The Food and Drug Administration said Thursday that it had formally approved remdesivir as the first drug to treat Covid-19, a move that indicated the government’s confidence in its safe and effective use for hospitalized patients.
The F.D.A. said the antiviral drug had been approved for adults and pediatric patients 12 years of age and older and weighing at least 40 kilograms (about 88 pounds) who require hospitalization for Covid-19, the disease caused by the coronavirus, which has killed more than 220,000 people in the United States.
In May, the F.D.A. granted remdesivir emergency authorization after a trial by the National Institutes of Health found that it modestly reduced the time to recovery in hospitalized patients. President Trump received the drug after he began showing symptoms earlier this month.
The drug does not prevent deaths in Covid-19 patients.
The formal approval now granted by the F.D.A. indicates that the drug cleared more rigorous regulatory hurdles involving a more thorough review of clinical data and manufacturing quality since it was given emergency authorization in May.
“The FDA is committed to expediting the development and availability of Covid-19 treatments during this unprecedented public health emergency,” Stephen M. Hahn, the F.D.A. commissioner, said in a statement. “Today’s approval is supported by data from multiple clinical trials that the agency has rigorously assessed and represents an important scientific milestone in the Covid-19 pandemic.”
The drug was approved less than two weeks before Election Day, amid a campaign overshadowed by the pandemic. Mr. Trump, widely criticized over his administration’s handling of the crisis, has repeatedly promised a “cure” as the virus spreads to all corners of the country, and skeptics have expressed concerns about the politicization of health agencies.
Before its approval, remdesivir did not go through an outside panel of experts, called an advisory committee. But Dr. Peter Lurie, a former associate commissioner with the F.D.A. who is now president of the Center for Science in the Public Interest, said that was not unusual.
“The F.D.A. tends to pick for advisory committees those drugs that are most novel and those that present safety issues, and those that are close calls with respect to effectiveness,” Dr. Lurie said. “This is not a blockbuster drug. This is not some massive breakthrough. It’s a drug that appears convincingly to benefit patients, but it’s not some kind of miracle cure.”
A study of more than 11,000 people in 30 countries sponsored by the World Health Organization found that the drug failed to prevent deaths in patients with Covid-19.
Remdesivir, which was originally developed as a treatment for Ebola and hepatitis C, interferes with the reproduction of viruses by jamming itself into new viral genes.
The F.D.A. approval Thursday did not apply to the entire population that was covered under the agency’s emergency authorization in May.
That emergency authorization allows doctors to use the drug on hospitalized pediatric patients weighing between 3.5 kg and 40 kg or hospitalized pediatric patients less than 12 years of age who weigh at least 3.5 kg. Clinical trials assessing the safety and efficacy of the drug in this pediatric patient population are still continuing, the F.D.A. said.
Shares of Gilead Sciences, the company that makes remdesivir, rose on Thursday amid news of the F.D.A. action.
Gina Kolata and Sheila Kaplan contributed reporting.
A hospital in Idaho is 99 percent full, and warning that it may have to transfer coronavirus patients to hospitals as far away as Seattle and Portland, Ore. Medical centers in Kansas City, Mo., have turned away ambulances recently because they had no room for more patients. And just outside Milwaukee, a new emergency field hospital set up on the Wisconsin State Fairgrounds admitted its first virus patient this week.
As the United States neared a bleak record on Thursday, recording the second-highest number ever of new daily coronavirus cases — over 74,000 — more than 40,000 people were being treated in hospitals for infections. That’s a figure that has risen by 40 percent over the last month as new cases have surged, with cooler weather pushing more people indoors.
At least 14 states have had more people hospitalized for the virus on a day in the past week than at any other time since the pandemic began, according to the Covid Tracking Project, and seven more states are nearing their peaks.
“Make no mistake about this, this is an urgent crisis,” Gov. Tony Evers of Wisconsin said at a news conference on Thursday.
