conspiracy Theories and I’m Scared for Us

The big lesson of 2020 is that everything keeps getting more dishonest

Lately, I have been putting an embarrassing amount of thought into notions like jinxes and knocking on wood. The polls for Joe Biden look good, but in 2020, any hint of optimism feels dangerously naïve, and my brain has been working overtime in search of potential doom.

I have become consumed with an alarming possibility: that neither the polls nor the actual outcome of the election really matter, because to a great many Americans, digital communication has already rendered empirical, observable reality beside the point.

If I sound jumpy, it’s because I spent a couple of hours recently chatting with Joan Donovan, the research director of the Shorenstein Center on Media, Politics and Public Policy at Harvard’s Kennedy School. Donovan is a pioneering scholar of misinformation and media manipulation — the way that activists, extremists and propagandists surf currents in our fragmented, poorly moderated media ecosystem to gain attention and influence society.

Donovan’s research team studies online lies the way crash-scene investigators study aviation disasters. They meticulously take apart specific hoaxes, conspiracy theories, viral political memes, harassment campaigns and other toxic online campaigns in search of the tactics that made each one explode into the public conversation.

This week, Donovan’s team published “The Media Manipulation Casebook,” a searchable online database of their research. It makes for grim reading — an accounting of the many failures of journalists, media companies, tech companies, policymakers, law enforcement officials and the national security establishment to anticipate and counteract the liars who seek to dupe us. Armed with these investigations, Donovan hopes we can all do better.

I hope she’s right. But studying her work also got me wondering whether we’re too late. Many Americans have become so deeply distrustful of one another that whatever happens on Nov. 3, they may refuse to accept the outcome. Every day I grow more fearful that the number of those Americans will be large enough to imperil our nation’s capacity to function as a cohesive society.

“I’m worried about political violence,” Donovan told me. America is heavily armed, and from Portland to Kenosha to the Michigan governor’s mansion, we have seen young men radicalized and organized online beginning to take the law into their own hands. Donovan told me she fears that “people who are armed are going to become dangerous, because they see no other way out.”

Media manipulation is a fairly novel area of research. It was only when Donald Trump won the White House by hitting it big with right-wing online subcultures — and after internet-mobilized authoritarians around the world pulled similar tricks — that serious scholars began to take notice.

The research has made a difference. In the 2016 election, tech companies and the mainstream media were often blind to the ways that right-wing groups, including white supremacists, were using bots, memes and other tricks of social media to “hack” the public’s attention, as the researchers Alice Marwick and Rebecca Lewis documented in 2017.

But the war since has been one of attrition. Propagandists keep discovering new ways to spread misinformation; researchers like Donovan and her colleagues keep sussing them out, and, usually quite late, media and tech companies move to fix the flaws — by which time the bad guys have moved on to some other way of spreading untruths.

While the media ecosystem has wised up in some ways: Note how the story supposedly revealing the contents of Hunter Biden’s laptop landed with a splat last week, quite different from the breathlessly irresponsible reporting on the Democrats’ hacked emails in 2016. But our society remains profoundly susceptible to mendacity.

Donovan worries about two factors in particular. One is the social isolation caused by the pandemic. Lots of Americans are stuck at home, many economically bereft and cut off from friends and relatives who might temper their passions — a perfect audience for peddlers of conspiracy theories.

Her other major worry is the conspiracy lollapalooza known as QAnon. It’s often short-handed the way Savannah Guthrie did at her town hall takedown of Donald Trump last week — as a nutty conspiracy theory in which a heroic Trump is prosecuting a secret war against a satanic pedophile ring of lefty elites.

But that undersells QAnon’s danger. To people who have been “Q-pilled,” QAnon plays a much deeper role in their lives; it has elements of a support group, a political party, a lifestyle brand, a collective delusion, a religion, a cult, a huge multiplayer game and an extremist network.

