The number of daily U.S. deaths from the coronavirus is declining again after peaking in early August, but scientists warn that a new bout with the disease this fall could claim more lives.The arrival of cooler weather and the likelihood of more indoor gatherings will add to the importance of everyday safety precautions, experts say.”We have to change the way we live until we have a vaccine,” said Ali Mokdad, professor of health metrics sciences at the University of Washington in Seattle. In other words: Wear a mask. Stay home. Wash your hands.The U.S. has seen two distinct peaks in daily deaths. The nation’s summertime surge crested at about half the size of the first deadly wave in April.Deaths first peaked on April 24 at an average of 2,240 each day as the disease romped through the dense cities of the Northeast. Then, over the summer, outbreaks in Texas, California and Florida drove daily deaths to a second peak of 1,138 on Aug. 1.Los Angeles Unified School District students stand in a hallway socially distance during a lunch break at Boys & Girls Club of Hollywood in Los Angeles, Aug. 26, 2020.Some states — Florida, Georgia, Mississippi, Nevada and California — suffered more deaths during the summer wave than during their first milder run-in with the virus in the spring. Others — Michigan, Pennsylvania, Maryland and Colorado — definitely saw two spikes in infections but suffered fewer deaths the second time around.Now about 700 Americans are dying of the virus each day. That’s down about 25% from two weeks ago but still not low enough to match the early July low of about 500 daily deaths, according to an Associated Press analysis of data compiled by Johns Hopkins University.The number of people being treated for COVID-19 in hospitals in the summertime hot spots of Florida and Texas has been on a steady downward trend since July.In Florida, the number of COVID-19 patients Thursday morning was less than 3,000 after peaking at more than 9,500 on July 23. Two weeks later, the state reached its highest seven-day average in daily reported deaths.In Texas, about 3,500 people were hospitalized with COVID-19 on Thursday, a measure that’s been improving since peaking July 22 at 10,893.Worryingly, a dozen states are bucking the national downward trend. Iowa, North Carolina, West Virginia and Kansas are among states still seeing increases in daily deaths, although none is anywhere near the death rates seen in the spring in the Northeast. Back then, the virus caught New York off guard and claimed 1,000 lives per day in that state alone, or five deaths per 100,000 people.”Often, it’s hard to understand the trends when looking at the whole country,” said Alison Hill, an infectious disease researcher at Harvard University. She noted that daily deaths are still rising in some metro areas, including Memphis, Sacramento, San Francisco and San Jose.”We’re at a really critical point right now,” Hill said. “Schools are reopening. The weather is getting colder, driving people indoors. All those things don’t bode particularly well.”What’s ahead may be worse because the virus is likely to have a seasonal swing similar to other respiratory illnesses, Mokdad agreed.”In the Northern Hemisphere, it’s hard to say we were lucky, but we were lucky that COVID-19 came at a time when seasonality was helping us,” he said.Bar and restaurant owners and workers protest against Covid-19 related restrictions in their sector in Madrid, Spain, Sept. 9, 2020.Similar fears grip Europe. The number of new confirmed coronavirus cases spiked Friday in parts of eastern Europe, with Hungary and the Czech Republic registering all-time daily highs. Signs of the pandemic’s resurgence were also evident in Britain and the Netherlands. Hungarian Prime Minister Viktor Orban said his government was drafting a “war plan” to defend against another wave of infection.Spain’s health minister pushed back against comments by President Donald Trump, who claimed Thursday that the United States had done “much better” than the European Union in fighting the pandemic.”No one is in a position to give lessons, and with all due respect to the American nation, less so its current president,” Salvador Illa told Spanish public broadcaster TVE on Friday. “You have to be very careful when making international comparisons. Each country has its specificities when it comes to providing the data.”Scientists do not yet know how much credit, if any, to give to treatment improvements for the decline in daily U.S. deaths. Doctors now use drugs such as remdesivir and tricks such as flipping patients from their backs to their stomachs.But gains seen on hospital wards are hard to document with national data. Strangely, the death rate for patients admitted to the hospital has not improved, Mokdad said. It’s possible that sicker patients are now being admitted to hospitals compared with earlier in the year, while healthier patients are treated at home. That would make it hard to see an improvement in the rate of deaths once patients are admitted to the hospital.Others insist better treatments must be making a difference.”We have many more tools in September of 2020 than we did in March of 2020,” said Dr. Amesh Adalja, an infectious diseases expert at the Johns Hopkins Center for Health Security in Baltimore.And nursing homes are safer, Adalja said. Early in the epidemic, hospitals discharged patients with coronavirus into nursing homes full of vulnerable people. “We’ve learned from those mistakes,” Adalja said.Vigilance is the byword for fall, Mokdad said.”This is a deadly virus. It’s very opportunistic,” he said. “It waits for us to make a mistake.”
