Louisiana superintendents ask for looser quarantine rules

BATON ROUGE, La. (AP) — Leaders of several Louisiana public school systems called on state officials Monday to relax coronavirus quarantine rules that have sent thousands of students home from school because they have been in close proximity to someone who tested positive for COVID-19.

School superintendents from Ascension, West Baton Rouge, Rapides and Livingston parishes said too many students are missing in-person classroom instruction because they have been sent home for 14 days to quarantine.

“We have a lot of healthy kids who are home when they don’t need to be,” West Baton Rouge Parish Superintendent Wesley Watts told lawmakers on the House health care committee. “We’re not asking to do away with quarantine. We’re just asking for some modifications.”

The request comes as Louisiana is seeing its third spike in coronavirus cases, with hospitals cautioning they are concerned the latest surge will overwhelm their facilities and threaten their ability to provide care.


“While we can create additional beds and repurpose hospital floors, it becomes extremely difficult to find and train the caregivers needed to properly treat patients when there is an unmitigated spread of the virus in our communities,” Paul Salles, president of the Louisiana Hospital Association, wrote in a letter circulated Monday by Gov. John Bel Edwards’ office.

More than 11,000 new infections of the COVID-19 disease caused by the virus have been confirmed in the state over the last week, and 6,039 people in Louisiana are confirmed to have died from the disease since March, according to the state health department.

Louisiana’s schools are required to follow virus safety guidelines adopted by the Board of Elementary and Secondary Education, based on recommendations from the health department. It wasn’t immediately clear Monday if the state education superintendent or state health officials will ask the board to make changes.

Those guidelines require anyone considered to be in “close contact” to someone who tested positive for COVID-19 or has symptoms of the disease to stay home for 14 days. Close contact is defined as anyone who has been within six feet (2 meters) of an infected person for at least 15 minutes.

Superintendents said those rules are too strict, sending entire classrooms of children home where online accessibility to virtual learning can be spotty.

Rapides Parish Superintendent Jeff Powell said his schools have quarantined nearly 4,100 students this school year, with 18 students on average sent home for each positive coronavirus test. Livingston Parish Superintendent Joe Murphy said of the 2,600 students in his system sent home to quarantine because of exposure risk, 162 have had to isolate more than once.

“We do believe the best place for them to be is in our school buildings,” said Ascension Parish Superintendent David Alexander.

The school leaders stopped short of offering a specific set of changes they wanted to see enacted, though there was talk of possibly shrinking the required quarantine days.

The superintendents said they’re seeing only small percentages of students forced to quarantine actually getting sick or testing positive

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Why Trump’s health care price transparency rules will reignite America’s economy: Art Laffer

In a historic win for all Americans on Thursday, President Trump issued a final rule requiring health insurers to post the prices they have negotiated with hospitals, medical facilities, and doctors. Under this rule, health care consumers, including employers sponsoring workplace coverage, can finally know prices before they receive care. This action will increase competition, lower prices, and save American families money.

Combined with the Trump administration’s already finalized hospital price transparency rule, which requires hospitals to publish the secret rates they negotiate with insurance companies as well as the cash payments they will accept, Thursday’s announcement will usher in a transparent health care sector with less need for the middlemen that have capitalized on patients’ misfortune.

Once these rules delivering complete health care price transparency take effect (January 1, 2021 for the hospital rule and one year later for the insurance rule), we can expect our economy to come roaring back, and our beleaguered health care system to rebound as well.

Knowing the real prices of health care and coverage beforehand will be a huge boon for all Americans–patients, workers, employers and taxpayers.

HEALTH INSURANCE FOR MILLENNIALS, GEN Z, MOST LIKELY TO BE AFFECTED BY PANDEMIC

Together the rules will unleash a real market in health care, usher in competition and choice, dramatically lowering the costs of care and coverage. Fewer dollars going to health care and more going to wages, jobs and small businesses in our local communities will help boost our nation’s economic recovery.

