U.S. Daily COVID Case Count Nears Record for Pandemic

FRIDAY, Oct. 23, 2020 (HealthDay News) -- The United States on Thursday recorded its second highest daily total of new coronavirus cases since the pandemic began, with 75,000 new infections, while eight states broke single-day records of new cases.

Also on Thursday, the antiviral medicine remdesivir became the first drug to gain U.S. Food and Drug Administration approval to fight COVID-19.

Such drugs are urgently needed: Adding to bleak national numbers, 13 additional states have added more cases in the past week than in any other seven-day stretch, The New York Times reported.

The Midwest and Rocky Mountains are struggling to contain major outbreaks, while new hot spots are emerging in other parts of the country. Kentucky announced more than 1,470 cases on Thursday, the biggest one-day jump ever in that state. And Colorado reported more than 1,300 cases, setting another single-day record, the Times reported. In Chicago, a nightly curfew will start on Friday, after officials reported an average of 645 new cases a day this past week, the newspaper said.

The current record for new daily cases was recorded in mid-July, when over 77,000 infections were recorded in one day.

Coronavirus cases have also been climbing on college campuses, where more than 214,000 infections have been diagnosed this year, a Times survey showed. More than 35,000 of those cases have been reported since early October.

While some colleges moved all classes online for the fall, many campuses remained open as positive tests accumulated, the Times reported. Of more than 1,700 institutions surveyed, more than 50 reported at least 1,000 cases while over 375 colleges have reported at least 100 cases.

The 214,000 cases account for 2.5 percent of all known cases in the United States, the Times reported. That tally is likely an undercount because some colleges have refused to provide any case data or have stopped giving updates. Large universities in the South and Midwest reported the highest case totals, including seven campuses where there have been more than 3,000 cases, the Times said.

Remdesivir gets full FDA approval to treat COVID

Remdesivir's full approval Thursday by the FDA comes after the agency granted it emergency use authorization last spring. It is given intravenously to hospitalized patients.

California-based Gilead Sciences Inc. is selling the drug under the brand name Veklury. It cut the time to recovery from COVID-19 by five days -- from 15 days to 10, on average -- in a large study led by the U.S. National Institutes of Health, the FDA announced in a statement.

"Today's approval is supported by data from multiple clinical trials that the agency has rigorously assessed and represents an important scientific milestone in the COVID-19 pandemic," FDA Commissioner Stephen Hahn said in the news release.

Veklury is approved for people aged 12 and older who weigh at least 88 pounds and are hospitalized for a COVID-19 infection. For patients younger than 12, the FDA will still allow the drug's use in certain cases under its previous emergency authorization.

The drug works by blocking the ability of the virus to replicate itself. Kidney and liver function tests are required before giving patients remdesivir, and the label warns against using it with the malaria drug hydroxychloroquine, because that can curb its effectiveness, the AP reported.

"We now have enough knowledge and a growing set of tools to help fight COVID-19," Gilead's chief medical officer, Dr. Merdad Parsey, said in a statement.

Remdesivir is either approved or has temporary authorization in about 50 countries, Parsey noted.

Its price has been controversial, costing between $2,000 and $3,000 for one course of treatment, given that no studies have yet found that it improves survival, according to the Associated Press. Last week, a large study led by the World Health Organization found the drug did not help hospitalized COVID-19 patients, but that study did not include a placebo group and was less rigorous than previous ones that found a benefit, the AP reported.

So far, only steroids such as dexamethasone have been shown to cut the risk of dying of COVID-19, the AP reported. The FDA also has given emergency authorization to using the blood plasma of survivors, and two companies are seeking emergency authorization for experimental antibody drugs.

CDC widens definition of 'close contact' for tracking COVID infections

In a move that widens the pool of people considered at risk for coronavirus infection, U.S. health officials released new guidance this week that redefines who's considered a "close contact" of an infected individual.

The change, issued by the U.S. Centers of Disease Control and Prevention, will likely have the biggest impact in group settings where people are in repeated contact with others for brief periods over the course of a day, such as schools and workplaces, the Washington Post reported.

The CDC had previously defined a "close contact" as someone who spent at least 15 consecutive minutes within six feet of a confirmed coronavirus case. Now, a close contact will be defined as someone who was within six feet of an infected individual for a total of 15 minutes or more over a 24-hour period. State and local health departments rely on this definition to conduct contact tracing, the Post reported.

CDC scientists had been discussing the new guidance for several weeks, said an agency official who spoke on the condition of anonymity, the Post reported. Then came unsettling evidence in a government report published Wednesday: CDC and Vermont health officials had discovered the virus was contracted by a 20-year-old prison employee who in an eight-hour shift had 22 interactions -- for a total of over 17 minutes -- with individuals who later tested positive for the virus.

Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security in Baltimore, called the updated guidance an important change.

"It's easy to accumulate 15 minutes in small increments when you spend all day together -- a few minutes at the water cooler, a few minutes in the elevator, and so on," Rivers told the Post. "I expect this will result in many more people being identified as close contacts."

At the same time, it's not clear whether the multiple brief encounters were the only explanation for how the prison employee became infected, Rivers added. Other possibilities might have included airborne or surface transmission of the virus. She also noted that the new guidance "will be difficult for contact tracing programs to implement, and schools and businesses will have a difficult time operating under this guidance."

COVID continues to spread around the globe

By Friday, the U.S. coronavirus case count passed 8.4 million while the death toll climbed above 223,000, according to a Times tally.

According to the same tally, the top five states in coronavirus cases as of Friday were: California with over 896,000; Texas with more than 891,000; Florida with over 768,000; New York with nearly 495,000; and Illinois with more than 365,000.

Curbing the spread of the coronavirus in the rest of the world remains challenging.

Several European countries are experiencing case surges as they struggle with another wave of coronavirus infections and hospital beds begin to fill up, the Post reported.

In England, Prime Minister Boris Johnson has instituted a three-tier lockdown in a bid to slow a startling spike in coronavirus cases across the country. In the past three weeks, new coronavirus cases have quadrupled and there are now more COVID-19 patients hospitalized than before the government imposed a lockdown back in March, the Post reported.

Addressing the nation recently, Johnson warned Britons that the country's rise in cases was "flashing like dashboard warnings in a passenger jet."

Things are no better in India, where the coronavirus case count has passed 7.7 million, a Johns Hopkins tally showed.

Nearly 117,000 coronavirus patients have died in India, according to the Hopkins tally, but when measured as a proportion of the population, the country has had far fewer deaths than many others. Doctors say this reflects India's younger and leaner population.

Still, the country's public health system is severely strained, and some sick patients cannot find hospital beds, the Times said. Only the United States has more coronavirus cases.

Meanwhile, Brazil passed 5.3 million cases and had nearly 156,000 deaths as of Friday, the Hopkins tally showed.

Cases are also spiking in Russia: The country's coronavirus case count has passed 1.4 million. As of Friday, the reported death toll in Russia was over 25,300, the Hopkins tally showed.

Worldwide, the number of reported infections passed 41.7 million on Friday, with over 1.1 million deaths, according to the Hopkins tally.

More information

The U.S. Centers for Disease Control and Prevention has more on the new coronavirus.