KANSAS CITY (AP) — The Kansas City area over the past week recorded its highest number of deaths over a one-week period, with more than 80 people dying from COVID-19.

Missouri is among several states across the U.S. seeing a spike in confirmed cases and hospitalizations related to the coronavirus. The state health department on Tuesday announced 1,695 additional confirmed cases and 28 more deaths. The state has reported 172,717 cases and 2,838 deaths since the pandemic began.

Hospitalizations statewide remain high, with 1,407 people in Missouri hospitals with confirmed or suspected COVID-19 illnesses as of Saturday, the most recent date available.

&nbsp;Kansas City along with Jackson, Clay and Platte counties in Missouri and Johnson and Wyandotte counties in Kansas has recorded 735 deaths since the pandemic began. But The most recent seven-day period was the most deadly.

The health department reported 81 deaths for the period of Oct. 20-26, and 163 deaths since the start of October.

“We are now what looks like moving into our third wave of this outbreak and that’s very, very concerning,” said Rex Archer, director of the Kansas City Health Department. “We’re very concerned about this surge and as we move more and more indoors, this is going to become even more problematic.”

KANSAS CITY (AP) — The Kansas City area over the past week recorded its highest number of deaths over a one-week period, with more than 80 people dying from COVID-19.Missouri is among several states across the U.S. seeing a spike in confirmed cases and hospitalizations related to the coronavirus. The state health department on Tuesday announced 1,695 additional confirmed cases and 28 more deaths. The state has reported 172,717 cases and 2,838 deaths since the pandemic began.Hospitalizations statewide remain high, with 1,407 people in Missouri hospitals with confirmed or suspected COVID-19 illnesses as of Saturday, the most recent date available.&nbsp;Kansas City along with Jackson, Clay and Platte counties in Missouri and Johnson and Wyandotte counties in Kansas has recorded 735 deaths since the pandemic began. But The most recent seven-day period was the most deadly.The health department reported 81 deaths for the period of Oct. 20-26, and 163 deaths since the start of October.“We are now what looks like moving into our third wave of this outbreak and that’s very, very concerning,” said Rex Archer, director of the Kansas City Health Department. “We’re very concerned about this surge and as we move more and more indoors, this is going to become even more problematic.”

Kansas City sees record number of virus deaths 

Barton County coronavirus update: 59 active cases

Barton County coronavirus update: 83 cases reported

WASHINGTON (AP) —U.S. regulators on Thursday approved the first drug to treat COVID-19: remdesivir, an antiviral medicine given to hospitalized patients through an IV.

The drug, which California-based Gilead Sciences Inc. is calling Veklury, cut the time to recovery by five days — from 15 days to 10 on average — in a large study led by the U.S. National Institutes of Health.

It had been authorized for use on an emergency basis since spring, and now becomes the first drug to win full Food and Drug Administration approval for treating COVID-19. President Donald Trump received it when he was sickened earlier this month.

Veklury is approved for people at least 12 years old and weighing at least 88 pounds (40 kilograms) who are hospitalized for a coronavirus infection. For patients younger than 12, the FDA will still allow the drug’s use in certain cases under its previous emergency authorization.

The drug works by inhibiting a substance the virus uses to make copies of itself. Certain kidney and liver tests are required before starting patients on it to ensure it’s safe for them and to monitor for any possible side effects. And the label warns against using it with the malaria drug hydroxychloroquine, because that can curb its effectiveness.

“We now have enough knowledge and a growing set of tools to help fight COVID-19,” Gilead’s chief medical officer, Dr. Merdad Parsey, said in a statement.

The drug is either approved or has temporary authorization in about 50 countries, he noted.

Its price has been controversial, given that no studies have found it improves survival. Last week, a large study led by the World Health Organization found the drug did not help hospitalized COVID-19 patients, but that study did not include a placebo group and was less rigorous than previous ones that found a benefit. The FDA’s approval statement noted that, besides the NIH-led one, two other studies found the drug beneficial.

Gilead charges $2,340 for a typical treatment course for people covered by government health programs in the United States and other developed countries, and $3,120 for patients with private insurance. The amount that patients pay out of pocket depends on insurance, income and other factors.

So far, only steroids such as dexamethasone have been shown to cut the risk of dying of COVID-19. The FDA also has given emergency authorization to using the blood of survivors, and two companies are currently seeking similar authorization for experimental antibody drugs.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/10/1603450089080.png" alt="" />
 <figcaption></figcaption>
 </figure>WASHINGTON (AP) —U.S. regulators on Thursday approved the first drug to treat COVID-19: remdesivir, an antiviral medicine given to hospitalized patients through an IV.The drug, which California-based Gilead Sciences Inc. is calling Veklury, cut the time to recovery by five days — from 15 days to 10 on average — in a large study led by the U.S. National Institutes of Health.It had been authorized for use on an emergency basis since spring, and now becomes the first drug to win full Food and Drug Administration approval for treating COVID-19. President Donald Trump received it when he was sickened earlier this month.Veklury is approved for people at least 12 years old and weighing at least 88 pounds (40 kilograms) who are hospitalized for a coronavirus infection. For patients younger than 12, the FDA will still allow the drug’s use in certain cases under its previous emergency authorization.The drug works by inhibiting a substance the virus uses to make copies of itself. Certain kidney and liver tests are required before starting patients on it to ensure it’s safe for them and to monitor for any possible side effects. And the label warns against using it with the malaria drug hydroxychloroquine, because that can curb its effectiveness.“We now have enough knowledge and a growing set of tools to help fight COVID-19,” Gilead’s chief medical officer, Dr. Merdad Parsey, said in a statement.The drug is either approved or has temporary authorization in about 50 countries, he noted.Its price has been controversial, given that no studies have found it improves survival. Last week, a large study led by the World Health Organization found the drug did not help hospitalized COVID-19 patients, but that study did not include a placebo group and was less rigorous than previous ones that found a benefit. The FDA’s approval statement noted that, besides the NIH-led one, two other studies found the drug beneficial.Gilead charges $2,340 for a typical treatment course for people covered by government health programs in the United States and other developed countries, and $3,120 for patients with private insurance. The amount that patients pay out of pocket depends on insurance, income and other factors.So far, only steroids such as dexamethasone have been shown to cut the risk of dying of COVID-19. The FDA also has given emergency authorization to using the blood of survivors, and two companies are currently seeking similar authorization for experimental antibody drugs.___

FDA approves the first drug for treating COVID-19

NEW YORK (AP) — U.S. health officials Wednesday redefined what counts as close contact with someone with COVID-19 to include briefer but repeated encounters.

For months, the Centers for Disease Control and Prevention said close contact meant spending a solid 15 minutes within 6 feet of someone who tested positive for coronavirus. On Wednesday, the&nbsp;<a href="https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/quarantine.html" target="_blank">CDC changed&nbsp;</a>it to a total of 15 minutes or more — so shorter but repeated contacts that add up to 15 minutes over a 24-hour period now count.

The CDC advises anyone who has been in close contact with a COVID-19 patient to quarantine for two weeks.

The change may prompt health departments to do contact tracing in cases where an exposure might previously have been considered too brief, said Dr. William Schaffner, a Vanderbilt University infectious diseases expert.

It also serves notice that the coronavirus can spread more easily than many people realize, he added.

The definition change was triggered by a report on that case of a 20-year-old Vermont correctional officer, who was diagnosed with a coronavirus infection in August. The guard, who wore a mask and goggles, had multiple brief encounters with six transferred prisoners before test results showed they were positive. At times, the prisoners wore masks, but there were encounters in cell doorways or in a recreational room where prisoners did not have them on, the report said.

An investigation that reviewed video footage concluded the guard’s brief interactions totaled 17 minutes during an 8-hour shift.

The report didn’t identify the prison but Vermont officials have said that in late July, six inmates tested positive when they arrived at the Marble Valley Correctional Facility in Rutland.

In a statement, CDC officials said the case highlights again the importance of wearing masks to prevent transmission, and that the agency’s guidance can change as new information comes in.

“As we get more data and understand this COVID we’re going to continue to incorporate that in our recommendations,” CDC Director Robert Redfield said at a press conference in Atlanta.

The CDC also says close contact can include hugging and kissing, sharing eating or drinking utensils with someone infected, and providing home care to someone who is sick. Someone sneezing or coughing on you also counts.

