A growing number of communities are now seeing COVID-19 cases and hospitalizations at levels high enough to warrant indoor masking and other measures to curb the virus, the Centers for Disease Control and Prevention warned Thursday. A number of major cities are now mulling a return to masking measures.
According to the agency’s weekly update, 13.7% of Americans now live in communities now rated at “high” COVID-19 Community Levels, up from 4.9% of the population last week. An additional 38.1% of Americans are in “medium” areas and 48.2% are in “low” areas.
More than ten large counties with more than a million residents are now at this “high” tier:
Los Angeles County, California (10,039,107 residents)
Maricopa County, Arizona (4,485,414)
Kings County, New York (2,559,903)
Queens County, New York (2,253,858)
San Bernardino County, California (2,180,085)
Santa Clara County, California (1,927,852)
New York County, New York (1,628,706)
Suffolk County, New York (1,476,601)
Bronx County, New York (1,418,207)
Nassau County, New York (1,356,924)
Pima County, Arizona (1,047,279)
The list includes much of the New York metro area. Officials in the state recently urged schools to return to indoor masking to curb the spread of COVID-19 as well as the respiratory virus RSV and influenza. Authorities in Los Angeles have also warned that indoor masking rules might return there as cases have mounted.
The updated figures come as CDC officials say they have been mulling new “pan-respiratory” benchmarks to measure the spread of all three viruses, as a possible replacement for the COVID-19 Community Levels framework.
If incorporated into the CDC’s COVID-19 recommendations, that could mean flu and RSV cases would also factor into when the agency urges Americans to don masks and take other precautions to help curb a surge that could overwhelm hospitals.
“We have also been working on trying to develop, as rapidly as possible, metrics that would be useful at state or regional levels for being able to visualize the level of overall respiratory viral activity,” the CDC’s Barbara Mahon said this week at a meeting of the agency’s outside advisers.
Mahon said the agency hoped the metrics would be “ready to come out soon.”
“Bumpy days ahead”
While Biden administration officials say they are confident this year’s surge in RSV seems to have peaked in most parts of the country, and there are early signs that flu hospitalizations may have also peaked, both remain near levels as bad as some of the worst previous seasons on record.
The pace of new COVID-19 hospitalizations has also climbed nationwide, up 13.8% from the week prior. In nursing homes this week the CDC tallied the worst rate of COVID-19 infections in residents since last February.
Roughly two in three cases are now estimated to be the BQ.1 or BQ.1.1 variants.Moderna and Pfizer say their lab data suggests their updated shots will offer added protection against these Omicron strains.
But the immune-evasive strains recently forced the FDA to bench the last available antibody treatment for COVID-19 patients.
Federal health authorities and some experts have encouraged doctors seeing vulnerable and immunocompromised patients to resort back to treatments like convalescent plasma, though they acknowledge that they can be hard to come by. Federal funding to support blood collection and boost plasma supplies earlier in the pandemic expired in 2021.
“We are seeing a clear uptick in infections of COVID pretty much in every region of the country, up about 40% over the last couple of weeks. So three challenges all arriving at the same time. There’s going to be some bumpy days ahead,” Dr. Ashish Jha, the White House’s top COVID-19 official, told the Health Action Alliance at an event Thursday.
Jha said he urged people to seek out treatments for the disease as well as an updated COVID-19 booster.
Thanks in part to an expected slowdown in vaccinations over holiday weekends, CDC figures suggest the average pace of new COVID boosters administered has now plummeted 66% from its mid-October peak. On Wednesday, Mahon lamented the pace of shots as now “woefully slow.”
Around 15.5% of adults and 34.2% of seniors now have an updated COVID booster, as of figures published Thursday. By comparison, CDC survey data estimates nearly 60% of seniors had an annual flu shot through November last year.
“The good news here is what happens, how this all plays out, how disruptive is it, how many people are going to get sick, so much of that is dependent on us,” Jha added.
Alexander Tin
CBS News reporter covering public health and the pandemic.
To help prevent outbreaks of food-related illness and problems like the formula shortage that left many parents in the US without adequate access to food for their babies, the US Food and Drug Administration needs a clearer mission and a different kind of leadership, and it has to act with more urgency, according to a highly critical new report.
After the agency faced serious criticism for its handling of the formula shortage, FDA Commissioner Dr. Robert Califf commissioned the review of the Human Foods Program in July from the Reagan-Udall Foundation, an independent group of experts.
The need for a review was considered so urgent that Califf asked the group to submit the report in 60 business days – lightning speed for government-focused reports. It was submitted to the FDA on Tuesday.
About 48 million Americans get some kind of foodborne illness every year, according to the US Centers for Disease Control and Prevention. Of those, 128,000 are hospitalized, and 3,000 die. Produce alone in 2019 was responsible for 46% of foodborne illness outbreaks, according to the US Department of Agriculture.
The FDA oversees the safety of 78% of the US human food supply.
It enforces food safety regulations, works with local governments on food safety information, promotes dietary guidelines, and develops food safety information and education, as well as overseeing nutrition labels on most food and being responsible for promoting good nutrition practices to the US public.
The US food supply is generally recognized as safe, the Reagan-Udall Foundation’s report said, but the FDA needs to be much more proactive in dealing with foodborne pathogens in order to protect Americans.
“An approach that is primarily focused on identifying and reacting to acute outbreaks of foodborne illness and death is unacceptable,” the report says.
Americans’ nutrition can also improve, the report says. Most people don’t follow the US dietary recommendations, and more than a million die of diseases that can be linked to diet such as heart disease, type 2 diabetes and cancer each year, according to the FDA
“Relying solely on food labeling and consumer education to drive the needed changes in the food supply is also an unacceptable strategy for reducing diet-related chronic diseases,” the new report says.
The report suggests that the agency needs major reformin order to do a better job managing food in the US. Some of the proposed changes would require congressional approval.
The report has several suggestions for ways to reach these goals. One would create a separate Center for Nutrition within the US Department of Health and Human Services. Another would have the FDA develop a strategy to increase funding for the Human Foods Program, with help from Congress. The agency could also connect its technology systems so they better communicate with each other.