When complete health care price transparency is in place, patients, consumers, and employers will be able to better shop for health care, and high-tech innovators will eagerly develop tools to help consumers access and compare prices. Better informed buyers of health care will take advantage of the huge price variation that exists in the current, opaque market.

For instance, a recent study from the respected RAND Corporation found employer-sponsored plans are paying hospitals two-and-a-half times more than Medicare pays for the same procedure. Since almost all hospitals accept Medicare, those government rates are by definition “acceptable,” which means hospitals are price-gouging workers and employers, and growing rich at the expense of the middle-class.

US MILITARY WON’T ADMINISTER CORONAVIRUS VACCINES, HEALTH OFFICIALS SAY

Insurance companies are no better, reaping huge profits as health care costs have soared. The average premium for an employer-provided family health insurance plan in 2020 jumped to $21,300–a 55 percent increase over a decade earlier. During that same time, deductibles more than tripled.

Last year I co-authored a study with health economist Larry Van Horn, it found that cash prices are, on average, 39 percent lower than the insurers’ negotiated rates for the same care. Throughout the country, businesses have saved 30 to 50 percent on health care costs by directly contracting with price transparent doctors and medical facilities, leaving insurers out of the equation.

It’s time to disrupt

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When are Medicare secondary payers? Insurers, claims, rules, and more

Medicare beneficiaries do not have to rely exclusively on Medicare for their healthcare coverage. People can use other insurance plans to allow them access to more services and lower their healthcare spending.

If someone has two different forms of coverage, the primary payer covers most costs, and the secondary payer then steps in to cover some or all remaining expenses.

With Medicare, secondary payers contribute to copayments and coinsurance. Usually, Medicare is the primary payer, although sometimes it can act as the secondary payer.

This article looks at Medicare as a secondary payer and how it works with other insurers. It also discusses the benefits of having two insurers and who pays first. It then looks at how the claims process works with both primary and secondary payers.

We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:

  • Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
  • Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
  • Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.

A person can choose to have more than one insurance plan to cover their healthcare costs and Medicare works with other insurance providers to give people comprehensive coverage.

Each insurance pays their share of the healthcare service or products that someone receives.

Medicare secondary payer (MSP) means that another insurer pays for healthcare services first, making them the primary payer.

The secondary payer covers some or all of the remaining costs that the primary payer leaves unpaid.

When someone has two insurers, they benefit from broader healthcare coverage. Each insurer could cover services that the other does not, such as dental care, eye examinations, or alternative health therapies.

As an example, a primary insurer may offer prescription drug coverage, meaning that a person with original Medicare would not need a separate Medicare Part D plan or a Medicare Advantage plan that includes prescription drug coverage. This could lower a person’s overall healthcare costs.

If someone needs to stay in a hospital or a nursing facility for a long time, they may find it beneficial to have two insurers. For example, an individual’s primary insurer would pay up to their limits, and Medicare Part A benefits would kick in much later, extending the coverage period.

Having two insurance plans could mean a person has two monthly premiums. For most Medicare beneficiaries, this means they have the standard Part B premium, plus the premium for the primary insurer.

Careful consideration of the overall costs could mean a person’s expenses increase or decrease with a secondary insurance plan, but since a secondary payer could cover most out-of-pocket expenses, a person may find they save money despite paying two premiums.

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PM under pressure to toughen rules after highest death toll since May



Shoppers in Nottingham ahead of the region being moved into Tier 3 coronavirus restrictions on Thursday. The very high level of restrictions includes a ban on social mixing both indoors and in private gardens, pubs and bars closing unless they can operate as a restaurant, and residents are advised against overnight stays in other parts of the UK and they should avoid travel where possible in and out of the area, unless it is for work, education or caring responsibilities. (Photo by Joe Giddens/PA Images via Getty Images)


© PA Wire/PA Images
Shoppers in Nottingham ahead of the region being moved into Tier 3 coronavirus restrictions on Thursday. The very high level of restrictions includes a ban on social mixing both indoors and in private gardens, pubs and bars closing unless they can operate as a restaurant, and residents are advised against overnight stays in other parts of the UK and they should avoid travel where possible in and out of the area, unless it is for work, education or caring responsibilities. (Photo by Joe Giddens/PA Images via Getty Images)

The prime minister is under mounting pressure to bring in tougher coronavirus rules after UK deaths hit their highest level for five months.

