Boone County is reporting an increase of 11 new cases of COVID-19. The Illinois Department of Public Health reported 2,166 new cases, including 25 additional confirmed deaths.
Friday, October 2, 2020
Tuesday, September 29, 2020
What voters should know about state’s graduated tax proposal
What voters should know about state’s graduated tax proposal
By Doug Finke
The State Journal-Register
Posted Sep 27, 2020 at 12:01 AMUpdated Sep 28, 2020 at 8:27 AM
Perhaps the biggest race in the upcoming general election doesn’t have any candidates running.
It is the race on whether or not to approve an amendment to the Illinois Constitution to bring a graduated state income tax to Illinois for the first time in its history.
It could be the defining moment in Gov. JB Pritzker’s tenure, something he pledged to bring to the state when he ran for the office and something he’s made a central component during the first half of his term.
Both proponents and opponents argue it will have a profound impact on Illinois’ economic future, with one side saying it is for the good and the other saying the opposite.
Here’s a rundown of what you need to know.
What is a graduated income tax?
It is a tax that applies different tax rates to different levels of income. The federal income tax works this way. People with higher incomes pay higher tax rates.
In fact, most states that have an income tax use a graduated tax system. There are 41 states that have a state income tax. Of those, 32 have a graduated income tax. Only nine, including Illinois, have a flat tax.
What is a flat tax?
Under the Illinois system, all individuals pay the same tax rate regardless if they make $20,000 a year or $20 million a year. Proponents of the current system argue that this promotes economic development and helps discourage lawmakers from raising the income tax. If the tax is increased, the increase must apply to everyone, not just a small group earning a larger income, which makes an increase less likely, they argue.
Proponents of the graduated tax contend it is fundamentally unfair for everyone to pay the same rate regardless of income level. They contend it has promoted income disparity in the state.
Can’t the General Assembly simply make the change?
No. The flat tax is written into the state constitution. It can only be changed by the voters.
There are two ways the amendment can be approved. If 60% of the votes cast on the amendment proposal are “yes,” it will be approved. It will also pass if a majority of all of those voting in the election vote in favor of it.
What will the tax rates be if the amendment is approved?
The General Assembly has already approved the rates that would go into effect if the amendment is approved. Remember, the rate for individuals is now 4.95%.
The new rates would be: 4.75% for income up to $10,000; 4.90% for income between $10,001 and $100,000; and 4.95% for income between $100,001 and $250,000. Those numbers apply for both single and joint filers.
For single filers, the rate is 7.75% for income of $250,001 to $350,000, and the rate is 7.85% for income of $350,001 and $750,000. For joint filers, the rate is 7.75% for income of $250,001 to $500,000, and the rate is 7.85% for income of $500,001 to $1 million.
The top rate is 7.99% for single filers making more than $750,000 and joint filers making more than $1 million.
The corporate rate would increase from the current 7% to 7.99% regardless of income.
One thing to remember is that the rates apply to those different levels of income, except for the highest earners. Thus, even for someone who makes $100,000 a year, the first $10,000 of income is taxed at 4.75%.
For individuals who make more than $750,000 a year and joint filers who make more than $1 million a year, the entire amount of their income is taxed at 7.99%.
Will I pay more under this amendment?
Pritzker and other proponents of the graduated tax have said that 97% of Illinois income tax payers will pay the same as or less than they now pay. Only the top 3% of earners will pay more, they said. That means people with incomes above $250,000 a year.Pritzker’s office has set up an online calculator that people can use to determine how the amendment will affect their taxes. It can be found at https://www2.illinois.gov/sites/gov/fairtax/Pages/default.aspx
That’s a big selling point, right?
For the proponents, it certainly is. But it is also a major reason why the opponents think it is a bad idea.
The opponents contend wealthier residents will be tempted to abandon the state and take their tax dollars with them. They also argue the higher rates on upper incomes will damage economic growth in the state. Finally, they argue that lawmakers will find it easier to raise taxes in the future because they can do it on a smaller number of earners rather than everyone. Inevitably, the opponents argue, those increases will also hit lower income levels.
Supporters of the amendment argue that it is never easy for elected officials to raise taxes making those fears are unfounded. Since no one can predict the future, it comes down to which voices you trust the most.
