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How A Florida Elections Official Is Leaning On Creativity During A Complicated Year

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Poll workers at the Miami-Dade County Elections Department deposit returned mail-in ballots into an official ballot drop box on primary election day on Aug. 18 in Doral, Fla. Joe Raedle/Getty Images hide caption

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Poll workers at the Miami-Dade County Elections Department deposit returned mail-in ballots into an official ballot drop box on primary election day on Aug. 18 in Doral, Fla.

Joe Raedle/Getty Images

Chris Anderson, supervisor of elections in Seminole County, Florida, had a stylus problem.

He says it would have cost more than a quarter of a million dollars to purchase enough pens and styluses needed for the county's 328,000 voters. So, his department got creative.

"We quite literally went to every Dollar Tree in the county, and we bought as many Q-tips as we could," Anderson tells Morning Edition. "Five dollars will buy you 1,500 Q-tips. And we put aluminum foil tape around them and that serves as a conductor of the static electricity from your body to allow you to sign on an iPad."

Not only did the Q-tip trick save his department money but, Anderson hopes, it will also help keep voters and election workers safer in the face of COVID-19.

"One use for one voter. We limit the transmission of germs between voters and the election workers, and that's just another way we keep people safe as they vote here in Seminole County," he says.

That's just one of the ways Anderson has had to shift his approach as an elections supervisor in 2020. He talks with NPR's Noel King about why — between the pandemic, the surge in mail-in voting and the president, at times, questioning the legitimacy of the process — this election will require extra ingenuity.


Interview Highlights

You are getting something like 96 calls and texts a day from voters in Seminole County. What are they asking? What are they worried about?

They're concerned about COVID-19 safety. They're concerned about their vote-by-mail ballots. They're concerned overall about how the election process is going to take place in the midst of everything that is going on in the world today. ... They want to make sure that the things that they're receiving, both through phone calls and texts, that they are legitimate.

In light of COVID-19, are you encouraging people to vote by mail?

Absolutely. That was one of the first things. We were the first supervisor of elections office in the state of Florida to send out the mail ballot request form to every voter, because it was logical to say that the safest way to vote in the midst of this pandemic is to vote at home. So we knew if we pushed folks to vote by mail, that would limit them coming to the polling locations because at the polling locations, as you know, we have to do many different things — from room occupancy rate control to social distancing and a lot of different things of that nature in in-person voting — which could create some longer wait times. So if we can get folks to vote by mail it's very convenient, they don't have to wait and it can be safe.

What is the main thing keeping you up at night?

The main thing that's keeping me up at night is just making sure that voters have the right information, between now and Election Day. They're going to receive a lot of stuff in their mailbox. My advice to each and every voter across the country: If you have questions about your elections administration, contact your local administrator.

Marc Rivers and Ziad Buchh produced and edited the audio version of this story.

Sizzler USA has filed for bankruptcy as a result of the COVID-19 pandemic and related restrictions. Here, drivers pass a closed Sizzler restaurant in Montebello, Calif. Frederic J. Brown/AFP via Getty Images hide caption

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Sizzler USA has filed for bankruptcy as a result of the COVID-19 pandemic and related restrictions. Here, drivers pass a closed Sizzler restaurant in Montebello, Calif.

Frederic J. Brown/AFP via Getty Images

The venerable Sizzler USA family steakhouse chain has filed for Chapter 11 bankruptcy protection, citing a business environment roiled by COVID-19 restrictions — and saying that not enough has been done to help restaurants survive.

"Our current financial state is a direct consequence of the pandemic's economic impact," Sizzler President Chris Perkins said, "due to long-term indoor dining closures and landlords' refusal to provide necessary rent abatements."

The company, which first opened 62 years ago, says it wants to keep all of its locations open. Sizzler says it hopes to renegotiate its leases over the next four months; it will also undergo a restructuring process aimed at reducing long-term debt.

Sizzler USA received between $2 million and $5 million in federal loans from the Paycheck Protection Program, which was designed to ease job losses from the coronavirus and help keep small businesses afloat. That's according to data released by the U.S. Treasury Department.

"It is our ultimate goal to keep all Sizzler locations open for business throughout this process," the company said in a statement sent to NPR. It added that it intends to fulfill financial commitments to employees, franchised locations and vendors.

Sizzler, based in Mission Viejo, Calif., filed for voluntary Chapter 11 protection in a federal bankruptcy court for the Northern District in California. The filing directly affects the company's 14 restaurants it owns. There are also more than 90 franchised locations, which Sizzler says "will not be impacted during the Chapter 11 process."

During the pandemic, Sizzler has been selling takeout meals, including to-go versions of its popular salad bar. Some of its locations also offer outdoor dining. And like many restaurants struggling to find customers, Sizzler is offering delivery through third-party companies such as DoorDash, GrubHub, Uber Eats and Postmates.

Sizzler got its start in 1958, when founders Del and Helen Johnson offered steak dinners for 99 cents at their first restaurant in Culver City, Calif. Sizzler currently has 107 locations in 10 states — most of them in the West — and Puerto Rico. That's down from 2018, when the chain said it had 134 locations.

Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, is pictured in a hearing on July 31. He is testifying on Wednesday alongside other top health officials in a Senate panel hearing. Pool/Getty Images hide caption

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Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, is pictured in a hearing on July 31. He is testifying on Wednesday alongside other top health officials in a Senate panel hearing.

Pool/Getty Images

Updated at 1:37 p.m. ET

Amid criticism from Democrats that politics may be guiding decisions at the nation's top health agencies, the commissioner of the Food and Drug Administration told Congress on Wednesday that a coronavirus vaccine would not be approved until it met "vigorous expectations" for safety and effectiveness.

"Decisions to authorize or approve any such vaccine or therapeutic will be made by the dedicated career staff at FDA through our thorough review processes, and science will guide our decisions," FDA commissioner Stephen Hahn told senators.

Hahn continued: "FDA will not permit any pressure from anyone to change that. I will fight for science ... I will fight for the integrity of the agency, and I will put the interests of the American people before anything else."

Four of the top federal officials responsible for managing the coronavirus pandemic all testified before of the Senate Health, Education, Labor and Pensions Committee.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases; Dr. Robert Redfield, director of the Centers for Disease Control and Prevention; Adm. Brett Giroir, the assistant secretary of health who is in charge of coronavirus testing, and Hahn all were questioned.

The hearing follows confirmation that the U.S. death toll from the coronavirus pandemic has topped 200,000 people.

Redfield told Congress that the CDC is in the process of conducting a large study to determine how widely the coronavirus has spread across the country.

"The preliminary results in the first round show that a majority of our nation, more than 90% of the population, remains susceptible," Redfield said.

Political overtones

Senate Minority Leader Chuck Schumer, D-N.Y., and Sen. Patty Murray, D-Wash., the committee's ranking member, called on Hahn and Redfield to testify earlier this month, citing what they called "political interference" in the public health agencies.

"It is painfully clear that the Trump administration won't stop the political interference which is threatening our response to this pandemic and putting lives in jeopardy on its own, so it is up to Congress to act," Murray wrote in a statement on Tuesday, introducing legislation that would create a task force to investigate such incidences.

There have been a number of controversial guidance changes from the CDC and FDA over the last few weeks.

In late August, for example, the CDC quietly stopped recommending that asymptomatic people be tested for the coronavirus. The CDC updated that guidance last week.

This week, the CDC posted and then removed guidance saying the coronavirus spreads through aerosol particles.

On Wednesday, Murray grilled Redfield about those changes. The CDC director sought to brush off the concerns, saying the agency sometimes modifies guidance based on new data and evolving science.

In response to a question from Sen. Tim Kaine, D-Va., about the aerosol guidance, Redfield said the document that appeared was a draft that had not been technically reviewed by career staff. It was taken down, he said, and replaced with the original document until the aerosol guidance could face scientific review and then be re-posted.

Hahn came under fire on the eve of the Republican National Convention for overstating the potential impact of an FDA authorization to treat the coronavirus with plasma. He later backtracked and apologized.

In his opening statement, Hahn anticipated that criticism, assuring senators and the public that science, not politics, guides his agency's decision-making. He raised the plasma authorization as an example of the FDA representing "science in action."

