November 16 coronavirus news

Dr Sanjay Gupta 1029
How the Covid-19 pandemic turned into a 'humanitarian disaster'
03:52 - Source: CNN

What you need to know

  • Moderna said today its coronavirus vaccine is 94.5% effective, similar to early results released by Pfizer last week, making it the second vaccine in the US to have a stunningly high success rate.
  • The US surpassed 11 million cases, with 1 million recorded in less than a week, as the virus spreads at an unprecedented speed. 
  • The end of the year is sneaking up. CNN spoke with medical experts about holiday travel risks and when you really should skip it altogether — read what they said here.

Our live coverage of the coronavirus pandemic has moved here.

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Los Angeles mayor warns of "very dangerous situation" amid surge of Covid-19 cases

Los Angeles Mayor Eric Garcetti speaks at a Los Angeles County Health Department news conference on Covid-19 on March 4, in Los Angeles.

Los Angeles Mayor Eric Garcetti urged residents to stay at home as much as possible for the next few weeks, as coronavirus cases surge across the county and California.

The county is currently seeing the highest daily case numbers since the middle of July, according to Garcetti. Infection rates are rising, and hospitalizations are increasing. 

“The situation in L.A. is more concerning than it’s ever been,” he added. “I don’t say this to scare you, I don’t say this to try to spin the numbers, it is just the truth.”

Coronavirus response: The county is expanding its testing sites and will be offering testing for passengers and employees at Los Angeles International Airport, where results can be expected within 24 hours. 

Travel during the holidays: Garcetti strongly urged residents to cancel any non-essential travel plans.

“If you don’t have essential travel, don’t travel,” he said. “If you don’t have to take a trip as an essential worker or because of a family emergency, don’t travel.”

A statewide travel advisory was issued on Friday asking all California residents to avoid non-essential travel to other states or countries. 

Biden team hoping to work with Trump administration on Covid-19, top adviser says

US President-elect Joe Biden’s coronavirus task force has yet to talk to the current administration about the transition, but is “very open” to doing so, said Dr. Marcella Nunez-Smith, co-chair of the task force, at a news conference on Monday.

“It hasn’t happened yet, but we’re very open to that. We would appreciate a chance to work together,” said Nunez-Smith, also an associate professor at the Yale School of Medicine.

Nunez-Smith said the task force is working very closely with policy teams and that the work of the transition is “driven by the data, by evidence, by science.”

Emphasizing vulnerable groups: Nunez-Smith said the task force was examining how Covid-19 disproportionately affects vulnerable populations like people of color, and those who work in high-risk places such as medical settings, nursing homes, and prisons.

On vaccines: She warned that the US is still many months away from full-scale distribution of a vaccine, and that people need to continue taking precautions like wearing masks and social distancing. If hospitalization numbers continue rising, it could overwhelm hospitals that are already strained.

“Our most precious and valuable resource right now is our healthcare system,” she said.

Fauci on vaccines: "The cavalry is coming, but the cavalry is not here yet"

The hope that a coronavirus vaccine may be just around the corner should motivate Americans to adhere closely to public health measures this holiday season, Dr. Anthony Fauci said on Monday.

“The cavalry is coming, but the cavalry is not here yet,” said Fauci, director of the National Institute of Allergy and Infectious Diseases, at an event hosted by the American Medical Informatics Association.

He added that he didn’t want to sound like a grinch, but reiterated that Americans should avoid gathering this holiday season.

“Just please do a risk-benefit assessment,” he said. 

Dr. James Phillips, chief of disaster medicine at George Washington University Hospital, told CNN he was “terrified” the US will see cases spike after Thanksgiving.

“We’re going to see an unprecedented surge of cases following Thanksgiving this year, and if people don’t learn from Thanksgiving, we’re going to see it after Christmas as well,” Phillips said.

US tops 70,000 Covid-19 hospitalizations

Medical staff treat a coronavirus patient at United Memorial Medical Center in Houston, Texas, on November 14.

There are now more than 70,000 people hospitalized in the United States with Covid-19, according to the Covid Tracking Project.

On Monday, 73,014 people were hospitalized with Covid-19, according to CTP. This is the highest number of Covid-19 hospitalizations the nation has ever experienced, and is at least 10,000 more hospitalizations higher than its spring and summer peaks.

The US currently averages more than 3,500 new hospitalizations per day, CTP data shows.

According to CTP data, these are the highest hospitalization numbers:

Nov. 16: 73,014 Nov. 15: 69,864 Nov. 14: 69,455 Nov. 13: 68,516 Nov. 12: 67,096

US should track people with persistent post-Covid-19 symptoms, Fauci says

The United States needs to do more to track people with post-Covid syndrome, those with persistent and long-term symptoms, to better understand the disease, Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said Monday.

Fauci said the National Institutes of Health is following people who have recovered from Covid-19 to try and determine what percentage of them have a persistence of symptoms after they’ve cleared the virus.

For those who experience lingering symptoms, doctors know that it doesn’t seem to matter how severe their illness was, Fauci said during an event hosted by the American Medical Informatics Association.

People who have recovered from coronavirus have reported fatigue, shortness of breath and brain fog, among other symptoms, that last for weeks and even months after they’ve recovered. 

It’s important to follow up to get a better understanding of the illness, Fauci said, but it won’t be easy. 

“I think the only way we’re going to do that is through registries so that we’re able do that. It makes it easy with electronic records but not everybody has an electronic health record. That’s really the problem that we have in this country,” he said. 

Fauci said it’s important to understand post-Covid syndrome to better understand the disease.