Will retirement income be taxed by the amendment?
No. Most retirement income isn’t taxed in Illinois now and that won’t change if the amendment is adopted. Amendment opponents are airing an ad showing a woman identified as a retiree saying the amendment will provide “new powers” to the state to tax retirement income. It won’t. The state could tax retirement income now, but it doesn’t because legislators know that is a hugely controversial and unpopular issue.AARP Illinois supports the amendment.
“No matter who has said it or how they have said it, the simple truth is that switching to a graduated income tax does not allow the state to tax retirement income,” the organization says on its web site. “And it does not make it easier to tax retirement income in the future. AARP Illinois adamantly opposes taxation of retirement income and we would not support the graduated income tax if it did.”
Will the graduated tax raise more money?
Yes. For a full fiscal year the graduated income tax is projected to bring in $3.4 billion. If the amendment is approved, the new rates would go into effect January 1 which is midway through the state’s fiscal year. Thus, the full amount won’t be realized immediately.
Pritzker has warned that without the extra income from the graduated tax, the state will likely have to cut spending or raise income taxes across the board. Many Republicans and other opponents of the amendment contend the state spends too much money as it is and budget cuts would not be a bad thing.
Contact Doug Finke at doug.finke@sj-r.com, (217) 788-1527 or twitter.com/dougfinkesjr.
Above is from: https://www.sj-r.com/news/20200927/what-voters-should-know-about-statersquos-graduated-tax-proposal?rssfeed=true
Mitigating begins Saturday
After two-point positivity rate jump in two weeks, resurgence mitigation imposed on Region 1
Tuesday, Sep 29, 2020
* Press release…
Governor Pritzker and the Illinois Department of Public Health (IDPH) are announcing COVID-19 resurgence mitigations will be implemented in Region 1, the northwestern most counties in Illinois, beginning Saturday, October 3, 2020. The region is seeing a 7-day rolling average test positivity rate of 8% or above for three consecutive days, which exceeds the threshold set for establishing mitigation measures in the region under the state’s Restore Illinois Resurgence Plan. This announcement follows last week’s warnings to local leaders that additional mitigation measures would be implemented if the region continued to see an increase in cases. Region 1 includes Boone, Carroll, DeKalb, Jo Daviess, Lee, Ogle, Stephenson, Whiteside and Winnebago counties.
“The concerning uptick in Region 1’s positivity – jumping more than two percentage points in two weeks even as the majority of Illinois continues to see downward trends – demands increased efforts to stop the spread in our northwestern counties,” said Governor JB Pritzker. “As other regions have demonstrated, stricter mitigations will lead to safer communities when people mask up, keep their distance, wash their hands and respect public health. It is my hope that the residents of Region 1 can turn this situation around quickly, and Dr. Ezike and I continue to coordinate with local officials to make that happen.”
“COVID-19 spread can increase very quickly, as we’ve seen in some regions in the state, now including Region 1,” said IDPH Director Dr. Ngozi Ezike. “As the pandemic continues, so must our fight against it: Please, don’t hold or attend large events or mass gatherings, wear your face covering, and keep six feet of distance between you and others.”
In the past week, Region 1 also had an early indication of increasing hospital admissions for COVID-like-illness. Although this increase has not yet reached the threshold level, it indicates more severe illness is increasing and IDPH will continue to monitor the region’s hospital capacity.
Mitigation measures taking effect October 3, 2020 in Region 1 include the following:
Bars
• No indoor service
• All outside bar service closes at 11:00 p.m.
• All bar patrons should be seated at tables outside
• No ordering, seating, or congregating at bar (bar stools should be removed)
• Tables should be 6 feet apart
• No standing or congregating indoors or outdoors while waiting for a table or exiting
• No dancing or standing indoors
• Reservations required for each party
• No seating of multiple parties at one tableRestaurants
• No indoor dining or bar service
• All outdoor dining closes at 11:00 p.m.
• Outside dining tables should be 6 feet apart
• No standing or congregating indoors or outdoors while waiting for a table or exiting
• Reservations required for each party
• No seating of multiple parties at one tableMeetings, Social Events, Gatherings
• Limit to lesser of 25 guests or 25 percent of overall room capacity
• No party buses
• Gaming and Casinos close at 11:00 p.m., are limited to 25 percent capacity, and follow mitigations for bars and restaurants, if applicableThese mitigations do not currently apply to schools.
