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These 10 states reported their highest number of new coronavirus cases on Friday

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Angela Merkel attends an EU summit in Brussels earlier this week.
Angela Merkel attends an EU summit in Brussels earlier this week. FRANCISCO SECO/POOL/AFP via Getty Images

German Chancellor Angela Merkel has appealed to citizens to do more to fight rising numbers of coronavirus infections across the country, urging Germans in a video message to abide by the regulations set out by the government.   

“We must do everything to ensure that the virus does not spread in an uncontrolled way. Every day now counts,” Merkel said as daily infections have hit record highs this past week.  

“How the winter will be, how our Christmas will be, that will be decided in the coming days and weeks,” Merkel added.  

Germany’s strategy against the pandemic has so far centered around effective contact tracing of infected individuals in order to isolate them before they can infect others.  

“Health authorities are doing amazing work in this regard … but where the number of infections become too high, they simply cannot keep up,” the German Chancellor said.  

In an effort to stem the continued spread of the virus, Merkel also urged citizens to “meet with a lot fewer people” both outside and inside their homes, adding that people should try to avoid traveling or attending large gatherings unless absolutely necessary.  

“If each us drastically reduces the amount of contacts outside if their own family, then it is possible to stop and even reverse this trend,” she added.

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What the next GDP figure will — and won’t — mean

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Five days before Election Day, new data will be released providing the first look at how fast the economy grew in the third quarter of 2020. It’s a safe bet that third-quarter growth will clock in at the fastest pace ever recorded. It’s also a safe bet that the number will be ballyhooed as a great accomplishment. Maybe the greatest ever.

But in reality, the job of rebuilding the economy will be far from done.

Most economic forecasters expect the GDP growth figure announced on October 29 to be somewhere in the neighborhood of 25 to 30 percent at an annual rate; some think it could even come in a few percentage points higher than that.

If the number is somewhere in that range, it will indeed earn the title of the fastest GDP growth figure ever posted. And it will signify that the country has made some progress on the road to recovery. But it will not mean the economy is booming, or even that it has fully recovered. In fact, the third-quarter increase will represent only a partial rebound from another record-setter: the sharpest collapse ever recorded during the second quarter.

The truth is that the recovery is far from complete; momentum has slowed in the past few months; and risks to further progress abound.

Even record-breaking growth won’t be enough to undo what happened this spring

During the spring quarter, there was a colossal drop in real GDP—more than 31 percent at an annual rate. That drop resulted from the imperative to put the economy into a temporary deep-freeze, in hopes of slowing the spread of the virus. The shape of this recession differed dramatically from any other in living memory. In the typical post-World-War-II recession, manufacturing and construction have been hit especially hard. This time, it was service industries that took it on the chin—especially ones that depend on lots of people being close together. Think bars, restaurants, air travel, hotels, conventions, and the like.

The second-quarter decline was triple the size of the previous worst-ever quarterly drop since the current method of score-keeping began in 1947. A couple of quarters during the Great Depression and during the decommissioning from World War II were probably worse, but when you need to reach back to the ‘30s and ‘40s for comparisons, you begin to get the idea for how bad the second quarter of this year was.

In fact, the decline was so bad that even the record-breaking growth we’re likely to see announced for the third quarter won’t be enough to reverse it. As shown in the chart, even if the late-October announcement comes in at 33 percent—toward the more optimistic end of the range, and in line with the expectation of the economic forecasting firm IHS Markit—real GDP will remain 3½ percent below its previous peak, reached at the end of last year. And it will remain a little more than 5 percent below where it would have been if growth had continued steadily, uninterrupted by the pandemic, at the average pace of 2018 and 2019.

Real GDP would have to have increased a whopping 53 percent at an annual rate in the third quarter to return to its previous level. (Why not 36.4 percent, if GDP declined at a 5 percent annual rate in the first quarter, and a further 31.4 percent rate in the second quarter? Because that’s not how it works. Suppose GDP was at 100, and then it fell to 50 — a drop of 50 percent. If it then rose by 50 percent, it would only move back to 75. A similar calculation is required here.)

