July 23 coronavirus news

Coercive quarantine mandates can send coronavirus patients into hiding, defeating the purpose of having such a policy, the World Health Organization said Thursday.

Covid-19 case contacts are more likely to develop and potentially transmit the disease to others, and it is “much, much better if someone is ready, willing and able to quarantine themselves on behalf of their community,” WHO’s Dr. Mike Ryan said Thursday.

“Quarantining yourself when you are a contact is an act of courage. It’s an act of contribution to society,” Ryan said. “We’ve seen some pretty intense clusters of cases shut down pretty quickly when quarantine has been implemented successfully in contacts.”

However, he said, some governments have laws in place to make quarantine and isolation mandatory.

WHO is against coercive procedures, Ryan said.

“It can shove the problem underground. And it can mean that people are unlikely to report their status in terms of either being a case, or being a contact, if they feel they will be unfairly treated,” he said.

This means that it is exceptionally important to make sure that there is strong community engagement, to help people understand how diseases spread and understand the roles they play in both transmitting and breaking the transmission chains of Covid-19, he said.

“In our experience, when people understand that fact, and they understand their own personal status, and when they’re supported in the process, most — the vast majority of people — will participate in the quarantine mechanism,” Ryan said. “And we would like to avoid coercive mechanisms to do that.” 

Here's what WHO recommends: WHO’s recommendations say that contacts of confirmed cases of Covid-19 should be quarantined for 14 days in a facility or in the home if they have the ability to quarantine appropriately there.

Dr. Maria Van Kerkhove, WHO’s technical lead for Covid-19, said that quarantine in the context of contact tracing is “arguably one of the most important elements to breaking chains of transmission.” 

She also said that WHO will be updating guidelines for quarantining and isolation in the next week or so, although there will not be many changes.

The main differences include removing the testing requirement at the end of the quarantine period and including language that focuses on children in isolation and quarantining of children with family members so they aren’t separated.

New York City has 18,839 confirmed coronavirus deaths and 4,624 probable coronavirus deaths as of July 23, according to the most recent data on the city website.

The New York City Health Department defines probable deaths as people who did not have a positive Covid-19 laboratory test, but their death certificate lists as the cause of death “Covid-19” or an equivalent.

The total number of confirmed coronavirus deaths and probable coronavirus deaths in New York City is 23,463.

Some context: There have been 219,489 coronavirus cases in New York City and 55,825 people have been hospitalized, according to the city.

The data is from the New York City Health Department and was updated on today at 1 p.m. ET, according to the website. The numbers may not line up exactly in real time with CNN’s database, which is drawn from Johns Hopkins University and the Covid Tracking Project.

More evidence is emerging to underscore that the anti-malarial drug hydroxychloroquine does not help Covid-19 patients. 

A study published in The New England Journal of Medicine on Thursday found that the use of hydroxychloroquine – given either alone or in combination with the antibiotic azithromycin – did not improve the conditions of hospitalized patients with mild-to-moderate Covid-19.

The study, led by researchers in Brazil, included 504 patients with confirmed Covid-19 who either needed no supplemental oxygen, or were receiving up to 4 liters per minute of oxygen. The study was conducted across 55 hospitals in Brazil.

The patients were randomly assigned to receive either standard of care; hydroxychloroquine at a dose of 400mg twice daily; or hydroxychloroquine at a dose of 400mg twice daily, plus azithromycin at a dose of 500mg once daily for seven days, according to the study. The researchers then assessed how the patients were doing 15 days later.

The study noted that receiving either hydroxychloroquine alone or hydroxychloroquine plus azithromycin did not appear to affect the condition of the patients at the 15-day mark.

Additionally, unusual heart rhythms and elevated liver-enzyme levels were more frequent in patients receiving hydroxychloroquine alone or with azithromycin, according to the study.

The study was funded by the Coalition Covid-19 Brazil and EMS Pharma, a pharmaceutical company in Brazil.

The Republican stimulus text will likely be released on Monday, a GOP aide told CNN. 

Senate Majority Leader Mitch McConnell may take to the chamber floor later today to announce where things stand.  

The White House and Senate GOP still haven't finalized how they'll structure their proposal to extend expiring jobless benefits, two sources involved in the talks told CNN. The dispute centers on the mechanics of how to implement the unemployment benefits.

Latest on stimulus negotiations: After days of back-and-forth on a stimulus proposal with the White House, Republicans and the administration reached what Treasury Secretary Steven Mnuchin called Thursday morning a "fundamental understanding," though many of the details are still being hammered out.

Republican senators say the White House conceded to Senate Republican demands during the negotiations — namely on money for contact tracing and testing, making funds available for schools that stay closed and dropping President Trump's demand for a payroll tax cut.

And, a top Republican chairman is pushing back on Trump's claim that testing is "overrated," saying it's essential to get a hold of the virus.

South Africa has crossed the threshold of 400,000 confirmed Covid-19 cases.

The country also has 6,000 confirmed Covid-19 deaths, President Cyril Ramaphosa said Thursday evening in a televised address to the nation.  

The country’s 408,052 confirmed cases is the fifth highest globally, according to a tally from Johns Hopkins University.

During the address, Ramaphosa also announced that all public schools will close for the next four weeks as the country experiences a peak in infection rates, extending the current academic year beyond 2020. 

Schools were previously closed during the country’s initial lockdown. Ramaphosa announced that certain grades will return sooner than others.

“It is important that schools do not become sites of transmission as our infections are rising fast,” Ramaphosa said.

