4.2 million COVID-19 cases in November

WASHINGTON (Reuters) – The United States entered the final month of the year hoping that promising vaccine candidates will soon be approved to halt the rapidly spreading novel coronavirus after 4.2 million new cases were reported in November.

The new COVID-19 cases were more than double the previous monthly record set in October, as large numbers of Americans still refuse to refuse to wear masks and continue to gather in holiday crowds, against the recommendation of experts.

A Food and Drug Administration panel of outside advisers will meet on Dec. 10 to discuss whether to recommend the FDA authorize emergency use of a vaccine developed by Pfizer Inc.

A second candidate from Moderna Inc could follow a week later, officials have said, raising hopes that Americans could start receiving inoculations before the end the year, although widespread vaccinations could take months.

Other global pharmaceuticals including AstraZeneca PLC and Johnson & Johnson also have vaccines in the works, leading a member of the Trump administration’s “Operation Warp Speed” program to predict the country could be vaccinated by June.

“One hundred percent of the Americans that want the vaccine will have the vaccine by (June). We will have over 300 million doses available to the American public well before then,” Paul Ostrowski, the vaccine program’s director of supply, production and distribution, told MSNBC television on Monday.

In the meantime, leading health officials are pleading with Americans to follow their recommendations and help arrest a pandemic that killed more than 36,000 people in November, pushing hospitalizations to a record high of nearly 93,000 on Sunday, according to a Reuters tally.

The widespread impact of the pandemic has led Merriam-Webster to choose “pandemic” as the Word of the Year after it racked up the most online dictionary lookups of any word.

“Sometimes a single word defines an era, and it’s fitting that in this exceptional – and exceptionally difficult – year, a single word came immediately to the fore,” the dictionary publisher said.

In the absence of a federal blueprint to curb the spread of the virus, states are issuing new or revamped restrictions on businesses and social life.

California’s governor said he may renew a stay-at-home order in the coming days, warning that ICU admissions are on track to exceed statewide capacity by mid-December unless public health policies and social behavior change.

“The red flags are flying,” Governor Gavin Newsom told reporters in an online briefing. “If these trends continue, we’re going to have to take much more dramatic, arguably drastic, action.”

(Reporting by Reuters staff; Writing by Daniel Trotta; Editing by Bernadette Baum)

Moderna to seek U.S. and EU authorization for its vaccine on Monday

By Julie Steenhuysen and Michael Erman

(Reuters) – Moderna Inc will apply for U.S. and European emergency authorization for its COVID-19 vaccine on Monday after full results from a late-stage study showed it was 94.1% effective with no serious safety concerns, the company said.

Moderna also reported that its vaccine’s efficacy rate was consistent across age, race, ethnicity and gender demographics as well as having a 100% success rate in preventing severe cases of a disease that has killed nearly 1.5 million people.

The filing sets Moderna’s product up to be the second vaccine likely to receive U.S. emergency use authorization this year following a shot developed by Pfizer and BioNTech which had a 95% efficacy rate.

“We believe that we have a vaccine that is very highly efficacious. We now have the data to prove it,” Moderna Chief Medical Officer Tal Zaks said. “We expect to be playing a major part in turning around this pandemic.”

Of the 196 people who contracted COVID-19 out of over 30,000 volunteers, 185 had received a placebo and 11 got the vaccine. Moderna reported 30 severe cases, all in the placebo group, which means the vaccine was 100% effective against severe cases.

Moderna shares opened 13% higher at a record $144 following the results and then went on to hit a peak of $150.14, or a gain of 668% so far this year.

“As the numbers of cases reported grows, confidence grows that this amazing protection will be maintained in a product that can be rolled out to protect the public,” said Alexander Edwards, associate professor in biomedical technology at Britain’s University of Reading.

In addition to filing its U.S. application, Moderna said it would seek conditional approval from the European Medicines Agency, which is already reviewing its data, and would continue to talk with other regulators doing similar rolling reviews.

“Although we await the full details of these results in published form, we can now assume that this vaccine will be approved for use in December,” said Gillies O’Bryan-Tear, chair of policy and communications at Britain’s Faculty of Pharmaceutical Medicine.

He expected Britain’s Medicines and Healthcare products Regulatory Agency to approve the vaccine within two weeks.

Pfizer has already applied for emergency use authorization in the United States and Europe, putting it about a week ahead of Moderna.

‘JUST OVERWHELMING’

Moderna said it was on track to have about 20 million doses of its vaccine ready to ship in the United States by the end of 2020, enough to inoculate 10 million people.

Switzerland’s Lonza, which has a contract with Moderna to supply ingredients for the vaccine, rose 4.4%.

The vaccines developed by both Moderna and Pfizer/BioNTech use a new technology called synthetic messenger RNA (mRNA) whereas others, such as Britain’s AstraZeneca, are using more traditional methods.

AstraZeneca has announced an average efficacy rate of 70% for its shot and as much as 90% for a subgroup of trial participants who got a half dose, followed by a full dose. But some scientists have expressed doubts about the robustness of the 90% efficacy figure for the smaller group.

Moderna’s latest efficacy result is slightly lower than an interim analysis released on Nov. 16 of 94.5% effectiveness, a difference that Zaks said was not statistically significant.

“At this level of effectiveness, when you just do the math of what it means for the pandemic that’s raging around us, it’s just overwhelming,” said Zaks, who said he cried when he saw the final results over the weekend.

