Covering COVID-19 is a daily Poynter briefing of story ideas about the coronavirus and other timely topics for journalists, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.

Over the weekend, President Donald Trump said the country needs and wants a second stimulus bill. But on Tuesday, President Trump called off any chance of a stimulus bill until after the November election.

Trump says he is asking Senate Majority Leader Mitch McConnell to spend his energy confirming Trump’s Supreme Court nominee, Amy Coney Barrett, and not negotiate further with Democrats, who wanted $2.6 trillion in stimulus relief. The White House had offered $1.6 trillion.

Millions of unemployed Americans hoped to get another round of enhanced unemployment benefits. Even more Americans might have gotten a stimulus check, as they did in the spring.

The president’s order came just hours after Federal Reserve Chair Jerome Powell warned the nation’s economic recovery could falter without more federal stimulus. The Associated Press reported:

Powell said Tuesday that the risks of Congress pouring too much stimulus into the economy are far lower than the risk of not doing enough. Although government spending is adding to an already sky-high federal budget, lawmakers should act, Powell argued.

The president’s announcement came just before the stock market closed Tuesday, but in the short period left in the trading day, the Dow dropped 400 points.

The Dow Jones Industrial Average dropped minutes after the president called off talks with Democrats

Airlines, in particular, saw a selloff. Airlines had said they could reverse some of the more than 35,000 layoffs they announced last week if Congress could approve a stimulus bill.

The Senate has a two-week hold on floor sessions after three GOP senators tested positive for COVID-19. Many experts predict the election will not be settled for days or even longer after Election Day, so it is difficult to imagine Congress being able to successfully take on a multi-trillion-dollar relief package in the midst of disruption, particularly if the balance of power changes in the election.

Some business analysts Tuesday evening offered the notion that the president might be bluffing and will reengage in talks.

Thousands fewer flights are available for holiday travel

Air travel is going to be more complicated this year. Beyond all of the COVID-19 testing and mask-wearing, there are going to be a lot fewer flights. Southwest Airlines, for example, says it will have 90,000 fewer flights in November and December. The Dallas Morning News reported:

Southwest cut 38,000 flights from its November plans, or about 36% of all trips, according to Dallas-based Airline Data Inc. The carrier also cut 55,000 flights for December, nearly half of its schedule.

American Airlines announced this week it was cutting holiday season flights, too. American removed 86,000 flights, almost half of its normal schedule, from the November calendar.

Boeing said this week that the pandemic will hurt jet sales for more than a decade.

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Restrictions return while cases rise

Six states are now in the process of reversing orders that reopened public gatherings, businesses and schools. Four more have paused further reopenings for now.

Wisconsin Gov. Tony Evers says starting Thursday morning, the state will reimpose restrictions on the size of indoor gatherings. Evers said, “We’re in a crisis right now and need to immediately change our behavior to save lives.”

Wisconsin has four of the top 10 cities on The New York Times’ calculation of average daily cases compared to population over the last two weeks.

(Data and graphic from The New York Times)

(Data and graphic from The New York Times)

New polling: Trump’s COVID-19 diagnosis may increase mask use

New polling from Axios/Ipsos finds about one in five Americans say President Trump’s COVID-19 diagnosis makes them more likely to wear a mask and stay six feet away from other people.

(Ipsos)

Another poll, this one from Long Island University, finds that one in 10 Americans do not believe masks help prevent COVID-19 infections.

What does obesity have to do with COVID-19 risk?

Journalists have repeatedly pointed out two COVID-19 risk factors that make President Trump more vulnerable to the virus. First is his age. The other is that he is “obese.”

What does obesity have to do with COVID-19 risk? It is a serious question since about 42% of American adults are “obese.”

Since the beginning of this pandemic, dozens of studies have shown obesity to be a key factor in who is likely to get the sickest from the virus. In one study involving 399,000 patients, “People with obesity who contracted SARS-CoV-2 were 113% more likely than people of healthy weight to land in the hospital, 74% more likely to be admitted to an ICU, and 48% more likely to die.”

One study of New York City COVID-19 cases found:

Being an individual with obesity increases the odds of COVID‐19 patients being hospitalized. Among diagnosed COVID‐19 patients, the prevalence of individuals with obesity in hospitalized patients was much higher than that in non-hospitalized patients. For example, a report that included 5700 patients with obesity in New York City showed that 41.7% of COVID‐19 hospitalized patients were individuals with obesity, whereas the average prevalence of individuals with obesity in New York City was 22.0%.

Another study of nearly 17,000 COVID hospitalized patients in the United States found 77% of those patients were either overweight or obese.

“In fact, obesity is the No. 1 risk factor for developing a severe case of COVID-19 in people under the age of 55,” warns Dr. Kyle Stephens, weight loss surgeon at Houston Methodist Hospital. Dr. Stephens says:

What we know historically from the influenza, tetanus and hepatitis B vaccines is that people who are obese seem to benefit less from vaccination than people who are at a healthy weight.

He adds that while researchers do not know exactly why vaccines do not work as well on obese people, it seems to have something to do with a “chronic state of inflammation” associated with obesity that interferes with a vaccine’s ability to do its work.

And obese patients are more likely to have other underlying health issues — including diabetes, heart disease and lung disease — which makes it more difficult to fight an invading virus.

