November 20 coronavirus news

By Helen Regan, Adam Renton, Sebastian Shukla and Angela Dewan, CNN

Updated 12:00 a.m. ET, November 21, 2020
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11:17 p.m. ET, November 19, 2020

More than 470,000 Americans will die from coronavirus by March, experts forecast

From CNN's Maggie Fox

The coronavirus pandemic is getting so bad, so quickly, across the United States that an influential academic modeling group has hiked its forecast of deaths considerably.

The Institute for Health Metrics and Evaluation at the University of Washington School of Medicine now predicts 471,000 people will die from Covid-19 by March 1.

That’s up from its forecast of 438,941 just a week ago.

"The pace of increase is faster than we expected, leading us to revise upward our forecast of deaths by March 1 to 471,000," the IHME said in its new report.

The group said their forecast "assumes that 40 states would reimpose social distancing mandates as the daily death rate exceeds 8 per million."

If states do not do this, the "death toll could reach 658,000 by March 1,” they added. 

“Hospital systems in most states will be under severe stress during December and January even in our reference scenario. Increasing mask use to 95% can save 65,000 lives by March 1," the institute said.

This increased death forecast is even taking into account that the US has improved the infection-fatality ratio with better treatments.

“Our analysis suggests that after controlling for age, sex, comorbidities, and disease severity at admission, the hospital-fatality rate has declined by about 30% since March/April,” it said. Obesity is a major factor in the fatality rate, it said.

10:03 p.m. ET, November 19, 2020

Japan records another daily high of Covid-19 cases but government says no state of emergency needed

From CNN's Yoko Wakatsuki in Tokyo

Japan reported its highest number of daily Covid-19 cases for the second consecutive day, with 2,397 infections on Thursday, according to the country's Health Ministry.

There were 21 deaths also reported, the Health Ministry said.

Despite the continued spike, Japan's Chief Cabinet Secretary Katsunobu Kato said imposing a state of emergency is not necessary.

"We are not in the situation to issue the state of emergency now. I understand the medical experts share the view," Kato said at a news conference on Friday.

Kato added that the weekly infection average has doubled in the past two weeks and said the government needs to be at maximum alert.

"We would like to pursue the economic and social activities while taking thorough implementation of basic prevention measures," the secretary said.

The total number of virus cases nationwide now stands at 125,979 and 1,956 deaths.

Rising cases: Tokyo, Osaka and six other prefectures also posted record high numbers from Thursday. 

Tokyo reported 534 new cases Thursday -- surpassing the 500 mark for the first time. Osaka reported 338 new cases.

9:37 p.m. ET, November 19, 2020

Pfizer’s potential Covid-19 vaccine is a "medical home run -- maybe a Grand Slam," says FDA commissioner 

From CNN Health’s Shelby Lin Erdman

The data Pfizer and BioNTech have released so far on their Covid-19 vaccine candidate “are really exciting and give us great hope,” US Food and Drug Administration Commissioner Dr. Stephen Hahn said Thursday.

“It’s the equivalent of a medical home run, maybe a Grand Slam, who knows, but really impressive from what we’ve heard so far,” Hahn told NBC News.

The companies said this week the data from the clinical trials show the potential coronavirus vaccine is 95% effective in preventing disease and that they plan to file for an emergency use authorization from the FDA on Friday.

Hahn said the agency needs to see the raw data on the vaccine.

“So what will be submitted to us is raw data around the clinical trial that would support a claim for safety and effectiveness of the vaccine, which of course is our primary responsibility here, with an emergency use authorization or an outright approval,” he said.

That’s not the only thing the agency reviews.

“We'll also be looking at manufacturing data because the other thing we need to ensure is that every vaccine that comes off the manufacturing line has the same high quality and represents the vaccine that was part of the study,” Hahn noted.

After the FDA receives the application, Hahn said the agency will set a date for a meeting of the Vaccines and Related Biological Products Advisory Committee, or VRBPAC. A source told CNN this week the date had already been set, for December 8, 9 and 10. But Hahn said a date has not yet been set. 

Once the application is submitted to the FDA, agency scientists review it and come to their own conclusions, Hahn said.

8:12 p.m. ET, November 19, 2020

Pfizer and Moderna Covid vaccines could be given European authorization by mid-December

From CNN’s James Frater in London

Vaccines produced by Pfizer/BioNTech and Moderna could be given approval for market by mid-December, European Commission President Ursula von der Leyen said Thursday.

“If all proceeds with no problems, EMA (European Medicines Agency) tells us that the conditional marketing authorization for BioNTech and Moderna could happen as early as the second half of December 2020,” von der Leyen said.

She added that this is the “very, very first step to be able to go on to the market” with both of these vaccines.     

The Commission president said that all vaccines are properly assessed by the EMA and authorized in cooperation with other authorities. They worked closely with the FDA on authorization of the BioNTech and Moderna vaccines.

The European Commission now has contracts with Pfizer/BioNTech, Curevac, AstraZeneca, Johnson & Johnson and Sanofi and continue negotiations with Moderna. They are also still in talks with Novavax.

12:36 a.m. ET, November 20, 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.

8:11 p.m. ET, November 19, 2020

Los Angeles records highest number of Covid cases in a single day

From CNN's Cheri Mossburg

With 5,031 new Covid-19 cases reported Thursday, Los Angeles County has reached a daily case count not seen before in the pandemic.

The previous daily case high, recorded just Wednesday, was 3,994. The summertime peak in Los Angeles averaged just over 3,000 cases per day.

The increase in cases is climbing at an alarming rate.

“From Oct. 28 to Nov. 10, the average daily cases have increased 68%,” County Health Officer Muntu Davis reported. “We are seeing a much more rapid surge in cases than we saw in the summer.”

Late June to early July saw a steep incline of a 43% case increase in Los Angeles. 

“Honestly, we never expected or hoped that we would be in this situation at this time of the year,” said Davis. “We were really hoping that would be, he would be in stage two by this time of the year. In November, getting our schools, you know, back open, but unfortunately we're not seeing that. And this is an unfortunate place to be, as we're going in the tradition of the traditional holiday season where people traveled and get together.” 

Davis was unable to identify the exact cause of the sudden surge.

“I think we have seen, based on interviews, a number of different activities that people have done it's been very hard to pinpoint unless they know exactly, if they were around someone who became sick or found out later that someone was sick and did have the virus. You know, that's where their exposure was,” he said.

Los Angeles health officials are encouraging people to stay with their households, wear face coverings when outdoors, and opt out of unnecessary travel.

8:09 p.m. ET, November 19, 2020

CDC recommends against travel for Thanksgiving

From CNN's Maggie Fox

The US Centers for Disease Control and Prevention recommends that Americans should not travel for Thanksgiving, and has posted updated guidelines for safely celebrating the holiday.

"CDC is recommending against travel during the Thanksgiving Day period," Dr. Henry Walke, Covid-19 incident manager for the CDC, told reporters in a conference call.
"Right now, especially as we are seeing exponential growth in cases and the opportunity to translocate disease or infection from one part of the country to another leads, to our recommendation to avoid travel at this time."

"The reason that we made the update is that the fact that over the week we've seen over a million new cases in the country," Dr. Erin Sauber-Schatz, the CDC's lead for Community Intervention and Critical Population Task Force, said during the briefing.

According to Johns Hopkins University, more than 250,000 people have died from Covid-19 in the United States. More than 11.5 million people have been diagnosed with the virus and the United States has set several new daily records for hospitalizations.

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