"Often we must make real-time decisions based on ever-evolving data concerning a previously unknown, highly contagious virus that we are still learning about, and sometimes it is necessary to reverse decisions as new data emerge," he said. "It is akin to how a doctor might approach a patient in an emergency situation, constantly updating a treatment plan when new data emerge."

Pursuit of a vaccine

There are also concerns about efforts to fast-track a vaccine for COVID-19 and the timeline for getting it to the general population.

On Friday, Trump insisted "every American" would have a vaccine by April. Redfield testified last week that it could be six to nine months after the FDA authorizes a vaccine before it is widely distributed. Potential vaccines are currently being tested.

On the campaign trail, Democratic nominee Joe Biden said last week, "I trust vaccines. I trust scientists. But I don't trust Donald Trump."

To that end, Hahn tried to temper concerns about the vaccine, laying out how the approval process will work. He told senators that vaccine sponsors will submit applications for approval or authorization. Career scientists will review safety and efficacy data and an independent advisory panel will weigh in. The data and the decision will be made public, he said.

"In the end, FDA will not authorize or approve a vaccine we would not feel comfortable giving to our families," Hahn said.

All the officials, including Fauci, said they would trust a vaccine if it was approved or authorized by the FDA after vetting by scientists.

Fauci also answered several basic questions about the vaccine.

He told Sen. Lamar Alexander, R-Tenn., who was presiding over his last HELP Committee meeting before retirement, that a vaccine will be available without cost to the public. Scientists do not know yet whether it will be effective for everyone and for how long immunity will last, and that two of the vaccines in development will require two doses — and another will require just one, Fauci said.

The officials also reiterated that even once a vaccine or vaccines are approved, it will be several months before they are practically available to everyone — and that because a vaccine will likely not be 100 percent effective, it will remain crucial for Americans to continue wearing masks, social distancing and taking part in testing and contact-tracing.

Redfield made that point at a hearing earlier this month and reportedly faced backlash from President Trump.

Asked on Wednesday by Sen. Tina Smith, D-Minn., whether Redfield had faced any political retribution, he responded: "I'm just going to stay with my comment that I'm going to present science and data as I see it."

After Aerosols Misstep, Former CDC Official Criticizes Agency Over Unclear Messaging

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A former CDC official criticizes the agency over its latest reversal, this time in guidance on how the coronavirus is transmitted. Kevin C. Cox/Getty Images hide caption

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A former CDC official criticizes the agency over its latest reversal, this time in guidance on how the coronavirus is transmitted.

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As of now, both the Centers for Disease Control and Prevention and World Health Organization say the primary way the coronavirus spreads is by hitching a ride on respiratory droplets when people are in close contact.

Respiratory droplets form when someone sneezes, coughs, talks or sings, for example. They don't travel far and fall to the ground quickly.

But on Friday, the CDC website was modified to include smaller, aerosolized particles as a way the coronavirus is commonly spread. These are the tiniest particles expelled in breath that can linger in the air and travel distances farther than 6 feet.

On Monday, the agency took that update down, saying it was a draft that had been posted in error.

Dr. Ali Khan, who used to direct the Office of Public Health Preparedness and Response at the CDC, says there was "nothing new" in the now-deleted update, which he characterized as saying "there's a minor role for airborne transmission."

The disease is "predominantly" spread by large particles from people near each other, he says. There's consensus in the scientific community that this seems to be the main mode of transmission.

Beyond that, Khan notes, there are a few other ways that people could, conceivably, contract the virus, researchers and health officials agree.

"Occasionally we get this disease from contaminated surfaces," Khan tells Steve Inskeep on NPR's Morning Edition. "And then there's a minor role, again, for these small particle aerosols. ... These are transmitted farther than 6 feet away, potentially around a corner, especially in poorly ventilated indoor spaces. And then, finally, there's a yet even more minor role, probably, for transmission via feces. So nothing new here."

Still, a number of environmental engineers and other infectious disease researchers have been critical in the past of both the CDC and WHO for, they say, being too slow to acknowledge the role this sort of fine aerosol might play in spreading the virus, especially indoors.

Khan is now the dean of the College of Public Health at the University of Nebraska Medical Center in Omaha. Here are excerpts from the interview:

What do you make of this unremarkable guidance being published and then withdrawn?

Confusing. So CDC's not perfect and certainly has made some mistakes this past year. But with due respect to the agency, it's hard to imagine that this is one of them, given the scrutiny that they've had in all of their messaging.

And for example, so just last week, we saw a flip-flop from CDC on testing of asymptomatic persons. We saw documented proof of manipulation of CDC's official publication. So, you know, it's not hard to understand people questioning that these changes may be deliberate interference by the [Trump administration]. ...

We've seen the deliberate undermining of public health over the course of this outbreak for political purpose. And we have seen numerous examples now of deliberate change of guidance that's not evidence-based.

Can we still trust what the CDC tells us then?

Unfortunately, it's becoming harder to trust what CDC tells us.

And this is extremely unfortunate because trust is the most important thing we need during a pandemic. As we tell people that, regardless of this minor role of aerosol transmission, we have the tools available to us today to stop this outbreak in its tracks with "test, trace, isolate." And please do our part [by] wearing a mask, washing our hands and socially distancing. And this trust is going to be even more important as we tell people to roll up their sleeves and get vaccinated — hopefully sometime at the end of this year and into next year.

I want to know if the practical advice after all of this confusion is still basically the same, so far as you see it: See people outdoors, rather than indoors; 6 feet apart; wear a mask. That sort of thing.

Correct. The guidance doesn't change. So there's lots of nice, sophisticated aerobiology studies now that look at what happens when you sneeze and cough and how far these particles go and whether there's virus riding along in them.

But we know that if we wear our masks and we couple that with the public health strategy of testing, isolating and tracing people, that we can get this disease under control.

Taylor Haney produced the audio interview.

Police have charged a Massachusetts high school student and the youth's parents with allegedly hosting a house party with underage drinking, a gathering that led the town's high school to delay in-person classes by two weeks amid coronavirus concerns.

The family members, who live in Sudbury, were charged under the state's "social host" law, which penalizes anyone "who is in control of the premises and who furnishes alcohol or allows it to be consumed [by underage people] on those premises," with fines of up to $2,000, up to a year of imprisonment or both.

The party was held late Sept. 11 at a private residence where police say they broke up a gathering of at least 50 students thought to be underage and from Lincoln-Sudbury Regional High School. There were no masks, and attendees did not appear to be practicing social distancing, police said.

The town's health board released a statement saying that there were "no known positive COVID cases involving these students at the time of this release." However, the town was not able to consult with the attendees of the party — many of them unknown — and therefore couldn't accurately assess the risk.

"As a result, the Board of Health and Lincoln Sudbury Regional School High School (LSRHS), in consultation with the school physician, collectively decided to delay in-person learning," the statement reads.

The high school was originally to begin in-person classes on Sept. 15 but will now keep students out of classrooms for at least two weeks. The health board is recommending that the partygoers be tested for the coronavirus and notify the town's health board and the school health office if they become symptomatic.

"These criminal charges are not unique to our town. The 'Social Host Law' is often charged when a department identifies gatherings allowing underage alcohol consumption," the Sudbury Police Department wrote in a Facebook post about the incident.

Last week in Attleboro, Mass., nearly 30 students were required to quarantine after possibly being exposed to the coronavirus after a high schooler was sent to classes even though the teen tested positive days earlier.

Other Massachusetts high schools have delayed in-person classes because students attended parties in Dedham, Reading and the Dover-Sherborn area.

The Centers for Disease Control and Prevention's guidelines for a safe Halloween during the COVID-19 pandemic include new methods of doing classic spooky activities. ArtMarie/Getty Images hide caption

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The Centers for Disease Control and Prevention's guidelines for a safe Halloween during the COVID-19 pandemic include new methods of doing classic spooky activities.

ArtMarie/Getty Images

In a year that's been plenty scary, this much is clear: Pandemic Halloween will be different than regular Halloween. Many traditional ways of celebrating are now considerably more frightful than usual, because now they bring the risk of spreading the coronavirus.

