The U.S. has reported 825,306 COVID-19 cases and 45,075 related deaths as of 8:30 a.m. CDT April 22.
Worldwide, 2,585,468 COVID-19 cases and 178,845 deaths have been confirmed, while 696,177 patients have recovered.
Seven updates:
1. The second wave of COVID-19 will be worse, CDC Director Robert Redfield, MD, warned in an April 21 interview with The Washington Post. If the second cycle occurs during the winter, it will coincide with the flu season, and the two simultaneous respiratory outbreaks will put an unimaginable strain on the healthcare system, according to Dr. Redfield. Officials should prepare for the next COVID-19 wave, continue to emphasize the importance of social distancing and increase the ability to identify the virus through testing and contact tracing.
2. An executive immigration order will halt green cards, President Donald Trump said during an April 21 news briefing. For 60 days, individuals will not be able to receive a green card to stay in the U.S. President Trump said the order won't apply to those entering the U.S. on a temporary basis. The pause will "protect the solvency of our healthcare system and provide relief to jobless Americans," the president said.
3. The Senate passed a $484 billion aid package April 21 that would increase funding for small business loans and hospitals, according to The Washington Post. The Senate unanimously approved the bill, called the Paycheck Protection Program and Health Care Enhancement Act, which will boost aid for hospitals and expand testing for COVID-19. The House is set to vote on the measure April 23.
4. The CDC is funding 650 workers to aid state health departments in testing and contact tracing, Dr. Redfield told NPR. The agency has allocated $45 million to hire the new public health workers and cover their salary for a year. The effort will place a regional director in each U.S. region, along with nurses, epidemiologists, microbiologists and lab technicians. The agency's goal is to boost the nation's public health workforce to ensure local communities can conduct enough testing and contact tracing to prevent future outbreaks as the nation reopens.
5. The state of Missouri is suing China for allegedly concealing the severity of the country's COVID-19 outbreak in December, according to ABC News. Missouri Attorney General Eric Schmitt filed a suit against the Chinese government April 21, claiming leaders concealed crucial information and failed to take early action while COVID-19 was rapidly spreading through China. The lawsuit also alleges that Chinese authorities arrested whistleblowers, destroyed medical research and denied human-to-human transmission despite mounting evidence, "thus causing a global pandemic that was unnecessary and preventable." Chinese officials have yet to respond to the suit.
6. The National Institute of Health has created a "living document" of COVID-19 treatment guidelines. The guidelines, based on published data and expert clinical expertise, are posted online and will be updated as new information emerges. Currently, two broad categories of therapies are being evaluated for COVID-19 — antivirals and host modifiers/immune-based therapies — though specific therapies weren't mentioned in the guidelines. The document also addresses considerations for critically ill patients and the use of concomitant medications.
7. The nation's first known COVID-19 deaths occurred in early February, according to The New York Times. Autopsy results from Santa Clara County, Calif., show two patients with COVID-19 died in their homes on Feb. 6 and Feb. 17, making them the earliest known American victims of the pandemic. Health officials said the patients likely contracted the virus via community transmission. This finding suggests that COVID-19 was spreading through California much earlier than suspected. Officials had previously attributed the nation's first COVID-19 deaths to two people who died in Seattle Feb. 26.