November 19 coronavirus news

The Smithsonian National Portrait Gallery stands on March 17 in Washington DC.

The Smithsonian Institute just announced it will be closing all Smithsonian museums and the National Zoo starting Monday. The move is a direct response to the rising number of Covid-19 cases across the Washington, DC, area and the country.

This will be the second time the museums have closed to the public this year. Both the museums and the zoo closed in March and had a limited reopening in September.

The Smithsonian did not announce a planned date to reopen.

A press release issued by the Institute Thursday said, “Visitors who had reserved timed-entry passes to visit at a future date are being contacted directly.”

The US Holocaust Museum in Washington, DC, also announced it would shut its doors on Monday.

The guided missile destroyer USS Michael Murphy (DDG 112) arrives at Joint Base Pearl Harbor-Hickam in Hawaii on November 21, 2012.

There has been a major coronavirus outbreak aboard a US Navy guided missile destroyer.

The virus has spread to nearly a quarter of the USS Michael Murphy’s 300-person crew, according to a US Navy official.

The ship has been in port in Hawaii so there has been limited operational impact due to the outbreak.

The US Navy did not immediately respond to a request for comment. NBC was first to report the outbreak aboard the ship.

CNN reported on Wednesday that the US military reported a record high number of coronavirus cases on Tuesday with 1,314 new cases, according to Defense Department statistics.

There are currently about 25,000 active Covid-19 cases in the ranks, and another 44,390 service members have recovered from the virus, according to the Pentagon. The number of military cases has grown over the last few weeks as case counts have increased in the general population.

Assisted living facilities have been a hotspot for Covid-19 deaths in this pandemic.

By Oct.15, the proportion of Covid-19 cases that were fatal in these facilities was at least 21%, a new report from the US Centers for Disease Control and Prevention found.

It is likely higher, but only 39 states track these deaths. For perspective, for the general population, only 2.5% of Covid-19 cases end in death, the CDC noted.

The CDC has been tracking cases in skilled nursing facilities. Those institutions where residents need more care have a federal reporting requirement if they get a Covid-19 case. There is no such requirement for assisted living facilities, where the seniors live more independently, but get some assistance with bathing, housekeeping, and medication management.

From this new CDC data published Thursday in the Morbidity and Mortality Weekly Report, researchers found 22% of all assisted living facilities had one or more Covid-19 cases among the residents or staff.

Residents are at a higher risk for Covid-19 because they live in close proximity with other community members. Their advanced age and underlying conditions put them at a higher risk for a more severe disease.

To prevent the spread of Covid-19 in these facilities, the CDC recommends that each facility identify a point of contact at the local health department so they have a relationship if there is an outbreak. Managers should educate residents, staff, and residents’ families about Covid-19.

They should have a plan for when the facility needs to restrict access for families and staff. The facilities should encourage the use of masks and social distancing, as well as step up infection control and find ways to rapidly identify and respond to cases.

Customers wear masks at the Farmers Market in Key West, Florida on September 17.

The city of Key West, Florida, will now require face masks to be worn outside, regardless of social distancing.

The city announced the move in a tweet following a commission meeting on Thursday.  

As of Wednesday, Key West has had 1,382 total Covid-19 cases, Mayor Terri Johnston said during a weekly update on Facebook.  

The island city has a population of 24,565, according to the US Census Bureau.  

“It’s [going to] take a collective effort of each and every one of us in order to get our numbers down,” Johnston said ahead of Thursday’s commission meeting. 

A general view of the Centers for Disease Control headquarters is seen in Atlanta on April 23.

The US Centers for Disease Control and Prevention recommends that Americans should not travel for Thanksgiving, and has posted updated guidelines for safely celebrating the holiday.

“CDC is recommending against travel during the Thanksgiving Day period,” Dr. Henry Walke, Covid-19 incident manager for the CDC, told reporters in a conference call.

Walke warned that if people gather in multiple generations, someone in that gathering could have diabetes or kidney disease, or simply be older and more vulnerable.

“What is at stake is the increased chance of one of your loved ones becoming sick and then being hospitalized and dying around the holidays,” Walke said.

Plus, about 40% of infections are asymptomatic. 