Donovan thinks QAnon represents a new, flexible infrastructure for conspiracy. QAnon has origins in a tinfoil-hat story about a D.C.-area pizza shop, but over the years it has adapted to include theories about the “deep state” and the Mueller probe, Jeffrey Epstein, and a wild variety of misinformation about face masks, miracle cures, and other hoaxes regarding the coronavirus. QAnon has been linked to many instances of violence, and law enforcement and terrorism researchers discuss it as a growing security threat.

“We now have a densely networked conspiracy theory that is extendible, adaptable, flexible and resilient to take down,” Donovan said of QAnon. It’s a very internet story, analogous to the way Amazon expanded from an online bookstore into a general-purpose system for selling anything to anyone.

Facebook and YouTube this month launched new efforts to take down QAnon content, but Q adherents have often managed to evade deplatforming by softening and readjusting their messages. Recently, for instance, QAnon has adopted slogans like “Save the Children” and “Child Lives Matter,” and it seems to be appealing to anti-vaxxers and wellness moms.

QAnon is also participatory, and, in an uncertain time, it may seem like a salvation. People “are seeking answers and they’re finding a very receptive community in QAnon,” Donovan said.

This is a common theme in disinformation research: What makes digital lies so difficult to combat is not just the technology used to spread them, but also the nature of the societies they’re targeting, including their political cultures. Donovan compares QAnon to the Rev. Charles Coughlin, the priest whose radio show spread anti-Semitism in the Depression-era United States. Stopping Coughlin’s hate took a concerted effort, involving new regulations for radio broadcasters and condemnation of Coughlin by the Catholic Church.

Stopping QAnon will be harder; Coughlin was one hatemonger with a big microphone, while QAnon is a complex, decentralized, deceptive network of hate. But the principle remains: Combating the deception that has overrun public discourse should be a primary goal of our society. Otherwise, America ends in lies.

https://mediamanipulation.org/

Today's Ad

The Lincoln Project - Men

Vote for change. Vote for our sons. Vote for Joe.

COVID-19 Update

World

• New Cases:   438,615 (⬆︎ 1.07%)
• New Deaths:      6,849 (⬆︎   .61%)

USA

• New Cases:   63,663 (⬆︎ .75%)
• New Deaths:    1,225 (⬆︎ .54%)

WaPo:

After a college town’s coronavirus outbreak, deaths at nursing homes mount

‘The very thing we worried about’: In La Crosse, Wis., students partied in September. Then infections and deaths among the elderly began to rise

Mayor Tim Kabat was already on edge as thousands of students returned to La Crosse, Wis., to resume classes this fall at the city’s three colleges. When he saw young people packing downtown bars and restaurants in September, crowded closely and often unmasked, the longtime mayor’s worry turned to dread.

Now, more than a month later, La Crosse has endured a devastating spike in coronavirus cases — a wildfire of infection that first appeared predominantly in the student-age population, spread throughout the community and ultimately ravaged elderly residents who had previously managed to avoid the worst of the pandemic.

For most of 2020, La Crosse’s nursing homes had lost no one to covid-19. In recent weeks, the county has recorded 19 deaths, most of them in long-term care facilities. Everyone who died was over 60. Fifteen of the victims were 80 or older. The spike offers a vivid illustration of the perils of pushing a herd-immunity strategy, as infections among younger people can fuel broader community outbreaks that ultimately kill some of the most vulnerable residents.

“It was the very thing we worried about, and it has happened,” Kabat said.

Local efforts to contain the outbreak have been hamstrung by a statewide campaign to block public health measures, including mask requirements and limits on taverns, he added. “Your first responsibility as a local government is really to protect the health and safety and welfare of your residents,” he said. “When you feel like that’s not happening and you have few tools or resources available to change that, it’s more than frustrating.”

As the number of coronavirus infections continue to soar in the upper Midwest, few places embody the nation’s divisions over how to tackle the pandemic better than Wisconsin. Even as the state’s weekly caseload has quadrupled in the past six weeks, bar owners and Republicans have thwarted some restrictions on public indoor gatherings, leaving public health professionals scrambling to contain the virus.