As a whole, the nation has had more people hospitalized at earlier points in the pandemic, during surges of cases in New York City in April and in the Sunbelt in July. But the sharply rising numbers now are deeply worrisome, not least because they are testing the limits of more limited hospital systems in smaller places.
Patients are now spread more broadly across the country, with troubling hot spots from North Dakota to Kentucky. And more people than ever are falling critically ill in rural areas, particularly in the Midwest and Mountain West, where they often must rely on hospitals with only a handful of beds.
In Utah, Dr. Angela Dunn, the state epidemiologist, seemed exasperated as she pleaded with people to take precautions. “Our health care system is at capacity, our health care providers are overwhelmed and exhausted, our public health system is stressed,” she said.
“I don’t know what to do anymore,” Dr. Dunn said. “I’m really not trying to scare anyone, I’m just trying to inform you of what’s going on.”
Experts worry that the strains will only grow as cases explode.
“I don’t really see any signs that things are slowing down, and that concerns me a lot,” said Caitlin M. Rivers, an epidemiologist at Johns Hopkins University. “It has to be our starting premise that it’s not going to slow down unless we force it to slow down.”
The Worst Virus Outbreaks in the U.S. Are Now in Rural Areas
Rural counties of fewer than 10,000 people are seeing more coronavirus cases than at any other time during the pandemic.
A highly anticipated meeting of the Food and Drug Administration’s vaccine advisory board took place on Thursday. Vaccine experts from academia, industry, nonprofits and government agencies peppered agency officials with a range of questions about its guidelines for approving a coronavirus vaccine.
Four companies are conducting late-stage clinical trials in the United States, and some have estimated they will have preliminary data that may allow them to apply for emergency authorization in certain high-risk groups by the end of November.
These were the highlights of the all-day meeting, which was broadcast on YouTube:
Several of the experts said that they believed the agency should ask the companies to wait for more safety data. They said the agency’s current guidelines, which require two months of safety data after a volunteer has received the last dose of a vaccine, were not good enough.
The experts were also asked to give their opinions about what should happen to ongoing clinical trials if the F.D.A. were to approve a vaccine for emergency use based on promising early data. Pfizer has said that if a vaccine is approved for emergency use, the company would be ethically obligated to offer the vaccine to people in the trial who received a placebo. But this would “unblind” the trial by revealing who was in each group, jeopardizing the broader results.
Many of the experts said that the results of the clinical trials — which include 30,000 to 60,000 people — were crucial to understanding whether the vaccines would work and would be safe to give to millions and possibly billions of people.
Some members said that if emergency use of the vaccine were limited to a small group of high-risk people — nursing home residents or older adults, for example — then the trials should continue, since most people in the placebo group would likely not be in those high-risk groups.
Some F.D.A. officials raised another possibility: that instead of an emergency approval, the agency could make the vaccine available in an even more limited way, through something known as “expanded access.” These programs are typically used to give experimental drugs to severely ill patients, but have been used with some vaccines.
The day’s event also included a presentation by a nonprofit group that interviewed people on their views about a coronavirus vaccine. Several people of color expressed concern about whether the vaccine had been studied in people who are Black, Latino or Native American. Others said their skepticism had historical roots, dating to the Tuskegee syphilis study, in which government scientists lied to Black men and allowed them to go untreated for the disease.
“I get along very well with Anthony," President Trump assured viewers of his debate Thursday night against former Vice President Joseph R. Biden Jr.
But that didn’t stop the president from dismissing the counsel of Dr. Anthony S. Fauci, the nation’s top infectious disease expert, as he defended his own record on the coronavirus by attacking others.
Asked by the debate moderator, Kristen Welker, why he described Dr. Fauci as “a disaster” earlier this week, Mr. Trump ticked through what he described as the health official’s mistakes in handling the pandemic.
“I’m listening to all of them, including Anthony,” he said. “I get along very well with Anthony. But he did say, ‘Do not wear a mask.’ He did say, as you know, ‘This is not going to be a problem.’ I think he is a Democrat, but that is OK.”