Both the Moderna and Pfizer vaccines proved more effective than anticipated and were far superior to the 50% benchmark set by the U.S. Food and Drug Administration (FDA).

The past few weeks of positive vaccine results have ignited hopes for an end to a pandemic that has battered economies and come as new infections and COVID-19 hospitalizations are at record levels across the United States.

Independent advisers to the FDA are scheduled to meet on Dec. 10 to review Pfizer’s data and make a recommendation to the U.S. regulator. They will review Moderna’s data a week later.

Soon after getting the green light, Moderna expects its vaccine to be shipped to distribution points across the United States by the government’s Operation Warp Speed program and drug distributor McKesson Corp.

The distribution is expected to be easier than Pfizer’s because while it needs to be stored in a freezer, it does not require the ultra-cold temperature needed by Pfizer’s vaccine.

CONSISTENT ACROSS AGE AND ETHNICITY

Moderna said the 196 COVID-19 cases in its trial included 33 adults over 65 years old and 42 volunteers from racially diverse groups, including 29 Latinos, 6 Blacks, 4 Asian Americans and 3 multiracial participants. There was one death related to COVID-19 in the placebo group during the trial.

“This is as black and white as an effect on a population will be. Your chances of actually being sick if you’ve been vaccinated are decreased 20-fold,” said Moderna’s Zaks.

Azra Ghani, chair in infectious disease epidemiology at Imperial College London, said Monday’s details confirmed the vaccine was highly effective, including against severe cases.

“Whilst this does not exclude some risk of severe disease after vaccination given the relatively small number of severe cases, these results suggest very high efficacy,” she said.

Moderna reported no new side effects since its interim analysis, which showed the most common side effects were fatigue, injection site redness and pain, headache and body aches, which rose after the second dose and were short-lived.

Zaks said the vaccine caused significant flu-like symptoms in some participants which, “goes hand-in-hand with having such a potent vaccine.” But it has not caused any significant safety concerns so far, he said.

Moderna plans to start a new trial to test the vaccine in adolescents before the end of the year, followed by another in even younger volunteers early in 2021. It hopes to have the vaccine available for adolescents by September, Zaks said.

Other vaccine makers have said they are studying their vaccines in young people as well.

(Reporting by Julie Steenhuysen and Michael Erman; Additional reporting by Ankur Banerjee and Manas Mishra in Bengaluru and Kate Kelland in London; Editing by Bill Berkrot, Edwina Gibbs and David Clarke)

New York City public schools will begin to reopen with weekly COVID-19 testing

By Jonathan Allen

NEW YORK (Reuters) – New York City’s public schools will begin to reopen for in-person learning on Dec. 7, starting with elementary schools for students whose parents agree to a weekly testing regimen for the novel coronavirus, Mayor Bill de Blasio announced on Sunday.

The schools, which make up the country’s largest school system, were closed less than two weeks ago after the citywide rate of coronavirus tests coming back positive exceeded a 3% benchmark agreed to by the mayor and the teachers’ union.

“It’s a new approach because we have so much proof now of how safe schools can be,” de Blasio told reporters, saying the 3% benchmark was being scrapped and pointing to research that shows young children appear to be less vulnerable to COVID-19. On Sunday, the city’s seven-day rolling average of positive tests was 3.9%, de Blasio said.

Schools Chancellor Richard Carranza, who joined the mayor at a news conference, said with the new measures he believed the city could “safely and successfully keep our schools open for the duration of this pandemic.”

Michael Mulgrew, the president of the United Federation of Teachers, said in a statement that the labor union was supportive of the mayor’s phased reopening so long as “stringent testing was in place.”

New York City, which teaches more than 1.1 million students in its public schools, was one of the few jurisdictions in the United States to attempt to reopen schools in the autumn as the country continues to struggle with the world’s deadliest outbreak of the coronavirus, and its efforts are being widely watched. But it closed classrooms back down in mid-November, less than eight weeks after they had begun to offer in-class lessons.

Some New Yorkers were frustrated to see schools close down again while gyms were allowed to operate and restaurants could offer indoor dining in most areas under rules enforced by New York Governor Andrew Cuomo, who has publicly feuded with de Blasio over how best to tamp down the virus’ spread.

“I think that’s the right direction,” Cuomo said of the mayor’s announcement on a later conference call with reporters. Health experts said schools “should be kept open whenever it’s possible to keep them open safely,” he said.

Pre-kindergarten classes will also reopen Dec. 7 alongside elementary schools. Schools that serve children with special educational needs, known as District 75 schools, will reopen Dec. 10. De Blasio said middle schools and high schools would reopen at later dates that had not yet been set.

Many families had opted for remote learning even as classrooms reopened in September, but the city also offered “blended” learning, with students attending in-person classes a few days each week if they agreed to monthly coronavirus tests.

With the reopening of schools next month, to enter a classroom, students must have a signed consent form agreeing to coronavirus testing or a letter of medical exemption from a doctor, de Blasio said. Tests will be soon be carried out in schools on a weekly, not monthly, basis, but only about a fifth of students will be tested in a given week.

The mayor said the plan was to have in-person learning five days a week where possible when schools reopen.

The governor retains the power to override the city and close schools in neighborhoods where the test positivity rate surges, de Blasio noted. The city will also monitor schools’ coronavirus test results, and may close down any individual classrooms or entire schools where multiple cases are reported.

