The ventilators never came: How graft hampered Brazil’s COVID-19 response

By Gram Slattery and Ricardo Brito

RIO DE JANEIRO (Reuters) – As COVID-19 patients flooded Rio de Janeiro’s public health system from early April to late May, Dr. Pedro Archer found himself making gut-wrenching decisions.

People struggling to breathe needed ventilators, he said, but there weren’t enough to go around; those with a slim chance of recovery were passed over.

“Every shift it was like that,” said Archer, a surgeon at a municipal hospital in Rio de Janeiro, a metropolis of 6.7 million people anchoring a state of the same name. “Sometimes, I would give them sedatives just so that they didn’t suffer. Eventually, they would pass away.”

Some of those deaths, state and federal prosecutors now say, may have been avoidable. They allege that top officials here sought to pocket up to 400 million reais ($72.2 million) via corruption schemes that steered inflated state contracts to allies during the pandemic. The deals, they said, included three contracts for 1,000 ventilators, most of which never arrived.

Rio state Health Secretary Edmar Santos was arrested July 10 and charged with corruption in connection with those contracts. A lawyer for Santos did not respond to a request for comment. Santos admitted to participating in various illicit schemes involving rigged public tenders, according to confidential court documents prepared by federal investigators laying out the alleged scams, which were reviewed by Reuters. He is now a cooperating witness in the probe, the documents said.

Separately, a federal judge suspended Rio state Governor Wilson Witzel from office on August 28 out of concern he might interfere with the investigations. Witzel is also facing impeachment proceedings over alleged graft.

He denied wrongdoing in a statement to Reuters. Vice-Governor Claudio Castro, who took over for Witzel in August, did not respond to a request for comment.

Latin America has been hit hard by the pandemic, with over 8.9 million confirmed coronavirus cases as of September 24, according to a Reuters tally. Brazil alone has registered over 139,000 COVID-19 deaths, second only to the United States.

If the city of Rio were a country, its per capita mortality rate from the coronavirus would rank as the world’s worst, according to a Reuters calculation based on John Hopkins University data. More than 10,000 people have died from COVID-19 in this postcard city of sea and sand, and more than 18,000 statewide.

The region’s response to the pandemic has been hobbled by various factors, experts say, including poverty and crowded urban living conditions. Some leaders, including Brazil’s right-wing President Jair Bolsonaro, have played down the pandemic’s severity.

But the virus has also been aided by greed.

Similar to Brazil, investigators in Bolivia, Ecuador, Colombia and Peru have likewise alleged that officials there lined their pockets through pandemic-related graft schemes.

In court documents detailing the alleged scams in Rio, Brazilian prosecutors describe a series of inter-related criminal enterprises, in which emergency contracts for masks, coronavirus tests – even hand gel – were allegedly rigged.

Reuters reviewed hundreds of pages of prosecutors’ allegations, many confidential and not previously reported; and it interviewed more than a dozen medical professionals and good-government experts who condemned the opportunism they say has compounded coronavirus misery in Rio.

“The pandemic allowed governments to spend significant resources very quickly while internal controls were relaxed due to the emergency,” said Guilherme France, research director for Transparency International in Brazil. “It ended up creating a perfect storm for corruption.”

A representative of Witzel said the suspended governor increased internal controls in the Rio state government, adding that he had fired many public servants accused of “irregularities” during his time in power.

GHOST HOSPITALS

Rio state’s pandemic response called for seven field hospitals to treat COVID-19 patients. Officials at the state health ministry, known as SES, awarded contracts worth 836 million reais ($151 million) to a nonprofit health organization named IABAS to build the structures, which were to open by April 30. Just two have  opened so far, one in mid-May, the other in late June, well after the initial COVID-19 surge.

In late July, as the pandemic eased in Rio, one of those structures located in the working-class city of São Gonçalo was dismantled amid a lack of patients. All that remains is a large field, stripped of grass and littered with debris.

The IABAS contracts are part of an alleged kickback racket spearheaded by Mario Peixoto, a local entrepreneur arrested in May for reputedly defrauding the Rio state health system. Federal court documents submitted by prosecutors describe a complex scheme in which associates of Peixoto allegedly arranged for bribes to be routed to government officials to secure a variety of public health contracts, including the field hospitals.

