COVID-19 is now leading cause of death in the U.S

COVID-19 is now leading cause of death in the U.S.: 'The death toll is quite staggering'

Rachel Grumman Bender

Fri, December 18, 2020, 11:19 AM CST·5 min read

As the mortality rate from COVID-19 continues to climb nationwide, researchers at the Virginia Commonwealth University state in a new JAMA editorial that the virus has emerged as the leading cause of death in the U.S. — killing more than 3,000 Americans a day.

To put the daily death toll from COVID-19 in context, the researchers state: “The daily U.S. mortality rate for COVID-19 deaths is equivalent to the September 11, 2001, attacks, which claimed 2,988 lives, occurring every 1.5 days, or 15 Airbus 320 jetliners, each carrying 150 passengers, crashing every day.”

The authors of the editorial — Dr. Steven H. Woolf, the director of the Virginia Commonwealth University Center on Society and Health; Derek A. Chapman, associate professor in the division of epidemiology; and Jong Hyung Lee — noted that “daily mortality rates for heart disease and cancer, which for decades have been the two leading causes of death, are approximately 1,700 and 1,600 deaths per day, respectively. With COVID-19 mortality rates now exceeding these thresholds, this infectious disease has become deadlier than heart disease and cancer, and its lethality may increase further as transmission increases with holiday travel and gatherings and with the intensified indoor exposure that winter brings.”

The lead author of the study, Woolf, tells Yahoo Life: “Our country has allowed COVID-19 to grow from a rare disease to the leading cause of death, surpassing major killers like heart disease and cancer. The tragedy is that much of this was preventable, and we wrote this piece to sound the alarm that action must be taken now to avoid further catastrophe.”

Dr. Iahn Gonsenhauser, chief quality and patient safety officer at the Ohio State Wexner Medical Center, tells Yahoo Life: “This is a staggering and sobering affirmation that the COVID pandemic has exacted a terrible human toll and that each and every one of us should be focused on doing everything we can do to change the trajectory of this crisis.”

A COVID-19 disaster morgue made up of refrigerated trailers stands at the South Brooklyn Marine Terminal on Dec. 14. (Michael Nagle/Xinhua via Getty Images)

Large-scale loss can be hard to comprehend

It’s difficult for most people to comprehend such large-scale losses. Part of the problem is also that the death toll is “a bit out of sight, out of mind,” Dr. Thomas Giordano, professor and section chief of infectious diseases at Baylor College of Medicine, tells Yahoo Life. “It is happening in hospitals that are largely closed to visitors, and you’re not seeing the funerals and wakes with as much regularity” due to COVID-19 restrictions and stay-at-home orders. “I notice it most on the obituary page. If you read those, you’ll see it,” he says. “The death toll is quite staggering.”

Giordano also says that it’s hard for people to react to a potential risk, “especially when it’s something you can’t see or feel — it’s a virus,” he explains.

He adds: “Trying to get people to change behavior when there’s a threat out there that they think is not relevant to them is hard. A lot of people who get [COVID-19] get better and are fine. And when your experience is, ‘Everyone I know is fine, or someone I know got it and died because he was really old and sick,’ people tend to minimize that kind of risk.”

Both Woolf and Gonsenhauser also say that “misinformation” about the seriousness of the virus and how it is spread has only added to the challenge. “It is both difficult to comprehend and, for some, difficult to trust,” says Gonsenhauser. “The plague of viral misinformation unleashed this year is the only thing we’ve seen that is even more contagious than COVID-19 in 2020.” He adds that the “intentional undermining of the public confidence in media and in the scientific establishment have created additional challenges.”

Woolf agrees, telling Yahoo Life: “There has been too much misinformation, much of it coming from politicians at the highest level seeking to downplay the pandemic and sow doubt about the science and motives of public health experts. They put lives at risk for self-interest, and we now have a catastrophe on our hands. I worry that the good news about the vaccine will tempt people to let down their guard, not realizing that the vaccine may not come fast enough to save them.”

When will the death toll start to slow down?

While the newly approved Pfizer vaccine is now being rolled out to high-risk people first, including health care workers, Gonsenhauser says it’s difficult to say when deaths from COVID-19 will start to slow down. “We likely have not seen the peak daily deaths resulting from surging numbers immediately following the Thanksgiving holiday,” Gonsenhauser says, “and depending on behavior during the December holidays, we cannot assume that the current trend will reverse until after the new year. That said, we are seeing a positive impact of the novel therapeutics that are being used, and vaccination of our highest-risk populations will also begin to impact the death toll in the near future.”

Woolf estimates it will be “months” before we can “vaccinate enough of the population to bring down the rate of infections.” But, he says, “we could bend the curve a lot faster if the public took action. If we all wore masks, maintained social distance and avoided large gatherings, we’d see infections drop in short order. It’s the lack of discipline that’s killing us.

Above is from:  https://www.yahoo.com/lifestyle/covid-19-is-now-leading-cause-of-death-in-the-us-the-death-toll-is-quite-staggering-171910121.html

December 18: 7377 New COVID 19 Cases in Illinois

December 18: Johns Hopkins COVID 19 Report

COVID-19

Updates on the COVID-19 pandemic from the Johns Hopkins Center for Health Security.

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The Johns Hopkins Center for Health Security also produces US Travel Industry and Retail Supply Chain Updates that provide a summary of major issues and events impacting the US travel industry and retail supply chain. You can access them here.

In light of the upcoming holidays, we will be altering the schedule for our COVID-19 updates over the next several weeks:

Tuesday, December 22: Normal briefing

Friday, December 25: No briefing

Tuesday, December 29: 12-month review

Friday, January 1: No briefing

Tuesday, January 5: Normal briefing

We hope you, your friends, and your family have a safe and healthy holiday season.