The United States has reported over 4 million new cases so far in November and over 35,000 coronavirus-related deaths, according to a Reuters tally, with more hospitalizations than ever this year and deaths reaching their highest level in six months.

(Reporting by Jonathan Allen; Additional reporting by Lisa Shumaker; Editing by Leslie Adler)

U.S. hits highest death toll since May with hospitals already full

By Daniel Trotta

(Reuters) -Daily U.S. deaths from COVID-19 surpassed 2,000 for the first time since May and with hospitals across the country already full, portending a surge in mortalities to come as the coronavirus pandemic casts a shadow over the holiday season.

The death toll reached 2,157 on Tuesday – one person every 40 seconds – with another 170,000 people infected, numbers that experts say could grow with millions of Americans disregarding official warnings and traveling for Thursday’s Thanksgiving holiday.

The deadliest day in more than six months was still short of the record of 2,806 deaths on April 14, in the early stages of the pandemic, according to a Reuters tally of official data. That one-day figure is sometimes reported higher due to a backlog of deaths that were not compiled until April 14.

With U.S. hospitalizations for COVID-19 reaching a record high of 87,000 on Tuesday, the nation’s leading infectious diseases official urged people to keep Thanksgiving gatherings as small as possible.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, stressed the need to “hang in there a bit longer” on wearing masks, maintaining distance and avoiding crowds, especially indoors.

“If we do those things, we’re going to get through it. So that’s my final plea before the holiday,” Fauci told the ABC News program “Good Morning America” on Wednesday.

Families with university students have been forced to evaluate the risk of reuniting for Thanksgiving.

Francesca Wimer, a student at Northwestern University in Illinois, flew home to Washington wearing an N95 mask and a face shield and checked into a hotel for 14 days, quarantining to protect her parents and grandparents.

“She was returning to a vulnerable set of people. We didn’t trust that a test was enough,” said her mother, Cynthia Wimer.

Others are just staying put.

Luke Burke, studying at Syracuse University in upstate New York, was planning to spend Thanksgiving with his family in New Jersey until his roommate tested positive last week.

“I’m sorry I can’t be there with my parents, but it’s the right thing to do,” Burke said.

Meanwhile school districts across the United States face pressure from all sides as they grapple with how to educate children during the pandemic, a Reuters survey of 217 districts showed.

Many parents are balking at online instruction, while others worry about sending kids back into classrooms prematurely. Teachers say they are not comfortable teaching in person.

“Every school district across the nation is in the position in which no matter what decision they make and how well thought out it is, it will leave some in the community thinking it’s the wrong decision,” said Larry Rother, senior executive director of pre-kindergarten through 12th-grade educational services in Chandler, Arizona.

Help may be coming with vaccines showing promise.

Officials from the U.S. government’s Operation Warp Speed program told reporters on Tuesday they plan to release 6.4 million COVID-19 vaccine doses nationwide in an initial distribution after the first one is cleared by regulators for emergency use, which could happen as soon as Dec. 10.

If all goes well, 40 million doses will be distributed by the end of the year, they said.

A Food and Drug Administration ruling on emergency use for Pfizer Inc’s vaccine is expected on Dec. 10.

(Reporting by Daniel Trotta, Lisa Shumaker, Gabriella Borter, Lisa Lambert, Kristina Cooke, Benjamin Lesser, M.B. Pell and Simon Lewis; Editing by Chizu Nomiyama, Andrea Ricci and Jonathan Oatis)

U.S. weekly jobless claims rise as COVID-19 infections surge

By Lucia Mutikani

WASHINGTON (Reuters) – The number of Americans filing first-time claims for jobless benefits increased further last week, suggesting that an explosion in new COVID-19 infections and business restrictions were boosting layoffs and undermining the labor market recovery.

Other data on Wednesday showed business spending on capital remained solid at the start of the fourth quarter, though momentum has cooled from the prior months. The economy is shifting into slower gear as the boost from more than $3 trillion in government coronavirus relief ends.

“There is a two-tier recovery from the pandemic recession where the top of society continues to spend as normal while the bottom-half of the country sits in long lines at food banks with the opportunities for employment few and far between,” said Chris Rupkey, chief economist at MUFG in New York.

Initial claims for state unemployment benefits increased 30,000 to a seasonally adjusted 778,000 for the week ended Nov. 21, the Labor Department said on Wednesday. It was the second straight weekly increase in claims. Economists polled by Reuters had forecast 730,000 applications in the latest week.

The weekly claims report, the most timely data on the economy’s health, was published a day early because of Thursday’s Thanksgiving Day holiday.

Unadjusted claims jumped 78,372 to 827,710 last week. Economists prefer the unadjusted number because of earlier difficulties adjusting the claims data for seasonal fluctuations due to the economic shock caused by the pandemic.

Including a government-funded program for the self-employed, gig workers and others who do not qualify for the regular state unemployment programs, 1.14 million people filed claims last week. There were at least 20.5 million people collecting unemployment benefits in early November.

The United States has been slammed by a fresh wave of coronavirus infections, with daily cases exceeding 100,000 since early November. More than 12 million people have been infected in the country, according to a Reuters tally of official data.

The respiratory illness has killed more than 257,000 Americans and hospitalizations are soaring, prompting state and local governments to reimpose a host of restrictions on social and economic life in recent weeks, which could keep claims above their 665,000 peak seen during the 2007-09 Great Recession.