Accordingly, the Centers for Disease Control and Prevention has issued new guidelines on how to celebrate Halloween safely. No big surprise: Classic door-to-door trick-or-treating and crowded, boozy costume parties are not recommended.

The CDC's guidelines group Halloween activities into lower-risk, moderate-risk and higher-risk buckets.

The higher-risk category includes both door-to-door trick-or-treating and events where kids get treats from the trunks of cars in a big parking lot.

Also no-nos: indoor haunted houses where people will be crowded and screaming, which could send infectious particles flying. Going on hayrides with people who aren't in your household or fall festivals in rural areas also carry a risk of spreading the virus that causes COVID-19. And using alcohol and drugs "can cloud [judgment] and increase risky behaviors," the CDC warns — though that's equally true in any season.

How to get your thrills instead?

The agency says this way of trick-or-treating poses a moderate risk (compared with the higher risk of the traditional style): Kids could pick up individually wrapped gift bags at the end of a driveway or yard while still preserving social distance.

You could also organize a small outdoor costume parade where everyone is 6 feet apart. An outdoor costume party would also be considered moderate risk, if people wear masks and stay 6 feet away from each other.

Haunted houses are out, and haunted forests are in. The CDC says an open-air scare-fest is moderately risky, so long as the route is one-way, people wear masks appropriately and stay 6 feet apart. But there's a caveat: "If screaming will likely occur, greater distancing is advised."

What about apple picking and pumpkin patches? Risks can be reduced if people use hand sanitizer before touching pumpkins or apples, wear masks and maintain social distance.

Also on the moderate-risk list: an outdoor scary movie night with local friends who are socially distanced. Again: The more screaming there is, the more space is needed for safe social distancing.

If you want to be really safe? Then you need to plan for either virtual activities or ones that you do largely with your own household.

The CDC's lower-risk activities include carving pumpkins with your household, or outdoors with friends while socially distanced. It also suggests a Halloween scavenger hunt: looking for witches, spiderwebs and black cats outside houses while walking around — or a scavenger hunt for treats in your own home.

And what about masks? A costume mask is no substitute for a cloth mask, according to the agency, but don't double up with one over the other because that can make it hard to breathe. Instead, consider a Halloween-themed cloth mask, the CDC suggests.

A costume mask can protect against spreading the coronavirus if it's like a regular cloth mask: two or more layers of breathable fabric covering the nose and mouth, without gaps around the face.

And remember this, friendly neighbors: If you think you might have COVID-19 or have been exposed to someone who does, don't attend in-person Halloween activities — and certainly don't hand out candy to trick-or-treaters.

The U.S. hit a tragic milestone Tuesday, recording more than 200,000 coronavirus deaths. Here, Chris Duncan, whose 75-year-old mother, Constance, died from COVID-19 on her birthday, visits a COVID Memorial Project installation of 20,000 U.S. flags on the National Mall. The flags are on the grounds of the Washington Monument, facing the White House. Win McNamee/Getty Images hide caption

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Win McNamee/Getty Images

The U.S. hit a tragic milestone Tuesday, recording more than 200,000 coronavirus deaths. Here, Chris Duncan, whose 75-year-old mother, Constance, died from COVID-19 on her birthday, visits a COVID Memorial Project installation of 20,000 U.S. flags on the National Mall. The flags are on the grounds of the Washington Monument, facing the White House.

Win McNamee/Getty Images

The U.S. death toll from COVID-19 surpassed 200,000 on Tuesday — reaching what was once the upper limit of some estimates for the pandemic's impact on Americans. Some experts now warn that the toll could nearly double again by the end of 2020.

"I hoped we would be in a better place by now," said Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security. "It's an enormous and tragic loss of life."

COVID-19 is now one of the leading causes of death in the U.S., which has reported more than 6.8 million coronavirus cases – more than any other country, according to data collected by Johns Hopkins University. More than 31 million cases have been reported worldwide, including more than 965,000 deaths.

Potential vaccines are currently being tested, but even if a successful candidate emerges, it would likely take months or even years for it to become widely available.

Many of the U.S. COVID-19 deaths likely would have been prevented by widespread use of face masks, social distancing and other measures, said Bob Bednarczyk, assistant professor of global health and epidemiology at Emory University in Atlanta.

"Seeing this number of COVID-19-related deaths is concerning because it shows we really have not done enough to control this pandemic, and we are experiencing a tremendous amount of unnecessary suffering," Bednarczyk said.

The disease was only given a formal name in February; one month later, COVID-19 was declared a pandemic — the first caused by a coronavirus. Since then, it has ravaged families and communities and wrecked economic dreams in the U.S. and around the world.

Rivers said that if mortality trends continue, "​COVID-19 will likely be the third-leading cause of death, after heart disease and cancer" in the United States.

"For comparison, by the end of the year we will likely have seen more deaths from COVID-19 than we saw from diabetes, influenza and pneumonia, kidney disease and suicide combined in 2017," she said.

The disease already exceeds the number of U.S. deaths from accidents and unintentional injuries, Bednarczyk said.

Firefighters in Littleton, Colo., move a patient on a gurney to an ambulance to take him to the hospital in May. Helen H. Richardson/MediaNews Group/The Denver Post via Getty Images hide caption

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Helen H. Richardson/MediaNews Group/The Denver Post via Getty Images

Death toll has far exceeded early predictions

The U.S. death toll is the highest in the world, by a large measure. Despite having less than 5% of the global population, the U.S. has suffered more than 20% of COVID-19 deaths worldwide.

In late March, Dr. Anthony Fauci, America's leading expert on infectious diseases, estimated that around 100,000 to 200,000 people in the U.S. might die as a result of the virus. Then, in early April, he predicted the toll could be far lower: 60,000 people.

Fauci cautioned that his more optimistic estimate was based on the American public adhering to physical separation and other restrictions in March and April — measures that, for a while at least, sharply reduced U.S. death toll projections.

But weeks after Fauci spoke, Georgia, Texas and some other states began relaxing their control measures.

"In late May, we were seeing around 1,000 to 1,400 deaths per day, but cases and deaths were declining and I was hopeful that things would continue to improve," Rivers said. "It's now September, and around 1,000 people are still dying in the U.S. every day, and that's been stable for weeks now."

The latest widely cited fatality projection for the U.S. indicates nearly 380,000 people will die from COVID-19 by the end of this year. The estimate comes from the Institute for Health Metrics and Evaluation, or IHME, a research center at the University of Washington.

While that projection is staggering — the loss of life could reach more than 445,000 by the end of 2020 if health and safety mandates are relaxed, the IHME said. Conversely, the estimate drops to fewer than 265,000 deaths if the use of face masks becomes universal in the United States.

"The U.S. population is getting numb to these numbers"

Huge figures such as those, Bednarczyk said, could contribute to another worrying phenomenon: pandemic fatigue.

"I am concerned that, by and large, the U.S. population is getting numb to these numbers," Bednarczyk said, "and grim milestones such as 200,000 deaths or nearly 7,000,000 confirmed cases will probably not get people's attention to spur more personal control measures."

Many of the first 100,000 people to die of COVID-19 in the U.S. were living in urban areas — densely populated places that are also transportation hubs. But the additional 100,000 deaths reflect a shift away from cities.

"It's easier for a virus to get into those locations and spread quickly," Bednarczyk said of cities. "However, as we continue through the summer and early fall, we are seeing a shift in cases to areas that were much less impacted in the spring. These rural settings have seen much higher spread of disease in the last two months, showing that nowhere is safe from the spread of this virus."

Images of Detroit-area residents who died from COVID-19 line a street during a drive-through memorial on Sept. 1 on Belle Isle in Detroit. The number of U.S. dead has crossed the 200,000 mark — and the figure could nearly double by the end of the year, experts say. Rebecca Cook/Reuters hide caption

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Rebecca Cook/Reuters

Images of Detroit-area residents who died from COVID-19 line a street during a drive-through memorial on Sept. 1 on Belle Isle in Detroit. The number of U.S. dead has crossed the 200,000 mark — and the figure could nearly double by the end of the year, experts say.

Rebecca Cook/Reuters

"We've seen hot spots move throughout the country," Rivers said. "In the spring, Northeastern states were particularly hard hit. Then through the summer, it was states in the South and Southwest, and now we see disease spreading rapidly in the Midwest."