EPI UPDATE The WHO COVID-19 Dashboard reports 73.28 million cases and 1.65 million deaths as of 4:00am EST on December 18.

In total, 72 countries and territories are reporting test positivity greater than 5%, the benchmark established by the WHO earlier in the pandemic, compared to only 35 countries and territories reporting less than 5%*. Among those reporting greater than 5%, 49 are reporting greater than 10% and 23 are reporting greater than 20%, including Mexico with 40%. A number of countries reporting elevated test positivity are clustered in Central and Eastern Europe, Sub-Saharan Africa, and Central and South America. However, many countries do not consistently report test positivity.

Among those with the highest test positivity, most are reporting relatively steady or decreasing trends in test positivity over the past several weeks. Over the past month, 17 countries and territories have reported test positivity decreases of 5 percentage points or more, including 7 that have reported decreases of 10 percentage points or more. Most notably, Trinidad and Tobago has reported a decrease of 22.3 percentage points over that time. A notable exception is the Democratic Republic of the Congo (DRC). The DRC’s test positivity has tripled from approximately 10% to more than 30%, since late October (and still increasing).

*Many countries do not routinely report test positivity at the national level.

UNITED STATES

The US CDC reported 16.76 million total cases and 306,427 deaths. Yesterday, the US reported 236,913 new cases, the second highest daily total to date. The US continues to average more than 210,000 new cases per day.

The US reported 3,435 deaths yesterday, the highest single-day total to date*. The US is averaging more than 2,500 deaths per day and still increasing. At this pace, the US could surpass 330,000 cumulative deaths—approximately 1 death for every 1,000 people—in the next 9-10 days. The CDC’s ensemble model projects that the US could surpass 3,000 deaths per day (50% range: 19,082-23,982 weekly deaths; 2,726-3,436 daily deaths) and 375,000 cumulative deaths (50% range: 369,333-384,185) by January 9.

*With the exception of April 15, when New York City reported more than 3,700 previously unreported probable deaths identified since the onset of its epidemic.

In total, 15 states are reporting cumulative mortality in excess of 100 deaths per 100,000 population (or 1 death per 1,000 population)—as well as Washington, DC, and New York City. This includes 4 states, and New York City (292), that are reporting more than 150 deaths per 100,000 population: Connecticut (153), Massachusetts (165), New Jersey (200), and North Dakota (153). With the exception of North Dakota, these states reported some of the earliest cases and were severely affected early in the US epidemic at a time when there were few available treatment options, critical supplies and equipment like ventilators were in short supply, and hospitals and health systems were overwhelmed. Among the rest of the states reporting more than 100 deaths per 100,000 population, several—including Arizona, Indiana, Illinois, Iowa, Mississippi, and North and South Dakota—were more severely affected later in the epidemic, in the summer surge or the ongoing autumn/winter surge.

The Johns Hopkins CSSE dashboard reported 17.24 million US cases and 311,230 deaths as of 11:30am EST on December 18.

US FDA MODERNA VACCINE MEETING A week after issuing a recommendation to authorize the Pfizer/BioNTech vaccine, the US Vaccine and Related Biological Products Advisory Committee (VRBPAC) recommended that the US FDA issue an Emergency Use Authorization (EUA) for Moderna’s candidate SARS-CoV-2 vaccine, based on Phase 3 clinical trial data. The FDA is expected to issue the EUA within the next day or so, which would make the Moderna vaccine the second vaccine authorized for use in the US. VRBPAC recommended the Moderna vaccine for adults aged 18 years and older, administered in 2 doses spaced 28 days apart. This differs slightly from the Pfizer/BioNTech vaccine, which was recommended for individuals aged 16 and older, with 2 doses given 21 days apart. VRBPAC voted 20-0 in favor of the recommendation, with 1 abstention.

The Moderna vaccine demonstrated an acceptable safety and efficacy profile in Phase 3 clinical trials, with an estimated 95% efficacy among participants under 65 years old. For participants aged 65 years and older, the efficacy decreased somewhat to 86.4%. In addition to demonstrating efficacy in preventing symptomatic COVID-19 disease, the Moderna vaccine also demonstrated efficacy in preventing severe disease, with 30 severe cases of COVID-19 among the placebo group compared to only 1 in the treatment group (which is reportedly still being investigated). One major advantage of the Moderna vaccine over the Pfizer/BioNTech vaccine is its cold chain requirements. The Moderna vaccine can be stored at 36-46°F (2-8°C), which is similar to standard freezers and refrigerators, as opposed to -112°F to -76°F (-80°C to -60°C) for the Pfizer/BioNTech formulation. This would make distribution and storage much less resource intensive for health departments, health systems, and other organizations as they implement mass vaccination operations.

US VACCINATION The complex cold chain logistics required for the Pfizer/BioNTech SARS-CoV-2 vaccine have proven challenging in certain settings in the first week of the United States’ vaccination operations. While the principal concern in planning for the distribution of this vaccine has been ensuring that the vaccine remains cold enough, incidents in Alabama and California demonstrate that allowing the vaccines to get too cold could also be a risk. Reportedly, several thousand doses of the vaccine shipped to Alabama and California were exposed to temperatures below the acceptable threshold of -112°F (-80°C) while en route to the state distribution centers. The issue was identified before the doses were unloaded from the truck, and the doses were “quarantined” while Pfizer and federal health and regulatory officials determine whether they remain viable. Pfizer shipped replacement doses to both states. These incidents highlight how challenges in implementing cold chain logistics can lead to wastage of vaccine doses, which could be particularly impactful when supply and production capacity are limited.