Dr. Fauci, who has an uneasy relationship with his boss, raised an objection after the first debate earlier this month when the president again claimed he had initially opposed mask wearing.
What Dr. Fauci had, in fact, opposed early in the pandemic, he noted, was encouraging the public to rush out and buy masks when it was unclear whether health workers treating Covid-19 patients would have enough for themselves.
Dr. Fauci has long since become an outspoken proponent of mask wearing.
He has also made a point of steering clear of politics — or trying to. That has not always been easy in the Trump administration. The president’s re-election team recently used video of Dr. Fauci in a campaign add talking out of context, and without his permission.
As parts of Europe have been hit with a second wave of the coronavirus in recent weeks, hospitals are scrambling to prepare for an onrush of Covid-19 patients at a time when bed and intensive care capacity will already be under strain during the winter flu season.
Poland has turned its largest stadium into an emergency field hospital. In Belgium and Britain, the numbers of Covid-19 patients have doubled in two weeks. And in the Czech Republic, doctors and nurses are falling ill at an alarming rate.
Europe’s current wave of infection is due in part to the relative normalcy it experienced this summer. Unlike in the United States, where the epidemic rose to a second peak in July and a third peak this month, travelers moved around Europe, college students returned to campus and many large gatherings resumed, all while the virus kept spreading.
Data released Thursday shows that the pandemic’s grip on Europe is still dangerous, and measures to control the spread of the virus over the next few weeks will be crucial in preventing hospitals from becoming overrun for a second time this year.
Where Europe’s Second Wave Is Filling Up Hospitals
People across much of Europe — including France, Italy, Poland and Spain — are now more likely to be hospitalized with Covid-19 than those in the United States.
— Allison McCann and
A senior scientist from the Centers for Disease Control and Prevention has acknowledged that the agency’s guidance on schools does not reflect the latest science showing that children can become infected with the coronavirus and transmit the virus to others.
According to a statement released Thursday by the House Select Subcommittee on the Coronavirus Crisis, the scientist told the committee on Wednesday that the agency’s guidance on schools is outdated and that three of the documents on school reopening are being updated.
The scientist, Dr. Michael Beach, the C.D.C.’s deputy incident manager for Covid-19 response, told the subcommittee that “it does appear that children can become infected” and that children “clearly can transmit,” according to the statement.
The briefing was held in response to a Sept. 30 letter to the Trump administration from the committee’s chairman, Representative James E. Clyburn, calling for revisions to the C.D.C.’s guidance “so that it faithfully reflects the science.”
On Thursday, Mr. Clyburn said he welcomed the change.
“I am pleased that the C.D.C. has finally acknowledged that the administration’s guidance on reopening schools does not reflect the best available science and has agreed to my request to revise this guidance so it accurately communicates the risks that the coronavirus poses to children,” he said in the statement. “With coronavirus cases rising around the country yet again, C.D.C. must act swiftly to provide objective, science-based information — without political meddling from the Trump administration — so schools and parents can make decisions based on unbiased advice from the agency’s public health experts.”
With discussions about school reopenings at a fever pitch, and under pressure from the White House, the C.D.C. released a guidance in July saying that “scientific studies suggest that Covid-19 transmission among children in schools may be low.”
Dr. Beach told the committee that more recent studies from the C.D.C. show “transmission from children to children,” but that wearing masks and maintaining a distance can mitigate the risks.
Overall, however, schools do not seem to be driving community transmission, according to early evidence emerging from random testing in school districts across the United States and Britain. Elementary schools, especially, seem to seed remarkably few coronavirus infections.
“The more and more data that I see, the more comfortable I am that children are not in fact driving transmission, especially in school settings,” said Brooke Nichols, an infectious disease modeler at the Boston University School of Public Health.
The bulk of evidence now suggests only limited transmission from young children to adults, at least until middle school age. But the situation for older children in middle and high schools is less clear.
