November 19 coronavirus news

By Nectar Gan, Adam Renton, Sebastian Shukla, Meg Wagner and Melissa Macaya, CNN

Updated 1:28 a.m. ET, November 23, 2020
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9:24 p.m. ET, November 19, 2020

The US has reported more than 182,000 Covid-19 cases so far today. That's a new daily high

From CNN's Dave Alsup

The United States has reported 182,601 Covid-19 cases so far on Thursday, according to Johns Hopkins University, the highest one-day total since the pandemic began.

The previous daily high was on November 13, with 177,244 cases.

The US has also reported 1,964 Covid-19 deaths so far on Thursday. At least 11,710,084 Covid-19 cases, including 252,484 deaths, have now been reported nationwide

The numbers are not the final count for the day, however, and could rise further.

The totals include cases from all 50 states, the District of Columbia and other US territories, as well as repatriated cases.

CNN is tracking the US cases:

9:03 p.m. ET, November 19, 2020

Mexico surpasses 100,000 Covid-19 deaths

From CNN’s Natalie Gallón and Philip Wang

Mexico has reported a total of 100,104 deaths from Covid-19, the country's Health Ministry said Thursday during its nightly health news conference. 

Mexico is the fourth country to surpass 100,000 coronavirus deaths after the United States, Brazil and India. 

According to John Hopkins University, Mexico has a 9.8% case-fatality rate of Covid-19, the second highest rate in the world.

The Health Ministry also reported 4,472 new Covid-19 cases on Thursday, bringing the total number of infections in Mexico to 1,019,543.

CNN is tracking worldwide cases:

8:44 p.m. ET, November 19, 2020

Rural hospitals are struggling with Covid-19 spike, health administrator says

From CNN Health’s Jen Christensen

The rural hospital system in the United States is struggling to manage the Covid-19 pandemic.

The spike of cases in rural America in the past few weeks has been a “challenge on a number of levels,” said Tom Morris, associate administrator for rural health policy in the federal government’s Health Resources and Services Administration. Morris made the comments Thursday during the National Institutes of Health rural health seminar. 

Rural hospitals are small: Of the 2,000 hospitals considered to be rural, about 1,700 have 50 beds or fewer and 1,300 of them have 25 beds or fewer, said Morris, whose agency is part of the Health and Human Services Department.

“We’re not talking about large facilities. We’re not talking about a lot of ICU capacity,” Morris said. “In a lot of these hospitals, they’re able to offer an ICU of one or two beds. So, they have very limited inpatient resources.”

Limited work force: The rural medical work force needed to care for Covid-19 patients is extremely limited, he said, as is the supply chain that would provide protective equipment. Many of these hospitals are also “financially vulnerable,” Morris said. 

Hospitals are closing: Morris said the Trump administration has given $150 million to the 1,700 50-bed rural hospitals to help with the extra costs of the pandemic. Rural hospitals, health clinics and community health centers also got an extra $11 billion to offset the losses they were facing due to the pandemic. But still, 17 rural hospitals have shut this year, adding to the 130 rural hospitals that have closed since 2010.

“We have many more rural hospitals that are at a financial risk and have been for quite some time,” Morris said, “The pandemic has not made any of that easier.”

7:12 p.m. ET, November 19, 2020

WHO recommends against use of remdesivir for treatment of Covid-19

From CNN's Jacqueline Howard

The World Health Organization has updated its ongoing guidance on Covid-19 medications to advise against using the antiviral drug remdesivir to treat hospitalized patients, no matter how severe their illness may be.

According to the update, published in the medical journal the BMJ on Thursday, current evidence does not suggest remdesivir affects the risk of dying from Covid-19 or needing mechanical ventilation, among other important outcomes.

WHO's new update comes about a month after the company Gilead Sciences, the maker of remdesivir, announced that the US Food and Drug Administration approved remdesivir for the treatment of coronavirus infection. The drug became the first coronavirus treatment to receive FDA approval. 

Remdesivir may have received FDA approval but not WHO's recommendation because of emerging research — which initially showed some benefit against Covid-19, but as more data accumulate, that appears to be changing, said Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security, who was not involved in the WHO guidance. 

"We've seen people realize that the benefit of remdesivir is marginal at best — and the only benefit we had been touting was maybe it gets people better quicker. But the evidence base for that is weak, it's not ironclad, and I think that's what we're seeing reflected in the WHO guidance, just more evaluation of the data that's out there and more of now,” Adalja told CNN on Thursday.

"The fact that it was an antiviral that showed some benefit in certain trials — but not in all trials — was enough to push people to want to use it because we had no tools, but I do think it probably will be supplanted shortly," Adalja said, adding that the indication for drugs can change over time.

Some context: WHO convened an international panel of 24 experts and four survivors of Covid-19 to review data and make recommendations. The recommendation against remdesivir was based on data from four randomized trials including 7,333 people hospitalized with Covid-19.

"The panel concluded that most patients would not prefer intravenous treatment with remdesivir given the low certainty evidence," researchers from various institutions around the world wrote in the updated WHO guideline.

7:10 p.m. ET, November 19, 2020

Midwest cold snap fed current surge in coronavirus cases, Birx says

From CNN’s Maggie Fox

Susan Walsh/AP
Susan Walsh/AP

An early cold snap in the middle of the country at the end of September has helped drive the most recent surge of coronavirus infections, White House coronavirus adviser Dr. Deborah Birx said Thursday.

“This virus increased so rapidly because there was an unusual cold snap that began in the northern plains and went down through the heartland,” Birx said.

People began moving indoors, she said. That’s when transmission really begin to take off, especially with close to half of all infections asymptomatic, so people do not even realize they are infecting others.