The incidents also highlight the importance of temperature monitoring throughout the vaccine distribution and administration process. Reportedly, Pfizer planned to disconnect the temperature monitoring sensors on the shipment containers once delivered to healthcare providers, which would not allow hospitals, health departments, and other organizations storing the vaccine to monitor temperatures to ensure they are stored properly and thawed in accordance with the requirements necessary to administer the vaccine. In response, the US government awarded a US$25 million contract to the Icelandic company that created the temperature monitoring platform used for Pfizer’s shipping containers. Under the new plan, Pfizer will stop monitoring temperatures after the shipment arrives, and the US government will turn the system on again to resume the temperature monitoring.

Vaccinating residents in nursing homes and long-term care facilities (LTCFs) will come with unique challenges. Residents and staff of LTCFs account for nearly 40% of COVID-19 deaths in the US, but while LTCF residents are prioritized in the first tier of vaccination, some residents and staff are expressing hesitancy about the vaccine. The concerns include staff members calling in sick due to side effects from the vaccine, which could exacerbate existing staffing shortages, particularly at a time when residents may require increased attention and care due to their own side effects. Additionally, there are questions about how to obtain informed consent for residents who are not capable of providing it themselves. The residents’ legal representatives will be able to provide consent by phone or electronically, but multiple news media reports indicate that there remains uncertainty about the consent process among LTCFs across the country. There are also questions regarding how to conduct make-up vaccination operations for residents and staff who may not be able to be vaccinated during their site’s designated time.

EASTERN MEDITERRANEAN VACCINE AUTHORIZATION Bahrain and the United Arab Emirates (UAE) are the first 2 countries to “grant full approval” for a SARS-CoV-2 vaccine. The vaccine, produced by China’s Sinopharm, reportedly has an efficacy of 86%, but supporting data have not been published publicly. Scientists and researchers around the world have called for clinical trial data to be released in order to better evaluate the vaccine’s safety and efficacy profile. Even China has not yet issued full approval for the vaccine. The UAE announced the vaccine’s approval on December 9 and Bahrain announced its decision shortly thereafter. Following its announcement, Bahrain unveiled its national SARS-CoV-2 vaccination plan and vaccine registration system. Bahrain aims to open 27 vaccination centers nationwide and administer 5,000 vaccinations per day with the aim of increasing to 10,000 per day.

In addition to the Sinopharm vaccine, Bahrain, Kuwait, Oman, and Saudi Arabia reportedly authorized the use of the Pfizer/BioNTech SARS-CoV-2 vaccine.

AUSTRALIAN VACCINE Last week, researchers stopped clinical trials of an Australian candidate SARS-CoV-2 vaccine after HIV tests returned false positive results in multiple participants. The vaccine, developed at the University of Queensland, uses a “small fragment of an HIV protein” as part of a “molecular clamp” mechanism that latches onto the SARS-CoV-2 spike protein. According to a statement by the University of Queensland, participants developed an antibody response to the protein fragment that was sufficient to “interfere with certain HIV tests.” The researchers anticipated that the protein fragment could elicit an immune response, but they did not anticipate that it would be on the scale identified in the Phase 1 trial. At no time was there any risk of vaccine recipients being infected with HIV, and the subsequent HIV testing confirmed that none of the participants were infected. No serious adverse events were identified among the participants.

Identifying these types of issues is exactly what clinical trials are designed to do. This example highlights the challenges that candidate vaccines and other drugs face, and the researchers demonstrated a level of transparency that should generate confidence that the appropriate steps are being taken to ensure that SARS-CoV-2 vaccines are safe and effective.

BRAZIL MANDATORY VACCINATION Brazil’s Supreme Court reportedly ruled that SARS-CoV-2 vaccination could, from a legal standpoint, be “required, but not forced.” Brazil already mandates a number of routine vaccinations, but the Supreme Court decision prompted protests against mandatory vaccination. In São Paulo, where Governor João Doria has supported mandatory vaccination, more than 300 protesters gathered in opposition of a vaccine mandate for SARS-CoV-2. Additionally, the protesters expressed support for Brazilian President Jair Bolsonaro, who has opposed large-scale social distancing and other mitigation policies throughout Brazil’s epidemic. President Bolsonaro recently stated that he will not get vaccinated due to having antibodies following his previous SARS-CoV-2 infection. If Brazil were to mandate vaccination, the exact mechanism by which such a mandate could be enforced is unclear, particularly without support from the president.

Brazil is currently reporting nearly 47,000 new cases per day, the second highest daily incidence globally, behind the US. Brazil’s current surge has already surpassed its first, and it is still increasing. Brazil’s daily mortality is increasing as well, with more than 1,000 deaths reported yesterday—for the first time since September. Cumulatively, Brazil ranks #3 globally in terms of incidence, with 6.18 million cases, and #5 globally in terms of mortality, with nearly 185,000 deaths.

AT-HOME TESTING The US FDA issued Emergency Use Authorizations (EUAs) for 2 new at-home testing products, including the first test that can be performed completely independently of the healthcare setting. The first test, produced by Ellume, is a lateral flow antigen test that can provide results in as few as 20 minutes. The kit can be used to test individuals with or without symptoms, including those as young as 2 years of age. The test was demonstrated to have a sensitivity of 96% and specificity of 100% for symptomatic individuals and a sensitivity of 91% and specificity of 96% for asymptomatic individuals. The Ellume test kit uses an analyzer that provides the results via a smartphone application, which also automatically reports the test results to local public health authorities. Perhaps most notably, the test will be available without a prescription. Ellume announced plans to scale up production of the test kits in 2021, and it is currently planning to sell individual test kits for $30 each.

The second EUA was issued for Abbott BinaxNOW COVID-19 Ag Card Home Test. This test is also a lateral flow antigen test, and it can provide results in as few as 15 minutes, but it requires telehealth supervision to administer. The Abbott test allows the user to see the test results directly via the test, much like an at-home pregnancy test. Notably, this test requires a prescription from a healthcare provider, and it is only authorized for individuals with COVID-19 symptoms. The test has an estimated sensitivity of 91.7% and specificity of 100%. Abbott indicated that it expects to distribute 30 million BinaxNOW tests by the end of March 2021, and the tests will cost $25 each.