Some high school reopenings have been disastrous, from the Georgia school shamed for unmasked students in its hallways to a high school in Utah that saw 90 cases within two weeks.
But research so far now suggests schools may be able to contain the virus, provided the community prevalence is low and the schools take abundant precautions.
“I think there’s a pretty good base of evidence now that schools can open safely in the presence of strong safety plans, and even at higher levels of case incidence than we had suspected,” said Dr. David Rubin, a pediatrician and infectious disease expert at the University of Pennsylvania.
The situation with colleges is different, he said. People of college age have the same risk of becoming infected and transmitting the virus as adults do, but tend to have many more social contacts.
Dr. Beach also told the House subcommittee that infections among 18- to 22-year-olds have “increased over time” and that students returning to college may have driven the second wave of infections.
“We do expect deaths to start going up, driven by that young adult group,” he said.
key data of the day
In something of a reversal of a dynamic that defined the summer, California’s new coronavirus case rates have fallen and stayed relatively low, even as the virus has surged in other states.
As of Wednesday, the nation’s most populous state was averaging 3,294 new cases each day over the past week, down from a peak of more than 10,000 in late July, when Gov. Gavin Newsom ordered most indoor businesses to close once again in order to stem the tide.
“Nothing is constant,” he said at the time. “Nothing is linear as it relates to infectious disease.”
Today, California’s per capita rate of new cases over the past week is lower than that of all but six states.
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The numbers this month have been encouraging validation for the state’s second major plan to allow businesses to reopen, after the first was criticized as too permissive, confusing and unevenly enforced by local officials across California’s vast and varied geography.
Many counties that grappled with alarming case loads over the summer have seen significant declines.
Alameda County’s seven-day average through Wednesday for new daily cases was below 100 after reaching 300 in August. San Diego County average over that same time was below 300 new cases per day, from a July peak of more than 500.
California has also significantly ramped up testing — it’s averaging more than 120,000 tests per day — and the governor previously announced a partnership with the diagnostics company PerkinElmer aimed at doubling the state’s testing capacity, which he has said will be up and running in coming days.
They have noted that the summer spike took off following Memorial Day and continued in the weeks after the Fourth of July.
And Mr. Newsom this week cautioned Californians against getting “overly exuberant” about the prospect of a vaccine, which he announced the state would independently review before making available.
About two-thirds of Californians surveyed in a recent poll by the Public Policy Institute of California said they were concerned about the development of a vaccine moving too quickly.
As part of efforts to stop the spread of false information about the coronavirus pandemic, Wikipedia and the World Health Organization announced a collaboration on Thursday: The health agency will grant the online encyclopedia free use of its published information, graphics and videos.
The collaboration is the first between Wikipedia and a health agency.
“We all consult just a few apps in our daily life, and this puts W.H.O. content right there in your language, in your town, in a way that relates to your geography,” said Andrew Pattison, a digital content manager for the health agency who helped negotiate the contract. “Getting good content out quickly disarms the misinformation.”
Since its start in 2001, Wikipedia has become one of the world’s 10 most consulted sites; it is frequently viewed for health information.
The agreement puts much of the W.H.O.’s material into the Wikimedia “commons,” meaning it can be reproduced or retranslated anywhere, without the need to seek permission — as long as the material is identified as coming from the W.H.O. and a link to the original is included.
“Equitable access to trusted health information is critical to keeping people safe and informed,” said Tedros Adhanom Ghebreyesus, the W.H.O.’s director general.
His agency translates its work into six official languages, which do not include, for example, Hindi, Bengali, German or Portuguese, so billions of people cannot read its documents in their native or even second language.
Wikipedia articles, by contrast, are translated into about 175 languages.
The first W.H.O. items used under the agreement are its “Mythbusters” infographics, which debunk more than two dozen false notions about Covid-19. Future additions could include, for example, treatment guidelines for doctors, said Ryan Merkley, chief of staff at the Wikimedia Foundation, which produces Wikipedia.