As people grieve over friends and loved ones lost to the pandemic, they've also been forced to cope with other life-upending changes, such as losing their jobs or having to turn their homes into virtual classrooms.

Many schools and colleges are trying to find ways to reopen safely for in-person classes. As they welcome back students, some are also starting large-scale sporting events, such as college football.

"People are trying to find ways to live more normally during what has been a very long and difficult year," Rivers said.

"In places where there is a lot of virus circulating, it won't be safe to hold gatherings in person without mitigation measures," she added. "But by controlling the virus, and by doing things like wearing masks, moving events outside and observing social distancing, we can gain more flexibility to do things that are important to us."

Attempts to return to normalcy present a tricky situation, Bednarczyk said, noting the potential for large gatherings to become "superspreader" events that can cause dangerous secondary infections.

"The need for education is strong, but we won't know the impact of these in-person classes for a while, and by that time, it is possible that the virus will have greatly expanded its spread," he said. "My concern with things like college football games is as much for the players and coaches and staff who have to travel as it is for fans who may still gather to watch the games."

For six horrible weeks, from late April into May, more than 10,000 Americans a week died from COVID-19, including 17,055 deaths in the week that ended April 18, according to the Centers for Disease Control and Prevention. The weekly death toll has fluctuated since then.

"For deaths, we still see that older adults and people with underlying health conditions are at highest risk of severe illness and death," Rivers said.

People attend a free concert at the Daytona Beach Bandshell on Labor Day weekend in Daytona Beach, Fla. For months, public health officials around the country have asked people to practice social distancing to slow the spread of the virus. Paul Hennessy/NurPhoto via Getty Images hide caption

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Paul Hennessy/NurPhoto via Getty Images

From the earliest phase of the disease's arrival in the United States, COVID-19 has taken a horrible toll on minority communities, where people have died in disproportionate numbers compared with the general population.

According to the CDC, Black people in the U.S. have a coronavirus death rate that's 2.1 times higher than white people. Latinos and Native Americans also have higher death rates.

Six months into the pandemic, majorities of Black, Latino and Native American households are facing serious financial problems, compared with 36% of white households, according to a recent national poll by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health.

Five U.S. states — New York, New Jersey, California, Texas and Florida — have reported more than 10,000 deaths each from the coronavirus. Globally, only 15 countries besides the U.S. have surpassed that tragic mark.

In terms of national population, the U.S. has seen more than 60 deaths per 100,000 people – slightly higher than the death rate in Mexico and lower than in Spain, Brazil, Chile, Bolivia and Peru, according to a mortality analysis by Johns Hopkins University's Coronavirus Resource Center.

While the U.S. has the highest number of reported coronavirus cases, India has been reporting new cases at an alarming rate. That country — which has a much larger population than the U.S. — has reported more than 50,000 new cases daily since late July, according to data compiled by Johns Hopkins. The U.S. has seen its daily rate of new coronavirus cases fall below 50,000 since early August; since then, it has wavered around the 40,000 mark.

A man places a white rose on the ground last month at a memorial in downtown Los Angeles to honor the Angelenos who lost their lives due to the coronavirus. Mel Melcon/Los Angeles Times via Getty Images hide caption

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Mel Melcon/Los Angeles Times via Getty Images

More can be done to reduce death toll, experts say

Both Rivers and Bednarczyk say the U.S. still has a chance to reduce the pandemic's tragic toll.

"The U.S. response has been chaotic, but there is always time to chart a better course," Rivers said. "I would like to see the U.S. continue to scale up diagnostic testing and case-based interventions like contact tracing."

Another positive step, she said, would be to use data collected from coronavirus case investigations "to identify high-risk settings and activities, so we can focus on those specifically."

Noting the lack of strong and consistent control measures in the country, Bednarczyk said, "It is still possible to prevent a much larger number of deaths if people consistently wore masks and practiced good physical distancing."

But he added, "I worry we'll see more gatherings without masks, which will keep allowing this virus to spread."

President Trump speaks in a prerecorded message played Tuesday during the 75th session of the U.N. General Assembly. UNTV via AP hide caption

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UNTV via AP

President Trump speaks in a prerecorded message played Tuesday during the 75th session of the U.N. General Assembly.

UNTV via AP

Updated at 12:50 p.m. ET

In a speech Tuesday to the U.N. General Assembly, President Trump once again sought to blame China for the COVID-19 pandemic and called on Beijing to be punished for its handling of the disease, which has killed nearly 1 million people worldwide – a fifth of them in the United States.

Trump, speaking in a video address from the White House to a sparsely occupied hall of mask-wearing delegates at U.N. headquarters in New York, referred to the disease as the "China virus" and implied that Beijing and the World Health Organization had worked in tandem to cover up the danger of the pandemic.

"In the earliest days of the virus, China locked down travel domestically while allowing flights to leave China and infect the world," the president said. "China condemned my travel ban on their country, even as they canceled domestic flights and locked citizens in their homes."

He added, "The Chinese government and the World Health Organization — which is virtually controlled by China — falsely declared that there was no evidence of human-to-human transmission. Later, they falsely said people without symptoms would not spread the disease."

More than 200,000 Americans have now died from the disease — the world's highest death toll — since the first known case in the U.S. was identified in January.

In the earliest days of the pandemic, Trump praised WHO for its response, but as the coronavirus spread in the U.S., he became increasingly critical of both the U.N. body and Beijing for what he said was an effort to obscure the extent of the crisis.

Despite his own efforts to downplay the pandemic in its early days and criticism over his administration's slow response to combat it, the president defended the U.S. action on Tuesday, calling it "the most aggressive mobilization since the Second World War."

"We will distribute a vaccine, we will defeat the virus, we will end the pandemic, and we will enter a new era of unprecedented prosperity, cooperation and peace," Trump told the assembled delegates.

Earlier this month, the administration announced that the U.S. would not participate in the global coronavirus vaccine initiative, known as COVAX, that is co-led by the World Health Organization.

Trump's speech followed remarks by U.N. Secretary-General António Guterres, who reiterated a theme he has hit on repeatedly in recent months — a warning against "vaccine nationalism." He advised against countries "making exclusive side deals" for vaccines.

"We need more international cooperation, not less" in the fight against COVID-19, Guterres said.

As Trump excoriated the United Nations and China, he also ticked off a campaign-style list of what he said were U.S. accomplishments: rebuilding the nation's economy, the fight against terrorism and the size and power of the American military.

"We have the most powerful military anywhere in the world, and it's not even close," he told the U.N. delegates.

Following Trump's speech, Chinese leader Xi Jinping and Russian President Vladimir Putin also addressed the General Assembly — both calling for a global effort to defeat the disease and calling on WHO to take a leading role in the fight.

In remarks that seemed aimed at Trump, Xi urged leaders to reject any attempt to politicize the pandemic.

"The virus will be defeated. Humanity will win this battle. Facing the virus we should put people and life first. We should mobilize all resources to make a science-based and targeted-response," Xi said, speaking in Mandarin.

"Facing the virus, we should enhance solidarity and get through this together," China's leader added. "We should follow the guidance of science, give full play to the leading role of the World Health Organization and launch a joint international response to beat this pandemic. Any attempt of politicizing the issue or stigmatization must be rejected."

Putin said that Russia, one of the countries hardest hit by the virus, is ready to provide its own vaccine, known as Sputnik V, which he has said will be ready for general distribution on Jan. 1. However, experts inside and outside Russia have greeted that news with skepticism, with some suggesting the haste in pushing an as-yet unproven vaccine may have more to do with politics than science.

"I would like to reiterate that we are completely open to partner relations and willing to cooperate," Putin said, adding, "We are ready to share experience and continue cooperating with all states and international entities, including in supplying the Russian vaccine, which has proved reliable, safe and effective, to other countries."

The NFL has fined San Francisco 49ers head coach Kyle Shanahan and two other coaches for not following rules about keeping their faces covered. Here, Shanahan walks off the field after his team's Sept. 13 game against the Arizona Cardinals. MSA/Icon Sportswire via Getty Images hide caption

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MSA/Icon Sportswire via Getty Images

The NFL has fined San Francisco 49ers head coach Kyle Shanahan and two other coaches for not following rules about keeping their faces covered. Here, Shanahan walks off the field after his team's Sept. 13 game against the Arizona Cardinals.

