Covid-19 Live Updates: Flu Season Could Worsen Virus Testing Delays


Flu-season testing delays could make it easier for the coronavirus to spread undetected.

Come fall, the rise of influenza and other seasonal respiratory infections could exacerbate already staggering delays in coronavirus testing, making it easier for the virus to spread unnoticed, experts said.

In typical years, doctors often don’t test for flu, simply assuming that patients with coughs, fevers and fatigue during the winter months are probably carrying the highly infectious virus. But this year, with the coronavirus bringing similar symptoms, doctors will need to test for both viruses to diagnose their patients, further straining supply shortages.

Testing for individual viruses poses many challenges for doctors and laboratory workers already fighting their way through supply shortages. Several of these tests use similar machines and chemicals, and require handling and processing by trained personnel.

Some manufacturers have begun making tests that can screen for several pathogens at once. But these combo tests are expensive and will likely make up only a small fraction of the market.

“The flu season is a bit of a ticking time bomb,” said Amanda Harrington, the medical director of microbiology at Loyola University Medical Center. “We are all waiting and trying to prepare as best we can.”

Flu viruses and coronaviruses differ in many ways, including how they spread, how long they linger in the body and the groups they affect most severely. Food and Drug Administration-approved antivirals and vaccines exist for the flu, but no such treatments exist for the coronavirus, which has killed at least 812,000 people worldwide in less than a year, according to a New York Times database.

Being infected with one virus doesn’t preclude contracting the other. And researchers also don’t yet know how risky it is for a person to harbor both viruses at the same time.

Those differences make it essential to tease the two pathogens apart, as well as to rule out other common winter infections like respiratory syncytial virus, or R.S.V., which hits the very young and very old especially hard.

But many flu and R.S.V. tests vanished from the market this spring as the companies that make them rapidly pivoted to address the coronavirus.

Two colleges where classes have started said they had identified new cases among students. Officials at the University of Alabama said that 531 cases had been identified among students, faculty and staff on its Tuscaloosa campus since classes resumed Wednesday. The university, which is holding in-person classes, said that other campuses in its system had reported a total of 35 cases over the same period. The mayor of Tuscaloosa ordered the city’s bars to close for two weeks to help tamp down the outbreak.

The University of Southern California, which is holding online classes but giving students limited access to campus, said it had identified 43 new cases in the past week, all of them related to “off-campus living environments.” The university, where classes began Aug. 17, called it “an alarming increase” and said that more than 100 students were under a two-week quarantine because of exposure to the virus. It warned students that “every surface, every interaction where you share close contact or remove your face covering, can pose a risk to yourself and your friends.”

In a matter of days, nearly all colleges and universities in the United States will be back in session — whether it’s online, in person, or some combination. Davidson College and The Chronicle of Higher Education are tracking the reopening plans of nearly 3,000 institutions:

  • 6 percent will be online-only.

  • 27 percent will be primarily online.

  • 15 percent will be a hybrid of online and in-person.

  • 20 percent will be primarily in-person.

  • 2.5 percent will be solely in-person.

  • 6 percent are doing something else entirely.

  • 24 percent of schools have still not yet finalized their plans.

In other education news:

  • To help improve poor ventilation in New York City’s aging public school buildings, the mayor said Tuesday that inspectors from the city’s agency overseeing school construction will assess air filtration systems in every classroom in every school between now and Sept. 1; classrooms without adequate ventilation will not open. The city will also install about 10,000 portable air filters, which have been recommended by public health experts, in nurses offices, isolation rooms and other high-risk areas. The city’s powerful teachers’ union has demanded that the city update ventilation systems before the scheduled start of school on Sept. 10, but many principals and teachers say they do not believe buildings will be ready by then, and have pushed the mayor to delay the start of in-person classes by a few weeks.

  • A Florida judge ruled on Monday that the state’s requirement that public schools open their classrooms for in-person instruction violates the state’s constitution because it “arbitrarily disregards safety” and denies local school boards the ability to decide when students can safely return. The state later filed an appeal to the ruling, prompting an immediate stay.

Two more cases of reinfection were reported, this time in Europe.

Two more cases of reinfection with the coronavirus were reported in Europe on Tuesday, a day after a 33-year-old man in Hong Kong was confirmed to have been infected a second time.

In all three cases, researchers compared genetic material from both rounds of infection and confirmed that the patients were not just carrying remnants of dead virus left over from the first illness.

The new cases were announced by European researchers. The data have not been published in any form as yet.

Experts told The Times on Monday that reinfections with the virus are not surprising, though not believed to be common. As with most other respiratory viruses, including common-cold coronaviruses and influenza, one bout with the new coronavirus may provoke an immune response that may not prevent a second infection — but nonetheless is likely to mute symptoms the second time around.

