Today's early morning highlights from the major news organizations.
KHN: Pfizer CEO Pushes Yearly Shots For Covid. Not So Fast, Experts Say.
When Pfizer CEO Albert Bourla said March 13 that all Americans would need a second booster shot, it struck many covid experts as a self-serving remark without scientific merit. It also set off spasms of doubt over the country’s objectives in its fight against the coronavirus. The decision on how often and widely to vaccinate against covid-19 is part science, part policy, and part politics. Ultimately it depends on the goals of vaccination at a time when it’s becoming clear that neither vaccines nor other measures can entirely stop the viral spread. (Allen, 3/21)
KHN: Money Flows Into Addiction Tech, But Will It Curb Soaring Opioid Overdose Deaths?
David Sarabia had already sold two startups by age 26 and was sitting on enough money to never have to work another day in his life. He moved from Southern California to New York City and began to indulge in all the luxuries his newly minted millionaire status conveyed. Then it all went sideways, and his life quickly unraveled. “I became a massive cocaine addict,” Sarabia said. “It started off just casual partying, but that escalated to pretty much anything I could get my hands on.” (Rinker, 3/21)
USA Today: Supreme Court Justice Thomas Admitted To Hospital With Infection
Supreme Court Associate Justice Clarence Thomas has been hospitalized for the past two days and is being treated for an infection, court officials said Sunday. Thomas, the most senior associate justice on the high court, is being treated with intravenous antibiotics, the court said, and his symptoms are improving. The Supreme Court said Thomas was admitted to Sibley Memorial Hospital in Washington, D.C., on Friday after experiencing flu-like symptoms. Court officials said Thomas expects to be released in a day or two. Thomas did not have COVID-19, the court said. (Fritze, 3/20)
The Hill: Justice Thomas Hospitalized, May Miss Some Oral Arguments
It's unclear why the court waited two days to announce Thomas' hospitalization. The news of Thomas's sickness comes one day before the Senate Judiciary Committee is set to begin confirmation hearings for the history-making Supreme Court nominee Judge Ketanji Brown Jackson. If confirmed, she will become the first Black woman to serve on the high court. (Polus, 3/20)
Politico: Surgeon General: No Need To Panic Over Latest Covid Spike In Europe
“Our focus should be on preparation, not on panic,” Surgeon General Vivek Murthy said Sunday in discussing the latest rising wave of Covid-19 cases in Europe. The emergence of a new subvariant has led to a steep rise of cases in Britain, Germany, Finland, Switzerland and other European nations in recent weeks. While the United States has not yet seen a noticeable increase, experts warn that a spike in cases is pretty much inevitable. (Cohen, 3/20)
The New York Times: Fauci Predicts Uptick In U.S. Cases From BA.2 Subvariant
Dr. Anthony S. Fauci, the Biden administration’s top adviser on the pandemic, predicted on Sunday an “uptick” in coronavirus infections similar to the current increase in Europe, despite the current decline in cases, hospitalizations and deaths in the United States. It is “no time at all to declare victory, because this virus has fooled us before and we really must be prepared for the possibility that we might get another variant,” Dr. Fauci said on ABC’s “This Week.” “And we don’t want to be caught flat-footed on that.” While anticipating a new rise, Dr. Fauci said that at this time he does not expect a surge. (Jewett, 3/20)
ABC News: Fauci Says COVID-19 Cases Will Likely Increase Soon, Though Not Necessarily Hospitalizations
Over the next few weeks, the U.S. should expect an increase in cases from the BA.2 variant, Dr. Anthony Fauci told ABC News, but it may not lead to as severe a surge in hospitalizations or deaths. "I would not be surprised if in the next few weeks we see somewhat of either a flattening of our diminution or maybe even an increase," Fauci told ABC News' Brad Mielke on the podcast "Start Here." (Haslett, 3/18)
USA Today: BA.2 COVID Variant: What To Know About New Omicron Strain In The US
A new COVID variant, first detected two months ago, is making its way across the U.S. and spreading more quickly in the Northeast and West, new data released this week shows. The BA.2 variant appears to be on its way to becoming the dominant COVID strain, having roughly doubled each week for the last month, according to the U.S. Centers for Disease Control and Prevention. BA.2 is considered by the World Health Organization as a "sublineage" of the highly transmissible omicron variant. It's a different version of omicron than BA.1, which was responsible for the surge that hit the Northeast late last year. (Fallon and Snider, 3/18)
Reuters: AstraZeneca COVID Drug Neutralises Omicron Sub-Variants In Lab Study