MSA/Icon Sportswire via Getty Images

The NFL has fined several head coaches $100,000 for not wearing face masks on the sidelines — a safety precaution that is required at games during the COVID-19 pandemic. The coaches' teams were also punished, with $250,000 fines.

The coaches include Pete Carroll of Seattle, Kyle Shanahan of San Francisco and Vic Fangio of Denver, according to ESPN's Adam Schefter. A league source confirmed details about the fines to NPR on Tuesday morning.

The fines were issued after the NFL completed the second week of games, all of which have been played in stadiums that are either empty of fans or at sharply reduced capacity due to concerns about the possible spread of the coronavirus.

Carroll, Shanahan and Fangio have all worn neck gaiters during their teams' first two games, but each of them has often been seen with the covering pushed down below their chin.

Carroll's opponent in Sunday night's game was New England coach Bill Belichick, who wore a traditional face mask but also put his own spin on it. The coach, known for his unique style, sometimes pushed the mask down below his mouth — but he also shoved it far up toward his eyes.

The NFL's game-day safety protocols state, "All individuals with Bench Area Access, except for Players, shall be required to wear masks at all times. Coaches must wear either a mask, neck gaiter, and/or face shield to satisfy this obligation."

Those protocols were issued a week before the first pro football games. The measures also encourage players who aren't in the game to wear masks, and the policy reminds them to comply with any local regulations.

The mask requirement extends beyond the teams' bench area. Anyone with field access, from stadium personnel to media, must also wear masks or other face coverings at all times.

COVID-19 has killed nearly 200,000 people in the U.S. — the highest death toll in the world.

In this image taken from video, British Prime Minister Boris Johnson makes a statement to the House of Commons on the state of the COVID-19 pandemic. House of Commons/AP hide caption

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House of Commons/AP

In this image taken from video, British Prime Minister Boris Johnson makes a statement to the House of Commons on the state of the COVID-19 pandemic.

House of Commons/AP

After a quiet summer where life largely returned to normal, England now faces new restrictions designed to slow the spread of COVID-19.

U.K. Prime Minister Boris Johnson announced in the House of Commons on Tuesday morning that pubs, bars and restaurants in England must close at 10 p.m. He also encouraged people who are able to work from home to do so, reversing a previous government position.

"This is the moment when we must act," Johnson said. "If we can curb the number of daily infections and reduce the reproduction rate to one, then we can save lives, protect the NHS [National Health Service] and the most vulnerable, and shelter the economy from the far sterner and more costly measures that would inevitably become necessary later on."

In addition, the prime minister said weddings will be limited to 15 people, though funerals are limited to 30. These measures follow rules imposed last week limiting social gatherings to no more than six people, indoors or out.

UK Parliament via YouTube

The U.K. government's COVID-19 dashboard shows that after a surge of cases and deaths this spring, a second wave of new cases began in August and has risen sharply this month. On Monday, the U.K. reported nearly 4,400 new cases.

The government's scientific advisers say that if the virus is left unchecked, the U.K. can expect to see 50,000 cases a day by mid-October and more than 200 deaths a day by mid-November.

"We have, in a bad sense, literally turned a corner," Chris Witty, England's chief medical officer, said Monday in a national telecast. "I think everybody will realize that at this point, the seasons are against us. ... This period of the next six months, I think we have to realize that we have to take this collectively very seriously."

There is skepticism about how much of an impact Johnson's new measures will have. For instance, in suburban London, the curfew would trim the operating time of some pubs only by 90 minutes. Meanwhile, the government continues to fail to meet the demand for coronavirus testing, raising concerns it won't be able to track the virus's spread this fall.

"We warned the prime minister months ago that testing needed to be fixed by the autumn," said Keir Starmer, leader of the opposition Labour Party, responding to Johnson in the House of Commons. "But the government didn't listen. They pretended it wasn't a problem. They didn't act quickly enough. Now the testing system isn't working just when we need it."

The Centers for Disease Control and Prevention briefly posted new guidance to its website stating that the coronavirus can commonly be transmitted through aerosol particles, which can be produced by activities like singing. Here, choristers wear face masks during a music festival in southwestern France in July. Bob Edme/AP hide caption

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Bob Edme/AP

The Centers for Disease Control and Prevention briefly posted new guidance to its website stating that the coronavirus can commonly be transmitted through aerosol particles, which can be produced by activities like singing. Here, choristers wear face masks during a music festival in southwestern France in July.

Bob Edme/AP

Updated at 6:03 p.m. ET

The Centers for Disease Control and Prevention posted guidance Friday evening saying that aerosol transmission might be one of the "most common" ways the coronavirus is spreading — and then took the guidance down on Monday.

The now-deleted updates were notable because so far the CDC has stopped short of saying that the virus is airborne.

The agency says the guidance was a draft version of proposed changes that was posted in error to its website. The CDC says that it is updating its recommendations regarding airborne transmission of the virus that causes COVID-19 and that it will post updated language once that process is complete.

Over the weekend, the CDC page "How COVID-19 Spreads" included among the most common modes of transmission "respiratory droplets or small particles, such as those in aerosols, produced when an infected person coughs, sneezes, sings, talks, or breathes."

It continued: "These particles can be inhaled into the nose, mouth, airways, and lungs and cause infection. This is thought to be the main way the virus spreads." The guidance also stated that these particles might travel farther than 6 feet.

For a few days, researchers who have suspected aerosol transmission for months cheered the update as a long-overdue acknowledgment of accumulating evidence for how the virus transmits, particularly in indoor spaces.

Now the page has reverted to what it said before — that the virus spreads between people in close contact through respiratory droplets. The page makes no mention of aerosol transmission.

In July, the World Health Organization updated its guidance on aerosols after more than 200 scientists urged it to do so. WHO's guidance now states:

"There have been reported outbreaks of COVID-19 in some closed settings, such as restaurants, nightclubs, places of worship or places of work where people may be shouting, talking, or singing. In these outbreaks, aerosol transmission, particularly in these indoor locations where there are crowded and inadequately ventilated spaces where infected persons spend long periods of time with others, cannot be ruled out. More studies are urgently needed to investigate such instances and assess their significance for transmission of COVID-19."

What's the difference between respiratory droplets and aerosol particles?

Respiratory droplets are larger and fall to the ground quickly — hence the 6-feet rule that's generally considered safe for social distancing amid the pandemic. Aerosol particles are smaller and can linger in the air, moving with air currents from which they can be inhaled.

An airborne virus is considered to be a virus that spreads in exhaled particles that are small enough to linger in the air and move with air currents, from which they can be breathed in by passersby who then get sick.

Linsey Marr is a professor of civil and environmental engineering who researches airborne transmission at Virginia Tech. She was excited to see the CDC's changes on Friday, though she was also surprised at how strongly the new guidance was written — particularly in that it stated plainly that SARS-CoV-2 is an airborne virus.

Such a classification could require additional precautions in health care settings, she says.

Marr says that the changes mistakenly posted by the CDC could be significant if they are implemented.

"It means that nationally we need to do something about [transmission] beyond 6 feet, which means masks and ventilation and filtration," she says. "And if we do that, I think we can get a better control on the spread of the virus."

The posted and withdrawn transmission guidelines are just the latest in public reversals and controversy at the CDC.

On Friday, the agency reversed its new guidance on testing, published in August, that suggested people who have possibly been exposed to the coronavirus don't necessarily need to get tested for infection.

Also last week, Michael Caputo, the top spokesperson for the Department of Health and Human Services, announced he was taking a leave of absence after a social media tirade in which he falsely accused government scientists of engaging in "sedition." He had also come under criticism after reports that he and scientific adviser Paul Alexander sought to edit and delay public health reports from the CDC. Alexander is leaving the agency permanently.

These episodes, among others, have raised questions about the agency's consistency and credibility during the coronavirus pandemic.

Dr. Howard Koh is a professor at the Harvard T.H. Chan School of Public Health who served as assistant secretary for health during the Obama administration.

"The consistent inconsistency in this administration's guidance on COVID-19 has severely compromised the nation's trust in our public health agencies," Koh said in a statement Monday.

