Even though it’s known as a respiratory virus, doctors believe the coronavirus can directly infect the heart muscle and cause other problems leading to heart damage.

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Health care professionals turn a COVID-19 patient over onto his back at St. Jude Medical Center in Fullerton, Calif., in July. Jae C. Hong/Associated Press

In some people, as COVID-19 decreases lung function, it may deprive the heart of adequate oxygen. Sometimes it causes an overwhelming inflammatory reaction that taxes the heart as the body tries to fight off the infection.

The virus can also invade blood vessels or cause inflammation within them, leading to blood clots that can cause heart attacks.

Clots throughout the body have been found in many COVID-19 patients. That has led some doctors to try blood thinners, although there is no consensus on that treatment.

Dr. Sean Pinney of the University of Chicago says people with heart disease are most at risk for virus-related damage to the heart. But heart complications also have been found in COVID-19 patients with no known previous disease.

A recent review in the Journal of the American College of Cardiology notes that evidence of heart involvement has been found in at least 25 percent of hospitalized coronavirus patients. At some centers, the rate is 30 percent or higher. And some studies have found elevated enzyme levels and other signs suggesting heart damage even in patients with milder disease. It is not known whether that damage is permanent.

One small study found evidence of the virus in the hearts of COVID-19 patients who died from pneumonia. Another, using heart imaging, found inflammation of the heart muscle in four college athletes who had recovered from mild COVID-19 infections. There were no images available from before the athletes got sick, and therefore no way to know if they had pre-existing heart problems.

Dr. Tom Maddox, an American College of Cardiology board member, says it’s unclear if the virus can cause a normal heart to become dysfunctional.

“There’s still so much we don’t know,” Maddox said.

Unions’ lawsuit against OSHA cites failure to keep workers safe from virus

Unions representing hundreds of thousands of nurses and health care workers filed a lawsuit against the Occupational Safety and Health Administration on Thursday, alleging that the agency is violating its duties to keep workers safe by failing to issue an infectious disease standard to protect health care workers during the pandemic.

The lawsuit was filed by the American Federation of Teachers, American Federation of State, County and Municipal Employees, the Washington State Nurses Association, and the United Nurses Associations of California with the U.S. Court of Appeals, Ninth Circuit. It alleges OSHA’s decision not to set safety standards about infectious diseases is “unreasonable and unlawful” and a violation of federal law that requires the agency to issue standards for significant health risks.

The move is the latest example of the brewing frustrations among labor advocates and Democrats over OSHA’s refusal to aggressively enforce workplace safety during the pandemic. A similar lawsuit filed by the AFL-CIO earlier in the pandemic was dismissed by a judge in the summer, while another lawsuit, filed by a group of meatpacking workers who say OSHA’s inaction has left them in danger, is ongoing.

Former OSHA officials have spoken out forcefully against the agency, but the Trump administration has defended the agency’s approach.

The lawsuit seeks a writ of mandamus – a court order that would require OSHA fulfill its duties.

OSHA says that its existing standards are sufficient to keep workers safe from the pandemic at work. It has received 9,818 COVID-related complaints during the pandemic, and issued 112 citations. In a statement sent by spokeswoman Megan P. Sweeney, it pointed to the dismissal of the AFL-CIO’s lawsuit.

Read the full story here.

Q&A: How does COVID-19 affect the heart?

Even though it’s known as a respiratory virus, doctors believe the coronavirus can directly infect the heart muscle and cause other problems leading to heart damage.

In some people, as COVID-19 decreases lung function, it may deprive the heart of adequate oxygen. Sometimes it causes an overwhelming inflammatory reaction that taxes the heart as the body tries to fight off the infection.

The virus can also invade blood vessels or cause inflammation within them, leading to blood clots that can cause heart attacks.

Clots throughout the body have been found in many COVID-19 patients. That has led some doctors to try blood thinners, although there is no consensus on that treatment.

Dr. Sean Pinney of the University of Chicago says people with heart disease are most at risk for virus-related damage to the heart. But heart complications also have been found in COVID-19 patients with no known previous disease.

A recent review in the Journal of the American College of Cardiology notes that evidence of heart involvement has been found in at least 25 percent of hospitalized coronavirus patients. At some centers, the rate is 30 percent or higher. And some studies have found elevated enzyme levels and other signs suggesting heart damage even in patients with milder disease. It is not known whether that damage is permanent.

One small study found evidence of the virus in the hearts of COVID-19 patients who died from pneumonia. Another, using heart imaging, found inflammation of the heart muscle in four college athletes who had recovered from mild COVID-19 infections. There were no images available from before the athletes got sick, and therefore no way to know if they had pre-existing heart problems.