AstraZeneca said on Monday its antibody-based cocktail to prevent and treat COVID-19 retained neutralising activity against Omicron coronavirus variants, including the highly contagious BA.2 sub-variant, in an independent lab study. This is the first data looking at the impact of AstraZeneca's Evusheld treatment on "cousins" of the Omicron variant following a recent global spike in cases. The Anglo-Swedish drugmaker said in December that another lab study found that Evusheld retained neutralising activity against Omicron. (3/21)
The Washington Post: Vaccines Remained Highly Effective At Preventing Serious Illness And Death During Omicron Surge, CDC Report Says
The coronavirus vaccines most widely used in the United States remained highly effective at preventing the worst outcomes from infections even in the face of the highly transmissible omicron variant in January, a report released Friday by federal disease trackers shows. While protection against mild illness waned over time, the mRNA vaccines from Moderna and Pfizer-BioNTech provided a robust shield against death and needing mechanical ventilation, the study from the Centers for Disease Control and Prevention found. (Shepherd, 3/18)
CBS News: "We Trust The COVID Vaccine," Heads Of Top Medical Groups Say In Ads Targeting Parents
The heads of some of America's largest professional health care associations are urging parents to get their children vaccinated against COVID-19, as part of a new advertising push by the Biden administration to persuade millions of families that have yet to do so. The ads — a pair of 60-second spots titled "Oath" and "Trust" – feature pleas from Dr. Gerald Harmon, president of the American Medical Association; Dr. Moira Szilagyi, president of the American Academy of Pediatrics; Ernest Grant, president of the American Nurses Association; and Dr. Ada Stewart, chair of the board of the American Academy of Family Physicians. (Tin, 3/17)
Stat: Covid-19 Vaccine Market Is Getting Crowded — As Demand Begins To Wane
CureVac, a pioneer in the effort to use messenger RNA as a vaccine platform, and its partner, pharmaceutical giant GSK, saw the writing on the wall last fall. When CureVac’s Covid-19 mRNA vaccine candidate underwhelmed in a Phase 2b/3 trial, the pair shifted plans. Too many other vaccines had already proven superior and been cleared by regulators. Rather than spend months tweaking a candidate that would end up battling for a rapidly shrinking share of the Covid vaccine market, they would focus instead on a second-generation product. Soon, experts tell STAT, other would-be Covid vaccine manufacturers are set to confront the same kinds of hard reality. (Branswell, 3/21)
NBC News: Is Tinnitus A Rare Side Effect Of Covid Vaccines?
It was the shock of a loud whistle that almost caused Gregory Poland to veer off the road as he was driving home after getting his second Covid-19 vaccine. "It startled me," said Poland, who is 66 years old. "I thought it was a dog whistle going off right next to me. "It was not a dog whistle; it was a piercing sound his brain conjured up for an unknown reason. Poland suspects it may have been a side effect of the vaccine. That was one year ago. The noise, he said, has been unrelenting ever since. (Edwards, 3/20)
CNN: Where The US Stands On Covid-19 Vaccines For Children Under 5
A month after the US Food and Drug Administration delayed key steps toward authorizing Covid-19 vaccines for children under 5, many parents are more eager for the shots than ever. Dr. Daniel Leonard, a pediatric hospitalist who is working on the Pfizer/BioNTech vaccine trial for these kids, said people are driving in from several states away to take part. "We're here in south central Nebraska, and while many may not think that this would be the epicenter of scientific progress, the influx that I've had with people from Colorado, Minnesota, Wisconsin, Iowa — some driving eight or nine hours each way overnight to participate in the study," he said. "They are dedicated." (Christensen, 3/19)
AP: South Dakota Ends Daily COVID-19 Reporting
Health officials in South Dakota say COVID-19 case rates have dropped so dramatically they’ll no longer give daily updates. The Argus Leader reported that the state health department ended daily reports on Friday and will now give only weekly reports. The first is expected on Wednesday. (3/20)
AP: North Dakota To Shift To Weekly COVID-19 Case Reports
North Dakota health officials have shifted from daily to weekly COVID-19 reports as the disease continues to wane across the state. The Bismarck Tribune reported the state health department made the move on Friday. Department officials said updating their website daily was time-consuming and results from the growing use of at-home test kits aren’t required to be reported to the state, leading to increasing inaccuracy in state data. (3/20)
The Boston Globe: A ‘Huge Anxiety Reducer’: Most COVID Patients Regain Consciousness Even After Weeks In A Coma, New Research Shows