The risk of spread is considered to be lower outdoors, but the CDC guidance update “makes scientific sense,” said Dr. Michael Saag, an infectious disease researcher at the University of Alabama at Birmingham.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/6/1591480312815.png" alt="" />
 <figcaption></figcaption>
 </figure>NEW YORK (AP) — U.S. health officials Wednesday redefined what counts as close contact with someone with COVID-19 to include briefer but repeated encounters.For months, the Centers for Disease Control and Prevention said close contact meant spending a solid 15 minutes within 6 feet of someone who tested positive for coronavirus. On Wednesday, the&nbsp;<a href="https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/quarantine.html" target="_blank">CDC changed&nbsp;</a>it to a total of 15 minutes or more — so shorter but repeated contacts that add up to 15 minutes over a 24-hour period now count.The CDC advises anyone who has been in close contact with a COVID-19 patient to quarantine for two weeks.The change may prompt health departments to do contact tracing in cases where an exposure might previously have been considered too brief, said Dr. William Schaffner, a Vanderbilt University infectious diseases expert.It also serves notice that the coronavirus can spread more easily than many people realize, he added.The definition change was triggered by a report on that case of a 20-year-old Vermont correctional officer, who was diagnosed with a coronavirus infection in August. The guard, who wore a mask and goggles, had multiple brief encounters with six transferred prisoners before test results showed they were positive. At times, the prisoners wore masks, but there were encounters in cell doorways or in a recreational room where prisoners did not have them on, the report said.An investigation that reviewed video footage concluded the guard’s brief interactions totaled 17 minutes during an 8-hour shift.The report didn’t identify the prison but Vermont officials have said that in late July, six inmates tested positive when they arrived at the Marble Valley Correctional Facility in Rutland.In a statement, CDC officials said the case highlights again the importance of wearing masks to prevent transmission, and that the agency’s guidance can change as new information comes in.“As we get more data and understand this COVID we’re going to continue to incorporate that in our recommendations,” CDC Director Robert Redfield said at a press conference in Atlanta.The CDC also says close contact can include hugging and kissing, sharing eating or drinking utensils with someone infected, and providing home care to someone who is sick. Someone sneezing or coughing on you also counts.The risk of spread is considered to be lower outdoors, but the CDC guidance update “makes scientific sense,” said Dr. Michael Saag, an infectious disease researcher at the University of Alabama at Birmingham.___

CDC redefines COVID-19 close contact, adds brief encounters

Barton County coronavirus update: 70 active cases

Barton County coronavirus update: 147 active cases

By AMY RICKER Great Bend Post

Seven months ago, Barton County received its first official case of COVID-19 on March 30, 2020.&nbsp;As of Oct. 19, the Barton County Health Department has investigated a total of 695 confirmed cases of the virus. There have also been seven deaths attributed to COVID-19 with more deaths pending physician confirmation reported to the Office of Vital Statistics.&nbsp;&nbsp;&nbsp;

At the Barton County Commissioners Board meeting,&nbsp;Public Health Director, Karen Winkleman says the State of Kansas provides a positivity rate for Barton County and that rate is used in a variety of ways.&nbsp;&nbsp;&nbsp;

“It is defined as the number of positive cases, PCR positive in a week’s timeframe.&nbsp; That information is out there, available to the public on the KDHE website.&nbsp;It’s based on laboratory test dates and it’s intended to be used as a guideline for different entities.”&nbsp;

Winkleman says that data is used by long-term-care facilities that are mandated by CMS&nbsp;to determine how often they have to test staff and residents. Schools&nbsp;and communities&nbsp;also use this information for guidance&nbsp;at the rates go up and down to make decisions.&nbsp;&nbsp;

“I pulled just the last three that were available and in Barton County on Sept. 27, we were at 15.49% positivity.&nbsp;In Kansas, it was 6.37%. A week later we were at 14.97% so that went down slightly&nbsp;and the state went up slightly, 7.51%. On the Oct. 11, which was a week ago, Barton County was at 18.2% and the state of Kansas is at 8.49%.”&nbsp;

Winkleman said&nbsp;that&nbsp;the last local health&nbsp;update from&nbsp;the Kansas Health Department that she participated in was last Friday&nbsp;and there were some minimal indications that there may be some changes in the recommendations of quarantine guidelines this week.&nbsp;&nbsp;

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/10/1603127733919.jpeg" alt="" />
 <figcaption></figcaption>
 </figure>By AMY RICKER Great Bend PostSeven months ago, Barton County received its first official case of COVID-19 on March 30, 2020.&nbsp;As of Oct. 19, the Barton County Health Department has investigated a total of 695 confirmed cases of the virus. There have also been seven deaths attributed to COVID-19 with more deaths pending physician confirmation reported to the Office of Vital Statistics.&nbsp;&nbsp;&nbsp;At the Barton County Commissioners Board meeting,&nbsp;Public Health Director, Karen Winkleman says the State of Kansas provides a positivity rate for Barton County and that rate is used in a variety of ways.&nbsp;&nbsp;&nbsp;“It is defined as the number of positive cases, PCR positive in a week’s timeframe.&nbsp; That information is out there, available to the public on the KDHE website.&nbsp;It’s based on laboratory test dates and it’s intended to be used as a guideline for different entities.”&nbsp;Winkleman says that data is used by long-term-care facilities that are mandated by CMS&nbsp;to determine how often they have to test staff and residents. Schools&nbsp;and communities&nbsp;also use this information for guidance&nbsp;at the rates go up and down to make decisions.&nbsp;&nbsp;“I pulled just the last three that were available and in Barton County on Sept. 27, we were at 15.49% positivity.&nbsp;In Kansas, it was 6.37%. A week later we were at 14.97% so that went down slightly&nbsp;and the state went up slightly, 7.51%. On the Oct. 11, which was a week ago, Barton County was at 18.2% and the state of Kansas is at 8.49%.”&nbsp;Winkleman said&nbsp;that&nbsp;the last local health&nbsp;update from&nbsp;the Kansas Health Department that she participated in was last Friday&nbsp;and there were some minimal indications that there may be some changes in the recommendations of quarantine guidelines this week.&nbsp;&nbsp;

Barton County COVID cases higher than state averages

By NOAH TABORDA <a href="https://kansasreflector.com/2020/10/14/hospital-staffing-and-capacity-a-concern-for-kansas-communities-as-covid-19-multiplies/">Kansas Reflector</a>

TOPEKA — Concerns are 
growing about adequate staffing levels and bed capacity at Kansas 
hospitals and nursing homes strained by rising COVID-19 cases.

Hospitals in southeast Kansas already are struggling with capacity issues. <a href="https://www.morningsun.net/news/20201013/county-health-officials-consider-policy-changes-as-area-hospitals-reach-capacity">Ascension Via Christi Hospital announced this week</a>
 it would implement its surge plan and cease all elective surgeries 
because of a spike in cases in Crawford and Bourbon counties.

Kansas Department of 
Health and Environment secretary Lee Norman said Tuesday most hospitals 
he has spoken with are staying ahead of the virus. He said as case 
numbers rise in a community, however, so will the strain on hospital 
staff.

“Staffing challenges will 
be the first thing that we notice as numbers get worse,” Norman said. 
“It’s not because the people are out with an illness or in quarantine. 
It’s just because there are only so many critical care practitioners — 
whether they are doctors, nurses or therapists — to go around.”

As flu season begins, 
Norman emphasized the need to keep community COVID-19 case numbers low 
and, in effect, keep all areas of the hospital operating at full 
capacity.

Norman said he has 
discussed surge capacity plans and the possibility of strain on staffing
 levels during conversations this week with hospitals and nursing homes 
across the state.

Physical inventory, such 
as dialysis machines and ventilators, is strong statewide, Norman said, 
and he expects hospitals to remain well-stocked. But he is advising a 
cautious approach to potential staffing shortfalls.

“We have to do whatever we
 can to push it down,” Norman said. “I think we might get pinched, which
 is an excellent reason, I think, to bolster up and strengthen the 
anti-contagion practices in every county, city and town.”

KDHE on Wednesday reported
 an increase in of 1,293 cases of COVID-19 since Monday, and a two-day 
increase of 67 deaths. That brings state totals to 69,155 cases and 838 
deaths since the pandemic began in early March.

Kansas remains in the red zone for total cases per 100,000 people compared to the United States as a whole.

Norman said there is 
mounting evidence people could face re-infection with different strains 
of the virus. A woman in the Netherlands died this week after 
reinfection with COVID-19, although she was also fighting a rare form of
 cancer at the same time.

Nonfatal reinfections also has been reported in Hong Kong, Belgium and Nevada.

Norman said these reports 
contrast with the belief many hold that those who are infected are no 
longer at risk of contracting it again.

“We don’t know for sure if
 an immunity to the first time you had it, if it is a slightly different
 virus, will provide immunity the next time you are exposed,” Norman 
said. “Which means as a person that had it before, can they act like 
they won’t get it again? We don’t know the answer to that.”