“So we have been going across the country to really tell them, (the) mid-Atlantic states and the Northeast, to really increase testing, looking for these asymptomatic cases and I really want to thank the governors across this great land who have really heeded that call,” Birx told a White House briefing – the first public briefing by the task force since July.

Birx said when states increase the use of masking and encourage people to avoid gatherings, it helps control the rise in cases. 

Health officials say smaller gatherings are helping drive the spread of the virus. The US Centers for Disease Control and Prevention earlier on Thursday advised against traveling for the Thanksgiving holiday and urged Americans to celebrate the holiday only with household members.

1:27 a.m. ET, November 23, 2020

US has 100 million kits for distributing coronavirus vaccines, Operation Warp Speed officer says

From CNN’s Maggie Fox

General Gustave Perna, chief operating officer for the Defense Department's Project Warp Speed
General Gustave Perna, chief operating officer for the Defense Department's Project Warp Speed Tasos Katopodis/Getty Images

Operation Warp Speed has 100 million vaccine kits ready to go if and when distribution of a coronavirus vaccine starts, Gen. Gustave Perna, Warp Speed’s chief operating officer, said Thursday. 

Vaccine maker Pfizer says it plans to ask the US Food and Drug Administration for emergency use authorization for its vaccine on Friday, and federal government officials have said they expect to have 40 million doses of vaccine ready to go in December.

Perna told a briefing by the White House coronavirus task force that the operation will be ready to move quickly after any FDA authorization.

“We take the Pfizer vaccine – they are capable of distributing on their own,” Perna said. “They will utilize FedEx and UPS in order to execute distribution. Simultaneously we will ship ancillary kits, needles and alcohol wipes and the dilution required to meet the vaccine at the end state facilities we are talking about,” he said.

Vaccine maker Moderna is also expected to apply for EUA soon. Both companies have been manufacturing vaccine doses in the expectation that their products will be proven safe and effective. 

“For Moderna vaccines, what we're going to do is that we are going to meet up the vaccine with the kits at a distribution warehouse. We’re going to put them together and distribute through FedEx and UPS down to our administration sites,” Perna said.

“We are taking it from fill-finish and bringing together all of the requirements to administer the vaccine and sending it down to the distribution sites. Any place a state wants to administer the vaccine, as long as they are enrolled into our process, we can distribute the vaccine,” Perna added.

“We can distribute the Pfizer vaccine and the Moderna vaccine. We can go to one place in the state or 10,000 places in the state.”

6:08 p.m. ET, November 19, 2020

Fauci says Pfizer and Moderna vaccine results are "extraordinary"

From CNN’s Maggie Fox

Dr. Anthony Faucispeaks during a White House Coronavirus Task Force press briefing in the James Brady Press Briefing Room at the White House on November 19.
Dr. Anthony Faucispeaks during a White House Coronavirus Task Force press briefing in the James Brady Press Briefing Room at the White House on November 19. Tasos Katopodis/Getty Images

Coronavirus vaccines under development by Moderna and Pfizer have shown extraordinary efficacy, Dr. Anthony Fauci, the nation's top infectious disease expert, said Thursday.

Both makers reported preliminary data that showed their vaccines prevented about 95% of coronavirus infections. Pfizer is expected to seek US Food and Drug Administration emergency use authorization for its vaccine Friday. 

The vaccines prevented both infection and severe disease, Fauci noted in a rare White House coronavirus task force briefing, the first held since July 8.  

“That is extraordinary,” Fauci said. “That is almost to the level of what we see with measles (vaccine), which is 98% effective.”  

Fauci defended the quick vaccine development process. “The process of the speed did not compromise at all safety, nor did it compromise scientific integrity,” he said.

“We need to put to rest any concept that this was rushed in an inappropriate way,” said Fauci, who, as director of the National Institute of Allergy and Infectious Diseases, is helping oversee vaccine development.

“This was solid.”

5:38 p.m. ET, November 19, 2020

California issues overnight curfew to halt Covid-19 spread

From CNN's Cheri Mossburg

California Gov. Gavin Newsom is enacting a curfew as part of a “limited stay-at-home order” that will affect about 94% of the state’s population.

The order requires those in California’s most restrictive of four tiers to stay home between 10 p.m. and 5 a.m. local time.

The month-long order takes effect Saturday night and is essentially the same as the stay-at-home order issued in March, but applies only during those specific hours to residents in "purple tier" counties, according to a news release sent by Newsom’s office.

The reason for the specific hours noted that activities conducted during this time that are often nonessential and more likely related to social activities and gatherings that have a higher likelihood of leading to reduced inhibition, the governor's office said.

“The virus is spreading at a pace we haven’t seen since the start of this pandemic and the next several days and weeks will be critical to stop the surge. We are sounding the alarm,” Newsom said. “It is crucial that we act to decrease transmission and slow hospitalizations before the death count surges. We’ve done it before and we must do it again.”

5:52 p.m. ET, November 19, 2020

Minnesota landmarks to light up purple in honor of Covid victims and frontline workers

From CNN's Raja Razek

Cities and towns across Minnesota tonight will light landmarks in purple to honor victims of Covid-19 and frontline workers, Gov. Tim Walz's office said in a news release.

"As Minnesota reaches the grim milestone of over 3,000 lives lost due to COVID-19, cities and towns across the state tonight will light dozens of Minnesota landmarks in purple to honor victims of COVID-19 and the frontline workers battling the pandemic. Cities, towns, sports team, museums, libraries, companies, and more will join in this solemn moment of unity across the state," the release said. 

The governor also directed flags be flown at half-staff on Nov. 19 and Dec. 19 "to remember, mourn, and honor lives lost due to COVID-19," the release said.