June 3 coronavirus news

ER visits during the pandemic for non-Covid emergencies have dropped 42% across the United States, when compared to this same time last year, according to a new report from the US Centers for Disease Control and Prevention (CDC).

The new research published on Wednesday found that emergency department visits drastically fell from about 2.1 million visits per week between March 31 and April 27 last year, to 1.2 million between March 29 and April 25 this year.

The "steepest decreases" were among children 14 and younger, women and girls, and people living in the Northeast region of the country, CDC researchers noted in the report.  

Yet overall, "the proportion of infectious disease-related visits was four times higher during the early pandemic period," according to the report.

In the report, CDC recommended for people to keep using virtual doctor's visits and triage help lines during the pandemic, but not to hesitate seeking care for serious conditions, such as heart attack.

The research had some limitations, including that the number of hospitals reporting to National Syndromic Surveillance Program change over time; the data do not capture all US hospitals, just those who reported to the surveillance program; and the data is limited to emergency department visits only, so people who may have sought treatment elsewhere are not captured in the data.

A sixth, and last extension of the state of emergency was approved in a close vote by the Spanish Parliament, to last until June 21.

Now in its third month, the extended state of emergency, which has been in place since March 14, will give the government continued authority to control movement across Spain even as the country continues to relax confinement measures. 

The country’s 17 regional governments will have the power to determine the pace and course taken during the last, third phase, of the de-escalation process in their communities, which has been managed by the central government until now.

He said the state of emergency, considered to be Europe’s strictest confinement measures, were fundamental to controlling the spread of Covid-19.

Answering the main conservative opposition Popular Party leader Pablo Casado’s accusation that the Prime Minister “was unable to save lives", Sánchez said: “Today, we have zero deaths from Covid-19 in Spain,” referring to the previous day’s zero mortality statistic. He continued by saying that “the strict confinement has been efficient” in battling Spain’s health emergency.

Sánchez, whose Socialist minority government worked in recent days to ensure enough votes from other parties to pass the extension, urged parliamentarians to approve it this last time, saying said it is needed in order to complete the country’s de-escalation towards a “new normality.”

Opposition parties, including the far-right Vox party, the third largest in parliament, have accused the government of dictatorial rule through the state of emergency, and pushing the country into economic ruin. Sanchez responded by saying “the government understands the impatience of economic sectors, but health takes priority. Without health, no business will stay open.”

Sanchez also said his cabinet will approve a decree for a “new normality,” with necessary containment measures until a vaccine or treatment is found.

Some more context: 70% of Spain is currently in Phase 2 of de-escalation from the severe confinement measures in place at the height of the pandemic, but the capital, Madrid, and Spain’s second largest city, Barcelona, are behind in Phase 1. 

They were the hardest hit areas by the virus, with the most cases and deaths. Four small islands in Spain’s Canaries and Balearic Islands have already advanced to Phase 3, which has the fewest restrictions on activity and movement.

Most recent data from Spain’s Ministry of Health published Wednesday afternoon show a total of 27,128 deaths due to Covid-19, and 240,326 infections. One new Covid-19 death has been reported in the latest data.

The World Health Organization (WHO) said a large number of scientists across the world are studying coronavirus and none of the genome sequences show the virus is mutating to become more dangerous.

But WHO warns that doesn’t mean the pandemic is not getting more dangerous. 

“There are more than 40,000 full genome sequences that are available,” WHO infectious disease epidemiologist Dr. Maria Van Kerkhove told a briefing.

“Scientists are looking to see, are there changes in the virus? And as it is a coronavirus — it is an RNA virus — there are normal changes in this virus that one would expect over time,” she said. RNA viruses such as influenza and coronaviruses are generally more unstable and prone to mutation than viruses that use DNA to replicate.

But Van Kerkhove said that doesn’t mean the spread of the virus isn’t becoming more dangerous. “People grow tired,” she said. They may become lax in the measures needed to control the spread of the virus, such as social distancing. “It's very difficult to keep up all of these measures and we must remain strong and vigilant,” she said.

As lockdowns are lifted, slowly, across the globe, some “social measures may need to be reintroduced again, and that may frustrate people,” Van Kerkhove said. 

Dr. Mike Ryan, WHO executive director of Health Emergencies Program, said the virus does remain stable, but added, “This is already a dangerous virus; we've been seeing this consistently for months now.”

New Jersey Gov. Phil Murphy will sign an executive order Wednesday to allow restaurants and bars to begin offering in-person, outdoor dining beginning June 15.

Guidance on the subject will be issued later today, he said in a news conference.

Murphy announced that there were 112 new coronavirus-related deaths Wednesday, bringing the statewide death toll to 11,880.

During his daily briefing, he also announced 652 new coronavirus cases across the state, bringing statewide total to 162,068.

The World Health Organization's Data Safety and Monitoring Committee has recommended for WHO to continue studying hydroxychloroquine as a potential Covid-19 treatment in its Solidarity Trial, WHO Director-General Tedros Adhanom Ghebreyesus said during a media briefing in Geneva on Wednesday. 

Last week, WHO announced that it had temporarily paused the hydroxychloroquine arms of the trial due to concerns surrounding the drug's safety.

"This decision was taken as a precaution while the safety data were reviewed. The Data Safety and Monitoring Committee of the Solidarity Trial has been reviewing the data," Tedros said on Wednesday.