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/10/1602783801990.png" alt="Kansas Department of Health and Environment secretary Lee Norman said capacity issues in southeast Kansas should serve as a wake-up call as concerns grow over rising COVID-19 case numbers and their strain on hospital staffing levels. (Noah Taborda/Kansas Reflector)" />
 <figcaption>Kansas Department of Health and Environment secretary Lee Norman said capacity issues in southeast Kansas should serve as a wake-up call as concerns grow over rising COVID-19 case numbers and their strain on hospital staffing levels. (Noah Taborda/Kansas Reflector)</figcaption>
 </figure>By NOAH TABORDA <a href="https://kansasreflector.com/2020/10/14/hospital-staffing-and-capacity-a-concern-for-kansas-communities-as-covid-19-multiplies/">Kansas Reflector</a>TOPEKA — Concerns are 
growing about adequate staffing levels and bed capacity at Kansas 
hospitals and nursing homes strained by rising COVID-19 cases.Hospitals in southeast Kansas already are struggling with capacity issues. <a href="https://www.morningsun.net/news/20201013/county-health-officials-consider-policy-changes-as-area-hospitals-reach-capacity">Ascension Via Christi Hospital announced this week</a>
 it would implement its surge plan and cease all elective surgeries 
because of a spike in cases in Crawford and Bourbon counties.Kansas Department of 
Health and Environment secretary Lee Norman said Tuesday most hospitals 
he has spoken with are staying ahead of the virus. He said as case 
numbers rise in a community, however, so will the strain on hospital 
staff.“Staffing challenges will 
be the first thing that we notice as numbers get worse,” Norman said. 
“It’s not because the people are out with an illness or in quarantine. 
It’s just because there are only so many critical care practitioners — 
whether they are doctors, nurses or therapists — to go around.”As flu season begins, 
Norman emphasized the need to keep community COVID-19 case numbers low 
and, in effect, keep all areas of the hospital operating at full 
capacity.Norman said he has 
discussed surge capacity plans and the possibility of strain on staffing
 levels during conversations this week with hospitals and nursing homes 
across the state.Physical inventory, such 
as dialysis machines and ventilators, is strong statewide, Norman said, 
and he expects hospitals to remain well-stocked. But he is advising a 
cautious approach to potential staffing shortfalls.“We have to do whatever we
 can to push it down,” Norman said. “I think we might get pinched, which
 is an excellent reason, I think, to bolster up and strengthen the 
anti-contagion practices in every county, city and town.”KDHE on Wednesday reported
 an increase in of 1,293 cases of COVID-19 since Monday, and a two-day 
increase of 67 deaths. That brings state totals to 69,155 cases and 838 
deaths since the pandemic began in early March.Kansas remains in the red zone for total cases per 100,000 people compared to the United States as a whole.Norman said there is 
mounting evidence people could face re-infection with different strains 
of the virus. A woman in the Netherlands died this week after 
reinfection with COVID-19, although she was also fighting a rare form of
 cancer at the same time.Nonfatal reinfections also has been reported in Hong Kong, Belgium and Nevada.Norman said these reports 
contrast with the belief many hold that those who are infected are no 
longer at risk of contracting it again.“We don’t know for sure if
 an immunity to the first time you had it, if it is a slightly different
 virus, will provide immunity the next time you are exposed,” Norman 
said. “Which means as a person that had it before, can they act like 
they won’t get it again? We don’t know the answer to that.”

Hospital staffing, capacity a concern for Kan. communities as COVID-19 multiplies

Barton County coronavirus update: 146 active cases

WASHINGTON (AP) —Independent monitors have paused enrollment in a study testing the COVID-19 antiviral drug remdesivir plus an experimental antibody therapy being developed by Eli Lilly that’s similar to a treatment President Donald Trump recently received.

Lilly confirmed Tuesday that the study had been paused “out of an abundance of caution” and said safety is its top concern. The company would not say more about what led to this step.

The U.S. National Institute of Allergy and Infectious Diseases, which sponsors the study, would not immediately comment.

Antibodies are proteins the body makes when an infection occurs; they attach to a virus and help it be eliminated. The experimental drugs are concentrated versions of one or two specific antibodies that worked best against the coronavirus in lab and animal tests.

<a href="https://clinicaltrials.gov/ct2/show/NCT04501978?term=ACTIV-3&amp;draw=2&amp;rank=1" target="_blank">This study</a>&nbsp;was testing a single antibody that Lilly is developing with the Canadian company AbCellera. Trump received an experimental two-antibody combo drug from Regeneron Pharmaceuticals Inc.

Lilly and Regeneron have asked the U.S. Food and Drug Administration to grant emergency use authorization for their drugs for COVID-19 while late-stage studies continue.

The paused study, called ACTIV-3, started in August and aims to enroll 10,000 hospitalized COVID-19 patients in the United States, Denmark and Singapore. All are given remdesivir, which has been authorized in the U.S. as an emergency treatment for COVID-19, plus either the Lilly antibody or a placebo.

The main goals are reducing the need for extra oxygen and time to recovery. Deaths, relief of symptoms and other measures also are being tracked. All of the drugs are given through an IV.

Such pauses are not uncommon in long clinical studies. Unlike a study hold imposed by government regulators, a pause is initiated by the sponsor of the drug trial and often can be quickly resolved.

The pause in the Lilly study comes a day after a temporary halt to enrollment in a coronavirus vaccine study. Johnson &amp; Johnson executives said Tuesday that it will be a few days before they know more about an unexplained illness in one participant that caused a pause in its late-stage vaccine study. Johnson &amp; Johnson isn’t disclosing the nature of the illness.

“It may have nothing to do with the vaccine,” said Mathai Mammen, head of research and development for Janssen, Johnson &amp; Johnson’s medicine development business.

Mammen said the company doesn’t know yet whether the ill participant received the experimental vaccine or a dummy shot. He says Johnson &amp; Johnson gave information on the case to the independent monitoring board overseeing the safety of patients in the study, as the research protocol requires. It will recommend next steps.

The study of the one-dose vaccine will include up to 60,000 people from multiple countries. The company expects to complete enrollment in the study in two or three months.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/10/1602636110217.png" alt="photo courtesy Eli Lilly" />
 <figcaption>photo courtesy Eli Lilly</figcaption>
 </figure>WASHINGTON (AP) —Independent monitors have paused enrollment in a study testing the COVID-19 antiviral drug remdesivir plus an experimental antibody therapy being developed by Eli Lilly that’s similar to a treatment President Donald Trump recently received.Lilly confirmed Tuesday that the study had been paused “out of an abundance of caution” and said safety is its top concern. The company would not say more about what led to this step.The U.S. National Institute of Allergy and Infectious Diseases, which sponsors the study, would not immediately comment.Antibodies are proteins the body makes when an infection occurs; they attach to a virus and help it be eliminated. The experimental drugs are concentrated versions of one or two specific antibodies that worked best against the coronavirus in lab and animal tests.<a href="https://clinicaltrials.gov/ct2/show/NCT04501978?term=ACTIV-3&amp;draw=2&amp;rank=1" target="_blank">This study</a>&nbsp;was testing a single antibody that Lilly is developing with the Canadian company AbCellera. Trump received an experimental two-antibody combo drug from Regeneron Pharmaceuticals Inc.Lilly and Regeneron have asked the U.S. Food and Drug Administration to grant emergency use authorization for their drugs for COVID-19 while late-stage studies continue.The paused study, called ACTIV-3, started in August and aims to enroll 10,000 hospitalized COVID-19 patients in the United States, Denmark and Singapore. All are given remdesivir, which has been authorized in the U.S. as an emergency treatment for COVID-19, plus either the Lilly antibody or a placebo.The main goals are reducing the need for extra oxygen and time to recovery. Deaths, relief of symptoms and other measures also are being tracked. All of the drugs are given through an IV.Such pauses are not uncommon in long clinical studies. Unlike a study hold imposed by government regulators, a pause is initiated by the sponsor of the drug trial and often can be quickly resolved.The pause in the Lilly study comes a day after a temporary halt to enrollment in a coronavirus vaccine study. Johnson &amp; Johnson executives said Tuesday that it will be a few days before they know more about an unexplained illness in one participant that caused a pause in its late-stage vaccine study. Johnson &amp; Johnson isn’t disclosing the nature of the illness.“It may have nothing to do with the vaccine,” said Mathai Mammen, head of research and development for Janssen, Johnson &amp; Johnson’s medicine development business.ADVERTISEMENTMammen said the company doesn’t know yet whether the ill participant received the experimental vaccine or a dummy shot. He says Johnson &amp; Johnson gave information on the case to the independent monitoring board overseeing the safety of patients in the study, as the research protocol requires. It will recommend next steps.The study of the one-dose vaccine will include up to 60,000 people from multiple countries. The company expects to complete enrollment in the study in two or three months.

Possible safety issue spurs pause of COVID-19 antibody study

NEW BRUNSWICK, N.J. (AP) — A late-stage study of Johnson &amp; Johnson’s COVID-19 vaccine candidate has been paused while the company investigates whether a study participant’s “unexplained illness” is related to the shot.

