COVID19 🦠 Newsbites
Thanksgiving could be the "mother of all super spreader events," health expert warns
With millions of Americans ignoring guidelines against holiday travel, the United States could see an explosion of Covid-19 infections in the weeks following Thanksgiving, CNN medical analyst Dr. Jonathan Reiner said Tuesday.

“One of the ways we think the Midwest was seeded with virus during the summer was with the Sturgis, South Dakota, motorcycle rally where people were infected and then dispersed out through the Midwest."

“Now imagine that on a massive scale -- people leaving from every airport in the United States, and carrying virus with them,” he added.

Why tests don't guarantee safe travel: Reiner cautioned that testing doesn’t always reveal whether someone is infected at a given point in time. For example, if a person is infected with Covid-19 and has a test a day or two later, there might not be enough viral RNA to detect the virus, he said.

So, testing as a litmus test for traveling won’t work, unless it reveals a positive result and the person stays home as a result, Reiner said.

Putin still hasn't taken Russia's vaccine, months after his daughter did
The Kremlin said Tuesday that Putin cannot get a vaccine that has not yet finished the final stage of trials, even though the jab has already been given to some Russian frontline health care workers, teachers and several top level officials outside the clinical trials.

"The President cannot use an uncertified vaccine," Kremlin spokesperson Dmitry Peskov said during a call with reporters. Peskov did not explain the difference between the vaccine being "certified" and "approved," but said: "Mass vaccination has not started yet. And, of course, the head of state cannot take part in vaccination as a volunteer. It's impossible."

Peskov said the trials should be completed soon and that Putin would inform people on his decision on whether to take the vaccine "if he considers it necessary."

... "I know that it works quite effectively, it forms a stable immunity," Putin said at the time, adding that one of his daughters had already taken the jab -- a rare move from the President, who is notoriously secretive about his family. He said she had a slightly higher temperature after each dose, but added "now she feels well."

Putin, at 68 years old, is in a high risk group. Vaccine trials for the first group of volunteers aged 60 and over began on October 28, according to Russian state new agency TASS.

Fred Sasakamoose, Indigenous NHL trailblazer, dies at 86 after battle with Covid-19
"This Covid virus just did so much damage into his lungs, he just couldn't keep responding, his body just couldn't keep up," Sasakamoose's Neil said in the video.

Sasakamoose played 11 games for the Chicago Black Hawks during the 1953-54 season, according to NHL's website. He is widely believed to be the first Indigenous player in the league's history, though the NHL tells CNN this is impossible to determine.

An outpouring of respect has come from across the NHL following the news of Sasakamoose's death.

"That lasting impact of his legacy will forever be celebrated and continue to bring people together for generations to come," the Black Chicago Hawks organization said on its website. "To the entire Sasakamoose family that includes his wife, Loretta, four children and over 100 grandchildren and great-grandchildren, the Chicago Blackhawks organization extends our deepest condolences."

NHL Commissioner Gary Bettman said in a statement that Sasakamoose was the first Cree player to appear in an NHL game at age 19. Sasakamoose then dedicated his life to "serving the First Nations community -- using hockey and other sports to provide opportunities for Indigenous youth," Bettman said.

... The Blackhawks honored Sasakamoose in 2002 and the Edmonton Oilers did the same in 2014 as part of their Celebration of First Nations Hockey, the NHL said.

Sasakamoose was inducted into the Saskatchewan Sports Hall of Fame in 2007, according to the NHL.

We need a nationwide Covid alert-level system to save lives and restore jobs, former CDC director says
The only way to get cases back down is to decrease contacts, including by selectively shutting businesses. But there's little clarity or consistency about what the risk is in different areas, or what criteria are used to decide what to close, leading to frustration and anger.

There's a way to reduce this confusion, and it's one people are already familiar with. Alert-level systems -- similar to those used to warn about bad weather, heavy traffic, poor air quality and other community-wide risks -- give people an at-a-glance indication of current status so they can adapt their behavior.

A color-coded system with nationwide agreed-on evidence triggering each level change empowers people to know the equivalent of how hard it's raining coronavirus in their community. This empowers people to protect themselves, their families and others. The system also increases accountability by making clear how well the community is reducing risk. Most importantly, alert-level systems get an entire community -- government, businesses and individuals -- on the same page, with everyone understanding what the current risk level is, and guidance on what they need to do to reduce it in order to allow more personal and commercial activity.

Some states have already adopted Covid alert-level systems, with varying degrees of success. This is a good step, but leaves a patchwork in which a specific level means different things in different places. People traveling or who see a news story about risk levels in another location can have only a vague idea what it actually means.

The incoming Biden Administration should establish an alert-level system for Covid that each state and county would use, with full transparency about the criteria behind the alert levels. "Red" should mean "red" wherever you are. It is possible to distill complex data -- including rates of reported new cases, testing and test positivity, and hospitalization -- to a single overall risk level for a state or community, with uniform criteria. Different parts of states are likely to be at different risk levels.

Although we should measure the level of risk -- how hard it's raining coronavirus -- in a standardized way, implications of this risk are best decided at state and local levels. Some core decisions as to what can stay open -- and what should not -- are based soundly on evidence and should be the same in all communities. At "red," for example, restaurants and bars need to stop indoor service. But some choices allow tradeoffs, depending on the values of different communities. One community may decide to close churches for in-person services at the orange level, and another might leave them open but with reduced capacity -- masks required and singing deferred.

