UK officials to mull north England virus steps

LONDON — Health officials are scheduled to meet Wednesday to discuss whether to add areas of northern England, including Manchester and Lancashire, to the highest-risk tier, meaning additional anti-coronavirus measures such as closing pubs could soon be imposed there. Only Liverpool was placed in the highest-risk category when the plan was unveiled Monday.

The discussions come as the regional government in Northern Ireland prepares to announce even tougher measures, including a two-week school closure. Northern Ireland has the highest infection rate among the U.K.’s four nations.

Prime Minister Boris Johnson is being criticized by all sides two days after announcing his three-tier approach to controlling the virus.


A report released Tuesday showed that the government’s science advisers have called for tougher measures, including a two- to three-week national lockdown. The opposition Labour Party has called for that advice to be followed, while members of Johnson’s Conservative Party say the measures already in place go too far and are damaging the economy,

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HERE’S WHAT YOU NEED TO KNOW ABOUT THE VIRUS OUTBREAK:

— Lives Lost: Indian doctor embodied his family’s dreams

— More masks, less play: Europe tightens rules as virus surges

— Possible safety issue spurs pause of COVID-19 antibody study

— AP-NORC poll: New angst for caregivers in time of COVID-19

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— Follow AP’s pandemic coverage at http://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak

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HERE’S WHAT ELSE IS HAPPENING:

NEW DELHI — India has confirmed more than 63,000 new cases of the coronavirus, an increase of over 8,000 from the previous day but still far fewer than it was reporting a month ago, when the virus was at its peak in the country.

The Health Ministry reported 63,509 new cases on Wednesday, raising India’s total to more than 7.2 million, second in the world behind the U.S. The ministry also reported 730 fatalities in the past 24 hours, raising the death toll to 110,586. The country was seeing more than 1,000 deaths per day last month.

According to the Health Ministry, India’s average number of daily cases dropped to 72,576 last week from 92,830 during the week of Sept. 9-15, when the virus peaked. Over the last month, the country has been seeing a trend of declining cases on a week-to-week basis.

On Tuesday, India registered 55,342 new cases, its lowest single-day tally since mid-August.

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BEIJING — China says it has carried out more than 4.2 million tests in the northern port city of Qingdao, with no new cases of coronavirus found among the almost 2 million sets of results received.

The city has reported a total of 12 cases, six with symptoms and six without, since the new outbreak was first spotted over the weekend at a hospital.

China on Wednesday reported 27 new cases of coronavirus, including 13 new cases of local transmission and 14 cases brought from outside the country.

China has reported a total of 4,634 deaths among 85,611 confirmed cases of COVID-19.

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BOISE, Idaho — Idaho health care experts say coronavirus is increasing

England and Tottenham on collision course over Harry Kane’s fitness

José Mourinho is strongly against Gareth Southgate’s plan to start Harry Kane for England in the Nations League tie with Denmark on Wednesday night and has communicated his concerns to the national setup.

The Tottenham manager had urged his England counterpart to handle Kane with care during the international window, given his high workload in the season so far, and the situation became more delicate when the striker felt an issue with his thigh last week.

Related: England’s class of 2018 return favour as Southgate looks back to go forward | David Hytner

Southgate has said Kane is not injured, rather he began to suffer from “muscle fatigue” last Wednesday when he started to train with England, having been given the Monday and Tuesday off. The Football Association sent him for a scan and there has been regular dialogue between their medics and those at Spurs.

Kane was never going to feature last Thursday in the against Wales, which England won 3-0 and, because he was unable to train fully, he was used only as a 66th-minute substitute in the 2-1 Nations League victory against Belgium on Sunday.

But now club and country are on a collision course, with Southgate wanting to start Kane against Denmark. Spurs argue that the fact Kane was sent for a scan shows the FA is worried that the player is carrying something, and they also know he will always turn out when asked to do so. The club blame the FA in part for the number of games Kane has already played this season. Before Belgium he had played 10 in 29 days – eight of them as a starter.

“Medically, there’s been conversations [with Spurs],” Southgate said. “He started to train on the Wednesday, was a little unhappy with how he felt, so then worked with our medical team the next couple of days. We scanned just to be certain but it’s a muscular fatigue issue rather than an injury so it just needed a bit more confidence.

“He knew by then he could push on a little bit but he just needed a bit more confidence in it and so his training week really wasn’t suitable to start [against Belgium]. I think he’ll have gained more confidence from the spell he had [as a substitute] and so, all being well, we hope he’ll be good to start on Wednesday.”