Dr. Tom Maddox, an American College of Cardiology board member, says it’s unclear if the virus can cause a normal heart to become dysfunctional.

“There’s still so much we don’t know,” Maddox said.

Public health experts see grave missteps in U.S. virus response

NEW YORK — A president who downplayed the coronavirus threat, scorned masks and undercut scientists at every turn. Governors who resisted or rolled back containment measures amid public backlash. State lawmakers who used federal COVID-19 aid to plug budget holes instead of beefing up testing and contact tracing.

Virus_Outbreak_Florida_54947

Vehicles line up as healthcare workers help check people in to be tested at the COVID-19 drive-thru testing center at Hard Rock Stadium in Miami Gardens, Fla., on Wednesday. David Santiago/Miami Herald via Associated Press

As a powerful new wave of infections sweeps the U.S. just ahead of Election Day, the nation’s handling of the nearly eight-month-long crisis has been marked by what health experts see as grave missteps, wasted time and squandered opportunities by leaders at all levels of government.

The result: The country could be looking at a terrible winter.

“The inconsistency of the response is what’s been so frustrating,” said Dr. Irwin Redlener of the National Center for Disaster Preparedness at Columbia University. “If we had just been disciplined about employing all these public health methods early and aggressively, we would not be in the situation we are in now.”

Though Redlener sees some of the new wave as inevitable, he estimates at least 130,000 of the nation’s more than 227,000 deaths could have been avoided had the country more widely embraced masks and social distancing.

Even if a Chinese-style lockdown wasn’t possible, Redlener said, a more modest approach like Canada’s, with a strong central message of caution in reopening and widespread mask-wearing and distancing, would have saved lives over the state-by-state and widely partisan approach.

Now the U.S. is seeing cases spike, especially in the Midwest and the Plains, with the country posting a record high number of new infections last week of nearly a half-million.

Dr. Anthony Fauci, the nation’s top infectious-disease expert, likewise pointed to states’ varied responses to reopening for the rocketing case numbers.

“It was like a free-for-all,” Fauci said in an online forum Wednesday.

Read the full story here.

Taiwan celebrates record 200 days with no locally transmitted infections

TAIPEI, Taiwan — Taiwan hit 200 days without any domestically transmitted cases of COVID-19 on Thursday, highlighting the island’s continued success at keeping the virus under control even as cases surge in other parts of the world.

Taiwan’s Center for Disease Control last reported a domestic case on April 12. CDC officials noted the milestone and thanked the public for playing a role, while urging people to continue to wear masks and to wash their hands often.

Since the pandemic began, Taiwan has recorded 553 cases of COVID-19, and just seven deaths. While it has stopped domestic transmission, it continues to record new cases in people arriving from abroad.

Taiwan has been pointed to as a success story in how to respond to the pandemic, especially considering its close business and tourism ties with China, where the virus first emerged late last year.

Shoppers in Taipei on Thursday. Associated Press/Chiang Ying-ying

Questions remain, however, as to whether the island is truly free of the coronavirus. Local media has been paying close attention to reports of people who tested positive for COVID-19 after leaving Taiwan.

Authorities said Wednesday that they received notice from Japanese and Thai health authorities that three people who had recently left the island tested positive.

Yet Taiwan is still undoubtable a success in light of the global scale of the pandemic — more than 44 million reported cases and 1.1 million deaths.

Its success has in part been attributed to acting very early on.

Taiwanese officials were checking passengers on flights from Wuhan, the Chinese city where the pandemic began, as early as Dec. 31 for fever and pneumonia symptoms, according to researchers writing in JAMA, a medical journal.

On Jan. 20, the government formally initiated the Central Epidemic Command Center to coordinate the government response between different departments and branches. The government also communicated effectively about the importance of wearing masks, while trying to prevent panic buying and price-gouging by rationing them.

The island was also quick to tighten its borders, suspending flights from Wuhan on Jan. 23, and banning the entry of Chinese nationals who reside in Wuhan.

Taiwan has a strict 14-day quarantine for all arrivals, whether Taiwanese or foreign.

Professionals with technical expertise led the response and messaging, such as Taiwan’s former Vice President Chen Chien-jen, who is a trained-epidemiologist.

Healthcare workers file lawsuit against OSHA, accusing agency of failing to keep them safe

Unions representing hundreds of thousands of nurses and healthcare workers filed a lawsuit against the Occupational Safety and Health Administration on Thursday, alleging that the agency is violating its duties to keep workers safe by failing to issue an infectious disease standard to protect health care workers during the pandemic.

