UChicago Medicine and UIC researchers to study expanded access to rapid COVID-19 testing

Researchers at the University of Chicago Medicine and the University of Illinois at Chicago (UIC) are launching an investigational study to determine the effects of increased education and access to rapid, FDA-approved COVID-19 testing on community perceptions, access, and use of COVID-19 testing resources.

The study will be funded by $2M in support from the National Institutes for Health RADx-UP program. A part of the Rapid Acceleration of Diagnostics (RADx) initiative, the RADx Underserved Populations (RADx-UP) program supports research that aims to better understand COVID-19 testing patterns among underserved and vulnerable populations; strengthen the data on disparities in infection rates, disease progression and outcomes; and develop strategies to reduce the disparities in COVID-19 testing.

The research will be led by Ayman Al-Hendy, MD, professor of obstetrics and gynecology at UChicago Medicine, and Renee Taylor, PhD, professor of occupational therapy and Nahed Ismail MD, PhD, D(ABMM), D(ABMLI), professor of pathology and medical director of clinical microbiology at the University of Illinois at Chicago. The investigators plan to leverage existing university-community partnerships and expertise in clinical microbiology, community engagement, and epidemiological infrastructures to expand access to rapid COVID-19 testing.

“There are testing deserts in Chicago, where many people don’t have easy or affordable access to testing,” said Taylor. “We can reach individuals who maybe don’t have health insurance or are concerned about having a COVID-19 test on their medical record and provide them with an easy and private opportunity to get tested.”

The project includes collaboration with community members to co-create advertisements to recruit other participants into the trial as well as a mobile health web app, called the mHealth Literacy and Outreach Suite, that will allow individuals to not only privately order testing, but also learn how to prevent the spread of COVID-19 and care for themselves if they fall ill.

Investigators are also sending out kits so participants can collect their own samples and send them to be tested at UIC. Sample collection can be performed rapidly at home with a nasal swab, without the discomfort of the typical nasopharyngeal swab, before sending the sample to the central lab for testing.

The team hopes that the privacy offered by these options, as well as the community advocacy, will help improve the public perception of receiving a COVID-19 test.

“Many people don’t trust the test, are concerned about the expense, or are worried that they’ll be forced out of work or forced to isolate if they have a positive test, which is creating a lot of stigma,” said Ismail. “We need to expand our testing in a community setting where people have some privacy, and the mHealth Suite provides that, as well as overcoming issues of cost.”

Al-Hendy credits the skills of the interdisciplinary team and their pooled community networks for making this collaborative effort possible. “The collaboration between UIC and UChicago Medicine will allow this project to reach many underserved populations,” he said. “Our two institutions already both have robust relationships within our local communities, which will help expand the

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Fred Hutch researchers uncover new genetic details of White House COVID-19 outbreak

Since it was revealed in early October, details about President Trump’s COVID-19 infection have been in short supply, including the likely source of his exposure and when he was tested.



a group of people standing in front of a building: Judge Amy Coney Barrett delivers remarks after President Donald Trump announces her nomination to the U.S. Supreme Court, Sept. 26, 2020, in the Rose Garden of the White House. The event is believed to be responsible for the spread of COVID-19 among some attendees. (Official White House Photo by Andrea Hanks, Public Domain )


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Judge Amy Coney Barrett delivers remarks after President Donald Trump announces her nomination to the U.S. Supreme Court, Sept. 26, 2020, in the Rose Garden of the White House. The event is believed to be responsible for the spread of COVID-19 among some attendees. (Official White House Photo by Andrea Hanks, Public Domain )

New research from the Fred Hutchinson Cancer Research Center in Seattle gives a glimpse into the spread of the disease among America’s first family and White House staff and guests.

Two journalists who directly interacted with White House officials at the end of September — but were not in each other’s company — contracted variations of the virus that were “highly genetically similar.” The genetic code from the SARS-CoV-2, the virus that causes COVID, that infected the journalists contained five unique mutations and were distinct from the genomes of more than 160,000 publicly available virus sequences.

The scientists said this particular lineage of the virus was first documented in the U.S. in April or May, but its exact spread from there was unclear.

