The US just topped 1,100 coronavirus deaths a day. One state is getting National Guard help, and others keep breaking records

You know Covid-19 is out of control when health officials are so overwhelmed, they can’t notify close contacts who may be infected.



a person holding a sign: Oct. 13, 2020; Phoenix, Arizona; Delta Air Lines has no-touch boarding at Sky Harbor International Airport. Delta Air Lines is promoting their health and safety practices in the COVID-19 air travel era.


© Rob Schumacher/The Republic/USA Today Network
Oct. 13, 2020; Phoenix, Arizona; Delta Air Lines has no-touch boarding at Sky Harbor International Airport. Delta Air Lines is promoting their health and safety practices in the COVID-19 air travel era.

That’s what’s happening in North Dakota, one of 31 states suffering more new Covid-19 cases this past week compared to the previous week.

Contact tracing is crucial to finding possible carriers of coronavirus, so they can quarantine and break the chain of infection.

But a “sharp increase” in new cases has engulfed contact tracers, leading to delays and “a backlog of positive cases that have yet to be assigned to a case investigator,” the North Dakota Department of Health said this week.

“Close contacts will no longer be contacted by public health officials; instead, positive individuals will be instructed to self-notify their close contacts and direct them to the NDDoH website, where landing pages will be created … explaining the recommended and required actions for both positive patients and close contacts.”

The North Dakota National Guard has shifted 50 soldiers from contacting close contacts to notifying people who have tested positive, the state health department said.

‘No safe period of time’ to be maskless with someone outside your bubble

Nationwide, all Americans need to double down on safety measures now that the definition of “close contacts” has expanded.

The Centers for Disease Control and Prevention just broadened “close contacts” to include anyone you may have had brief contact with, within 6 feet, during a combined 15 minutes over the course of a day. (Previously, the CDC defined close contacts as anyone you had close encounters with for at least 15 minutes straight.)

“It reiterates the importance of everybody wearing a mask,” said Dr. Ashish Jha, dean of the Brown University School of Public Health.

Jha and other health experts say there’s nothing magical about 15 minutes, and that the public shouldn’t assume spending less time with people without masks is safe.

“There is no safe period of time to be with somebody who’s not part of your bubble if both of you are not wearing masks,” he said.

“It’s really critical that people wear masks if you’re going to be with somebody for any period of time, even if it’s less than 15 minutes.”

The new CDC guidance came after researchers discovered even brief exposures (less than 15 minutes each) with an infected person nearby can silently spread coronavirus.

“A mask can protect other people from the virus-containing particles exhaled by someone who has COVID-19. As many as half of all people who have COVID-19 don’t show symptoms, so it’s critical to wear a mask because you could be carrying the virus and not know it,” the CDC said.

“While a mask provides some limited protection to the wearer, each additional person who wears a mask increases the individual

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Indiana nursing homes will receive help from National Guard

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The older, sicker residents in Indiana nursing homes make the environments particularly susceptible to the coronavirus. But there are other reasons why the disease has been so lethal there.

Indianapolis Star

Gov. Eric Holcomb announced on Wednesday that he would send members of the Indiana National Guard into nursing homes to help an “exhausted” staff care for residents.

The announcement comes as long-term care facilities are experiencing a surge of cases and deaths. To date, 2,205 residents of nursing homes or assisted living facilities in Indiana have died of COVID-19, about 58% of coronavirus deaths statewide.

Beginning on Nov. 1, the National Guard will help with tasks such as staff screenings, data entry and testing to allow long-term care staff more time to directly care for residents. Facilities currently experiencing outbreaks will be the first to receive the aid.

Staff, residents and families are “simply, like so many, overwhelmed by the scale and pace that this virus can take on,” Holcomb said during the state’s weekly coronavirus press conference. “There is fatigue there. You’re seeing that; we’re hearing that when you’re on the ground.”

IndyStar investigation: Nursing home residents suffer as county hospitals rake in millions

But that fatigue should not necessarily come as a surprise. The pandemic exacerbated what was already a chronic problem revealed in an IndyStar investigation, published back in March.

Even before the pandemic, Indiana’s nursing home facilities were significantly understaffed, on average ranking 48th in the nation according to an analysis of federal data by IndyStar. Poor staffing at the state’s homes is one of the reasons AARP rates Indiana’s elder care system dead last in the country. The IndyStar investigation found several instances where poor staffing was cited as contributing to injury or death at Indiana facilities.