The lawsuit was filed by the American Federation of Teachers, American Federation of State, County and Municipal Employees, the Washington State Nurses Association, and the United Nurses Associations of California with the U.S. Court of Appeals, Ninth Circuit. It alleges OSHA’s decision not to set safety standards about infectious diseases is “unreasonable and unlawful” and a violation of federal law that requires the agency to issue standards for significant health risks.

The move is the latest example of the brewing frustrations among labor advocates and Democrats over OSHA’s refusal to aggressively enforce workplace safety during the pandemic. A similar lawsuit filed by the AFL-CIO earlier in the pandemic was dismissed by a judge in the summer, while another lawsuit, filed by a group of meatpacking workers who say OSHA’s inaction has left them in danger, is ongoing.

Former OSHA officials have spoken out forcefully against the agency, but the Trump administration has defended the agency’s approach.

The lawsuit seeks a writ of mandamus – a court order that would require OSHA fulfill its duties.

Virus_Outbreak_Home_Front_69899

Healthcare professionals including Dr. Michael Katz, left, turn a COVID-19 patient over onto his back at St. Jude Medical Center in Fullerton, Calif., Friday, July 10. AP Photo/Jae C. Hong

“OSHA has a duty to issue a safety and health standard to protect healthcare workers from the significant risk of harm from infectious diseases,” the complaint reads. “The record of this risk to public health, even in ordinary times, is clear. The risks are especially high during pandemics like H1N1 in 2009 and now COVID-19. OSHA’s 10-year delay in acting on the Infectious Diseases Standard is unreasonable.”

OSHA says that its existing standards are sufficient to keep workers safe from the pandemic at work. It has received 9,818 COVID-related complaints during the pandemic, and issued 112 citations. In a statement sent by spokeswoman Megan P. Sweeney, it pointed to the dismissal of the AFL-CIO’s lawsuit.

Read the full story here.

Public health experts see grave missteps in U.S. virus response

NEW YORK — A president who downplayed the coronavirus threat, scorned masks and undercut scientists at every turn. Governors who resisted or rolled back containment measures amid public backlash. State lawmakers who used federal COVID-19 aid to plug budget holes instead of beefing up testing and contact tracing.

As a powerful new wave of infections sweeps the U.S. just ahead of Election Day, the nation’s handling of the nearly 8-month-old crisis has been marked by what health experts see as grave missteps, wasted time and squandered opportunities by leaders at all levels of government.

The result: The country could be looking at a terrible winter.

“The inconsistency of the response is what’s been so frustrating,” said Dr. Irwin Redlener of the National Center for Disaster Preparedness at Columbia University. “If we had just been disciplined about employing all these public health methods early and aggressively, we would not be in the situation we are in now.”

Though Redlener sees some of the new wave as inevitable, he estimates at least 130,000 of the nation’s more than 227,000 deaths could have been avoided had the country more widely embraced masks and social distancing.

Virus_Outbreak_Florida_54947

Vehicles line up as a healthcare workers help check people in as they are being tested at the COVID-19 drive-thru testing center at Hard Rock Stadium in Miami Gardens, Fla. on Wednesday, Oct. 28. David Santiago/Miami Herald via AP

Even if a Chinese-style lockdown wasn’t possible, Redlener said, a more modest approach like Canada’s, with a strong central message of caution in reopening and widespread mask-wearing and distancing, would have saved lives over the state-by-state and widely partisan approach.

Now the U.S. is seeing cases spike, especially in the Midwest and the Plains, with the country posting a record high number of new infections last week of nearly a half-million.

Dr. Anthony Fauci, the nation’s top infectious-disease expert, likewise pointed to states’ varied responses to reopening for the rocketing case numbers.

“It was like a free-for-all,” Fauci said in an online forum Wednesday.

Read the full story here.

France prepares to shut down to try to stop outbreak

French doctors are expressing relief and business owners despair as France prepares to shut down for a month to try to put the brakes on a fast-moving fall coronavirus outbreak.

Shoppers at a Paris farmers’ market said Thursday they were ready to relinquish some freedom given the country’s rising number of virus-related deaths and COVID-19 patients filling French hospitals.

The new lockdown is gentler than the one the French government ordered in the spring, but restaurants and other non-essential businesses have been ordered to close their doors in one of the world’s biggest economies.

French schools will stay open this time, to reduce learning gaps and allow parents to keep working. Farmer’ markets, parks and factories can also continue operating, officials said.

French lawmakers are voting Thursday on the new restrictions announced by President Emmanuel Macron, which are set to come into effect at midnight. The lower house of parliament is dominated by Macron’s centrist party, so approval is virtually guaranteed. The prime minister plans to lay out details of the virus-fighting plan Thursday evening.