Doctors and nurses say one of the toughest parts of their job is counseling anguished families about a loved one’s chances of waking up from a coma. Now a new study by Boston and New York researchers offers hope and some guideposts. It focuses on individuals who have come off of ventilators but still require life support. At that stage, patients remain hooked to machines that deliver life-saving medicine, food, and hydration as doctors regularly check their ability to respond to a voice command. If there isn’t a response in the first few days, families can start to lose hope. In the study, researchers found that most patients with severe COVID-19 regained consciousness even after spending weeks in a coma. (Lazar, 3/20)
CIDRAP: US Flu Activity Continues Slow Rebound
Flu activity continued to rise in most of the nation last week, with three more pediatric flu deaths reported, but markers are still below epidemic baselines, the US Centers for Disease Control and Prevention (CDC) said today in its latest update. The national percentage of outpatient visits for flulike illness rose slightly, to 1.7%. (3/18)
The Atlantic: America's Flu-Shot Problem Is Also Its Next COVID Problem
About 18 years ago, while delivering a talk at a CDC conference, Gregory Poland punked 2,000 of his fellow scientists. Ten minutes into his lecture, a member of the audience, under Poland’s instruction, raced up to the podium with a slip of paper. Poland skimmed the note and looked up, stony-faced. “Colleagues, I am unsure of what to say,” he said. “We have just been notified of a virus that’s been detected in the U.S. that will take somewhere between 10,000 and 15,000 lives this year.” The room erupted in a horrified, cinematic gasp. Poland paused, then leaned into the mic. “The name of the virus,” he declared, “is influenza.” (Wu, 3/18)
The New York Times: Shrugs Over Flu Signal Future Attitudes About Covid
When Dr. Arnold Monto, a public health researcher at the University of Michigan, lectures about influenza, he starts by saying: “Flu is bad.” “You don’t have to start a lecture about hypertension by saying, ‘Hypertension is bad,’” he noted. It’s self-evident. But he has to convince his audiences that flu is, in fact, bad. In good years, it kills Americans in the low tens of thousands and sickens many times more. Yet even in the time of Covid, flu, the other respiratory killer caused by a virus, is underestimated. Almost half of American adults don’t bother to get vaccinated against it. (Kolata, 3/18)
Modern Healthcare: Becerra: HHS Will Fight For More Telehealth After Public Health Emergency Ends
The Department of Health and Human Services will seek to sustain and expand access to telemedicine after the federal government declares the COVID-19 public health emergency to be over, Secretary Xavier Becerra said Friday. Telehealth proved critical to Medicare beneficiaries during the first year of the pandemic, according to a report the HHS Office of Inspector General released Tuesday. "We would be really closing our eyes to a new form of quality healthcare if we did not expand authorities for telehealth to be available to Americans," Becerra said during a news conference. (Goldman, 3/18)
CBS News: Most Medical Debt Will Be Dropped From Consumers' Credit Reports
Medical bills have become a source of major financial trouble for millions of Americans, amounting to the largest source of personal debt in the U.S. Now, the top three credit reporting agencies plan to drop most medical debt from consumers' credit reports starting this summer. Equifax, Experian and TransUnion on Friday said that they are making a number of changes to the way they handle medical debt on credit reports, which is a record of a consumer's borrowing and repayment. Lenders use credit reports to determine whether a consumer is a good bet for a loan, which means a poor credit score can make it hard to get a mortgage, car loan or other products. Credit reports can also affect people's ability to rent an apartment and even get a job. (Picchi, 3/18)
CIDRAP: COVID-19 Patients May Owe Thousands For After-Hospital Care
Even when insurance companies waived charges for COVID-19 hospitalizations, 10% of patients still had out-of-pocket costs of $2,000 or more for care that took place in the 6 months after they were released, finds a new study in the American Journal of Managed Care. The same team published a study Feb 14 in JAMA Network Open showing that COVID-19 hospitalizations alone could cost patients, on average, $1,600 to $4,000. (3/18)
Modern Healthcare: HRSA: Providers That Lost 340B Eligibility During COVID-19 Can Reapply
Providers that were kicked out of the 340B Drug Pricing Program during the pandemic will be able to apply for reinstatement, the Biden administration said Friday in a notice to providers. Disproportionate Share Hospitals, sole community hospitals, rural referral centers, children's hospitals and free-standing cancer hospitals that were terminated from the program after Jan. 26, 2020, due to a change in patient mix, can apply to be reinstated. Providers must prove that the share of Medicare or Medicaid patients they treated decreased as a result of the public health emergency or the pandemic. (Hellmann, 3/18)
AP: Xavier-Louisiana Students Can Get Early Admission To LSU Med