The recovery has slowed

Most of the rebound reflected in the GDP growth figure that will be published at the end of October actually occurred in May and June — before the third quarter even began.

IHS Markit constructs estimates of monthly GDP using methodology that mimics as closely as possible the procedures underlying the official quarterly numbers published by the Commerce Department. According to their estimates, real GDP rebounded about 5 percent in May and 6 percent in June. After that, though, monthly growth slowed sharply, to 1½ percent in July and ½ percent in August. If their estimates prove accurate, a 33 percent GDP growth rate for the third quarter would be consistent with essentially no growth in the month of September.

Sound crazy? Plenty of other indicators suggest that momentum has slowed. In May and June, the pace of household spending rebounded quickly following a breathtaking collapse in the preceding two months. But in July and August, the improvement slowed to a crawl.

Job growth has slowed as well. By September, employment had recovered only about half the losses sustained in March and April. Even if the September pace of job recovery is maintained, the previous peak level of employment will not have been reattained until January 2022. The unemployment rate in September—the latest figure currently available—was 7.9 percent. That was down from a peak of 14.7 percent in April, but still more than twice the 3.5 percent rate in February, just before the roof fell in.

Why has the momentum of recovery slowed? One likely contributing factor is that the easy part has already been done. Once the initial lockdown was lifted, many employers were still financially viable, and their lines of business didn’t depend on bringing together large numbers of people, so they could bring more workers back on board. But others were not so fortunate. For them, the current situation has begun to look more like a classic recession. A second likely contributing factor is that with each passing day, more and more families have run out of spending power: The $600 supplement to weekly unemployment insurance benefits provided under the CARES Act expired at the end of July; the relief payments of $1,200 per adult and $500 per child have not been not renewed; and the aid provided to small businesses under the Paycheck Protection Program has in many cases run dry.

Unfortunately, there’s ample cause for concern that the recovery may continue to stall. The virus remains out of control. No one knows for sure when a safe and effective vaccine will be widely available, but everyone agrees that it will be difficult to build a durable and complete economic recovery until one is. Somehow, not all hope for a near-term fiscal agreement has been snuffed out, and one may yet be struck before November 3. But another possibility is that Congressional action will have to await a lame-duck session late this year, or even be postponed until the new Congress is seated in 2021.

Amid all the conflicting interpretations that you will hear over the next few weeks, what we know is this: The economy has taken a step toward recovery since the bottom fell out in April. But the job is nowhere near complete; if you need convincing on that point, just ask the millions of people who remain jobless or the millions who report being food-insecure.

The big number for GDP growth during the July-September period will represent a step back toward normal, but it will be no cause for unfurling another “Mission Accomplished Banner.” Unfortunately, there is still a long way to go yet in putting back together any semblance of a robust economy. Congress can help in that process by passing another fiscal support bill.


David Wilcox is a nonresident senior fellow at the Peterson Institute for International Economics and the former director of the Division of Research and Statistics at the Federal Reserve Board.

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The FDA approved remdesivir to treat Covid-19. Scientists are questioning the evidence.

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The Food and Drug Administration on Thursday gave its first full approval for a drug to treat Covid-19 to the antiviral remdesivir. But some researchers say the FDA is once again promoting a Covid-19 therapy based on shaky evidence.

Developed by Gilead Sciences and marketed under the brand name Veklury, remdesivir previously received emergency use authorization from the FDA in May, which allowed it to be used to treat patients with severe Covid-19. In August, the FDA relaxed its guidelines to allow the drug to be used in less serious cases. President Donald Trump also took the drug as part of his treatment when he was diagnosed with Covid-19 earlier in October.

Full FDA approval promotes remdesivir to the standard of care for hospitalized patients, and other potential treatments for Covid-19 will now have to be compared to it during clinical research.

“Today’s approval is supported by data from multiple clinical trials that the agency has rigorously assessed and represents an important scientific milestone in the Covid-19 pandemic,” FDA commissioner Stephen Hahn in a statement Thursday. The FDA based its decision on three randomized controlled trials. (The largest of those looked at 1,062 hospitalized patients.) The trials’ results showed that remdesivir reduced the length of hospital stays in some Covid-19 patients.