Wisconsin ranks fourth among states in daily reported cases per capita, with 59 per 100,000 residents. According to The Washington Post’s analysis of state health data, in the past week new daily reported cases have gone up more than 20 percent, hospitalizations have increased more than 26 percent and daily reported deaths have risen 22 percent.

In recent briefings, Wisconsin health secretary designee Andrea Palm said the state is doing worse than it was in March and April and has pleaded with residents to avoid going to bars and to practice social distancing.

“Wisconsin is in crisis, and we need to take this seriously,” Palm said last week.

Last week a judge in Wisconsin’s Sawyer County temporarily blocked an order from Gov. Tony Evers (D) limiting crowds in bars, restaurants and other indoor spaces to 25 percent of capacity, though a judge in Barron County reinstated it Tuesday. The Tavern League of Wisconsin, which represents the state’s bars, argued it amounted to a “de facto closure.” In May, the state Supreme Court struck down Evers’s “Safer at Home” order after Republican lawmakers challenged it, and a conservative activist has just sued to block Wisconsin’s statewide mask mandate.

Elizabeth Cogbill, who specializes in geriatrics and internal medicine in the Gundersen Health System, has been working 14-hour days since the pandemic began, staying late to talk to families who can no longer visit their elderly relatives.

Since June, Cogbill has been working with the county, other medical professionals and nursing home officials to curb coronavirus infections. They had managed to stifle several flare-ups without a death, until September.

In an interview, the 41-year-old doctor said that as the number of infections among young people began to rise six weeks ago, “I had this feeling of just terror.” She had watched similar community outbreaks throughout the country migrate from younger to older populations and hoped the same tragedy would not unfold in La Crosse. But it did.

“These are my people. These are my patients,” she said. “It entered our facilities and it just spread like wildfire. … I don’t have words to describe this experience.”

Recent data released by Johns Hopkins University and the Centers for Medicare and Medicaid Services shows that weekly cases in nursing homes rose nationwide in late September as the disease became more widespread in 38 states and the country entered its third coronavirus spike. That marked the first uptick in seven weeks in long-term care, after new cases dropped throughout August and early September.

To Paraic Kenny, a La Crosse-based cancer geneticist at the Kabara Cancer Research Institute who has turned to genetic sequencing to track the coronavirus, the nursing home deaths are a corollary of bringing students back to campus and allowing a party culture to reignite.

“Completely, completely, completely predictable,” said Kenny, who said he saw over 13 “overflowing” parties on a late-September drive home from work that took him through neighborhoods where many students live. “Everything we’ve known about this virus since January, everything we’ve known about 20-year-olds for the last 3,000 years — it’s predictable.”

In a new study that has not yet been formally peer-reviewed, Kenny found genetic links between a number of nursing home covid-19 cases — including several deaths — and large outbreaks in the local student population. Because the coronavirus mutates roughly twice a month, scientists decoding its evolution can construct detailed family trees that track the virus’s spread from one person to the next.

“Risks of rapid spread of SARS-CoV-2 among college-age individuals are not limited to college environs but pose a direct threat to older persons in the surrounding community,” the study states.

In addition to the genetic connections, Kenny noted that the large outbreak in the student population came first.

Several other researchers who read the paper cautioned that while students certainly could have fueled cases among vulnerable elderly residents, genetics in isolation cannot definitively prove that link. For instance, saying that two cases are genetically related or even identical does not necessarily prove who infected whom; it is also possible that a third party, perhaps one whose virus genome was never sampled by researchers, infected both separately.

Thomas Friedrich, a researcher at the University of Wisconsin at Madison who has done extensive genetic sequencing of the coronavirus, said that the only way to get more precise would be to conduct additional contact tracing or epidemiological investigations.

In an email, he compared the outbreak among college students to “a large fire, which can throw off sparks that start additional fires.” He added that “high levels of transmission among students in La Crosse absolutely increased the risk of outbreaks in skilled nursing facilities. [Kenny’s] data are totally consistent with this scenario, but they do not prove beyond a shadow of a doubt that specific viruses traveled from students to nursing home residents.”