Walke said he is not visiting his own family. “I haven’t seen my parents since January. I’m staying home and I have older parents who would like to see me and who would like to see my children as well,” he said.

The CDC also advised that students who have been away at college don’t count as household members and need to keep their distance when they come home for holidays.

The same goes for people who have been away on military duty. 

“People who have not been living in your household for the 14 days before you are celebrating should not be considered members of your household and so you should take those extra precautions, even wearing masks within your own home,” Dr. Erin Sauber-Schatz, the CDC’s lead for Community Intervention and Critical Population Task Force, told reporters.

Families can also ask college students or other people who would normally be loosely considered household members to quarantine as much as possible for 14 days before coming home.

Safer gatherings can be held outside as much as possible, the CDC recommends. People can wear masks when together, and place chairs and furniture farther apart.

The White House coronavirus task force will hold a press briefing at 4 p.m. ET today, according Vice President Mike Pence’s office. 

It is unclear whether or not President Trump will attend. 

The briefing comes a day after the US death toll from coronavirus surpassed 250,000 deaths. In less than 10 months, Covid-19 has killed more people than strokes, suicides and car crashes typically do in a full year — combined.

German Finance Minister Olaf Scholz

German Finance Minister Olaf Scholz said Thursday that the country’s new restrictions are already helping and the country is on “the right path.” However, he warned “there is nothing someone can say about the next month because no one knows what the virus will do.”

Germany is in a nationwide partial lockdown that requires restaurant and bars to remain closed. It also requires people to avoid travel, “keep their contacts to an absolute minimum” and limit public meetings to members of two different households.

Schools and shops have remained open. German federal and state leaders will meet next week to decide on introducing further restrictions. 

Speaking in an exclusive interview with CNN’s Richard Quest, Scholz said that he is “quite confident” about the economic future.

CNN’s Eleanor Pickston contributed to this report.

Delirium was common among elderly patients with Covid-19 who came to the emergency department, according to a study published Thursday in JAMA Network Open, and many of them did not have other typical signs or symptoms of the disease.

“In this multicenter retrospective cohort study, 28% of 817 older patients with Covid-19 infection had delirium on arrival to the ED, and delirium was the sixth most common presenting symptom or sign overall,” read the study, from lead authors Dr. Maura Kennedy of Massachusetts General Hospital and Harvard Medical School and Benjamin Helfand of the University of Massachusetts Medical School.

“Delirium at presentation was significantly associated with increased risk for poor hospital outcomes, including ICU stay, discharge to a rehabilitation facility, and death,” the study said.

Of the 226 patients with delirium, 37, or 16%, had delirium as their primary symptom. Importantly, the authors said, 84 of those 226, or 37%, had no fever or shortness of breath. 

More on the study: The study was conducted at seven sites across the United States and included older adults who went to emergency departments on or after March 13. 

Some of the factors associated with delirium included being older than 75, living in a nursing home or assisted living facility, prior use of psychoactive medication, vision or hearing impairment, stroke and Parkinson’s disease. 

“Our study demonstrates that it is critical to recognize that older adults with Covid-19 may present with delirium as the primary or sole symptom,” the study says. “In addition, delirium is an important risk marker to identify patients at high risk for poor outcomes, including death.” 

Remember: The study does have some limitations, including the fact that they suspect that the delirium rate observed is an underestimate, they were unable to evaluate site-specific data and enrollment occurred primarily in the Northeast during a time when it was undergoing a surge in Covid-19 infections. 

New York City Mayor Bill de Blasio speaks during a press conference in New York on November 19.

New York City Mayor Bill de Blasio said he expects New York Gov. Andrew Cuomo will close indoor dining and gyms in the next week or two.

The mayor said in a news conference this morning that after speaking with the governor at length yesterday and with cases showing a clear uptick, the city will move to the orange zone. In that zone, indoor dining and gyms will be closed.  

The mayor also reiterated, “We will bring our schools back, but we have to reset the equation.”

Yesterday, de Blasio announced that the city’s public schools would close today as coronavirus cases rise in the city.

De Blasio said for those who might feel a little better if they knew indoor dining and gyms were going to be closed, “It’s just a matter of time.” 