The company said in a statement Monday evening that illnesses, accidents and other so-called adverse events “are an expected part of any clinical study, especially large studies,” but that its physicians and a safety monitoring panel would try to determine what might have caused the illness.

The pause is at least the&nbsp;<a href="https://apnews.com/article/virus-outbreak-archive-4239b8c69ba4b3703b2ca8c77810bf07">second such hold</a>&nbsp;to occur among several vaccines that have reached large-scale final tests in the U.S.

The company declined to reveal any more details about the illness, citing the participant’s privacy.

Temporary stoppages of large medical studies are relatively common. Few are made public in typical drug trials, but the work to make a coronavirus vaccine has raised the stakes on these kinds of complications.

Companies are required to investigate any serious or unexpected reaction that occurs during drug testing. Given that such tests are done on tens of thousands of people, some medical problems are a coincidence. In fact, one of the first steps the company said it will take is to determine if the person received the vaccine or a placebo.

The halt was first reported by the health news site STAT.

Final-stage testing of a vaccine made by AstraZeneca and Oxford University remains on hold in the U.S. as officials examine whether an&nbsp;<a href="https://apnews.com/article/virus-outbreak-archive-82885b32aeeae6c2a0a84cadf55ced90">illness in its trial</a>&nbsp;poses a safety risk. That trial was stopped when a woman developed severe neurological symptoms consistent with transverse myelitis, a rare inflammation of the spinal cord, the company has said. That company’s testing&nbsp;<a href="https://apnews.com/article/virus-outbreak-archive-drug-trials-bc340f0a92d940aff88ee140f2774aee">has restarted</a>&nbsp;elsewhere.

Johnson &amp; Johnson was aiming to enroll 60,000 volunteers to prove if its single-dose approach is safe and protects against the coronavirus. Other vaccine candidates in the U.S. require two shots.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/10/1602590971875.png" alt="photo courtesy Johnson &amp; Johnson" />
 <figcaption>photo courtesy Johnson &amp; Johnson</figcaption>
 </figure>NEW BRUNSWICK, N.J. (AP) — A late-stage study of Johnson &amp; Johnson’s COVID-19 vaccine candidate has been paused while the company investigates whether a study participant’s “unexplained illness” is related to the shot.The company said in a statement Monday evening that illnesses, accidents and other so-called adverse events “are an expected part of any clinical study, especially large studies,” but that its physicians and a safety monitoring panel would try to determine what might have caused the illness.The pause is at least the&nbsp;<a href="https://apnews.com/article/virus-outbreak-archive-4239b8c69ba4b3703b2ca8c77810bf07">second such hold</a>&nbsp;to occur among several vaccines that have reached large-scale final tests in the U.S.The company declined to reveal any more details about the illness, citing the participant’s privacy.Temporary stoppages of large medical studies are relatively common. Few are made public in typical drug trials, but the work to make a coronavirus vaccine has raised the stakes on these kinds of complications.Companies are required to investigate any serious or unexpected reaction that occurs during drug testing. Given that such tests are done on tens of thousands of people, some medical problems are a coincidence. In fact, one of the first steps the company said it will take is to determine if the person received the vaccine or a placebo.The halt was first reported by the health news site STAT.Final-stage testing of a vaccine made by AstraZeneca and Oxford University remains on hold in the U.S. as officials examine whether an&nbsp;<a href="https://apnews.com/article/virus-outbreak-archive-82885b32aeeae6c2a0a84cadf55ced90">illness in its trial</a>&nbsp;poses a safety risk. That trial was stopped when a woman developed severe neurological symptoms consistent with transverse myelitis, a rare inflammation of the spinal cord, the company has said. That company’s testing&nbsp;<a href="https://apnews.com/article/virus-outbreak-archive-drug-trials-bc340f0a92d940aff88ee140f2774aee">has restarted</a>&nbsp;elsewhere.Johnson &amp; Johnson was aiming to enroll 60,000 volunteers to prove if its single-dose approach is safe and protects against the coronavirus. Other vaccine candidates in the U.S. require two shots.

2nd COVID-19 vaccine trial paused over unexplained illness

Barton County coronavirus update: 144 active cases (727 quarantines)

Barton County coronavirus update: 114 active cases

REPUBLIC COUNTY —The Kansas Department of Health and Environment, along with local public health, are advising people who attended an auction in Republic County on September 26 that they may have been exposed to COVID-19, as six of cases have been connected to the event to date, according to a media release from KDHE.

 The auction was held at 208 Bedford Street in Cuba, Kansas on September 26 from about 9 a.m. to 2:30 p.m. This auction had attendees from other communities in Kansas as well as those from out of state.

Anyone who attended this event should be aware of symptoms of COVID which can develop up to 14 days after exposure. Those symptoms include fever, cough, chills, muscle pain, sore throat, new loss of taste or smell, fatigue, diarrhea, and/or shortness of breath/difficulty breathing. If symptoms develop, please stay home and contact your health care provider or local health department for guidance on testing. In an emergency please call 911 and notify first responders that you were potentially exposed to COVID-19 and, if possible, wear a cloth face mask before they arrive.

REPUBLIC COUNTY —The Kansas Department of Health and Environment, along with local public health, are advising people who attended an auction in Republic County on September 26 that they may have been exposed to COVID-19, as six of cases have been connected to the event to date, according to a media release from KDHE. The auction was held at 208 Bedford Street in Cuba, Kansas on September 26 from about 9 a.m. to 2:30 p.m. This auction had attendees from other communities in Kansas as well as those from out of state.Anyone who attended this event should be aware of symptoms of COVID which can develop up to 14 days after exposure. Those symptoms include fever, cough, chills, muscle pain, sore throat, new loss of taste or smell, fatigue, diarrhea, and/or shortness of breath/difficulty breathing. If symptoms develop, please stay home and contact your health care provider or local health department for guidance on testing. In an emergency please call 911 and notify first responders that you were potentially exposed to COVID-19 and, if possible, wear a cloth face mask before they arrive.

KDHE: COVID-19 cases linked to Republic Co. auction

By CELIA LLOPIS-JEPSEN <a href="https://www.kcur.org/news/2020-10-08/clues-from-the-blood-of-kansans-suggest-the-coronavirus-pandemic-could-stick-around-for-a-long-time">Kansas News Service</a>

Perhaps two in every 50 Kansans have <a href="https://www.livescience.com/antibodies.html" target="_blank">antibodies</a> swimming in their bloodstream that show they’ve had COVID-19.

That relatively low number — based on the assumption that <a href="https://www.redcross.org/give-blood.html" target="_blank">blood donors</a>
 reflect the broader population — suggests a gloomy reality. Kansas is 
still in the early days of this pandemic and it's looking at a future 
likely to bring many more cases than it has so far seen.

“Absolutely,”
 said Roger Shapiro, an immunologist at Harvard University’s School of 
Public Health. “When you look at these figures, you realize how far we 
are from herd immunity.”

The overwhelming number of Kansans, perhaps more than 95%, haven’t yet experienced the virus that has killed more than <a href="https://coronavirus.jhu.edu/data/mortality" target="_blank">200,000 Americans</a>.

So
 medical pros say the only thing to do is sit tight, keep your masks on 
and stay away from other people, until we have a vaccine.

“This
 is not the time to play a guessing game of, ‘Do I have the flu or do I 
have COVID?’” said Gigi Gronvall, an immunologist at Johns Hopkins’ 
Center for Health Security.

Many people still can’t get fast 
coronavirus tests that would let them isolate in time to stop the 
disease from spreading further, and hospitals remain at risk of getting 
overwhelmed by coronavirus and flu cases this fall.

The
 human body produces antibodies when exposed to a disease, to fend it 
off. And those microscopic defenders can stick around after recovery.

So the American Red Cross screens blood donations for antibodies against <a href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it" target="_blank">SARS-CoV-2</a>, the virus behind COVID-19. It then sends <a href="https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=160&amp;ContentID=37" target="_blank">plasma</a>
 with the specialized proteins to hospitals treating coronavirus 
patients, and it reports how often it detects the antibodies to state 
health agencies trying to piece together the bigger picture.

Nationally, the <a href="https://www.redcross.org/give-blood.html" target="_blank">Red Cross</a> has tested about 1.2 million blood donations for the antibodies.

From
 mid-June to mid-September, it found them in about 2% of donations 
nationally. The same was true for Kansas donors. It’s not known how well
 that statistic might reflect the broader population.

Weekly 
tallies suggest the number of people carrying the antibodies has ticked 
upward in Kansas, as elsewhere. In recent weeks, the Red Cross reported 
antibodies in 4% to 5% of Kansas donations.

Could someone with 
antibodies catch the virus again a year from now and get seriously sick?
 How about two years from now? Or could they catch it, not show any 
symptoms, and spread the virus anyway? Scientists can’t yet say.

“This
 is not a get-out-of-jail-free card,” Gronvall said. If a test shows you
 have antibodies, she said, you should still wear a mask and follow 
social distancing rules.

