COVID-19 still rising in much of US; Brazil now 2nd hardest-hit nation - CIDRAP

As Americans ventured out for the Memorial Day weekend, the latest projections from modeling experts at Imperial College London suggested that COVID-19 activity isn't under control in 24 US states

And in the Muslim world, lockdowns and mosque closures are affecting Eid celebrations.

Meanwhile, a surge of ongoing activity in Brazil vaulted the country into the second-most affected nation, ahead of Russia and behind the United States.

Outbreaks still developing in South, Midwest

At a White House briefing yesterday, Deborah Birx, MD, who coordinates its coronavirus task force, said Americans can go outside over Memorial Day, as long as they take precautions and observe physical distancing recommendations, Politico reported.

For the first time since Mar 8, President Trump played golf today, according to several media outlets that described his arrival at his Sterling, Virginia, golf club.

During yesterday's briefing, Birx warned that the United States still isn't out of the woods with the pandemic. She added that Washington, DC, and surrounding suburbs have the nation's highest rate of people testing positive for the virus, despite restrictions and stay-at-home orders, and that major urban areas including Chicago and Los Angeles are in similar situations, the Washington Post reported.

In a related development, the infectious disease modeling group at Imperial College London released its latest estimates yesterday for the United States and individual states. Its analysis suggests that the COVID-19 epidemic isn't under control across much of the United States, with the reproduction number still above the threshold of 1.0 in 24 states. The highest reproduction numbers cluster in the South and Midwest, where outbreaks are still developing.

The group urged states to take caution in relaxing current restrictions and warned that increased mobility following eased restrictions will lead to new spikes in COVID-19 activity, if all factors are kept constant, with a doubling of deaths or worse. Rapid testing, contact tracing, and behavioral precautions are key factors that could offset the resulting rise in transmission.

They also estimated that 4.1% (range 3.7% to 4.5%) of the US population has been infected, with wide variation among states, with a high of 16.6 % in New York. "Overall, we show that while all US states have substantially reduced their reproduction numbers, we find no evidence that any state is approaching herd immunity or that its epidemic is close to over," they wrote.

In other US developments:

• North Dakota's Republican Governor Doug Burgum yesterday at a press briefing made an emotional plea for state residents to avoid politics when deciding whether to wear face masks, NBC News "If someone is wearing a mask, they’re not doing it to represent what political party they're in or what candidates they support," said, choking back tears as he said people who wear masks may have vulnerable people in their homes, such as a young child going through cancer treatment.
• New York Governor Andrew Cuomo said yesterday that his state may soon open two regions that border New York City—Long Island and Mid-Hudson—if deaths decline and contact tracing programs are operating, CBS News reported.
• The Trump administration is mulling a plan to shift its global health response, including those focusing on pandemics, to the State Department, Politico reported today, based on documents it obtained and interviews with people familiar with the issue. The proposal was discussed May 21 at a National Security Council meeting and has touched off a turf battle between the State Department and the US Agency for International Development. If the program is established, sources said Birx would likely lead the unit, which would also be set up to mirror some of the work the World Health Organization (WHO) does. The discussions come amid Trump administration criticism of the WHO's response to the pandemic and accusations that the agency is too closely aligned with China.
• The number of US COVID-19 cases rose to 1,618,948, and 96,983deaths, according to the Johns Hopkins online dashboard.

South America outbreaks intensify

Brazil today reported nearly 10,000 new cases, passing Russia to become the second hardest-hit nation and raising its total to 340,887. It also reported 630 more deaths, lifting the fatality count to 21,678.

Unlike other global hot spots, Brazil is seeing deaths in younger people—15% are in people younger than 50, the Washington Post reported today. Similar trends are emerging in other nations, such as India and Mexico, and experts say poverty, densely populated areas, and inadequate access to healthcare are likely contributing factors.

In Brazil's Amazon region, the COVID-19 virus seems to be moving upriver to indigenous villages in Brazil's Amazon region, Reuters reported today. It described the experience of the village Tres Unidos, which locked out all visitors but was hit by the virus anyway. Health officials suspect it came from the Rio Negro, which is 5 hours by boat from the city of Manaus, one of Brazil's major hot spots. Tres Unidos is home to 35 families who are part of the Kambeba tribe.

Activity in Brazil has made South America the newest global epicenter, but other countries in the region are seeing surges of activity, as well. Peru today announced that it is extending its state of emergency lockdown until the end of June, Reuters reported. Peru has the second most cases in South America and has been on lockdown since the middle of March, marking one of the world's longest.

Pandemic dampens Eid celebrations

Elsewhere, as Muslim nations prepare to break the Ramadan fast with the Eid al-Fitr celebrations that begin this evening, Saudi Arabia began a 5-day lockdown. The country had eased some of its restrictions in late April, but COVID-19 cases increased during Ramadan, Foreign Brief reported.

Mosques in Saudi Arabia and the United Arab Emirates are closed for Eid prayers, according to Reuters.

In other global developments:

• China today reported no new cases for the first time during the pandemic, according to an update today from the National Health Commission. However, it did report 28 more asymptomatic cases, 2 of them imported.
• France yesterday said it will issue a decree allowing religious services to resume, which will require worshipers to wear face masks and observe other distancing measures, Reuters reported.
• The United Kingdom yesterday announced a plan to quarantine all international visitors for 14 days, which will start on Jun 8. France today said it was disappointed in the UK announcement and said it may place a 14-day quarantine on UK arrivals.
• Cuba said it has reduced COVID-19 deaths by using two drugs that seem to lessen the effects of the "cytokine storm" hyperinflammatory component of the illness, Reuters One is itoluzumab, a monoclonal antibody produced in Cuba and other countries, and the other is a Cuban-developed peptide that is under investigation for treating rheumatoid arthritis.
• The global total today climbed to 5,284,830 cases and 340,805 deaths, according to the Johns Hopkins online dashboard.

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COVID-19 still rising in much of US; Brazil now 2nd hardest-hit nation - CIDRAP
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