Lawyers for Peixoto said he is innocent and did not participate in the field hospital deal. His trial is pending.

Federal prosecutors have not charged IABAS. But in confidential court documents they filed asking a judge to authorize the arrest of additional suspects, they said there was no “room for doubt” that IABAS’ winning bid was tainted by graft. Among the various irregularities cited by prosecutors: IABAS drafted its winning proposal before SES solicited offers.

IABAS told Reuters it won the hospital contracts by offering the lowest price. It said SES made frequent changes to the agreement, which slowed construction. IABAS said six of the seven structures were either completed or nearly finished in early June, when Rio state canceled its contract and took control of all the project sites.

In a statement to Reuters, SES disputed IABAS’ characterization of the progress it had made. It said four of the seven field hospitals were far from complete when the state took over.

SES declined to comment on IABAS’ allegation that the health ministry made frequent changes to the construction agreement. SES said it had saved more than 500 million reais ($90.3 million) by suspending payments to IABAS following the corruption allegations made by prosecutors. The ministry said it is cooperating with the investigation.

MISSING VENTILATORS

Prosecutors say Rio’s state government also rushed out ventilator contracts to three companies that had little or no relevant experience.

According to court documents summarizing prosecutors’ findings, Rio on March 21 awarded a little-known firm, Arc Fontoura, a contract worth 68 million reais ($12.3 million) to provide 400 ventilators for immediate delivery. State auditors have since determined Rio’s health ministry paid a nearly 200% markup from the market price.

Arc Fontoura had not previously contracted with the state, and tax documents indicated the firm’s annual revenue was no more than 4.8 million reais ($870,000), prosecutors said. The company’s registered address, Reuters found, is a small residence in a working-class part of the city.

When Rio received a small batch of the ventilators from the company at the end of March, hospital workers complained to SES that the machines lacked key components, prosecutors said in the court documents summarizing their findings. The documents did not make clear in which hospital the health workers were stationed.

Arc Fontoura did not respond to phone calls or e-mails or receive Reuters at its listed address.

On April 1, SES awarded contracts worth a combined 116 million reais ($20.9 million) to two other firms – MHS Produtos e Servicos and A2A Comercio – to supply 300 ventilators each.

Rio prosecutors quickly identified irregularities, according to court documents, starting with the timing of the companies’ bids.  The little-known enterprises submitted their proposals less than an hour after SES opened the tender, which was not advertised beforehand, a sign the firms had been tipped off, prosecutors said.

By May 8, Rio’s state health department said publicly that of the 1,000 ventilators it had ordered, just 52 had been delivered, all from Arc Fontoura. SES said in early May it had canceled its contract with A2A because of “the company’s inability to deliver” the ventilators. A2A did not respond to requests for comment.

MHS owner Glauco Guerra  denied wrongdoing. He said in an email that his company had significant experience providing services to federal agencies. He said he submitted his bid a day after the tender was opened, not within a few hours, as prosecutors had alleged. Guerra said SES entered his bid documents into its computer system in a way that led prosecutors to misinterpret the timeline.

He said 97 ventilators were delivered to SES on June 6, and that the agency later canceled the contract for the remainder. State prosecutors confirmed in public documents seen by Reuters that 97 ventilators ordered by MHS had arrived at a Rio airport in early June.

SES said in a statement to Reuters that all contracts signed “during the pandemic are being audited and revised,” adding that any irregularities will be punished. The ministry declined to comment on  MHS’ claim that its bid documents were entered into the SES system in a misleading fashion, citing ongoing investigations into the matter.

Archer, the surgeon, says his experience battling COVID-19 without enough ventilators has left him bitter.

During the peak of the pandemic in April and May, he said as many as 30 patients in his care were waiting for the machines. Many were too unstable to move to hospitals elsewhere and ultimately died, he said.

How many patients could have been saved, he wondered. How many did corruption kill?

“It’s very difficult to accept things you know are wrong,” Archer said.

(Reporting by Gram Slattery in Rio de Janeiro and Ricardo Brito in Brasília; Additional reporting by Rodrigo Viga Gaier in Rio de Janeiro; editing by Stephen Eisenhammer and Marla Dickerson)

U.S. surpasses grim milestone of 200,000 COVID-19 deaths

By Sangameswaran S

(Reuters) – The death toll from the spread of the coronavirus in the United States exceeded 200,000 on Tuesday, by the far the highest number of any nation.

