195,000 people have died from Covid-19 in the US

There are at least 6,601,337 cases of coronavirus in the US and at least 195,637 people have died from the virus, according to Johns Hopkins University.

So far on Tuesday, Johns Hopkins has reported 47,685 new cases and 1,144 deaths.

The totals include cases from all 50 states, the District of Columbia and other US territories, as well as repatriated cases. 

Medical grade masks such as N95 respirators may not fit female and Asian health care workers as well as their male, Caucasian counterparts, researchers in Australia reported Tuesday.

It’s an especially important question because of the coronavirus pandemic and the researchers recommend more consistent testing of masks for health care workers, rather than having each worker check the fit.

Britta von Ungern-Sternberg from the Perth Children's Hospital and colleagues reviewed data and studies going back to 2003 on how well filtering facepiece respirators fit, and found the masks passed fit tests just 85% of the time for women, compared to 95% of the time for men.

They also found these rates were lower among Asians, (84%), than Caucasians, (90%). Fit test pass rates were particularly low in Asian females, with an average fit pass rate of 60%, they reported in the journal Anaesthesia. How well a mask fits is more important than the how well the material it is made of filters the air, the researchers said.

Health care workers are more likely than other people to become infected with coronavirus, the team noted. Inadequate personal protective equipment (PPE) is sometimes to blame, and poorly fitting masks and respirators can be a factor.

The US National Institute for Occupational Safety and Health standards requires N95 masks used in the US to meet a fit of 95%, defined by a fit test panel. The team notes that the dimensions of that test panel come from a group in which women and Asian people are underrepresented.

The researchers also compared mask “fit checks,” when a health care worker checks their own mask to make sure it’s fitting properly, to “fit tests,” which are more involved and costly but yield a more accurate assessment. Health care workers are supposed to check their masks every time they are used, but the researchers do not recommend replacing fit tests with fit checks.

Qualitative fit testing involves releasing sprays that test bitter or sweet test agents. If the mask-wearer cannot taste the bitter or sweet test agents, the mask is determined to fit. Quantitative fit testing involves actually measuring the concentration of substances inside and outside the mask to determine how well the mask fits and filters particles.

Researchers believe they have found evidence that the novel coronavirus may have been circulating in the US as early as late December, about a month before the current timeline from the US Centers for Disease Control and Prevention shows.

Their study, published last Thursday in the Journal of Medical Internet Research, found a statistically significant uptick in clinic and hospital visits by patients who reported respiratory illnesses as early as the week of Dec. 22.

The first known case of Covid-19 in the US was thought to be a patient in Washington who had visited Wuhan, China, according to the CDC.

Dr. Joann Elmore and colleagues looked through nearly 10 million medical records from the UCLA Health system, including three hospitals and 180 clinics. Elmore said she started the search after receiving a number of emails from anxious patients in March through her clinic's patient portal at UCLA. Patients kept asking if the cough they had in January could have been Covid-19.

"With the outpatients, I found a 50% increase in the percentage of patients coming in complaining of a cough. It came out to over 1,000 extra patients above the average of what we would typically see," Elmore told CNN.

The number of patient visits to the ER for respiratory complaints, as well as the number of people hospitalized with acute respiratory failure between December 2019 and February 2020, were all up compared to records from the past five years. The uptick in cases started in the final week of December.

"Some of these cases could have been due to the flu, some could be for other reasons, but to see these kinds of higher numbers even in the outpatient setting is notable," Elmore said.

Elmore hopes this research shows that real time data collected on diseases like this could potentially help public health experts identify and track emerging outbreaks much earlier and potentially slow or stop the spread of disease.

Dr. Claudia Hoyen, an infectious disease specialist at University Hospitals Cleveland Medical Center who did not work on the study, also believes it's possible Covid-19 may have been in the US much sooner than first realized.

Kristian Andersen, a professor in the Department of Immunology and Microbiology at Scripps Research, doesn't, however. "We know from the SARS-CoV-2 genetic data that the pandemic started in late November / early December in China so there's absolutely no way the virus could have been spreading widely in December 2019. From the same genetic data we know that widespread transmission didn't start in the United States until (around) February 2020," Andersen said in an email.

"The paper is picking up spurious signals and the hospitalizations are more likely from flu or other respiratory diseases," Andersen wrote.

Health agents of the City of Rio de Janeiro walk in an alley of Favela da Mangueira on September 3. Bruna Prado/Getty Images

Brazil’s health ministry reported 36,653 new Covid-19 infections and 1,113 new coronavirus-related deaths on Tuesday.

That brings the country’s total number of coronavirus cases to 4,382,263 and raises the death toll to 133,119.

According to a tally by Johns Hopkins University, Brazil is the third-worst hit country in the world in terms of cases, behind only India and the United States.

Brazil is second-worst in terms of deaths, with only the US having suffered more coronavirus fatalities so far.

It might not be until 2022 when the world can begin thinking about returning to "pre-Covid" life, Dr. Soumya Swaminathan, chief science officer at the World Health Organization in Geneva, said Tuesday.

