Trump Covid-19: Live Tracker – The New York Times

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President Trump announced on Tuesday that he was planning to attend next week’s debate in Miami against former Vice President Joseph R. Biden Jr. despite his continued struggle with the coronavirus and unresolved questions about the event’s rules.

“I am looking forward to the debate on the evening of Thursday, October 15th in Miami. It will be great!” the president tweeted early Tuesday, the morning after he returned to the White House from Walter Reed National Military Medical Center.

“FEELING GREAT!” he added in a separate tweet, hours before his physician reported that he was feeling well.

Mr. Biden’s campaign did not respond to a request for comment.

But physicians who specialize in infectious diseases quickly warned that Mr. Trump’s optimism might be premature, and could reflect a false sense of security about his condition, reinforced by temporary improvements that could be reversed once he is removed from medications.

People with mild to moderate cases of the illness are likely to “remain infectious no longer than 10 days after symptom onset,” according to guidelines from the Centers for Disease Control and Prevention. But that period could be doubled in cases of more serious illness.

That means Mr. Trump could still be contagious, depending on the severity of his case and when his symptoms began, during the next debate, according to Dr. Krutika Kuppalli, an infectious-disease physician in South Carolina.

“We don’t even know what’s going to happen tomorrow, let alone in a few days,” she said.

Medical details that Mr. Trump’s doctors disclosed over the weekend — including his fluctuating oxygen levels and a decision to begin treatment with a steroid drug — suggested to many infectious-disease experts that he had a more severe case of Covid-19 than the physicians acknowledged.

He has been taking a steroid called dexamethasone — a drug known to buoy feelings of well-being, said Dr. Taison Bell, an emergency medicine physician at the University of Virginia, and patients typically need to demonstrate they can function without medication before being allowed to resume normal activities.

Should Mr. Trump’s condition continue to improve and should he be definitively cleared by physicians to participate in next week’s event, Dr. Bell added, masking and distancing will remain crucial. “They need to stick with the rules they’ve set,” he said.

If Mr. Trump is able to follow through on his promise, he faces a campaign transformed by an infection that has spread to his top aides, and stakes that have been heightened by a disruptive performance in the first debate that prompted the Commission on Presidential Debates to consider revising its procedures.

Mr. Trump had previously questioned whether he would participate if new rules, including the possibility that his microphone would be muted to discourage interruptions, were enacted. But his illness has upended those calculations, and Republican officials said that

Mental health days. Meeting-free times. Companies are adding new benefits to help workers cope

A few months into working remotely, Jamie Coakley noticed a worrisome trend at her company: 70% of employees had not taken more than two days off since the beginning of the year.

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“We were going to run into a brick wall pretty soon,” said Coakley, vice president of people at IT solutions company Electric.


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The company changed to a flexible vacation policy, but that still wasn’t enough. Employees were working longer hours, having a hard time disconnecting from work and felt perpetually behind.

So Electric announced over the summer that the entire company would close on the first Friday of every month for a mental health and wellness day.

Giving everybody the day off means the work doesn’t pile up while you’re off and it eliminates the fear of missing out on something.

With everything going on this year, mental health has become a major focus for employers, and some companies are increasing their offerings to help their workers stay healthy amid so much uncertainty.

Here are some of the ways companies are trying to help their workers:

Scheduling meeting-free times

In the office, mini-breaks occur naturally to break up the workdays and allow us to recharge a little: a colleague stopping by to chat, going to get a cup of coffee, running an errand or walking to the conference room for a meeting. But at home, we tend to stay glued to our keyboards and stuck on back-to-back Zoom calls.

To force workers to take a break, some companies have changed their meeting policies. At data platform company Talend, Friday afternoons are meeting-free to give workers more uninterrupted time to get work done ahead of the weekend.

At Electric, Thursdays before noon are designated meeting-free. “It’s everyone’s heaven time,” said Coakley. “You have no internal meetings, you wake up and actually do work.”

Increasing access to professional help

With so much going on right now, insurance company Unum increased the number of counseling sessions its workers get through its employee assistance program (EAP) to six sessions per issue, up from three.