And because evidence changes, thresholds and decisions on what to close and when may also change. We must communicate this clearly and transparently to prevent the type of confusion that occurred over recommendations for mask wearing, which evolved over time. People are more likely to adhere to recommendations if they understand the basis for establishing them, what they need to do and why, and, most importantly, what needs to happen for restrictions to end.

Let's focus on what people can do rather than what they can't. Ultimately, people will make their own determination of risk. It's crucial that communication is clear so that people are more likely to voluntarily limit social activities such as small gatherings and parties -- restrictions which are nearly impossible to monitor and enforce. An easily understood risk-level system can provide guidance to help people make what can be very tough decisions. Implementing such a system won't be easy, and will require political leadership and technical excellence.

Covid levels will come down before there's widespread vaccination. At that point, to avoid a fourth wave, we'll need much more effective public health programs, including programs to get infectious people tested and isolated quickly and a more nuanced, more transparent approach to restrictions and closures that protects both our economy and our health -- through a risk-alert level system.

Virus Surge, Once in the Nation’s Middle, Gains Steam All Around
With cases and deaths rising fast, scientists say they worry about the virus’s course in the United States as Thanksgiving celebrations and cold weather arrive.

What started as a Midwestern surge has grown into coast-to-coast disaster.

Over the last two months, rural counties and midsize cities in the Great Plains and Upper Midwest have been the main drivers of the dizzying growth in coronavirus cases in the United States.

But the virus appears to have entered a new phase in recent days: The reason the country is continuing to break case records has less to do with North Dakota and Wisconsin than it does with swift resurgences of the virus in cities like Baltimore, Los Angeles, Miami and Phoenix and with first-time spikes in smaller cities away from the nation’s middle, like Cumberland, Md.

Covid in the U.S.: Latest Map and Case Count
More than 1.2 million cases in the U.S. have been identified in the past week alone, and the country is on pace to reach 13 million known cases within days. The seven-day average of daily deaths is over 1,600. Scientists are expressing deep foreboding about the arrival of Thanksgiving and cold weather during such a surge.

Covid Combat Fatigue: Doctors and Nurses Are Running on Empty
Doctors and nurses on the front lines are running on empty. “This is my job, what I wanted to do for a living,” said a critical care physician in Houston who brought the virus home with him, sickening his whole family. “And it could have killed my children, could have killed my wife — all this, because of me.”

Surveys from around the globe have recorded rising rates of depression, trauma and burnout among a group of professionals already known for high rates of suicide. And while some have sought therapy or medications to cope, others fear that engaging in these support systems could blemish their records and dissuade future employers from hiring them.

“We’re sacrificing so much as health care providers — our health, our family’s health,” said Dr. Cleavon Gilman, an emergency medicine physician in Yuma, Ariz. “You would think that the country would have learned its lesson” after the spring, he said. “But I feel like the 20,000 people that died in New York died for nothing.”

Many have reached the bottom of their reservoir, with little left to give, especially without sufficient tools to defend themselves against a disease that has killed more than 1,000 of them.

Another Trump campaign lawyer tests positive, along with other officials.
Boris Epshteyn, a member of the Trump campaign legal team, tested positive for the coronavirus on Tuesday, he said in a tweet.

“I have tested positive for COVID-19. I am experiencing mild symptoms, and am following all appropriate protocols, including quarantining and contact tracing,” he wrote.

Mr. Epshteyn was present at a news conference at Republican National Committee headquarters last week, along with Andrew Giuliani, a White House aide who announced the next day that he had tested positive for the virus.

Mr. Epshteyn has spent lots of time with Rudolph W. Giuliani, Andrew’s father and President Trump’s lead lawyer on efforts to overturn the results of the 2020 elections.

Mr. Giuliani attended a gathering of Republican lawmakers in Gettysburg, Pa., on Wednesday afternoon to talk about allegations of voting irregularities. President Trump was scheduled to join him, but his trip was canceled just before they were to depart by car, after Mr. Epshteyn’s tweet.

In Gettysburg, more than 100 people crowded into the halls leading to the hotel conference room before the hearing started. Once seated, many sat shoulder-to-shoulder without masks. Despite a bottle of hand sanitizer and a tiny handful of masks at a table a few steps from the entrance to the room, there were no other coronavirus protection measures visible for the large indoor gathering.

Mr. Giuliani walked in shortly after 12:30 p.m. He did not wear a mask when he was speaking, but put one on once he had finished. Very few of the state legislators hosting the hearing wore masks, and many sat closer than six feet from one another.

Another federal official, John Barsa, of the U.S. Agency for International Development, tested positive for the virus, his office said late Wednesday. Mr. Barsa, who manages the $20 billion agency, had been having in-person meetings at its headquarters this week without a mask, two people familiar with the matter said. He joined USAID as acting administrator in April at the Trump administration’s behest. This month, the night his appointment was set to expire, the administration terminated the agency’s Senate- confirmed deputy administrator, Bonnie Glick, allowing Mr. Barsa to become acting deputy administrator and remain the top-ranking official there. During his tenure the agency has seen personnel chaos, infighting and delays in distributing coronavirus assistance worldwide.

Also on Wednesday, the office of Gov. Mark Gordon in Cheyenne, Wyo., announced he had tested positive for Covid-19. The Wyoming Tribune Eagle reported that Mr. Gordon, a Republican, was experiencing minor symptoms and planned to quarantine and work remotely.

At least 45 people closely connected to the White House — including the president and first lady, aides, advisers and others — have tested positive for the virus since the start of the pandemic.