"We're looking at 2022 at least before enough people start getting the vaccine to build immunity. So for a long time to come, we have to maintain the same kind of measures that are currently being put in place with physical distancing, the masking and respiratory hygiene," said Swaminathan, speaking to reporters during a virtual meeting hosted by the United Nations Foundation.

"Those will have to continue after the vaccine starts getting rolled out, because we need 60% to 70% of the population to have immunity before you will start seeing a dramatic reduction in transmission of this virus," Swaminathan said. "We also don't know how long these vaccines will protect for — that's the other big question mark: How long does immunity last? And it's possible that you will need a booster."

Swaminathan added that health officials are currently looking to control the coronavirus that causes Covid-19, rather than eliminate it at this point.

Swaminathan added that she doesn't think the coronavirus will become a seasonal virus as time goes on, but instead we could expect to see "ups and downs" in cases and transmission.

Boston Mayor Marty Walsh announced Tuesday he is extending the city's outdoor dining program until December. It was originally set to expire Oct. 31.

This means restaurants can continue to use private outdoor spaces as well as public spaces on streets and sidewalks, Walsh said during a briefing. 

Restaurants will be able to use electric heaters without a permit as long as the cords don't cross the sidewalk," the mayor said.

The latest numbers: Boston reported at least 51 new cases of Covid-19 on Tuesday, bringing the total to approximately 16,245 cases in the city, Walsh said. There were two deaths over the weekend, bringing the total number of deaths to approximately 757. 

The positive Covid-19 test rate in Boston is 1.6%, down from 1.7% last week but Walsh encouraged residents to continue adhering to mask and social distancing guidance to avoid a spike in numbers. Walsh said 2,700 Boston residents were tested every day on average last week, including college students.

Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, testifies before a House Subcommittee on the Coronavirus Crisis hearing on July 31 in Washington. Kevin Dietsch/Pool/Getty Images

Dr. Anthony Fauci said “it’s just a matter of time” before the AstraZeneca Covid-19 vaccine clinical trial resumes in the United States. 

The trial went on pause worldwide last week while doctors looked into the illness of a Phase 3 clinical trial participant who received the vaccine and became ill. 

“It would be unusual to completely stop a trial on the basis of one single adverse event,” Fauci told CNN on Tuesday afternoon. 

The study participant who became ill is enrolled in a trial in the UK being run by the University of Oxford, which is working with AstraZeneca on the vaccine, since they developed.

The UK arm of the trial has already resumed. In its information for trial participants, the university mentions that study volunteers “developed unexplained neurological symptoms including changed sensation or limb weakness” and that “after independent review, these illnesses were either considered unlikely to be associated with the vaccine or there was insufficient evidence to say for certain that the illnesses were or were not related to the vaccine.” 

Fauci, director of the National Institute for Allergy and Infectious Diseases, said doctors leading the trial sites in the US will be told to look out for similar symptoms. 

“You have to be extra special careful and watch out to see if it happens again, and then if it does, it becomes an entirely different situation,” he said.

Sondra Wolfe speaks during an interview with CNN affiliate KCCI. Her husband died of Covid-19. KCCI

After her husband died of Covid-19, Sondra Wolfe wants people to see the human lives behind the numbers.

She described her husband, Mike, as a great father, grandfather and husband. She said losing him is leaving a big hole in their family and community.

"He took care of all of us. He was just an all around great guy," Wolfe said.

She said it is frustrating that President Trump and other federal leaders did not act on the severity of the pandemic earlier.

"Other countries have this under control and are protecting their citizens, and that they've made this political and about an election and about ratings, just makes me angry. This is about people and lives," she said.

"It is not going away," she added. "It is not political. It is a health crisis and we need to do what we can to take care of each other."

She urged people to wear masks and have empathy, saying that simple action could save lives.

"If you would pass this on to somebody else, how would it make you feel. If your selfishness was responsible for somebody's death," Wolfe said.

Watch:

Ohio Gov. Mike DeWine announced 87 Covid-19 deaths reported in the last 24 hours, the highest number of deaths reported in one day since early May. 

He clarified that while the deaths were reported in the last 24 hours, it doesn't mean the deaths occurred in that time frame. About 83% of the deaths occurred within the last month, while the rest happened before then, he said. 

DeWine said there have also been at least 1,001 new Covid-19 cases – bringing the total to approximately 139,485 cases with a 3.6% positivity rate. There have been at least 4,506 total deaths reported in the state.

The governor said that in a recent conversation with university presidents in Ohio about the return to campus, many said that the major issue they are facing is large student gatherings without masks. DeWine encouraged students to wear their masks in any social situation and to remain outdoors whenever possible.

On the economy: DeWine also announced the launch of a new work program meant to help those lost their jobs during the pandemic find new positions. The program, which will first launch in Cleveland, will pair each person with a coach that will identify their strengths and provide any additional job training that is needed, he said.

The state is currently working with 30 employers on the job program and will provide job fairs to connect applicants and companies, he said.

Note: These numbers were released by the state of Ohio, and may not line up exactly in real time with CNN’s database drawn from Johns Hopkins University and the Covid Tracking Project.