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England and Tottenham on collision course over Harry Kane’s fitness | England

José Mourinho is strongly against Gareth Southgate’s plan to start Harry Kane for England in the Nations League tie with Denmark on Wednesday night and has communicated his concerns to the national setup.

The Tottenham manager had urged his England counterpart to handle Kane with care during the international window, given his high workload in the season so far, and the situation became more delicate when the striker felt an issue with his thigh last week.

Southgate has said Kane is not injured, rather he began to suffer from “muscle fatigue” last Wednesday when he started to train with England, having been given the Monday and Tuesday off. The Football Association sent him for a scan and there has been regular dialogue between their medics and those at Spurs.

Kane was never going to feature last Thursday in the against Wales, which England won 3-0 and, because he was unable to train fully, he was used only as a 66th-minute substitute in the 2-1 Nations League victory against Belgium on Sunday.

But now club and country are on a collision course, with Southgate wanting to start Kane against Denmark. Spurs argue that the fact Kane was sent for a scan shows the FA is worried that the player is carrying something, and they also know he will always turn out when asked to do so. The club blame the FA in part for the number of games Kane has already played this season. Before Belgium he had played 10 in 29 days – eight of them as a starter.

“Medically, there’s been conversations [with Spurs],” Southgate said. “He started to train on the Wednesday, was a little unhappy with how he felt, so then worked with our medical team the next couple of days. We scanned just to be certain but it’s a muscular fatigue issue rather than an injury so it just needed a bit more confidence.

“He knew by then he could push on a little bit but he just needed a bit more confidence in it and so his training week really wasn’t suitable to start [against Belgium]. I think he’ll have gained more confidence from the spell he had [as a substitute] and so, all being well, we hope he’ll be good to start on Wednesday.”

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Boris Johnson Announces Three-tier Coronavirus Strategy for England

Tighter restrictions have been confirmed by the Government as the Prime Minister confirmed a ‘three-tier’ system for England to classify the severity of rates of COVID-19.

From Wednesday, regions will be classed as either ‘medium’, ‘high’, or ‘very high’ risk.

The details, announced in the Commons by Boris Johnson, came as the NHS said that Nightingale hospitals in Manchester, Sunderland, and Harrogate were being asked to mobilise in the next few weeks in response to growing rates of SARS-CoV-2 infections in the North West and North East.

Speaking at a Downing Street news briefing earlier, Prof Jonathan Van-Tam, England’s deputy chief medical officer, warned that additional hospital admissions and deaths were now ‘baked in’ as the virus spread from younger to older age groups.

What the Three Tiers Mean

Speaking ahead of his evening televised address to the nation, Mr Johnson said he did not believe another national lockdown was appropriate but that he was not prepared to “let the virus rip”.

The three-tier system would mean:

  • Medium: Covering most of England, national restrictions such as the ‘rule of six’ and the 10pm curfew for pubs, bars, and restaurants would apply

  • High: People in areas including Greater Manchester and Birmingham would be prevented from socialising with other households indoors

  • Very High: People would be banned from socialising with other households both indoors and in private gardens, while bars and pubs would be closed unless they were able to operate as restaurants

The Prime Minister said that agreement had been reached with leaders in Merseyside for the Liverpool city region to move into the ‘very high’ alert level. There, gyms, leisure centres, betting shops and casinos would also be told to close.

Mr Johnson said that discussions were ongoing with other leaders in the North West, North East, and Yorkshire and Humber over lockdown restrictions.

Mr Johnson told the Commons: “They, like us, like everyone in this House, are grappling with very real dilemmas, but we cannot let the NHS fall over.”

He warned MPs that “the weeks and months ahead will continue to be difficult and will test the mettle of this country”.

A debate and a vote on the new restrictions will take place at Westminster. The Government has promised to keep the measures under continual review.

In reply, Labour leader Keir Starmer said it was clear that the country faced a “critical moment” in efforts to contain the SARS-CoV-2 virus.

However, he added: “I’m now deeply sceptical that the Government has actually got a plan to get control of this virus, to protect jobs, or regain public trust.”

Cases of Coronavirus ‘Heating Up’

Illustrating the latest situation this morning with a series of maps and graphs, Prof Van-Tam said latest data showed COVID-19 cases were “heating up” south of the West Midlands and East Midlands.

“It has changed in a matter of just a few days, and that is clearly of concern to me,” he said.