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Cases of COVID-19 are “increasingly rapidly among young adults in the U.S.,” according to a research letter from Harvard, published at the online site of the JAMA medical journal.The study included 3,222 young adults between the ages of 18 and 34.The investigation found that the young adults “experienced substantial rates of adverse outcomes: 21% required intensive care, 10% required mechanical ventilation, and 2.7% died.”Patients with morbid obesity, hypertension, and diabetes were at “greater risks of adverse events.” The young adults with more than one of the conditions, the researchers found, “faced risks comparable with those observed in middle-aged adults without them.” Black and Hispanic patients made up more than half of the patients who required hospitalization.A separate Centers for Disease Control and Prevention report says an investigation of symptomatic outpatients from 11 U.S. health facilities found that people who tested positive for COVID-19 were twice as likely to have reported dining at a restaurant than those who tested negative.British Prime Minister Boris Johnson announced this week his government will launch an ambitious program to test at least half a million people daily for COVID-19, with the results back within minutes.  Johnson said he hoped the “moonshot” program — a reference to the 1960s-era American manned lunar landing program — will be in place before the end of the year, and would return Britain to some sort of normality and grant more freedom to those who test negative for the coronavirus.Johnson coupled the announcement of the mass testing initiative with a new order limiting the number of people taking part in most social gatherings to six, from the current 30.The new limit would take effect next week, as Britain is experiencing a surge of nearly 3,000 new COVID-19 cases daily in recent weeks, the highest daily figures since May.Britain’s Chief Medical Officer Chris Whittey says the new “rule of six” restrictions are likely to remain in place for several months.Johns Hopkins University reports there are more than 28 million cases of COVID-19 cases worldwide with more than 900,000 deaths.The U.S. continues to lead the world in the infection numbers with almost 6.4 million cases and more than 191,000 deaths.  
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This September 11 is different. Every year, Americans have remembered the largest terrorist attack on American soil by coming together – to read names, to pray, to hold hands.  But this year, one of the most trusted remedies for grief – togetherness – is not available because of the worldwide coronavirus pandemic. In New York City, even the twin columns of light that traditionally shine into the Manhattan sky on the anniversary will not appear this year. A spokesman for the National September 11 Memorial and Museum told the New York Times that the decision was made in order to avoid the health risks of a crew of nearly 40 people working closely together to install the lights. One could argue that the pandemic, like 9/11, has changed everything. FILE – Spectators look across the Hudson River from Jersey City, N.J., at the Sept. 11 tribute lights in New York City on the 18th anniversary of the attacks on the twin towers of the World Trade Center, Sept. 11, 2019.Seven months into social distancing and stay-at-home orders, long after many Americans expected things to have returned to normal, the stress of the pandemic has taken its toll. A study published earlier this month in the Journal of the American Medical Association found that the prevalence of depression in April was three times higher nationwide than it had been before the start of social distancing. The researchers conducting the survey, including lead author Catherine Ettman, noted that by mid-April, 42 U.S. states, accounting for 96% of the population, were under stay-at-home or shelter-in-place advisories. The crisis has touched nearly everyone. “We found that over one quarter of Americans reported depression,” she said in a phone interview Wednesday. “This was a threefold increase from before COVID.” Acute vs. chronic stressors Dana Rose Garfin of the University of California at Irvine has studied populations linked to 9/11 and to the pandemic. She said this week, also in a phone interview, that the distinction between the two crises is clear. “With 9/11 it’s an acute stressor,” she said. “It had a clear beginning and end. The pandemic is different because it’s chronic.” “This is not just one event,” Ettman said. “This is COVID and fear and anxiety around COVID, as well as its dramatic consequences.” Those consequences include loss of loved ones, loss of jobs, and in some cases loss of a sense of security. The study notes that the people most likely to be affected by depression were those who were lower income and had less than $5,000 in savings. FILE – A man walks past a “we give up” sign outside a shop that closed permanently because of the COVID-19 outbreak, in Salt Lake City, May 8, 2020.“The economic consequences of this moment,” Ettman said, “may perpetuate stressors. For example, stressors such as the death of someone close to you due to COVID, losing a job, having difficulty paying rent, having family problems, financial difficulties. Those were associated with higher rates of depression, and in fact people who had higher stressor scores were three times more likely to experience depression.” Ettman added, “Stress is cumulative.”  In some ways 9/11 was easier to bounce back from because after a few hours of terror and more weeks of uncertainty, it seemed to be over. There was a distinctly defined time to heal.  “After 9/11, we did not see the high levels of pathology that we expected to see,” Garfin said. She was lead author on a long-term study of 9/11 effects published in 2018. “The thing about acute trauma is, it’s a little bit different. After it’s over there’s a natural healing process.” “The pandemic is different because it’s ongoing,” Garfin continued. “It’s not giving people a chance to recover. The stress is unrelenting.” And in some cases, stress brings the threat of self-harm. “Evidence shows that financial strain is linked to higher rates of suicidal ideation,” Ettman said. Help is possible While it is impossible to control stressful events, there are things communities and governments can do to help. For a start, meeting people’s basic needs, according to Dr. Ruth Shim of the University of California at Davis. In a companion piece to Ettman’s study, she wrote, “Because of the inadequate structure of safety net systems in the U.S., lack of employment can lead to increasing poverty, loss of health insurance, housing insecurity, and food insecurity. These social determinants have been exacerbated for many families and communities during the COVID pandemic.” Shim argued that the study on mental health should remind Americans of the importance of investing in people’s basic needs – stable housing, unemployment benefits, access to healthy food and policies that prevent discrimination – as a first step toward managing mental illness. Garfin had similar thoughts. “Always, the first thing you have to do is treat physical needs. … And once you can get people stable with that, you can address their psychological stressors.” She said while it can be useful to reach out with psychological help to someone who has lost his or her job, the bottom line remains: “They need a job.” The elderly collect fresh produce and shelf-stable pantry items outside Barclays Center as Food Bank For New York City provides assistance to those in need due to the COVID-19 pandemic, in New York, Sept. 10, 2020.Ettman said public health officials can do three things to help, particularly with people with fewer resources: Create awareness, by alerting people to the fact that they are at risk for depression and may in fact be suffering from it. Second, she said, “provide opportunities to screen people and identify those with poor mental health. Third, ensure that there are sufficient opportunities to seek treatment.” If this doesn’t happen, Ettman and Garfin both warned, the impact on public health could be serious – and expensive. A 2018 study from Penn State University found that a single poor mental health day –  when a person describes their mental health as not good – in a month was associated with a 1.84% drop in a person’s income growth rate – and in rural areas, the average drop was 2.3%.  The same study found that the global economic cost of mental illness is expected to be more than $16 trillion over the next 20 years, which is more than the cost of any other noncommunicable disease. And that study was done before the pandemic had begun.  But there is hope. Ettman and Garfin agree that meeting people’s basic needs can go a long way toward preserving mental health.  “The best thing the country can do is create the healthiest conditions for people to live in,” Ettman said. “This would call for doubling down on our societal investment in supporting people through difficult times.” More personally, Ettman said she hopes people will reach out for help if they need it. “If somebody is feeling depressed and they read this, I want them to know medical care can help.” Garfin, too, offered encouragement. For those whose basic needs are met but whose mental health is suffering, she noted that exercise can provide relief, as well as spending time outdoors, doing good deeds for others, and using technology to connect with family and friends.  “Even though the tunnel is long, it really isn’t going to last forever,” she said.  “If we all come together, we can get through it. We did that after 9/11. … We don’t have any reason to think this will be any different.” If you are struggling with depression or thoughts of suicide, contact the National Alliance on Mental Health for help or call the National Suicide Prevention Lifeline at 800-273-TALK (8255).
 
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NASA on Thursday launched an effort to pay companies to mine resources on the moon, announcing it would buy from them rocks, dirt and other lunar materials as the U.S. space agency seeks to spur private extraction of coveted off-world resources for its use. NASA Administrator Jim Bridenstine wrote in a blog post accompanying the announcement that the plans would not violate a 1967 treaty that holds that celestial bodies and space are exempt from national claims of ownership. FILE – NASA Administrator Jim Bridenstine talks to multiple media outlets at NASA’s Jet Propulsion Laboratory in Pasadena, California, Nov. 26, 2018.The initiative, targeting companies that plan to send robots to mine lunar resources, is part of NASA’s goal of setting what Bridenstine called “norms of behavior” in space and allowing private mining on the moon in ways that could help sustain future astronaut missions. NASA said it views the mined resources as the property of the company, and the materials would become “the sole property of NASA” after purchase. Under NASA’s Artemis program, President Donald Trump’s administration envisions a return of American astronauts to the moon by 2024. NASA has cast such a mission as a precursor to a future first human voyage to Mars. “The bottom line is we are going to buy some lunar soil for the purpose of it demonstrating that it can be done,” Bridenstine said during an event hosted by the Secure World Foundation, a space policy organization. Bridenstine said NASA eventually would buy more types of resources such as ice and other materials that may be discovered on the moon. NASA in May set the stage for a global debate over the basic principles governing how people will live and work on the moon, releasing the main tenets of what it hopes will become an international pact for moon exploration called the Artemis Accords. This would permit companies to own the lunar resources they mine, a crucial element in allowing NASA contractors to convert the moon’s water ice for rocket fuel or mine lunar minerals to construct landing pads. ‘Giant leap’ for policy, precedentUnder the initiative disclosed on Thursday, NASA offered to purchase limited amounts of lunar resources and asked companies to offer proposals. Under contracts whose terms would vary, a company mining on the moon would collect lunar rocks or dirt to sell to NASA without having to bring the resources back to Earth. “This is one small step for space resources, but a giant leap for policy and precedent,” Mike Gold, NASA’s chief of international relations, told Reuters. “They are paying the company to sell them a rock that the company owns. That’s the product,” Joanne Gabrynowicz, former editor-in-chief of the Journal of Space Law, said in an interview. “A company has to decide for itself if it’s worth taking the financial and technological risk to do this to sell a rock.”
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