There were 367 deaths linked to the virus recorded on Tuesday, and nearly 23,000 more cases.

Downing Street has not rebuffed an internal projection from its SAGE experts that this winter could see more fatalities than the spring, with a spokesman calling latest figures “concerning”.



a man wearing a suit and tie: Boris Johnson is said to be under 'intense lobbying' to take action


© Getty
Boris Johnson is said to be under ‘intense lobbying’ to take action

The prime minister is coming under “intense” lobbying from experts such as chief scientific adviser Sir Patrick Vallance to ramp up restrictions, according to The Daily Telegraph.

It says government advisers fear that daily deaths could remain in the hundreds for at least three months.

____________________________________________________

More on coronavirus:

Download the Microsoft News app for full coverage of the crisis

Latest social rules for all three tiers explained (Mirror)

‘PM isn’t taking Covid seriously anymore’ (The Independent)

____________________________________________________

They have also warned that the whole of England will need to be under the toughest Tier 3 restrictions by mid-December, The Sun reports.

The current official count of COVID-related deaths in the UK is nearly 59,000.

Gallery: Second wave of COVID-19 hits Europe (Photo Services) 

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Federal judge rules against gym owner who sued CA governor

The front entrance at Fitness System’s health club in Sacramento, with a copy of the Bill of Rights taped to the door. A federal judge dismissed a lawsuit Tuesday, Oct. 27, 2020, that the owner had filed against California Gov. Gavin Newsom and other officials because of COVID-19 shutdowns. 

The front entrance at Fitness System’s health club in Sacramento, with a copy of the Bill of Rights taped to the door. A federal judge dismissed a lawsuit Tuesday, Oct. 27, 2020, that the owner had filed against California Gov. Gavin Newsom and other officials because of COVID-19 shutdowns. 

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A federal judge on Tuesday dismissed a lawsuit against Gov. Gavin Newsom and San Joaquin County and Lodi officials that had been filed by the owner of three Sacramento-area gyms after officials ordered the shutdown of fitness centers last spring because of COVID-19.

After a Zoom hearing in Sacramento federal court, U.S. District Judge John A. Mendez agreed to requests by the defendants that the lawsuit be dismissed and found that the coronavirus pandemic was so dangerous that officials were within their authority when they first ordered the closures.

The orders were “a constitutional response to an unprecedented pandemic,” Mendez said.

Attorney John Killeen argued for the state that since Newsom’s original stay-at-home orders the state has loosened restrictions on fitness centers, including allowing some outdoor exercising and indoor workouts in San Joaquin County at 10% of capacity.

“A number of restrictions have been lifted,” Mendez said.

“I just don’t see any basis for allowing this lawsuit to go forward in the district court,” he added.

The suit was brought by Sean Covell, owner of Fitness System gyms in Land Park, West Sacramento and Lodi, and argued that the shutdown orders violated the Constitution and were costing his operations huge amounts of revenues and lost memberships.

The lawsuit was one of numerous complaints filed by fitness centers, churches and businesses against orders Newsom and health officials issued to combat the spread of COVID-19.

The lawsuits have largely been unsuccessful, although some are pending and yet another involving gyms in Dixon and Sacramento was filed in federal court in Sacramento on Monday.

Sam Stanton has worked for The Bee since 1991 and has covered a variety of issues, including politics, criminal justice and breaking news.

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H.K. Eases Some Rules; India Case Growth Slows: Virus Update

(Bloomberg) — Hong Kong will ease some social distancing rules and announced plans for mandatory testing of people with symptoms and specific groups as India’s daily infections fell below 40,000 for the first time in more than three months.

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Eli Lilly & Co. said a U.S.-run clinical trial of its experimental antibody therapy will end while AstraZeneca Plc’s vaccine candidate produced a robust immune response in elderly people. New research from the U.K. suggests antibody responses may diminish over time.