This comes after the governor said Wednesday New York City’s Covid-19 numbers could warrant putting the city into an orange zone soon.  

Chairman of the NYC Council Health Committee, Mark Levine responds:

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Karin Smith.

Karin Smith, a Florida resident and single mom of a 14-year-old boy, is one of millions of Americans who may lose expanded unemployment benefits on Dec. 26.

She said she is able to qualify for food stamps, but has given up on going to food banks because “if they open at 9, you have to be there at 5 a.m. to hope to get anything.” 

Smith previously worked for the Department of Education in data compliance and has been searching for a new job.

“It’s not laziness … A job making $8 an hour is not going to pay my $1,650 rent, let alone all the other expenses I have because I had a good job,” she said. 

Smith said her son is old enough to understand her stress and has tried to help with his own suggestions, like buying a motor home and moving them into it because he doesn’t want to lose their dog or cat. 

Watch:

The economic fallout of the Covid-19 pandemic is driving up food insecurity across America.

“What we’ve seen, has been, unfortunately, a steady level of greatly, significantly increased need, since the pandemic started,” said Katie Fitzgerald, Chief Operating Officer of Feeding America.

Feeding America, the nation’s largest hunger-relief organization, says more than 54 million people in the country could soon face food insecurity. That is 17 million more than before the coronavirus outbreak. The non-profit has seen a 60 percent increase in food assistance needs since March.

Several federal programs are available to help people make ends meet during these difficult times.

If you, or someone you know, is one of those people facing food insecurity at the moment, CNN has a list of resources that can help. You can see the full list here.

An ensemble forecast published Thursday by the US Centers for Disease Control and Prevention now projects there will be 276,000 to 298,000 coronavirus deaths in the United States by Dec. 12.

Unlike some individual models, the CDC’s ensemble forecast only offers projections a few weeks into the future.

The previous ensemble forecast, published Nov. 12, projected up to 282,000 coronavirus deaths by Dec. 5.

At least 250,652 people have already died from Covid-19 in the United States, according to data compiled by Johns Hopkins University.

A health care worker at Los Angeles International Airport in California places a Covid-19 nasal swab test into a specimen bag on November 18.

The US just surpassed a tragic milestone of more than 250,000 coronavirus deaths and more than 11.5 million infections nationwide, according to data from Johns Hopkins University.

Just how bad things could get will be determined by Thanksgiving celebrations next week. Health officials have warned against traditional indoor gatherings that seem to be a big driver in the surge of cases.

Each family will need to weigh the risks of celebrating Thanksgiving in person or virtually depending on individual circumstances. As well as taking precautions like masks and hand sanitizer, Dr. Sanjay Gupta has said the dose of the virus you receive might make the difference between being asymptomatic, getting mildly sick or becoming critically ill.

Another way to think of it is like conception: You don’t need millions of sperm to fertilize an egg – you only need one – but men make millions of sperm to improve the chances that one will reach the egg, overcome its defenses and fertilize it.

“Each person has a different amount of virus that they need,” explains Erin Bromage, an associate professor of biology at the University of Massachusetts, Dartmouth.

Put it all together, and the chance of infection depends on the physiology of the potential host, as well as their personal behaviors and health habits such as smoking status, diet, physical activity and sleep. An elderly or unhealthy host in the face of large, recurrent exposures is clearly the worst case scenario. But a medically fragile person could be sickened by even a low dose of virus; conversely, a healthy person can be overwhelmed with a high enough dose.

If you are planning on gathering with family or friends this holiday season, CNN’s Dr. Leana Wen explain some of the safest ways to do so in this video.

US stocks opened lower on Thursday. Investors are worried that the resurgence in Covid-19 cases are clouding the economic outlook.

Weekly jobless claims data from the Labor Department didn’t help matters either: First-time claims for regular state benefits rose for the first time in about a month and were higher than expected.

Here’s where things stood at opening:

Dr. David Burkard.

A healthy 28-year-old emergency room doctor thought he would be fine if he contracted coronavirus. But he went from running nearly every day to being barely able to walk or catch his breath after getting the virus.