IDPH will track the positivity rate in Region 1 to determine if mitigations can be relaxed, if additional mitigations are required, or if current mitigations should remain in place. If the positivity rate averages less than or equal to 6.5% for three consecutive days, then Regions 1 will return to Phase 4 mitigations under the Restore Illinois Plan. If the positivity rate averages between 6.5% and 8%, the new mitigations will remain in place and unchanged. If the positivity rate averages greater than or equal to 8% after 14 days, more stringent mitigations can be applied to further reduce spread of the virus.
Region 4, the Metro East, remains under additional mitigation measures as well. Although the 7-day rolling average test positivity rate is less than 8%, it remains above 6.5% and has increased in recent days.
IDPH continues to monitor each region in the state for several key indicators to identify early, but significant increases of COVID-19 transmission in Illinois, potentially signifying resurgence. Indictors include an increase in the region’s positivity rate with a simultaneous increase in either hospital admissions for COVID-like-illness or a decrease in hospital capacity, or three consecutive days of greater than or equal to 8% test positivity rate (7-day rolling average). These indicators can be used to determine whether additional community mitigation interventions are needed for a region to prevent the further spread of COVID-19.
A full list of mitigation measures pertaining to some businesses and industries may be found on the Illinois Department of Commerce and Economic Opportunity (DCEO) website at www.dceocovid19resources.com/restore-illinois.
Above is from: https://capitolfax.com/2020/09/29/after-two-point-positivity-rate-jump-in-two-weeks-resurgence-mitigation-imposed-on-region-1/
September 29: 1362 New COVID 19 Cases in Illinois
24 additional fatalities in Illinois. 10 new COVID 19 cases in Boone County.
Region 1 (DeKalb, Rockford area, Sauk Valley) one day from COVID-19 mitigations; state positivity rate drops to 3.6%
One more day at or above 8% will trigger additional mitigations for Region 1
By JOHN SAHLYFollow12:14 PM
Nam Y. Huh
Caption
As a public service, Shaw Media will provide open access to information related to the COVID-19 (Coronavirus) emergency. Sign up for the newsletter here
The Illinois Department of Public Health reported 1,362 new confirmed cases of COVID-19 and 23 additional deaths Tuesday.
The seven-day rolling average of Illinois’ positivity rate decreased slightly to 3.6%. The state received the results of 45,624 COVID-19 tests in the 24 hours leading up to Tuesday afternoon.
Illinois now has seen 291,001 total cases of the virus and 8,637 people have died. The state has conducted a total of 5,566,276 tests since the start of the pandemic.
- Region 1 (DeKalb, Rockford area, Sauk Valley) one day from COVID-19 mitigations; state positivity rate drops to 3.6%
- Worldwide death toll from coronavirus eclipses 1 million
- Region 1 (DeKalb, Rockford area and Sauk Valley) hits 8% fail-safe as IDPH announces 1,709 new virus cases
As of late Monday, Illinois had 1,535 COVID-19 patients in the hospital. Of those, 363 were in intensive care units, and 151 were on ventilators.
Regional update: Additional restrictions can be placed on any of the state's 11 health regions if the region sustains an increase in its average positivity rate for seven days out of a 10-day period.
A region may also become more restrictive if there is a seven-day increase in hospital admissions for COVID-19-related illness or a reduction in hospital medical/surgical beds or ICU capacity below 20%. If a region reports three consecutive days with greater than an 8% average positivity rate, additional infection mitigation will be considered through a tiered system of restriction guidelines offered by the IDPH.
The North Suburban region (McHenry and Lake counties) has seen two days of positivity increases and one day of hospital admission increases. The region's positivity rate decreased slightly to 4.8%. Currently, 40% of medical/surgical beds are available and 49% of ICU beds.
The West Suburban region (DuPage and Kane counties) has seen two days of positivity increases and two days of hospital admission increases. The region's positivity rate remained flat at 5.4%. Currently, 32% of medical/surgical beds are available and 44% of ICU beds.