The latest surge in U.S. coronavirus cases sent the S&P 500 Index to its biggest drop in a month. An infection spike that started with younger Americans is now moving to older communities.

Key Developments:

Global Tracker: Cases top 43.4 million; deaths exceed 1.15 millionU.S. ‘surge’ virus testing targets asymptomatic peopleCovid Fear Is Back and Driving Markets Again: John AuthersP&G’s new Lysol competitor wins EPA approval to fight virusAmericans see record flu shot demand in first season with CovidU.S. recovery’s surprise strength linked to aid, quick reopeningVaccine Tracker: Vaccine trials restart, providing hope

Subscribe to a daily update on the virus from Bloomberg’s Prognosis team here. Click CVID on the terminal for global data on coronavirus cases and deaths.



chart, histogram: Seven-day average of U.S. death toll is at 800 again


© Bloomberg
Seven-day average of U.S. death toll is at 800 again

Hong Kong to Relax Some Social Distancing, Bars to Stay Open Later (2:52 p.m. HK)

Hong Kong will allow more people to sit at the same table in bars and restaurants as well as letting them stay open later.

From Friday, restaurants will be allowed to stay open until 2 a.m. with six people permitted at a table, up from four, Secretary for Food and Health Sophia Chan told a briefing on Tuesday. Bars also will be open later with the limit on patrons doubling to four per table.

Hong Kong also eased its rule mandating face masks for people exercising at indoor venues but a four-person limit on public gatherings will stay for another week.

Earlier, Chief Executive Carrie Lam said the city would re-open public beaches as the Asian financial starts legislative work on mandatory Covid-19 testing for specific groups including people with symptoms.

Bulgaria Posts Record High New Cases, Deaths (2:08 p.m. HK)

Bulgaria reported record numbers of new cases, deaths and patients in intensive care, putting fresh pressure on the country’s health-care system.

The Balkan country reported 2,243 daily coronavirus cases, the first time new infections topped 2,000, as well as 42 deaths. The numbers come as Prime Minister Boyko Borissov is recovering at home after testing positive for Covid-19.

Dubai in Talks on London Air-Travel Agreement to Boost Demand (12:15 p.m. HK)

A plan to open up air travel between Dubai and London is ready and could be implemented once approved by the respective governments, according to the head of the emirate’s airport operator.

Testing and quarantine requirements have been agreed by hubs and airlines, Paul Griffiths, chief executive officer of Dubai Airports, said in an interview. Whether they move forward lies

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Government Payment Rules Are the Culprit on Infusion

Scientists work with a bioreactor at a Regeneron Pharmaceuticals facility in New York, Oct. 2.



Photo:

/Associated Press

Regarding Drs. Scott Gottlieb and Mark McClellan’s “Where Do I Go to Get My Covid Antibody Cocktail?”(op-ed, Oct. 19): They are right regarding the need for the government to prime the pump to stimulate the development of private infusion clinics for Covid patients. However, they overstate the associated problems.

Infusion clinics are quite simple, requiring only a room, one registered nurse, four patients and IV poles. Infusion pumps are generally not necessary. The big issue is the Centers for Medicare & Medicaid Services’ payment scheme for professional services, which is in the range of $60-$70 per infusion, regardless of how long it takes (many exceed four hours for allergy and neurology services). Hence, the profit in such centers hinges on the split between the cost of the drug and the amount a payor gets reimbursed for it. In such circumstances, volume is the key to financial stability.

If CMS will change its reimbursement methodology to reimburse professional services by the hour infused, and reimburse for drugs with modest profit for the provider, there will be no shortage of clinics.

Robert Chiffelle

Phoenix

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New outbreak delays easing of rules in Melbourne

MELBOURNE, Australia — A COVID-19 outbreak in the north of Melbourne has led health authorities in Australia’s Victoria state to hold off on any further easing of restrictions in the beleaguered city.

Victoria Premier Daniel Andrews withheld any announcement on an easing on Sunday as the state awaits results on 3,000 people who were tested in the city’s north in the past 24 hours.