After five days with symptoms of Covid-19, Michigan physician Dr. David Burkard said he could not breathe on the sixth day and needed to be hospitalized in the same place where he treats patients. 

Burkard also said that someone reported him to Facebook for spreading “hoax” information. He encouraged people to wear masks and stay home for Thanksgiving. 

“Instead of just like saying mean things from behind the keyboard … imagine what it’s like to have that conversation with someone — that you are putting a breathing tube down their throat and they may not be able to say ‘I love you’ to their loved one again — and that’s what we’re doing every day, constantly,” he said. 

Watch:

Dr. Anthony Fauci arrives for a hearing in Washington, DC, on June 30.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told NPR’s Rachel Martin on Morning Edition Tuesday that his Thanksgiving will be “significantly” different this year than previous holidays.

His three adult daughters, who live in separate parts of the country, got together and said that they did not want to put him, as an elderly person, at risk. Fauci is 79 years old. 

He and his wife will have a meal and Zoom with his daughters to spend time with them.

“I don’t like it that way, but I think they’re making a prudent decision in trying to protect their father and I’m proud of them for that,” he said. 

A person checks information displayed at an Illinois Department of Employment Security workNet center in Arlington Heights on November 5.

The pandemic is far from over as infections are on the rise and millions of Americans remain unemployed.

At least 742,000 Americans filed for first-time unemployment benefits on a seasonally adjusted basis last week, the Labor Department reported on Thursday.

That was a up from the week before and the first increase in unemployment claims since the week of Oct.10.

Meanwhile, 320,237 workers filed claims under the Pandemic Unemployment Assistance program, which is designed to help those who aren’t usually eligible for jobless benefits, such as the self-employed. That number also rose from the prior week.

Added together, first-time claims stood at 1.1 million, not adjusted for seasonal changes.

Continued jobless claims, which count people who have applied for benefits for at least two weeks in a row, came in at 6.4 million.

Economists worry that a growing number of people are exhausting their states’ regular jobless benefits, which commonly last for 26 weeks. After that, the unemployed get rolled onto other government programs, including the Pandemic Emergency Unemployment Compensation program.

People walk past a public school in New York on November 18.

New York City is closing down its public school buildings starting today after the city’s 7-day average reached the 3% positive testing rate threshold. All students will transition to remote learning.

Mayor Bill de Blasio tweeted yesterday that schools are being closed out of “an abundance of caution.”

New York City is the largest public school district in the country.

New York Gov. Andrew Cuomo said during a briefing on Wednesday that the state is in a “dangerous” situation and a number of factors could fuel a surge in positive cases. Cuomo cited Covid-19 fatigue, cold weather keeping people indoors and the upcoming holidays as possible factors.

Cuomo said that reopening schools in NYC would require a different plan than the rest of the state because by sheer volume it wouldn’t be possible to test every student in the city.

Minks look through their cage on a farm in Bording, Denmark, on November 7.

No further cases of the mutated strain of coronavirus have been found in Danish minks, leading scientists to believe that the strain has “most likely become extinct.”

The Danish Health Ministry said that mink in seven municipalities have now been killed and temporary restrictions on people can be relaxed.

The discovery of the virus in mink earlier this month prompted authorities to order all mink in Denmark to be culled.

The Danish Medicines Agency said it is “unlikely” that the mutated form of coronavirus will have any significant impact on the efficacy of the first generation of vaccines.

Danish officials had previously expressed concern that the outbreak in mink could pose a risk to vaccine efficacy.

The World Health Organization’s Senior Emergency Officer in Europe, Catherine Smallwood, reiterated on Thursday that culling was an “appropriate measure.”

However, the culling sparked a government backtrack after it discovered it had no legal authority to mandate the killing of mink of farms that did not have cases of coronavirus. Instead the government was only able to make a recommendation to farmers.

A medical worker waits for patients at a Covid-19 testing center in Warsaw, Poland, on October 22.

Poland has registered a record number of Covid-19 deaths for a second day in a row, according to new data from the country’s Health Ministry.

Figures released on Thursday show a further 637 people died, compared to the 603 deaths reported on Wednesday.

Overall, Poland’s death toll from the pandemic has reached 12,088. 