Shortly after Trump was infected, Anthony S. Fauci — the nation’s top infectious-disease expert — said that the White House had been the site of a so-called super spreader event when it hosted a Rose Garden reception for Judge Amy Coney Barrett, now a member of the U.S. Supreme Court. Photos show that many in attendance did not wear masks. At least 50 COVID-19 cases have been connected to an outbreak associated with the White House, according to the researchers.

Trump Administration officials at the time of the outbreak made little effort to do contact tracing to potentially help contain the spread — a decision that drew criticism from some health experts.

When it comes to the source of the White House infections, “it’s sort of an unknowable question, where it entered the environment,” said White House deputy press secretary Brian Morgenstern, in a press conference on Oct. 7.

The Fred Hutch-led research calls that assertion into question. While it’s too late to use the information to limit spread from the initial event, genomic sequencing could provide additional insights into the path of transmission if more samples were tested. It could also help build a more complete picture of the outbreak’s spread by analyzing infections that occur weeks or months following the White House event.



chart: Researchers at the Fred Hutchinson Cancer Research Center have created a family tree for SARS-CoV-2, the virus that causes COVID-19, and identified the form associated with the White House outbreak. (Fred Hutch Image)


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Researchers at the Fred Hutchinson Cancer Research Center have created a family tree for SARS-CoV-2, the virus that causes COVID-19, and identified the form associated with the White House

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Researchers find new deadly inflammatory disease, NIH says

National Institutes of Health (NIH) researchers reported a newly discovered deadly inflammatory disorder last week.

“We had many patients with undiagnosed inflammatory conditions who were coming to the NIH Clinical Center, and we were just unable to diagnose them,” Dr. David Beck, a clinical fellow at NHGRI and lead author of the paper, said in a news release. “That’s when we had the idea of doing it the opposite way. Instead of starting with symptoms, start with a list of genes. Then, study the genomes of undiagnosed individuals and see where it takes us.”

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The team examined over 2,500 people with undiagnosed inflammatory diseases and assessed over 800 genes involved in cells’ regulatory processes, per the release.

In doing this, they found one mutated gene, UB1, causing the syndrome dubbed VEXAS for “vacuoles, E1 enzyme, X-linked, autoinflammatory and somatic syndrome.”

Nearly half the patients under study died from the serious condition, researchers said. (iStock)

Nearly half the patients under study died from the serious condition, researchers said. (iStock)

“So far, 40% of VEXAS patients who the team studied have died, revealing the devastating consequences of the severe condition,” per the release. The disease involves blood clotting, repeated fevers, heart issues and problems with blood cells, called myeloid cells.

Findings were published in the New England Journal of Medicine.

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“Our objective was to see if any of the 2,560 patients shared variations in the same gene,” Dr. Daniel Kastner, scientific director of the Intramural Research Program at NHGRI and a senior author of the paper, said in a news release. “Instead of looking at clinical similarities, we were instead taking advantage of shared genomic similarities that could help us discover a completely new disease.”

Of the 2,560 patients, researchers said 1,000 had repeated fevers and widespread inflammation. Three men had the mutated gene in the X chromosome; men have one X chromosome and one Y chromosome, while women have two X chromosomes.

Researchers found “mosaicism” among the affected patients, which happens when some cells carry the gene in its mutated form, and other cells carry the gene in its normal form, per the release. Ultimately, 25 total men across other NIH databases showed to have the mutated gene with similar symptoms: blood clotting, repeated fevers and heart issues, among others.

“By using this genome-first approach, we have managed to find a thread that ties together patients carrying all of these seemingly unrelated, disparate diagnoses,” Kastner concluded.

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Coronavirus crowd study: German researchers find ‘glimmers of hope’ after inviting thousands to indoor concert in Leipzig

In one scenario modeled by the scientists, the infection risk for participants and their contacts was around 70 times lower when health and safety instructions were followed, compared with what it could have been under pre-pandemic behavior.

“A concert or handball game with a strictly enforced safety protocol is safer than the participation in a big wedding,” said Michael Gekle, the dean of the medical department at the Martin Luther University of Halle-Wittenberg, who was involved in the research.

The scientists’ conclusions are based on an experiment that drew around 1,400 people to an indoor concert simulation in August, hosted in one of the country’s largest venues in the eastern German city of Leipzig.