The pandemic has made it difficult to travel to Australia and almost impossible to leave

CANBERRA, Australia — Astrid Magenau wasn’t able to keep a promise to hold her father’s hand at his deathbed in Germany because of Australia’s extraordinary pandemic restrictions that make her feel like a prisoner in her adopted country.

Australia has sought to prevent new coronavirus cases from reaching its shores by banning most of its residents from leaving in the first place. But the ban on overseas travel creates a heartbreaking burden on a multicultural nation such as Australia, where around half the people were born abroad or have an immigrant parent.

Prime Minister Scott Morrison has held up Australia’s travel ban as an example to the world of how to avoid severe coronavirus spikes caused by citizens who are infected while on vacation.

Still, Australia is the only member of the Organisation for Economic Cooperation and Development — a group of 37 developed nations — that has banned its citizens from leaving during the pandemic.

Morrison has described the ban as “uncontroversial.” But with Australia becoming one of the most successful countries in containing the spread of the virus, some are questioning how long the ban can be justified.

Australia, with a population of 26 million, had recorded 27,541 virus cases, including 907 deaths, as of Wednesday — with 74% of the cases and 90% of the fatalities coming in the city of Melbourne and surrounding Victoria state. But Melbourne came out of lockdown on Wednesday, with authorities confident they have contained community transmission.

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Pellegrini’s Espresso Bar is open again as Melbourne, Australia’s former coronavirus hot spot, allows restaurants, cafes and bars to reopen. Associated Press/Asanka Brendon Ratnayake

Some categories of Australian citizens and residents automatically qualify for permission to travel.

U.S. citizen Michelle Parker is a flight attendant, and Australia considers her an essential worker who flies between her Sydney home and San Francisco.

But New South Wales state’s added layer of strict quarantine rules meant that when she was returning to her husband and children in Sydney for days, she was no longer considered an essential worker but a traveler who was expected to pay 3,000 Australian dollars ($2,100) to quarantine in a Sydney hotel for two weeks.

This meant Parker spent her layover at friends’ homes in San Francisco for weeks. The New South Wales state government recently gave her a one-month permit to self-isolate at her Sydney home when she isn’t working, rather than at a hotel.

Australia’s extreme response to the pandemic reflects an island nation that has some of the world’s toughest border controls and lacks the interconnections with its neighbors that many other countries around the world share.

“We just have much, much stronger border controls than almost anywhere else,” Griffith University law expert Susan Harris Rimmer said. “I think we think they’re normal, but they’re just not normal.”

Harris Rimmer said it would be “very difficult“ for the European Union to follow Australia’s example because of its strong human rights protections and its focus on free travel. But some Middle Eastern and Asian countries with weak human rights protections could, she said.

One of the last places on earth to be coronavirus-free reports its first cases

WELLINGTON, New Zealand — The Marshall Islands has reported its first cases of the coronavirus after two people who flew from Hawaii to a U.S. military base tested positive.

The small Pacific nation had been among the last places in the world to have no reported cases of the virus.

Laura Island, part of the Marshall Islands. Photo courtesy of the U.S. Department of Defense

The Office of the Chief Secretary says a 35-year-old woman and a 46-year-old man tested positive this week after flying directly from Honolulu to the base on Kwajalein Atoll. The office says that the two cases weren’t connected and that both people are in quarantine. The office says all businesses and government operations will continue as normal.

Home to about 78,000 people, the Marshall Islands maintains close military and civilian ties with the U.S. under a compact of free association.

Fauci expresses support for national mask mandate, hasn’t spoken to Trump in ‘quite a while’

Anthony S. Fauci, the nation’s top infectious-disease expert, appeared to call for a nationwide mask mandate for the first time on Wednesday in interviews with CNBC and the Journal of the American Medical Association.

The director of the National Institute of Allergy and Infectious Diseases has historically been reluctant to advocate for such a sweeping policy, telling reporters last month that a national mandate “probably would not work.” But in a Friday interview with CNN, he suggested that the federal government should “maybe” consider instituting one.

Questioned about his apparent hesitation on Wednesday by CNBC’s Shepard Smith, Fauci said that he had hoped “we could pull together as a country” and recognize the importance of mask-wearing without the government getting involved. “We haven’t,” Smith interrupted, before going on to ask Fauci if it was time for a national mandate.

“You know, yes,” Fauci replied. “If we don’t get one, I would hope that the mayors and the governors do it locally.”

President Trump has resisted calls to issue a nationwide mask mandate, something that Democratic presidential nominee Joe Biden has said he would do if elected. Pressed further by Smith, Fauci acknowledged that he had not spoken to Trump in “quite a while.”

