The latest on the coronavirus pandemic

San Francisco will temporarily pause the planned reopening of some businesses and activities due to a recent increase of coronavirus cases and hospitalizations, Mayor London Breed announced in a briefing on Friday.

In a press release, city officials said the reopening pause was due to an uptick of cases and hospitalizations in San Francisco following an increase in cases across the state and nation.

“Today is not unexpected with regard to our pause in reopening,” San Francisco Department of Public Health Director Dr. Grant Colfax said. “As our activity increased, we realize, we know, we expected an increase in infections was likely.”

Colfax added that “this increase is a cause for concern.”

“We want to pause on increasing the capacity of riskier activities because we do not want the virus to get too far ahead of us,” Colfaxm said.

The pause means that the indoor capacity for businesses will remain at 25%, according to Breed. The city had planned to expand the capacity for some indoor businesses to 50% starting next week.

Reaching natural herd immunity in the United states would mean “so much suffering and death in the country, it would be unacceptable,” Dr. Anthony Fauci, the nation's top infectious disease expert, told SirusXM’s Doctor Radio Reports on Friday.

“We only have 10% or a little bit more of the population that has already been infected, and we have 225,000 deaths,” Fauci said. “If you want to get to a 75% protection, just multiply that and you see how many deaths you have to have to have herd immunity through natural infection.” 

“What you need is a combination of a heavy, heavy element of vaccine-induced protection, together with the protection that those who unfortunately have already been infected have,” Fauci said. “That’s the reason why a vaccine is so important in a much safer approach towards herd immunity.”

Fauci also discussed the importance of “equitable” vaccine distribution.

“Obviously the first ones are going to be health care providers, but then also we're going to have people who are frontline essential workers, and then those who are vulnerable – people with underlying conditions,” Fauci said.

“We know from painful experience with this pandemic that our minority populations, our Latinx and our African Americans, are especially vulnerable because of the prevalence of their underlying conditions,” he said. “You’ve got to access them and get them to be vaccinated, when we get a safe and effective vaccine.”

The Los Angeles Football Club revealed on Friday two additional players have tested positive for Covid-19. LAFC now has three players who have tested positive for the virus.

In a Friday statement, the team said the two additional positive tests followed the club’s win over the Houston Dynamo on Wednesday, a victory that assured LAFC a spot in the MLS playoffs. 

For precautionary reasons, the club has canceled all in-person activities until further notice.

All three players are self-isolating and are being treated by the team’s medical staff.

Covid-19 had disrupted the MLS season as multiple teams will not be able to play the full 23 games as scheduled. For this reason, qualification for the 2020 MLS Cup Playoffs will be determined by points-per-game rather than regular season standings.

New York City Mayor Bill de Blasio said Friday that the city’s daily Covid-19 case count is better than it was the day prior.

There were 68 new hospital admissions, down from 81 the day before and of these admissions, there was a positivity rate of 18.9% compared to 26% on the prior day. 

New York City also has 514 new cases, down from 532 reported Thursday. This represents a 1.75% overall positivity rate, which is down from what de Blasio called a “striking” figure of 2.7% positive yesterday.

As there is some variation to be expected from day-to-day case counts, the mayor emphasized the importance of the seven-day rolling average in determining spread. This seven-day rate is currently at 1.87%.

Speaking on "The Brian Lehrer Show" on WNYC, de Blasio said that stopping a second wave will “take a lot of discipline and recognizing that we cannot do a lot of the things that we would like to do in the short term but we have to hold the line."

The mayor warned against indoor gatherings for Halloween, urging New Yorkers to wear masks over costumes, stay in small groups, and socially distance during holiday festivities.

The US Food and Drug Administration is in the "early stages" of looking into whether expanded access — a regulatory pathway typically used for investigational drugs — could be used as a way to make a potential Covid-19 vaccine available to the public, an FDA official said on Friday.

Among the regulatory pathways for making a potential Covid-19 vaccine available, emergency use authorization has been the most discussed so far.

"Emergency use authorization is one of those mechanisms and is dependent upon declaration of a public health emergency, which is the situation we're currently in with Covid-19. Expanded access does not require the declaration of a public health emergency but it does have additional requirements for use," Fink said on Friday. "Expanded access is not an approval process."