Prof Van-Tam said that while the resurgence of cases in Northern England

New England Journal of Medicine calls for US leadership to be voted out over Covid-19 failure

In an unprecedented move, the New England Journal of Medicine on Wednesday published an editorial written by its editors condemning the Trump administration for its response to the Covid-19 pandemic — and calling for the current leadership in the United States to be voted out of office.



Donald Trump looking at the camera: U.S. President Donald Trump leads a meeting with the White House Coronavirus Task Force and pharmaceutical executives in Cabinet Room of the White House on March 2, 2020 in Washington, DC. President Trump and his Coronavirus Task Force team met with pharmaceutical companies representatives who are actively working to develop a COVID-19 vaccine.


© Drew Angerer/Getty Images
U.S. President Donald Trump leads a meeting with the White House Coronavirus Task Force and pharmaceutical executives in Cabinet Room of the White House on March 2, 2020 in Washington, DC. President Trump and his Coronavirus Task Force team met with pharmaceutical companies representatives who are actively working to develop a COVID-19 vaccine.

“We rarely publish editorials signed by all the editors,” said Dr. Eric Rubin, editor-in-chief of the medical journal and an author of the new editorial.

The editorial, which Rubin said was drafted in August, details how the United States leads the world in Covid-19 cases and deaths. So far, more than 7.5 million people in the United States have been diagnosed with Covid-19 and more than 200,000 people have died of the disease.

“This crisis has produced a test of leadership. With no good options to combat a novel pathogen, countries were forced to make hard choices about how to respond. Here in the United States, our leaders have failed that test. They have taken a crisis and turned it into a tragedy,” the editorial says.

It does not endorse a candidate, but offers a scathing critique of the Trump administration’s leadership during the pandemic.

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“Anyone else who recklessly squandered lives and money in this way would be suffering legal consequences. Our leaders have largely claimed immunity for their actions. But this election gives us the power to render judgment,” the editorial says. “When it comes to the response to the largest public health crisis of our time, our current political leaders have demonstrated that they are dangerously incompetent. We should not abet them and enable the deaths of thousands more Americans by allowing them to keep their jobs.”

The New England Journal of Medicine began publishing in 1812. There have been only four previous editorials collectively signed by its editors in the recent past: one in 2014 about contraception; an obituary that same year for a former editor-in-chief; an editorial that year about standard-of-care research and an editorial in 2019 about abortion.

“The reason we’ve never published an editorial about elections is we’re not a political journal and I don’t think that we want to be a political journal — but the issue here is around fact, not around opinion. There have been many mistakes made that were not only foolish but reckless and I think we want people to realize that there are truths here, not just opinions,” Rubin said.

“For example, masks work. Social distancing works. Quarantine and isolation work. They’re not opinions. Deciding not to use them is

New England Journal of Medicine publishes first election stance in anti-Trump editorial

“Our leaders have largely claimed immunity for their actions,” said the piece, which was signed by 34 of the journal’s editors. “But this election gives us the power to render judgment.”

The journal has only published four other editorials signed by all the editors, including an obituary for longtime editor in chief Arnold S. Relman, who died in 2014. The three others, published in 2014 and 2019, tackled contraception access, abortion policy and draft guidance from the federal government on informed consent requirements in standard-of-care research. Never before have the journal’s editors collectively weighed in on an election, let alone a presidential race.

The coronavirus, which has now killed at least 211,000 Americans, changed that. Wednesday’s editorial argued that national leaders had the opportunity to limit the virus’s spread and prevent widespread illness, deaths and lasting economic turmoil.

“Here in the United States, our leaders have failed that test,” the editorial said. “They have taken a crisis and turned it into a tragedy.”

The U.S. “leads the world in Covid-19 cases and in deaths due to the disease,” the editorial says. Its infection and death rates have outstripped those in China, where the pandemic began; in Japan, which has a large and vulnerable elderly population; and in Vietnam, which has fewer national resources. And testing has also lagged behind much of the world, the editorial said, when measured by tests performed per infected person.

“The magnitude of this failure is astonishing,” the editorial said. “We have failed at almost every step.”

Differing opinions on neutrality in the scientific community have led some journals to regularly weigh in on political issues and others to abstain almost entirely. NEJM’s editors previously remained mum on elections and most other political issues, in part to preserve the perception of neutrality and credibility behind the peer-reviewed science the journal publishes.

Wednesday’s editorial shifted that stance, deriding the administration for undermining experts and relying heavily on layman allies to promote policies that furthered Trump’s political aims.