The country reported 23,975 new coronavirus cases in its Thursday update, bringing the total to 796,798 since the pandemic began. 

On Wednesday, the WHO listed Poland as having one of Europe’s highest mortality rates (60 people per 1 million).

Quarantine for Americans is a much more difficult concept to grapple and come to terms with, compared to Asian countries such as China or South Korea, where there is a more entrenched infectious disease prevention policy.

But should Americans feel like that? After all, quarantines were strictly observed in Italy, New Zealand and Spain. Even Canadians are confounded as to why Americans seem to feel quarantine is a breach of civic freedom.

Lambeth Hochwald, a New York City-based writer and professor of journalism at New York University has spoken to a Singaporean and Canadian about how they view Americas reticence to quarantine.

“What worries me looking at our good neighbors to the south is that the deep divisiveness that exists now seems to be mitigating against something we take for granted here, this common good, this belief that we’re all in this together. We’re each other’s neighbors, and it’s our obligation to not make somebody else ill if we can help it.”

Related article Are American adults capable of quarantining?

Lothar Wieler, president of the Robert Koch Institute, attends a news conference in Berlin on November 19.

German Covid-19 infections are still “too high,” the Robert Koch Institute for infectious diseases (RKI) said on Thursday.

Lothar Wieler said Germany “cannot afford to have higher Covid-19 numbers” and that while the numbers has stabilized, the country has not yet “turned a corner.”

Wieler, however, did add that he was “optimistic that the positive trend of Covid-19 cases would continue.”

The news was not all so positive, with some grisly figures coming out of Germany.

Ute Rexroth, head of RKI’s surveillance unit, added that while the new restrictions were working, Covid-19 deaths and patients in ICU were rising.

The number of people in ICU’s was at an all-time high of 3,561 and cautioned that Germany could see “1,000 deaths” a day.

According to RKI data, Germany recorded 22,609 new coronavirus cases with 251 more deaths.

Hospital beds sit inside Renown Regional Medical Center's parking garage, which has been transformed into an alternative care site for Covid-19 patients in Reno, Nevada on November 11.

An end to the Covid-19 pandemic may now be in sight with more good news on vaccine candidates, but for now “this will get worse,” a top US official said Wednesday.

It is what experts have repeatedly warned in the past weeks, as Covid-19 conditions continue to deteriorate across the country: things will get worse before they get better.

Infection numbers in Massachusetts are eight times what they were on Labor Day and hospitalizations have quadrupled. Only 6% of Oklahoma’s ICU beds remain available. In Arkansas, more than 1,000 people could lose their lives in the next five weeks, according to the governor. In Illinois, the virus is now the third leading cause of death behind heart disease and cancer.

More than 250,000 Americans have so far died of the virus – a higher death toll than any other country – and another 188,000 are projected to lose their lives over the next three and a half months, according to the University of Washington’s Institute for Health Metrics and Evaluation. By mid-January, the IHME model predicts more than 2,100 Americans could be dying daily.

“As you’ve heard so many times before, we know how to fix this,” Giroir told CNN Wednesday night. “It’s all about absolute adherence to wearing a mask, avoiding crowds, and yes, we can keep the economy open but we’re going to have to diminish indoor places like indoor dining and restaurants.”

Read the full story:

MILWAUKEE, WISCONSIN - NOVEMBER 17: Residents line up in their cars at a COVID-19 test center on the grounds of Miller Park on November 17, 2020 in Milwaukee, Wisconsin. Wisconsin recently reported a seven-day average COVID-19 positivity rate of nearly 40%. (Photo by Scott Olson/Getty Images)

Related article 'This will get worse.' A top US official says hospitalizations and deaths will keep climbing as Covid-19 cases explode nationwide

Ciara Sase, RN, with Grover Wilhelmsen as his holds a musical instrument.

A retired orchestra teacher battling Covid-19 in a Utah hospital turned to his true passion – music – to help spread some joy in the ICU.

Even while being intubated and unable to speak, Grover Wilhelmsen wanted to show his gratitude to the health care workers at McKay-Dee Hospital in Ogden. 

The 70-year-old patient used pen and paper to communicate with a nurse and had one request.