“We have people who have had mild disease, moderate disease or people who have been in intensive care units, who come out, who are very strong vigorous athletic people who just can’t function very well at all and we need to know how long that lasts and what is the physiological mechanism of it,” Fauci said.

California considers curfew to mitigate Covid spread

California officials are considering a curfew as the state grapples with the rapid spread of coronavirus.

Gov. Gavin Newsom said a curfew is just one of the ideas being researched and officials are figuring out what it might look like in California. It’s unclear what they have in mind, but a curfew could be implemented statewide, or may just accompany one or more of the state’s four restriction tiers which are determined county by county. 

Los Angeles County officials are specifically considering a curfew, “so businesses do not have to close again, but would instead have limited hours for essential activities,” according to County Supervisor Mark Ridley-Thomas. Data presented by the county’s health director shows young people are accounting for more and more of the cases, while the elderly are suffering the most serious effects.

California would not be the first state to employ a curfew:

  • A newly-implemented curfew in Massachusetts keeps residents at home between the hours of 10 p.m. and 5 a.m.
  • New York City businesses with liquor licenses must close by 10 p.m.
  • Virginia has implemented an alcohol-related curfew, prohibiting on-site sale, consumption, and possession after 10 p.m. at restaurants, breweries, and wineries.

Newsom’s team is evaluating studies from France, Germany and Saudi Arabia. The team is examining the efficacy of a curfew while assessing how they are working in other areas.

Fauci's advice to young health professionals: Prepare for another pandemic

Dr. Anthony Fauci has a message for the next generation of health professionals: pandemics happen, and it’s important to be prepared. 

During an event hosted by the American Medical Informatics Association, Fauci was asked what young professionals should be taught about responding to public health threats.

“First of all, pandemics occur,” said Fauci, National Institute of Allergy and Infectious Diseases director. “They’re not somebody’s fantasy.”

Fauci cited several examples of pandemics throughout history.

“Preparation is much, much, much more important than response,” he said. “Ultimately, you have to respond, but if you prepare well, your response will be well.”

“If you don’t prepare, and then start chasing after a pandemic, that is generally not a good formula for success,” he added.

Science is ultimately going to get us out of the pandemic, Fauci says

Science will ultimately help humanity end the coronavirus pandemic, Dr. Anthony Fauci said Monday.

“When you have a pandemic outbreak like this, science is ultimately going to get us out of it,” Fauci said at an event hosted by the American Medical Informatics Association.

Developments like coronavirus vaccines are being driven by science, Fauci, the director of the National Institute of Allergy and Infectious Diseases, pointed out.

“I think you’ve got to understand the important role of science in containing public health threats,” he said. “Namely, what we’re doing now with a vaccine.”

“What’s going to get us out of this dilemma – not a dilemma, this terrible situation that we’re in – is going to be the vaccine,” he added. 

NIH has been "all in" on development of coronavirus therapeutics, Fauci says

Dr. Anthony Fauci testifies at a Senate Heath Committee hearing in Washington, DC, on September 23.

The National Institutes of Health (NIH) have been “all in” on the development of therapeutics for coronavirus, Dr. Anthony Fauci said Monday.

“All of these interventions that people see on the outside started off in somebody’s lab, with a creative idea,” Fauci, the director of the National Institute of Allergy and Infectious Diseases, said.

He cited monoclonal antibodies, which, “we showed to be quite successful in the treatment of Ebola.”

“We’re going to be doing the same thing here with Covid, namely taking monoclonal antibodies and passively transferring them for the purpose of preventing someone from getting advanced disease,” Fauci said at an event hosted by the American Medical Informatics Association.

Fauci noted that the NIH-run trial of the antiviral drug remdesivir proved to be successful. He added that they are also working to develop state of the art testing.

One big goal is a better coronavirus test for everyone.

“Ultimately, what we really want is a home kit diagnostic, so you could wake up in the morning and say, ‘should I be going to work, should I be going to dinner with my elderly mother or father or should I be in the presence of people who have underlying diseases?’” Fauci added. 

Coronavirus can infiltrate the diaphragm and weaken ability to breathe, study shows

Coronavirus can infiltrate the diaphragm, perhaps interfering with a patient’s ability to breathe, researchers reported Monday.

Researchers with Amsterdam University Medical Centers examined the diaphragm muscle from autopsies of 26 patients who had died from Covid-19 and eight patients who did not have coronavirus in the Netherlands in April and May of this year. The diaphragm sits at the base of the chest and plays an important role in breathing.

The team found evidence of coronavirus in the diaphragm of four of the patients who died from Covid-19, the team reported in the journal JAMA Internal Medicine.

The diaphragm muscle has cells rich in a cellular doorway called angiotensin-converting enzyme 2 (ACE-2), which they say provides “an entry point for SARS-CoV-2 to infect diaphragm myofibers.” 

The team also found increased evidence of fibrosis, a response to injury or damage, in the diaphragm. In fact, they found the level of fibrosis was more than two times higher in the diaphragms of coronavirus patients than non-coronavirus patients.

The team suggests that severely weakened or damaged diaphragm muscles linked with coronavirus infection may lead to persistent difficulty breathing and fatigue. They also say this could make it more difficult for these patients to be weaned off of ventilators.

About 92% of the patients studied needed help breathing with mechanical ventilation. The length of mechanical ventilation and intensive care unit stay was comparable between the coronavirus and non-coronavirus patients.

The researchers say it’s still unclear whether damaged or weak diaphragm muscle is a direct effect of coronavirus infection.