However, shortly before the approval was granted, a study from the World Health Organization announced preliminary results that found the drug had no effect on mortality and — unlike the FDA’s findings — negligible effects on how long patients were in hospitals. The study, known as the Solidarity Trial, recruited almost 12,000 patients, making it the largest Covid-19 treatment study in the world thus far. Researchers say the findings should have given the FDA pause.

“I think it’s really inappropriate to give this a full approval because the data don’t support it,” said Eric Topol, a professor of molecular medicine at the Scripps Research Translational Institute. “What [the FDA] should have done instead of issuing the approval was put on the brakes.”

Absent a vaccine, doctors are desperate for an effective treatment for Covid-19, and the FDA’s approval of remdesivir finally gives them an option. In the United States, Covid-19 case counts are rising again, with states like Wisconsin opening field hospitals to deal with a looming surge.

But the approval of remdesivir has raised concerns, not only because of the results of the WHO’s trial but also because it follows a number of questionable FDA authorizations for other Covid-19 therapies that appear to have been influenced by political pressure from the White House.

Now some researchers and doctors are concerned that remdesivir could not only be less effective than promised, but that its approval could also undermine other efforts to develop better Covid-19 therapies.

How remdesivir works against Covid-19 — and why its effects are limited

Remdesivir seems to be most effective relatively early on for hospitalized patients with severe Covid-19. To help beat back the illness, it interferes with how SARS-CoV-2, the virus that causes Covid-19, makes copies of itself. The virus uses genetic instructions in the form of RNA, written in a code made of molecules represented by the letters A, U, G, and C. The drug mimics the molecule represented by A, adenosine. The fake adenosine blocks the virus from copying itself but doesn’t fool human cells. The result is the virus can’t reproduce as much within a patient’s body.

The antiviral drug was originally developed to treat the Ebola virus, and it has received a hefty investment from the US government over almost two decades, as Ekaterina Cleary, lead data analyst and research associate at the Center for Integration of Science and Industry, wrote in a piece for Stat News:

Research from the Center for Integration of Science and Industry, with which I am affiliated, determined that between gathering knowledge behind remdesivir’s chemical structure and molecular target, the NIH invested as much as $6.5 billion between 2000 and 2019.

Remdesivir treatment is not without risks. It has been shown to cause some side effects in some people, such as elevated liver enzymes, which could indicate liver damage. The drug can also trigger allergic reactions, resulting in fever, shortness of breath, wheezing, swelling, low blood oxygen, and changes in blood pressure.

For a patient with private insurance, the intravenous drug can cost $3,120 for a five-day course of treatment.

Antivirals like remdesivir are most effective early on during the progression of Covid-19, when most of the damage is being done by the virus itself. It’s less effective in later stages, when the problem isn’t just the virus. “The severe manifestations of the disease are caused by an out-of-control immune response to the infection,” said Angela Rasmussen, a virologist at the Columbia University Mailman School of Public Health.

Gilead Sciences sign
Gilead Sciences initially developed the antiviral drug remdesivir to treat the Ebola virus.
Liu Guanguan/China News Service via Getty Images

If the immune system gets riled up, it can cause a lot more destruction than SARS-CoV-2 and require more drastic interventions like intubation, at which point another approach is needed. That’s a big reason why corticosteroids like dexamethasone, which tamp down on the immune system, are the only drugs so far reliably demonstrated to actually reduce mortality from Covid-19.

But giving a patient steroids too early in an infection could prevent the immune system from mounting an effective response against SARS-CoV-2.

Coming up with an effective treatment regimen for Covid-19 requires delicately balancing where a patient is in the course of their infection and how severe their illness has become. But given how murky it is to identify a Covid-19 infection to begin with, let alone confirming the diagnosis and starting the correct treatment during the appropriate window, researchers have a hard time teasing out what interventions work best.

That’s why carefully controlled large-scale clinical trials are so important. And with mixed results coming from the studies conducted to date, some scientists don’t think the evidence produced for remdesivir’s effectiveness is enough for the FDA to grant approval.

“I was really surprised when I saw that news,” Rasmussen said.