GLOBAL VACCINATION The initiation of mass vaccination programs in countries like Canada, the UK, and the US have drawn additional attention to questions regarding the timeline for global vaccination efforts and vaccine efforts in other countries. Public data has shown that higher-income countries have secured access to more vaccine supply than what is actually needed to fully immunize their populations, while lower-income countries may only be able to vaccinate 20% of their population by the end of 2021. While these countries have theoretically ordered a surplus of vaccine doses, it is likely that not all of the vaccines on order will ultimately receive an authorization from regulatory authorities.

A statement issued by the People’s Vaccine Alliance, which includes Amnesty International and Oxfam among other organizations, warned that large purchases by individual countries could jeopardize the success of collaborative, multilateral efforts like GAVI’s COVAX financing facility, which strives to provide access to vaccines to under-resourced countries. While some higher-income countries—including Canada, which recently authorized the use of the Pfizer vaccine—are major donors for COVAX, the funding may not be able to provide vaccines if the initial supply is concentrated in higher-income countries.

DOWN SYNDROME A recent report finds that Down syndrome, a genetic condition that results from a third copy of chromosome 21, could increase the risk of severe COVID-19. A commentary published in the Annals of Internal Medicine in October reported that the risk of hospitalization for COVID-19 increased 5 times and the risk of death increased 10 times among individuals with Down syndrome, based on a study of 8.26 million people in the UK. The risk increased substantially for individuals aged 40 and older, putting their risk of severe illness on par with individuals aged 80 and older among the general population.

As countries finalize plans and begin implementing mass vaccination efforts, some experts are calling for individuals with Down syndrome to be placed at high priority for vaccination and to receive therapeutics such as monoclonal antibodies. Notably, the UK’s Joint Commission on Vaccination and Immunisation included Down syndrome among other priority health conditions for SARS-CoV-2 vaccination, but the US CDC does not list it among the conditions associated with increased risk of severe COVID-19 disease and death.

US ECONOMIC STIMULUS It appears that momentum is building for US government efforts to finalize an economic relief package in response to its ongoing COVID-19 epidemic. The current effort continues to evolve, but there is reportedly growing support for a US$900 billion relief package. Congressional negotiations are ongoing in conjunction with efforts to finalize the federal budget and avoid a government shutdown. Reportedly, Democrat and Republican leaders have made efforts to compromise in recent days and weeks on some of their biggest priorities. Democrats have withdrawn demands to include additional funding for state and local governments that are facing both decreased income through sales tax and other revenue and increased budgets due to the COVID-19 response, and Republicans have compromised on demands for liability protections for business owners. It remains unclear whether an economic package could include direct payments to individuals like the CARES Act did.

Public support for another economic relief package, the first since the CARES Act in March, is high across the country. A poll conducted by Vox and Data for Progress found that the public prioritizes COVID-19 relief over the size of the US deficit. Delays in government relief packages have led some states to take individual actions. For example, New Mexico recently approved a plan to distribute US$1,200 payments to 130,000 unemployed residents.

EXCESS MORTALITY IN US ADULTS AGES 25-44 Young adults are generally at lower risk for severe disease and death than older adults, and increased activity in the community. However, a recent study found that all-cause excess mortality increased among younger adults in the US from March to July, not all of which was directly attributable to COVID-19. The study, published in JAMA, was conducted by researchers in Arizona, Connecticut, and Massachusetts who evaluated COVID-19 and all-cause mortality data published by the US National Center for Health Statistics (NCHS).

In total, the NCHS reported 76,088 deaths among adults aged 25-44 years during the study period, including 4,535 COVID-19 deaths. Compared to the same months in 2016-2019, the 2020 all-cause mortality was nearly 12,000 deaths above the expected total, an increase of 19%. Notably, however, COVID-19 deaths accounted for only 38% of the increase. The direct impact of COVID-19 on excess mortality varied by US Department of Health and Human Services regions (1-10). For example, in Region 2—which includes New York and New Jersey—the all-cause mortality was 130% hither than expected, and COVID-19 deaths accounted for 80% of the increase. The proportion of excess deaths due directly to COVID-19 was much higher than most other regions. Both New York and New Jersey were severely affected during the initial US surge, so it is not surprising that COVID-19 directly accounts for a large proportion of excess mortality during that period.

The authors did not attempt to determine the cause of the excess mortality not attributed directly to COVID-19; however, they discussed potential contributors. The authors suggest that lower testing rates among younger adults, as they are lower risk and experience milder symptoms, may result in underascertainment and underreporting of COVID-19 deaths among this population. If this is the case, then COVID-19 would directly account for a larger proportion of the excess mortality. Additionally, as we have covered previously, many individuals delayed screening and treatment for health conditions during periods of enhanced social distancing measures (e.g., stay at home/safer at home orders), which some believe contributed to increased mortality for some diseases and conditions. The study period covers the initial COVID-19 surge in the US, and further analysis will be required to account for excess mortality during the summer and autumn/winter surges.

TURKEY COVID-19 REPORTING Beginning November 25, Turkey updated its COVID-19 reporting to include asymptomatic infections. Since July, Turkey had only reported symptomatic cases, and the update increased Turkey’s average daily incidence from approximately 6,000 new cases per day to more than 30,000. As part of this update, Turkey added previously unreported asymptomatic infections to its cumulative total on December 10, increasing its cumulative incidence by more than 800,000 cases. Turkey is now reporting a cumulative total of 1.98 million cases and 17,610 deaths, jumping to #6 globally in terms of total incidence. Turkey’s change in reporting policy comes after months of pressure from the Turkish Medical Association, a nationwide organization of clinicians, which advocated for reporting the full COVID-19 incidence rather than just symptomatic cases.