“An employee could be dealing with a relationship issue and need support to handle that, and then later in the year could be dealing with issues with anxiety. So the six visits would reset. That is really important, people have multiple things going on,” said Laurie Mitchell, assistant vice president of global wellbeing at Unum.

Offering apps and subscriptions

Giving employees quick and convenient ways to practice self care can go a long way.

Shortly after going fully remote, people management platform Lattice started offering access to Modern Health, a platform that connects employees to professional help, including therapists, and digital programs and meditations. Lattice made the move after internal surveys reveled workers needed more support, and the company covers the fees.

Talend held a seminar with experts from Healthy Minds Innovations about how to maintain resilience during these tough times. Different teams within the company have also been incorporating their own mental

Live Covid-19 Global Updates – The New York Times

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In photos and videos released by the White House, there was hardly any sign that President Trump is sick, and painting in the broadest of strokes, his doctors offered a fairly rosy portrait of his condition.

But to some outside experts who examined that portrait closely, some things seemed off.

How much, for example, should people make of the president’s fluctuating oxygen levels? And why did his doctors decide to begin treatment with a steroid drug?

Too some infectious disease experts, there were signs that Mr. Trump may be suffering a more severe case of Covid-19, the disease caused by the coronavirus, than his physicians have acknowledged.

“This is no longer aspirationally positive,” Dr. Esther Choo, a professor of emergency medicine at Oregon Health & Science University in Portland, said of the doctors’ statements. “And it’s much more than just an ‘abundance of caution’ kind of thing.”

Based his doctors’ account, Mr. Trump’s symptoms appear to have rapidly progressed since he announced early Friday that he had tested positive for the coronavirus.

Mr. Trump had a “high fever” on Friday, and there were two occasions when his blood oxygen levels dropped, his doctors said, including to a level that can indicate that a patient’s lungs are compromised. The symptom is seen in many patients with severe Covid-19.

The president’s medical team also said that he had been prescribed dexamethasone. The drug is a steroid used to head off an immune system overreaction that kills many Covid-19 patients. And it is generally reserved for those with severe illness.

“The dexamethasone is the most mystifying of the drugs we’re seeing him being given at this point,” said Dr. Thomas McGinn, physician in chief at Northwell Health, the largest health care provider in New York State.

The drug, he said, is normally not used unless the patient’s condition seems to be deteriorating.

“Suddenly, they’re throwing the kitchen sink at him,” Dr. McGinn said. “It raises the question: Is he sicker than we’re hearing, or are they being overly aggressive because he is the president, in a way that could be potentially harmful?”

Of course, given the patient, there may be another explanation.

Some experts raised an additional possibility: that the president is directing his own care, and demanding intense treatment despite risks he may not fully understand. The pattern even has a name: V.I.P. syndrome.

Credit…Alex Wroblewski/Reuters

As President Trump and some of his associates test positive for the coronavirus, the number of new cases reported each day across the United States has been slowly rising.

The country is at a key moment in the pandemic, and spread of the virus could worsen significantly through the autumn, experts fear, as colder weather forces people indoors. Every day, some 43,000 new cases

Charting a Coronavirus Infection – The New York Times

After months of downplaying the threat of the Covid-19 pandemic, President Trump announced early Friday morning that he and First Lady Melania Trump had tested positive for the coronavirus. He is now hospitalized at the Walter Reed National Military Medical Center, with what people close to him said on Friday were mild symptoms, including a fever, cough and congestion.

It’s too soon to tell whether his illness will follow a typical course, or how severe his symptoms may become. And with millions of people sickened worldwide, no single timeline can encompass the range of Covid cases. But months of data have helped scientists home in on the general portrait of a symptomatic coronavirus case.

Exposure and incubation

The time between initial exposure to the virus and the appearance of symptoms is known as the incubation period. This period is typically four to five days, although it can last up to 14 days, or perhaps even longer in rare cases.

It remains unclear who infected Mr. Trump, although there are many potential candidates, several of whom gathered with the president during events last weekend and have traveled with him to crowded campaign rallies.