Several factors complicate any genetic analysis of the Wisconsin outbreak, these experts said, including the large scale of the spread and the fact that only a small percentage of patients’ samples have been sequenced.

“Actually, finding any resolution when you have uncontrolled transmission like this is really, really difficult,” said Joseph Fauver, a postdoctoral associate in global health at Yale University who specializes in genetic sequencing.

Kenny and other experts, including local health officials, noted that because long-term care residents rarely leave such facilities, the virus somehow had to make its way in from outside. Cogbill said that in each facility where a resident died of covid-19, the virus also had turned up on the staff.

Across the country, colleges’ strategies for containing the virus have been uneven, often because some have greater resources than others.

The University of Wisconsin at La Crosse, for example, had the money to test roughly 3,000 residential students every other week but did not initially test 4,000 off campus.

“It’s a big challenge,” the school’s chancellor, Joseph Gow, said in an interview. “And we really legally don’t have much ability to regulate people’s behavior off campus. If someone is 21 years old and wants to have people come over to their apartment, you can’t really stop that. But we do encourage them not to do that.”

As infections on Gow’s campus surged last month, with positivity rates ranging between 36 percent and 78 percent, school administrators made the decision to shut down in-person classes for two weeks. They resumed Oct. 5. Recently, the university has begun testing nonresidential students, targeting those who belong to campus organizations such as the marching band and sports teams.

“We know what the stakes are, and we’re really taking it seriously,” Gow said. But while students have been largely cooperative, the school cannot legally compel off-campus students to get tested and it lacks the capacity to test them all.

“We would like to know: Do we have any students who are working in assisted-living and long-term care facilities?” he said. “And if they are, we would like them to come in immediately and get tested.”

Some other universities are taking far more aggressive steps, such as the University of Arizona, which has poured at least $8 million into a far-ranging effort to curb the virus’s spread. It is regularly analyzing wastewater, an early indicator of infections, overhauling its ventilation systems and modifying its cafeterias to minimize personal contact. At one point the school had 240 to 270 new coronavirus cases a day. On Friday, it recorded zero.

In La Crosse, local officials praised university leaders for stricter measures that have lowered infections among 18-to-30-year-olds. “They’ve done a good job of adjusting behavior,” Kevin Fitzgerald, a doctor with the Mayo Clinic Health System, said at a briefing late last week.

Other health officials urged La Crosse residents not to grow complacent.

“We are all woven together as the fabric of this community,” said Cogbill, the geriatrics doctor. “And our choices have the potential to have an enormous impact on those around us.”

Pam Severson buried her father last week. Henry Becker, 86, died Oct. 9 after contracting the virus last month in his La Crosse nursing home.

Severson said she doesn’t blame anyone for her father’s infection. Exactly how he got sick will probably remain a mystery, and she said the staff was doing its best in an unenviable situation. But she bristles when she sees people not wearing masks or social distancing.

“They don’t realize what those actions can do,” she said. “They don’t realize what it’s like to see a family member have to be alone. They don’t realize how sick people are really getting.”

Becker had not had visitors since March, when his facility put strict protocols in place to keep out the virus. During his final days, family members would sit outside his window to be near him, even though he did not know they were there. His wife of 64 years, Elaine, was by his bedside in protective gear, holding his hand when he died.

Last week, the family organized a socially distant funeral Mass. The mourners remembered the Wisconsin native as a dedicated Catholic, a devoted father and grandfather, a master electrician who loved woodworking, bowling and his family.

A soloist sang “Ave Maria,” and they laid him to rest at the Gate of Heaven Cemetery.

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Go From There - Joe Biden campaign

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Demi Lovato via The Lincoln Project

COVID-19 Update

World

• New Cases:   382,218 (⬆︎ .94%)
• New Deaths:      6,177 (⬆︎ .55%)

USA

• New Cases:   62,072 (⬆︎ .73%)
• New Deaths:       952 (⬆︎ .42%)

And here we go, diving headlong into the next surge, just in time for the most important election in at least 45 or 50 years.