Recent reports of a few patients catching the novel coronavirus <a href="https://www.statnews.com/2020/08/28/covid-19-reinfection-implications/" target="_blank">more than once</a>
 in a relatively short time may not signal what to expect for most 
people, but leave open the possibility that one infection doesn’t 
protect you against another.

The Red Cross reported in <a href="https://jamanetwork.com/journals/jama/fullarticle/2770771" target="_blank">a medical journal</a>
 last month that blood donations from people of color test positive for 
the antibodies at a higher rate than blood from white donors.

That matches <a href="https://www.mayoclinic.org/diseases-conditions/coronavirus/expert-answers/coronavirus-infection-by-race/faq-20488802" target="_blank">other research</a>
 that shows communities of color bearing the brunt of the pandemic. It 
likely reflects broader social and economic disparities, such as lower 
incomes and a greater likelihood of working high-risk jobs that involve 
in-person contact with many customers or colleagues in a single day.

The virus spread fast in crowded Kansas <a href="https://www.hppr.org/post/emails-show-kansas-agencies-helped-keep-meatpacking-plants-open-despite-concerns-about" target="_blank">meatpacking plants</a>, for example, that rely heavily on the labor of people of color in southwest Kansas.

Some
 studies and modeling point to higher antibody rates nationally and 
globally than the Red Cross has seen among blood donors, but still don’t
 offer good news.

“The (World Health Organization) just came out with an estimate that maybe <a href="https://abcnews.go.com/Health/wireStory/10-worlds-people-infected-virus-73427817" target="_blank">up to 10%</a>
 of the world has been infected,” Shapiro said. “But even at that 
number, we’re still so far from achieving herd immunity. … We really 
need to create immunity with a vaccine.”

Vaccines <a href="https://www.cdc.gov/vaccines/hcp/conversations/downloads/vacsafe-understand-color-office.pdf" target="_blank">mimic natural infections</a>. They kick a person’s immune system into gear so that it churns out antibodies and stores viral information in <a href="https://askabiologist.asu.edu/memory-b-cell" target="_blank">memory cells</a>
 that could defend us even after those antibodies fade. (Researchers 
have found SARS-CoV-2 antibodies triggered by natural infection two or 
even three months after infection, and say it varies from person to 
person.)

Ongoing coronavirus vaccine trials aim to check how 
protective these immune responses will prove long-term, and whether 
people will need booster shots over time to keep their defenses up.

Part
 of the benefit from vaccines will ultimately come from the sheer number
 of people who would gain some level of protection at once.

“As we
 get to high enough vaccine levels, the herd immunity will actually just
 lower the amount of virus that’s circulating,” Shapiro said. “There 
will be just less virus around. This is our hope.”

The Red Cross’ free antibody tests serve three functions.

They
 gather the information that helps public health experts studying the 
virus’ spread, and they allow the Red Cross to flag plasma with 
antibodies for hospitals.

Scientists <a href="https://thehill.com/policy/healthcare/513405-science-inconclusive-on-use-of-convalescent-plasma-in-covid-19-patients" target="_blank">still can’t say</a> whether the donated plasma works for treating COVID-19. A separate, <a href="https://www.sciencemag.org/news/2020/09/provocative-results-boost-hopes-antibody-treatment-covid-19" target="_blank">lab-based approach</a>, may prove more effective.

But either way, donations remain as critical as ever to the nation’s blood supply.

And that’s a third reason for offering antibody tests. They attract people to <a href="https://www.redcross.org/give-blood.html" target="_blank">keep donating</a> amid the pandemic.

The
 Red Cross uses respected tests, and when a blood sample proves positive
 for antibodies, it double-checks with a second, high-quality process.

For
 people who had respiratory symptoms in recent months — but couldn’t get
 checked for COVID-19 because of the nationwide shortage of <a href="https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html" target="_blank">viral tests</a> — that may satisfy their curiosity.

And
 that could help keep donations flowing as the pandemic hampers 
traditional blood drives, such as a major annual effort that would have 
attracted thousands of donors next week.

“The biggest blood
 drive the Red Cross does across the country is at the University of 
Missouri in Columbia,” said Joe Zydlo, a regional communications manager
 in St. Louis. “And that has been canceled.”

Meanwhile, Gronvall 
advises against buying an antibody test somewhere. After all, the 
information won’t help you medically, she said, and many products are 
unreliable anyway.

“There’s just been so many bad tests out there,” she said. “Right now I would not spend money on it.”

Celia Llopis-Jepsen reports on consumer health and education for the Kansas News Service. You can follow her on Twitter <a href="https://twitter.com/Celia_LJ" target="_blank">@celia_LJ</a> or email her at celia@kcur.org.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/10/1602251360190.png" alt=" Photo illustration by Celia Llopis-Jepsen / Kansas News Service" />
 <figcaption> Photo illustration by Celia Llopis-Jepsen / Kansas News Service</figcaption>
 </figure>By CELIA LLOPIS-JEPSEN <a href="https://www.kcur.org/news/2020-10-08/clues-from-the-blood-of-kansans-suggest-the-coronavirus-pandemic-could-stick-around-for-a-long-time">Kansas News Service</a>Perhaps two in every 50 Kansans have <a href="https://www.livescience.com/antibodies.html" target="_blank">antibodies</a> swimming in their bloodstream that show they’ve had COVID-19.That relatively low number — based on the assumption that <a href="https://www.redcross.org/give-blood.html" target="_blank">blood donors</a>
 reflect the broader population — suggests a gloomy reality. Kansas is 
still in the early days of this pandemic and it's looking at a future 
likely to bring many more cases than it has so far seen.“Absolutely,”
 said Roger Shapiro, an immunologist at Harvard University’s School of 
Public Health. “When you look at these figures, you realize how far we 
are from herd immunity.”The overwhelming number of Kansans, perhaps more than 95%, haven’t yet experienced the virus that has killed more than <a href="https://coronavirus.jhu.edu/data/mortality" target="_blank">200,000 Americans</a>.So
 medical pros say the only thing to do is sit tight, keep your masks on 
and stay away from other people, until we have a vaccine.That, and get a flu shot.“This
 is not the time to play a guessing game of, ‘Do I have the flu or do I 
have COVID?’” said Gigi Gronvall, an immunologist at Johns Hopkins’ 
Center for Health Security.Many people still can’t get fast 
coronavirus tests that would let them isolate in time to stop the 
disease from spreading further, and hospitals remain at risk of getting 
overwhelmed by coronavirus and flu cases this fall.<h2>Clues in the blood</h2>The
 human body produces antibodies when exposed to a disease, to fend it 
off. And those microscopic defenders can stick around after recovery.So the American Red Cross screens blood donations for antibodies against <a href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it" target="_blank">SARS-CoV-2</a>, the virus behind COVID-19. It then sends <a href="https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=160&amp;ContentID=37" target="_blank">plasma</a>
 with the specialized proteins to hospitals treating coronavirus 
patients, and it reports how often it detects the antibodies to state 
health agencies trying to piece together the bigger picture.Nationally, the <a href="https://www.redcross.org/give-blood.html" target="_blank">Red Cross</a> has tested about 1.2 million blood donations for the antibodies.From
 mid-June to mid-September, it found them in about 2% of donations 
nationally. The same was true for Kansas donors. It’s not known how well
 that statistic might reflect the broader population.Weekly 
tallies suggest the number of people carrying the antibodies has ticked 
upward in Kansas, as elsewhere. In recent weeks, the Red Cross reported 
antibodies in 4% to 5% of Kansas donations.Could someone with 
antibodies catch the virus again a year from now and get seriously sick?
 How about two years from now? Or could they catch it, not show any 
symptoms, and spread the virus anyway? Scientists can’t yet say.“This
 is not a get-out-of-jail-free card,” Gronvall said. If a test shows you
 have antibodies, she said, you should still wear a mask and follow 
social distancing rules.Recent reports of a few patients catching the novel coronavirus <a href="https://www.statnews.com/2020/08/28/covid-19-reinfection-implications/" target="_blank">more than once</a>
 in a relatively short time may not signal what to expect for most 
people, but leave open the possibility that one infection doesn’t 
protect you against another.<h2>Greater risk</h2>The Red Cross reported in <a href="https://jamanetwork.com/journals/jama/fullarticle/2770771" target="_blank">a medical journal</a>
 last month that blood donations from people of color test positive for 
the antibodies at a higher rate than blood from white donors.That matches <a href="https://www.mayoclinic.org/diseases-conditions/coronavirus/expert-answers/coronavirus-infection-by-race/faq-20488802" target="_blank">other research</a>
 that shows communities of color bearing the brunt of the pandemic. It 
likely reflects broader social and economic disparities, such as lower 
incomes and a greater likelihood of working high-risk jobs that involve 
in-person contact with many customers or colleagues in a single day.The virus spread fast in crowded Kansas <a href="https://www.hppr.org/post/emails-show-kansas-agencies-helped-keep-meatpacking-plants-open-despite-concerns-about" target="_blank">meatpacking plants</a>, for example, that rely heavily on the labor of people of color in southwest Kansas.<h2>The need for a vaccine</h2>Some
 studies and modeling point to higher antibody rates nationally and 
globally than the Red Cross has seen among blood donors, but still don’t
 offer good news.“The (World Health Organization) just came out with an estimate that maybe <a href="https://abcnews.go.com/Health/wireStory/10-worlds-people-infected-virus-73427817" target="_blank">up to 10%</a>
 of the world has been infected,” Shapiro said. “But even at that 
number, we’re still so far from achieving herd immunity. … We really 
need to create immunity with a vaccine.”Vaccines <a href="https://www.cdc.gov/vaccines/hcp/conversations/downloads/vacsafe-understand-color-office.pdf" target="_blank">mimic natural infections</a>. They kick a person’s immune system into gear so that it churns out antibodies and stores viral information in <a href="https://askabiologist.asu.edu/memory-b-cell" target="_blank">memory cells</a>
 that could defend us even after those antibodies fade. (Researchers 
have found SARS-CoV-2 antibodies triggered by natural infection two or 
even three months after infection, and say it varies from person to 
person.)Ongoing coronavirus vaccine trials aim to check how 
protective these immune responses will prove long-term, and whether 
people will need booster shots over time to keep their defenses up.Part
 of the benefit from vaccines will ultimately come from the sheer number
 of people who would gain some level of protection at once.“As we
 get to high enough vaccine levels, the herd immunity will actually just
 lower the amount of virus that’s circulating,” Shapiro said. “There 
will be just less virus around. This is our hope.”<h2>Should you get an antibody test?</h2>The Red Cross’ free antibody tests serve three functions.They
 gather the information that helps public health experts studying the 
virus’ spread, and they allow the Red Cross to flag plasma with 
antibodies for hospitals.Scientists <a href="https://thehill.com/policy/healthcare/513405-science-inconclusive-on-use-of-convalescent-plasma-in-covid-19-patients" target="_blank">still can’t say</a> whether the donated plasma works for treating COVID-19. A separate, <a href="https://www.sciencemag.org/news/2020/09/provocative-results-boost-hopes-antibody-treatment-covid-19" target="_blank">lab-based approach</a>, may prove more effective.But either way, donations remain as critical as ever to the nation’s blood supply.And that’s a third reason for offering antibody tests. They attract people to <a href="https://www.redcross.org/give-blood.html" target="_blank">keep donating</a> amid the pandemic.The
 Red Cross uses respected tests, and when a blood sample proves positive
 for antibodies, it double-checks with a second, high-quality process.For
 people who had respiratory symptoms in recent months — but couldn’t get
 checked for COVID-19 because of the nationwide shortage of <a href="https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html" target="_blank">viral tests</a> — that may satisfy their curiosity.And
 that could help keep donations flowing as the pandemic hampers 
traditional blood drives, such as a major annual effort that would have 
attracted thousands of donors next week.“The biggest blood
 drive the Red Cross does across the country is at the University of 
Missouri in Columbia,” said Joe Zydlo, a regional communications manager
 in St. Louis. “And that has been canceled.”Meanwhile, Gronvall 
advises against buying an antibody test somewhere. After all, the 
information won’t help you medically, she said, and many products are 
unreliable anyway.“There’s just been so many bad tests out there,” she said. “Right now I would not spend money on it.”Celia Llopis-Jepsen reports on consumer health and education for the Kansas News Service. You can follow her on Twitter <a href="https://twitter.com/Celia_LJ" target="_blank">@celia_LJ</a> or email her at celia@kcur.org.