The FDA could seek to amend the Federal Food, Drug, and Cosmetic Act to allow the disclosure of more information to local agencies. Or it could get regulatory authority to request records from food manufacturers in advance or in lieu of inspection.
The report recommends that the FDA explore applying its authority to require infant formula manufacturers, for instance, to keep microbiological testing records that are available on request so there is real-time disclosure of results.
It also suggests that the FDA use its mandatory recall authority more often and that there should be a process by which accommodations are made for products that are considered life-sustaining, like formula. At the moment, food recalls are usually voluntarily initiated by a manufacturer or food distributor.
The report also notes that the food program is run under the leadership of several managers. This “lack of a single, clearly identified person” to lead the program has led to a culture of “constant turmoil” and “indecisiveness and inaction” that has created “disincentives for collaboration,” according to the report.
That turmoil was partly to blame for the agency’s problematic handling of the formula shortage, the report says.
Experts have said the agency failed to act quickly enough on sanitation complaints at an Abbott Nutrition formula manufacturing facility in Michigan, and because of a lack of communication across departments, it didn’t circumvent what became a massive shortage of formula after the plant shut down.
“A review of events indicates that lack of communication and engagement across the Agency accounted, in part, for missteps,” the new report says. “There was little motivation, and apparently no requirement, to share information and interact across the Agency to facilitate critical thinking and proactive decision-making.
“This is especially problematic in a crisis, where decisions should be made quickly and be vetted properly.”
The report suggests that the FDA create a new structure with clear roles and leaders. It also encourages development of a culture that is more transparent, that acts quickly and collaborates.
“The current culture of the FDA Human Foods Program is inhibiting its ability to effectively accomplish this goal” of protecting public health,” the report says.
Califf said Tuesday that the agency has not had the opportunity to review the report in depth but that the report provides “significant observations” and options to consider.
“The work of these independent evaluators will help to inform a new vision for the FDA Human Foods Program,” Califf said in a news release.
Some critics have suggested that foodsafetytakes a back seat to the FDA’s regulations of drugs and medical devices. Califf acknowledged that food policy was important to the agency, citing the decline in life expectancy in the US largely due to chronic diseases that can be improved with good nutrition.
“The Human Foods Program is a top priority for the agency. America’s food supply is as safe as it’s ever been,” he said. “That said, over the past several years, the program has been stressed by the increasing diversity and complexity of the nation’s food systems and supply chain, the ongoing impacts associated with climate change and rapid advances in the science underlying many of the foods we eat today.”
The FDA will inform the public about how it is moving forward on the panel’s suggestions by the end of January and will provide additional updates at the end of February, including on any structural or procedural changes it will make, Califf said.
He said he’s putting together a group of leaders at the FDA that will advise him on how to “operationalize these findings,” and he expects these leaders to be “bold and focused on the transformative opportunities ahead for the FDA’s food program.”
In April, a coalition of 30 organizations that represent industry, local regulators and consumers sent a letter to the FDA asking for the creation of a deputy commissioner for foods with direct line authority over all the agency’s food components.
One of the organizations, Consumer Reports, has called for months for more accountability and focused leadership from the FDA.
“We need strengthened leadership and accountability at the FDA to implement a culture of prevention, respond more quickly to problems as they arise, and take timely action on proposed food safety rules and initiatives,” Brian Ronholm, Consumer Reports’ director of food policy, said Tuesday.
Ronholm called the new report a “very encouraging first step.”
“We cannot afford to tolerate the status quo and let this moment go by without adopting fundamental changes to improve the FDA’s ability to protect the public and ensure our food is safe,” he said in a statement.
The Consumer Brands Association, a trade association for food manufacturers that also signed the April letter, said Tuesday that the lack of a single leader on food policy leads to “a lot of inefficiencies.”
“A siloed approach across FDA makes it harder for industry to engage,” said Sarah Gallo, the organization’s vice president for product policy. “It is just really complicated when you don’t have somebody looking over the different parts of the agency that have some form of jurisdiction over all those things.
“We can’t ignore what happened with the formula crisis,” Gallo added, a tangible example of what can happen when the FDA is not functioning at its best.
Roberta Wagner, vice president of regulatory and technical affairs for the Consumer Brands Association, agreed that if there were one person in charge, they could make sure the inspection and policy parts of the FDA would work together.
Wagner added that the food industry has embraced a more prevention-oriented kind of philosophy when it comes to safety. “Quite frankly, the problem is, FDA’s inspection force has not modernized itself or its approaches to basically mirror that prevention-oriented system and philosophy,” Wagner said.
The FDA food division has its work cut out for it, though, added Wagner, who worked with the agency in several capacities before joining the association.
“Think about it: The FDA has to keep up with hundreds of thousands of farms and facilities,” she said. “If you have these siloed operations, you’re not having these really critical conversations about where we should be and what should we be doing out there.
“We all want an FDA with a strong foods program. We want consumers not to worry about what they’re eating or whether they’re going to be able to get that certain needed food product,” Wagner added.
Following a series of consultations with global experts, WHO will begin using a new preferred term “mpox” as a synonym for monkeypox. Both names will be used simultaneously for one year while “monkeypox” is phased out.
When the outbreak of monkeypox expanded earlier this year, racist and stigmatizing language online, in other settings and in some communities was observed and reported to WHO. In several meetings, public and private, a number of individuals and countries
raised concerns and asked WHO to propose a way forward to change the name.
Assigning names to new and, very exceptionally, to existing diseases is the responsibility of WHO under the International Classification of Diseases (ICD) and the WHO Family of International Health Related Classifications through a consultative process
which includes WHO Member States.
WHO, in accordance with the ICD update process, held consultations to gather views from a range of experts, as well as countries and the general public, who were invited to submit suggestions for new names. Based on these consultations, and further discussions
with WHO’s Director-General Dr Tedros Adhanom Ghebreyesus, WHO recommends the following:
Adoption of the new synonym mpox in English for the disease.