"During the greatest public health emergency in a century, trust in public health is essential — without it, this pandemic could go on indefinitely. To rectify the latest challenge, the CDC must acknowledge that growing scientific evidence indicates the importance of airborne transmission through aerosols, making mask wearing even more critical as we head into the difficult fall and winter season."

NPR's Pien Huang contributed to this report.

Tourists visit the Taj Mahal on Monday, when it reopened after being closed for more than six months due to the coronavirus pandemic. Pawan Sharma/AP hide caption

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Pawan Sharma/AP

Tourists visit the Taj Mahal on Monday, when it reopened after being closed for more than six months due to the coronavirus pandemic.

Pawan Sharma/AP

Visitors are capped at 5,000 a day. Everyone must wear a mask and have their temperature taken. Tickets are digital. Selfies are allowed, but no group photos. And no touching the gleaming white marble.

Those are among the new coronavirus-era rules at India's Taj Mahal, which reopened to tourists at sunrise Monday for the first time in more than six months. The monument shut on March 17, just days before India imposed the world's biggest coronavirus lockdown, when infections were still low in the country.

Since late May, India has been easing restrictions to try to revive its economy, which shrank by nearly 24% in the last quarter. Tourism and travel — which, according to the World Travel and Tourism Council, amounted to $194.3 billion or 6.8% of India's economy in 2019 — have slumped. The Taj Mahal is India's most-visited tourist site.

Fewer than 300 people reserved tickets for Monday's reopening. Before the pandemic, the Taj Mahal received up to 70,000 visitors a day. In recent years, authorities — concerned about damage to the monument — sought to limit the number of domestic visitors to 40,000 a day and restrict the duration of visits to under three hours.

Built by the 17th century Mughal emperor Shah Jahan to house the tomb of his beloved wife, Mumtaz Mahal, the white marble Taj Mahal has only closed a handful of times in its history, including during World War II. In 1978, it shut briefly amid floods. In 1971, it also closed when India and Pakistan fought a war.

A Chinese citizen and a visitor from New Delhi were among the first to enter after sunrise Monday. Workers could be seen sanitizing handrails. Paramilitary police instructed tourists not to touch any surfaces.

On Monday, India confirmed 1,130 deaths and nearly 87,000 new coronavirus cases. It's the first time in the past six days that its daily case tally has fallen below 90,000.

India is where the virus is now spreading fastest, and scientists say it has yet to reach a peak. With nearly 5.5 million confirmed cases, India may soon surpass the United States as the world's most-infected country. With a population of nearly 1.4 billion, its infection and fatality rates are still lower per capita than that of many countries, including the U.S., Brazil and Great Britain.

Since the pandemic began, 87,882 people have died in India after testing positive for the coronavirus.

If the U.K.'s rate of new coronavirus cases doubles four more times, Chief Scientific Advisor Sir Patrick Vallance said, "you would end up with something like 50,000 cases in the middle of October per day." 10 Downing Street hide caption

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10 Downing Street

The U.K.'s COVID-19 numbers are rising fast and could reach new 50,000 cases per day by mid-October, the country's top science adviser announced Monday. Sir Patrick Vallance said his warning is based on current trends that show "the epidemic is doubling roughly every seven days."

"There's no doubt we're in a situation where the numbers are increasing," Vallance said during an online briefing hosted by 10 Downing Street. The challenge now, he added, is to prolong the time it takes for infection rates to double.

If the U.K.'s rate of new cases doubles four more times, the government health expert said, "you would end up with something like 50,000 cases in the middle of October per day."

That, in turn, would likely lead to more than 200 deaths per day by the middle of November, he added.

The figures are a warning, not a prediction, Vallance said, in a briefing hours before U.K. Health Secretary Matt Hancock was to speak in Parliament.

"The announcement on Monday is designed to prepare people here for more restrictions," NPR's Frank Langfitt reports from London. "Last week, the government limited gatherings to no more than six people, indoors or out. New restrictions could reportedly include banning separate households from meeting and imposing a curfew on pubs and restaurants — as has already occurred in parts of England."

In one week, anyone who has coronavirus symptoms or is otherwise asked to self-isolate will be legally required to do so — or face fines that start at 1,000 pounds (about $1,280).

Prime Minister Boris Johnson's goal, Langfitt adds, is to avoid a repeat of the national lockdown he instituted earlier this year.

The U.K. government's COVID-19 dashboard shows that after the initial wave of new cases and deaths from the pandemic in the spring, a definite second wave of new cases has emerged since the beginning of August. It has risen sharply in recent weeks.

"The lowest increase has been in children and in the population age 70 to 79," Vallance said. "But in every age group, we've seen an increase."

"Could that increase be due to increased testing? The answer is no," he added, saying that the proportion of people testing positive has grown.

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The U.K. has confirmed nearly 400,000 coronavirus cases — but Vallance says the actual number of infected people could be in the millions, citing antibody tests with positivity rates ranging from 6% to 7.1%.

"So about 8% — 3 million or so people — may have been infected and have antibodies," Vallance said.

Antibodies can protect against the virus, but their efficacy also fades over time and people have been reinfected in some cases, according to Vallance. "It means that the vast majority of us are not protected in any way, and are susceptible to this disease," he said.

Other European countries are also seeing worrying spikes in cases, months after the European Union began easing restrictions on travel within the region.

Referring to outbreaks in Spain and France, Vallance said, "It started with younger people in their 20s and spread gradually to older ages, as well. That increasing case number has translated into an increase in hospitalizations" — and more deaths.

He urged everyone in the U.K. to be mindful of preventing the virus from spreading.

"This disease spreads by droplets, by surface contact and by aerosols," Vallance said. He stressed the importance of avoiding environments where viral spread is likely — such as crowded or indoor places, and spots with poor ventilation — and urged anyone who could be infectious to also take precautions.

Guatemalan President Alejandro Giammattei, shown at an event marking the country's independence earlier this week, tested positive for COVID-19 Friday. Moises Castillo/AP hide caption

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Moises Castillo/AP

Guatemalan President Alejandro Giammattei, shown at an event marking the country's independence earlier this week, tested positive for COVID-19 Friday.

Moises Castillo/AP

Guatemalan President Alejandro Giammattei said Friday he's tested positive for the coronavirus. Giammattei made the announcement to Sonora, a local radio station.

He said he feels well, is showing typical symptoms of high fever and body aches and has been treated at the Centro Medico Militar, one of the hospitals designated to treat COVID-19 patients in Guatemala City.

In a live appearance on the Guatemalan government website, Giammettei said he's following his doctor's recommendations, "resting and isolating myself from all public activity," though he said, "your government continues to work."

Giammettei said he's asked his entire cabinet to be tested and to work remotely.

The Central American country closed its borders with Belize, Honduras, El Salvador and Mexico as well as its international airports on March 16.

Giammettei's announcement came on the same day that Guatemala reopened its borders, the International Aurora Airport in the capital, and Mundo Maya International Airport in the northern part of the country.

The Ministry of Health announced new travel protocols, asking that everyone older than 10 seeking to enter the country present a COVID-19 negative test result taken at most 72 hours before arrival.

The ministry is also making face masks, social distancing and hand sanitizing mandatory at the ports of entry. If a foreign traveler presents suspect symptoms upon arrival, the traveler will be denied entry; a local traveler will be isolated.

The small country with a population of less than 20 million has 84,344 confirmed COVID-19 cases and 3,076 deaths, according to the Guatemalan Ministry of Health.

Giammettei was elected president last year. He is a former prisons chief who has butted heads with President Trump over immigration.

Giammettei joins the ranks of other world leaders who have tested positive for coronavirus, such as Jair Bolsonaro of Brazil and Boris Johnson of the U.K.

"I ask for your prayers," said Giammettei on his live remarks. The 64-year-old president has multiple sclerosis and walks with the help of a cane.

Wanted in Israel: More Shofar Blowers For Socially Distanced Jewish New Year

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Rabbi Yehonatan Adouar (right) teaches a student during a shofar-blowing course in Rambam Synagogue in Ramat Gan, Israel. Daniel Estrin/NPR hide caption

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Rabbi Yehonatan Adouar (right) teaches a student during a shofar-blowing course in Rambam Synagogue in Ramat Gan, Israel.