In response to its ongoing COVID-19 surge, Turkish President Recep Tayyip Erdoğan reportedly announced a 4-day national “lockdown” starting New Year’s Eve in an effort to slow transmission over the holiday weekend. Turkey has used weekend “lockdowns” over the past several weeks in an effort to curb transmission, following a surge in reported mortality. Turkey’s daily mortality has tripled since the end of October—and doubled since November 21—up to 230 deaths per day and still increasing.

CRISIS STANDARDS OF CARE Hospitals across much of the US are experiencing alarming surges in COVID-19 patients. Many intensive care units (ICUs) across the country are already at or exceeding their design capacity, and many more will reach this point in the coming weeks. In an effort to mitigate the impact of the current surge, hospitals are canceling admissions and non-emergency procedures; implementing creative solutions to augment staffing; transferring patients to other facilities, including in other jurisdictions; and even establishing and operating alternate care sites.

The Johns Hopkins Center for Health Security and 7 other national organizations issued a statement calling for immediate action to implement crisis standards of care (CSC) during the current COVID-19 surge. CSC may be necessary when healthcare resource shortages—including staffing, hospital or ICU beds, equipment, and medications—are severe enough that conventional standards and processes for treating patients are not feasible. Many hospitals and localities are experiencing such shortages now. CSC plans ensure that the most good is done for the largest number of people, and using consistent plans can help ensure equity among patients, speed decision-making regarding the allocation of limited resources, and relieve clinicians of the burden of making these difficult decisions on their own. The joint statement recommends key actions for governors, state health departments, and hospitals and health systems to support, plan for, and equitably implement crisis standards of care in the midst of the ongoing national COVID-19 s

Who’s the radical?

The Georgia Senate runoff race will be a crucial one for climate action. If Democrats can win both seats and secure a majority in the Senate (with VP Harris’ deciding vote), there will be a far greater chance that climate legislation can be passed in support of the Biden climate agenda. Working to clean our air, ensure safe drinking water, affordable energy and a greener economy is not radical (despite the default lines from the Republican Senate candidates), it’s what lawmakers should be doing to protect Americans.

Every little bit will help in this incredibly close race. If you have time over the next 3 weeks, please consider volunteering with our friends at the Environmental Voter Project to help turn out environmental voters.

1 in 5 prisoners in the US has had COVID-19, 1,700 have died

One in every five state and federal prisoners in the United States has tested positive for the coronavirus, a rate more than four times as high as the general population

By BETH SCHWARTZAPFEL and KATIE PARK of The Marshall Project and ANDREW DEMILLO of The Associated Press

December 18, 2020, 8:02 AM

• 9 min read

LITTLE ROCK, Ark. -- One in every five state and federal prisoners in the United States has tested positive for the coronavirus, a rate more than four times as high as the general population. In some states, more than half of prisoners have been infected, according to data collected by The Associated Press and The Marshall Project.

As the pandemic enters its 10th month — and as the first Americans begin to receive a long-awaited COVID-19 vaccine — at least 275,000 prisoners have been infected, more than 1,700 have died and the spread of the virus behind bars shows no sign of slowing. New cases in prisons this week reached their highest level since testing began in the spring, far outstripping previous peaks in April and August.

“That number is a vast undercount,” said Homer Venters, the former chief medical officer at New York’s Rikers Island jail complex.

Venters has conducted more than a dozen court-ordered COVID-19 prison inspections around the country. “I still encounter prisons and jails where, when people get sick, not only are they not tested but they don’t receive care. So they get much sicker than need be,” he said.

Now the rollout of vaccines poses difficult decisions for politicians and policymakers. As the virus spreads largely unchecked behind bars, prisoners can’t social distance and are dependent on the state for their safety and well-being.

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This story is a collaboration between The Associated Press and The Marshall Project exploring the state of the prison system in the coronavirus pandemic.

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Donte Westmoreland, 26, was recently released from Lansing Correctional Facility in Kansas, where he caught the virus while serving time on a marijuana charge. Some 5,100 prisoners have become infected in Kansas prisons, the third-highest COVID-19 rate in the country, behind only South Dakota and Arkansas.

“It was like I was sentenced to death,” Westmoreland said.

Westmoreland lived with more than 100 virus-infected men in an open dorm, where he woke up regularly to find men sick on the floor, unable to get up on their own, he said.

“People are actually dying in front of me off of this virus,” he said. “It’s the scariest sight.” Westmoreland said he sweated it out, shivering in his bunk until, six weeks later, he finally recovered.

Half of the prisoners in Kansas have been infected with COVID-19 — eight times the rate of cases among the state’s overall population. Eleven prisoners have died, including five at the prison where Westmoreland was held. Of the three prison employees who have died in Kansas, two worked at Lansing Correctional Facility.

In Arkansas, where more than 9,700 prisoners have tested positive and 50 have died, four of every seven have had the virus, the second-highest prison infection rate in the U.S.

Among the dead was 29-year-old Derick Coley, who was serving a 20-year sentence at the Cummins Unit maximum security prison. Cece Tate, Coley’s girlfriend, said she last talked with him on April 10 when he said he was sick and showing symptoms of the virus.

“It took forever for me to get information,” she said. The prison finally told her on April 20 that Coley had tested positive for the virus. Less than two weeks later, a prison chaplain called on May 2 to tell her Coley had died.

The couple had a daughter who turned 9 in July. “She cried and was like, ‘My daddy can’t send me a birthday card,’" Tate said. “She was like, ‘Momma, my Christmas ain’t going to be the same.’”