One of the new reinfection cases was an older person in the Netherlands with a weakened immune system, researchers said. The other patient, in Belgium, was a woman who had only mild symptoms in March and became infected again in June.

The man in Hong Kong, too, had only mild symptoms and did not develop detectable antibodies after the first infection. Even so, he had no symptoms at all the second time and his case was found only by routine screening at an airport. His case suggests that even people who did not produce a strong antibody response to an initial case may be protected from becoming seriously ill if exposed to the virus again, experts have said.

Some news reports have speculated that the cases raise questions about the effectiveness of vaccines for preventing coronavirus infection. But experts have said the opposite: Vaccines can be designed to elicit immunity that’s stronger and longer lasting than that resulting from natural infection.

“In order to provide herd immunity, a potent vaccine is needed to induce immunity that prevents both reinfection and disease,” Akiko Iwasaki, an immunologist at Yale University, told The Times on Monday.

At a recent news conference, President Trump and two of his top health officials announced the emergency authorization of the use of blood plasma for treatment of hospitalized Covid-19 patients, citing a statistic that scientists and experts later said is misleading.

Mr. Trump, Alex M. Azar II, the health and human services secretary, and Dr. Stephen M. Hahn, the commissioner of the Food and Drug Administration said on Sunday that the treatment reduced Covid-19 deaths by 35 percent. The data point, a subset of a Mayo Clinic study, was not mentioned in the official letter authorizing the treatment, the 17-page memo written by F.D.A. scientists about the treatment or in the Mayo Clinic’s analysis.

Dr. Hahn’s claim that 35 out of 100 sick Covid-19 patients would have been saved by receiving plasma appeared to be an overstatement, statisticians and scientists said.

“For the first time ever, I feel like official people in communications and people at the F.D.A. grossly misrepresented data about a therapy,” said Dr. Walid Gellad, who leads the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh.

Some fear that the process of approving treatments and vaccines for the coronavirus has been politicized, and as data emerges from vaccine clinical trials, the safety of potentially millions of people will rely on the scientific judgment of the F.D.A.

“That’s a problem if they’re starting to exaggerate data,” Dr. Gellad said.

Plasma has been touted by Mr. Trump as a promising cure for the coronavirus, with his administration funneling $48 million into a program with the Mayo Clinic to test infusions. Although there have been some positive signs that it can reduce deaths in Covid-19 patients, no randomized trials have shown that it works.

Dr. Eric Topol, a professor of molecular medicine at Scripps Research in La Jolla, Calif., said that convalescent plasma has not yet shown the benefit that Dr. Hahn described — and that he should issue a correction.

On Monday night, after The New York Times published an article questioning the statistic, Dr. Hahn said on Twitter that the “criticism is entirely justified,” and clarified that his earlier statements imprecisely suggested an absolute reduction in risk, instead of the relative risk of a certain group of patients compared with another.

President Trump and his political allies mounted a fierce and misleading defense of his political record on the first night of the Republican convention on Monday, while unleashing a barrage of attacks on Joseph R. Biden Jr. and the Democratic Party that were unrelenting in their bleakness.

Hours after Republican delegates formally nominated Mr. Trump for a second term, the president and his party made plain that they intended to engage in sweeping revisionism about Mr. Trump’s management of the coronavirus pandemic, his record on race relations and much else.

A team of New York Times reporters followed the developments and fact-checked the speakers, providing context and explanation.

At times, the speakers and prerecorded videos appeared to be describing an alternate reality: one in which the nation was not nearing 180,000 deaths from the coronavirus; in which Mr. Trump had not consistently ignored serious warnings about the disease; and in which someone other than Mr. Trump had presided over an economy that began crumbling in the spring.

Donald Trump Jr., the president’s son, praised his father’s management of the pandemic in one of several segments asserting an unsupported narrative that the president had been a sturdy leader in a crisis even as polls show Americans believe he has handled the pandemic poorly.

“As the virus began to spread, the president acted quickly and ensured ventilators got to hospitals that needed them most,” the president’s son said, making no mention of the millions of Americans sickened and killed or the complaints from governors that they were not receiving the necessary equipment. “There is more work to do, but there is light at the end of the tunnel.”

Another defense of Mr. Trump’s management of the pandemic took the form of a video that criticized the news media, Democrats and the World Health Organization, and presented a greatly distorted version of Mr. Trump’s record, casting him as a decisive leader against Democrats who had minimized the threat of the disease. The video featured three clips of Democratic governors, including Gov. Andrew M. Cuomo of New York, praising Mr. Trump in the spring, when state executives were pleading with the federal government for help and taking exceptional pains to stay on the president’s good side.

