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What you need to know about coronavirus on Thursday, October 22 - CNN

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A version of this story appeared in the October 22 edition of CNN's Coronavirus: Fact vs. Fiction newsletter. Sign up here to receive the need-to-know headlines every weekday.
Spain has become the first western European country to record more than 1 million cases. In recent days, Germany, the United Kingdom and Greece have all recorded their highest daily infections since the crisis began. The Czech Republic, which is currently seeing the world's worst Covid-19 outbreak, has registered yet another record one-day tally.
To curb the virus' spread, European leaders are returning to social distancing measures and business closures not seen since the start of the pandemic. Curfews have been imposed across parts of England, France and Italy, while the Czech Republic has ordered most shops to close. Restrictions have so far stopped short of nationwide stay-at-home orders, but by Friday, Wales and Ireland will impose lockdowns similar to last spring.
The US could soon follow Europe's lead, with one health expert suggesting Covid-19 cases will begin to accelerate rapidly across America in a week. The US reported more than 1,100 new Covid-19 deaths on Wednesday -- the highest daily toll recorded in more than a month. At least 31 states are seeing more new cases than in the previous week and hospitalizations are on the rise -- concerning trends reminiscent of previous surges. Only this time, doctors say, Americans will likely see the worst surge yet.

YOU ASKED. WE ANSWERED

Q: How long do you need to be exposed to someone with Covid-19 before you are at risk of infection?
A: The US Centers for Disease Control and Prevention has updated its definition of a close contact with a Covid-19 patient to include multiple, brief exposures, director Dr. Robert Redfield said Wednesday.
The new definition includes exposures adding up to a total of 15 minutes spent six feet or closer to an infected person. Previously, the CDC defined a close contact as 15 minutes of continuous exposure to an infected individual.
Some background: The agency changed the definition after a report from Vermont of a corrections officer who became infected after several brief interactions with coronavirus-positive inmates -- none of them lasting 15 minutes, but adding up over time.​
Send your questions here. Are you a health care worker fighting Covid-19? Message us on WhatsApp about the challenges you're facing: +1 347-322-0415.

WHAT'S IMPORTANT TODAY

The number of older people getting coronavirus in Europe is rising again
Europe is deep in the second wave of the coronavirus epidemic, and a particularly worrying trend is beginning to emerge: More older people are becoming infected.
Over summer, the continent saw infection clusters popping up mostly among younger people venturing out into bars, restaurants and other public spaces. While that wasn't ideal, it meant the death rate stayed relatively low, since younger people are statistically less vulnerable to the virus and most avoid getting seriously ill.
But a sharp increase in infections among older people in recent weeks can be seen in almost all European countries where data is available. And that's worrying because older people are much more likely to end up in hospital and to face a significantly higher risk of dying, Ivana Kottasová and Krystina Shveda report.
A vaccine volunteer in Brazil has died -- but authorities say trial to continue
A volunteer in Brazil's trial of AstraZeneca's experimental coronavirus vaccine has died, the Brazilian health agency Anvisa announced on Wednesday, but organizers said there was no reason to stop the trial -- an indication that the death is not linked to the vaccine.
Anvisa said that it was notified of the death Monday but the International Evaluation and Security Committee overseeing the trial recommended that the trial continue. It was unclear whether the volunteer received the vaccine or a placebo shot as part of the trial, and Anvisa said no more information was being released for reasons of medical privacy.
Promising Covid-19 treatment falls short in clinical trials
Tocilizumab, a repurposed rheumatoid arthritis drug once considered a promising treatment for hospitalized patients with Covid-19, generally did not increase patients' chances of survival or help them recover faster, according to three trials published this week. A fourth trial did find the drug increased the chances of survival, but because it was an observational study, the results are considered less definitive.
While this leaves the picture for tocilizumab use a bit muddy, the studies taken together show the drug isn't a magic bullet that should be used in all patients hospitalized with Covid-19, but they leave the door open for possible use in specific patient groups.
How a 'shoddy' Bannon-backed paper on coronavirus origins made its way to an audience of millions
It was a blockbuster story. A respected Chinese virologist appeared on Tucker Carlson's show on Fox News in mid-September to share the results of her just-completed report. The conclusion: The novel coronavirus that causes Covid-19 was likely engineered in a Chinese lab. On Carlson's show, she claimed it was intentionally released into the world.
Then, its validity began to unravel. The publication of the paper by lead author Li-Meng Yan -- an expatriate from China seeking asylum in the US -- was quickly linked to former White House adviser Steve Bannon, long a strident critic of China's government. The Johns Hopkins Center for Health Security -- a leading authority on the pandemic --  criticized the science behind the report, and pointed out that Yan and her co-authors "cite multiple papers in their reference section that have weaknesses or flaws."

ON OUR RADAR

TODAY'S TOP TIP

Getting a flu shot this year is more important than ever. Not only will it help prevent you from getting sick from the flu, it will also make it easier to tell if any symptoms you are experiencing are more likely to be Covid-19. It is also critical to stopping a double pandemic, by saving healthcare resources for the care of those with the coronavirus.
But in order to make sure that flu shot is effective, sleep specialist Matthew Walker, the bestselling author of "Why We Sleep," told CNN's Christiane Amanpour practicing "good sleep hygiene" is key. Insufficient sleep in the week before getting a flu shot can lead to the production of less than 50% of the normal antibody response -- a reaction that would render the flu shot largely ineffective, Walker told Amanpour.

TODAY'S PODCAST

"I think as early as March, I could see the impact of Covid, the fear of Covid on my patients and how they were deciding how to manage their medical care." -- Dr. Michelle Kittleson, a cardiologist in Los Angeles
For people with chronic diseases, avoiding the doctor's office out of fear of contracting Covid-19 could be fatal. Today, Dr. Kittleson tells CNN's Chief Medical Correspondent Dr. Sanjay Gupta how she tries to get her heart failure patients to come back before it's too late. Listen Now.

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