The United States, on a weekly average, is now losing about 800 lives each day to the virus, according to a Reuters tally. That is down from a peak of 2,806 daily deaths recorded on April 15.

During the early months of the pandemic, 200,000 deaths was regarded by many as the maximum number of lives likely to be lost in the United States to the virus.

The University of Washington’s health institute is forecasting coronavirus fatalities reaching 378,000 by the end of 2020, with the daily death toll skyrocketing to 3,000 per day in December.

Over 70% of those in the United States who have lost their lives to the virus were over the age of 65, according to CDC data.

The southern states of Texas and Florida contributed the most deaths in the United States in the past two weeks and were closely followed by California.

California, Texas and Florida – the three most populous U.S. states – have recorded the most coronavirus infections and have long surpassed the state of New York, which was the epicenter of the outbreak in early 2020. The country as a whole is reporting over 42,000 new infections on average each day and saw cases last week rise on a weekly basis after falling for eight weeks in a row.

Deaths rose 5% last week after falling for four weeks in a row, according to a Reuters analysis.

Six out of every 10,000 residents in the United States has died of the virus, according to Reuters data, one of the highest rates among developed nations.

Brazil follows the United States in the number of overall deaths due to the virus, with over 137,000 fatalities. India has had the world’s highest daily death rate over the last week with total deaths now approaching 100,000.

(Reporting by Sangameswaran S in Bengaluru; Additional reporting by Susan Heavey in Washington; Editing by Lisa Shumaker and Rosalba O’Brien)

U.S. to surpass grim milestone of 200,000 COVID-19 deaths

By Sangameswaran S

(Reuters) – The death toll from the spread of coronavirus in the United States was approaching over 200,000 lives on Monday, more than double the number of fatalities in India, the country reporting the second-highest number of cases in the world.

The United States, on a weekly average, is now losing about 800 lives each day to the virus, according to a Reuters tally. That is down from a peak of 2,806 daily deaths recorded on April 15.

During the early months of the pandemic, 200,000 deaths was regarded by many as the maximum number of lives likely to be lost in the United States to the virus.

U.S. Centers for Disease Control and Prevention (CDC) Director Robert Redfield recently told Congress that a face mask would provide more guaranteed protection than a vaccine, which would only be broadly available by “late second quarter, third quarter 2021.”

The CDC currently predicts that the U.S. death toll will reach as high as 218,000 by Oct. 10.

The University of Washington’s health institute is forecasting coronavirus fatalities reaching 378,000 by the end of 2020, with the daily death toll skyrocketing to 3,000 per day in December.

Over 70% of those in the United States who have lost their lives to the virus were over the age of 65, according to CDC data.

The southern states of Texas and Florida contributed the most deaths in the United States in the past two weeks and was closely followed by California.

California, Texas and Florida – the three most populous U.S. states – have recorded the most coronavirus infections and have long surpassed the state of New York, which was the epicenter of the outbreak in early 2020. The country as a whole is reporting over 40,000 new infections on average each day.

As it battles a second wave of infections, the United States reported a 17% increase in the number of new cases last week compared with the previous seven days, with deaths rising 7% on average in the last, according to a Reuters analysis.

Six out of every 10,000 residents in the United States has died of the virus, according to Reuters data, one of the highest rates among developed nations.

Brazil follows the United States in the number of overall deaths due to the virus, with over 136,000 fatalities.

(Reporting by Sangameswaran S in Bengaluru; Editing by Lisa Shumaker and Rosalba O’Brien)

What you need to know about the coronavirus right now

(Reuters) – Here’s what you need to know about the coronavirus right now:

Biden rejects Trump claim that vaccine is imminent

U.S. Democratic presidential candidate Joe Biden on Thursday bluntly contradicted President Donald Trump’s suggestion that a coronavirus vaccine may be only weeks away, warning Americans they cannot trust the president’s word.

“The idea that there’s going to be a vaccine and everything’s gonna be fine tomorrow – it’s just not rational,” Biden said during a CNN town hall in Moosic, Pennsylvania.

Trump again said on Wednesday that a vaccine for COVID-19 could be ready for distribution ahead of the Nov. 3 election.