Ramaphosa said his government would be focused on investigating and punishing corruption in the country’s Covid-10 response as several scandals of alleged procurement fraud in government and price gouging by companies have surfaced in recent weeks. 

"The consequences for those who break the law or bypass regulations must be severe,” Ramaphosa said. “The people of South Africa require nothing less than full accountability from those who have been elected and appointed to serve them.” 

Uganda has registered its first Covid-19 death, the country's Ministry of Health said Thursday.

The Seychelles and Eritrea are now the only countries in Africa not to have reported a Covid-19 death, according to Johns Hopkins University data.

Uganda’s first reported death is a 33-year-old Ugandan woman, from Namisindwa District, who was admitted to the hospital on July 15 and treated for severe pneumonia after suffering Covid-19 symptoms. She died on July 21, the Ministry of Health tweeted Thursday.

So far, 30 of her contacts have been traced and placed under quarantine by local health authorities, the ministry said. They will be monitored for 14 days and tested for the virus.

Some background: Since the pandemic began, at least 1,079 Ugandans have tested positive for Covid-19, Ministry of Health figures showed Thursday.

The country took stringent steps to try to halt the spread of the virus early on in March. It was one of the first African countries to impose travel restrictions on its citizens and others traveling from 16 countries it said had a high number of cases of coronavirus, including the US and UK. 

It was also among the first African country to announce a ban on large public gatherings including weddings, church and Jumat services for a period of 30 days. On March 18, schools were closed and public rallies banned.

The country’s President Yoweri Museveni notably encouraged Ugandans to stay home during the country's lockdown by releasing his own home workout video.

At least 157 Covid-19-related deaths were being reported in California in the past 24 hours, marking a single-day high for number of coronavirus deaths in the state.

These new deaths bring the state’s death toll to more than 8,000, according to data from California Department of Public Health.

California added 12,040 more confirmed coronavirus cases in the past 24 hours, for a total of 425,616 total cases since the pandemic began. This is the second highest daily uptick, following only yesterday's reported high of 12,807.

The positivity rate in the Golden State over the past two weeks stands at 7.6%.

The number of hospitalized patients and those in intensive care units are down slightly in the past day. 

Note: These numbers were released by California Department of Public Health, and may not line up exactly in real time with CNN’s database, which is drawn from Johns Hopkins University and the Covid Tracking Project.

The three countries worst hit by coronavirus right now are strong and able, but the World Health Organization can help if needed, officials said Wednesday.

“We are always ready and will always remain ready to provide advice, input and service to any of our member states wherever they are,” WHO’s Dr. Mike Ryan said during a briefing Thursday in Geneva.

Ryan said that the WHO regional office for Southeast Asia was in Delhi and one of their largest country offices in the Americas is in Brazil.

“Those countries are intertwined with us,” Ryan said. The US, Brazil and India lead the world in new coronavirus cases at present.

Ryan said he believes all three of these countries are “powerful, able, democratic countries, who have tremendous internal capacities to deal with this disease,” and they can “turn this around, because of the nature of their public health, their science and their innate capacities to fight this disease.” 

Dr. Maria Van Kerkhove, WHO’s technical lead for coronavirus response, agreed with Ryan.

“We are here to help all countries, and we work through our regional offices and we work through our country offices to provide support to everyone, everywhere,” she said. “And I think just a message to say that even in those three countries that have the highest number of cases right now, can be turned around. It can be turned around, and there are tools that all countries have that can do that.”

These tools involve physical distancing, hand hygiene and being informed about where the virus is present, Kerkhove said.

Peru’s President Martín Vizcarra announced his government issued an emergency decree in order to impose additional measures and help the region of Arequipa, which has become the new epicenter of the Covid-19 pandemic in the country.

Vizcarra said Peru’s health ministry will intervene and cooperate with Arequipa’s regional government to tackle the crisis after the region reported a significant increase in the number of coronavirus cases in the last few weeks.

Arequipa, in southern Peru, had been one of the least affected of Peru’s 24 regions. It registered 11,012 Covid-19 cases and 601 deaths on Wednesday evening, according to data released by the health ministry. 

Vizcarra traveled to the region last Sunday and admitted the lack of resources in the region. His administration had ordered more than 110,000 rapid tests, almost half million drugs and more than one million personal protective equipment units (PPE).

“This help hasn’t arrived yet,” the president said.

“They are even asking for donations,” he added, according to state news agency, Andina.

Dr. Miguel Palacios, dean of the Medical College of Peru, told CNN the government’s announcement is a good start but more action is needed as the situation in Arequipa has reached breaking point. 

“The health system has been totally overwhelmed, we think Arequipa should be declared a 'health disaster area' to be able to activate more resources apart from the health ministry’s support," Palacios said.

Palacios highlighted that hospitals have reached their capacity, there is lack of oxygen for treating patients and a shortage of doctors, many of them working with delayed payments and under challenging labor conditions.

At least 120 doctors have been infected with the virus while nine have died in Arequipa since the pandemic started, Palacios told CNN.

More on the country's figures: On Wednesday evening, Peru’s Health Minister Pilar Mazzetti Soler announced 3,688 new Covid-19 deaths that were previously unaccounted for. The new deaths were brought to light after an analysis by a special commission that studied 20,000 cases from March to June, Mazzetti Soler said. 

With Mazzetti Soler's announcement, Peru's Covid-19 death toll went from 13,767 to 17,455. Peru’s health ministry reported 366,550 Covid-19 cases on Wednesday evening.

At least 2,650 doctors have been infected with coronavirus while 95 have died due to the virus, according to data released by the Medical College of Peru.