If I was the kind of asshole who thinks like President Stoopid and his Dead-Soul Son-In-Law, I'd say, "Yay - the virus is gonna fuck people in the red states now and we'll benefit politically - ain't we just so fuckin' smart".

But I'm not that kind of asshole - I'm a completely different kind of asshole.

Although, there is in fact a fair probability that since "the conservative base" turns out in person to vote on election day, a raging contagion might tamp down that enthusiasm - not that I'm laughing up my sleeve just a bit.

NYT:

‘It Has Hit Us With a Vengeance’: Virus Surges Again Across the United States

Unlike earlier outbreaks concentrated in the Northeast and South, the virus is simmering at a worrisome level in most regions

As the coronavirus races across the country, it has reached every corner of a nursing home in Kansas, infecting all 62 residents inside. There are so few hospital beds available in North Dakota that patients sick with the virus are being ferried by ambulance to facilities 100 miles away. And in Ohio, more people are hospitalized with the virus than at any other time during the pandemic.

After weeks of warnings that cases were again on the rise, a third surge of coronavirus infection has firmly taken hold in the United States. The nation is averaging 59,000 new cases a day, the most since the beginning of August, and the country is on pace to record the most new daily cases of the entire pandemic in the coming days.

But if earlier surges were defined by acute and concentrated outbreaks — in the Northeast this spring, and in the South during the summer — the virus is now simmering at a worrisome level across nearly the entire country. Colorado, Illinois, Kentucky, Michigan, Montana, New Mexico, North Dakota, Ohio, South Dakota, Utah, Wisconsin and Wyoming each set seven-day case records on Tuesday. Even New Jersey, once a model for bringing the virus under control, has seen cases double over the past month.

“It is a really dangerous time,” said Dr. Tom Inglesby, an infectious-disease expert at the Johns Hopkins Bloomberg School of Public Health.

“The majority of states are on the rise,” he said. And at the same time, “there are very few places where things are stable and going down.”

The latest wave threatens to be the worst of the pandemic yet, coming as cooler weather is forcing people indoors and as many Americans report feeling exhausted by months of restrictions. Unlike earlier waves, which were met with shutdown orders and mask mandates, the country has shown little appetite for widespread new restrictions.

“We’re seeing spread virtually everywhere,” said Gov. Mike DeWine of Ohio, where 69 of 88 counties are now considered “high incidence,” meaning at least 100 virus cases per 100,000 people in the past two weeks. But at a news conference on Tuesday, Mr. DeWine, a Republican who was among the first governors to shut down businesses this spring and who imposed a statewide mask mandate this summer, did not announce new measures to curb the spread.

“The fastest way we can do it is not for me to issue some order that you can’t enforce or would be difficult to enforce, but rather for every Ohioan to take this seriously,” he said, grabbing his cloth mask and holding it up.

The newest surge sets the stage for a grueling winter that will test the discipline of many Americans who have spent warmer months gathering in parks and eating outdoors, where the virus is known to spread less easily. At the current rate of growth, new daily confirmed cases could soon surpass 75,687, the record set on July 16.

The rising case count has so far not translated to increased deaths: About 700 people are dying on average each day, a high but steady rate. So far, more than 220,000 Americans have died from the virus.

The latest developments represent a serious new level of spread. Deaths are considered a lagging indicator of new infection, and experts believe the daily toll is likely to rise in the coming months. Nationwide, hospitalizations, the most accurate gauge of how many people are currently sick from the virus, are already trending upward, at a pace slightly lower than new infections.

In North Dakota, which is leading the nation in new coronavirus cases per capita, hospitalizations and deaths are at a high, and just 20 intensive care beds were available statewide.

“Is bed capacity an issue? Yes,” said Tim Blasl, president of North Dakota Hospital Association, who described patients who have had to drive far out of their way to find an open bed in the rural state. But, he added, “Are people receiving care? Yes.”

