COVID-19-associated deaths were reported in the United States (1). Understanding the demographic and clinical characteristics of decedents could inform medical and public health interventions focused on preventing COVID-19-associated mortality. This report describes decedents with laboratory-confirmed infection with SARS-CoV-2, the virus that causes COVID-19, using data from 1) the standardized CDC case-report form (case-based surveillance) (https://www.cdc.gov/coronavirus/2019-ncov/php/ reporting-pui.html) and 2) supplementary data (supplemental surveillance), such as underlying medical conditions and location of death, obtained through collaboration between CDC and 16 public health jurisdictions (15 states and New York City). Case-based surveillanceDemographic and clinical data about COVID-19 cases are reported to CDC from 50 states, the District of Columbia, New York City, and U.S. territories using a standardized case-report form (case-based surveillance) or in aggregate. Data on 52,166 deaths from 47 jurisdictions among persons with laboratoryconfirmed COVID-19 were reported individually to CDC via case-based surveillance during February 12-May 18, 2020. Among the 52,166 decedents, 55.4% were male, 79.6% were aged ≥65 years, 13.8% were Hispanic/Latino (Hispanic), 21.0% were black, 40.3% were white, 3.9% were Asian, 0.3% were American Indian/Alaska Native (AI/AN), 0.1% were Native Hawaiian or other Pacific Islander (NHPI), 2.6% were multiracial or other race, and race/ethnicity was unknown for 18.0%. (Table 1). Median decedent age was 78 years (interquartile range (IQR) = 67-87 years). Because information about underlying medical conditions was missing for the majority of these decedents (30,725; 58.9%), data regarding medical conditions were not analyzed further using the case-based surveillance data set. Because most decedents reported to the supplementary data program were also reported to case-based surveillance, no statistical comparisons of the decedent characteristics between the data sets were made. * Underlying medical conditions include cardiovascular disease (congenital heart disease, coronary artery disease, congestive heart failure, hypertension, cerebrovascular accident/stroke, valvular heart disease, conduction disorders or dysrhythmias, other cardiovascular disease); diabetes mellitus; chronic lung disease (chronic obstructive pulmonary disease/emphysema, asthma, tuberculosis, other chronic lung diseases); immunosuppression (cancer, human immunodeficiency virus (HIV) infection, identified as being immunosuppressed); chronic kidney disease (chronic kidney disease, end-stage renal disease, other kidney diseases); neurologic conditions (dementia, seizure disorder, other neurologic conditions); chronic liver disease (cirrhosis, alcoholic hepatitis, chronic liver disease, end-stage liver disease, hepatitis B, hepatitis C, nonalcoholic steatohepatitis, other chronic liver diseases); obesity (body mass index ≥30 kg/m 2 ). Information was collected from decedent medical records or death certificates. ...

In the middle of a pandemic, patients with cough and fever are thought to have SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2). It should be remembered that in the desert southwest of the United States, we have an ongoing epidemic of coccidioidomycosis (CM). There are additionally many other respiratory illnesses that could be confused with CoV-2 or overlooked. This is a case report of CoV-2 engrafted on chronic cavitary pulmonary CM. In a time where the coronavirus pandemic is becoming rampant, we demonstrate the case of a coinfection with cavitary pulmonary CM. In this case, the importance of detection of the coronavirus and treatment of the coinfection is explored.

Emerging research on aquaculture governance has pointed to the conundrum of negative global environmental effects from economic incentives for aquaculture production to shift from more highly regulated to less regulated countries. This study has focused on examining whether regulatory costs on U.S. tilapia farms may have contributed to their contraction in contrast to the growth of global tilapia production that contributes to the volume of seafood imports into the U.S. A national survey (coverage rate = 75% of tilapia sold; response rate = 18%) found that on-farm regulatory costs accounted for 15% of total production costs on U.S. tilapia farms, the fifth-highest cost of production. The total direct regulatory costs nationally were $4.4 million, averaging $137,611/farm. Most problematic were regulations of effluent discharge, predatory bird control, international export, and water and energy policies. Manpower costs for monitoring and reporting were the greatest cost of regulatory compliance. The lost sales revenue resulting from regulations was $32 million a year, or 82% of total annual sales, indicating that the regulatory framework has constrained the growth of U.S. tilapia farming. The smallest tilapia farms had the greatest regulatory cost per kg. This study provides evidence that regulatory costs, along with other challenges related to live fish markets, have contributed to the decline in U.S. tilapia production. Increased competitiveness of the U.S. tilapia industry will require a combination of: (1) improved regulatory efficiency that reduces on-farm cost burdens without reducing societal benefits; (2) research and on-farm extension assistance to evaluate new tilapia fillet equipment; and (3) research on changing consumer preferences to provide guidance on effective strategies to penetrate the large U.S. fillet market.

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The greatest percentage of crustacean farm respondents (42%) were located in the Southern Aquaculture Region, followed by the North Central Aquaculture Region (33%), the Tropical and Subtropical Aquaculture Region, and the Western Aquaculture /Region (8%) (Table 3). There were no crustacean respondents from the Northeastern Aquaculture Region. Table 3. Participation by USDA aquaculture region. Region Percentage of survey respondents Southern 42% North Central 33% Tropical and Sub-tropical 17% Western 8% Northeastern 0% Key FindingsOne hundred percent of crustacean respondents reported that their farm or business had been impacted by the COVID-19 pandemic.