Mr. Trump’s first appearance in the evening program came in a brief segment that showed him at the White House interacting with frontline workers, who related their experiences in the health crisis. Mr. Trump largely deferred to the other speakers and prompted them to make comments — “Please, go ahead,” he said repeatedly — though he interjected his own commentary about the drug hydroxychloroquine, which the president had promoted aggressively as a remedy for the coronavirus despite no consensus among doctors that it was effective.

How Spain has become a new virus hot spot.

Prime Minister Pedro Sánchez of Spain announced on Tuesday that at least 2,000 troops could be deployed to track local coronavirus outbreaks, as the country faces one of Europe’s largest surges in infections in recent days.

In today’s edition of the Morning newsletter, David Leonhardt examined how Spain has, like the United States, become one of the few rich countries suffering a major outbreak. He writes:

Adjusted for population, Spain’s outbreak has even surpassed the U.S. outbreak over the last few days. How has it happened? Health experts are still trying to figure that out. But some of the early answers may sound familiar to Americans.

Lack of a clear national message. Spain’s prime minister — Pedro Sánchez, of the Socialist Workers’ Party — has not promoted medical disinformation, as President Trump has. Yet Sánchez has recently handed back control of virus policy to regional governments, instead of continuing to provide clear leadership about how people should behave.

Premature reopening. Spanish officials, like their American counterparts, made the mistake of thinking they could help the economy by prioritizing it over public health. Bars and nightclubs reopened. British tourists — a major source of revenue — were allowed to travel to Spain without restriction.

In truth, the only way to help the economy is to control the virus.

Not enough testing and contact tracing. The shortages have made it “difficult for health authorities to identify and isolate potential virus carriers,” according to The Wall Street Journal.

As I’ve written before, there is a set of consistent lessons from around the world about how to beat back the virus: Mass testing. Rapid quarantines, contact tracing and, when necessary, lockdowns. Limited social gatherings, especially indoors. Widespread mask wearing.

South Korea said it was again closing schools and switching back to online classes for students in the Seoul metropolitan area, as the country reported 280 new cases on Tuesday, the 12th-straight day of triple-digit daily increases in virus infections.

A rapidly spreading outbreak early this year had forced South Korea to delay the reopening of schools, originally scheduled for February. After a successful battle against the epidemic, students began returning to classrooms in May. But​ on Tuesday, Education Minister Yoo Eun-hae said another fast-spreading outbreak from a church in Seoul made it inevitable that schools would need to be shut down again in the greater Seoul area, home to half the country’s 51 million people.

Ms​. Yoo said that all students at kindergartens, elementary, middle and high schools would begin remote learning starting Wednesday until Sept. 11, except for high school seniors who will continue to go to school ​and prepare for the year-end college-entrance exams​.

To South Korean students and parents, the ​national college-entrance exams are of paramount importance. Students endure years of cramming for the written tests​, which determine which universities they can enter. Diplomas from elite universities often decide the students’ career prospects.​ On the day of the exam, the Air Force cancel​s all of its flights for fear ​their noise might disrupt students.

As the epidemic surged again, concern has​ grown about whether the exams can proceed, or whether they should be conducted online. Ms. Yoo said on Tuesday that online exams ​will be all but impossible because of potential problems like cheating.

“The priority is to quickly stem the spread of transmissions and stabilize the situation, if only to hold the Dec. 3 national college entrance exam as planned without disruption,” she said.

The new outbreak started at Sarang Jeil Church in Seoul, where a worshiper tested positive on Aug. 12. So far, 915 infections have been found among church members and their contacts. Nationwide, 3,285 cases have been reported since Aug. 12, 193 of them students or teachers in the Seoul metropolitan area.

In other news from around the world:

  • As Hong Kong on Tuesday announced plans to begin easing its social-distancing rules, the city’s leader, Carrie Lam, said that criticism by health experts of a new, Beijing-backed coronavirus testing program was a “politically calculated” effort to smear the Chinese government. Some of those experts say the plan is a waste of resources, while activists fear it could lead to the harvesting of DNA samples for China’s surveillance apparatus, accusations that local officials deny.

  • The Chinese government has imposed a sweeping lockdown across the Xinjiang region in western China, penning in millions of people as part of what officials describe as an effort to fight a resurgence of the coronavirus. But many residents accuse the government of acting too harshly, reviving concerns about human rights abuses in Xinjiang. The Chinese government has spent years perfecting a system of mass surveillance and control in the region and has long imposed draconian social rules on the region’s largely Muslim ethnic minority groups, who make up about half the population.

After flouting restrictions, ‘GolfGate’ dinner in Ireland has prompted a political backlash.