The South Suburban region (Will and Kankakee counties) has seen one day of positivity increases and four days of hospital admission increases. The region's positivity rate remained flat at 5.2%. Currently, 29% of the region's medical/surgical beds are available and 31% of ICU beds.
The North region (Boone, Carroll, DeKalb, Jo Daviess, Lee, Ogle, Stephenson, Whiteside and Winnebago counties) has seen eight days of positivity increases – meeting one of the criteria for stricter mitigation measures – and four days of hospital admission increases. The region's positivity rate increased to 8.3%, the highest rate of any of the state's 11 regions. Currently, 41% of medical/surgical beds are available and 50% of ICU beds.
This marked the second consecutive day the region's positivity has hit at or above the state's fail-safe of 8.0%. If it is at 8.0% or higher on Wednesday, the region will be subject to additional COVID-19 mitigation measures from the IDPH.
The North-Central region (Bureau, Fulton, Grundy, Henderson, Henry, Kendall, Knox, La Salle, Livingston, Marshall, McDonough, McLean, Mercer, Peoria, Putnam, Rock Island, Stark, Tazewell, Warren and Woodford counties) has seen two days of positivity increases and one day of hospital admission increases. The region's positivity rate increased slightly to 5.4%. Currently, 44% of medical/surgical beds are available and 45% of ICU beds.
Chicago has seen three days of positivity increases and four days of hospital admission increases. The region's positivity rate decreased to 4.4%. Currently, 26% of medical/surgical beds are available and 32% of ICU beds.
Suburban Cook County has seen three days of positivity increases and two days of hospital admission increases. The region's positivity rate remained flat at 5.1%. Currently, 27% of medical/surgical beds are available and 36% of ICU beds.
To see how other regions across the state are doing, see the full IDPH dashboard here.
****************************************************************************************************************************************************************
Is Mitigation on the Way?
Boone County officials prepare to re-enter COVID-19 mitigation this week
by: Michele Rave
Posted: Sep 28, 2020 / 05:09 PM CDT / Updated: Sep 28, 2020 / 05:09 PM CDT
BOONE COUNTY, Ill. (WTVO) — Boone County has one of the highest COVID-19 positivity rates in our area.
On Monday, the Board of Health discussed the next steps for them as they try to help local businesses.
Boone County health officials are preparing to go into mitigation this week or next. Forward Boone County as well as the Belvidere Chamber are doing what they can do aid local bars and restaurants if they are not allowed to have indoor dining.
There is no time limit for this phase. In fact, to get out of the mitigation process, Boone County has to hold a 6.5% positivity rate for three days. Reducing that rate is essential to getting back to normal.
“Providing some online resources to help some of our small businesses download some apps where they can have the public order online, do curbside pickup,” explained Amanda Mehl, the Public Health Administrator for the Boone County Health Department.
“So, if we do end up limiting and closing indoor dining and going back to more of the drive thru, walk up and pick up order options while we’re in mitigation we can assist our small businesses with those online options as well.”
Forward Boone County is encouraging businesses to attend their online discussion about what the mitigation steps will look like. The discussion is Tuesday at 7:00 p.m.
Join the meeting online at https://us02web.zoom.us/j/83499557500 or dial-in at 1.312.626.6799 Meeting ID: 834 9955 7500.
Above is from: https://www.mystateline.com/news/boone-county-officials-prepare-to-re-enter-covid-19-mitigation-this-week/
Monday, September 28, 2020
September 28: 1709 New COVID 19 Cases in Illinois
Region 1 (DeKalb, Rockford area and Sauk Valley) hits 8% fail-safe as IDPH announces 1,709 new virus cases
Two more days at or above 8% will trigger additional mitigations for Region 1
By JOHN SAHLYFollow12:12 PM
Ted Schurter
Caption
As a public service, Shaw Media will provide open access to information related to the COVID-19 (Coronavirus) emergency. Sign up for the newsletter here
The Illinois Department of Public Health reported 1,709 new confirmed cases of COVID-19 and 13 additional deaths Monday.
The seven-day rolling average of Illinois’ positivity rate remained flat at 3.7%. The state received the results of 41,142 COVID-19 tests in the 24 hours leading up to Monday afternoon.