Most health experts, including Robert Redfield, the director of the Centers for Disease Control and Prevention, have said a vaccine will likely not be widely available until mid-2021.

Israel imposes second lockdown

Israel will enter a second nationwide lockdown on Friday at the onset of the Jewish high-holiday season, forcing residents to stay mostly at home amid a resurgence in new coronavirus cases.

The country’s initial lockdown was imposed in late March and eased in May as new cases tapered off, reaching lows in the single digits.

But in the past week, new cases have reached daily highs of over 5,000, and Israeli leaders now acknowledge they lifted measures too soon.

The new lockdown will last three weeks and coincides with the start of the Jewish New Year, Rosh Hashana, traditionally a time for large family gatherings and group prayer.

UK COVID hospital admissions double every eight days

Britain’s health minister said that the novel coronavirus was accelerating across the country, with hospital admissions doubling every eight days, but he refused to say if another national lockdown would be imposed next month.

The United Kingdom has reported the fifth-highest number of deaths from COVID-19 in the world after the United States, Brazil, India and Mexico, according to data collected by Johns Hopkins University of Medicine.

COVID-19 cases started to rise again in Britain in September, with between 3,000 and 4,000 positive tests recorded daily in the last week. More than 10 million people are already in local lockdowns.

China reports highest new cases since Aug. 10

Mainland China reported 32 new COVID-19 cases on Thursday, marking the highest daily increase in more than a month and up sharply from nine cases reported a day earlier.

Although the latest increase still remains well below the peaks seen at the height of the outbreak in China early this year, it is the biggest since Aug. 10 and suggests continued COVID-19 risks stemming from overseas travelers coming into the country as the pandemic rages on in other parts of the world.

The National Health Commission said that all new cases were imported infections. Mainland China has not reported any local COVID-19 infections since mid-August.

Canada’s Ontario clamps down on parties

Canada’s most populous province will clamp down on social gatherings to prevent “reckless careless people” from spreading the coronavirus at illegal parties, Ontario Premier Doug Ford said on Thursday.

His warning came as the nation’s top medical officer said authorities could potentially lose the ability to manage the pandemic.

Indoor social events in Toronto, Canada’s biggest city – along with Ontario’s Peel and Ottawa regions – would be authorized to include no more than 10 people, down from a previous limit of 50, Ford said.

“This is a serious situation, folks. We will throw the book at you if you break the rules,” he told a news conference.

(Compiled by Linda Noakes; Editing by Hugh Lawson)

Latin American nations seek more time to join WHO vaccine plan

By Anthony Boadle

BRASILIA (Reuters) – Several Latin American countries have informed the World Health Organization (WHO) they intend to request more time to sign up for its global COVID-19 vaccine allocation plan known as COVAX, an official at the WHO’s regional branch said on Thursday.

Countries have until midnight on Friday to formalize legally binding commitments to COVAX, a mechanism for pooled procurement and equitable distribution of eventual vaccines.

A representative for the GAVI Alliance, the COVAX secretariat, said by email that details of which nations have joined COVAX will only be made public after the deadline.

Health officials in Mexico, which has the worst outbreak in Latin America after Brazil, said their country would sign the commitment on time. Brazil, which has the world’s most severe outbreak outside the United States and India, was still studying what to do, a ministry spokesperson said.

More than 170 countries have joined the global vaccine plan to help buy and distribute immunization shots for COVID-19 fairly around the world, WHO’s director general Tedros Adhanom Ghebreyesus said on Thursday.

Jarbas Barbosa, assistant director of the Pan-American Health Organization, said in a briefing on Wednesday that Latin American countries were having trouble meeting the deadline and some wanted to push back the date.

Barbosa said all countries in the Americas except the United States had expressed interest in the vaccine facility, even those that have separate agreements with vaccine makers, because it gives them an added guarantee of access to doses.

Ten Latin American countries are among 90 poor nations in the world that will not have to pay for the vaccine, while the others in the region will pay an “accessible” price through COVAX, Barbosa said.

Colombian President Ivan Duque confirmed on Wednesday that his government was joining COVAX and Paraguay’s health ministry said it has already signed, even as it plans to buy the vaccine being developed by AstraZeneca PLC and Oxford University.