Mpox will become a preferred term, replacing monkeypox, after a transition period of one year. This serves to mitigate the concerns raised by experts about confusion caused by a name change in the midst of a global outbreak. It also gives time to
complete the ICD update process and to update WHO publications.
The synonym mpox will be included in the ICD-10 online in the coming days. It will be a part of the official 2023 release of ICD-11, which is the current global standard for health data, clinical documentation and statistical aggregation.
The term “monkeypox” will remain a searchable term in ICD, to match historic information.
Considerations for the recommendations included rationale, scientific appropriateness, extent of current usage, pronounceability, usability in different languages, absence of geographical or zoological references, and the ease of retrieval of historical
scientific information.
Usually, the ICD updating process can take up to several years. In this case, the process was accelerated, though following the standard steps.
Various advisory bodies were heard during the consultation process, including experts from the medical and scientific and classification and statistics advisory committees which constituted of representatives from government authorities of 45 different
countries.
The issue of the use of the new name in different languages was extensively discussed. The preferred term mpox can be used in other languages. If additional naming issues arise, these will be addressed via the same mechanism. Translations are usually
discussed in formal collaboration with relevant government authorities and the related scientific societies.
WHO will adopt the term mpox in its communications, and encourages others to follow these recommendations, to minimize any ongoing negative impact of the current name and from adoption of the new name.
Note to editors
Background information on naming of the disease, the virus that causes the disease, and the virus variants or clades:
Naming the disease:
Human monkeypox was given its name in 1970 (after the virus that causes the disease was discovered in captive monkeys in 1958), before the publication of WHO best practices in naming diseases, published in 2015. According to these best practices, new disease names should be given with the aim to minimize unnecessary negative impact of names on trade, travel, tourism
or animal welfare, and avoid causing offence to any cultural, social, national, regional, professional or ethnic groups.
Assigning new names to new and, very exceptionally, to existing diseases is the responsibility of WHO under the International Classification of Diseases and the WHO Family of International Health Related Classifications (WHO-FIC) through a consultative process which includes WHO Member States. ICD is part of the WHO Family of
International Health Related Classifications (WHO-FIC).
Naming of viruses: The naming of viruses is the responsibility of the International Committee on the Taxonomy of Viruses (ICTV). Prior to the 2022 global
monkeypox outbreak, there was already a process underway to reconsider the naming of all orthopoxvirus species, including monkeypox virus. This will continue under ICTV leadership.
Naming monkeypox virus variants or clades: In August, a group of global experts convened by WHO agreed on new names for monkeypox virus variants, as part of ongoing efforts to align the names of the monkeypox disease, virus and variants
– or clades – with current best practices. Consensus was reached to refer to the former Congo Basin (Central African) clade as Clade one (I) and the former West African clade as Clade two (II). Additionally, it was agreed that the Clade
II consists of two subclades, IIa and IIb. See WHO press release on naming of monkeypox clades.
Since the release of the GeForce RTX 4090 graphics card, NVIDIA has seen multiple reports of issues with the 12VHPWR 16-pin power connector. Corsair’s power supply expert, “JonnyGuru,” believes the issue lies in user error.
NVIDIA 16-Pin “12VHPWR” Connector Issues Maybe Occurring Due To User-Error, Highlights JonnyGuru
JonnyGuru explains that users may not be fully inserting the 16-pin “12VHPWR” connector cable into the graphics card, which would cause issues with the connection itself, with wires melting and the connectors overheating.
This theory is not new, as discussed previously, but is one in ideas that have arisen within technology circles from content creators, experts, and media sources. This also remains a theory, as no complete evidence supports the idea. However, JonnyGuru does show us how he reached this verdict with the NVIDIA GeForce RTX 4090 GPU hardware and connection issues.
First, the Corsair PSU expert uses a Corsair HX1500i, utilizing three PCIe cables connected to NVIDIA’s 16-pin “12VHPWR” adapter. Included in the testing is a thermistor to monitor temperatures and tie around the wires to ensure that the cables would not bend as much. To initiate the problem, he began damaging the connectors, especially the durability of the joints that were soldered on the connection. Everything was still in place after that test, and the temperature remained as high as 53°C.
Next, he researched all known cases of melted and warped connections, reviewing each published picture & comparing undamaged connections to ones that were part of the melting & overheating issues. Recognizing similarities across all manufacturers, he came to a single conclusion.
ANY 12VHPWR connector can potentially burn up because ANY of them can be hard to insert.
… VERY DIFFICULT to insert completely.
— JonnyGuru, Corsair’s expert on power supply units
The PSU expert for Corsair noticed that it was not fully connected to the GPU in images where the cable or connection was damaged. He does recommend that users who own the NVIDIA GeForce RTX 4090 graphics card and are worried that the same might happen to them to use dielectric grease (around four dollars on Amazon) — a minimal amount — to the power connector.
NVIDIA has not revealed any details or answers to the public since this has begun. It is known that the company has treated this issue with the utmost priority. Meanwhile, a new notification from PCI-SIG is being shared which might hint at a new revision of the 16-pin “12VHPWR” cable to be published by 6th December 2022. The latest review zone shows an ECR or Engineering Change Request has been made and will close by the 20th of December, 2022.
ECR = engineering change requesthttps://t.co/GxmpjzA4pE Very interesting, what will be changed at this time🧐🧐🧐 pic.twitter.com/iFOioScvkl
— chi11eddog (@g01d3nm4ng0) November 8, 2022
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WASHINGTON, Nov 7 (Reuters) – Just days after taking control of powerful social media giant Twitter Inc, billionaire Elon Musk on Monday recommended that voters pick Republican candidates for Congress in Tuesday’s U.S. midterm election.
Musk, who is also Tesla(TSLA.O) CEO, has faced criticism from some groups over his absolutist stance on free speech. They expect his position to increase the volume of misinformation and hate speech on the platform.
His tweet on Monday represented the first time the head of a major social media platform explicitly endorsed a U.S. political party.
Musk directed his Twitter message to what he called “independent-minded voters,” writing: “Shared power curbs the worst excesses of both parties, therefore I recommend voting for a Republican Congress, given that the presidency is Democratic.”