A national leader in the number of Black graduates accepted by medical schools has a new early acceptance agreement with one of Louisiana’s largest medical schools. LSU Health New Orleans School of Medicine will admit up to 10 Xavier University of Louisiana students a year under the program, with a pair of four-year full scholarships open to those who don’t apply to any other medical school. (3/20)
Crain's Detroit Businesss: Metro Detroit Hospitals Most Racially Segregated In U.S.: Study
Metro Detroit hospitals are the most racially segregated in the country, according to a new study released Thursday by healthcare think tank Lown Institute. Researchers studied more than 2,800 hospitals in the U.S. using Medicare claims and the U.S. Census Bureau's American Community Survey from 2020 to determine the racial makeup of patients at each hospital versus the makeup of the community in which they serve. Metro Detroit's hospitals scored the worst for racial inclusiveness at 90 percent segregated. St. Louis ranked second with a 77 percent segregation. (Walsh, 3/18)
San Francisco Chronicle: In Wake Of COVID, Advocates For HIV Care Seek Return To Spotlight
San Francisco’s aggressive, nationally recognized push to drive HIV infections to near zero and improve the health of those living with the virus took a discouraging hit during the COVID pandemic, as attention citywide focused on a new and different public health crisis. HIV cases continued a decade-long decline during the pandemic, but testing also fell off dramatically and health officials worry they missed some infections in 2020 and 2021. Prescriptions for drugs to prevent HIV also decreased, potentially leaving some San Francisco residents vulnerable. (Allday, 3/20)
AP: Lawmakers Consider Proposal To Expand Birth Control Access
Lawmakers in Rhode Island are considering a proposal to allow pharmacists to give people birth control without authorization from a doctor. Rhode Island’s House of Representatives approved a bill last week that would allow pharmacists to prescribe birth control. The measure is now under consideration in the Senate, where similar legislation has been introduced. (3/20)
AP: Lawmakers Seek Increase In School Mental Health Services
Connecticut lawmakers are looking at ways to increase mental health services for school students, and a recent report has illuminated where the help is needed most. The legislative task force, led by the state Department of Health, began meeting late in 2021 to look at how and where the services should be offered. (3/20)
AP: Most Vermont Barracks Now Have A Mental Health Crisis Worker
Nearly all of the state police barracks in Vermont now have an embedded mental health crisis worker. The Burlington Free Press reports that the Vermont Department of Public Safety has hired mental health workers for nine of its 10 barracks, who ride in cruisers with troopers and interact with the public alone while the trooper stays in the car when it’s safe to do so. (3/19)
Milwaukee Journal Sentinel: Milwaukee County Mental Health Emergency Center Receives $2.5 Million
More funding has been procured for the Milwaukee County Mental Health Emergency Center, as the center eyes a September opening. Wisconsin Gov. Tony Evers announced last August that he was allocating $5.7 million for the center, which will serve county residents. This week, U.S. Sen. Tammy Baldwin announced in a news release that she had worked to secure just over $2.5 million for the center, 1525 N. 12th St., Milwaukee. “Many people are struggling with depression, anxiety, and other mental health challenges as the result of a pandemic that has brought disruption, isolation and stress," Baldwin said in the release. "We need to provide more support for people and this legislation does just that, including better mental health services for kids who have had to endure a great deal throughout this pandemic." (Casey, 3/18)
Fox News: Fentanyl Found In Ventilation System Of Ohio Juvenile Detention Facility; 7 Victims Rushed To Hospital
At least seven people have been taken to the hospital after fentanyl was discovered in the air ventilation system of an Ohio juvenile detention facility, forcing an evacuation. Multiple ambulances and emergency personnel responded to dispatch calls at the Northwest Ohio Juvenile Detention Training and Rehabilitation Center in Stryker after several victims began collapsing for an unknown reason, WTOL reported. It was later discovered that fentanyl was being spread throughout the facility via the air conditioning, affecting four juveniles and three corrections officers, Williams County Sheriff's Deputy Jeff Lehman told the outlet. (Richard, 3/21)
Anchorage Daily News: ‘Lethal Batch’ Of Heroin Has Caused At Least 6 Deaths In Mat-Su, According To Alaska State Troopers
A “lethal batch” of heroin circulating now in Mat-Su has caused at least six deaths and 17 overdose emergencies, Alaska State Troopers say. Troopers, along with Palmer and Wasilla police departments, responded to several suspected overdoses just this week, troopers said in an online dispatch. “Law enforcement believe that a lethal batch of heroin is currently circulating in the Mat-Su, causing the rise in overdose events.” The deaths and emergencies — any overdose that required a 911 call for help or other request for assistance — were all within the last 30 days, according to troopers spokesman Austin McDaniel. (Hollander, 3/18)