(Reporting by Anthony Boadle in Brasilia, Diego Ore in Mexico City, Julia Cobb in Bogotá, Daniela Desantis in Asunción; Editing by Daniel Flynn and Chizu Nomiyama)

Global coronavirus cases surpass 30 million: Reuters tally

By Jane Wardell

(Reuters) – Global coronavirus cases exceeded 30 million on Thursday, according to a Reuters tally, with the pandemic showing no signs of slowing.

India was firmly in focus as the latest epicenter, although North and South America combined still accounted for almost half of the global cases.

Global new daily case numbers reached record levels in recent days and deaths neared 1 million as the international race to develop and market a vaccine heated up.

The official number of global coronavirus cases is now more than five times the number of severe influenza illnesses recorded annually, according to World Health Organization data.

Around the world, there have been almost 1 million deaths, considered a lagging indicator given the two-week incubation period of the virus. That has well exceeded the upper range of 290,000 to 650,000 annual deaths linked to influenza.

India this week became only the second country in the world, after the United States, to record more than 5 million cases. On Thursday, it reported another record daily rise in cases of almost 98,000.

The south Asian nation, the world’s second most populous country, has been reporting more new daily cases than the United States since mid-August and accounts for just over 16% of global known cases.

Reported deaths in India have been relatively low so far but are showing an uptick, and the country has recorded more than 1,000 deaths every day for the last two weeks.

The United States has about 20% of all global cases, although it has just 4% of the world’s population. Brazil, the third worst-hit country, accounts for roughly 15% of global cases.

It took 18 days for global cases to surge from 25 million to more than 30 million. It took 20 days for the world to go from 20 million to 25 million and 19 days to go from 15 million to 20 million.

The global rate of new daily cases is slowing, reflecting progress in constraining the disease in many countries, despite a few big surges.

Australia on Thursday reported its lowest single-day case rise since June as strict lockdown measures in its second largest city of Melbourne, the center of the country’s second wave, appeared to pay off.

Health experts stress that official data almost certainly under-reports both infections and deaths, particularly in countries with limited testing capacity.

The race to develop and bring to market a novel coronavirus vaccine has grown increasingly frenetic in recent weeks with about 200 candidates in development globally.

U.S. President Donald Trump has said his country could have a vaccine ready for distribution before the U.S. election on Nov. 3, while a Chinese health official this week said China may have a vaccine ready for public use as early as November.

While the trajectory of the coronavirus still falls far short of the 1918 Spanish flu, which infected an estimated 500 million people, killing at least 10% of them, experts worry the available data is underplaying the true impact of the pandemic.

(Reporting by Jane Wardell; editing by Robert Birsel and Lisa Shumaker)

Swiss add Paris, Vienna to list of areas for coronavirus quarantine

ZURICH (Reuters) – Switzerland has added the regions around Paris and Vienna to its list of areas with high COVID-19 infection rates requiring incoming travelers to enter quarantine for 10 days.

The government said it was adopting a regional approach for neighboring countries for the measures which will come into force on Sept. 14. As part of this, it named Ile de France and the Vienna region as areas with a raised risk of infection.

The government also put the Czech Republic and all of Spain on its list of entire countries with a quarantine requirement, which already includes the United States,  India and Brazil.

“It is not a good idea to go to high-risk areas,” Health Minister Alain Berset told a media conference, advising Swiss travelers to steer clear of places on the list.

Switzerland, which has had quarantine restrictions since July 6, said it was responding to a spike in infection numbers in the country.

Switzerland reported 528 new cases of the coronavirus on Friday, the highest daily rise in infections since early April.

As part of its new approach, the government said only regions of neighboring countries where the infection rate is above its limit of 60 cases per 100,000 people will be added to the list, rather then the entire country.

Border regions may be exempted from the list to take into account the close interaction with neighboring regions, it said.

Thousands of workers cross Switzerland’s borders with France, Germany and Italy daily to work in Geneva, Basel and the southern canton of Ticino.