President Joe Biden’s Democrats face a steep battle to retain control of Congress in Tuesday’s vote.
Nonpartisan election forecasters and polls suggest Republicans have a very strong chance of winning a majority in the House of Representatives, with control of the Senate likely to be more closely fought.
“Hardcore Democrats or Republicans never vote for the other side, so independent voters are the ones who actually decide who’s in charge!”, Musk added on Twitter, which he purchased late last month.
Musk has previously said he would vote for Republicans but says he backs moderates on both sides of the aisle.
In April, Musk said that for “Twitter to deserve public trust, it must be politically neutral, which effectively means upsetting the far right and the far left equally.”
Musk frequently comments on U.S. politics.
He said previously that he was leaning towards supporting Florida’s Republican Governor Ron DeSantis for president in 2024 and that former president Donald Trump was too old to serve as president again.
Reporting by Scott Malone, Rami Ayyub, Kenneth Li and Kanishka Singh; Editing by Howard Goller
Our Standards: The Thomson Reuters Trust Principles.
The Parkland school shooter has avoided the death penalty after a jury recommended he be sentenced to life in prison without the possibility of parole for the February 2018 massacre at Florida’s Marjory Stoneman Douglas High School – a move that left some of the victims’ loved ones disappointed and angry.
The jury’s recommendation Thursday, coming after a monthslong trial to decide Nikolas Cruz’s punishment, is not an official sentence; Broward Circuit Judge Elizabeth Scherer still is expected to issue the gunman’s formal sentence on November 1. Under Florida law, however, she cannot depart from the jury’s recommendation of life.
Families of the gunman’s victims bowed or shook their heads as the verdict forms for each of the 17 people he killed were read in court Thursday morning. The jury found the aggravating factors presented by state prosecutors did not outweigh the mitigating circumstances – aspects of Cruz’s life and upbringing his defense attorneys said warranted only a life sentence.
None of the jurors looked in the direction of the victims’ families as their verdicts were read, but instead looked down or straight ahead. Cruz – flanked by his attorneys, wearing a blue and gray sweater over a collared shirt and eyeglasses – sat expressionless, looking down at the table in front of him.
Live updates: Jury reaches decision in Nikolas Cruz sentencing trial
Tony Montalto, the father of 14-year-old victim Gina Montalto, called the jury’s recommendation a “gut punch” for the victims’ families, lamenting that “the monster that killed them gets to live to see another day.”
“This shooter did not deserve compassion,” he said outside the courtroom, after the jury’s findings were read. “Did he show the compassion to Gina when he put the weapon against her chest and chose to pull that trigger, or any of the other three times that he shot her? Was that compassionate?”
Cruz, now 24, pleaded guilty last October to 17 counts of murder and 17 counts of attempted murder for the shooting in Parkland, Florida, in which 14 students and three school staff members were killed, and 17 others were injured. Because Cruz pleaded guilty to all counts, the trial phase was skipped and the court went directly to the sentencing phase.
Prosecutors had asked the jury to sentence the gunman to death, arguing Cruz’s decision to carry out the shooting was not only especially heinous or cruel, but premeditated and calculated and not, as the defense contended, related to any neurological or intellectual deficits.
To illustrate their point, prosecutors detailed Cruz’s thorough planning for the shooting, as well as comments he made online expressing his desire to commit a mass killing.
In their case, the shooter’s defense attorneys said Cruz had neurodevelopmental disorders stemming from prenatal alcohol exposure, and presented evidence and witnesses claiming his birth mother had used drugs and drank alcohol while pregnant with him. Cruz’s adoptive mother was not open about this with health professionals or educators, preventing him from receiving the appropriate interventions, the defense claimed.
Of the 12 jurors, three voted against the death penalty, jury foreman Benjamin Thomas told CNN affiliate WFOR, saying, “I don’t like how it turned out but it’s that’s how the jury system works.”
“There was one with a hard ‘no,’ she couldn’t do it, and there was another two that ended up voting the same way,” said Thomas.
The woman who was a hard no “didn’t believe because he was mentally ill he should get the death penalty,” Thomas said.
The parents of Alyssa Alhadeff, another 14-year-old victim, said they were disgusted by the verdict.
“I’m disgusted with those jurors,” Alyssa’s father, Ilan Alhadeff, said. “I’m disgusted with the system, that you can allow 17 dead and 17 others shot and wounded, and not get the death penalty. What do we have the death penalty for?”
Linda Beigel Schulman, the mother of geography teacher Scott Beigel, echoed that question, telling reporters, “If this was not the most perfect death penalty case, then why do we have the death penalty at all?”
She, like many of the families who addressed reporters, commended prosecutors for their work, saying they perfectly executed the state’s arguments against the gunman.
“Justice was not served today,” her husband, Michael Schulman, said.
The jury’s recommendation robbed the victims’ families of justice, the father of 14-year-old Jaime Guttenberg told reporters, saying it could make another mass shooting “more likely.”
“We are all in this position now of doing the work that we do around this country to keep this from happening to another family,” Fred Guttenberg said after court. “This decision today only makes it more likely that the next mass shooting will be attempted.”
The widow of 49-year-old Christopher Hixon, who was the school’s athletic director, said the jury’s decision indicated the gunman’s “life meant more than the 17 that were murdered” and the rest of the community who remain “terrorized and traumatized.”
Debra Hixon also rejected the defense’s arguments about the gunman’s mental or intellectual struggles, pointing to another one of her sons, who has special needs.
“I have a son that checked … a lot of those boxes that the shooter did as well,” she said. “And you know what? My son’s not a murderer. My son’s the sweetest person that you could ever meet.
Florida Gov. Ron DeSantis also was disappointed by the jury’s decision, he said Thursday, as well as how long it took for the judicial process to play out.
“I was very disappointed to see that,” he said of the jury’s verdict. “I’m also disappointed that we’re four and a half years after these killings, and we’re just now getting this.”
Broward County Public Defender Gordon Weekes commended the attorneys in his office who represented the gunman, telling reporters, “With the greatest bit of sympathy, we attempted to prepare this case and present this case in the most professional and legal manner as we could.”