If the arrangement works out, it could be extended to counter misinformation regarding AIDS, Ebola, influenza, polio and dozens of other diseases, Mr. Merkley said, “But this was something that just had to happen now.”
Faced with a frightening surge in coronavirus cases, some cities in hard-hit Great Plains states where governors have refused to issue statewide mask mandates are taking matters into their own hands.
Mayor Tim Mahoney of Fargo, the largest city in North Dakota, used his emergency powers to issue a mandatory mask order on Monday, the first city in the state to do so. Hours later, the City Council of Minot, the state’s fourth-largest city, followed suit.
“We were hoping we had escaped the Covid-19,” Mr. Mahoney, who is also a practicing surgeon, said in an interview. “Now we’re just like everybody else in the country. It has hit us with a vengeance. We kind of thought we’d outsmart it, and you can’t outsmart this virus.”
Gov. Doug Burgum of North Dakota has implored residents to wear masks but has resisted ordering them to do so, arguing that a “light touch of government” is the best way to handle the pandemic.
Though the state had few coronavirus cases in the spring and summer, it is being hammered in the fall. In recent weeks it has consistently reported more new cases relative to its population than any other state, filling its hospitals to capacity and overwhelming its public health resources. Earlier this week, the state gave up trying to do contact tracing, and asked people who test positive to do their own instead.
A similar dynamic is playing out in Missouri. Reports of new cases there have been climbing since July, and Gov. Mike Parson contracted the virus himself in September, but the state has still not issued a statewide mask mandate.
The mayors of two small cities south of Springfield — Nixa and Ozark — issued local mask orders this week using emergency powers. Over the summer, city councils in both cities had rejected proposed mandates. But the mounting strains of Covid-19 hospitalizations in recent weeks prompted hospitals in the area to appeal to the cities to take action.
The reaction to the new mandates has been mixed, said Drew Douglas, spokesperson for the city of Nixa.
“I think our mayors really want to be careful in prioritizing the public health of our community,” Mr. Douglas said. “And balancing that with people’s concerns about personal freedom and people’s concerns about local government not imposing more than necessary.”
France will extend its nightly curfew to cover a total of 46 million people, more than two-thirds of its population, Prime Minister Jean Castex announced on Thursday. Thirty-eight additional areas in France, as well as French Polynesia, will be affected by the change, which takes effect Saturday.
The decision comes as France approaches a million recorded cases since the start of the pandemic. France has reported 178,358 cases over the past seven days, which works out to 266 cases per 100,000 people, a marked increase.
“The situation is serious,” Mr. Castex said. “The virus circulation has reached an extremely high level.”
France Covid Map and Case Count
A detailed map shows the extent of the coronavirus outbreak, with charts and tables of the number of cases and deaths.
Eight big cities and the densely populated region of Ile-de-France, around Paris, were already under a 9 p.m. curfew instituted over the weekend. The changes announced Thursday pertain to many rural areas as well.
The restrictions are aimed at mitigating the strain on hospitals. More than 40 percent of the country’s 5,800 intensive care beds are occupied. In four regions, including Ile-de-France, Covid-19 patients occupy more than half of the intensive care beds.
The government also encouraged the population to download TousAntiCovid, the new version of its tracking app, which launched on Thursday. The first version had only been downloaded 2.7 million times. Contact tracing apps are most effective when they are widely used.
Mr. Castex warned that “much more severe measures” would be under consideration if the situation did not improve.
In other developments around Europe:
The European Union said that it would extend a ban on nonessential travel by visitors from Canada, removing it from a short list of safe countries. Travelers from the United States will continue to be banned, and the refreshed list also saw the 27-nation bloc remove Tunisia and Georgia from the safe countries. Travelers from Singapore were added to the list of safe-origin visitors, while those wishing to visit the bloc from Australia, New Zealand and a handful of other nations will continue being able to do so. While there are exemptions to the rules, including for essential workers and family members, their application is up to each individual states. See the full list here.