(Reporting by John Revill; Editing by Michael Shields)

Severe COVID-19 riskier than heart attack for young adults; antibiotic shows no benefit

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

More young adults survive heart attacks than severe COVID-19

Among COVID-19 patients treated at 419 U.S. hospitals from April through June, only about 5% were ages 18 to 34. But that group had “substantial rates of adverse outcomes,” according to a report on Wednesday in JAMA Internal Medicine. Roughly one in five needed intensive care, one in 10 needed mechanical ventilation, and nearly 3% died. While the mortality rate is lower than in older adults, it is roughly double the death rate of young adults from heart attacks, the authors say. Obesity, high blood pressure, and diabetes were tied to higher risk for adverse events. For young adults with more than one of these conditions, the risk of a bad outcome was similar to middle-aged adults without the risk factors. More than half of hospitalized young adults were Black or Hispanic, “consistent with prior findings of disproportionate illness severity in these demographic groups,” the authors said. “Given the sharply rising rates of COVID-19 infection in young adults, these findings underscore the importance of infection prevention measures in this age group,” the concluded.

Antibiotic fails to help hospitalized COVID-19 patients

The antibiotic azithromycin did not appear to provide any benefit to hospitalized COVID-19 patients who were having trouble breathing, according to a study in Brazil. At 57 hospitals, 243 COVID-19 patients who needed oxygen or mechanical ventilation were randomly assigned to receive azithromycin, while 183 similar patients did not get the antibiotic. All received other standard treatment, which in Brazil included hydroxychloroquine, a malaria drug that other studies have shown provides little or no benefit. While azithromycin did not appear to do any harm, after 15 days it was not associated with any patient improvement nor did it reduce their risk of death. In an April survey of more than 6,000 physicians in 30 countries, azithromycin was the second most commonly prescribed treatment for COVID-19, the study investigators wrote in The Lancet medical journal. The absence of any benefit in this new study “suggests that the routine use of this strategy should be avoided,” they said.

Risk of catching COVID-19 while hospitalized can be low

Among nearly 8,500 patients admitted to a large Boston hospital between early March and the end of May, only two became sick with coronavirus infections that may have been acquired while they were hospitalized, doctors report. One likely was infected by a spouse who initially appeared well during daily visits but who developed symptoms while the patient was still hospitalized. That was before visitor restrictions and universal masking rules had been implemented. The other patient developed symptoms four days after leaving the hospital. The source of the infection is not known. According to a paper published on Wednesday in JAMA Network Open, infection control efforts at the hospital included dedicated COVID-19 units with airborne infection isolation rooms, personal protective equipment for staff and monitoring to make sure those were used correctly, universal masking, visitor restriction, and liberal COVID-19 testing of symptomatic and asymptomatic patients. These “robust and rigorous infection control practices may be associated with minimized risk” of COVID-19 spreading through hospitals, the authors conclude. Their findings, if replicated at other U.S. hospitals, “should provide reassurance to patients,” they said.

Longer-term COVID-19 lung damage can improve over time

COVID-19 lung damage persists long term but tends to improve, researchers reported on Monday at the European Respiratory Society International Virtual Congress. Researchers studied 86 hospitalized COVID-19 patients, 48% of whom had a smoking history and 21% of whom required intensive care. At 6 weeks after discharge, 47% of patients still reported feeling short of breath. By 12 weeks, that dropped to 39%. CT scans still showed lung damage in 88% of patients at six weeks, dropping to 56% at 12 weeks. “Overall, this study shows that COVID-19 survivors have persisting pulmonary impairment weeks after recovery. Yet, overtime, a moderate improvement is detectable,” lead researcher Dr. Sabina Sahanic, from University Clinic of Internal Medicine in Innsbruck, Austria, said during a press briefing. A related study featured at the meeting stressed the importance of early pulmonary rehabilitation after COVID-19 patients come off a ventilator. This should include balance and walking, muscle strengthening, respiratory exercises and endurance training. “The sooner rehabilitation started and the longer it lasted, the faster and better was the improvement in patients’ walking and breathing capacities and muscle gain,” coauthor Yara Al Chikhanie, from Grenoble Alps University in France, said in a statement.

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

U.S. COVID-19 deaths surpass 190,000; Iowa and South Dakota emerge as new hotspots

By Anurag Maan

(Reuters) – Coronavirus deaths in the United States topped 190,000 on Wednesday along with a spike in new cases in the U.S. Midwest with states like Iowa and South Dakota emerging as the new hotspots in the past few weeks.

Iowa currently has one of the highest rates of infection in the nation, with 15% of tests last week coming back positive. Nearby South Dakota has a positive test rate of 19% and North Dakota is at 18%, according to a Reuters analysis.