"On the basis of the available mortality data, the members of the committee recommended that there are no reasons to modify the trial protocol," Tedros said, adding that the recommendation about resuming hydroxychloroquine studies will be shared with the trial's principal investigators.

Currently, there is no approved treatment for Covid-19.

"In fact, it’s an urgent priority for all of us to do the needed studies, to do the randomized clinical trials, in order to get that evidence," Swaminathan said. "You can do analyses but there are so many potential biases in the way that patients are managed in a regular clinical setting that the only way to get definitive answers is to do a randomized trial."

The World Health Organization said that “cases in Europe continue to decline” during a briefing Wednesday.

“Yesterday saw the fewest cases reported in Europe since the 22nd of March,” said WHO Director-General Tedros Adhanom Ghebreyesus.

Though Tedros added, WHO is “especially worried” about Central and South America where “many countries are witnessing accelerating epidemics.”

“For several weeks, the number of cases reported each day in the Americas has been more than the rest of the world put together,” Tedros said.

He added WHO is also seeing an increase of cases in the Eastern Mediterranean, Southeast Asia and Africa. 

The Venezuelan government, led by embattled President Nicolas Maduro, and the opposition led by Juan Guaidó, have signed an agreement to cooperate in the fight against Covid-19 by allowing aid into the country through the Pan American Health Organization (PAHO).

This is one of the few times the two sides are known to have signed an agreement.

In the same statement, the Vice President for Communication, Culture, and Tourism, Jorge Rodríguez, added that both sides need to "set politics aside and work together to fight Covid-19"

More on the agreement: The agreement was signed on Monday by the Venezuelan Minister of Health, Carlos Alvarado, the Health Adviser of the opposition-led National Assembly, Julio Castro, and the Venezuelan representative of the Pan American Health Organization, Gerardo de Cosio. 

On their website, PAHO says it is the specialized international health agency for the Americas. It serves as Regional Office for the Americas of the World Health Organization.

The Venezuelan opposition confirmed the agreement in a statement:

"We took an important step, but it won't be enough for what's ahead," the statement added. Guaidó is recognized as the interim leader of Venezuela by more than 50 countries, including the United States. 

According to the opposition, the agreement will allow the PAHO to receive and manage the funding allocated for humanitarian aid. The funds will be used towards protection equipment, "improving diagnostic capacity" and treating confirmed cases, according to the opposition. 

The PAHO confirmed to CNN in an email that "this agreement is real and that PAHO is taking action to support its implementation."

Researchers are learning more about how Covid-19 affects children, and a new study finds that among a group of children and adolescents in New York who were hospitalized with the disease, about a fifth — 22% — had obesity.

The study, published in the journal The Lancet on Wednesday, suggests that having obesity could put a child at an increased risk of getting severely ill with Covid-19, the disease caused by the novel coronavirus.

"Obesity was the most significant factor associated with mechanical ventilation in children 2 years and older," the researchers added. "Contrary to some previous reports, infants seemed largely spared severe manifestations." 

More on the study: The study included data on 50 young people, ages 21 and younger, who were diagnosed with Covid-19 between March 1 and April 15 and hospitalized for at least a day or longer.

The data, which came from the patients' electronic medical records, showed that about half of the patients — 52% — had an adult family member or was living with someone with symptoms associated with Covid-19. None of the patients had a history of international travel around the time they were diagnosed. 

Most of the patients — 80% — had a fever, and 64% had some respiratory symptoms, but three of the patients only experienced gastrointestinal problems, the researchers found. Nine of the patients, or 18% of them, needed mechanical ventilation and one patient died.

Overall, the researchers found that obesity was significantly associated with needing mechanical ventilation among children ages 2 or older. Among the patients who required mechanical ventilation, six of them — 67% — had obesity.

About the study: The study had some limitations, including that the group of patients included in the data was small and half of the patients were Hispanic. The researchers noted that the hospital serves a predominantly Hispanic community. So more research is needed to determine whether similar findings would emerge among a more diverse group of patients.

Yet overall, "studies such as this one emphasize that certain groups of children may be disproportionally affected. In this study, 50% were Hispanic," Dr. Jason Newland of the Washington University School of Medicine in St Louis, and Dr. Kristina Bryant of the University of Louisville in Kentucky, co-wrote in an editorial that accompanied the new study.

"As the Covid-19 pandemic has spread and created adversity for many people physically, emotionally, and economically, the groups most affected have been those of color," Newland and Bryant wrote.

"Going forward, multicenter collaborative studies are needed to define the infectious and postinfectious sequelae of Covid-19 in children in communities across the US, including rural communities, and in all racial and ethnic groups. We also need to understand the association of the pandemic with adverse health outcomes in children beyond the consequences of viral infection," they wrote.

The researchers noted that on May 15, "the US Centers for Disease Control and Prevention reported a precipitous drop in the ordering and administration of pediatric vaccines. Are outbreaks of vaccine-preventable diseases on the horizon? That could be the next important chapter of the evolving Covid-19 story."

New York state reported its lowest daily coronavirus death toll so far, with 49 deaths reported yesterday, Gov. Andrew Cuomo said.

That's down from 58 deaths on Monday and 54 on Tuesday, the governor said. Hospitalizations are also at an all-time low.

Cuomo warned that although many headlines are focusing on the nationwide protests over George Floyd's death at the hands of police, coronavirus remains a threat.

"It is still in people and in society. We're still battling that," he said of the virus.

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