Weekes urged the community to respect the verdict, saying Thursday “is not a day of celebration, but a day of solemn acknowledgment, and a solemn opportunity to reflect on the healing that is necessary for this community.”
Weekes declined to comment when asked whether Cruz had a reaction to the jury’s recommendation.
To decide on a recommended sentence, jurors were asked to weigh the aggravating factors and mitigating circumstances presented by the prosecution and defense during trial.
Prosecutors pointed to seven aggravating factors, including that the killings were especially heinous, atrocious or cruel, as well as cold, calculated and premeditated. Other aggravating factors, prosecutors said, were that the defendant knowingly created a great risk of death to many people, and that he disrupted a lawful government function – in this case, the running of a school.
The defense, meantime, offered 41 possible mitigating circumstances, including that Cruz was exposed to alcohol, drugs and nicotine in utero; that he has a “neurodevelopmental disorder associated with prenatal alcohol exposure;” and that his adoptive mother did not follow the recommendations of medical, mental health and educational providers, among many others.
For each victim, jurors unanimously agreed the state had proven the aggravating factors beyond a reasonable doubt and that they were sufficient to warrant a possible death sentence.
However, to recommend death, all jurors still would have needed to find that the aggravating factors outweighed the mitigating circumstances. They did not unanimously agree on this, the jurors indicated Thursday on their verdict forms – meaning Cruz must be sentenced to life in prison and not death.
In closing arguments Tuesday, prosecutors argued Cruz’s decision to commit the shooting was deliberate and carefully planned, while Cruz’s defense attorneys offered evidence of a lifetime of struggles at home and in school.
“What he wanted to do, what his plan was and what he did, was to murder children at school and their caretakers,” lead prosecutor Michael Satz said Tuesday. “The appropriate sentence for Nikolas Cruz is the death penalty,” he concluded.
However, defense attorney Melisa McNeill said Cruz “is a brain damaged, broken, mentally ill person, through no fault of his own.” She pointed to the defense’s claim that Cruz’s mother used drugs and drank alcohol while his mother was pregnant with him, saying he was “poisoned” in her womb.
“And in a civilized humane society, do we kill brain damaged, mentally ill, broken people?” McNeill asked Tuesday. “Do we? I hope not.”
The federal agency responsible for conducting independent accident investigations has recommended technologies in new vehicles to limit speeding and prevent impaired driving in an attempt to cut down on a growing number of related fatal crashes.
The National Transportation Safety Board’s recommendation of alcohol impairment detection systems are on a pathway toward requirement, after the Infrastructure Investment and Jobs Act gave the Transportation Department three years to craft a mandate for such a feature in new vehicles. The board’s re-recommendation of incentivizing intelligent speed adaptation systems, however, has yet to gain broader federal backing and could face resistance from US drivers accustomed to speed limits being enforced by law enforcement rather than the vehicle itself.
The NTSB’s recommendations – which cannot be implemented without being adopted by the National Highway Traffic Safety Administration – specifically include requiring all new vehicles have “passive vehicle-integrated alcohol impairment detection systems, advanced driver monitoring systems or a combination of the two that would be capable of preventing or limiting vehicle operation if it detects driver impairment by alcohol.”
Reiterating a recommendation made in 2017, the NTSB also suggested the NHTSA incentivize “vehicle manufacturers and consumers to adopt intelligent speed adaptation (ISA) systems that would prevent speed-related crashes.”
Intelligent speed adaptation systems can range from a warning system that issues visual or audible alerts when a driver is speeding to a system that electronically limits the speed of a vehicle. The NTSB did not specify which type of system should be adopted.
An investigation into a California crash that killed nine people, including seven children, on New Year’s Day in 2021 led to Tuesday’s recommendations, according to the NTSB. Investigators, the agency said, “found that the SUV driver (involved in the crash) had a high level of alcohol intoxication and was operating at an excessive speed.”
NTSB Chairwoman Jennifer Homendy said on Tuesday that the technologies “can prevent the tens of thousands of fatalities from impaired-driving and speeding-related crashes we see in the U.S. annually.”
Thirty-two people die of alcohol-related collisions every day – more than 11,000 every year, according to the NHTSA. It reported fatalities climbed 5% in 2021.
There are a number of technologies aimed at preventing impaired driving that are being evaluated by the Department of Transportation, according to the advocacy group Mothers Against Drunk Driving. The department was given three years to craft a requirement that new vehicles feature “advanced drunk and impaired driving prevention technology” as part of the infrastructure law, which passed with bipartisan support last year.
The NHTSA said in statement Monday that it “has initiated work to meet the Bipartisan Infrastructure Law’s requirement for rulemaking concerning advanced impaired driving technology in vehicles.”
Such technologies include cameras and sensors outside a vehicle that monitor driving performance, cameras and sensors inside a vehicle that monitor a driver’s head and eyes and alcohol sensors to determine whether a driver is drunk and subsequently prevent the vehicle from moving.
The prospective regulation has sparked privacy concerns and questions about whether the systems would falsely classify certain people, like those with disabilities, as being intoxicated.
Intelligent speed adaptation systems have gained some traction in the European market, where they will be mandatory in all new cars being sold there from July 2024. The new cars will issue either a “cascaded acoustic warning,” a “cascaded vibrating warning,” “haptic feedback through the acceleration pedal” or a “speed control function,” according to the European Commission. A driver can override the ISA system, the commission says.
New York City is also piloting a fleet of city vehicles with an ISA system in place. The city announced in August that 50 vehicles operated by city employees will have systems that will set a maximum speed for the vehicle and “will also be adaptable based on the local speed limit.” The system has an active modality, which will automatically slow a vehicle down, and passive modality, which will alert a driver when they’re speeding.
The vehicles will be retrofitted and installed in vehicles across a variety of city departments, and will also be tested on 14 new, all-electric Ford Mach Es.
This story has been updated with comment from the NHTSA.
Michigan has 14 counties at a high COVID-19 Community Level this week according to the Centers for Disease Control and Prevention.