U.S. stocks were mixed in early trade. The dollar dipped against a basket of currencies. U.S. Treasury prices rose.

RECORD THIRD-QUARTER GROWTH

Unemployment claims dropped from a record 6.867 million in March as about 80% of the people temporarily laid off in March and April were rehired, accounting for most of the rebound in job growth over the last six months.

That improvement, which spilled over to the broader economy through robust consumer spending, was spurred by the fiscal stimulus. In a separate report on Wednesday, the Commerce Department confirmed the economy’s historic pace of expansion in the third quarter.

Gross domestic product grew at an unrevised 33.1% annualized rate, the government said in its second estimate of third-quarter output. The economy contracted at a 31.4% rate in the second quarter, the deepest since the government started keeping records in 1947.

(Reporting By Lucia Mutikani; additional reporting by Dan Burns, Editing by Chizu Nomiyama)

To reopen or not to reopen – That is the fraught question for U.S. schools

By Kristina Cooke, Benjamin Lesser and M.B. Pell

(Reuters) – After a two-week deluge of calls and messages from parents – and at least one death threat – the school board in Chandler, Arizona, called a special meeting this fall.

The board would revisit its decision, prompted by the coronavirus, to temporarily close local campuses and offer all classes online.

Parents, teachers and others poured out their thoughts in 1,100 public comments posted online before the September meeting. “If our schools do not open in person I will yank both my boys OUT and take them to another school district!!!” one parent wrote.

Many teachers assailed the district, which serves about 44,000 students near Phoenix, for wavering. “You look weak to the public; you look unconcerned for safety to your employees,” wrote one instructor. Ultimately, the board backtracked, voting 3-2 to start reopening school buildings. Eight-six percent of students returned to campus.

Across the United States, district leaders face pressure from all sides as they grapple with how to educate children during the pandemic, a Reuters survey of 217 districts showed. Many parents are balking at online instruction, seeing it as inferior to classroom learning and disruptive to life at home and work. Other parents worry about sending kids back into classrooms prematurely amid a raging pandemic.

At the same time, many teachers, some backed by powerful unions, say they are not comfortable teaching in person, fearing kids may infect them with a virus generally more dangerous for adults. Union leaders complain of inconsistent COVID-19 testing and safety standards.

Districts are caught in the middle, struggling to accommodate both families and faculty as they juggle the separate challenges of in-class and virtual instruction. Meanwhile, a new wave of infections has arrived, sending caseloads in parts of the United States soaring out of control.

“Every school district across the nation is in the position in which no matter what decision they make and how well thought out it is, it will leave some in the community thinking it’s the wrong decision,” said Larry Rother, senior executive director of pre-kindergarten through 12th grade educational services at Chandler.

Adding to the stress on everyone involved is unpredictability. Plans can change suddenly depending on the vicissitudes of the virus and officials’ tolerance for risk. New York City, with the largest school system in the country, epitomizes the problem. Six weeks after opening schools to optional in-person attendance, the mayor reversed course last week, closing campuses through at least Nov. 30. Parents and caregivers for more than 300,000 students had no choice but to adapt on the fly.

Reuters surveyed 217 districts in 30 states, which serve about 2.4 million students, to determine how jurisdictions large and small are coping with the question of reopening campuses. The broad survey began in late September, and Reuters conducted more detailed reporting through mid-November, focusing on 12 districts serving a combined 1 million students. The New York City school system did not respond to the survey.

Among the findings:

* The vast majority of the districts settled on offering a mix of in-person and remote learning this fall. Five percent said they were remote only and 5% in-person only. Some, like Chandler, changed plans after opening. The Jefferson County School District near Denver, for instance, is temporarily switching most students to all-remote learning this month amid the surge of cases in Colorado.

Most districts that provide in-person instruction require preventive measures such as masks and social distancing. Some have tried a little creativity: In Premont, Texas, a rural community about 70 miles southwest of Corpus Christi, administrators gave the youngest elementary school students Hula Hoops to help them keep their distance from others in hallways.

* Given the option, the districts said most parents want their kids to go back to campus at least part-time. About 70% of parents and guardians chose a learning model that includes some classroom instruction. Several district leaders told Reuters that virtual instruction has led to “learning loss”, or a regression in skills, among some students. But districts said they have to balance that concern against teachers’ desire for safety.

* Adapting to the pandemic has been costly. As of late September, the districts collectively had spent more than $340 million on COVID-related expenses including new laptops and internet hotspots for remote learners, as well as improved building ventilation and extra cleaning supplies for classrooms.

Some districts have been able to cover costs through the federal CARES Act, the initial relief package for COVID-19 passed in March, or supplemental state funding. But many have been forced to raid their regular budgets and reserves, creating the potential for cutbacks later affecting anything from textbook purchases to payroll.

* About half the districts reported problems keeping their schools properly staffed, in part because teachers and other workers on campus must go into quarantine if potentially exposed to COVID-19. In Storm Lake Community School District in rural Iowa, Superintendent Stacey Cole recalled brainstorming in October with an elementary school principal who worried she lacked enough staff to get through the week. As of November 16, the staff was down about 10%, with five positive cases among adults and 30 in quarantine.