While the request took some planning and approval by doctors, Sase was ultimately able to grant him his wish. She stayed in his room and monitored him as he played church hymns and the “Tennessee Waltz,” according to the news release.

Read more.

A volunteer receives an injection at a hospital in Johannesburg, South Africa on June 24 as part of Africa's first participation in a Covid-19 vaccine trial developed at the University of Oxford in Britain in conjunction with the pharmaceutical company AstraZeneca.

AstraZeneca’s experimental coronavirus vaccine appears to work safely in older people, generating as strong an immune response in those over the age of 70 as it does in younger people, British researchers reported Thursday.

The Phase 2 trial did not show whether the vaccine protected volunteers from infection, but it generated an immune response that would be expected to provide protection, the researchers reported in the Lancet medical journal.

AstraZeneca, which developed its vaccine with researchers at Britain’s Oxford University, is testing its vaccine in Phase 3 clinical trials around the world – the last stage before seeking regulatory approval.

The results: The Phase 2 results published Thursday involved 560 volunteers aged 18 and up; 240 of them over 70. That’s important, because older people are more likely to develop severe disease and to die from infection. 

How does the vaccine work? ChAdOx1 is the vaccine’s experimental name. It’s made differently from the Pfizer and Moderna vaccines. It uses a modified cold virus called an adenovirus, but it’s one that infects chimpanzees and doesn’t make people sick. The virus is genetically engineered to carry a little piece of the coronavirus into the body and train the immune system to recognize and attack it.

The vaccines prompted the body to produce both antibodies and immune cells called T-cells. “The robust antibody and T-cell responses seen in older people in our study are encouraging. The populations at greatest risk of serious Covid-19 disease include people with existing health conditions and older adults,” Dr. Maheshi Ramasamy of the University of Oxford, who worked on the study, said in a statement.

Some context: The study comes after two Covid-19 vaccine candidates in the US reported 95% efficacy. Pfizer says it expects to seek emergency use authorization from the US Food and Drug Administration for its vaccine on Friday, and Moderna says it also plans to seek authorization soon.

Russia surpassed 2 million Covid-19 cases on Thursday, according to data from the country’s coronavirus response center. 

In the past 24 hours, Russia officially reported 23,610 new cases of Covid-19 and 463 deaths – both the highest daily increase since the beginning of the pandemic. 

Russia’s official caseload stands at 2,015,608 on Thursday, with 34,850 deaths, although independent observers and critics have cast doubts on the country’s counting methods. 

Read more about Russia’s Covid crisis:

CNN's Matthew Chance with Andrey Shkoda, the chief doctor of Krylatskoye field hospital in Moscow, in November 2020.

Related article How bad is Russia's Covid crisis? Packed morgues and excess deaths tell a darker story than official numbers suggest

Masks are advertised near a handwashing station amid a surge of coronavirus cases in the city on November 18, in El Paso, Texas.

Americans could make the holidays into a turning point for the coronavirus pandemic by masking up and following other tried and true safety precautions, the Infectious Diseases Society of America said Wednesday.

The group said virtual gatherings remained the safest way to bring friends and family together from distant points, while outdoor settings could reduce the risks of gathering with people from other households.

It urged people who had been exposed to an infected person to stay in quarantine for two weeks. “If you have been infected, you should remain isolated until it has been determined that you are no longer infectious,” the group said.

“All these measures will remain essential to advances against this pandemic even after the development and distribution of a safe and effective vaccine,” it said.

Indiana reported 6,143 new positive coronavirus cases and 60 deaths on Wednesday, according to its Covid-19 dashboard.

Box said hospitals in the state are “struggling,” with more than 3,000 patients hospitalized due to Covid-19.

When asked about two state legislators who refused to wear masks on the Indiana House floor and filed motions to end the state public health threat, Box said “there is no single Hoosier in this state” that should not follow the mask mandate, whether to protect themselves or others. 

Gov. Eric Holcomb, who is quarantining due to possible Covid-19 exposure and joined the news conference remotely, said he appreciated that the “vast majority” of the House of Representatives were wearing masks. But he said enforcement falls on local jurisdictions.

A general view of Rundle Street East on November 19 in Adelaide, Australia.