“Our current leaders have undercut trust in science and in government, causing damage that will certainly outlast them,” they wrote. “Instead of relying on expertise, the administration has turned to uninformed ‘opinion leaders’ and charlatans who obscure the truth and facilitate the promulgation of outright lies.”

Officials in the Trump administration have tried to discredit and undermine some experts who have criticized the way the federal government responded to the pandemic. Last month, Michael Caputo, the top communications official for the Department of Health and Human Services, claimed scientists at the Centers for Disease Control and Prevention were conspiring against the president and engaged in “sedition.” Others have tried to tightly control information about the state of the pandemic.

The NEJM isn’t the first science-focused publication pushed to weigh in on the election due to the tense relationship between the Trump administration and the scientific community. Scientific American also published a presidential endorsement for the first time in its October issue, urging its readers to vote for former vice president

The New England Journal of Medicine urges people to vote Trump out in an extraordinary editorial

The first question at Wednesday’s vice presidential debate was why the U.S. has fared so much worse than other countries in handling the COVID-19 pandemic. The New England Journal of Medicine had offered an answer hours earlier, in a very unusual editorial: The U.S. government has, uniquely in the world, “failed at almost every step.” The 202-year-old medical journal’s editors did not endorse Joe Biden, as Scientific American did last month, or mention President Trump by name, but the message was a clear prescription to vote him out in November.

“The United States came into this crisis with enormous advantages,” the editors detail. But “the response of our nation’s leaders has been consistently inadequate. The federal government has largely abandoned disease control to the states. Governors have varied in their responses, not so much by party as by competence. But whatever their competence, governors do not have the tools that Washington controls. Instead of using those tools, the federal government has undermined them.”

The federal government’s “weak and inappropriate” policies have cause additional U.S. deaths “at least in the tens of thousands,” the editorial estimates, concluding:

Anyone else who recklessly squandered lives and money in this way would be suffering legal consequences. Our leaders have largely claimed immunity for their actions. But this election gives us the power to render judgment. Reasonable people will certainly disagree about the many political positions taken by candidates. But truth is neither liberal nor conservative. When it comes to the response to the largest public health crisis of our time, our current political leaders have demonstrated that they are dangerously incompetent. We should not abet them and enable the deaths of thousands more Americans by allowing them to keep their jobs. [New England Journal of Medicine editorial]

“We rarely publish editorials signed by all the editors,” Dr. Eric Rubin, the NEJM‘s editor-in-chief, told CNN. And “the reason we’ve never published an editorial about elections is we’re not a political journal and I don’t think that we want to be a political journal — but the issue here is around fact, not around opinion. There have been many mistakes made that were not only foolish but reckless and I think we want people to realize that there are truths here, not just opinions.” Read the full editorial at The New England Journal of Medicine.

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Rebuking Trump, The New England Journal of Medicine calls for ousting the nation’s ‘dangerously incompetent’ leaders.

Throughout its 208-year history, The New England Journal of Medicine has remained staunchly nonpartisan. The world’s most prestigious medical journal has never supported or condemned a political candidate.

Until now.

In an editorial published on Wednesday, the journal said the Trump administration had responded so poorly to the coronavirus pandemic that it had “taken a crisis and turned it into a tragedy.”

The journal did not explicitly endorse former Vice President Joseph R. Biden Jr., the Democratic nominee, but that was the only possible inference, other scientists noted.

The N.E.J.M.’s editors join those of another influential journal, Scientific American, who last month endorsed Mr. Biden.

The political leadership has failed Americans in many ways that contrast vividly with responses from leaders in other countries, the editorial said.

In the United States, it said, there was too little testing for the virus, especially early on. There was too little protective equipment, and a lack of national leadership on important measures like mask wearing, social distancing, quarantine and isolation.

There were attempts to politicize and undermine the Food and Drug Administration, the National Institutes of Health and the Centers for Disease Control and Prevention, the journal noted.

As a result, the United States has had tens of thousands of “excess” deaths — those caused both directly and indirectly by the pandemic — as well as immense economic pain and an increase in social inequality as the virus hit disadvantaged communities hardest.

The editorial castigated the Trump administration’s rejection of science. “Instead of relying on expertise, the administration has turned to uninformed ‘opinion leaders’ and charlatans who obscure the truth and facilitate the promulgation of outright lies.”

The uncharacteristically pungent editorial called for change: “When it comes to the response to the largest public health crisis of our time, our current political leaders have demonstrated that they are dangerously incompetent. We should not abet them and enable the deaths of thousands more Americans by allowing them to keep their jobs.”