The researchers from the Martin Luther University of Halle-Wittenberg, a public institution, used tracking devices to gather data on the movements and behavior of participants, all of whom had to test negative for the virus to be allowed to participate. Over the following two months, the data gathered during the day-long experiment in August was fed into a computer simulation to estimate the hypothetical spread of the coronavirus for varying safety protocols and infection rates.

Finding a balance between economic incentives to fill a venue as much as possible and safety constraints to limit the risks was the main goal of the experiment that looked at three scenarios.

In the first, participants — while still wearing masks — pretended that the pandemic did not exist, allowing the researchers to create a detailed computer simulation of a concert with no social distancing and with an auditorium at full capacity.

In the second scenario, organizers imposed light social distancing rules and reduced the number of participants. This scenario, the researchers said Thursday, would provide sufficient safety to hold indoor events up to an infection rate of 50 new cases per 100,000 people within a week. Germany deems regions that cross this threshold as risk areas.

Events could still be held with infection levels above that rate, the researchers found, but only if organizers were to follow stringent distancing, as modeled in a third scenario.

In all three scenarios, participants had assigned seats.

The researchers cautioned that participants’ safety largely depends on face masks and on indoor ventilation systems, which were both found to play a critical role in preventing infections.

Germany already approved a $580 million program last month to improve ventilation systems in museums, theaters and other spaces. As long as no effective vaccine has been widely distributed more funding for ventilation will be needed, said Stefan Moritz, who headed the experiment. “This pandemic won’t be over in a few months,” he said.

In the lead-up to the concert, the prospect of the experiment sparked hate mail and accusations that it would become a superspreader event, but the researchers said Thursday that the concert had resulted in no known infections.

The release of their findings Thursday came at a pivotal time in Germany, and one day after Chancellor Angela Merkel announced a month-long partial national lockdown this

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Researchers link severe COVID-19 cases to mental decline equal to aging a decade

People that have suffered severe cases of COVID-19 may experience mental decline equal to the brain aging by a decade, according to a new study released this month.  

Researchers from the U.K. analyzed the test data of over 84,000 participants who took the Great British Intelligence Test and were suspected or confirmed to have COVID-19. 

The study, which has not yet been peer-reviewed, found that people who had recovered from severe cases of the disease exhibited “significant cognitive deficit” after controlling for other factors such as age, gender and pre-existing medical conditions. 

Some deficits were of “substantial effect size,” the researchers found, specifically among those who had been hospitalized and those who had mild cases and reported no difficulty breathing. However, among those who ended up on a ventilator, the deficits were “equivalent to the average 10-year decline in global performance between the ages of 20 to 70.” 

The cognitive decline could be the result of other health events that are thought to be associated with COVID-19 such as stoke, inflammatory syndrome and micro bleeds, according to the study.

COVID-19 is a disease that can have critical impacts on the upper respiratory system, leading patients with severe cases to require supplemental oxygen. As a result, researchers in the study have also hypothesized that hypoxia in the brain could also lead to cognitive decline. 

However, they write, “it is yet to be established whether COVID-19 infection is associated with cognitive impairment at the population level; and if so, how this differs with respiratory symptom severity and relatedly, hospitalisation status. Measuring such associations is challenging.”

In all, the scientists said that their findings “align with the view that there are chronic cognitive consequences of having COVID-19. Individuals who recovered from suspected or confirmed COVID-19 perform worse on cognitive tests in multiple domains than would be expected given their detailed age and demographic profiles.” 

The researchers said their study should be a “clarion call” for more research into the basis cognitive deficits in recovered COVID-19 patients. 

Some scientists say that the study’s results should be viewed cautiously. 

Derek Hill, a professor of medical imaging science at University College London, told Reuters that the study did not compare before and after scores of participants, and that a large number of them only self-reported having the virus without a positive test. 

“Overall (this is) an intriguing but inconclusive piece of research into the effect of COVID on the brain,” Hill told Reuters. “As researchers seek to better understand the long term impact of COVID, it will be important to further investigate the extent to which cognition is impacted in the weeks and months after the infection, and whether permanent damage to brain function results in some people.”

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Measuring brain tissue damage accurately identifies cognitive decline, researchers say

Oct. 27 (UPI) — By analyzing brain tissue damage using a new MRI evaluation tool, researchers accurately identified people with early signs of cognitive decline up to 70% of the time, a study published Tuesday by the journal Academic Radiology found.