Prime Minister Kyriakos Mitsotakis of Greece announced new rules to curb a spike in cases, including making face masks mandatory in public throughout the country and a 12:30 a.m. curfew in hot spots. The areas that will be put under curfew starting Saturday include greater Athens, Thessaloniki and several Aegean Islands, including the popular tourist destinations of Santorini and Mykonos; and Samos and Lesbos, which house migrant reception centers. “The next few months are expected to be difficult,” Mr. Mitsotakis said in a televised speech. “As a general lockdown is not among my choices, other measures are required — smarter, more targeted and, in the end, more effective.”
The foreign minister of Belgium, Sophie Wilmes, was admitted to an intensive care unit with the virus. A spokesperson said she was stable and conscious, but required professional help. Ms. Wilmes had served as prime minister until the beginning of October.
Russia’s health minister, Mikhail Murashko, will quarantine after a member of his family tested positive for the coronavirus, an aide said on Thursday, according to the Interfax news agency. Several other Russian government ministers have already recovered from the virus, including Mikhail V. Mishustin, the prime minister, and Alexander Novak, the energy minister. Russia is in the midst of a second wave of the pandemic, but the authorities are resisting reimposing lockdowns.
Four students at a university in Britain were fined a total of 40,000 pounds (about $52,000) for breaking the law on gatherings and holding a house party of more than 30 people. The students at Nottingham Trent University, in the Midlands of England, held the party in an area where mixing indoors with anyone from another household had been banned and said to the police officers who broke up the party that they were spoiling their fun. They have been suspended pending an investigation.
Spain’s Parliament rejected an attempt by Vox, a far-right party, to oust the left-wing coalition government over its management of the pandemic. Lawmakers voted down a motion of no-confidence presented by Vox by 298 votes against 52, with only representatives from Vox in favor. The vote underlined the political tensions generated by Covid-19 in Spain, but it also ended up giving the conservative Popular Party an opportunity to distance itself from the more radical demands of Vox, which is now Spain’s third-largest party.
Germany on reported 11,287 new cases of the virus in the past 24 hours, the first time the country — widely lauded for its ability to manage the pandemic — broke the 10,000 mark. The country’s seven-day case average is now above 7,200 cases, according to a New York Times database. Most of the new cases can be traced to private meetings and celebrations, said Dr. Lothar Wieler, head of the Robert Koch Institute, Germany’s public health authority. Young people now account for most of the new cases, he said, but they are increasingly spreading it to those who are older than 60. (Because of an editing error, an earlier version of this post misspelled Dr. Wieler’s given name.)
The music website jambands.com published an item on Oct. 14 about the death of Mayor Lonnie Norman of Manchester, Tenn. It might seem unusual for such a site to note the passing of an elected official from a small city. But Manchester is home to the Bonnaroo Music and Arts Festival, the largest camping music festival in North America. And Mayor Norman was Manchester’s — and by association Bonnaroo’s — champion.
“For Lonnie, it was ‘If I help here, it helps the greater good of my county, my state,’” Jeff Cuellar, a vice president of AC Entertainment, the co-producer of Bonnaroo, said in a phone interview.
Local officials don’t always embrace rock promoters. But Mayor Norman saw the economic benefits to his city (the festival injects tens of millions of dollars into the area each year), and believed in “community first,” Mr. Cuellar said.
The mayor died on Oct. 12 at a hospital in nearby Smyrna, Tenn. He was 79. The cause was Covid-19, his daughter Priscilla Norman said.
Mr. Norman’s political career began in 1984, when he served as an alderman for Manchester, a city of 10,000 65 miles southeast of Nashville. In 1991, he was elected Manchester’s first Black mayor. He served one term in the office, which is part time.
Over the next 15 years, Mayor Norman held other positions in local government. He then ran successfully for a second mayoral term in 2012. He was re-elected in 2016, and again this August.