Some background: If expanded access were to be considered for a potential Covid-19 vaccine, the vaccine manufacturer would need to have an active "investigational new drug" application on file with the FDA. Then the manufacturer would need to "submit a protocol for use of the vaccine under expanded access regulations and would work potentially with public government agencies" to organize and implement the expanded access protocol, Fink said.

Expanded access has been used before for vaccines, Fink added, just not on the massive scale that would be needed for a potential Covid-19 vaccine.

"We do have recent examples of expanded access treatment protocols that have been used to provide vaccine to thousands of individuals or tens of thousands of individuals," Fink said. "One example was to address meningococcal B disease outbreak on several college campuses prior to FDA licensure of meningococcal vaccines, and then more recently, there's been an expanded access protocol for use of non-US-licensed yellow fever vaccine."

Just days before Election Day, White House strategic communications director Alyssa Farah called Nov. 3 an "arbitrary deadline" for a coronavirus vaccine, despite President Trump pushing for a pre-election development for months.

Asked by CNN about the 250-person limit at the President’s rally today in Rochester, Minnesota, due to guidance from the Minnesota Health Department, Farah declined to speak on behalf of the campaign and said she was not involved in planning.

The city-state of Monaco will introduce a 8 p.m. to 6 a.m. local time curfew to control spread of Covid-19 starting midnight on Saturday. The curfew will run for at least a month.

Prince Albert II of Monaco announced the new measures in a televised address on Thursday evening.

Businesses and shops “will remain open with a certain number of arrangements” and “remote work will be encouraged in the public and private sectors,” he said adding that schools and universities will remain open whilst respecting social distancing measures.

The announcement comes after the principality reported 10 new positive cases and eight recoveries on Thursday, according to a government tweet. 

Some background: Monaco is located on the French riviera, in Western Europe. Despite its independence, it has close economic ties with neighbor France, which started a four-week lockdown this Friday.

The move in France, in response to spiraling coronavirus case numbers, was announced by President Emmanuel Macron on Wednesday, just hours after German Chancellor Angela Merkel declared a similar four-week nationwide lockdown in her own country.

Read more about the French and German lockdowns:

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Dr. Paul Casey, emergency department medical director at Bellin Hospital in Green Bay, Wisconsin, said it’s “mind-boggling” that President Trump is holding a campaign event today in the city as Covid-19 cases skyrocket in the state.

“We're seeing a steady stream of patients needing to be admitted to the hospital. So far, we've been able to keep up, but that is more than likely going to change fairly quickly,” he added.

Amid soaring cases, Trump is set to hold a campaign event in Green Bay today, which Casey said “simply boggles my mind.” 

Casey said there is an entire ward in his hospital set aside for coronavirus patients right now. 

“20% of our hospital capacity is currently filled with Covid patients. And in my 34-year career, that's unprecedented. I have never, ever seen a time where we had a single ward devoted to a single disease. … It takes back memories of the foregone times when we saw things like smallpox, that kind of thing, where we had a single disease overrunning the hospital,” he said. 

Nurses are working 12-hour shifts and are exhausted, Casey said. 

“It's also extremely hard to see patients without family members in the last days of their life, having to comfort them. It takes a human toll on the nursing staff,” he said. 

WATCH:

Over the past six months pharmaceutical companies have made various predictions about their Covid-19 vaccine timelines that have turned out not to be true.

In one recent example, Pfizer has said repeatedly it would know by the end of October if its vaccine works or not – but Tuesday on an investor call, the company’s CEO essentially ruled that out. 

Scientists say that should guide us as we move closer to having a vaccine: Don’t believe everything you hear, because testing and manufacturing vaccines are notoriously unpredictable.    

In May, University of Oxford researchers predicted they would have data from their clinical trials by September at the latest, but that did not happen. Their clinical trial is still underway. 

While at times Pfizer, Oxford and other vaccine developers have couched their statements, at other times, they have been more definitive about their timelines. 

There are 45 candidate vaccines currently at the clinical evaluation stage of development and 156 in preclinical evaluation, according to the World Health Organization.