The Australian state of South Australia reported no new Covid-19 cases Thursday on the first day of its six-day “circuit-breaker” lockdown, according to the state’s Chief Health Officer Nicola Spurrier.

South Australia announced Wednesday it would shut down for six days following an outbreak of 23 cases in Adelaide.

Meanwhile, South Australia Premier Steven Marshall said a record number of people had received Covid-19 tests over the past two days.

“Yesterday alone almost 12,000 tests were taken and processed by public & private labs,” Marshall said in a tweet Thursday. “A huge shout out to our frontline workers - you’re doing an amazing job.”

The United States reported 170,161 new coronavirus cases and 1,848 virus-related deaths on Wednesday, according to Johns Hopkins University.

At least 11,527,483 Covid-19 cases and 250,520 deaths have now been reported in the US, according to the university’s tally.

The totals include cases from all 50 states, the District of Columbia and other US territories, as well as repatriated cases.

CNN is tracking US cases:

Commuters wearing face masks to protect against the spread of the coronavirus walk on a street in Tokyo on November 17.

Tokyo is raising its Covid-19 alert to level 4, the highest of the four-tier alert system, officials in the Japanese capital announced on Thursday.

Koike urged the public and business owners to follow prevention measures such as wearing masks, social distancing, air ventilation, and minimizing dining in groups as the holiday season approaches.

Dr. Norio Ohmagari, chairman of the city’s expert monitoring meeting, said infections are rising in all age groups including the elderly, who are particularly vulnerable to the virus. 

Tokyo confirmed 493 new infections Wednesday, the highest daily increase since the pandemic began. 

The Centers for Medicare & Medicaid Services (CMS) on Wednesday urged nursing homes to “double down on infection control and adhere to testing requirements” during the holiday season.

The agency said while residents have a right to leave their nursing homes to see family over the holidays, even a short trip can raise the risk of exposure to Covid-19.

It encouraged facilities to educate residents about the risks of leaving the facility, to go over steps they should take to reduce their Covid-19 risk and to encourage them to consider alternatives to family gatherings, like celebrating by phone or video.

As of Nov. 1, nearly 66,000 nursing home residents have died from Covid-19, according to the US Centers for Disease Control and Prevention.

Family members in personal protective equipment perform the burial of a person who died of Covid-19 at a graveyard in New Delhi on November 12.

India’s capital region recorded its highest number of new fatalities from Covid-19 on Thursday, with 131 deaths, according to the Delhi government.

The figure surpasses the previous daily high of 104 deaths reported last Friday. A total of 7,943 people have died of the virus in Delhi.

The city also reported 7,486 new cases in the past 24 hours, bringing its total caseload to 503,084.

The Delhi government has reintroduced restrictions on social gatherings. The number of people allowed at weddings is now limited to 50.

Delhi Chief Minister Arvind Kejriwal said Tuesday that Covid-19 cases rose in the city because people weren’t practising social distancing or wearing masks in markets, warning that the government will be forced to shut down certain areas and treat them as hotspots.

National numbers: Across India, 45,576 new coronavirus cases and 585 additional deaths were reported on Thursday, according to the Ministry of Health and Family Welfare. The total number of cases in India stands at more than 8.9 million, among which 443,303 are considered active.

Adm. Brett Giroir listens during a hearing of the Senate Appropriations subcommittee reviewing coronavirus response efforts on September 16 in Washington.

Covid-19 vaccine distribution won’t be slowed by the delay in the presidential transition process, Adm. Brett Giroir, Assistant Secretary for Health at the US Department of Health and Human Services, said Wednesday.

Giroir said that the US will have at least 50 million vaccine doses distributed by the end of 2020.

Giroir said that he doesn’t make the rules, but he does want to be transparent. HHS staff will not work with President-elect Joe Biden’s transition team until the General Services Administration (GSA) makes a determination that Biden is the President-elect, HHS Secretary Alex Azar said Wednesday.

“The deputy Surgeon General, Dr. Erica Schwartz, is the transition official for HHS,” Giroir said. “The rule is if someone from the Biden transition team contacts one of those on the presidential transition team, the official person for each agency, they are supposed to notify Dr. Schwartz – Admiral Schwartz – and she is supposed to tell the GSA.”