The approval of remdesivir may actually complicate research and treatment of Covid-19

The FDA has already made some controversial decisions around drugs to treat Covid-19. In March, the agency granted an emergency use authorization for the anti-malaria drug hydroxychloroquine after President Trump called it a “game changer.” Then in June, FDA revoked the EUA, saying hydroxychloroquine was “unlikely to be effective” and could cause lead to heart problems.

Then in August, the agency granted an EUA for convalescent plasma to treat Covid-19. But the National Institutes of Health said that the evidence the FDA used was “insufficient.”

There is more evidence that remdesivir works, but that’s not saying much. “It’s not as weak as the case for plasma, but that’s no standard. The case for plasma is nonexistent,” said Jeremy Faust, an attending physician in the Brigham and Women’s Hospital and an instructor at Harvard Medical School. “There is actually randomized controlled trial data that suggests for a subset of patients remdesivir can decrease hospital length of stay.”

The strongest results in favor of remdesivir show that the patients who received it had a median recovery time of 10 days compared to 15 days for those who took the placebo. It’s a significant effect, but it’s not huge, and it’s certainly not a cure for Covid-19 — or a way to guarantee fewer deaths.

Faust said that one of his concerns with this new FDA approval is a phenomenon known as indication creep, where a treatment that is shown to work in only a limited set of circumstances gets prescribed to more and more people. In this case, the worry is remdesivir, which is approved only for Covid-19 patients over 12 years old who needed to be hospitalized, could start being used in patients with milder courses of the illness, or used in more severe cases of the disease past the point where it could be effective.

“What will happen, I guarantee, is people will start to use the medication more than they need it,” Faust said. And since the course of treatment is five days, it could extend the length of hospital stays in patients who would otherwise have remained for a shorter duration, while saddling them with unnecessary costs.

Another concern is that the approval of remdesivir, especially with such mixed evidence for its effectiveness, could undermine further research.

Topol noted that with remdesivir now as the only fully approved standard of care, it becomes much more difficult to conduct studies on other therapies, since they now have to be compared to remdesivir, the new standard of care, as well as a placebo.

That raises the cost and complexity of trials, delaying results. Such comparisons are worthwhile if the standard of care is effective, but it adds unnecessary complications if it’s not.

It also makes it harder to recruit people for subsequent clinical trials of the drug to better validate its effectiveness. People may be more reluctant to sign up for a trial where they could get a placebo when they know they could get the actual drug.

“The biggest, most serious problem is that we won’t get to the truth,” Topol said.

It’s worth noting that remdesivir could still be a viable treatment for Covid-19, but the evidence presented so far is contradictory, and more investigation is needed to clarify its effectiveness. So then why did FDA go ahead with its approval?

It’s hard to say, but Herschel Nachlis, a research assistant professor of government at Dartmouth College, suggested that the FDA approval might be a strategic move by the agency to deflect political pressure away from the all-important Covid-19 vaccination campaign. There is no evidence that the White House is interfering with the vaccine approval process directly, but President Trump has linked a vaccine to his election prospects and blamed the FDA for holding it back. The appearance that a Covid-19 vaccine was rushed to meet political needs could make people reluctant to get vaccinated, so regulators are keen to distance themselves from the 2020 election campaign.

“If, in the short term, approving remdesivir gives the President a win and alleviates some pressure on the agency from the President about vaccines, that helps buy the FDA important time,” Nachlis said in an email. “It might be another case, like convalescent plasma, of giving up some ground in a battle to put yourself in the position to be able to win the broader war.”

Whether Nachlis’s hypothesis is correct isn’t yet known. But what is clear is that the evidence on remdesivir’s effectiveness appears to be mixed, which is why it would have been helpful for the FDA to have held a public advisory committee meeting to discuss the evidence, a step it typically takes for full pharmaceutical approvals.

Since it may be months before a vaccine for Covid-19 is available, treatments are still urgently needed — and other approaches are being studied. Trump, for example, also underwent a course of an experimental monoclonal antibody therapy from the company Regeneron when he was treated for Covid-19. There are now multiple clinical trials of these drugs underway, but now they have competition.