With no statewide mask mandate, some mayors are resorting to options they had long resisted. On Monday, the mayor of Fargo used his emergency powers to issue a mandatory mask order, the first of its kind in the state. Hours later, the City Council of Minot, the fourth-largest city in North Dakota, issued a similar order.

“We were hoping we had escaped the Covid-19,” Mayor Tim Mahoney of Fargo, a practicing surgeon, said in an interview. “Now we’re just like everybody else in the country. It has hit us with a vengeance.

“We kind of thought we’d outsmart it, and you can’t outsmart this virus.”

In other parts of the country, officials are also returning to another tried-and-true method of containing the virus: stay-at-home orders. On Tuesday, local health officials ordered students at the University of Michigan in Ann Arbor to stay in their residences except for essential activities effective immediately, in an effort to control an escalating community outbreak.

Since Oct. 12, cases associated with the university have made up about 61 percent of confirmed and probable local infections, said Jimena Loveluck, the health officer for Washtenaw County, who warned that many cases have been tied to parties and other big gatherings.

“During the day, on campus, everyone’s fine and following the rules,” said Emma Stein, a senior news editor at The Michigan Daily, the student paper, who is now confined at home with her eight roommates. “But at night, on weekends, they don’t.”

The order could leave the campus unusually quiet ahead of Oct. 31, when the university is expected to play its first home football game of the season against its biggest in-state rival, Michigan State. For added deterrence, health officials are considering an extra kick: Within the week, officials said, the health department may start fining people who violate the order to stay at home.

In a sign of how quickly the virus is spreading in many parts of the Midwest and the Great Plains, infections recently overtook a private nursing home in northern Kansas.

The nursing home, Andbe Home, noticed the first sign of a problem on Oct. 7, when a single resident tested positive. But within days, the virus had run rampant, sneaking from room to room.

Two weeks later, all 62 residents who live there have been infected, and 10 have died. At least 12 employees have also tested positive.

“It is with great sadness and concern that I announce that we have a full Covid outbreak in our home, despite the precautions we have been taking since March,” Megan Mapes, the administrator of the Andbe Home, wrote on Facebook. The home has since barred all visitors, and residents are isolated in their rooms.

The nursing home is in Norton County, the hardest-hit county in Kansas right now relative to its population of 5,400. The county is grappling with two serious outbreaks — in the nursing home and in the Norton Correctional Facility, a state prison where 18 prisoners and three officers have tested positive. Of the 340 total cases reported in the county, more than 300 have come this month.

Tammy Steinmetz has not been able to talk to her father, who is 89 and has dementia, since he tested positive for the virus as part of the nursing home outbreak this month. She used to see him every week, bringing him homemade meals of catfish caught by his great-grandchildren in a nearby lake.

“I just want to be able to see my dad,” Ms. Steinmetz said. “I’m just completely at a loss. You think everybody’s doing everything to keep everybody safe, and then next thing you know everything is just different.”

Classified Schmlassified

More from the President Stoopid Just Runnin' His Mouth file:

Raw Story:

Two weeks ago, President Donald Trump declared that he had declassified all documents related to Russia’s interference in the 2016 presidential election — but now his own chief of staff is saying under oath that isn’t true.

On October 6th, the president claimed on Twitter that “all Russia Hoax Scandal information was Declassified by me long ago,” and then added that “Unfortunately for our Country, people have acted very slowly, especially since it is perhaps the biggest political crime in the history of our Country.”

In a follow-up tweet, the president similarly wrote, “I have fully authorized the total Declassification of any & all documents pertaining to the single greatest political CRIME in American History, the Russia Hoax.”

For good measure, the president also insisted on “no redactions.”

This claim of declassification inspired BuzzFeed News reporter Jason Leopold to file a Freedom of Information Act to get access to those documents.

However, as USA Today reporter Brad Heath reveals, Trump chief of staff Mark Meadows submitted a reply to Leopold’s request indicating that those documents have not been declassified.

“The President indicated to me that his statements on Twitter were not self-executing declassification orders and to not require the declassification of any particular documents,” Meadows said in a filing with the United States District Court for the District of Columbia.