Illinois now has seen 289,639 total cases of the virus and 8,614 people have died. The state has conducted a total of 5,520,652 tests since the start of the pandemic.
- Virus cases rise in U.S. heartland, home to anti-mask feelings
- Here's where each health region in northern Illinois stands as of Friday
As of late Sunday, Illinois had 1,491 COVID-19 patients in the hospital. Of those, 346 were in intensive care units, and 135 were on ventilators.
Regional update: Additional restrictions can be placed on any of the state's 11 health regions if the region sustains an increase in its average positivity rate for seven days out of a 10-day period.
A region may also become more restrictive if there is a seven-day increase in hospital admissions for COVID-19-related illness or a reduction in hospital medical/surgical beds or ICU capacity below 20%. If a region reports three consecutive days with greater than an 8% average positivity rate, additional infection mitigation will be considered through a tiered system of restriction guidelines offered by the IDPH.
The North Suburban region (McHenry and Lake counties) has seen two days of positivity increases and two days of hospital admission increases. The region's positivity rate increased slightly to 5.0%. Currently, 38% of medical/surgical beds are available and 48% of ICU beds.
The West Suburban region (DuPage and Kane counties) has seen two days of positivity increases and two days of hospital admission increases. The region's positivity rate increased slightly to 5.4%. Currently, 30% of medical/surgical beds are available and 41% of ICU beds.
The South Suburban region (Will and Kankakee counties) has seen two days of positivity increases and four days of hospital admission increases. The region's positivity rate decreased slightly to 5.2%. Currently, 28% of the region's medical/surgical beds are available and 30% of ICU beds.
The North region (Boone, Carroll, DeKalb, Jo Daviess, Lee, Ogle, Stephenson, Whiteside and Winnebago counties) has seen eight days of positivity increases – meeting one of the criteria for stricter mitigation measures – and three days of hospital admission increases. The region's positivity rate increased to 8.0%, the highest rate of any of the state's 11 regions. Currently, 40% of medical/surgical beds are available and 48% of ICU beds.
This marked the first time the region's positivity has hit the state's fail-safe of 8.0%. If it is at 8.0% or higher for the next two days, the region will be subject to additional COVID-19 mitigation measures from the IDPH.
The North-Central region (Bureau, Fulton, Grundy, Henderson, Henry, Kendall, Knox, La Salle, Livingston, Marshall, McDonough, McLean, Mercer, Peoria, Putnam, Rock Island, Stark, Tazewell, Warren and Woodford counties) has seen one day of positivity increases and two days of hospital admission increases. The region's positivity rate remained flat at 5.3%. Currently, 42% of medical/surgical beds are available and 43% of ICU beds.
Chicago has seen three days of positivity increases and three days of hospital admission increases. The region's positivity rate increased to 4.5%. Currently, 24% of medical/surgical beds are available and 30% of ICU beds.
Suburban Cook County has seen three days of positivity increases and one day of hospital admission increases. The region's positivity rate increased to 5.1%. Currently, 26% of medical/surgical beds are available and 34% of ICU beds.
To see how other regions across the state are doing, see the full IDPH dashboard here.
September 28: Johns Hopkins COVID 19 Report
COVID-19
Updates on the COVID-19 pandemic from the Johns Hopkins Center for Health Security.
The Center for Health Security is analyzing and providing updates on the COVID-19 pandemic. If you would like to receive these updates, please subscribe below and select COVID-19. Additional resources are also available on our website.
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.
EPI UPDATE The WHO COVID-19 Dashboard reports 32.97 million cases and 995,836 deaths as of 10:00am EDT on September 28. The global weekly incidence remained greater than 2 million new cases last week, but it decreased slightly (1.45%) compared to the previous week. At approximately 36,000 deaths per week (~5,142 deaths per day), the global cumulative COVID-19 mortality could reach 1 million by tomorrow.