Anchorage Daily News: Emails Show Anchorage Spokesman Had Information About Mayor Bronson’s Fluoride Shutoff Before Denying It Occurred
Newly released public records about Mayor Dave Bronson’s decision to briefly shut off fluoridation of Anchorage’s water supply show that the mayor’s spokesman had been emailed information about the shutoff by another official before he categorically denied the incident happened. Bronson temporarily halted fluoridation of the city’s water supply during an Oct. 1 visit to Anchorage Water and Wastewater Utility’s Eklutna Water Treatment Plant. City law requires Anchorage’s water supply be fluoridated. The mayor eventually said he ordered fluoride to be shut off after workers told him they were experiencing health issues related to the substance. The fluoride shutoff was first reported by the Alaska Landmine in December in an anonymously-sourced article. (Goodykoontz, 3/20)
Los Angeles Times: L.A. Homeless Encampment Is Cleared Amid Taunts And Shoves
Night was falling Thursday when sanitation crews had to pause work on clearing a homeless encampment at a Little Tokyo plaza. A protester had jumped into a sanitation truck and refused to get out. She cursed and yelled at sanitation workers for tearing down the encampment. By then, most of the homeless people had been given temporary housing or moved to the sidewalk. The 10-minute standoff was one of several clashes that continued past midnight as sanitation crews tried to clear and fence off Toriumi Plaza, reflecting the knot of tensions in a city with little agreement on how to deal with the homeless crisis. (Vives, 3/18)
CNN: BPA Linked To Asthma In School-Age Girls, Study Finds
Exposure in the womb to bisphenol A, commonly known as BPA, may increase the risk of asthma among school-age girls, according to a new study of over 3,000 pairs of mothers and children from six European countries. "We believe that the effect may be due to the fact that bisphenols can cross the placental barrier and interfere with the child's respiratory and immune systems during the developmental phase," said first author Alicia Abellán, a postdoctoral researcher at Barcelona Institute for Global Health, in a statement. There was a significant association between levels of BPA in mothers' urine and asthma and wheezing for girls, but not boys, according to the the study published Friday in the journal Environment International. (LaMotte, 3/18)
The Washington Post: 2.55 Million Middle And High School Students Use Some Type Of Tobacco Product
The latest analysis of smoking habits among U.S. youths describes 2.55 million middle school and high school students as users of some type of tobacco product (combustible, smokeless or electronic). That equates to about 13 percent of high school students and 4 percent of middle school students. The findings are from the 2021 National Youth Tobacco Survey, run jointly by the Centers for Disease Control and Prevention and the Food and Drug Administration. (Searing, 3/20)
NPR: Americans Got A Bit Happier Last Year, But They've Still Got Nothing On The Finns
The World Happiness Report's annual rankings remain remarkably stable despite the lingering effects of the pandemic across the globe. Finland once again ranked the happiest according to people's self-reported assessment of their lives on a scale of zero to 10, with zero being the worst possible life they could have expected to have, and 10 being the best. Finland's neighbors, Denmark, Iceland, Sweden and Norway, all ranked in the top 10. The United States saw its ranking edge up slightly from last year, from 19th to 16th. (Dean Hopkins, 3/18)
The Washington Post: Trauma In Infancy Can Have A Lingering Effect Throughout Life
Are infants too young to experience and remember painful emotions or traumatic events? A growing body of research suggests no, and researchers believe that if left untreated, trauma experienced in infancy can sometimes result in lifelong health consequences. Beyond such obvious triggers as war and terrorism, exposure to domestic violence, natural disasters such as a house fire, physical abuse and community violence are examples of experienced events that can be traumatic for infants, experts say. (Reilly, 3/20)
The Wall Street Journal: Ukraine’s World-Class Drug-Molecule Industry Imperiled By Russia Invasion
Russian attacks are endangering Ukraine’s world-leading medicinal chemistry industry, which supplies scientists across the globe with molecular building blocks needed for early drug development. Ukraine’s dominance in medicinal chemistry is little known beyond drug developers, who fine-tune a drug’s molecular design to give it the best chance of hitting the desired biological target in the body. Kyiv-based Enamine Ltd. has become a go-to supplier for drug-discovery scientists at academic laboratories and the largest pharmaceutical companies. (Roland, 3/20)
Stat: When Should Drug Makers Cut Off Essential Medicines To Russia?