Nearly every prison system in the country has seen infection rates significantly higher than the communities around them. In facilities run by the federal Bureau of Prisons, one of every five prisoners has had coronavirus. Twenty-four state prison systems have had even higher rates.

Prison workers have also been disproportionately affected. In North Dakota, four of every five prison staff has gotten coronavirus. Nationwide, it’s one in five.

Not all states release how many prisoners they’ve tested, but states that test prisoners broadly and regularly may appear to have higher case rates than states that don’t.

Infection rates as of Tuesday were calculated by the AP and The Marshall Project, a nonprofit news organization covering the criminal justice system, based on data collected weekly in prisons since March. Infection and mortality rates may be even higher, since nearly every prison system has significantly fewer prisoners today than when the pandemic began, so rates represent a conservative estimate based on the largest known population.

Yet, as vaccine campaigns get underway, there has been pushback in some states against giving the shots to people in prisons early.

“There’s no way it’s going to go to prisoners ... before it goes to the people who haven’t committed any crime,” Colorado Gov. Jared Polis told reporters earlier this month after his state’s initial vaccine priority plans put prisoners before the general public.

Like more than a dozen states, Kansas’s vaccination plan does not mention prisoners or corrections staff, according to the Prison Policy Initiative, a non-partisan prison data think tank. Seven states put prisoners near the front of the line, along with others living in crowded settings like nursing homes and long-term care facilities. An additional 19 states have placed prisoners in the second phase of their vaccine rollouts.

Racial disparities in the nation’s criminal justice system compound the disproportionate toll the pandemic has taken on communities of color. Black Americans are incarcerated at five times the rate of whites. They are also disproportionately likely to be infected and hospitalized with COVID-19, and are more likely than other races to have a family member or close friend who has died of the virus.

The pandemic “increases risk for those who are already at risk,” said David J. Harris, managing director of the Charles Hamilton Houston Institute for Race and Justice at Harvard Law School.

This week, a Council on Criminal Justice task force headed by former attorneys general Alberto Gonzalez and Loretta Lynch released a report calling for scaling back prison populations, improving communication with public health departments and reporting better data.

Prison facilities are often overcrowded and poorly ventilated. Dormitory-style housing, cafeterias and open-bar cell doors make it nearly impossible to quarantine. Prison populations are sicker, on average, than the general population and health care behind bars is notoriously substandard. Nationwide, the mortality rate for COVID-19 among prisoners is 45% higher than the overall rate.

From the earliest days of the pandemic, public health experts called for widespread prison releases as the best way to curb virus spread behind bars. In October, the National Academies of Science, Medicine, and Engineering released a report urging states to empty their prisons of anyone who was medically vulnerable, nearing the end of their sentence or of low risk to public safety.

But releases have been slow and uneven. In the first three months of the pandemic, more than 10,000 federal prisoners applied for compassionate release. Wardens denied or did not respond to almost all those requests, approving only 156 — less than 2%.

A plan to thin the state prison population in New Jersey, first introduced in June, was held up in the Legislature because of inadequate funding to help those who were released. About 2,200 prisoners with less than a year left to serve were ultimately released in November, eight months after the pandemic began.

California used a similar strategy to release 11,000 people since March. But state prisons stopped accepting new prisoners from county jails at several points during the pandemic, which simply shifted the burden to the jails. According to the state corrections agency, more than 8,000 people are now waiting in California’s county jails, which are also coronavirus hot spots.

“We call that ‘screwing county,’” said John Wetzel, Pennsylvania’s secretary of corrections, whose prison system has one of the lower COVID-19 case rates in the country, with one in every seven prisoners infected. But that’s still more than three times the statewide rate.

Prison walls are porous even during a pandemic, with corrections officers and other employees traveling in and out each day.

“The interchange between communities and prisons and jails has always been there, but in the context of COVID-19 it’s never been more clear,” said Lauren Brinkley-Rubinstein, a professor of social medicine at UNC-Chapel Hill who studies incarceration and health. “We have to stop thinking about them as a place apart.”

Wetzel said Pennsylvania’s prisons have kept virus rates relatively low by widely distributing masks in mid-March — weeks before even the Centers for Disease Control and Prevention began recommending them for everyday use in public — and demanding that staff and prisoners use them properly and consistently. But prisoners and advocates say prevention measures on the ground are uneven, regardless of Wetzel’s good intentions.

As the country heads into winter with virus infections on the rise, experts caution that unless COVID-19 is brought under control behind bars, the country will not get it under control in the population at large.

“If we are going to end this pandemic — bring down infection rates, bring down death rates, bring down ICU occupancy rates — we have to address infection rates in correctional facilities,” said Emily Wang, professor at Yale School of Medicine and co-author of the recent National Academies report.

“Infections and deaths are extraordinarily high. These are wards of the state, and we have to contend with it.”

———

Schwartzapfel reported from Boston and Park from Washington.

———

This story has been corrected to show that the rate of prisoners who tested positive for the coronavirus was more than four times as high as the general population, not more than four times higher than the general population.

Above is from:  https://abcnews.go.com/Health/wireStory/prisoners-us-covid-19-1700-died-74797059

Apparent Russian Cyber Attacks are Widespread

More Hacking Attacks Found as Officials Warn of 'Grave Risk' to U.S. Government

WASHINGTON, DC - JUNE 4: An American flag flies outside the Department of Commerce building on June 4, 2017 in Washington, D.C. The nation's capital, the sixth largest metropolitan area in the country, draws millions of visitors each year to its historical sites, including thousands of school kids during the month of June. (Photo by George Rose/Getty Images)More

David E. Sanger and Nicole Perlroth

Fri, December 18, 2020, 7:26 AM CST

WASHINGTON — Federal officials issued an urgent warning on Thursday that hackers, who U.S. intelligence agencies believed were working for the Kremlin, used a far wider variety of tools than previously known to penetrate government systems, and said that the cyberoffensive was “a grave risk to the federal government.”