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Tense calm in Nigeria after days of unrest

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Abuja, Nigeria – Relative calm has returned to Nigerian cities after more than two weeks of deadly protests against police brutality and widespread anger over the shooting of peaceful demonstrators.

In Lagos, the country’s commercial hub and the epicentre of the protests, authorities on Saturday eased a 24-hour curfew, while the streets of the capital, Abuja, gradually returned to normal.

With Lagos’s residents allowed to leave their homes between 8am and 6pm local time, some decided to go out and help government workers clean up the streets and buildings damaged by arsonists.

“The level of destruction is shocking. We can’t leave everything to the government,” said Lagos resident Chinwendu Madubuike.

“Lagos belongs to all of us. We are not happy with the destruction of buildings and burning of shops. The bit we can do is to clean up the mess and begin to rebuild what has been destroyed,” added Madubuike.

But others decided to boycott the clean-up exercise despite online appeals by some volunteers.

“We the youths have been on the streets protesting peacefully for over a week and cleaning up our mess day and night,” said entrepreneur Chelsea Balls.

“As much I would love to clean up my state and have my state back to its normal form, we the youths didn’t make that mess – the hoodlums hired by the government did that,” added the 36-year-old.

People have started cleaning the streets of Lagos as the state eases a round-the-clock curfew imposed in response to protests against alleged police brutality [Afolabi Sotunde/Reuters]

Demonstrators against police violence have long expressed fears that agitators might be used to disrupt the peaceful character of their movement and create the conditions that would justify a security crackdown against them.

On Tuesday, hours after Lagos State Governor Babajide Sanwo-Olu had announced the round-the-clock curfew, citing what he described as the degeneration of demonstrations “into a monster”, peaceful protesters who had gathered at a toll gate in Lagos’s Lekki district in defiance of the measures were shot at.

Witnesses and rights group said soldiers opened fire on the protesters. The military maintains its men were not involved. Amnesty International said at least 12 protesters were killed by the army and police in Lekki and Alausa, another area of Lagos, on Tuesday.

As tensions rose, gangs on Wednesday vandalised public buildings, burned private businesses, police stations, media houses and courthouses.

“Our beautiful city has seen a level of destruction almost akin to a war zone,” Sanwo-Olu tweeted after visiting some of the sites that came under attack.

“It was a shocking and very sad spectacle. Our land took a beating and this hurts. Historical buildings, cultural centres, private malls, government holdings and private businesses were pillaged and burnt,” added Sanwo-Olu, whose government has pledged to support business owners targeted by gangs.

“Lagos will not burn. Not on my watch. Enough is enough. We want peace and we will get peace.”

Demonstrations against police abuses

Peaceful protests against police brutality broke out across Nigeria earlier in October, demanding the scrapping of the Special Anti-Robbery Squad (SARS), a notorious police unit accused of torture, extortion, harassment and even extrajudicial killings.

Authorities on October 11 announced the dissolution of SARS but protesters remained unconvinced by the announcement, saying they would remain on the streets until their demands were met, including the release of imprisoned protesters and implementation of structural law enforcement reforms.

On Friday, President Muhammadu Buhari said 51 civilians were killed in the unrest and blamed “hooliganism” for the violence while asserting security forces used “extreme restraint”.

Buhari said 11 policemen and seven soldiers had also been killed by “rioters” and another 37 civilians were injured as of Thursday. He did not mention the shooting of peaceful protesters in Lagos that prompted international outrage.

In Abuja, attacks by gangs on Monday and Tuesday left at least eight people dead, according to police. Vehicles were also burned in the unrest, which forced many business owners to close shop.

On Saturday, a growing number of shops opened their doors on Saturday.

Elsewhere, however, pockets of violence and looting were still being reported in parts of Nigeria, including in the states of Plateau, Oyo and Cross River.

Meanwhile, videos of people looting warehouses of COVID-19 palliatives in several cities have been widely shared online in recent days.

The clips show residents scrambling for bags of grain and other food items which were reportedly meant for distribution during the coronavirus lockdown.

Separately, a number of state governments said they have set up judicial panels of inquiry to try policemen accused of abuses.

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