Daniel Estrin/NPR

Never before has Israel had such a high need for those schooled in the rarefied art of shofar blowing.

The wail of the biblical shofar — made from the horn of a ram or a certain antelope species — is a hallmark of prayer gatherings on Rosh Hashana, the Jewish New Year, which begins this weekend.

But because of the coronavirus pandemic, Israel is mandating smaller, socially distanced prayer gatherings — so the country needs many more shofar blowers than in years past.

Shofars on a table during a shofar-blowing course in a Ramat Gan synagogue. Daniel Estrin/NPR hide caption

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Daniel Estrin/NPR

Shofars on a table during a shofar-blowing course in a Ramat Gan synagogue.

Daniel Estrin/NPR

Usually, shofar blowers with years of experience are tapped for the honor in synagogues that draw hundreds. This year, to help fill the need, some Israeli cities have offered free shofar-blowing courses, and experts have taught Zoom sessions.

At a lesson sponsored by the city of Ramat Gan near Tel Aviv, 50 men gather in an Orthodox synagogue to practice, creating a cacophony of horns not dissimilar to high school band practice.

"My shofar abilities are getting close to being perfect, but still I'm missing the final touch," says Nissan Uzan, a mechanical engineer whose shofar blows at a low timbre.

Teaching a shofar-blowing course, Adouar indicates how to take breaths during the traditional rhythms of the shofar during prayers. Daniel Estrin/NPR hide caption

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Daniel Estrin/NPR

Teaching a shofar-blowing course, Adouar indicates how to take breaths during the traditional rhythms of the shofar during prayers.

Daniel Estrin/NPR

Lessons include how to form an effective embouchure with one's lips, and centuries-old variations on how to toot the traditional rhythms, from the long tekiah to the rapid-fire t'ruah.

The shofar is an ancient summons, interpreted as a wake-up call to the faithful to atone for sins at one of the holiest times in the Jewish calendar, known as the Day of Judgment.

"I feel tremendous awe when you hear it," says diamond dealer Chaim Braun, another student, whose practice session receives applause from his fellow learners. "It's like a thunder. And that's one of the reasons why we blow. It's to wake up people, to wake you up to reality. There's no electronics involved. ... It's just blowing, and you blow to God."

Chaim Braun (center), a diamond dealer, attends the shofar-blowing course. Daniel Estrin/NPR hide caption

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Daniel Estrin/NPR

Chaim Braun (center), a diamond dealer, attends the shofar-blowing course.

Daniel Estrin/NPR

You could also blow droplets of the coronavirus.

"There is a risk to some extent that a person who is asymptomatic, blowing the shofar might spread some aerosols," says veteran shofar blower and Bar Ilan University immunologist Cyrille Cohen, who is advising an Israeli team working on a COVID-19 vaccine.

Cohen recommends keeping the shofar at a distance from worshippers, ideally outdoors, and covering the open end with a face mask. He says he consulted with rabbis about this, and "at first, they say, 'Oh-ho,' they kind of dismissed the idea."

There was religious debate whether a mask would distort the sound and violate the biblical commandment to hear the shofar's call. But in the end, leading Orthodox rabbis in Israel and in the U.S. have endorsed shofar masks this year.

Israel is facing one of the world's biggest resurgences of the virus and is imposing a nationwide lockdown for the second time, to start just hours before the Rosh Hashana holiday begins Friday evening. Israelis will be restricted from venturing more than 1,000 yards from their homes.

An exception to that rule: shofar blowers. They will be permitted to wander neighborhoods and play the shofar outside the windows of the faithful who are either on lockdown at home or don't want to take the health risk of attending synagogue during a pandemic.

Larry Yarbroff visits his wife Mary at Chaparral House in Berkeley, Calif. in July. California health authorities had allowed some visits to resume, and now federal regulators are doing the same, with measures to try to block the spread of the coronavirus. Jeff Chiu/AP hide caption

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Jeff Chiu/AP

Larry Yarbroff visits his wife Mary at Chaparral House in Berkeley, Calif. in July. California health authorities had allowed some visits to resume, and now federal regulators are doing the same, with measures to try to block the spread of the coronavirus.

Jeff Chiu/AP

The Centers for Medicare and Medicaid Services, which regulate nursing facilities, are lifting the ban on visitors, effective immediately. CMS imposed the restriction in March in an effort to control outbreaks of the coronavirus.

Advocates for nursing home residents and family organizations have been clamoring for a repeal, noting the many residents who have suffered anxiety or depression, as well as physical or mental decline since the ban was imposed. The issue was also raised in the report of the Coronavirus Commission for Safety and Quality in Nursing Homes, which became public on Wednesday.

Now, all nursing homes can allow outdoor visits with social distancing, as a few states have recently allowed. And most nursing homes can allow indoor visits as long as there have been no new COVID-19 infections in the past 2 weeks and the infection rate in the surrounding county is no more than 10%. But CMS recommends that nursing homes limit how many visitors a resident can have at one time, as well as limiting the number of visitors that can be in the facility at once.

A nursing facility that fails to allow visitation without a valid medical reason can suffer sanctions.

Also, nursing home residents can once again participate in social activities and communal dining, as long as there is social distancing and residents wear masks.

Since March, family members have only been allowed to visit their loved ones for so-called compassionate care. This was interpreted strictly by many nursing homes to mean end of life situations. The new guidance from CMS expands the criteria to include residents who were living with their family before admission to the nursing home and are now struggling with the change in environment, residents who need family members to provide encouragement with eating or drinking, and residents experiencing emotional distress or crying more frequently. The guidance says this should not be regarded as an exhaustive list.

The fines that the government collects for nursing home violations can now be used for facilities to buy technology that aids in family communication, as well as plastic partitions, tents, or other equipment that can help prevent transmission of the virus.

The rules do not apply only to the nursing homes. CMS states that visitors who don't follow infection prevention routines such as wearing a mask, should not be permitted to visit or should be asked to leave.

Texas Gov. Greg Abbott announced on Thursday that certain sectors in most of the state can expand their occupancy limits starting Monday. He also said that hospitals in those regions can now resume elective procedures and that eligible long-term care facilities can resume limited visitation next week. Eric Gay/AP hide caption

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Eric Gay/AP

Texas Gov. Greg Abbott announced on Thursday that certain sectors in most of the state can expand their occupancy limits starting Monday. He also said that hospitals in those regions can now resume elective procedures and that eligible long-term care facilities can resume limited visitation next week.

Eric Gay/AP

Certain businesses in most of Texas will be able to expand their operations starting Monday, thanks to an improvement in the state's COVID-19 metrics. But there is one notable exception: Bars must stay closed.

Gov. Greg Abbott on Thursday announced a slew of executive orders loosening restrictions on hospitals, long-term care facilities and certain business sectors. This is the state's first major step toward reopening since June, when a drastic uptick in coronavirus cases forced Abbott to hit the brakes.

The number of new cases and hospitalizations has declined significantly since July, Abbott said, adding that the state reported its lowest number of hospitalizations in three months on Wednesday. It averaged 3,396 new cases and 112 deaths per day in the past week.

Abbott credited the improvement to "Texans taking COVID seriously" by social distancing, wearing masks, washing their hands and following other public health guidance over the summer.

"Texans have shown that we can address both the health and safety concerns of COVID-19 while also taking careful, measured steps to restore the livelihoods that Texans depend on," said Abbott. "Achieving both goals requires safe standards that contain COVID-19, emphasize protecting the most vulnerable and establish clear metrics that the public can depend on."

He said hospitalization levels — specifically, the number of COVID-19 patients as a percentage of all people hospitalized in a region — will guide the state's reopening efforts. Areas that have experienced seven consecutive days during which that figure is 15% or less can proceed with additional reopenings, while those with higher rates will have to tighten restrictions.

Nineteen of the state's 22 hospital regions currently meet the threshold for further reopening.

Hospitals in those regions can resume elective procedures, Abbott said. He also announced guidance allowing eligible nursing homes and other long-term care facilities to reopen for limited visitation beginning Sept. 24, abiding by specific protocols.

And businesses that had previously been operating at 50% capacity may expand to 75% starting Sept. 21. Those include restaurants, retail stores, office buildings, manufacturing facilities, gyms, libraries and museums.