In a normal year, staffers report to work even when they have a cold, Cole said. “Now we say, ‘Don’t come in, get a COVID test,’” she said. But it takes as long as eight days to get back test results there, she said – sidelining those staffers in the meantime.

* Only about two-thirds of the 217 districts said they collect data on positive tests among students and staff. Most of those reported few or no COVID-19 cases during the first weeks of the school year. Since then, several, including the Dallas Independent School District, have reported surges, though the numbers there still account for less than 1% of students and employees overall.

The number of reported cases in Arizona’s Chandler district has remained low since students returned to campuses. Fewer than 1% of staff, and half a percent of students, tested positive as of mid-November.

In most instances, it is unclear whether cases originate in schools or somewhere else.

Most children infected with the coronavirus have mild or no symptoms, but kids can spread the virus to others, including adults and other family members, according to the U.S. Centers for Disease Control and Prevention.

After members of her soccer team tested positive for coronavirus, 14-year-old Maddie Weiser of the Jefferson County district said she worried she might have passed on the virus unknowingly to others at school, or to her grandmother. “It’s so hard for me to think about it. If this is this stressful for me, it must be 800 times worse for my teachers,” Weiser said.

A study from the Kaiser Family Foundation found that one in four teachers and school staff has conditions putting them at heightened risk for serious illness from COVID-19, though the researchers said that is about the same percentage as in other workplaces.

“Where’s the data that prove that we are not risking our health and safety or even our lives by coming to work every day?” Mamie Huff, who has taught in Dallas elementary schools for 24 years, asked her district’s school board on Oct 22. “This is heartbreaking. Because I love my students. I love my school. I love my job. But what I don’t love is that I have no true control over my own health and safety.”

‘GREAT INTENTIONS’

Michael Hester, superintendent of the Batesville School District in rural Arkansas, captured the feelings of many school administrators during the fall term: “We count it as a blessing to even make it to Friday,” he said.

Hester said one of his greatest frustrations is the shifting rules coming down from the state. For instance, when the school year started in late August, the original plan was for the Arkansas Department of Health to conduct “contact tracing” on any positive coronavirus cases among students and staff on campuses. That means finding and notifying everyone who may have been exposed to the virus by an infected person. But within weeks of reopening, Hester said, that responsibility was largely shifted to the individual districts.

Dr. Joel Tumlison, who focuses on infectious disease outbreaks for the health department, acknowledged that officials had “some problems initially” doing timely contact tracing when schools reopened, requiring districts to assist with the work.

“It’s a big task, we recognize that,” Tumlison said.

Contact tracing is just one example of the challenges districts now confront that fall well outside the realm of traditional schooling. Others are enforcing mask and social distancing requirements and planning around the individual quarantine schedules of infected students and staff.

In the Batesville district, which had about 3,400 students and a cumulative total of 95 cases among adults and kids as of mid-November, some families have had to keep students home for multiple 14-day quarantine periods, Hester said.

Then, in the case of virtual instruction, there is the dreaded problem of “learning loss.” When students in Dallas, Texas, returned to school in September, the district found through testing that there had been a significant deterioration in students’ math skills in the second half of the last school year when all kids were attending online.

“This concerns us significantly,” said Superintendent Michael Hinojosa, who also acknowledged some teachers were “scared to death” to return to campuses. “Math is sequential, you have to have (grasped) the prerequisites before you can learn the next skill.”

Maren Butcher, the mother of a high school sophomore and a third grader at Chandler in Arizona, said remote learning was a disaster for her children. “I watched the spark for school slowly die in my older son. We felt like we were picking him up with a spatula every day.”

After he went back in person, his motivation improved, the classes were more rigorous and he’s “been able to advance more academically,” she said.

In Texas’ rural Louise Independent School District, about a third of the roughly 500 students started the year with remote instruction.

Within weeks Garth Oliver, the district’s superintendent, started to see that students working remotely were struggling to keep up with their peers.

“You call the parents and they say, ‘They have been on the computer all day’ – but they are playing games,” Oliver said.

So on Sept. 22, Oliver sent a letter to district families announcing that the remote instruction would end the following week. “Everybody had great intentions but there is no substitute for face-to-face instruction with a professional educator,” Oliver said.

Only two families left the district afterward, he said.

A JUGGLING ACT

For the nation’s districts and teachers, there is no common playbook.

Districts, for instance, have different thresholds for when to close campuses, based on COVID-19 testing results. In New York City, schools were closed because the city’s positivity rate hit a 3% seven-day average, a standard set by the mayor. Elsewhere, the thresholds are much higher. And some districts don’t have thresholds at all.

Randi Weingarten, president of the American Federation of Teachers, a national union, said both educators and parents would be more open to having students return to campuses if the federal government provided a well-funded reopening strategy with clear measures of how it’s working.

“That’s the issue, instead of pitting teachers against parents,” said Weingarten, who top Democrats see as a candidate for secretary of education in President-elect Joe Biden’s incoming administration.

Meanwhile, teachers struggle to adapt to ever-evolving directives that vary by district.

In some places, instructors must handle both face-to-face and online instruction. Some teach the two groups concurrently – juggling, for instance, technology glitches with classroom misconduct. Other districts split up their staff, assigning them to virtual or in-class instruction.

“We’ve been pulling off the impossible, teaching virtual and in-person classes at the exact same time,” Jennifer Lees, a teacher in Dallas, told her school district board on Oct. 22. “We’re exhausted, scared and stressed.”