He especially loved presenting the guitar-shaped key to his city to each year’s headliner of the Bonnaroo festival, which attracts tens of thousands of people to four days of performances in June. (This year’s festival was delayed and then canceled because of the pandemic.)
Priscilla Norman said her father’s involvement in politics flowed from his love of his hometown: “He just wanted to make a difference in the community that he grew up in.”
new york roundup
On Saturday, New York State will begin offering early voting in a presidential election for the first time in its history. Democrats in the State Legislature approved early voting last year, overhauling election rules that were among the more restrictive in the nation, and the initiative has gained urgency amid concerns about the potential hazards of voting in crowded quarters during the coronavirus pandemic.
From this Saturday to Nov. 1, voters will be allowed to cast ballots early at designated poll sites. Election Day is Nov. 3.
But New York City’s spotty track record handling elections has raised fears that early voting could be marred by the kind of chaotic operations and long waits that have occurred in some other states.
State law says there should ideally be at least one early voting site for every 50,000 voters, though counties are not required to have more than seven locations.
But Manhattan, for example, has 16 early voting sites, or one for every 75,000 registered voters, while Queens has one location for every 72,000 voters. That ratio could place a larger strain on those locations than poll sites in Staten Island, where 10 sites serve about 32,000 voters on average.
The city’s Board of Elections was forced to scramble earlier this year to recruit enough poll workers and secure poll sites, keeping the health and safety of workers and voters in mind.
An increase in mail-in voting could lessen problems at the polls, but it took more than six weeks for the board to tally some races in the Democratic primary in June because of widespread problems with mail-in voting. Then in September, the board mailed ballots with wrong names and addresses to as many as 100,000 voters in Brooklyn because of a printing error.
Even with more people voting early and an anticipated crush of mail-in ballots, officials are warning of potentially serpentine lines on Election Day that might be too long to allow people to maintain social distancing.
Elsewhere in the New York area:
On Thursday, Gov. Andrew M. Cuomo said that the statewide daily rate of positive test results was at 1.2 percent, down from 1.6 percent. In the areas he has been calling “micro-clusters,” where cases had risen in recent weeks, 3.2 percent of tests were positive. Hospitalizations in the state increased to 986, up 36 from the day before, and the highest total since June 24. In New York City, the seven-day average positivity rate was 1.76 percent, Mayor Bill de Blasio said.
In early March, when coronavirus testing was still scarce, Maggie Flannery, a Manhattan sixth-grader, and both her parents fell ill with the symptoms of Covid-19. After three weeks, her parents recovered. Maggie also seemed to get better, but only briefly before suffering a relapse that left her debilitated.
“It felt like an elephant sitting on my chest,” Maggie said. “It was hard to take a deep breath, I was nauseous all the time, I didn’t want to eat, I was very light-headed when I stood up or even just lying down.” She also experienced joint pain and severe fatigue.
She tested negative for both the coronavirus itself and for antibodies to it. But viral tests taken long after the initial infection are generally negative, and antibody tests are frequently inaccurate.
“They didn’t know anything about ‘long-Covid’ at that point,” said Amy Wilson, Maggie’s mother. “They said it was anxiety. I was pretty sure that wasn’t true”
Maggie’s pediatrician, Dr. Amy DeMattia, has since confirmed the Covid-19 diagnosis, based on the child’s clinical history and the fact that both her parents tested positive for coronavirus antibodies.
More than seven months into the coronavirus pandemic, it has become increasingly apparent that many patients with both severe and mild illness do not fully recover. Weeks and months after exposure, these Covid-19 “long-haulers,” as they have been called, continue experiencing a range of symptoms, including exhaustion, dizziness, shortness of breath and cognitive impairments. Children are generally at significantly less risk than older people for serious complications and death from Covid-19, but the long-term impacts of infection on them, if any, have been especially unclear.
Although doctors recognize that a small number of children have suffered a rare inflammatory syndrome shortly after infection, there is little reliable information about how many who get Covid-19 have prolonged complaints like Maggie. That could change as the proportion of children who are infected rises.