October 6, 2020

The coronavirus can spread more than 6 feet through the air, CDC warns

Daily Briefing

    CDC in new guidance released Monday said the novel coronavirus can spread through the air—and acknowledged that spread can occur beyond six feet.

    How Covid-19 is changing the future of the health care industry

    US new coronavirus cases near 7.5M, deaths top 210K

    The new guidance comes as U.S. officials as of Tuesday morning reported a total of 7,486,900 cases of the novel coronavirus virus since the country's epidemic began—up from 7,444,677 cases reported as of Monday.

    According to Bloomberg, the latest CDC data on coronavirus cases in the United States suggests that most states are seeing a resurgence in their numbers of newly reported cases. According to that data, 34 states have seen increases in their seven-day averages of newly reported coronavirus cases when compared with seven-day averages from the previous month. States in the Midwest, as well as rural and smaller American cities, are seeing the largest spikes in their seven-day averages of newly reported coronavirus cases, Bloomberg reports.

    According to data from the New York Times, the rates of newly reported coronavirus cases are "staying high" in Guam and 24 states that have had a daily average of at least 15 newly reported cases per 100,000 people over the past week. Those states are Alabama, Alaska, Arkansas, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Minnesota, Mississippi, Missouri, Montana, Nebraska, North Carolina, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Wisconsin, and Wyoming.

    Meanwhile, the rate of newly reported cases over the past seven days is "going down" in Puerto Rico, which had previously seen elevated case rates.

    Sixteen states that have had comparatively low case rates are now seeing those rates "going up," according to the Times. Those states are Connecticut, Delaware, Maine, Massachusetts, Michigan, Nevada, New Hampshire, New Jersey, New Mexico, New York, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont, and Washington.

    In the 12 remaining U.S. states and territories, rates of newly reported coronavirus cases are "staying low," according to the Times' analysis.

    U.S. officials as of Tuesday morning also reported a total of 210,029 deaths linked to the coronavirus since the country's epidemic began—up from 209,603 deaths reported as of Monday morning.

    Public health experts are concerned that coronavirus transmission will further accelerate in the coming months, as temperatures drop across America and people spend more time indoors. Experts also worry that the country's traditional flu season will mix with high rates of coronavirus transmission and overwhelm the U.S. health care system.

    CDC says coronavirus may spread through the air—and farther than six feet

    As the novel coronavirus continues to spread throughout the United States, CDC on Monday updated its guidance detailing how the pathogen can be transmitted.

    In the latest guidance, CDC said the novel coronavirus can "sometimes be spread by airborne transmission" and by the large droplets and small aerosols people release when they "cough, sneeze, sing, talk, or breathe." The agency added, "Some infections can be spread by exposure to virus in small droplets and particles that can linger in the air for minutes to hours."

    CDC also acknowledged that the novel coronavirus may spread through the air farther than six feet.

    "These viruses may be able to infect people who are further than six feet away from the person who is infected or after that person has left the space," CDC wrote. According to CDC, evidence has shown that "[t]hese transmissions occurred within enclosed spaces that had inadequate ventilation." CDC added, "Sometimes the infected person was breathing heavily, for example while singing or exercising."

    However, the agency in a release stated that it "continues to believe, based on current science, that people are more likely to become infected the longer and closer they are to a person" who is infected with the novel coronavirus.

    CDC's updated guidance comes two weeks after the agency retracted an earlier statement that had referred to the novel coronavirus as "an airborne virus." According to the Times, that specific language, which is absent from the new guidance, may have required hospitals to treat patients infected with the virus in specialized rooms and providers to wear N95 masks everywhere in hospitals.

    White House rejects FDA proposal to strengthen EUA requirements for coronavirus vaccines

    Separately, the White House on Monday rejected FDA's proposal to issue stricter criteria for the agency to use to evaluate coronavirus vaccine candidates for emergency use authorizations (EUAs).

    Over the past few months, some experts and observers have raised concerns over whether FDA is facing political pressure to authorize a coronavirus vaccine before robust clinical trial data on the experimental vaccines' efficacy and safety is available—and particularly before the upcoming presidential election. In response to the public's dwindling trust in federal health care officials, FDA in recent weeks has sought to bolster Americans' confidence in the agency by promising to share as much data on potential coronavirus vaccines as possible and ensure that officials will adhere to science when reviewing the vaccine candidates.

    For example, FDA Commissioner Stephen Hahn last month announced that the agency planned to issue stricter criteria that it would use to evaluate coronavirus vaccine candidates for EUAs. Some observers noted that the new EUA guidance could have made it less likely that FDA would authorize a coronavirus vaccine before Election Day, which is a target Trump has touted for authorizing a vaccine.

    Last month, Trump during a press conference said the White House "may or may not approve" FDA's tougher EUA guidelines, and he questioned whether the guidance was needed or "was a political move."

    "I have tremendous trust in these massive companies that are so brilliantly organized in terms of what they've been doing with the tests. … I don't see any reason why [a vaccine] should be delayed further because if they delay it a week or two weeks or three weeks, you know, that's a lot of lives you're talking about," Trump said at the time.

    According to Politico, the White House this week rejected the proposed guidelines, and officials said the decision was primarily based on objections to the proposal from the pharmaceutical industry.

    However, people familiar with the proposal's approval process said Mark Meadows, the White House's chief of staff, had opposed the proposal's recommendation that FDA grant an EUA for a coronavirus vaccine candidate only after drugmakers had collected data on clinical trial participants for a median of two months after they received their final dose of the experimental vaccine, the Times reports. According to the Times, Meadows questioned whether that follow-up data was necessary, and he suggested that Hahn was being overly influenced by FDA's career scientists.

    The White House on Monday did not respond to questions about the guidance, Politico reports.

    But an FDA spokesperson told Politico that the proposed guidance remains under review, and the status of the proposed guidance's publication will not affect how the agency evaluates coronavirus vaccine candidates for EUAs. According to the spokesperson, FDA has "already communicated with individual manufacturers about its expectations, the data the agency intends to consider, and what we expect to see," Politico reports.

    HHS Secretary Alex Azar also has said that the proposed guidance is in line with standards FDA already has made clear to drugmakers. "What [Hahn] is proposing to put out is public [EUA] guidance on a vaccine that would be consistent with letters already sent to the manufacturers," Azar said during a House committee hearing on Friday. "[FDA] has already told the manufacturers what they're going to look for," he added (Levin/Brown, Bloomberg, 10/5; Mandavilli, New York Times, 10/5; McCabe/McKay, Wall Street Journal, 10/5; Rodriguez, USA Today, 10/5; LaFraniere/Weiland, New York Times, 10/5; Owens, "Vitals," Axios, 10/6; Cancryn, Politico, 10/5; New York Times, 10/6).

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