Staffing shortages and budgetary constraints make matters worse.

After work dried up last spring, many substitute teachers opted to find other employment, said Katie Nash, president of the Chandler Education Association, the Phoenix-area teachers’ union.

To cover COVID-related expenses, many districts received at least some federal CARES Act money, but the White House and congressional leaders have been unable to agree on a new relief package. And most states face budget deficits, limiting their ability to help.

Some districts also confront potentially costly lawsuits from parents of children with special needs, whose individualized education plans often weren’t designed for remote learning.

Another financial challenge comes when dissatisfied parents leave the district. State aid is often based, at least in part, on student attendance, so departures can decrease funding.

“A lot of these districts are hoping the federal government will come through at some point and make them whole,” said Dan Domenech, executive director of the AASA The School Superintendents Association. “If that doesn’t happen, a lot of school districts are going to be short.”

THE LOUDEST VOICES

Not all parents or teachers are of one mind about school reopening. But some voices are louder than others.

Even before the summer break began, the Chandler Education Association, the teachers’ union near Phoenix, made its opposition to in-person instruction known to the district.

Nash, the union’s president, armed herself with survey data to show the district that more than half of teachers who responded felt unsafe returning to campuses.

She told Reuters that a small but highly vocal group of parents drowned out instructors’ concerns.

But Chandler parent Butcher, the daughter of a teacher, said she opposed what she saw as the union’s steady pressure on the district to stay remote.

“The loudest voice,” she said, “was not the parents.”

In Grantham, New Hampshire, about 30 parents attended a school board meeting in October to call for a full school campus reopening. The group clapped loudly when people made points in favor of reopening and was “somewhat disrespectful” in its behavior, said Superintendent Sydney Leggett.

She said parents who wanted to stick with strictly virtual or hybrid instruction were not as well-represented at the meeting, held in the school gym, because they were worried about contracting the coronavirus.

After seeing parents argue on social media, she sent a letter to families asking them to be kind to one another. The district decided to open for four days a week, in person, starting in November. It also will continue to offer a remote option.

“I’m hoping when we come out of this we still have a good community feeling,” Leggett said. “It’s going to be work to make sure that this divisiveness doesn’t stick around.”

(Kristina Cooke reported from Los Angeles, Benjamin Lesser and M.B. Pell from New York City. Editing by Julie Marquis and Janet Roberts)

With U.S. hospitals overrun, surgeon general urges Americans to ‘hold on’

(Reuters) – U.S. Surgeon General Jerome Adams on Tuesday pleaded with Americans to grasp “the severity of the moment” and remain vigilant against the coronavirus pandemic, as record hospitalizations pushed healthcare professionals to the brink.

“We are almost to a vaccine. … We’ve got new remedies out there. We just need you, the American people, to hold on a little bit longer,” Adams, a White House Coronavirus Task Force member, told Fox News in an interview.

He urged people to adjust their plans ahead of the Thanksgiving holiday on Thursday, which has led to the busiest U.S. air travel since the early days of the pandemic in March, with millions of people flying despite the hazards of a crowded airport. U.S. health officials last week strongly recommended that Americans avoid travel for the holiday.

Global pharmaceutical companies have reported promising trial results in the development of vaccines, which could be administered to high-priority patients in December. Meanwhile, the U.S. government will begin distributing Regeneron Pharmaceuticals Inc’s newly authorized COVID-19 antibody combination therapy starting Tuesday.

But hospitals need immediate relief.

The United States was on pace to surpass 85,000 hospitalizations for COVID-19 on Wednesday, a record, as 30 of the 50 states reported record numbers of patients this month.

That has taxed already exhausted healthcare providers as more than 1,500 coronavirus deaths and 171,000 new cases pile up daily.

After pounding big U.S. cities in the spring, COVID-19 now has engulfed rural and small-town America. Case rates in the 12 Midwestern states are more than double that of any other region, according to the COVID Tracking Project, up more than 20 times from mid-June to mid-November.

Many Midwestern hospitals severely lack beds, equipment and clinical staff, providers say. Some are repurposing areas to accommodate COVID-19 patients or cramming multiple patients in a single room, and are asking staffers to work longer hours and more frequent shifts.

“There’s a disconnect in the community, where we’re seeing people at bars and restaurants, or planning Thanksgiving dinners,” said Dr. Kelly Cawcutt, an infectious disease physician at the University of Nebraska Medical Center. As health workers, she said, “we feel kind of dejected.”

Thirty states had a record number of hospitalized COVID-19 patients in November, including all 12 Midwestern states, according to a Reuters tally of official data. Michigan reported over 4,000 hospitalized COVID-19 patients on Monday, surpassing its previous record on April 13.

“A quarter of all of our coronavirus cases this year have occurred in the last month. … Those cases are turning into hospitalizations and deaths,” Adams warned, saying heart patients, pregnant women and others could be turned away.

“That’s the reality.”

(Reporting by Susan Heavey, Nick Brown and Lisa Shumaker; Writing by Daniel Trotta; editing by Jonathan Oatis)

AstraZeneca vaccine can be up to 90% effective; COVID-19 reinfection unlikely for at least six months

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.