Science Magazine described something physicians refer to as “sticky blood” that is associated with obesity:

 For starters, the blood of people with obesity has an increased tendency to clot — an especially grave risk during an infection that, when severe, independently peppers the small vessels of the lungs with clots. In healthy people, “the endothelial cells that line the blood vessels are normally saying to the surrounding blood: ‘Don’t clot,’” says Beverley Hunt, a physician-scientist who’s an expert in blood clotting at Guy’s and St. Thomas’ hospitals in London. But “we think that signaling is being changed by COVID,” Hunt says, because the virus injures endothelial cells, which respond to the insult by activating the coagulation system.

Add obesity to the mix, and the clotting risk shoots up. In COVID-19 patients with obesity, Hunt says, “You’ve got such sticky blood, oh my — the stickiest blood I have ever seen in all my years of practice.”

For a more detailed explainer on some of the theories about the connections between obesity and COVID-19, go to this study and flip down to Section 4.

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One way to increase your COVID-19 resistance: sleep more

I am not sure how well this claim would sit with the Food and Drug Administration if a mattress or pillow company tried to claim their product fights COVID-19. But National Geographic ran an interesting piece quoting Monika Haack, a psychoneuroimmunologist at Harvard Medical School, as saying, “We have a lot of evidence that if you have an adequate amount of sleep, you definitely can help to prevent or fight any kind of infection.”

When you do not get enough sleep, the body can reduce antibody responses to hepatitis A, hepatitis B and H1N1 swine flu vaccines. Researchers say one sleepless night might make a difference.

The story says:

Growing evidence also shows that sleep deprivation impairs a person’s ability to fight off a disease once they are infected. In a number of studies, people with sleep disorders, people who catch less than five or six hours of shut-eye per night, and people with low levels of sleep efficiency (the percentage of time spent snoozing during the night) report higher rates of respiratory illnesses, head colds, and related ills.

In a 2019 study, Haack and colleagues listed more than three dozen ways that various immune-system players vary based on sleep changes. For instance, T cells are part of the immune system and are often described as the soldiers that fight infections. During sleep, according to studies by German researchers, T cells normally move out of the blood and likely into lymph nodes, where they conduct surveillance for invading pathogens, Haack says. But just one night of sleep deprivation, studies show, is enough to keep T cells circulating in the blood, making them less able to learn about and respond to invading viruses. When the body is denied sleep, T cells also become less able to interact with virus-infected cells, reducing their power to fight the infection.

Cytokines, a category of inflammatory molecules connected to the pandemic, are also a major focus of research on sleep and immunity. Pro-inflammatory cytokines normally help organize an immune response to infections, triggering other cells to come fight, says Sheldon Cohen, a psychoneuroimmunologist at Carnegie Mellon University. But the production of too many of these molecules adds up to a cytokine storm, an overreaction associated with severe and fatal cases of COVID-19. In studies of colds and influenza, infected people with poor sleep show worse symptoms, probably because elevated levels of pro-inflammatory cytokines interfere with T cells and other immune cells.

The National Geographic story points to a fascinating study from the University of California, San Francisco, and Carnegie Mellon University in Pittsburgh that took 164 healthy adults and squirted the virus connected with the common cold up their noses. The adults who slept less than six hours a night before being infected were more than four times more likely to get sick.

Other evidence shows that when you do not get enough sleep, you are more likely to make bad decisions that may include not adequately protecting yourself from viral hazards.

The Sleep Foundation says the pandemic is interrupting our sleep, even when we try to get enough rest. Worry, anxiety and working on computers late in the day before you go to bed are all sleep-killers. “The blue light from screens can suppress the natural production of melatonin, a hormone that the body makes to help us sleep,” the Sleep Foundation says.

Other ways the pandemic may be messing with your sleep:

It can be difficult to adjust to a new daily schedule or lack of a schedule.

Keeping track of the time, and even the day, can be hard without typical time “anchors” like dropping kids at school, arriving at the office, attending recurring social events, or going to the gym.

Being stuck at home, especially if it has low levels of natural light, may reduce light-based cues for wakefulness and sleep, known as zeitgebers, which are crucial to our circadian rhythm.

If you are not working at the moment or your weekly hours have been decreased due to COVID-19, you may be tempted to oversleep each morning. Sleeping more than seven to eight hours per night can make waking up on time much more difficult, even if you use an alarm. Oversleepers may also feel groggy, irritable and unfocused throughout the day.

The way we live now

Eddie Van Halen died, which just adds to the pain.

Joint Chiefs of Staff in quarantine,
stock market tanks, stimulus talks collapse, “learning to live with Covid,” East Wing staff in full PPE, Pence doesn’t want Plexiglas at debate…. it’s barely noon on the West Coast!

— Michael M. Grynbaum (@grynbaum) October 6, 2020

The way we work now

Dan Zak, White House correspondent for The Washington Post, documented a moment you never thought you would see. A guy in a hazmat suit walked through the West Wing press area with a sanitizing wand.

This is going on at the White House today. (This is the press area.) Video by @jabinbotsford. pic.twitter.com/46nFvIeKHs

— Dan Zak (@MrDanZak) October 6, 2020

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Al Tompkins is senior faculty at Poynter. He can be reached at atompkins@poynter.org or on Twitter, @atompkins.