Japan’s Prime Minister Yoshihide Suga said the country is on “maximum alert” as it reported its highest number of new Covid-19 cases in a single day since the pandemic began.

The country’s Health Ministry recorded 2,191 new coronavirus cases and nine new deaths for Wednesday.

Suga asked the public to wear masks, even at the dinner table, and to abide by prevention measures. He also told ministers to increase testing in high-risk facilities.

Tokyo recorded 493 new cases for Wednesday, the highest since the last peak of 472 cases on Aug. 27. Japan’s capital city has now reported a total of 35,723 cases.

Japan’s total caseload stands at 123,578, with 1,935 deaths.

In less than 10 months, Covid-19 has killed more people than strokes, suicides and car crashes typically do in a full year – combined.

The victims include an elderly father and his grown daughter who died within moments of each other. Two parents who died before their son’s 5th birthday. In rare cases, even children with no known prior health conditions.

Health experts say if Americans don’t get more serious about wearing masks and avoiding careless socializing, the rate of deaths will keep soaring this fall and winter.

Here’s a look at how deadly Covid-19 is, compared with several other causes of death in the US. To get a more balanced picture, we took the five-year annual average ending in 2018, the latest available year of data for most causes.

See the graphics:

TOPSHOT - EDITORS NOTE: Graphic content / Bodies wrapped in plastic line the walls inside a refrigerated trailer used as a mobile morgue by the El Paso County Medical Examiner's office in El Paso, Texas on November 13, 2020. - Due to a recent spike in coronavirus deaths, El Paso County officials have brought in five mobile morgue trailers with five more on standby. Within the past 48 hours there have been 45 recorded COVID-19 deaths (Photo by Justin HAMEL / AFP) (Photo by JUSTIN HAMEL/AFP via Getty Images)

Related article Covid-19 has killed 250,000 people in the US. That's 10 times the deaths from car crashes in a year

A final analysis of the Phase 3 trial of Pfizer’s coronavirus vaccine shows it was 95% effective in preventing infections, even in older adults, and caused no serious safety concerns, the company said Wednesday.

The company counted 170 cases of coronavirus infection among volunteers who took part in the trial. It said 162 infections were in people who got placebo, or plain saline shots, while eight cases were in participants who got the actual vaccine. That works out to an efficacy of 95%, Pfizer said.

The data show Pfizer’s initial claim of a better than 90% efficacy – a claim that stunned and pleased health officials and vaccine developers last week – holds up.

An independent group has been keeping an eye on results and side-effects. “To date, the Data Monitoring Committee for the study has not reported any serious safety concerns related to the vaccine,” the companies said.

“The only Grade 3 (severe) solicited adverse event greater than or equal to 2% in frequency after the first or second dose was fatigue at 3.7% following dose 2,” the companies said. Older adults tended to have fewer adverse events and those they had were milder.

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This May 4, 2020, file photo provided by the University of Maryland School of Medicine, shows the first patient enrolled in Pfizer's COVID-19 coronavirus vaccine clinical trial at the University of Maryland School of Medicine in Baltimore. On Monday, Nov. 9, 2020, Pfizer said an early peek at its vaccine data suggests the shots may be 90% effective at preventing COVID-19. (Courtesy of University of Maryland School of Medicine via AP)

Related article Pfizer coronavirus vaccine was 95% effective with no safety concerns

New York City is closing down its public school buildings starting on Thursday after the city’s seven-day average reached the 3% positive testing rate threshold. All students will transition to remote learning.

Mayor Bill de Blasio tweeted that schools are being closed out of “an abundance of caution.”

“We must fight back the second wave of COVID-19,” he wrote in the tweet.

New York City is the largest public school district in the country.

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A hallway is empty on what would otherwise be a school day as teachers and faculty members learn remote teaching and methods for students at Yung Wing School P.S. 124 in the Manhattan borough of New York City. Public schools in New York City have been shut down until at least until April 20th amid the spread of coronavirus (COVID-19).

Related article NYC schools will close after the city reached a 3% Covid positivity rate threshold