The approach uses magnetic resonance imaging to identify — and measure the number and size — of bright spots on the mostly gray images of the brain called white matter hyperintensities, or lesions, the researchers said.

These spots have long been linked to memory loss and emotional problems, especially as people age. Now, newly available MRI technologies could make it possible for them to be used for diagnosis of dementia, the researchers said.

“White matter lesion captured by MRI scans may reveal cognitive decline much earlier than behavioral symptoms,” study co-author Jingyun “Josh” Chen told UPI.

“Amounts of white matter lesions above the normal range should serve as an early warning sign for patients and physicians,” said Chen, a research assistant professor of neurology at New York University Langone Health.

Roughly 6 million adults in the United States have dementia, according to the Alzheimer’s Association.

Although the condition is common, it remains challenging to accurately diagnose, and no effective treatments exist, according to Chen and his colleagues.

The bright spots seen on MRI scans represent fluid-filled holes in the brain — lesions that are believed to develop from the breakdown of blood vessels that nourish nerve cells.

Earlier research has shown that increased numbers of spots and their presence in the center of the brain is linked with worsening dementia and other brain-damaging conditions, such as stroke and depression.

Current methods for grading white matter lesions, however, rely on little more than the “trained eye” using an imprecise three-point scale, according to the researchers.

The new tool, called the white matter hyperintensities toolbox and developed by Chen and his colleagues at NYU Grossman School of Medicine, is intended to provide neurologists with a uniform, objective method for calculating the spots’ volume and location in the brain.

For this study, Chen and his colleagues randomly selected 72 MRI scans from a national database of adults age 70 and older who participated in the Alzheimer’s Disease Neuroimaging Initiative, a research project seeking to identify clinical, imaging, genetic and biochemical biomarkers for the early detection and tracking of Alzheimer’s disease.

Using MRI techniques to map the brain’s surface, the researchers then used the new tool to calculate the precise position and volume measurements for all observed white matter spots or lesions.

When researchers cross-checked their measurements, they found that seven out of 10 calculations correctly matched the patient’s actual diagnosis.

With the standardized tracking and measuring tool, physicians could monitor the growth of white matter lesions in patients with suspected dementia, the researchers said.

White matter brain measures alone are not sufficient to diagnose early dementia, Chen said, but should be considered along with other factors. This includes a history of brain injury, memory loss and hypertension, as well as clear symptoms

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Researchers identify gene that signals need to urinate

Scientists say they have spotted the gene responsible for telling you when it’s time to pee.

The gene, called PIEZO2, may help at least two different types of cells sense when the bladder is full and needs to be emptied.

“Urination is essential for our health. It’s one of the primary ways our bodies dispose of waste. We show how specific genes and cells may play critical roles in initiating this process,” said study senior author Ardem Patapoutian, a professor at the Scripps Research Institute, in La Jolla, Calif. “We hope that these results provide a more detailed understanding of how urination works under healthy and disease conditions.”

The study, which was funded by the U.S. National Institutes of Health and included NIH researchers, was published recently in the journal Nature.

The PIEZO2 gene has instructions for making proteins that are activated when cells are stretched or squeezed. The researchers found that patients who are born with a genetic deficiency in PIEZO2 have trouble sensing when their bladder is full, and experiments in mice suggest the gene has two roles in this process.

According to study lead author Kara Marshall, “There were a lot of reasons to think that PIEZO2 could be important for urination. Theoretically, it made sense as it is a pressure sensor for other internal sensory processes.” Marshall is a postdoctoral researcher at Scripps.

In 2015, researchers discovered people who were born with mutations in their PIEZO2 genes. They had no sense of the movement of the body and could not feel some types of touch and pain. They also had something else in common, the study authors said in an NIH news release.

“We were really struck by what we heard during background interviews with patients and their families,” said researcher Dr. Dimah Saade, a clinical fellow at the NIH. “Almost everyone mentioned that the patients had problems with urination. As children, they had trouble potty training. They would often have urinary tract infections. And most of them follow a daily urination schedule. After seeing a consistent pattern, we decided to take a closer look.”

Almost all of the patients said they could go all day without feeling the need to urinate, and most urinated less than the normal five to six times per day.

Marshall said, “These results strongly suggested that PIEZO2 plays a role in urination. We wanted to know how it may do this.” Experiments in mice helped find the answer.