He described it as a “cautious pause” – not a setback – to rule out there wasn’t widespread community transmission linked to the cluster.

Among the current restrictions are mandatory wearing of masks and no traveling beyond 25 kilometers (15 miles) from home. At the start of the second wave of cases two months ago, Andrews instituted an overnight curfew and shut down most businesses.

“I know it is frustrating,” Andrews said. “I know people are keen to have a long and detailed list of changes to the rules. It is not appropriate for us to do that now.”″

Victoria reported seven new coronavirus cases on Sunday, with six linked to the latest outbreak, which involves 39 people across 11 households.

No additional deaths kept the state toll at 817 and the national toll at 905.

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HERE’S WHAT YOU NEED TO KNOW ABOUT THE VIRUS OUTBREAK:

— Surging coronavirus colors White House race in closing days

— Europe, US watch case totals grow, debate new restrictions

— Colombia reaches 1 million confirmed coronavirus cases

— Iran’s supreme leader has urged authorities to prioritize public health above any economic or security concerns, amid the Mideast’s worst outbreak of the coronavirus. Iran’s death toll from the global pandemic topped 32,000 this week.

— Pope Francis met with the Spanish prime minister Saturday at the Vatican, which has had a rash of COVID-19 infections confirmed in recent days, but neither man used a face a mask during the public part of their meeting.

— Poland’s President Andrzej Duda has tested positive for the coronavirus; apologizes to those in quarantine because of contact, including Poland’s recent French Open winner.

— Police force in England says it will try to stop people from leaving Wales, which has started a 17-day lockdown to slow a surging rate of coronavirus infections.

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Follow all of AP’s coronavirus pandemic coverage at http://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak

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HERE’S WHAT ELSE IS HAPPENING:

COLOMBO, Sri Lanka — Sri Lankan authorities have terminated a number of passenger trains and widened the curfew as COVID-19 cases related to a new cluster at a garment factory continue to surge.

The Railway Department canceled at least 16 trains — mostly ran through busy office hours — after the number of commuters declined due to the curfew imposed in many parts of the country.

More than a dozen villages are isolated in densely populated Western province, which includes capital Colombo.

Authorities last week closed the island’s main fish market on Colombo’s outskirts after 49 traders tested positive for the coronavirus. By Sunday, the number of cases from the fish

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Hospitals are full but some parts of Idaho refuse mask rules

BOISE, Idaho (AP) — Moments after hearing an Idaho hospital was overwhelmed by COVID-19 patients and looking at sending people as far away as Seattle for care, members of a regional health department board voted Thursday to repeal a local mask mandate.

“Most of our medical surgical beds at Kootenai Health are full,” Panhandle Health District epidemiologist Jeff Lee told board members in the state’s third most populated county.

The hospital in Coeur d’Alene reached 99% capacity a day earlier, even after doubling up patients in rooms and buying more hospital beds. Idaho is one of several states where a surge of COVID-19 infections is overwhelming hospitals, likely in part because cooler weather is sending people indoors, U.S. health officials said.

“We’re facing staff shortages, and we have a lot of physician fatigue. This has been going on for seven months — we’re tired,” Lee said.


He introduced several doctors who testified about the struggle COVID-19 patients face, the burden on hospitals and how masks reduce the spread of the virus.

But the board voted 4-3 to end the mask mandate. Board members overseeing the operations of Idaho’s public health districts are appointed by county commissioners and not required to have any medical experience.

Board member Walt Kirby said he was giving up on the idea of controlling the spread of coronavirus.

“I personally do not care whether anybody wears a mask or not. If they want to be dumb enough to walk around and expose themselves and others, that’s fine with me,” Kirby said. “Nobody’s wearing the damned mask anyway. … I’m sitting back and watching them catch it and die. Hopefully I’ll live through it.”

Another member, Allen Banks, denied COVID-19 exists.

“Something’s making these people sick, and I’m pretty sure that it’s not coronavirus, so the question that you should be asking is, ‘What’s making them sick?’” he told the medical professionals who testified.