Symptoms and recovery

Most people who come down with Covid recover within a couple weeks and do not require hospitalization. Mr. Trump has reportedly experienced only mild symptoms so far.

Severe cases, however, may take far longer to resolve. And a growing cohort of coronavirus survivors, called long-haulers, has reported symptoms and side effects — including fatigue, impaired memory and heart problems — that can linger for months.

People who develop severe cases of Covid tend to be hospitalized within two weeks or so of the emergence of symptoms. But many of the factors that catapult certain people toward severe forms of the disease remain a scientific mystery. Scientists know that people who are male, older and obese — all descriptors of President Trump — are at higher risk for more serious effects of Covid.

Viral load

After an initial exposure, the number of virus particles in a person’s body, or viral load, takes time to build up as the pathogen infiltrates cells and copies itself repeatedly. Mathematical models indicate that the viral load tends to peak before symptoms appear, if they appear at all, and starts to decline rather quickly in the days following the first signs of illness.

Experts have said that people are more likely to be contagious when their viral loads are high. If so, the window of peak infectiousness might be only a few days long, beginning a day or two before symptoms appear, and closing within a week thereafter.

This also means that people can be highly contagious during the so-called presymptomatic stage, in the days before they develop symptoms. Separately, asymptomatic carriers of the coronavirus have also been repeatedly pinpointed as the source of transmission events, although how the virus behaves in the bodies of such people is less understood.

If Mr. Trump’s symptoms appeared on Wednesday or Thursday,

Several New York zip codes are reporting infection rates five times higher than statewide rate

New York has reported several Covid-19 clusters that have created “hotspot” zip codes, the governor said, with a positivity rate about five times more than statewide.

a person taking a selfie in a car: Medical technicians work at a drive-thru coronavirus disease (COVID-19) testing facility at the Regeneron Pharmaceuticals company's Westchester campus in Tarrytown, New York, U.S. September 17, 2020. Picture taken September 17, 2020. Brendan McDermid/Reuters

© Brendan McDermid/Reuters
Medical technicians work at a drive-thru coronavirus disease (COVID-19) testing facility at the Regeneron Pharmaceuticals company’s Westchester campus in Tarrytown, New York, U.S. September 17, 2020. Picture taken September 17, 2020. Brendan McDermid/Reuters

The new clusters are a “stark reminder” that the state is still not out of the woods when it comes to the pandemic, Gov. Andrew Cuomo said.

“We’ve had clusters in the past stemming from factories, churches, bars and other locations,” Cuomo said . “We’re quite familiar with this, and when there’s a cluster, we are very aggressive on it and we’re oversampling in the clusters.”

Cuomo’s announcement comes as states across the US have begun reporting alarming Covid-19 trends in recent days — and after experts warned of a coming surge in cases.

Wisconsin reported its highest number of Covid-19 hospitalizations on record, with patients nearly doubling in the state since September 18, according to hospital officials. The governor of Illinois is tightening restrictions in one part of the state after an increase in positivity rates. And in Kentucky, Gov. Andy Beshear urged the state needs to stop a recent “escalation” of cases after reporting more than 1,000 new infections for the second day in a row.

At least 27 states have reported more new cases since the previous week and only nine are reporting a decline, according to data from Johns Hopkins University. Nationwide, more than 7.2 million people have been infected and more than 206,000 Americans have died.

When a vaccine could be available to US population

On Wednesday, Moderna CEO Stéphane Bancel said if their Covid-19 vaccine is proven safe and effective, it could be available to the general population by late March or early April.

Moderna began their Phase 3 clinical trial for Covid-19 in the US in July. It’s one of four companies that have begun Phase 3 Covid-19 vaccine trials in the US — the others include Johnson & Johnson, Pfizer/BioNTech and AstraZeneca. The AstraZeneca trial was paused after an unexplained illness in a volunteer, and US health authorities are still considering crucial questions that remain around the injections of the experimental vaccine.

“I think a late Q1, early Q2 approval is a reasonable timeline, based on what we know from our vaccine,” Bancel said at a conference hosted by the Financial Times.

But there are several steps that will have to come before that.