Antibody tests show 'we’re still so far from achieving herd immunity'

MISSION, Kan. (AP) — Treating the sick and dying isn't even the toughest part for nurse Amelia Montgomery as the coronavirus surges in her corner of red America.

It's dealing with patients and relatives who don't believe the virus is real, refuse to wear masks and demand treatments like&nbsp;<a href="https://apnews.com/article/b9b6dc204d780fac7e6a79c1dbf21b8d">hydroxychloroquine,</a>&nbsp;which President Donald Trump has championed even though experts say it is not effective against the scourge that has killed over 210,000 in the U.S.

Montgomery finds herself, like so many other doctors and nurses, in a world where the politics of the crisis are complicating treatment efforts, with some people even resisting getting tested.

It's unclear how&nbsp;<a href="https://apnews.com/article/election-2020-virus-outbreak-donald-trump-infectious-diseases-michael-pence-a037f5cf6d6f14f90313a3aa7cd58043">Trump’s&nbsp;</a>bout with the virus will affect the situation, but some doctors aren't optimistic. After a few days of treatment at a military hospital, the president tweeted Monday, “Don’t be afraid of Covid. Don’t let it dominate your life. ... I feel better than I did 20 years ago!”

After one tough shift on the coronavirus unit at Cox South Hospital in Springfield, Montgomery went onto Facebook to vent her frustrations about caring for patients who didn't socially distance because they didn't believe the virus was real. The hospital later shared her post on its&nbsp;<a href="https://www.coxhealth.com/newsroom/letter-heart-covid-19-nurse/">website</a>.

She complained that some people demand the anti-malaria drug hydroxychloroquine and think the only patients who get really sick have underlying health problems.

“The majority of people don’t understand and can’t picture what we are seeing. That has been frustrating for all of us,” Montgomery said in an interview, adding: “It wears.”

Combating virus skeptics is a battle across the country.

In Georgia, at Augusta University Medical Center, visitors have tried to get around the mask requirement by wearing face coverings made of fishnet and other material with visible holes, something the hospital has dubbed “malicious compliance." People also have shown up with video cameras in an attempt to collect proof the virus is a hoax, said Dr. Phillip Coule, the health system's chief medical officer, who contracted the virus in July and has seen two staff members die.

“Just imagine that while you are caring for your own staff that are dying from this disease, and while you are trying to keep yourself safe, and you are trying to keep your family safe, and you are trying to deal with a disease that such little is known about, and then to have somebody tell you that it is all a hoax after you have been dealing with that all day," he said. “Imagine the emotional distress that that causes.”

He said most skeptics — including some who have argued with him on Facebook — are converted to believers when they get sick themselves. And he is starting to hear fewer people dismiss the virus entirely since the president was diagnosed.

“It is unfortunate that the president has contracted the disease, but it is difficult for groups who support the president to be out there saying it doesn’t exist," he said.

But he also said he fears people may draw the wrong lesson about the seriousness of the disease from what happened to Trump: "People may extrapolate that the risk for a 74 is low when the reality is the risk to a 74 year-old is quite high."

Dr. Beth Oller, who practices family medicine with her physician-husband in rural Kansas' Rooks County, isn't optimistic the president's diagnosis will change much in her community, where cases are on the rise, many resist masks, and weddings with hundreds of guests have been held in recent weeks.

“None of the things he did since he had it have helped us a bit, and, if anything, would fly in the face of it," she said, noting that the president took his mask off as soon as he returned to the White House. “All he did was continue to show people that the things we are saying to do are overblown and an overreaction. As a physician, it is so damn frustrating."

The issue has been a challenge in red states for months.

In Iowa, home health nurse Lisa Dockery was fired from her job caring for a boy with severe disabilities after arguing with his parents, who said COVID-19 is a “hoax.” The argument started because the parents refused to wear masks around Dockery and the boy, even though she told them their son's life was in danger because he has respiratory problems, relies on tube feedings and cannot walk, state unemployment records show.

The case ended with a judge ordering her former employer to pay her unemployment.

Dr. Gary LeRoy, president of the American Academy of Family Physicians, said he isn’t surprised that it has been so hard to persuade the public, noting that there was also a lot of denial as the Spanish flu was sweeping across the world a century ago, killing tens of millions of people.

“When you look at human history, it is what happens in every situation," he said. “In war, in famine, in disease, there is going to be a population of people where the bombs are dropping all around them and they don’t believe that it exists.”

Dr. Brad Burmeister, an emergency medicine physician at Bellin Hospital in Green Bay, Wisconsin, said he has encountered a few patients who have declined to be tested for the coronavirus despite having possible symptoms.

“They say they don’t want to become a statistic or some kind of rhetoric like that," he said, adding that he thinks a shift might be coming, given what happened to Trump. “It just sort of shows how infectious COVID-19 is and how easily it can spread, that even when you are taking all of those precautions, you can still get infected with the virus."

Dr. Natasha Bhuyan, a family physician in Phoenix, said politics often come up in discussions with patients who come in asking whether the death toll is being inflated.

“It’s an info-demic as well as a pandemic,” she lamented.