Total Daily Incidence (change in average incidence; change in rank, if applicable)
1. India: 83,875 new cases per day (-7,719)
2. USA: 44,319 (+3,628)
3. Brazil: 26,811 (-3,785)
4. Argentina: 12,627 (+1,705)
5. France: 12,115 (+1,734; ↑ 1)
6. Spain: 10,920* (-185; ↓ 1)
7. Russia: 6,863 (+1,064; ↑ 1)
8. Colombia: 6,854 (-111; ↓ 1)
9. Israel: 6,086 (+1,538; ↑ 1)
10. Indonesia: 5,846 (+2,090; new)
Per Capita Daily Incidence (change in average incidence; change in rank, if applicable)
1. Israel: 703 daily cases per million population (+178)
2. Andorra: 503 (+96; ↑ 2)
3. Montenegro: 387 (-45; ↓ 1)
4. Bahrain: 359 (-53; ↓ 1)
5. Argentina: 279 (+38)
6. Costa Rica: 234 (+2)
7. Spain: 234* (-4)
8. Czech Republic: 205 (+31)
9. France: 186 (+27; new)
10. Peru: 158 (-12; ↓ 1)
*Spain’s average daily incidence is not reported for today; these values correspond to the previous day’s averages.
India’s daily incidence continues to decline from its peak in mid-September, down 10% over the past 2 weeks. Peru fell out of the top 10 in terms of total daily incidence, and it was replaced by Indonesia. Israel set a new record for per capita incidence over the weekend, with 718 daily cases per million population. The Bahamas fell out of the top 10 in terms of per capita daily incidence, and it was replaced by France.
UNITED STATES
The US CDC reported 7.06 million total cases and 204,033 deaths. From the first case reported in the US on January 22, it took 96 days to reach 1 million cases. From there:
1 million to 2 million: 44 days
2 million to 3 million: 27 days
3 million to 4 million: 15 days
4 million to 5 million: 17 days
5 million to 6 million: 22 days
6 million to 7 million: 25 days
The US is averaging 44,307 new cases and 755 deaths per day. This is the highest average daily incidence since August 21 and nearly 30% greater than the low reported on September 12. We are now 3 weeks past the Labor Day holiday—which is also typically the latest that US schools begin the school year—and the US is exhibiting another increase in incidence at the national level.
In total, 22 states (no change) are reporting more than 100,000 cases, including California and Texas with more than 700,000 cases; Florida with more than 600,000; New York with more than 400,000; Georgia with more than 300,000; and Arizona, Illinois, New Jersey, and North Carolina with more than 200,000. California’s state COVID-19 website is currently reporting more than 800,000 cases, and Florida’s COVID-19 website is reporting more than 700,000 cases. We expect both of those to be reflected in the CDC data in the coming days.
The Johns Hopkins CSSE dashboard reported 7.12 million US cases and 204,790 deaths as of 11:30pm EDT on September 28.
FLORIDA On Friday, Florida Governor Ron DeSantis announced that the state would enter Phase 3 of Florida’s COVID-19 recovery plan, which would essentially lift all COVID-19-related restrictions on businesses, including measures that restricted capacity for bars and restaurants. Local governments are permitted to institute their own COVID-19 restrictions on restaurants; however, they must “quantify the economic impact of each limitation” and justify “why each limitation...is necessary for public health.” Governor DeSantis’ executive order also suspends fines or other penalties for individuals who do not comply with COVID-19 restrictions. Businesses are still free to set and enforce their own policies for employees and patrons. The announcement comes as Florida surpasses 700,000 cumulative cases, and COVID-19 incidence is increasing in many parts of the country.
VACCINE CLINICAL TRIAL Johnson & Johnson (J&J) published (preprint) preliminary findings from the Phase 1/2a clinical trials for its candidate SARS-CoV-2 vaccine (Ad26.COV.S). The studies included nearly 800 participants, who were split into 3 cohorts for the randomized, double-blinded, placebo-controlled study. The first 2 cohorts were made up of 402 healthy adults aged 18-55 years, and the third cohort included 394 healthy adults over the age of 65. The vaccine was given as a single dose or 2 doses administered 56 days apart. The vaccine was generally well tolerated, and the researchers reported 2 serious adverse events. One of the serious adverse events was determined to be unrelated to the vaccine, and the other was a fever that resolved within 12 hours.