The discovery suggests that the scope of the hacking, which appears to extend beyond nuclear laboratories and the Pentagon, Treasury and Commerce departments' systems, complicates the challenge for federal investigators as they try to assess the damage and understand what had been stolen.

Minutes after the statement from the cybersecurity arm of the Department of Homeland Security, President-elect Joe Biden warned that his administration would impose “substantial costs” on those responsible.

“A good defense isn’t enough; we need to disrupt and deter our adversaries from undertaking significant cyberattacks in the first place,” Biden said, adding, “I will not stand idly by in the face of cyberassaults on our nation.”

President Donald Trump has yet to say anything about the attack.

Echoing the government’s warning, Microsoft said Thursday that it had identified 40 companies, government agencies and think tanks that the suspected Russian hackers, at a minimum, had infiltrated. Nearly half are private technology firms, Microsoft said, many of them cybersecurity firms, like FireEye, that are charged with securing vast sections of the public and private sector.

“It’s still early days, but we have already identified 40 victims — more than anyone else has stated so far — and believe that number should rise substantially,” Brad Smith, Microsoft’s president, said in an interview on Thursday. “There are more nongovernmental victims than there are governmental victims, with a big focus on IT companies, especially in the security industry.”

The Energy Department and its National Nuclear Security Administration, which maintains the U.S. nuclear stockpile, were compromised as part of the larger attack, but its investigation found the hack did not affect “mission-essential national security functions,” Shaylyn Hynes, a Department of Energy spokesperson, said in a statement.

“At this point, the investigation has found that the malware has been isolated to business networks only,” Hynes said. The hack of the nuclear agency was reported earlier by Politico.

Officials have yet to publicly name the attacker responsible, but intelligence agencies have told Congress that they believe it was carried out by the SVR, an elite Russian intelligence agency. A Microsoft “heat map” of infections shows that the vast majority — 80% — are in the United States, while Russia shows no infections at all.

The government warning, issued by the Cybersecurity and Infrastructure Security Agency, did not detail the new ways that the hackers got into the government systems. But it confirmed suspicions expressed this week by FireEye, a cybersecurity firm, that there were almost certainly other routes that the attackers had found to get into networks on which the day-to-day business of the United States depend.

FireEye was the first to inform the government that the suspected Russian hackers had, since at least March, infected the periodic software updates issued by a company called SolarWinds, which makes critical network monitoring software used by the government, hundreds of Fortune 500 companies and firms that oversee critical infrastructure, including the power grid.

Investigators and other officials say they believe the goal of the Russian attack was traditional espionage, the sort the National Security Agency and other agencies regularly conduct on foreign networks. But the extent and depth of the hacking raises concerns that hackers could ultimately use their access to shutter American systems, corrupt or destroy data, or take command of computer systems that run industrial processes. So far, though, there has been no evidence of that happening.

The alert was a clear sign of a new realization of urgency by the government. After playing down the episode — in addition to Trump’s silence, Secretary of State Mike Pompeo deflected the hacking as one of the many daily attacks on the federal government, suggesting China was the biggest offender — the government's new alert left no doubt the assessment had changed.

“This adversary has demonstrated an ability to exploit software supply chains and shown significant knowledge of Windows networks,” the alert said.

“It is likely that the adversary has additional initial access vectors and tactics, techniques and procedures,” which, it said, “have not yet been discovered.”

Investigators say it could take months to unravel the extent to which American networks and the technology supply chain are compromised.

In an interview on Thursday, Smith, of Microsoft, said the supply-chain element made the attack perhaps the gravest cyberattack against the United States in years.

“Governments have long spied on each other but there is a growing and critical recognition that there needs to be a clear set of rules that put certain techniques off limits,” Smith said. “One of the things that needs to be off limits is a broad supply chain attack that creates a vulnerability for the world that other forms of traditional espionage do not.”

Reuters reported Thursday that Microsoft was itself compromised in the attack, a claim that Smith emphatically denied Thursday. “We have no indication of that,” he said.

Officials say that with only one month left in its tenure, the Trump administration is planning to simply hand off what appears to be the biggest cybersecurity breach of federal networks in more than two decades.

Biden’s statement said he had instructed his transition team to learn as much as possible about “what appears to be a massive cybersecurity breach affecting potentially thousands of victims.”

“I want to be clear: My administration will make cybersecurity a top priority at every level of government — and we will make dealing with this breach a top priority from the moment we take office,” Biden said, adding that he plans to impose “substantial costs on those responsible.”

The Cybersecurity and Infrastructure Security Agency’s warning came days after Microsoft took emergency action along with FireEye to halt the communication between the SolarWinds network management software and a command-and-control center that the Russians were using to send instructions to their malware using a so-called kill switch.

That shut off further penetration. But it is of no help to organizations that have already been penetrated by an attacker who has been planting back doors in their systems since March. And the key line in the warning said that the SolarWinds “supply chain compromise is not the only initial infection vector” that was used to get into federal systems. That suggests other software, also used by the government, has been infected and used for access by foreign spies.

Across federal agencies, the private sector and the utility companies that oversee the power grid, forensic investigators were still trying to unravel the extent of the compromise. But security teams say the relief some felt that they did not use the compromised systems turned to panic on Thursday, as they learned other third-party applications may have been compromised.

Inside federal agencies and the private sector, investigators say they have been stymied by classifications and siloed approach to information sharing.

“We have forgotten the lessons of 9/11,” Smith said. “It has not been a great week for information sharing and it turns companies like Microsoft into a sheep dog trying to get these federal agencies come together into a single place and share what they know.”