At a news conference on Thursday, Abbott said bars are "nationally recognized as COVID-spreading locations" and must remain closed statewide. He added that officials are working on finding ways to get them back open.

"If we fully reopen Texas without limits, without safe practices, it could lead to an unsustainable increase in COVID that would require the possibility of being forced to ratchet back down," Abbott said. "The better approach is to safely take strategic steps that help Texans return to jobs while also protecting them from COVID."

He urged Texans to practice "personal vigilance" and keep up with their mitigation efforts, especially with schools in session, sporting events resuming and flu season on the way.

Massachusetts parents sent their child to Attleboro High School despite knowing the teenager was infected with the coronavirus. Above, a coronavirus test is performed at Boston University in July. Charles Krupa/AP hide caption

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Charles Krupa/AP

Massachusetts parents sent their child to Attleboro High School despite knowing the teenager was infected with the coronavirus. Above, a coronavirus test is performed at Boston University in July.

Charles Krupa/AP

Nearly 30 Massachusetts high school students have been told to quarantine after parents sent their child to school despite knowing that the teen was positive for the coronavirus.

The students, who attend Attleboro High School, will be required to quarantine for two weeks. Attleboro Mayor Paul Heroux told NPR that the student should have been self-isolating since Sept. 9 — the day the student was tested for the coronavirus. However, the parents of the student continued to send the teen to school even after receiving the positive results on Friday.

Authorities have not released the identity of the student or family.

Chatter about the positive case began on social media, and eventually a contact-tracing team notified the school. That's when the parents were contacted and admitted to knowing that their child was positive for the virus, Heroux said.

Attleboro has six active cases of COVID-19 within the school district, which serves about 6,000 students, Heroux said. However, this is the only case he's aware of where a student was sent to school knowingly when the student was positive for the coronavirus.

The district notified everyone as soon as possible and did everything possible, he said, so the responsibility here falls on the parents of the student.

"If your child has tested positive, keep your child home. You cannot send your child to school," he said. "If they are awaiting results, please keep your child home."

Superintendent David Sawyer wrote to the families of the high school's students to inform them of the situation and urged them to keep confidence in the school's protocols. Sawyer's office declined to comment but shared the letter with NPR.

"I understand that this inevitable moment is stressful for many. However, it shouldn't change anything. The guidance from the state cannot ensure a virus-free environment, especially considering we know that some carriers are asymptomatic," Sawyer wrote in the letter, saying that contact tracing and daily pre-screening help to reduce the threat but don't eliminate it.

"We will have to wait for the end of the quarantines to be certain we were successful, but there is no reason at this moment to assume differently," he added.

Outside Attleboro, at least five Massachusetts high schools have moved classes online in response to COVID-19 concerns or outbreaks from students attending parties, according to NBC Boston.

A health worker wearing protective gear collects a swab sample during a medical screening for the coronavirus in Mumbai on Wednesday. The number of registered coronavirus cases passed 5 million on Wednesday. Punit Paranjpe/AFP via Getty Images hide caption

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Punit Paranjpe/AFP via Getty Images

A health worker wearing protective gear collects a swab sample during a medical screening for the coronavirus in Mumbai on Wednesday. The number of registered coronavirus cases passed 5 million on Wednesday.

Punit Paranjpe/AFP via Getty Images

With nearly 98,000 new coronavirus cases confirmed Thursday, India again broke the record for the highest daily tally of infections for any country since the pandemic began. It is on track, within weeks, to become the worst-affected country in the world.

On Wednesday, India's total caseload surpassed 5 million — a number only the United States had so far exceeded. The U.S. still has more cases overall, some 6.6 million. But India is where the virus is spreading fastest. The country confirmed 1 million new infections in the past 11 days alone.

Cases had plateaued in Mumbai and New Delhi, India's two biggest cities, in recent weeks. But they are climbing again, and spreading fast as well in smaller towns and rural areas, where health care is already scant.

The Health Ministry said Thursday that 1,132 people had died in the previous 24 hours after testing positive for the coronavirus. According to government figures, 83,198 people have died of COVID-19 since the pandemic began. But a majority of India's deaths are not medically certified, so the real tally may be higher. India ranks third, behind the U.S. and Brazil, in total confirmed COVID-19 deaths.

India has ramped up its testing to more than 1 million samples per day. But that's still low, per capita, for a country of nearly 1.4 billion people, and scientists believe the extent of India's outbreak may still be underestimated.

Serological studies have shown as many as 1 in 4 Indians already have coronavirus antibodies, suggesting that real rates of exposure to the virus may be much higher than confirmed cases indicate.

Back in March, with cases of COVID-19 still low in India, the government imposed the world's biggest coronavirus lockdown. The restrictions left hundreds of millions of impoverished laborers stranded in urban centers and industrial zones, with little to eat. Many starved to death as they tried to walk back to their home villages, sometimes hundreds of miles away. Their exodus helped spread the virus all over the country.

In late May, the Indian government began easing lockdown restrictions to try to alleviate economic damage. Most offices, restaurants and malls have reopened nationwide. Public transit is running again in many cities, but schools remain shut.

India's parliament also reopened Monday for the first time in nearly six months. But at least 25 lawmakers were barred from the chamber after testing positive for the coronavirus.

Despite the reopenings, India's economy shrank by nearly 24% last quarter.

On Wednesday, an Indian pharmaceutical company and Russia's sovereign wealth fund announced a partnership to distribute 100 million doses of an experimental Russian vaccine against COVID-19. The company, Hyderabad-based Dr. Reddy's Laboratories, said it was conducting phase three trials of the vaccine in India, assessing safety and effectiveness in the general population, to meet the Indian government's regulatory requirements.

The vaccine had already been approved last month in Russia, drawing international skepticism because Russia had not completed phase three trials.

The NCAA Division I Council announced on Wednesday that the 2020-2021 men's and women's college basketball seasons can begin on Nov. 25. Keith Srakocic/AP hide caption

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Keith Srakocic/AP

The NCAA Division I Council announced on Wednesday that the 2020-2021 men's and women's college basketball seasons can begin on Nov. 25.

Keith Srakocic/AP

Athletes and fans anticipating the start of college basketball will have to wait a little bit longer.

The NCAA Division I Council announced on Wednesday that the upcoming men's and women's basketball seasons can begin on Nov. 25, roughly two weeks later than originally planned, in an effort to mitigate the spread of COVID-19.

In a press release, the Division I Men and Women's Oversight Committees said they moved the start date back from Nov. 10 so that the season begins when at least three-quarters of their schools will have finished with in-person instruction for the fall semester, ideally reducing the risk of COVID-19 transmission between student-athletes and the rest of the student body.

"The new season start date near the Thanksgiving holiday provides the optimal opportunity to successfully launch the basketball season," said Dan Gavitt, NCAA senior vice president of basketball. "It is a grand compromise of sorts and a unified approach that focuses on the health and safety of student-athletes competing towards the 2021 Division I basketball championships."

No exhibition games or closed scrimmages will be allowed prior to Nov. 25, which is the day before Thanksgiving.

The council also lowered the maximum number of games a team can play in the shortened season. Men's teams can schedule 24 or 25 regular-season games in addition to one multiple-team event. Women's teams can schedule 23 regular-season games and one multiple-team event, or 25 regular-season games.

Teams must play a minimum of 13 games in order to meet sport sponsorship requirements and be considered for NCAA championship selection, which the council said amounts to a 50% reduction of the current minimum.

Officials said programs can begin their preseason practices on Oct. 14, regardless of when their first scheduled game occurs. Council members also approved a transition period, allowing athletes to participate in strength and conditioning activities and skill instruction for a certain number of hours per week from Sept. 21 to Oct. 13.

Gavitt said games and events already on the calendar between Nov. 10 and Nov. 25 will have to be rescheduled, noting schools can request waivers to play earlier but are unlikely to receive them.

"Because this is really based on medical and health and safety reasons, the oversight committees are not very open-minded about supporting waivers to start earlier than the 25th," Gavitt said.

Conference and team schedules have not yet been released.

The novel coronavirus, first detected at the end of 2019, has caused a global pandemic.

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