The CDC uses Community Levels to determine COVID risk, putting counties in one of three buckets: low (green), medium (yellow) or high (orange).
The CDC recommends masking while indoors in public when counties are at a high Community Level, regardless of vaccination status. However, people with symptoms, a positive test or exposure to someone with COVID-19 should wear a mask regardless of where they live, the CDC says.
The 14 counties at a high level this week are: Calhoun, Clare, Clinton, Dickinson, Eaton, Ingham, Ionia, Iron, Lapeer, Macomb, Midland, Schoolcraft, Shiawassee and Washtenaw counties.
Michigan has 34 counties at a medium level and 35 counties at a low COVID-19 Community Level this week.
Here’s the latest map showing the Community Level for each Michigan county. Tap or hover over a county to see details.
(Can’t see the map? Click here.)
The CDC considers cases and hospitalizations when determining COVID risk for an area. The goal is to prevent severe disease and limit strain on hospitals.
For Community Levels, the CDC looks at three factors for each county: the percentage of staffed hospital beds occupied by COVID patients, COVID hospital admissions per capita and COVID cases per capita.
A county is at a high level when there are 200 or more new cases per 100,000 in the past week and either (a) 10-plus new COVID-19 hospital admissions per 100,000 or (b) when at least 10% of the staffed inpatient beds are occupied by COVID patients.
If hospitalizations are particularly high, even a county with low cases can be at a high level, per the CDC formula.
(Not every county has a hospital, so each one is assigned a health services area, a geographic region that contains at least one hospital. Counties are attributed the metrics calculated for the entire area, weighted based on each county’s population.)
Here’s more on the state of COVID-19 in Michigan.
Michigan is reporting 2,086 new, confirmed cases per day in the past week
Reported COVID cases are up 16.0% from last week, as the state had 2,086 new, confirmed cases this week.
Michigan has hovered around the 2,000-case-per-day mark for most of the summer.
Michigan also reported 539 “probable” COVID cases per day this week.
Cases are “confirmed” when there’s a positive result from an NAAT/RT-PCR test. Cases are “probable” when there’s a reported antigen (rapid) test or if somebody has symptoms and was exposed to a person with COVID-19.
All graphics in this story except the initial one (which uses CDC case calculations) are based only on “confirmed” numbers.
The Michigan Department of Health and Human Services reports COVID cases once per week. The department announced 18,375 confirmed and probable cases this week.
Michigan has reported 2.4 million confirmed COVID cases and nearly 378,000 probable cases since the pandemic began.
The chart below shows the seven-day average for new, confirmed COVID cases throughout the pandemic.
(Can’t see the chart? Click here.)
Michigan ranks 8th in the U.S. in new cases per capita
Michigan’s COVID rate was the eighth highest in the U.S. in the past week, according to the New York Times.
Michigan had fewer COVID cases than last week, but managed to move up the list for highest COVID rate because 46 of the 50 states saw their rate decline in the past week.
West Virginia, Kentucky, South Carolina, Alaska, North Carolina and Ohio had the most COVID cases per capita this week. Nevada, California, Washington, Utah, Montana and Wyoming had the lowest COVID rates.
For COVID hospitalizations, Michigan ranked 14th of 50 this week. The state also had the fourth-most COVID deaths per capita this week.
42 counties saw rise in cases in last seven days
Of Michigan’s 83 counties, 42 had more cases this week than last week.
Many of Michigan’s larger counties had big increases in cases. Ingham County was up 39% compared to last week, Kalamazoo County increased 34%, Wayne County jumped 32%, Oakland County was up 23%, Washtenaw County jumped 20%, Macomb County increased by 19% and Kent County rose 8%.
See the database below to search by county and sort by most/fewest cases. The chart also shows the percent change from week to week and the seven-day case average per capita.
(Can’t see the database? Click here.)
37 Michigan counties at highest risk for cases
There are 37 counties at the highest risk level (Level E) for cases, down from 43 counties last week.
The MDHHS has five risk levels for COVID cases:
Level A: 7-19 cases per day per million
Level B: 20-39 cases per day per million
Level C: 40-69 cases per day per million
Level D: 70-149 cases per day per million
Level E: 150+ cases per day per million
The counties with the highest COVID rates in Michigan this week were Iron, Dickinson, Washtenaw, Midland, Schoolcraft and Ingham counties.
The lowest COVID rates were in Alcona, Huron, Presque Isle, Leelanau, Antrim and Cheboygan counties.
The map below is shaded by the state’s six risk-assessment levels from A to E. This is based on new cases reported per day per million people from Sept. 7-13.
The arrows on each county show if new cases this week are up or down compared to the previous week. Put your cursor over a county to see the underlying data. (Hint: Drag the map with your cursor to see the entire U.P.)
(Can’t see the map? Click here.)
COVID case totals don’t tell the whole story. At-home tests are not reported, so those aren’t included in the data. That’s why it’s also key to look at percent positivity of reported tests and data on hospitalizations and deaths.
Average test positivity is 18%
About 18 of every 100 COVID tests reported to the state on Monday, Sept. 12, came back positive.
The positivity rate has hovered between 18% and 19% in the past week.
The World Health Organization considers there to be a substantial level community transmission when positivity rates are above 5%.
Michigan’s rate peaked at 35% in January. It dipped as low as 2% in early March before climbing again.
The graph below shows the percentage of COVID-19 tests reported that came back positive throughout the pandemic.
(Can’t see the chart? Click here.)
Eaton County had the highest positivity rate of all Michigan counties this week, at 30.5%. Baraga, Keweenaw and Lake counties all had a positivity rate less than 5%.
To see the COVID test positivity rate for your county, see the searchable table below.
(Can’t see the database? Click here.)
The interactive map below shows the seven-day average testing rate by county. Put your cursor over a county to see details.
(Can’t see the map? Click here.)
Hospitals treating 1,145 confirmed or suspected adult COVID-19 patients
Michigan had 1,145 adults in hospitals with confirmed or suspected COVID as of Wednesday, Sept. 14. That’s down slightly from 1,172 adult hospitalizations last week.