Just say nyet? As the war in Ukraine intensifies, several of the world’s largest pharmaceutical companies have now joined hundreds of corporations in other industries that are cutting ties to Russia. One by one, many big drugmakers announced they would wind down clinical trial work, curtail investments, and withhold medicines that are not essential, which is to say, lifesaving treatments. But is that enough? (Silverman, 3/19)
Fox News: Chernobyl Staff Held Hostage By Russian Troops For Weeks Rotated: IAEA
Fox News confirmed that a group of 46 employees rotated into the facility on Sunday to start a new shift. Russian forces took control of the Chernobyl nuclear power plant on Feb. 24, with the staff there forced to stay behind and continue to operate the plant where radioactive waste management facilities are located. Officials had repeatedly expressed alarm that the staff was suffering exhaustion after weeks of forced, unrelieved work and that this compromised the decommissioned plant's safety. (Betz, 3/20)
The Wall Street Journal: War In Ukraine Is Already Taking Its Toll On Global Food Supplies
Ukrainian farmer Igor Borisov has 2,000 metric tons of corn from the fall harvest stuck in a warehouse behind Russian battle lines. Like other farmers across Ukraine, his crop for this year is also imperiled. Global concerns that Russia’s invasion would curtail Ukraine’s 2022 harvest have come to fruition. The crop shortfall will extend to the many countries that rely on Ukraine for wheat, corn and cooking oil. (MacDonald, 3/20)
NPR: Russia's War With Ukraine Is Devastating To Ukraine's War On TB
"We have 20 patients we can't find, so we don't know if they are alive or not," says Dr. Olha Konstantynovska. She's referring to the tuberculosis patients under her care in Kharkiv, where, as in much of Ukraine, the Russian war has disrupted lives – including her own. She and her three daughters evacuated to her father's home about 20 miles away after a bomb hit a building down the street from their apartment. TB — a serious bacterial infection of the lungs — is a big problem in Ukraine. According to the World Health Organization, the country has the fourth highest incidence of the disease in Europe. And it has one of the highest rates of multidrug resistant TB anywhere in the world. (Daniel, 3/19)
AP: Young Ukrainian Cancer Patients Get Medical Help In Poland
Twenty-two-month-old Yeva Vakulenko had been through four rounds of chemotherapy for leukemia at a hospital in Ukraine, and then suffered a relapse. As she began returning again for more treatment, Russia invaded, disrupting doctors’ efforts to cure her. Air raids forced the toddler to shelter in the basement of the hospital in the western city of Lviv for hours at a time, making her feel even worse. She cried a lot and sought comfort from her grandmother, who is caring for her after her parents were in an accident that left her mother disabled with brain and leg injuries. (Gera and Kuczynski, 3/19)
AP: China Reports First COVID-19 Deaths In More Than A Year
China’s health authorities reported two COVID-19 deaths on Saturday, the first since January 2021, as the country battles its worst outbreak in two years driven by a surge in the highly transmissible omicron variant. The deaths, both in northeastern China’s Jilin province, bring the country’s coronavirus death toll to 4,638. (3/20)
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