Neutralizing antibody activity was observed in 98% of participants aged 18-55 years, and 99% of participants in those cohorts also demonstrated seroconversion following the vaccination. The younger adult cohorts also had strong T cell, antibody, and a Th1 cytokine response. Only 15 participants from the older cohort had immunogenicity data available, although the researchers reported that initial data are promising. Last week, J&J announced that it will commence Phase 3 clinical trials involving 60,000 participants across approximately 215 sites to test the single-dose vaccine formulation. The J&J candidate vaccine is the only vaccine in Phase 3 trials utilizing only 1 dose, which may expedite results of the trial.
SUSCEPTIBILITY IN CHILDREN & ADOLESCENTS A systematic review and meta-analysis published in JAMA: Pediatrics describes findings from 32 contact tracing studies and population screening studies to compare susceptibility to SARS-CoV-2 infection among children and adolescents to susceptibility among adults. The researchers—from Australia, the Netherlands, and the UK—evaluated studies representing 41,640 children and 268,945 adults. They determined that individuals under 20 years old had 44% lower odds of infection compared to older adults, a statistically significant difference. Notably, they determined that this association appeared to be largely attributable to younger children—under the age of 10-14 years—and that adolescents appeared to have similar infection risk as adults.
The younger children also exhibited lower seroprevalence compared to adults, but adolescents and adults exhibited similar seroprevalence. Many of the included studies were conducted at a time when highly restrictive social distancing measures were in place, including school closings, which could have affected children’s exposure both inside and outside the home. Additionally, contact tracing efforts and community-level seroprevalence studies had lower participation for children compared to adults. The researchers were unable to determine the risk of community transmission by children, and further research is necessary to better characterize the role of pediatric cases in the COVID-19 pandemic. This study does provide evidence that older children and adolescents may be similarly susceptible to SARS-CoV-2 as adults.
DRIED BLOOD SPOT TESTING A study published in the US CDC’s Emerging Infectious Diseases journal demonstrates that dried blood spot (DBS) samples could be used to detect SARS-CoV-2 antibodies. Compared to blood serum, which must be obtained by venipuncture, DBS specimens are much easier to collect, including at home by the general public; ship/transport; and process. A study of 80 participants in the UK tested 87 DBS specimens against matched blood serum specimens from the same participant. The DBS test exhibited 98% sensitivity and 100% specificity compared to the serum samples. DBS testing is used to test for antibodies for a variety of other pathogens, and this capability could reduce the cost, difficulty, and logistical burden of expanding community-level seroprevalence efforts, particularly in lower- and middle-income countries. Additional study is needed to fully characterize the capabilities of DBS testing for SARS-CoV-2, but this initial data provides promising indication that DBS could be a useful tool during the COVID-19 pandemic.
FACE COVERINGS The use and availability of face coverings, including for the general public and for healthcare workers, has been one of the major ongoing storylines over the course of the pandemic. Researchers continue to evaluate the role of masks and other face coverings in mitigating SARS-CoV-2 transmission, and hospitals and health systems in the US (and likely elsewhere) continue to struggle to maintain sufficient supply of respirators and surgical masks that are critical for protecting healthcare workers and patients.
Researchers from the University of California Davis and the Icahn School of Medicine at Mount Sinai (New York) published findings from a study to evaluate the ability of various mask types in reducing exhaled respiratory droplets. The study, published in Scientific Reports (a Nature journal), evaluated several different mask types, including N95 and KN95 respirators (vented and unvented; not fit-tested), surgical masks, and homemade cloth masks (single and double-layer). Measurements for respiratory droplets were taken while participants breathed, spoke, coughed, and chewed, and additional measurements were taken before and after washing cloth masks. The respirators and surgical masks exhibited a statistically significant decrease in respiratory droplets, whereas the homemade t-shirt masks did not. Notably, the cloth masks resulted in an increase in droplets in some instances, similar to results from a previous study that found increased droplets for neck gaiters. The researchers determined that cloth masks have the potential to shed cloth particles as the material breaks down, which could contribute to the volume of airborne particles. The current study only evaluated paper towel and t-shirt material for the homemade masks, and further research is needed to better characterize the effects of different types of cloth and mask construction. The researchers also note that the sampling methodology did not account for droplets that escape around the edges of the masks.