Earlier on Wednesday, Fauci was also asked about his comments regarding a potential mask mandate during a question-and-answer session hosted on JAMA’s YouTube channel. He emphasized that getting 90 percent or more of the population to wear masks could be a key to avoiding future lockdowns.

Calling the prospect of a new round of economically bruising stay-at-home measures “almost radioactive,” Fauci said that Americans would have to “at least do the fundamental, basic things” if they want to avoid additional shutdowns. “What we can’t have is this very inconsistent wearing that you see, where some states absolutely refuse to wear a mask,” he said.

Court halts order requiring masks at Texas polling places

AUSTIN, Texas — A federal appeals court has suspended a judge’s order requiring people in Texas to wear face masks inside polling stations.

The 5th U.S. Circuit Court of Appeals stayed the U.S. District Judge Jason Pulliam’s order late Wednesday.

Pulliam ruled this week that not requiring face coverings inside Texas polling places created a discriminatory burden on Black and Latino voters, who face higher risks of death and severe illness from the coronavirus.

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Hundreds gather in protest against Gov. Greg Abbott’s handling of the coronavirus pandemic outside the governor’s mansion in Austin Oct. 10. Bronte Wittpenn /Austin American-Statesman via Associated Press

Texas elections administrators had expected Pulliam’s ruling to be put on hold and did not begin enforcing his order requiring face coverings. Texas has had a statewide mask mandate since July, but Republican Gov. Greg Abbott carved out an exception for polling places.

More than 8 million votes have been cast early in Texas, which is nearly the total number that were cast in the the nation’s second-largest state during the 2016 election. Early voting in Texas ends Friday.

The lawsuit seeking the mask requirement inside polling stations was filed by the Texas NAACP and the Latino rights group Mi Familia Vota.

Scotland will issue cards showing exemption from face-covering rules over discrimination fears

Scotland will issue official cards for those exempt from mandatory face-covering rules to make them “feel more safe and confident in public and when accessing and using public spaces and services,” a government statement announced Thursday.

The cards will be issued amid concerns that people with disabilities could be discriminated against if they are unable to wear a mask.

“Since face coverings became mandatory, we have been inundated with calls from our members, many of whom cannot wear face coverings for a variety of health reasons,” Morven Brooks, chief executive of Disability Equality Scotland, told the Herald newspaper.

The Last Drop pub closes on Oct. 9 as temporary restrictions to help curb the spread of coronavirus have come into effect in Edinburgh. Andrew Milligan/PA via Associated PressP

Under Scottish laws that went into force on Oct. 16, face coverings such as masks are mandatory on public transportation, inside shops and workplaces, as well as most indoor public places.

However, the government has made exemptions to the requirement: For example, if you have a health concern, a disability or mental health concerns, you are not required to wear a mask.

The new cards could be shown to law enforcement officers or other members of the public. Per the government’s website, Exempt.Scot, those applying for an exemption card do not need to provide written proof for their reason behind it.

The government also advises that anyone who suffers abuse for not wearing a mask should consider reporting a disability hate crime with Scottish authorities.

Most countries or regions with mask requirements make exceptions for those with health problems or disabilities. In England and Wales, the government has also suggested that those exempt from face-covering rules carry a card explaining why, although the government only provided a template for a card.

Number of patients in Belgian hospitals highest since the beginning of pandemic

BRUSSELS — The number of patients in Belgian hospitals is now higher than during the first wave of the coronavirus crisis.

The latest figures showed that 5,924 patients were in hospital, surpassing the previous April 6 record of 5,759. The figures by the Sciensano center underscored the seriousness of the situation, which already pushed authorities to reinforce measures which they had relaxed only a month ago.

Patients in intensive care units reached 993, and virologists have said that unless tougher measures having a quick impact the saturation point of 2,000 patients will be reached on Nov. 6.

On Wednesday, Prime Minister Alexander De Croo promised tougher measures across the nation to avoid a breakdown of the country’s health system.

Xianjiang officials believe they have contained the latest outbreak

BEIJING — Officials in the northwestern China region of Xinjiang say they believe they have contained the country’s latest coronavirus outbreak.

Xinjiang reported 23 new confirmed cases Thursday, all involving people who had initially tested positive but displayed no symptoms. It was the second consecutive day in which newly confirmed cases emerged entirely among such people.

Officials say that development appears to show new infections have been curbed in Kashgar prefecture, where the outbreak appeared Saturday. They say all the cases seem to be linked to a garment factory that employs 252 people and has since being sealed off.

More than 4.7 million people in Kashgar have been tested for the virus.

 


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