This article originally appeared in The New York Times.

© 2020 The New York Times Company

Above is from:  https://www.yahoo.com/news/more-hacking-attacks-found-officials-132602161.html

Will Trump React to Cyber Attack?

Russia Hack Confronts Trump With Decision That Echoes Obama’s

Nick Wadhams

Fri, December 18, 2020, 1:00 AM CST

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(Bloomberg) -- A massive hack on the federal government presents President Donald Trump with the same choice Barack Obama faced in the waning days of his tenure: whether to impose sanctions on Russia, and how severe to make them. So far, Trump has shown little willingness to impose costs.

Confronted with evidence that Vladimir Putin’s government orchestrated cyberattacks aimed at interfering with the 2016 election, Obama levied sanctions against Russia’s intelligence services and expelled 35 diplomats.

Now, it’s Trump’s turn to decide whether to call out and punish the Kremlin, as Obama did, or go easy on the Russian president and leave it to President-elect Joe Biden to formulate a response to a hack so serious it prompted National Security Advisor Robert O’Brien to cut short an overseas trip and return to oversee daily crisis meetings at the White House.

Government agencies and hundreds of Fortune 500 companies are still assessing the damage done by the cyberattack, which involved code embedded in updates for a widely used network-management software made by SolarWinds Corp.

Unlike in 2016, the latest attack didn’t involve election interference, but there’s little doubt it was a serious strike. The U.S. Cybersecurity and Infrastructure Security Agency on Thursday called it a “grave risk” to federal, state and local governments, as well as critical infrastructure and the private sector. SolarWinds said 18,000 customers downloaded the tampered software update.

Security experts familiar with the hack said that even if evidence is still being gathered, it’s important to come out with a swift condemnation and set about taking measures to establish some sort of deterrence.

“The one thing you can say is the Trump administration has basically given the Russians a green light by not calling them out,” said James Lewis, director of the Strategic Technologies Program at the Center for Strategic and International Studies. “That’s what you want to watch for: Does the Trump administration take any action even if it’s just symbolic? And so far the answer is no.”

Although Obama has been criticized for reacting too slowly to the Russian election meddling, the sanctions he eventually imposed sparked one of the most notorious episodes of the Trump era: the decision by Trump’s incoming national security adviser, Michael Flynn, to privately urge Russia not to respond to Obama’s sanctions. Trump last month pardoned Flynn after he was convicted of lying about the conversations he had with Russia’s ambassador on the matter.

Suspected Russian Hackers Target Frail U.S. Supply Chain

Trump and many of his top aides have repeatedly tried to shift the spotlight to China as America’s biggest national security threat, sometimes downplaying Russian actions in comparison. Ending his presidency by going after Russia would contradict that strategy.

According to one person familiar with the president’s thinking, who asked not to be identified discussing private deliberations, Trump has never let go of the belief that he could leverage personal ties with President Putin to improve relations with Russia. That would make it much harder for his staff to discuss punishment for fear that Trump would reject it out of hand.

Fraught Issue

Issues of cybersecurity seem to be particularly fraught for Trump’s aides. In his 2017 book “Fear,” Bob Woodward recounts an episode when Trump’s homeland security adviser at the time, Tom Bossert, tried to approach the president.

“I want to watch the Masters,” Woodward says Trump told Bossert, referring to the annual golf tournament. “You and your cyber...are going to get me in a war — with all your cyber sh_t.”

In an opinion piece in the New York Times on Thursday, Bossert suggested an idea that’s likely to find a better reception from the Biden team than Trump’s. He said the U.S. must call out Russia but also work with allied nations to pressure Russia.

Although Trump has yet to say anything about the hack, Biden echoed Bossert’s argument in a statement Thursday, vowing to united with allies and impose “substantial costs on those responsible for such malicious attacks.” He promised to make cybersecurity a “top priority at every level of government.”

There are many ways for Trump’s administration to respond -- new sanctions on Russia’s intelligence services, for example. Yet one challenge officials face is that such actions, as the current episode proves, clearly have failed to deter Russia in the past.

Another issue that Trump -- and later Biden -- will have to confront is that no one knows the true extent of the hack and what the hackers will do with the information they gleaned. Snooping on an adversary’s networks is something countries routinely do to each other and, as brazen as the hack may be, might provoke only a moderate response, in keeping with what past administrations have done.

But if the hackers use the breach for more nefarious ends -- shutting down electrical grids, for example, or wiping out people’s bank accounts or exposing sensitive information publicly -- that could provoke a more serious response.

“Sanctions are probably the most politically expedient option,” said Lauren Zabierek, executive director of the Cyber Project at Harvard University’s Belfer Center for Science and International Affairs. “That’s probably the minimum that we can expect out of this from this administration, but I honestly don’t know what they’re going to do especially given their response to previous Russian actions.”

Indeed, top advisers including Secretary of State Michael Pompeo have played down the hack. In a recent interview, Pompeo portrayed it as more of the same from Russia.

“The Russian efforts to use cyber capabilities against us here in the United States is something that’s been consistent certainly for – goodness, I guess I was in Congress six years and now four years in the administration,” Pompeo said on the Ben Shapiro Show.

Given that Russia is unlikely to be deterred, experts argue that the best result will have to be a fundamental rethinking of cyber issues, something that will require new money and more time than the Trump team has left before Biden’s Jan. 20 inauguration.

“We’ve been talking about this for 25 years, and we’re not there,” said Christopher Painter, who was the State Department coordinator for cyber issues before Trump shut down his office in 2017.

“The way you do that is you make this whole area much more of a mainstream national security priority and not treat it as this little boutique-y tech issue, which I think in large part it has been relegated to,” Painter said.

Above is from:  https://finance.yahoo.com/news/russia-hack-confronts-trump-decision-070002618.html