While You Were Sleeping: Coronavirus updates for November 19


INDIANAPOLIS — There were several developments in the coronavirus pandemic that you may have missed overnight.

Here’s a look:

250,000 deaths. The United States marched past yet another grim marker Wednesday as deaths from COVID-19 climbed above 250,000.

The U.S. had 250,140 recorded deaths as of 7 p.m. EST Wednesday, with a staggering 11,492,593 cases – the most in the world – according to Johns Hopkins University data.

Brazil follows the U.S. with the second-most deaths at 166,699, while India has the second-most cases at 8,912,907.

The number of people in the hospital with COVID-19 in the U.S. has doubled in the past month and set new records every day this week. As of Tuesday, nearly 77,000 were hospitalized with the virus.

Newly confirmed infections per day in the U.S. have exploded more than 80% over the past two weeks to the highest levels on record, with the daily count running at close to 160,000 on average. Cases are on the rise in all 50 states.

Deaths are averaging more than 1,155 per day, the highest in months.

Indiana hospitalizations. COVID-19 hospitalizations in Indiana have reached an all-time high.

Experts are worried the high case count in recent days will make things worse inside hospitals within the coming weeks.

“I think we’re seeing similar increases many places in the Midwest. So, I think this trend is consistent with what we’re seeing in many parts of the country. And it’s not surprising, typically hospitalizations tend to be slightly lagging behind test counts,” said Regenstrief Institute Vice President of Data and Analytics Dr. Shaun Grannis.

Grannis says things took a turn for the worse when the weather got cold and people started congregating inside. But there are several viruses that circulate in the fall, making things worse with no approved COVID vaccine.

“There are a number of viruses that are exchanged because we are in closer proximity that is one driver of this exchange,” said Grannis

The highest number of COVID-19 hospitalizations in the spring was 1,799 on April 13. Seven months later, there are 3,000 patients hospitalized. Experts say what’s different is the virus is no longer isolated. 

“All of these [cases] should be wake up calls, and warning signs for people…to continue to follow safety precautions,” said Grannis.

Indiana has 25% of intensive care unit (ICU) beds available and 75% of its ventilators are going unused.

But health experts are still worried about what’s next and their ability to continue caring for patients after 8,451 positive cases were reported Saturday. 

Tests for colleges. The Indiana State Department of Health has offered to provide BinaxNOW cards to universities that are not currently screening students before they leave campus.

More than a dozen colleges and universities have expressed interest in receiving the COVID-19 rapid tests.

ISDH expects that number to grow and the state will deploy those cards this week.

“Ultimately, this is going to really give the students peace of mind,” said Jennifer Zentz, director of strategic communications for Independent Colleges of Indiana (ICI).

ICI is a nonprofit that serves all 30 private institutions in the state. Zentz explained institutions were invited to participate in a meeting on Tuesday where ISDH outlined the request and answered questions. Requests for tests needed to be submitted by noon on Wednesday.

ISDH is distributing BinaxNOW test kits to campuses for free, said Zentz. The kits will include everything that is needed: test cards, swabs, reagents, gowns, gloves, and training and information pieces. It is a college’s responsibility to report the results of the tests that are administered back to ISDH.

“The more students know, the more students can do to stop that spread,” said Zentz.

Zentz said many of their campuses took up the state’s offer on rapid tests. ICI helped distribute kits to campuses on Wednesday evening.

“Several of our campuses are even starting to send students home by the end of the week,” she said.

Zentz believes it is safe to say tens of thousands of tests will be distributed. Some campuses had already planned for exit testing as part of their end of semester plans.

State Health Commissioner Dr. Kristina Box encouraged college students to behave as if they have COVID or have been exposed. She suggested they plan to spend 14 days in quarantine, even in their own home.

She strongly encouraged students to not see elderly relatives until they have completed that 14-day period without any symptoms.

“We know these rapid tests are just a snapshot in time so we want to remind the students that if they were recently exposed that they could test negative but just be too early to be showing up positive,” said Box.

Exponential growth.” “In the next several weeks we will continue to see cases climb, individuals hospitalized and unfortunately more deaths,” said State Health Commissioner Dr. Kristina Box at Wednesday’s coronavirus briefing. 

When Box was asked if Hoosiers should expect hospitalizations and community spread to continue, she replied, “I can tell you that we’re on an exponential growth curve right now, and we do not expect this to turn around quickly.”  

Box and ISDH Chief Medical Officer Dr. Lindsay Weaver led Wednesday’s press conference and were joined by other Indiana health professionals.

Dr. Eric Fish of Schneck Medical Center in Seymour, Vice President of Nursing and Clinical Services at Memorial Hospital in South Bend Sarah Paturalski, and Chief Medical Officer IU Health Methodist and University Hospitals in Indianapolis Dr. Mark Luetkemeyer shared stories of how their organizations are responding to the latest surge of hospitalizations.

They explained they are currently executing surge plans and are rationing care. Health officials are using protocols put in place earlier this year, but some facilities are already seeing increased wait times and cancelling some non-critical treatments because of tight resources.

Governor Holcomb joined the briefing by phone as he remains in quarantine. Holcomb and the first lady are isolating after several members of the governor’s security detail tested positive for COVID-19. He’s expected to get tested this week.

Holcomb said the recently-signed executive order is still in effect. Last week, the governor announced new restrictions for Indiana counties based on the state’s color-coded map.

Box explained, based on the number of cases per 100,000, the entire state of Indiana is in red. She again described how daily hospital admissions are at the highest level and officials are still getting reports of exhausted nurses and doctors from around the state.

Box also asked Hoosiers to not go to the hospital to get a COVID-19 test, but instead leave the emergency rooms open for people who are coronavirus symptomatic.

The state has seen an increasing number of deaths at long-term care facilities and the National Guard is continuing to be trained, according to Dr. Box. She said the cases are still primarily occurring in older people, but new cases are trending back to the 18-to-30-year-old demographic. 

NFL change. The NFL is placing all teams in intensive protocol starting Saturday to mitigate the risk of COVID-19 as the number of cases rises around the country.

Use of masks will be mandatory at all times at team facilities, including during practice and in weight rooms. Meetings must be held either virtually or in the largest indoor space with approval by the league. Meals have to be made available for grab-and-go to avoid players and staff congregating in cafeterias. Time spent in the locker room also has to be limited.

Clubs operating under the intensive protocols have reduced close contacts by more than 50% since the fifth week of the regular season, according to a memo obtained by The Associated Press that was sent from NFL Commissioner Roger Goodell to teams on Wednesday.

“These sustained reductions and the resulting health and safety benefits make it appropriate to implement the intensive protocols on a mandatory, league-wide basis,” Goodell said in the memo.

So far, 28 teams have entered intensive protocol at some point and 16 teams have done it more than once.

“The upcoming holidays, beginning with Thanksgiving next week, will introduce new risks of exposure that we need to address now,” Goodell wrote. “Because we have a highly sophisticated program of daily testing, we know when the virus enters our facilities, which underscores the importance of contact tracing and other steps to minimize close contacts within a facility.

“Recent experience has highlighted the importance of minimizing high-risk close contacts; on multiple occasions, we have seen individuals identified on that basis test positive within a short time. We have also seen many instances in which effective action by clubs to minimize these close contacts prevented the virus from spreading within the club, and avoided players or coaches being ruled out of practice or games.”

The NFL said Tuesday there were 17 new confirmed positives among players and 35 among other personnel during testing from Nov. 8-14. That brought the league’s total to 95 players and 175 other personnel since Aug. 1, not counting new cases this week.

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