The surge in Iowa and South Dakota is being linked to colleges reopening in Iowa and an annual motorcycle rally last month in Sturgis, South Dakota.

Kansas, Idaho and Missouri are also among the top 10 states for positive test rates.

New coronavirus infections have fallen for seven weeks in a row for the United States with a death rate of about 6,100 per week from COVID-19 in the last month.

On a per capita basis, the United States ranks 12th in the world for the number of deaths, with 58 deaths per 100,000 people, and 11th in the world for cases, with 1,933 cases per 100,000 residents, according to a Reuters analysis.

U.S. confirmed cases are highest in the world with now over 6.3 million followed by India with 4.4 million cases and Brazil with 4.2 million. The U.S. death toll is also the highest in the world.

The U.S. Centers for Disease Control and Prevention had forecast last month that the U.S. death toll will reach 200,000 to 211,000 by Sept. 26.

The University of Washington’s health institute last week forecasted that the U.S. deaths from the coronavirus will reach 410,000 by the end of the year.

(Reporting by Anurag Maan in Bengaluru; Editing by Lisa Shumaker)

What you need to know about the coronavirus right now

(Reuters) – Here’s what you need to know about the coronavirus right now:

White House slams “corrupt” WHO

The White House pushed back on concerns expressed by the World Health Organization after a U.S. health official said a coronavirus vaccine might be approved without completing full trials.

The Washington Post newspaper reported that the administration of President Donald Trump would not join a global effort to develop, manufacture and distribute a coronavirus vaccine because of the involvement of the WHO.

About 172 countries are engaging with the WHO’s COVID-19 vaccine plan to ensure equitable access to vaccines, the organization has said.

“The United States will continue to engage our international partners to ensure we defeat this virus, but we will not be constrained by multilateral organizations influenced by the corrupt World Health Organization and China,” White House spokesman Judd Deere said in a statement.

India reopens

India’s coronavirus infections rose to almost 3.8 million on Wednesday, as states continued to relax rules on movement despite the surge in cases.

The country reported 78,357 new cases in the past 24 hours, according to federal health data, taking total infections to 3,769,523. Some 66,333 people have died.

India’s total cases lag only the United States and Brazil, which it will overtake in days based on current trends.

Authorities in the capital New Delhi are due to meet to discuss the reopening of the city’s metro, despite fresh cases there sitting at a two-month high.

In Sydney, the show must go on

Australia’s most-populous state reported the biggest daily jump in coronavirus infections in two weeks on Wednesday but said there were no plans to cancel the New Year fireworks show over Sydney Harbor, as new cases nationally also ticked up.

New South Wales state reported 17 new cases, the biggest one-day jump since Aug. 12, while nationally the count rose to 109 cases from 85 a day earlier.

Victoria state remained the hardest-hit region with 90 cases, although this was well down from its daily peak of more than 700 in early August at the height of a second wave of infections.

NSW Premier Gladys Berejiklian said the state was pushing ahead with plans to host large events such as the New Years Eve fireworks over Sydney Harbor. “I think for a lot of people the fireworks represent hope.”

Elderly drive South Korea case surge

More than 40% of new coronavirus cases in South Korea are being found in people over the age of 60, contributing in part to a surge in the number of COVID-19 patients who are severely or critically ill, health authorities said on Wednesday.

The surge in cases over the past three weeks has depleted medical facilities, with less than 3% of hospital beds – or just nine – available for critical cases in greater Seoul, versus 22% about 10 days ago, the health ministry said.

South Korea is battling a second wave of infection, centered in the capital Seoul and surrounding areas which are home to 25 million people.

Pandemic ignites demand for home appliances

From sanitizing closets to customizable fridges, the coronavirus pandemic has fanned demand for home appliances – so much so that Samsung Electronics is adding warehouses and bringing popular products to more markets.

In particular, consumers have been willing to splurge on products that make their homes cleaner.

In Brazil and other emerging economies, households which once relied on maids are now investing in dishwashers and robot vacuum cleaners, while Samsung says its overseas sales of air purifiers jumped more than five times in January-July compared to the same period last year.

Samsung’s AirDresser, a closet that steam cleans clothes and kills bacteria, has seen a spike in sales. Big fridges have also climbed in popularity as people cooking more often at home seek more freezer space.

(Compiled by Linda Noakes; Editing by Alison Williams)