Before this week, Michigan COVID hospitalizations had risen in eight of the previous nine weeks.
Of the 1,145 adults in the hospital with COVID on Wednesday, 148 were in intensive care and 69 were on a ventilator.
There were also 46 kids hospitalized with COVID in Michigan as of Wednesday.
Michigan is reporting 21 new COVID deaths per day in the past week
Michigan averaged 21 COVID deaths per day this week, the highest mark since March.
But it’s still far fewer COVID deaths than Michigan had during omicron’s winter peak. Michigan was averaging more than 100 COVID deaths per day during parts of January.
Michigan has had 34,970 confirmed COVID-19 deaths and 3,347 probable COVID deaths since the pandemic began. Put another way, roughly one in every 287 Michigan residents have died from confirmed COVID.
Below is a chart illustrating the seven-day average for reported deaths throughout the pandemic.
(Can’t see the chart? Click here.)
Vaccinations: 63.4% of residents have received at least one dose
About 63.4% of Michigan residents have gotten at least one COVID shot, 58.3% have received the full original regimen and 33.9% have been boosted.
The omicron-specific COVID-19 booster shot is now available in Michigan from both Pfizer and Moderna.
The new shots are authorized for use as a single booster dose, administered at least two months after a previous COVID vaccine. Moderna’s shot is authorized for people 18 and older, while Pfizer’s is for those 12 and older.
Below is a vaccination breakdown by age group of Michiganders who have gotten at least one shot (initiated) and those who are “completed,” meaning two shots of mRNA vaccines or one Johnson & Johnson shot, as of Wednesday, Sept. 14:
75 and older: 87.1% initiated; 81.3% completed
65 to 74: 90.4% initiated; 85.4% completed
50 to 64: 76.9% initiated; 72.2% completed
40 to 49: 67.6% initiated; 62.4% completed
30 to 39: 65.9% initiated; 59.6% completed
20 to 29: 55.6% initiated; 49.4% completed
16 to 19: 56.6% initiated; 51.6% completed
12 to 15: 49.8% initiated; 46.1% completed
5 to 11: 30.3% initiated; 27.3% completed
Younger than 5: 6.2% initiated, 1.5% completed
Below is a chart that ranks counties from most vaccinated to least vaccinated.
(Can’t see the chart? Click here.)
For more statewide data, visit MLive’s coronavirus data page.
To find a testing site near you, check out the state’s online test find send an email to COVID19@michigan.gov, or call 888-535-6136 between 8 a.m. and 5 p.m. on weekdays.
If you have any COVID-19 questions, please submit them to covidquestions@mlive.com to be considered for future MLive reporting.
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Two scientific committees under the Centre for Health Protection have said men who have sex with men should be among those prioritized for the monkeypox vaccine in Hong Kong.
Monkeypox continues to spread around the world in recent months, with the virus declared a global health emergency by the World Health Organization.
The committees noted that the latest global epidemiology of monkeypox showed the dominant affected group was men having sex with men (MSM) who have multiple sexual partners and there were practical challenges to identify and reach sexual contacts in this group via contact tracing for post-exposure vaccination.
It said they considered individuals at high risk of exposure, importantly but not exclusively gay, bisexual and other MSM with certain high-risk sexual practices or history of sexually transmitted infection within the past 12 months, should be included as a target group for pre-exposure vaccination against monkeypox with the highest priority on a voluntary basis.
Other target groups for pre-exposure vaccination, in order of priority, could include other high-risk groups in the community.
They include sex workers, participants in group sex or persons having multiple sexual partners, healthcare workers responsible for care of confirmed monkeypox patients, laboratory personnel working with zoonotic pox viruses, staff responsible for decontamination of environments contaminated by confirmed cases following case-by-case assessment, and animal care personnel with a high risk of exposure in case of monkeypox occurrence in animals in Hong Kong.
The health experts highlighted that vaccination should be given on a voluntary basis rather than mandatory.
Meanwhile, noting the results of a related clinical trial and overseas practice, the committees said the administration of one-fifth of the volume of a full dose of third-generation modified vaccinia vaccine for immunocompetent adults could be adopted as an alternative dosing regime and antigen-sparing measure if there is limited vaccine supply locally.
The Centers for Disease Control and Prevention recommended Thursday that millions of eligible Americans, including those as young as 12, get an updated omicron-targeting booster shot to bolster defenses against serious illness and death during a potential fall or winter rise in covid-19 cases.
CDC Director Rochelle Walensky endorsed a recommendation by an advisory panel, paving the way for some clinicians, pharmacies and other providers to begin administering the shots as early as this weekend. The Advisory Committee on Immunization Practices voted 13-1 to recommend updated shots from Moderna, for those 18 and older, and from Pfizer-BioNTech, for people 12 and older.
Thursday’s action, along with authorization of the shots a day earlier by the Food and Drug Administration, marked another turning point in the pandemic and reflected the persistent struggle to tamp down illness and death 2½ years since the pandemic dawned.
“The updated COVID-19 boosters are formulated to better protect against the most recently circulating COVID-19 variant,” Walensky said in a statement. “They can help restore protection that has waned since previous vaccination and were designed to provide broader protection against newer variants. … If you are eligible, there is no bad time to get your COVID-19 booster and I strongly encourage you to receive it.”
Several advisory panel members expressed concern about the lack of clinical data about the reformulated boosters but also noted the potential harm in waiting for clinical data until November.
Matthew Daley, a physician at Kaiser Permanente Colorado, said the cost of waiting until later in November to roll out the updated booster shot could be an additional 9,700 deaths and 137,000 hospitalizations, based on projections presented at the day-long meeting.
“I think that is the tension that I feel for sure,” Daley said. But with the FDA decision, “we’re now in the position where we have millions of doses of bivalent vaccines that are ready and available. And I think they’re going to be an effective tool for disease prevention this fall and into the end of the winter.”
The latest recommendation for boosters provides a new opportunity for the Biden administration and public health experts to launch another round of messaging to a pandemic-weary public about the importance of vaccination against a virus still killing an average of more than 500 people a day in the United States.