AstraZeneca COVID-19 vaccine shows up to 90% efficacy

An interim analysis of late-stage trials of AstraZeneca’s COVID-19 vaccine finds it prevented 70% of COVID-19 cases with no confirmed serious adverse effects, the company announced on Monday. In 8,895 participants who got two full doses, the efficacy was 62%. But due to a dosing error that proved to be a happy accident, among 2,741 volunteers who got a half dose followed by a full dose, efficacy rose to 90%. Pfizer and Moderna reported that their vaccines were about 95% effective at preventing illness. But AstraZeneca’s vaccine is cheaper, easier to make, and can be stored at normal refrigerator temperatures. Investment analysts at SVB Leerink said Astra’s vaccine was unlikely to gain U.S. approval because safety data so far are inadequate and the trial design did not meet U.S. requirements for representation of high-risk groups such as the elderly and minorities. AstraZeneca said it plans to seek approval to modify its U.S. study to get more data on the smaller initial dose. Eventually, all three vaccines could prove comparable. “My suspicion is that by the time we are a year down the line, we’ll be using all three vaccines with about 90% protection,” said immunologist Danny Altmann of Imperial College London.

COVID-19 reinfection appears unlikely for at least 6 months

People who have had COVID-19 are unlikely to contract it again for at least six months, British researchers said on Thursday in a report posted on medRxiv ahead of peer review. Between April and November, they tracked more than 12,000 frontline healthcare workers at high risk for infection with the new coronavirus. COVID-19 with symptoms occurred in 89 of 11,052 workers who did not already have antibodies showing exposure to the virus, whereas none of the 1,246 staff with antibodies developed a recurrent infection. Staff with antibodies were also less likely to test positive for COVID-19 without symptoms, the researchers said. “This is really good news because we can be confident that, at least in the short term, most people who get COVID-19 won’t get it again,” said coauthor David Eyre of Oxford’s Nuffield Department of Population Health. Maria van Kerkhove of the World Health Organization added, “We still need to follow these individuals for a longer period of time to see how long immunity lasts.”

Delirium may signal COVID-19 in elderly

Delirium is common among older patients with COVID-19 and may be their only symptom, U.S. researchers warned on Thursday in JAMA Network Open. Among more than 800 COVID-19 patients over age 65 who showed up at emergency departments around the country, nearly 30% had delirium, they found. Overall, delirium was the sixth most common of all the symptoms and signs in these older patients. Those most at risk for delirium included elders with vision or hearing impairment, stroke, Parkinson’s disease and residents of assisted living or skilled nursing facilities. Delirium is not on any official list of COVID-19 signs and symptoms, but the U.S. Centers for Disease Control and Prevention (CDC) should add it, said coauthor Dr. Maura Kennedy of Massachusetts General Hospital in Boston. “Sometimes delirium is the chief complaint when these patients arrive at the emergency department,” Kennedy said. “But there can be a number of reasons they come, including falls that occurred because of the delirium. They may present without what we consider typical COVID-19 symptoms, such as fever, shortness of breath and cough.”

New data help distinguish COVID-19 from flu

Certain findings can help distinguish COVID-19 from influenza or other respiratory illnesses, a new study suggests. Israeli doctors studied 693 hospitalized patients with COVID-19, plus more than 8,000 adults who had been hospitalized in previous years for the flu or severe respiratory infections. Compared to the other patients, those with COVID-19 were on average younger, more overweight, and had fewer preexisting conditions other than dementia, which was more prevalent in COVID-19 patients. Upon hospital admission, COVID-19 patients had overall lower levels of infection-fighting white blood cells and neutrophils, but their hearts were beating faster, they had less oxygen in their blood, and they had higher percentages of immune-system B cells, which produce antibodies to attack invading germs, and T cells, which destroy cells that have become infected. During the first two days of hospitalization, white blood cell and neutrophil levels rose in COVID-19 patients but fell in the other groups, the researchers said in a paper posted on Sunday on medRxiv ahead of peer review. “At the dawn of winter, recognizing the characteristics discriminating COVID-19 from influenza, will be critical to support the management of the current pandemic,” they conclude.

(Reporting by Nancy Lapid, Linda Carroll, Kate Holton, Josephine Mason and Kate Kelland; Editing by Bill Berkrot)

Despite COVID-19 travel warnings, many Americans ‘not living in fear’ ahead of Thanksgiving

By Daniel Trotta and Nathan Layne

(Reuters) – Millions of Americans appear to be defying health warnings and traveling ahead of the Thanksgiving holiday, likely exacerbating a surge in coronavirus infections before a series of promising new vaccines become widely available.

With U.S. COVID-19 infections hitting a record 168,000 per day on average, Americans are flocking to airports against the advice of the Centers for Disease Control and Prevention (CDC), the U.S. surgeon general and Dr. Anthony Fauci, the nation’s top infectious disease expert.

For Americans, the long holiday weekend, which begins on Thursday, is traditionally the busiest travel period of the year, and 2020 may prove to be no exception.

Some 1 million passengers passed through airport screenings on Sunday, the highest number since March. It was the second time in three days that passengers screened topped 1 million but screenings are down nearly 60% from the same time last year, the U.S. Transportation Security Administration said.

Meanwhile, the seven-day average number of U.S. COVID-19 deaths rose for a 12th straight day, reaching 1,500 as of Monday, according to a Reuters tally of official data.

That has further taxed already exhausted medical professionals, as coronavirus hospitalizations have surged nearly 50% over the past two weeks and the United States has surpassed 255,000 deaths and 12 million infections since the pandemic began.