The researchers found that the PIEZO2 gene was highly active in a few neurons that send nerve signals from the mouse bladder to the brain. Aided by an imaging system, they saw that the cells lit up with activity when a mouse’s bladder filled.

“These were the first clues to understanding wherein the urinary tract PIEZO2 worked. They suggested that it may help control the bladder,” said researcher Nima Ghitani, a postdoctoral fellow at the NIH.

More information

For more on urination, head to the U.S. National Library of Medicine.

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7-hour flight to Ireland linked to 59 covid-19 cases, researchers say

A seven-hour international flight to Ireland this summer has been linked to 59 coronavirus cases in the country, Irish researchers said in a report.

Thirteen of the 49 passengers onboard tested positive for the novel coronavirus, even though the flight was only 17 percent full, according to the report released last week by the Irish Department of Public Health. Those 13 passengers went on to infect 46 more people throughout Ireland, the report says, which “demonstrates the potential for spread of SARS-COV-2 linked to air travel.”

Researchers did not clarify where the flight originated but said the cases and their subsequent spread show that “restriction of movement on arrival and robust contact tracing” can limit travel-linked transmissions of the coronavirus.

Masks were utilized by nine of those 13 infected passengers, with one child not wearing a mask and three passengers’ mask use “unknown,” the report noted.

Out of the 13 who tested positive on the flight, 12 were symptomatic. The 13 ranged in age from 1 to 65. Four were hospitalized, with one ending up in intensive care.

The report showed the cases on an in-flight map of the aircraft, which had a three-by-three configuration.


A diagram shows passenger seating on flight to Ireland in summer 2020. (Health Service Executive)

“Four of the flight cases were not seated next to any other positive case, had no contact in the transit lounge, wore face masks in-flight and would not be deemed close contacts under current guidance from the European Centre for Disease Prevention and Control (ECDC),” the report states. Researchers defined “close contacts” on the flight as passengers within two seats of one another in every direction.

Symptoms began to appear in the earliest cases two days after the flight, and the latest case linked to the plane experienced symptoms 17 days after the flight. Researchers noted that the “source case is not known,” although one passenger reported that a family member that had tested positive three weeks before the flight.

“Air travel has accelerated the global pandemic, contributing to the spread of coronavirus disease (COVID-19) throughout the world,” the study said. Researchers say the flight-linked cases show “the nature of transmission on board, despite implementation of non-pharmaceutical interventions” such as masks.

In September, the Centers for Disease Control and Prevention estimated that nearly 11,000 people have been potentially exposed to the coronavirus on flights. A study released this month by the Defense Department that simulated in-flight transmission of the virus suggested that air passengers would need to be near an infectious person on a plane for 54 hours to receive a significant dose of the virus. The study has not yet been peer reviewed.

The report was published the same week that Ireland reimposed a stay-at-home order for six weeks in an effort to curb the spread of the virus. Daily new

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Work by Minnesota researchers reveals deadly combo: COVID and major heart attacks

Complications from COVID-19 can make the most dangerous kinds of heart attacks even more deadly, according to a new study.

The finding has special implications for African American and Hispanic residents, as well as diabetics, since those three groups are at greater risk of having severe heart attacks and contracting COVID-19.

In a first-of-its-kind effort, a group of North American heart hospitals examined nearly 600 patients and found a surprisingly high death rate among COVID-19 patients with the most severe heart attacks, caused by complete blockage of an artery supplying oxygen to the heart muscle.

“These patients are at very high risk,” said interventional cardiologist Dr. Santiago Garcia, primary investigator at the Minneapolis Heart Institute Foundation, where the data are being analyzed. “Mortality for heart attack patients … should be in single digits. We’re seeing mortality here that is 32%.”

The findings, announced at a medical conference this month, were the public’s first glimpse of results from the ongoing project known as NACMI, an international consortium compiling data from COVID-19 patients who have a so-called “STEMI” heart attack involving a completely blocked blood vessel.

The study examined 594 STEMI patients treated at 64 hospitals during the pandemic in Canada and the U.S. through Oct. 4 and found those with confirmed cases of COVID died in the hospital at almost triple the rate as those who tested negative for the viral illness.

About 20% of all heart attacks are thought to be STEMI.

The study also documented an increased risk of in-hospital strokes among COVID-positive heart-attack patients.