An investigation conducted by ECRI—”an independent, nonprofit organization improving the safety, quality, and cost-effectiveness of care across all healthcare settings”—found that KN95 respirators originating in China may not provide sufficient protection for healthcare workers. During the pandemic, KN95 respirators have been used to supplement limited supply of NIOSH-certified N95 respirators, including in healthcare settings. In theory, KN95 respirators should provide similar filtration capabilities as the certified N95 respirators; however, ECRI found that some KN95 respirators do not meet the same filtering standards. The researchers tested 200 respirators across 15 different models, and 60-70% of the KN95 masks imported from China did not filter 95% of airborne particles like they should. Notably, it may be difficult to distinguish between KN95 and N95 respirators visually; however, many of the tested KN95 respirators utilize ear loops, as opposed to elastic straps that go around the head and neck, which do not provide an adequate seal between the respirator and the wearer’s face. ECRI recommended that hospitals and health systems purchasing KN95 respirators conduct tests to ensure the products are providing appropriate protection. In April, the US FDA issued an Emergency Use Authorization (EUA) for non-NIOSH-certified respirators, and it has issued several updates since then to address quality control issues with imported products, including a list of products no longer authorized under the EUA due to inadequate performance.
DISEASE SEVERITY INDICATORS Last week, two studies published in Science provide evidence that type 1 interferon may play an important role in fighting SARS-CoV-2 infection. The first article, researchers conducted whole-genome or exome sequencing for for 659 patients with life-threatening pneumonia due to COVID-19 and compared the results against sequencing from 534 participants with asymptomatic infection or mild disease. The researchers evaluated the genomes for 13 rare mutations associated with decreased interferon production. Among the patients with severe COVID-19 infection, 3.5% had loss of function in one of these genes, representing 8 of the 13 mutations evaluated. Notably, no members of the control group (asymptomatic/mild) had any of these mutations.
The second study found the body’s immune response could also inhibit interferon activity in patients who are able to produce their own in sufficient quantities. Among 987 patients with severe COVID-19 pneumonia, the researchers identified “rogue antibodies” (auto-Abs) that attacked interferon in 101 patients. These antibodies were not observed in 663 individuals with asymptomatic infection or mild disease, and only 4 of 1,227 healthy individuals had the rogue antibodies. Interestingly, 94% of the patients with the rogue antibodies were male.
These studies may help identify individual risk factors for developing severe COVID-19 disease. The authors indicate that these 2 conditions could account for 14% of severe COVID-19 cases. They suggest that convalescent plasma donors be screened for rogue antibodies prior to donation to reduce the chance that they could attack interferon in patients receiving the treatment and that synthetic interferons could be a potential area of investigation in terms of developing additional treatment options.
RELIGIOUS PRACTICES As Israel’s COVID-19 epidemic continues to surge, setting new records in terms of per capita daily incidence, Jewish rabbis, particularly those serving ultra-Orthodox communities, are addressing a myriad of questions to help their followers safely worship during the High Holiday season. Social distancing restrictions have had significant impacts on religious services around the world, in particular on the role of large gatherings for many religious holidays and celebrations. The questions posed to ultra-Orthodox rabbis range from how to best lead prayers and services remotely (eg, via Zoom) to the role of blessing food for those who lost their senses of taste and smell due to COVID-19. There has been some opposition to social distancing measures in some ultra-Orthodox communities, including keeping schools open during national “lockdowns,” but the Israeli government is working to engage with local religious leaders and promote lower-risk alternatives or adaptations for religious services and celebrations, particularly for the High Holiday season.
JOHNS HOPKINS COVID-19 DASHBOARD Since the early days of the COVID-19 pandemic, the Johns Hopkins Coronavirus Resource Center, including the global and US dashboards developed by the Center for Systems Science and Engineering (CSSE), has served as a principal source of updated COVID-19 information for experts and the public around the world. COVID-19 data published via these resources are cited by elected officials, experts, and the media, often over officially reported data. On Wednesday, September 30 (4-5pm EDT), the Science and Entertainment Exchange (US National Academy of Sciences) will host a webinar featuring several experts from across the Johns Hopkins University and Medicine system—including the Center for Health Security’s own Dr. Jennifer Nuzzo—to discuss the dashboard and the role of data in the COVID-19 response, including efforts to compile, analyze, and present data collected from a variety of disparate sources and ways that these data can and should be leveraged to support response operations at all levels of government.
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