Pleading with residents to stay home and avoid gatherings during the holiday season, Governor Andrew Cuomo reminded New Yorkers of the grim early days of the pandemic when as many as 800 people died in a single day in the state.

Hospitalizations have spiked 122% in New York state over the last three weeks, Cuomo said, prompting the re-opening of an emergency medical facility on Staten Island.

Help could arrive soon. The head of the U.S. campaign to rapidly deploy a vaccine said the first Americans could start receiving vaccinations as early as mid-December, and another global drug company on Monday unveiled promising trial results on a vaccine candidate.

“NOT LIVING IN FEAR”

Still, many Americans are refusing to follow the health advice that could save their lives.

In Pennsylvania, the number of COVID-19 tests coming back positive was 25% last week, according to data from The COVID Tracking Project. On Monday, Secretary of Health Dr. Rachel Levine warned that the latest models indicated the state could start to run out of intensive care unit beds within a week.

Linda Lafferty, a nurse and the owner of a bed and breakfast in McConnellsburg, said family and friends gathered on the first Sunday in November to celebrate, as they do every year because she and others often have to work on Thanksgiving Day.

But Lafferty said her family would have assembled if they could.

“We are not living in fear and if we were able to get together on Thanksgiving Day we absolutely would,” said Lafferty, 47. “We would still get together and we wouldn’t limit the number of folks because if you are family you are family.”

To be sure, many Americans said they would do their best to conform with health recommendations.

Donnalie Hope, a 78-year-old resident of Petersburg, West Virginia, is planning to make fresh cranberries, mash potatoes and her famous corn pudding for Thanksgiving, which she will spend with her daughter, who will be visiting, and a neighbor.

Hope said they would social distance as much as possible in her home, and that she planned to ready rubber gloves and hand sanitizer. She acknowledged that her guests might eventually take off their masks in the home.

“I’m trying very hard to comply with the regs because I want this country to get back to where it belongs,” she said.

(Reporting by Daniel Trotta and Nathan Layne; Additional reporting by Lisa Lambert, David Shepardson and Susan Heavey in Washington, Barbara Goldberg in Maplewood, New Jersey; Writing by Daniel Trotta and Maria Caspani; Editing by Bernadette Baum and Lisa Shumaker)

U.S. prepares for first COVID-19 shots as another vaccine candidate emerges

By Daniel Trotta

(Reuters) – U.S. officials expect to begin inoculating Americans against the novel coronavirus by mid-December as another global drug company on Monday unveiled promising trial results on a vaccine candidate, providing hope as the pace of infections accelerated.

The head of the U.S. campaign to rapidly deploy a vaccine that U.S. healthcare workers and other high-risk people could start getting shots produced by Pfizer Inc within a day or two of regulatory consent next month.

“I would expect, maybe on day two after approval on the 11th or 12th of December, hopefully the first people will be immunized across the United States,” Dr. Moncef Slaoui, chief scientific adviser for “Operation Warp Speed,” told CNN on Sunday.

With many Americans traveling and potentially increasing their risk ahead of the Thanksgiving holiday on Thursday, the United States has surpassed 12 million infections and the death toll has climbed to more than 255,000 since the pandemic began.

Coronavirus hospitalizations have surged nearly 50% over the past two weeks as the pace of new infections quickened, and the average number of new COVID-19 deaths reported in United States has been increasing for 12 days.

The latest vaccine breakthrough came on Monday as British company AstraZeneca said its vaccine could be 90% effective without any serious side effects. The vaccine would give the world another important tool against the pandemic and one that is potentially cheaper to make, easier to distribute and faster to scale up than those of rivals.

The vaccine was 90% effective in preventing COVID-19 when administered in two different doses a month apart, late-stage trials showed.

The British drugmaker said it would have as many as 200 million doses by the end of 2020 and 700 million doses could be ready globally as soon as the end of the first quarter of 2021.

Pfizer, working with German partner BioNTech, says its vaccine was 95% effective against infection from the highly contagious respiratory virus.

Other pharmaceutical companies making progress include Moderna Inc, which is expected to seek separate approval later in December, and Johnson & Johnson, which is working on a single-dose vaccine.

In the United States, the first people to receive the Pfizer vaccine would likely include doctors, nurses and front-line emergency medical personnel, as well as those at the highest risk of severe illness and death from the virus, Slaoui said.

But U.S. Surgeon General Jerome Adams expressed concern that Americans who are dismissive of science and skeptical about vaccines may discourage people from getting their jabs.

“What I’d hate is for us to have a vaccine that could end this pandemic but people don’t trust it,” Adams told the ABC News show “Good Morning America” on Monday.

“I’m just excited we now have three vaccines out there because when you’re trying to immunize the entire planet we want to have as many different tools in our arsenal as possible,” Adams said.

Adams warned Americans that holiday parties “can be super-spreader events,” while New Jersey Governor Phil Murphy urged people to scale back or cancel Thanksgiving plans.

“We’ve pleading with people: Please, God, do the right thing,” Murphy told “Good Morning America.”

California Governor Gavin Newsom said late Sunday he would quarantine for 14 days after three of his children were exposed to a California Highway Patrol officer who tested positive for the virus.

(Additionl reporting by Lisa Lambert, Susan Heavey, Doina Chiacu, Kate Holton, Josephine Mason and Kate Kelland; Editing by Bernadette Baum)