Close to the rugged Atlantic coast, the Station House Hotel in the Irish town of Clifden offers well-heeled guests a stay that will “live in your memories forever.” But right now, that slogan seems more a threat than a promise for some of Ireland’s political leaders.

Two have already resigned after an outcry over their attendance at a dinner hosted at the hotel last week and organized by the Golf Society of the country’s legislature, the Oireachtas. The gathering took place a day after the government tightened virus restrictions to combat a spike in infections, and has sparked a backlash that has also threatened the jobs of two other public figures.

The fallout from the private gala dinner, now known as “GolfGate,” reverberated well beyond Ireland on Monday as the future of the country’s representative on the European Commission and the European Union’s trade commissioner, Phil Hogan, hung in the balance following his attendance.

The dinner, first reported last week by The Irish Examiner, occurred the day after the Irish government imposed restrictions limiting most gatherings to six people, though there were some exemptions, and hotels were still trying to clarify how to apply the new rules.

But the dinner may have broken a more longstanding pandemic rule in Ireland that limited the size of gatherings to 50 people, though the Golf Society’s defenders have argued weakly that the room was divided by a partition.

The furor prompted the resignation of the agriculture minister, and the deputy chair of the upper house of Ireland’s parliament also quit.

A Supreme Court judge and former attorney general, Seamus Woulfe, also attended the dinner and is under pressure to resign.

But attention has focused on the future of Mr. Hogan, the trade commissioner. The prime minister, Micheal Martin, and the deputy prime minister, Leo Varadkar, have both criticized him, though so far he has resisted calls to quit.

Uganda has recalled its ambassador to Denmark and her deputy after allegations that they were plotting to steal funds allocated to deal with the coronavirus pandemic.

The ambassador, Nimisha Madhvani, and her deputy, Elly Kamahungye, were recorded devising ways to share the money along with other embassy staff members. During the conversation, the group is heard talking about paying themselves “per diems” and discussing how much they should receive in total.

“Instead of calling it Covid, we will do it as an allowance,” Mr. Kamahungye is heard saying.

Uganda’s ministry of foreign affairs called the allegations “grave” and said it would carry out a “thorough investigation” into the matter.

“Any deviation by any officer will be met with appropriate sanctions,” Patrick S. Mugoya, the ministry’s permanent secretary, said in a statement posted on Twitter.

The news from Uganda came days after demonstrations in Kenya by protesters who accused government officials of the theft of hundreds of millions of dollars aimed at fighting the pandemic.

Hundreds of Kenyan doctors in public hospitals have also gone on strike over what they say is shoddy protective gear, delayed salaries and a lack of medical insurance. Thousands more are expected to join them if authorities do not improve their working conditions.

On Monday, a court in the Somali capital Mogadishu also sentenced four officials, some for as many as 18 years, for diverting thousands of dollars of Covid-19 funds.

Many people feel trapped by the coronavirus pandemic. In Japan, some are distracting themselves by screaming inside closed caskets.

During 15-minute shows performed in Tokyo over the weekend, thrill seekers shrieked and trembled in glass caskets as they listened to ghost stories and the roar of chain saws. With nowhere to run, they were menaced by zombies, poked with rubber hands and splashed with water, all for less than $10 in admission.

The event was organized by Kowagarasetai, a horror event production company whose name means “Scare Squad.” But some customers said they actually left feeling more relaxed.

The coffins are a better place to scream than at Japanese theme parks, which have encouraged visitors to keep their mouths shut on roller coasters to prevent virus transmission through droplets. (“Please scream inside your heart,” the Fuji-Q Highland amusement park suggested in June in a video demonstration by two of its executives, who inspired social media users to try the “serious face challenge” on their own roller coaster rides.)

Kenta Iwana, founder of Kowagarasetai, said he wanted to give people a way to express themselves without holding back.

“There are no places to scream,” Mr. Iwana, 25, told Agence France-Presse this summer as he introduced another one of his socially distanced productions, a drive-in haunted house. In addition to providing people with an emotional outlet, he said, his company creates job opportunities for performers who normally work at theme parks.

Japan, which has been fighting a resurgence of the virus in recent weeks, reported 740 new cases nationwide on Sunday, including 212 in Tokyo. The country has had a total of more than 63,000 cases and almost 1,200 deaths, according to a New York Times database.

Reporting was contributed by Gillian R. Brassil, Alexander Burns, Stephen Castle, Choe Sang-Hun, Abdi Latif Dahir, Sheri Fink, Javier C. Hernández, Mike Ives, Annie Karni, David Leonhardt, Jonathan Martin, Tiffany May, Amelia Nierenberg, Adam Pasick, Elian Peltier, Eliza Shapiro, Eileen Sullivan, Katie Thomas, Katherine J. Wu and Elaine Yu.





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