WEDNESDAY, Sept. 23, 2020 (Healthday News) — The U.S. coronavirus death toll reached the tragic milestone of 200,000 on Tuesday, with at least 22 states now reporting a rise in new cases.

Just last Monday, only nine states were reporting increases in new COVID-19 cases, CNN reported. For the most part, the case spikes are showing up in the country’s heartland and the Midwest.

“We’re entering into the fall and into the winter, and that means there’s going to be more indoor things than outdoor things,” Dr. Anthony Fauci said Tuesday, CNN reported. “Going into that situation, I would like to have seen the baseline of where we are — the daily number of infections — come way, way down, and not be stuck at around 30 to 40,000 per day.”

In the next three months, another 150,000 people could lose their lives to COVID-19, according to the University of Washington’s Institute for Health Metrics and Evaluation (IHME), CNN reported.

Alarm is growing in states like Kentucky and Wisconsin, which has one of the highest COVID-19 positivity rates in the nation, higher than 16%, CNN reported.

Wisconsin’s governor declared a new public health emergency this week following a surge of cases among young people and issued a new order for face coverings. Kentucky also saw a spike in its positivity rate after several counties witnessed a surge in coronavirus cases, according to CNN.

COVID-19 is now the second-leading cause of death in the United States, just after heart disease, according to the IHME, CNN reported.

As worry builds over what winter will bring, four of the top doctors leading the government’s coronavirus response will testify in the Senate on Wednesday, The New York Times reported. Updates on the state of the government’s response will come from Fauci; Dr. Robert Redfield, director of the U.S. Centers for Disease Control and Prevention; Dr. Stephen Hahn, commissioner of the Food and Drug Administration; and testing czar Adm. Brett Giroir.

Redfield will likely face questions about testing guidelines issued last month that suggested certain people exposed to the virus did not need to be screened, the Times said. Internal documents show the guidance was posted on the CDC website despite serious objections from agency scientists, and the agency reversed the guideline last week.

Hahn will probably be asked about the FDA’s plan to issue stricter guidelines for the emergency use of any new coronavirus vaccine, the Times reported. The guidelines may be released this week, and would recommend that vaccine trial data be vetted by a committee of independent experts before the FDA approves any emergency use, several people familiar with the draft told the Times.

One-shot vaccine moves to larger trials

In news that might help make vaccinating all Americans against COVID-19 more easy to accomplish, the first coronavirus vaccine that only requires a single shot has entered the final stages of testing in the United States, the Washington Post reported.

The international trial will eventually recruit up to 60,000 participants. The vaccine, made by Johnson & Johnson, is the fourth to enter the large, Phase 3 trials that determine effectiveness and safety, the Post reported.

Paul Stoffels, the company’s chief scientific officer, predicted on Tuesday there may be enough data to have results by the end of the year and the company plans to manufacture 1 billion doses next year.

Three other vaccine candidates have a head start, with U.S. trials that began earlier this summer, but the vaccine being developed by Johnson & Johnson could be easier to administer and distribute if it’s proven safe and effective, the Post reported.

The company is initially testing a single dose, while the other vaccines require a second shot three to four weeks after the first one, the newspaper said. The Johnson & Johnson vaccine can also be stored in liquid form at refrigerator temperatures for three months, whereas two of the three other vaccines must be frozen or kept at ultra-cold temperatures for long-term storage, the Post reported.

“A single-shot vaccine, if it’s safe and effective, will have substantial logistic advantages for global pandemic control,” said Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston, who partnered with Johnson & Johnson to develop the vaccine.

“It is a really good thing that we have this diversity of platforms because this is a critical crisis in terms of our global circumstance,” said Dr. Francis Collins, director of the U.S. National Institutes of Health. “Now, here in the U.S. with 200,000 deaths, we want to do everything we can without sacrificing safety or efficacy.”

Study shows having both flu, COVID doubles death risk in hospital patients

While health officials worry about a potential “twindemic” of COVID-19 and the flu this winter, a new study finds that hospital patients who were infected with both viruses were more than twice as likely to die as those infected only with the new coronavirus.

British government scientists conducted the research during the early months of the pandemic, and the results were troubling: 43% of patients who were hospitalized with both infections died, compared with 26.9% of people who were hospitalized for coronavirus infection alone, the Post reported.

While the study only followed 58 people between the months of January and April, the findings line up with similar research that is already underway, the Post reported.

“If you get both, you are in some serious trouble, and the people who are most likely to get both of these infections may be the very people who can least afford to in terms of their own immune system, or their risk for serious outcomes,” Yvonne Doyle, Public Health England’s medical director, said in an agency news release. She urged people considered high-risk to go for a flu shot if they were eligible.

“The flu vaccine is more important than ever, to help reduce transmission of flu and protect the nation from the double threat of flu and COVID-19,” Doyle said.

As for a COVID-19 vaccine, some U.S. pediatricians are warning that a coronavirus vaccine for children might not arrive before the fall of 2021. While scientists are racing to develop a vaccine for adults, no one has started the process for children, The New York Times reported.

“Right now, I’m pretty worried that we won’t have a vaccine available for kids by the start of next school year,” Dr. Evan Anderson, a pediatrician at Children’s Healthcare of Atlanta, told the Times.

Anderson and his colleagues recently published a commentary in the journal Clinical Infectious Diseases in which they called for vaccine makers to address the issue.

Cases keep mounting

By Wednesday, the U.S. coronavirus case count passed 6.9 million as the death toll reached 200,731, according to a Times tally.

According to the same tally, the top five states in coronavirus cases as of Wednesday were: California with over 795,000; Texas with more than 749,000; Florida with nearly 688,000; New York with almost 456,000; and Georgia with nearly 291,000.

Curbing the spread of the coronavirus in the rest of the world remains challenging.

By Wednesday, India’s coronavirus case count had passed 5.6 million, just over one month after hitting the 3 million mark, the Times reported.

More than 90,000 coronavirus patients have died in India, but when measured as a proportion of the population, the country has had far fewer deaths than many others. Doctors say this reflects India’s younger and leaner population.

Still, the country’s public health system is severely strained, and some sick patients cannot find hospital beds, the newspaper said. Only the United States has more coronavirus cases.

Meanwhile, Brazil posted nearly 4.6 million cases and more than 138,000 deaths as of Wednesday, the Times tally showed.

Cases are also spiking in Russia: The country’s coronavirus case count has passed 1.1 million, the Times reported. As of Wednesday, the death toll in Russia was over 19,700.

Worldwide, the number of reported infections passed 31.6 million on Wednesday, with over 971,000 deaths, according to the Hopkins tally.

More information

The U.S. Centers for Disease Control and Prevention has more on the new coronavirus.