If the safety and efficacy data checks out, Bancel says he expects Moderna will be able to file a Biologics License Application (BLA) with the US Food and Drug Administration by late January or early February. That application asks the FDA to consider fully licensing a drug, while an emergency use authorization (EUA) expedites a drug candidate for use on an emergency basis.

Moderna could file for an EUA as early as November 25 for

Laughter May Be Effective Medicine for These Trying Times

Dr. Peter Viccellio, a professor of emergency medicine at Stony Brook University Hospital on Long Island, has seen many Covid-19 patients during his hours in the emergency room. A touch of playfulness and kindly humor, he said, has helped to ease an enormously painful situation for both his patients and members of the overburdened hospital staff.

“Genuine levity can make patients believe that they are not going to meet their doom today” Dr. Viccellio said, but he added that it needs to flow naturally. “If you are empathetic with the person, your humor tends to fit them, it’s not forced. If you are not emotionally connected to them and force a joke it can go very wrong.”

A case in point: “A colleague of mine once said casually to a patient whose medical history he did not know, ‘Don’t worry about it, at least it’s not cancer,’” Dr. Viccellio recalled. “The patient replied, ‘Actually, Doc, it is.’”

Other kinds of joking that are potentially destructive, he said, are the in-group humor that mocks patients or other members of the hospital staff, and the gallows humor that focuses on the darker sides of medicine. And one needs to be careful not to appear to be making light of somebody else’s pain.

Despite these potential pitfalls, some hospitals have initiated formal humor programs, making funny books and videos available and inviting clowns in to interact with their younger patients. Some caregivers are also innovating ways to bring humor into their own practice.

Mary Laskin, a nurse case-manager at Kaiser Permanente in San Diego, has been working with her chronic pain patients online, teaching them laughter exercises alongside practices designed to develop other positive mental states like gratitude and forgiveness.

“This pandemic is like a tiger creeping toward us, a huge slow-motion stressor that makes the experience of pain worse. Humor helps my patients relax and release their grip on pain,” she said.

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Covid-19 News: Live Updates – The New York Times

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More than 60 percent of households with children in the United States reported serious financial problems — including struggles to afford medical care, depletion of household savings and difficulty paying credit card and other debts — during the coronavirus pandemic, according to a new poll.

Black and Latino households with children bear the brunt of the hardships. Of the Latino households who responded, 86 percent reported these difficulties; in Black households, 66 percent reported them. In white households, the number hovers around 50 percent.

The immense differences were surprising, as they came after federal and state governments invested heavily in programs for communities disproportionately affected by the pandemic, said Robert Blendon, a director of the study behind the report and a professor at the Harvard School of Public Health.

“So much money was spent to put a cushion under households,” Dr. Blendon said, adding that because of this, “the expenditures should have lowered for everybody.” But, he said, “the numbers of people in trouble, that is the shock.”

The poll, conducted by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health, surveyed more than 3,400 adults, 1,000 of whom were living with children under the age of 18, between July 1 and Aug. 3.

Now that some government measures to support households financially during the pandemic are waning, experts are concerned that the financial devastation could be worse than what the survey shows, said Julie Morita, the executive vice president of the Robert Wood Johnson Foundation. Now, Dr. Morita said, “households are probably suffering just as much if not more,” leaving Black and Latino communities especially “unprotected.”

The survey highlights other challenges faced by households with children during the pandemic. Over a third of them reported “serious problems” keeping children’s education going. Six in 10 said that an adult in the home lost their job, was furloughed or had wages or hours cut. And in nine out of 10 households where someone was diagnosed with Covid-19, they faced “serious financial problems” in addition to difficulty caring for their children.

These responses, Dr. Blendon said, show that a high number of households — particularly Black and Latino ones — will face substantial long-term financial effects from the pandemic.

“It’s a very large number of people who can’t pay the basics,” Dr. Blendon said. “You have unbelievably vulnerable people over the next six months.”




Trump and Biden on a Coronavirus Vaccine

President Trump claimed that a vaccine for the coronavirus would be available to the public “soon,” while Joseph R. Biden Jr. expressed concern over the safety of any rapidly approved vaccine.