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Data provided on Oct. 20 by Worldometers shows a spike in cases across the U.S. and Europe, please see the daily graph at that site. 
          On Oct 20, 2020 in the U.S., there were 57,327 new cases, on the 13th there were 45,791 new cases and on the 20th there are 8,456,653 total cases): on the 20th there were 442 deaths and the death total has reached 225,222. In comparison, in Italy there were 9,338 new cases (a doubling from prior week in “day of reported cases” and as reminder that day was also a doubling of prior week’s day of reported cases) and 423,758 total cases) and 73 deaths (36,616 total); in France, where once again both new cases and deaths increased by over a third, 13,242 new cases (910,277 total cases) and 146 deaths (33,623 total); in Germany – where yesterday’s new cases and deaths increased by over one-third from the prior week – there were 4,809 new cases (373,731 total cases) and 33 deaths (9,338 total deaths); the United Kingdom had 18,804 new cases (an approximate 50 percent increase since last week) and 741,212 total cases, 80 deaths, an approximate 60 percent increase since last week) increasing their Covid death total to 43,726. India, which remains in second place for total cases had 46,498 new cases (7,594,736 total cases) and 594 new deaths (115,236 total deaths); and Brazil remains in third place with 15,783 new cases (5,251,127 total cases) and 321 new deaths (154,226 total deaths). 

As our readers have seen and read, Big 10 football and fall leaf trips have been replaced by field hospitals and mask mandates, we quote the NY Times who reports: “Case numbers in the United States are rising rapidly as states in the Midwest and Rocky Mountains struggle to control major outbreaks, and as new hotspots emerge elsewhere in the country. The national trajectory is only worsening. Wisconsin has opened a field hospital. North Dakota, which not long ago had relatively few cases, now has the most per capita in the country. And across the rural West, states like Alaska, Wyoming and Montana that had long escaped the worst of the pandemic have seen case numbers soar to alarming new records.” And it is in the U.S. we start with an article in StatNews, whose lead is: “Here we go again.” StatNews then reports: “As hospitalizations for Covid-19 inch up around the country, some states are readying plans for field hospitals. Communities are delaying reopening plans and even imposing new measures, though some governors remain opposed to additional restrictions. Deaths — currently standing about 220,000 — have not surged again yet, but that might just be a matter of time.” The final article in the lead section is from the Washington Post supported by outside analyses, including researchers at Yale University and their own team, "have found two main causes for excess deaths" The Post finds that "Many probably were the result of Covid-19, although they were not recorded that way on death certificates. Please read "The coronavirus pandemic has caused nearly 300,000 more deaths than expected in a typical year"

A highly simplified and inaccurate form of Herd Immunity is now advanced by the White House and a small number of epidemiologists, the curators respond with an op ed “from the man who wrote the book” John M. Barry, the author of The Great Influenza: The Story of the Deadliest Pandemic in History: “What fans of ‘Herd Immunity’ don’t tell you."

We then turn to where seniors get health care insurance; Skilled Nursing News offers a look at Medicare Advantage (MA) and reports that MA has seen dramatic enrollment growth over the past six years, significantly outpacing traditional Medicare.

Election day is 13-days away, at this point we believe the readers’ are interested in what specific programs and policies will a Biden administration employ to address the pandemic. The N.Y. Times’ The Daily as podcast and transcription offers a most interesting analysis of how responding to the pandemic may help the Biden administration garner Senate and public support for programs that have been more difficult to pass in the past. And an analysis by Axios writers about the long financial tail of the pandemic.

From the more-and-more-everyday-outdoor tables in coffee houses and restaurants in Culver City, the suburbs of Cincinnati, Chelsea, Michigan, Milwaukee, the almost-empty football stadiums across the Now Big 14 conference, and the world this is the Revitalize list for Oct. 21, 2020:
Revitalize: The week in health-care news you need
What Fans of ‘Herd Immunity’ Don’t Tell You: A proposal to let people with low risk of infection live without constraint could lead to a million or more preventable deaths.

"At a breaking point": New surge of Covid-19 cases has states and hospitals scrambling, yet again

Medicare Advantage (MA) has seen dramatic enrollment growth over the past six years, significantly outpacing traditional Medicare, according to a report commissioned by the Better Medicare Alliance. The report examined the growth in enrollment in MA and the similarities and differences between enrollees in that program.

The coronavirus pandemic has caused nearly 300,000 more deaths than expected in a typical year.
The Candidates: Joe Biden’s Plans:
In the second part of our look at the presidential candidates’ policies, we explore Joe Biden’s plans for a crisis presidency.

One big thing:
Long tail of the virus
Industries that once were expected to recover after the initial coronavirus lockdowns lifted are now unlikely to bounce back until a vaccine arrives, Sara Fischer and Courtenay Brown write.
Jerry Seelig, CEO
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