Another cut & paste job. The Washington Post. Coronavirus Updates.

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Important developments in the pandemic.       By Avi Selk with Derek Hawkins  Email The Post's coronavirus coverage linked in this newsletter is free to access from this email.    The latest With minimal help from the federal government, mayors and governors of both parties are making unilateral, desperate attempts to slow the virus's spread without wrecking their economies. A voluntary “lockdown” in Newark; a belated mask mandate in Ohio; and the mayor of Denver's plea that residents stay home for the next month: “I know this is hard. I know you hate this.” These combined local efforts are dragging the United States closer to something resembling a national shutdown, but our Health desk writes that it's probably too little, too late. “Most governors are trying to fight a forest fire of infection with garden-hose measures, and they aren’t even aiming at the right targets or starting at the right time,” warned Anne Sosin, program director at the Dartmouth College Center for Global Health Equity. As we wrote in yesterday's letter, the U.S. vaccine program is focused on inoculating as many Americans as possible, as quickly as possible, an enormous challenge. But China and Russia are playing a deeper game, rushing to share their own state-backed vaccines with countries in need, thus buying influence that could help them shape the post-pandemic world order. “For the U.S. this creates geopolitical nightmares, because we are not in the game,” David Fidler, senior fellow for global health at the Council on Foreign Relations, told our World desk. Meanwhile, there is a deep suspicion of a U.S. vaccine in some of the same communities that most need one, according to a new survey. Fewer than half of Black people surveyed and only two-thirds of Latinos said they were likely to get inoculated. Even fewer believe the shots will be safe and effective. Since the pandemic started, depression and anxiety have become rampant. One in four young adults has recently thought about killing themselves, according to a Centers for Disease Control and Prevention survey that has alarmed mental health experts. “America’s system for monitoring suicides is so broken and slow that experts won’t know until roughly two years after the pandemic whether suicides have risen nationally,” The Post wrote. “But coroners and medical examiners are already seeing troubling signs.” Other important news A 70-year-old nurse in Dallas came out of retirement so she could train others to battle the virus, caught it from one of her students, and last month became one of at least 836 U.S. health-care workers who have been killed by it. A union representing 900,000 grocery employees and others are urging chains such as Walmart, Amazon and Kroger to reinstitute hazard pay as soaring infection rates collide with the holiday shopping rush. California thought it had corralled the coronavirus. Now its hospitals are full, and shutdowns are back.   Guide to the pandemic Track deaths and confirmed cases in the U.S. and across the world.  Vaccine tracker: These are the top ones to watch. Post reporters are publishing live dispatches nearly 24 hours a day. Submit a question and we may answer it in a future story or newsletter.   Your questions, answered "What is the criteria for classifying a death by covid-19 in the United States? For instance, if someone with covid-19 dies but had an underlying condition, what cause of death is being put on that person's death certificate?" — Jean in Ireland The physicians who examine a patient with covid-19 have the main responsibility for determining cause of death. They rely on their knowledge of the patient’s infection and response to treatment and consider other factors such as the patient’s medical history and even past tobacco use. If a patient has underlying conditions — as is the case in the vast majority of covid-19 deaths — physicians look closely at whether the disease was part of the chain of problems that killed them. Because of the way the novel coronavirus affects the human body, covid-19 is typically listed as a contributing cause of death. The primary causes are usually listed as something triggered by the infection, such as respiratory distress or pneumonia. Those fatalities are included in the overall pandemic death toll because covid-19 set off a sequence of health issues that killed the patients. The same principle applies to tallying influenza deaths. “If somebody has cancer and their treatments are going well, and then covid-19 comes in and abruptly changes the trajectory, that becomes a cause of death,” said Jorge Salinas, a hospital epidemiologist at the University of Iowa hospital system. “The fact that people have comorbidities doesn’t mean that the disease didn’t play a major role in their death. It doesn’t mean they were meant to die this year because of otherwise manageable conditions.” The same is true even for a terminal illness, Salinas said. “They may not have that much longer to live,” he said, “but if covid happens and kills someone earlier, it’s the cause of death.” Guidelines from the CDC say death certifiers should use their “best medical judgment based on the available information and their expertise” in reporting covid-19 deaths. If certifiers can’t make a definitive diagnosis, the agency recommends assigning a probable or presumed cause of death, so long as the circumstances are “compelling within a reasonable degree of certainty.” Once the death certificate is completed, it goes to the health department in the place where the person died. There, health officials may examine lab results, physician’s notes, patient medical history and other information related to the case to get a clearer picture. A copy of the death certificate also goes to the CDC’s statistics office, where it is reviewed and coded as a covid-19 death. After that, officials disclose the death to the public.   Today’s top reads Find more stories, analysis and op-eds about the outbreak on our coronavirus page, including: Princeton will allow many more students to live on campus in spring term amid the pandemic  Online school has sent F’s spiking by 83 percent in Virginia’s largest school system  Coronavirus vaccine will likely be required for international flights, Qantas CEO says Head home or hunker down? The Thanksgiving covid dilemma. By Marc Fisher, Victoria St. Martin and Lori Rozsa ●  Read more »   TSA records its busiest travel weekend since March By Shannon McMahon ●  Read more »   Coronavirus is roaring back in parts of Asia, capitalizing on pandemic fatigue By Simon Denyer ●  Read more »   What was lost when covid forced addiction support groups online — and what was gained By Allyson Chiu ●  Read more »   These women are secretly relieved to be off the hook for the holidays this year Read more »