Dr. Jay W. Lee, a family physician in Orange County, California, recalled a patient who demanded the “largest hydroxychloroquine prescription you can give me."

“If I didn’t have my mask on, he would have seen my mouth agape,” said Lee, chief of the Share Our Selves medical clinics, adding that a small number of patients “flat-out said this was a hoax."

He has found himself turning to&nbsp;<a href="https://twitter.com/familydocwonk">social media</a>&nbsp;and meeting with elected leaders to combat some of the misinformation.

“I think part of it is we feel like we can’t just sit back and take it because silence is complicity,” he said.

MISSION, Kan. (AP) — Treating the sick and dying isn't even the toughest part for nurse Amelia Montgomery as the coronavirus surges in her corner of red America.It's dealing with patients and relatives who don't believe the virus is real, refuse to wear masks and demand treatments like&nbsp;<a href="https://apnews.com/article/b9b6dc204d780fac7e6a79c1dbf21b8d">hydroxychloroquine,</a>&nbsp;which President Donald Trump has championed even though experts say it is not effective against the scourge that has killed over 210,000 in the U.S.Montgomery finds herself, like so many other doctors and nurses, in a world where the politics of the crisis are complicating treatment efforts, with some people even resisting getting tested.It's unclear how&nbsp;<a href="https://apnews.com/article/election-2020-virus-outbreak-donald-trump-infectious-diseases-michael-pence-a037f5cf6d6f14f90313a3aa7cd58043">Trump’s&nbsp;</a>bout with the virus will affect the situation, but some doctors aren't optimistic. After a few days of treatment at a military hospital, the president tweeted Monday, “Don’t be afraid of Covid. Don’t let it dominate your life. ... I feel better than I did 20 years ago!”After one tough shift on the coronavirus unit at Cox South Hospital in Springfield, Montgomery went onto Facebook to vent her frustrations about caring for patients who didn't socially distance because they didn't believe the virus was real. The hospital later shared her post on its&nbsp;<a href="https://www.coxhealth.com/newsroom/letter-heart-covid-19-nurse/">website</a>.She complained that some people demand the anti-malaria drug hydroxychloroquine and think the only patients who get really sick have underlying health problems.“The majority of people don’t understand and can’t picture what we are seeing. That has been frustrating for all of us,” Montgomery said in an interview, adding: “It wears.”Combating virus skeptics is a battle across the country.In Georgia, at Augusta University Medical Center, visitors have tried to get around the mask requirement by wearing face coverings made of fishnet and other material with visible holes, something the hospital has dubbed “malicious compliance." People also have shown up with video cameras in an attempt to collect proof the virus is a hoax, said Dr. Phillip Coule, the health system's chief medical officer, who contracted the virus in July and has seen two staff members die.“Just imagine that while you are caring for your own staff that are dying from this disease, and while you are trying to keep yourself safe, and you are trying to keep your family safe, and you are trying to deal with a disease that such little is known about, and then to have somebody tell you that it is all a hoax after you have been dealing with that all day," he said. “Imagine the emotional distress that that causes.”He said most skeptics — including some who have argued with him on Facebook — are converted to believers when they get sick themselves. And he is starting to hear fewer people dismiss the virus entirely since the president was diagnosed.“It is unfortunate that the president has contracted the disease, but it is difficult for groups who support the president to be out there saying it doesn’t exist," he said.But he also said he fears people may draw the wrong lesson about the seriousness of the disease from what happened to Trump: "People may extrapolate that the risk for a 74 is low when the reality is the risk to a 74 year-old is quite high."Dr. Beth Oller, who practices family medicine with her physician-husband in rural Kansas' Rooks County, isn't optimistic the president's diagnosis will change much in her community, where cases are on the rise, many resist masks, and weddings with hundreds of guests have been held in recent weeks.“None of the things he did since he had it have helped us a bit, and, if anything, would fly in the face of it," she said, noting that the president took his mask off as soon as he returned to the White House. “All he did was continue to show people that the things we are saying to do are overblown and an overreaction. As a physician, it is so damn frustrating."The issue has been a challenge in red states for months.In Iowa, home health nurse Lisa Dockery was fired from her job caring for a boy with severe disabilities after arguing with his parents, who said COVID-19 is a “hoax.” The argument started because the parents refused to wear masks around Dockery and the boy, even though she told them their son's life was in danger because he has respiratory problems, relies on tube feedings and cannot walk, state unemployment records show.The case ended with a judge ordering her former employer to pay her unemployment.Dr. Gary LeRoy, president of the American Academy of Family Physicians, said he isn’t surprised that it has been so hard to persuade the public, noting that there was also a lot of denial as the Spanish flu was sweeping across the world a century ago, killing tens of millions of people.“When you look at human history, it is what happens in every situation," he said. “In war, in famine, in disease, there is going to be a population of people where the bombs are dropping all around them and they don’t believe that it exists.”Dr. Brad Burmeister, an emergency medicine physician at Bellin Hospital in Green Bay, Wisconsin, said he has encountered a few patients who have declined to be tested for the coronavirus despite having possible symptoms.“They say they don’t want to become a statistic or some kind of rhetoric like that," he said, adding that he thinks a shift might be coming, given what happened to Trump. “It just sort of shows how infectious COVID-19 is and how easily it can spread, that even when you are taking all of those precautions, you can still get infected with the virus."Dr. Natasha Bhuyan, a family physician in Phoenix, said politics often come up in discussions with patients who come in asking whether the death toll is being inflated.“It’s an info-demic as well as a pandemic,” she lamented.Dr. Jay W. Lee, a family physician in Orange County, California, recalled a patient who demanded the “largest hydroxychloroquine prescription you can give me."“If I didn’t have my mask on, he would have seen my mouth agape,” said Lee, chief of the Share Our Selves medical clinics, adding that a small number of patients “flat-out said this was a hoax."He has found himself turning to&nbsp;<a href="https://twitter.com/familydocwonk">social media</a>&nbsp;and meeting with elected leaders to combat some of the misinformation.“I think part of it is we feel like we can’t just sit back and take it because silence is complicity,” he said.

'So frustrating': Doctors and nurses battle virus skeptics

WICHITA, Kan. (AP) — Even as some of the state’s largest districts reopen, most Kansas counties have such a high rate of new coronavirus cases that they have moved into the red zone on a key state benchmark that suggests schools consider putting the brakes on in-person classes and sports.

Seventy-five of the state’s 105 counties were in the worst reopening zone for the&nbsp;<a href="https://www.coronavirus.kdheks.gov/160/COVID-19-in-Kansas" target="_blank">two-week cumulative incident rate</a>, which measures the rate of new cases per 100,000 people and is one of five school reopening indicators established by the state, The Wichita Eagle&nbsp;<a href="https://www.kansas.com/news/coronavirus/article246231905.html" target="_blank">reports</a>. That’s an increase of 10 counties from a week ago, according to a Kansas Department of Health and Environment map published Monday using data through Saturday.

Individual districts aren’t bound by the state gating criteria and can make their own reopening decisions, often with guidance from county-level health officials.

The KDHE case rate map also placed 11 counties in the yellow zone and 16 counties in the orange zone. Under the state’s gating criteria, a blend of in-person, hybrid and remote learning is recommended in these zone. The state also urges restrictions on sports, especially high-risk activities such as football.

The number of counties in the green zone, which is the only zone that calls for all in-person classes and extracurricular activities, dropped from seven to three on the case rate map.

Among the districts sending students back to in-person classes this month are several in Douglas and Johnson counties, which are in the red zone for new cases. But the counties are in the yellow zone for the percent positivity rate.

Meanwhile, Democratic Gov. Laura Kelly called a meeting for Wednesday with eight leaders of the Republican-controlled Legislature to have them extend the state’s existing declaration of a state of emergency for the coronavirus pandemic.

A law enacted in June requires Kelly to obtain an extension every 30 days from the lawmakers, six of them Republicans. Without their approval, the current emergency declaration would expire Oct. 15.

Top Republicans and Kelly have been at odds over her handling of the pandemic, and GOP lawmakers have forced her to accept local control of decisions about reopening schools, mandating mask wearing and restricting businesses and public gatherings. When she and the legislative leaders met in September to extend the emergency declaration, Republicans extracted a promise that she wouldn’t try to close businesses again as she did in the spring.

The state health department reported that Kansas saw 1,597 new confirmed and probable coronavirus cases from Friday to Monday, an increase of 2.5%, bringing the total cases to 62,708. The number of coronavirus cases is thought to be higher because people can be infected without feeling ill and because of limited testing early in the pandemic.

The department also reported eight new COVID-19-related deaths since Friday, bringing the total to 706. Deaths have continued to represent about 1.1% of the total number of reported cases.