The use of the National Guard is one of several steps the state announced to prevent the spread of the disease in long-term care facilities and to maintain hospital capacity, one of the state’s four guiding principles for reopening. The state has twice as many Hoosiers hospitalized with COVID-19 today compared to late June and early July, said Dr. Lindsay Weaver, chief medical officer of the state health department.

The state will also connect facilities with clinical workers through its health care reserve program, which pairs retired or out-of-work health care workers with facilities in need. Weaver said the state had received 11 requests for help from the program from long-term care facilities just this week.

Additional workers will work with the Indiana State Department of Health to visit each long-term care facility at least three times a week, possibly more, to provide additional infection control training, Weaver said.

In addition to staffing help, the state will send 2 million N95 masks to long-term care facilities, the largest distribution of personal protective equipment in Indiana to date.

The efforts come as ISDH closes in on its goal to perform infection control surveys at every facility in the month of October, which Weaver expects to wrap up

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CDC updates its guidelines for close Covid-19 contact after prison guard gets infected

The US Centers for Disease Control and Prevention has updated its definition of a close contact with a Covid-19 patient to include multiple, brief exposures, after a Vermont prison worker appears to have been infected that way, CDC Director Dr. Robert Redfield said Wednesday.



a man and a woman sitting on a bench: People gather on the pier at the Pacific Ocean on the first day of the Labor Day weekend amid a heatwave on September 5, 2020 in Santa Monica, California.


© Mario Tama/Getty Images
People gather on the pier at the Pacific Ocean on the first day of the Labor Day weekend amid a heatwave on September 5, 2020 in Santa Monica, California.

The new definition includes exposures adding up to a total of 15 minutes spent six feet or closer to an infected person. Previously, the CDC defined a close contact as 15 minutes of continuous exposure to an infected individual.

The agency changed the definition after a report from Vermont of a corrections officer who became infected after several brief interactions with coronavirus-positive inmates — none of them lasting 15 minutes, but adding up over time.

The corrections officer never spent much time with any particular inmate, but opened and closed cell doors, collected soiled linen, opened doors to shower and recreation rooms for inmates, conducted health checks and dispensed medication, Julia Pringle, a CDC officer working with the Vermont Department of Health, and colleagues reported.

The six inmates had no symptoms and had traveled from out-of-state facilities while they were awaiting coronavirus test results, Pringle’s team reported in the CDC’s weekly report, the MMWR.

His 22 short encounters added up to about 17 minutes of total exposure, the team calculated.

The data suggests at least one of the six inmates transmitted the virus to the officer during one of these brief encounters. The six inmates wore microfiber cloth masks for some, but not all interactions with the officer. “During all interactions, the correctional officer wore a microfiber cloth mask, gown, and eye protection (goggles),” the team wrote.

Redfield said it’s an example of real-world science informing policy. The CDC has now updated its definition of what constitutes a close contact.

“As we get more data and understand the science of Covid, we are going to incorporate that in our recommendations,” Redfield said at a news conference held at CDC headquarters in Atlanta.

“Originally, contact that was considered to be high risk for potential exposure to Covid was someone within six feet for more than 15 minutes,” Redfield added.

The new data is being incorporated into recommendations, he said.

“In an MMWR published today, CDC and Vermont health officials found that multiple, short and non-consecutive exposures to persons confirmed to have COVID-19 led to transmission,” the CDC said in a statement.

“The CDC website now defines a close contact as someone who was within 6 feet of an infected person for a total of 15 minutes or more over a 24-hour period. Previous language defined a close contact as someone who spent at least 15 minutes within 6 feet of a confirmed case.”

The website notes that this is not an exact science

“Factors to consider when defining close contact include proximity (closer

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Cases again up at Notre Dame; Pope Swiss Guard cases

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Holidays are usually for gatherings but many get-togethers are complicated or canceled because of COVID-19.

USA TODAY

The U.S. recorded more than 69,000 new cases Friday for the first time since July, andupdated virus projections are bringing the long-feared “winter surge” of COVID-19 cases into focus as health experts warn an increasing number of infections in the U.S. will soon mean more deaths.