The NACMI findings aren’t published in a journal yet, but the initial data were presented Oct. 14 at the annual Transcatheter Cardiovascular Therapeutics conference.

Scientists widely believe COVID makes heart attacks and strokes more likely, and more dangerous, by causing changes in the heart, lungs and blood. The NACMI research can’t prove COVID triggers heart attacks and strokes — only that mortality rose when both were present.

But doctors say the correlation is noteworthy.

“Those are stunning numbers,” said Dr. Mladen Vido­vich, an interventional cardiologist and associate journal editor in Chicago who was not involved in the research. He said the death rate in the COVID group was similar to what was seen among heart-attack patients 50 years ago.

The risks are especially significant for African American and Hispanic patients, who tested positive for COVID more often than white and Asian patients in the first release of NACMI data. Organizers will be adding patients in Mexico and South America and tracking long-term outcomes.

Cardiologists say the early results underscore the longstanding recommendation that people feeling heart-attack signs should go to the hospital — even with hospitalizations for COVID-19 on the rise.

In Minnesota, 500 people have been admitted to the hospital for COVID-19 in the past week, including 106 cases sent to intensive care, the Minnesota Department of Health reported.

On Sunday, the Health Department added 1,684 new cases to the state’s tally, which now stands at 133,802. The deaths of 2,335 Minnesotans have

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Total U.S. COVID-19 deaths could hit 500,000 by February, researchers say

NEW YORK (Reuters) – The U.S. death toll from COVID-19 could surpass 500,000 by February unless nearly all Americans wear face masks, researchers said on Friday, as 14 states set new records for one-day increases in infections.

The latest estimate by the widely cited University of Washington’s Institute for Health Metrics and Evaluation reflects fears that cold winter weather will drive Americans indoors, where the virus is more likely to spread.

Nationwide, 76,195 new cases were reported on Thursday, according to a Reuters analysis, just shy of the single-day record high of 77,299 reported on July 16. Only India has reported more cases in a single day: 97,894, on Sept. 17.

“We are heading into a very substantial fall/winter surge,” said IHME director Chris Murray, who co-led the research.

The number of possible deaths could drop by 130,000 if 95% of Americans would cover their faces, the IHME said, echoing a recommendation by Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

U.S. Health Secretary Alex Azar attributed the increase in cases nationwide to the behavior of individuals, saying household gatherings have become a “major vector of disease spread.”

Asked about an assertion by President Donald Trump during Thursday night’s presidential debate that the United States is “rounding the turn” on the pandemic, Azar told CNN that Trump was trying to provide hope to Americans waiting for a vaccine.

FILE PHOTO: Certified nursing assistant (CNA) Shameka Johnson, wearing NFL Green Bay Packers apparel, processes a nasal swab at a drive-thru testing site outside the Southside Health Center as the coronavirus disease (COVID-19) outbreak continues in Milwaukee, Wisconsin, U.S., October 21, 2020. REUTERS/Bing Guan

Pennsylvania, a swing state which is expected to play a crucial role in the Nov. 3 presidential election, reported its largest single-day increase in cases since the pandemic began.

“Daily increases are now comparable with what we saw in April 2020,” the Pennsylvania Department of Health said in a statement issued on Friday.

Also reporting record one-day increases were the states of Alaska, Arkansas, Illinois, North Carolina, North Dakota, Ohio, Oregon, Rhode Island, South Dakota, Tennessee, Utah, Wisconsin and Wyoming.

HOSPITALIZATIONS CLIMB

On Thursday, there were 916 reported fatalities in the United States, a day after the country recorded over 1,200 new deaths for the first time since August.

Also on Thursday, the number of COVID-19 patients in U.S. hospitals climbed to a two-month high. There are now more than 41,000 hospitalized patients with coronavirus across the country, up 34% from Oct. 1, according to a Reuters analysis.

North Dakota, with 887 new cases on both Thursday and Friday, remains the hardest-hit state, based on new cases per capita, followed by South Dakota, Montana and Wisconsin, according to a Reuters tally.

Eight states reported record numbers of COVID-19 patients in the hospital on Friday: Alaska, Kentucky, New Mexico, North Dakota, Ohio, Oklahoma, West Virginia and Wyoming.

In Tennessee, hospitals in Nashville said they have experienced a 40% increase in

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