Similar scenes — with doctors and nurses asking officials for help, only to be met with reluctance or even open skepticism — have played out across the conservative state. Idaho is sixth in the nation for new coronavirus cases per capita, with the average number of confirmed cases increasing by more than 55% every day over the past two weeks.

Still, Republican Gov. Brad Little has declined to issue a statewide mask mandate or limit crowd sizes beyond requiring social distancing at large events and in businesses, which is seldom enforced. Instead, Little has left it up to local health departments and school districts to make the tough decisions that sometimes come with blowback from the public.

In the southern city of Twin Falls, hospital officials told health board members this week that they too were in danger of being overwhelmed, with one out of every four hospitalized patients sick with COVID-19. The region’s hospitals, operated by St. Luke’s Health System, have been forced to postpone non-emergency surgeries and ship patients elsewhere.

“I want to be very clear: Punting those decisions is saying

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COVID shielding rules for vulnerable criticised

Britain's Prime Minister Boris Johnson speaks during a virtual press conference inside 10 Downing Street in central London on October 20, 2020. - British Prime Minister Boris Johnson said on Tuesday he will impose tougher coronavirus restrictions on the English city of Manchester, defying local leaders who oppose the move without greater financial help. Johnson said the city region of around 2.8 million residents would enter the highest risk category this weekend but, for the first time under a new system of localised curbs, would do so without the support its mayor and other leaders. (Photo by Leon Neal / POOL / AFP) (Photo by LEON NEAL/POOL/AFP via Getty Images)
Boris Johnson speaks during a virtual press conference on coronavirus inside 10 Downing Street. (Getty)

Scientists have hit out at the government’s refusal to enforce shielding rules for the most vulnerable as COVID cases continue to rise.

Advice published last week stated that the more than two million people who shielded during the peak of the pandemic do not yet need to shield again – despite what tier their area is in.

But the move triggered a backlash among experts and some charities, which said vulnerable people may feel forced to go to work.

Dr Stephen Griffin, associate professor in the school of medicine, University of Leeds, described recent numbers, which showed the highest daily figure for cases, as a “worrying trend”.

He said: “Critically, I am aghast that shielding remains paused. Whilst it saddens me to see that this is once again our only recourse to protect those most vulnerable to COVID, they must be enabled both socially and financially to protect themselves once more.

Screen grab of Deputy Chief Medical officer Jonathan Van-Tam during a media briefing in Downing Street, London, on coronavirus (COVID-19). (Photo by PA Video/PA Images via Getty Images)
Deputy chief medical officer Jonathan Van-Tam this week expressed concern for the rate of change in infections among the over-60s. (Getty)

“Whatever transpires as a result of policy, it must be accompanied by a return to the commitments made earlier this year. Most importantly, testing must be overhauled.”

His comments come after deputy chief medical officer Jonathan Van-Tam expressed concern for the rate of change in infections among the over-60s across the nation.

He said at a press conference on Tuesday: “I really want to emphasise that it is the over-60s that really worries us most because these are the people who become severely ill with COVID-19, they are more likely to be admitted to hospital, if they are admitted to hospital they stay in hospital for longer and sadly they are more difficult to save.”

Watch: Hundreds of thousands ‘could be told to shield’

Griffin hit out at the government’s testing programme, and said there was “no evidence” that the tier system for local lockdowns worked in bringing down numbers.

Arguing for tougher restrictions, Griffin said: “It is difficult to understand why urgent action is not being taken on a national level, as advised by Sage, independent Sage and many other observers.

“This is a UK wide problem. If we wait for other areas to reach prevalence as we are seeing in the north of England then the situation will be grim indeed.”

He added: “The pain of the previous lockdown has been squandered, the summer has been wasted. The commitment to suppressing cases and organising effective testing was not met.”

Oxford University scientists this week shared a model that identifies the most at-risk people from the disease.

Mark Woolhouse, Professor of Infectious Disease Epidemiology at Edinburgh University, said the research showed that shielding just 5% of those people could reduce deaths by as much as 75%.

The government have said that rather than force vulnerable people to stay at home – risking feelings of isolation and fearful of leaving the

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