Scientific American, too, had never before endorsed a political candidate. “The pandemic would strain any nation and system, but Trump’s rejection of evidence and public health measures have been catastrophic,” the journal’s editors said.

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New England Journal of Medicine editorial takes aim at Trump administration: “This election gives us the power to render judgment”

The New England Journal of Medicine made a rare political move Wednesday, publishing an editorial by dozens of U.S. editors who denounced the Trump administration’s handling of the coronavirus pandemic and said this election “gives us the power to render judgment.” 

The editorial, titled “Dying in a Leadership Vacuum,” does not explicitly endorse former Vice President Joe Biden, but the editors’ message is clear — the current leadership must change.

“Our current leaders have undercut trust in science and in government, causing damage that will certainly outlast them. Instead of relying on expertise, the administration has turned to uninformed ‘opinion leaders’ and charlatans who obscure the truth and facilitate the promulgation of outright lies,” the editorial says. 

“Anyone else who recklessly squandered lives and money in this way would be suffering legal consequences,” the editorial added. “Our leaders have largely claimed immunity for their actions. But this election gives us the power to render judgment.”

The editorial notes that, while some deaths in the U.S. were inevitable, tens of thousands could have been saved with a better response.

Meanwhile, President Trump is claiming personal victory over the virus, saying he feels great as he presumably continues to still be shedding the virus. The president said it was a “blessing from God” that he contracted COVID-19, so he can encourage greater access for the experimental drugs he used.

“I feel great. I feel like, perfect,” the president said in a four-minute video posted to Twitter. “I think this was a blessing from God, that I caught it. This was a blessing in disguise. I caught it, I heard about this drug, I said let me take it, it was my suggestion. I said, let me take it. And it was incredible the way it worked, incredible. And I think if I didn’t catch it, we’d be looking at that like a number of other drugs. But it really did a fantastic job. I want to get for you what I got. I’m going to make it free, you’re not going to pay for it.”

Meanwhile, “isolation carts” have been set up in the West Wing, where staff can pull personal protective equipment in order to interact with the president.

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New England Journal of Medicine blasts Trump officials’ response to virus, calls for new leaders

The New England Journal of Medicine on Wednesday, in an unprecedented editorial, denounced the Trump administration’s handling of the coronavirus pandemic and called for voting out “current political leaders” who are “dangerously incompetent.”

The harshly worded editorial is the first time the prestigious medical journal, which usually stays out of politics, has weighed in on an election.  

The editorial does not mention President TrumpDonald John TrumpTrump and Biden’s plans would both add to the debt, analysis finds Trump says he will back specific relief measures hours after halting talks Trump lashes out at FDA over vaccine guidelines MORE by name, but it refers to “the administration” and calls for voting out “our current political leaders.”

“When it comes to the response to the largest public health crisis of our time, our current political leaders have demonstrated that they are dangerously incompetent,” the editorial states. “We should not abet them and enable the deaths of thousands more Americans by allowing them to keep their jobs.”

The journal takes the Trump administration to task on a wide range of issues that it argues the U.S. has failed on, from inadequate testing to shortages of protective equipment for health workers. 

“We have failed at almost every step,” the editorial states. “We had ample warning, but when the disease first arrived, we were incapable of testing effectively and couldn’t provide even the most basic personal protective equipment to health care workers and the general public. And we continue to be way behind the curve in testing.”

The editorial also criticizes states for reopening businesses before the virus had been controlled and for a lack of mask-wearing, which it blames on leaders not modeling the behavior. Trump has rarely worn a mask during appearances for months and has mocked their use. 

“Our rules on social distancing have in many places been lackadaisical at best, with loosening of restrictions long before adequate disease control had been achieved,” it states. “And in much of the country, people simply don’t wear masks, largely because our leaders have stated outright that masks are political tools rather than effective infection control measures.”

The U.S. leads the world in cases and deaths from the virus, it notes. 

“The magnitude of this failure is astonishing,” the editors write. “According to the Johns Hopkins Center for Systems Science and Engineering, the United States leads the world in Covid-19 cases and in deaths due to the disease, far exceeding the numbers in much larger countries, such as China.” 

It adds that countries like South Korea and Singapore were able to suppress the virus through robust testing and contact tracing, in contrast to the U.S.  

The journal also points to political pressure Trump has placed on health agencies ranging from the Centers for Disease Control and Prevention to the Food and Drug Administration, warning of the undermining of scientific expertise. 

“Our current leaders have undercut trust in science and in government, causing damage that will certainly outlast them,” it states.