Despite the rise in cases, Wichita schools will now allow parents and other fans to be spectators at sporting events, The Eagle&nbsp;<a href="https://www.kansas.com/sports/high-school/article246247110.html" target="_blank">reports</a>. Sedgwick County, where Wichita is located, also is in the red zone for its case rate.

Board member Mike Rodee voiced the most concern with the plan, though he voted for it. He also questioned whether COVID-19 indicators will worsen in the county “because we’re being a little bit selfish about watching a football game.”

“I want to see kids in classrooms and on the field, and I don’t want to shut those things down. The parents are about the 10th priority to me on this,” he said, adding that he understands the point of view of parents. “I want to see kids in the classroom more than I want to see parents in the stadiums.”

WICHITA, Kan. (AP) — Even as some of the state’s largest districts reopen, most Kansas counties have such a high rate of new coronavirus cases that they have moved into the red zone on a key state benchmark that suggests schools consider putting the brakes on in-person classes and sports.Seventy-five of the state’s 105 counties were in the worst reopening zone for the&nbsp;<a href="https://www.coronavirus.kdheks.gov/160/COVID-19-in-Kansas" target="_blank">two-week cumulative incident rate</a>, which measures the rate of new cases per 100,000 people and is one of five school reopening indicators established by the state, The Wichita Eagle&nbsp;<a href="https://www.kansas.com/news/coronavirus/article246231905.html" target="_blank">reports</a>. That’s an increase of 10 counties from a week ago, according to a Kansas Department of Health and Environment map published Monday using data through Saturday.Individual districts aren’t bound by the state gating criteria and can make their own reopening decisions, often with guidance from county-level health officials.The KDHE case rate map also placed 11 counties in the yellow zone and 16 counties in the orange zone. Under the state’s gating criteria, a blend of in-person, hybrid and remote learning is recommended in these zone. The state also urges restrictions on sports, especially high-risk activities such as football.The number of counties in the green zone, which is the only zone that calls for all in-person classes and extracurricular activities, dropped from seven to three on the case rate map.Among the districts sending students back to in-person classes this month are several in Douglas and Johnson counties, which are in the red zone for new cases. But the counties are in the yellow zone for the percent positivity rate.Meanwhile, Democratic Gov. Laura Kelly called a meeting for Wednesday with eight leaders of the Republican-controlled Legislature to have them extend the state’s existing declaration of a state of emergency for the coronavirus pandemic.A law enacted in June requires Kelly to obtain an extension every 30 days from the lawmakers, six of them Republicans. Without their approval, the current emergency declaration would expire Oct. 15.Top Republicans and Kelly have been at odds over her handling of the pandemic, and GOP lawmakers have forced her to accept local control of decisions about reopening schools, mandating mask wearing and restricting businesses and public gatherings. When she and the legislative leaders met in September to extend the emergency declaration, Republicans extracted a promise that she wouldn’t try to close businesses again as she did in the spring.<figure>
 <img src="https://media.eaglewebservices.com/public/2020/10/1601918639222.png" alt="Monday Oct. 5, 2020 KDHE image" />
 <figcaption>Monday Oct. 5, 2020 KDHE image</figcaption>
 </figure>The state health department reported that Kansas saw 1,597 new confirmed and probable coronavirus cases from Friday to Monday, an increase of 2.5%, bringing the total cases to 62,708. The number of coronavirus cases is thought to be higher because people can be infected without feeling ill and because of limited testing early in the pandemic.The department also reported eight new COVID-19-related deaths since Friday, bringing the total to 706. Deaths have continued to represent about 1.1% of the total number of reported cases.Despite the rise in cases, Wichita schools will now allow parents and other fans to be spectators at sporting events, The Eagle&nbsp;<a href="https://www.kansas.com/sports/high-school/article246247110.html" target="_blank">reports</a>. Sedgwick County, where Wichita is located, also is in the red zone for its case rate.Board member Mike Rodee voiced the most concern with the plan, though he voted for it. He also questioned whether COVID-19 indicators will worsen in the county “because we’re being a little bit selfish about watching a football game.”“I want to see kids in classrooms and on the field, and I don’t want to shut those things down. The parents are about the 10th priority to me on this,” he said, adding that he understands the point of view of parents. “I want to see kids in the classroom more than I want to see parents in the stadiums.”

Most Kansas counties enter COVID school red zone

Barton County coronavirus update: 82 active cases

NEW YORK (AP) —The top U.S. public health agency said Monday that the coronavirus can spread more than 6 feet through the air, especially in poorly ventilated and enclosed spaces. But agency officials maintained that such spread is uncommon and current social distancing guidelines still make sense.

However, several experts faulted the updated Centers for Disease Control and Prevention guidance. They said the virus can spread more easily than the CDC seems to be indicating, and suggested that the public should wear masks even in prolonged outdoor gatherings when they are more than 6 feet apart.

The virus “is traveling through the air and there is no bright line. You’re not safe beyond 6 feet. You can’t take your mask off at 6 feet,” said Dr. Donald Milton of the University of Maryland School of Public Health.

For months, the CDC has said that the virus spreads mainly through small airborne droplets when an infected person coughs or sneezes. Most CDC guidance about social distancing is built around that idea, saying that 6 feet is a safe buffer between people who are not wearing masks.

In interviews, CDC officials have also acknowledged growing evidence that the virus can sometimes spread on even smaller particles called aerosols that spread over a wider area.

In the update posted on its website, the agency again acknowledged recent research showing people with COVID-19 infected others who were more than 6 feet away or shortly after an infected person left an area. CDC officials called those ”limited, uncommon circumstances.”

In those cases, spread occurred in poorly ventilated and enclosed spaces where people were doing activities that caused heavier breathing, like singing or exercise, CDC officials said.

People can protect themselves by staying at least 6 feet away from others, wearing a mask, washing their hands, cleaning touched surfaces and staying home when sick

<a href="https://apnews.com/article/virus-outbreak-archive-public-health-cfb43dd5a28dd449cd1100a067cfd112">Last month,</a>&nbsp;the CDC ignited controversy among experts when it quietly posted an update that seemed to suggest the agency’s position had changed, and then within days took it down again.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/9/1600453488360.png" alt="CDC Director Dr. Robert Redfield during testimony before a congressional committee in August -Image courtesy CSPAN" />
 <figcaption>CDC Director Dr. Robert Redfield during testimony before a congressional committee in August -Image courtesy CSPAN</figcaption>
 </figure>NEW YORK (AP) —The top U.S. public health agency said Monday that the coronavirus can spread more than 6 feet through the air, especially in poorly ventilated and enclosed spaces. But agency officials maintained that such spread is uncommon and current social distancing guidelines still make sense.However, several experts faulted the updated Centers for Disease Control and Prevention guidance. They said the virus can spread more easily than the CDC seems to be indicating, and suggested that the public should wear masks even in prolonged outdoor gatherings when they are more than 6 feet apart.The virus “is traveling through the air and there is no bright line. You’re not safe beyond 6 feet. You can’t take your mask off at 6 feet,” said Dr. Donald Milton of the University of Maryland School of Public Health.For months, the CDC has said that the virus spreads mainly through small airborne droplets when an infected person coughs or sneezes. Most CDC guidance about social distancing is built around that idea, saying that 6 feet is a safe buffer between people who are not wearing masks.In interviews, CDC officials have also acknowledged growing evidence that the virus can sometimes spread on even smaller particles called aerosols that spread over a wider area.In the update posted on its website, the agency again acknowledged recent research showing people with COVID-19 infected others who were more than 6 feet away or shortly after an infected person left an area. CDC officials called those ”limited, uncommon circumstances.”In those cases, spread occurred in poorly ventilated and enclosed spaces where people were doing activities that caused heavier breathing, like singing or exercise, CDC officials said.People can protect themselves by staying at least 6 feet away from others, wearing a mask, washing their hands, cleaning touched surfaces and staying home when sick<a href="https://apnews.com/article/virus-outbreak-archive-public-health-cfb43dd5a28dd449cd1100a067cfd112">Last month,</a>&nbsp;the CDC ignited controversy among experts when it quietly posted an update that seemed to suggest the agency’s position had changed, and then within days took it down again.The short-lived post said the virus can remain suspended in the air and drift more than 6 feet, and officials emphasized the importance of indoor ventilation. It also added singing and breathing to the ways the virus can go airborne.Federal health officials later said the post was a mistake and that it had been released before full editing and clearance was completed. They said there was no major change in the agency’s position, but they would finalize a post to clarify the CDC’s thinking. That’s what was posted Monday.A small group of researchers — including Milton — on Monday published a letter in the journal Science that called for clearer public health guidance about how coronavirus spreads in the air.They said health officials need to use clearer language in talking about the size of airborne particles and droplets that can spread the disease, and be more straightforward about the role that viruses in small aerosols can play in infecting people.Masks and good ventilation are crucial indoors. But they can be important outdoors too, said Linsey Marr of Virginia Tech.___

Coronavirus Update