Doses began shipping Wednesday to pharmacies, clinics and doctor’s offices after the FDA authorized the updated shots from Moderna and from Pfizer and its German partner, BioNTech. Like earlier coronavirus vaccines, the updated boosters will be free.
The new boosters — the first changes since the mRNA vaccines were rolled out in December 2020 — target the BA.4 and BA.5 omicron subvariants dominant in the United States. Officials say the new shots will help broaden immunity because they are a closer match to the strain that is circulating.
Until now, vaccines have targeted the original version of the coronavirus, even as different variants emerged. Half of the new booster, known as a bivalent vaccine, contains the original formulation, while the other half carries a recipe against BA.4 and BA.5, by far the most contagious versions of the virus since coronavirus swept the globe in 2020. BA.5 now accounts for nearly 90 percent of cases in the United States, according to the CDC.
People can receive the updated shots if it has been at least two months since they completed their primary vaccine series or their most recent booster. Even if an individual received boosters of the original formulation, they can get the updated booster as long as it has been two months after their last shot. The interval of at least two months is intended to broaden immunity because getting shots too early reduces the vaccine’s effectiveness.
A longer interval between shots also lessens the risk, especially for young adults and older teens, of rare side effects such as myocarditis, inflammation of the heart muscle, health officials have said.
The CDC estimates about 200 million Americans 12 and older are eligible for the updated shot. While nearly 22 million adults 50 and older have received a second booster dose, most people 5 and older are at least six months out from their last coronavirus vaccine dose, CDC official Sara Oliver told the advisory panel Thursday.
Americans have been slow to get boosters, and experts say it is unclear whether uptake of the reformulated booster will be different. The country may be transitioning from the coronavirus as an emergency, “to becoming something we have to learn to manage on a more regular, routine basis, including through routine [coronavirus] immunization,” said Jen Kates, a senior vice president at the Kaiser Family Foundation.
“It’s hard to see how there will be a groundswell, a rush to get boosted,” Kates said in an email. Some people — about 20 percent of people who have been vaccinated — “are waiting for updated vaccines that can target variants,” Kates said, referring to a recent Kaiser Family Foundation survey. “On the other hand, if people don’t perceive these as better or needed, or have other reasons for not wanting to get a booster, it’s hard to see how this will change things.”
Albert Ko, an infectious-disease physician and epidemiologist at the Yale School of Public Health, said he was worried about what Americans will face this winter, noting the country is experiencing more than 500 covid-19 deaths a day.
“Poor uptake of the new boosters is a real and urgent concern since we rely on vaccination to protect our communities, especially now that the use of social distancing and face masks is disappearing,” Ko said.
Panel members, echoing questions among some experts, raised concerns about the lack of human data on the shots’ effectiveness — the FDA relied heavily on mouse studies — which experts have said could fuel skepticism about the boosters’ effectiveness. The data used by the FDA to authorize the shot included human studies of earlier experimental bivalent shots, including one that generated virus-fighting antibodies against BA.1 — the first omicron subvariant — and the overall record of the shots since December 2020.
Pablo J. Sanchez, professor of pediatrics at Ohio State University, said he voted no because he thinks that “we need the human data” on the new vaccine, which is only being gathered now.
But Jeffrey Duchin, health officer for Seattle and King County, said he was comfortable with the animal data in support of the reformulated boosters. Panel members also noted that animal studies have been regularly used to adjust the composition of annual influenza vaccines.
Oliver, of the CDC, presented data showing how a booster vaccination program in September could avert significant deaths, hospitalizations, infections and direct medical costs. Oliver noted that as the virus has evolved, the effectiveness of vaccines has waned more rapidly. Inclusion of a variant in the vaccine broadens the antibody response.
Interest in earlier booster shots has proved lukewarm, at best.
In a recent Kaiser Family Foundation survey, almost 6 in 10 people who are vaccinated but not boosted said they feel they have enough protection, “which we know from the data is not the case given waning and new variants,” Kates said. Three in 10 said they are just too busy, and 15 percent are concerned about missing work, the survey found. Democrats are more likely to have been vaccinated and boosted than Republicans.
A CDC survey conducted in August with the University of Iowa suggests more people will want the shots — 72 percent of eligible respondents said they definitely or probably will get an updated booster against omicron, Oliver said.
Only half of booster-eligible Americans — about 108 million people — received the first recommended booster dose, and only about a third of those 50 and older — about 22 million people — got a second booster. CDC surveys have shown that older adults, college graduates and people with higher incomes remain most likely to be vaccinated and boosted.
Anyone who has received the two-shot primary series of the mRNA or Novavax vaccines orthe single-shot Johnson & Johnson vaccine will be eligible, regardless of whether they received any booster shots.
FDA officials expect pediatric data on the new boosters in the next month or two and could authorize the shots for some children younger than 12 later this year.
What you need to know about the updated covid booster shots for the fall
The booster change is already causing confusion. Some people who signed up to receive the original booster formulation will need to reschedule appointments to get the new version because the original formulations are no longer authorized by the FDA to be used as boosters.
“The last thing we need to be doing is telling people who signed up [for the original booster] and expected to get vaccinated this week that they need to wait,” said Michael Fraser, chief executive of the Association of State and Territorial Health Officials. “We have seen lagging demand nationally, and this doesn’t build confidence among the public and providers who are asking their health official what to do now.”
The CDC recommends coronavirus vaccination for everyone 6 months and older, and boosters for everyone 5 years and older who is eligible.
CDC data at Thursday’s meeting showed that adults who had a primary series and two boosters had a 14 times lower risk of death from covid-19 than unvaccinated people. People who had a second booster had a threefold lower risk of death than people who had only one booster.
Experts and officials have differed on whether an updated booster is needed because the original vaccines still offer strong protection against severe disease and death for generally healthy people, especially if they received the first booster dose. Some experts have said it is not clear how much additional benefit a reformulated booster will offer.
People should check with local pharmacies and providers and visit vaccines.gov before showing up to receive shots because only about 1.5 million doses are likely to be available initially, according to information provided to state health officials. Another 10 million doses are scheduled to be delivered next week.