The University of Washington’s Institute for Health Metrics and Evaluation’s latest model updates released this week contain spots of good news: 74,000 American lives can still be saved if mask use becomes nearly universal, and increased testing may explain why more young people are testing positive.

But the influential model still projects daily U.S. deaths will surpass 2,000 in January, even with states reimposing stricter orders.

The guidance also called out North Dakota specifically for its alarming death rate, following a well-documented lax approach to health mandates in the state: “North Dakota presently has one of the highest COVID-19 death rates in the world,” a briefing on the model says.

The state joins South Dakota as having some of the lowest mask use rates in the nation. Rural counties across Wisconsin, North Dakota, South Dakota and Montana sit among the top in the nation for new cases per capita over the last two weeks,

Some significant developments:

📈 Today’s numbers: The U.S. has reported more than 8.1 million cases and 219,000 deaths, according to Johns Hopkins data. There have been more than 39.6 million confirmed cases around the world and nearly 1.1 million deaths. 

📰 What we’re reading: Italy, once an epicenter for COVID-19, is worlds apart from the United States in its handling of the pandemic. “Italians have always looked up to the United States but what is happening now makes us watch in disbelief,” says one Italian professor.

🗺️ Mapping coronavirus: Track the U.S. outbreak in your state

This file will be updated throughout the day. For updates in your inbox, subscribe to The Daily Briefing newsletter.

Cases again surge at Notre Dame after parties

The University of Notre Dame announced a return to stricter rules on gatherings after cases at the school surged in recent days. Officials say off-campus tailgates and watch parties following a recent football home game are part of the reason for the increase in cases.

In a letter posted Thursday to the university’s COVID-19 website, Vice President for Student Affairs Erin Hoffmann Harding and Vice President for Campus Safety and University Operations Mike Seamon said the number of close contacts for each positive case had “increased substantially, with as many as 10 to 15 close contacts needing to quarantine.” At one time, the number of close contacts was only five per positive test.

The increase, he said, “would indicate they’re gathering in groups.”

In August, the university temporarily pivoted to online learning to stem a rash of cases.

— Andrew S. Hughes, South Bend Tribune

Man upset with mask mandate threatened Wichita mayor, police say

A retired firefighter

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Is a $ 700 Mouth Guard Better For Your Dentist Or You?

If you are one of the more than 30 million Americans who grind their teeth, your dentist has probably recommended you buy a mouth guard. When it comes to the choice between buying a $ 10 to $ 50 custom-moldable or custom configurable mouth guard, and buying a $ 300 to $ 700 dentist-made mouth guard, you might not be surprised that most dentists recommend the dentist-made mouth guards. But who benefits more from these dentist-made mouth guards, you or your dentist?

In a recent phone survey conducted in the Boston area, various dentists were charging between $ 300 and $ 700 for exactly the same dentist-made mouth guard, so if you decide to go for a dentist-made mouth guard to keep your tooth grinding from wearing down your teeth, you might want to be a smart shopper and call around first to compare prices.

I inquired recently at the Yankee Dental Congress in Boston how much the dentist-made mouth guards cost the dentists to make. The various companies that make the systems used to make the guards said the price of the materials is about $ 12 per custom mouth guard. Add to that technician time, and they assured me "the cost is well under $ 100 – these are very high-profit items for dentists". I was not shocked, but this does seem to present a possible conflict of interest for a dentist deciding whether to recommend you buy an inexpensive over-the-counter mouth guard or an expensive dentist-made mouth guard.

More and more brands of inexpensive custom-moldable or custom-configurable mouth guards have become available in recent years. Some of the units were designed by dentists who say they are just as good (or in some cases better) than the dentist-made mouth guards.

Any mouth guard could make your pain worse if the feel of it winds up feeding your tooth grinding and clenching habit and having you grind and clench more. Since dentists don't offer money-back guarantees on the custom mouth guards they make, you might want to try one or two of the inexpensive over-the-counter versions before you plunk down the big bucks for a dentist-made mouth guard. You might also want to try biofeedback, which can be tried for free, to see if that can significantly reduce your tooth grinding and clenching and reduce or eliminate your pain. There are many other things you can try, and it makes sense to try first the things that can be tried for free or with a money-back guarantee.

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