Coronavirus Technology Solutions
October 2, 2020

physIQ and Purdue University Launch Study to Develop Algorithms for Detecting Earliest Signs of COVID-19 From Biometric Smartwatch Data

BTL Providing Face Masks and Ventilators as of September 2020

Could be 63 Million COVID Cases in India Not Just 6 Million

Half of World’s 34 million COVID Cases and 1 Million Deaths are in the Americas

Cases Surging in Spain

UK has Areas of Increased Cases

Germany Experiences Highest Daily Case Numbers Since April

Netherlands Cases Spiking

France has Rising Cases in Paris as Well as Marseille

Envirco HEPA Filter System for Isolation Rooms

Envirco Fan Filter Units have Wide Applicability in COVID Battle

A Number of Republican Officials have Tested Positive for COVID and More are Anticipated

__________________________________________________________________________

physIQ and Purdue University Launch Study to Develop Algorithms for Detecting Earliest Signs of COVID-19 From Biometric Smartwatch Data

Purdue University researchers have begun a study that would help determine if continuously collected biometric smartwatch data could be used to reliably and accurately detect these signs early, which could indicate that a potentially asymptomatic user should get tested for COVID-19.

Data from the study will inform new algorithms to be developed by physIQ, a Purdue-affiliated digital health technology company based in Chicago. The company has support from the Purdue Research Foundation’s Foundry Investment Fund.

Smartwatches on the market already collect a wide range of physiologic data, but incorporating metrics such as heart rate, heart rate variability and respiration rate that may help detect COVID-19 at the earliest stages will take more research, studies by companies such as Fitbit have stated.

Although smartwatch-like devices are not currently substitutes for gold-standard diagnostic tests used in clinics and hospitals, some wearable devices are starting to serve as tools for helping a clinician make a diagnosis.

“There won’t be a point where a smartwatch can tell you that you’re COVID-19 positive, but it could potentially say, ‘Within the next couple of days, you might be getting sick and should go get tested,’” said Craig Goergen, Purdue’s Leslie A. Geddes Associate Professor of Biomedical Engineering.

Previous studies have shown that viral infections increase resting heart and respiration rates and decrease heart rate variability before a patient develops a fever, Goergen said. It’s not yet known if these indicators, particularly respiration rate, can be measured reliably enough at the wrist to imply infection.

“An increased heart rate or respiration rate means something different if it increased while you were resting as opposed to running, but most smartwatches have difficulty distinguishing that. So it is really recovery and resting periods that we are focused on with this approach,” Goergen said.

In a study of up to 100 participants, Goergen’s team will first determine whether wearing a smartwatch to collect these indicators is practical, unobtrusive and user-friendly. The researchers are recruiting Purdue students, staff and faculty as study participants.

Each participant will be mailed a Samsung Galaxy smartwatch with a physIQ app loaded to collect data, FDA-cleared adhesive chest-based biosensors that collect a single-lead electrocardiogram signal, and a Samsung Galaxy smartphone to use for five days of continuous monitoring while Goergen’s lab analyzes data from the app remotely using physIQ’s cloud-based accelerateIQ platform.

Data from the chest patches will be processed by physIQ’s FDA-cleared artificial intelligence-based algorithms for deriving heart rate, respiration rate and heart rate variability. These data will serve as “gold standard” references to compare with data from the smartwatches.

Researchers led by Fengqing Maggie Zhu, a Purdue assistant professor of electrical and computer engineering, will analyze data collected by Goergen’s lab and determine how much of it could be used to train algorithms for developing smartwatch software aimed at detecting these metrics better. Watchband tightness, for example, could affect data availability and quality.

“We recognize this work as the first step in enabling advanced personalized analytics for continuous monitoring of individuals using smartwatch data,” said Stephan Wegerich, physIQ’s chief science officer. “This could lead to a solution that is applicable to many physiological monitoring applications in both clinical trial markets as well as in healthcare delivery.”

The end goal is that the software, which a smartwatch would access from a cloud-based server, would show subclinical changes in metrics unique to the individual by “learning” from large amounts of data continuously collected while wearing the watch.

The researchers plan to eventually expand the study to include individuals at high risk of contracting COVID-19.

The work is funded by a faculty innovations grant from Protect Purdue, the university’s initiative to keep the campus and surrounding community safe from COVID-19.

PhysIQ is a leading digital medicine company dedicated to generating unprecedented health insight using continuous wearable biosensor data and advanced analytics. Its enterprise-ready cloud platform continuously collects and processes data from any wearable biosensor using a deep portfolio of FDA-cleared analytics. The company has published one of the most rigorous clinical studies to date in digital medicine and are pioneers in developing, validating, and achieving regulatory approval of Artificial Intelligence-based analytics. With applications in both healthcare and clinical trial support, physIQ is transforming continuous physiological data into insight for health systems, payers, and pharmaceutical companies.

BTL Providing Face Masks and Ventilators as of September 2020

BTL is revamping several major manufacturing facilities to be able to provide face masks and ventilators to the medical community.  As a health company, they believe it is their obligation to protect and serve the doctors and medical workers that have continued to support the BTL community, and beyond.

As of September 2020, BTL's European manufacturing facilities have been producing ventilators and masks.  Most recently, FFP2 (European Equivalent to N-95) flat-fit respirator masks, for both medical professionals and consumers. The respirator masks received both an FDA Emergency Use Authorization and a CE Marking.

"There is little doubt that this pandemic has changed the way we all do business. BTL recognized that as a company, we needed to find a way to help our physicians and partners in the industry.  As a true manufacturer of aesthetic technologies, BTL was able to quickly re-prioritize some of its manufacturing efforts to start building ventilators, respirators and masks to provide support and protection for those who need it most," said Ron Borsheim, VP of Product Development.

"All staff and docs gave these masks a 5-star rating for comfort, breathability, tight seal and ear relief.  Ready to order many more," shared Robert Weiss, MD.

Melanie Palm, MD, FACS stated "I got to tell you, it's a real nice edge up in terms of comfort compared to some of the K95 and N95 respirators. Carolyn Jacob, MD further elaborated "They are more comfortable than any other mask we have been wearing."

More than 1 million masks are currently available for sale at its Massachusetts facility.

Founded in 1993, BTL has grown to become one of the world's major manufacturers of medical and aesthetic equipment. With 1,800 employees located in more than 55 countries, BTL says it has revolutionized the way to offer the most advanced non-invasive solutions for body shaping, skin tightening & other medical aesthetic treatments, including women's intimate health and wellness. BTL's brands include EMSCULPT, EMSELLA, EMTONE, BTL Vanquish ME, BTL Exilis ULTRA, and BTL Cellutone


Could be 63 Million COVID Cases in India Not Just 6 Million

More than 63 million people in India may have contracted Covid-19, health authorities said on Tuesday -- about 10 times higher than the official reported figures.

A national survey of more than 29,000 people across 700 villages and wards found that about one in 15 people above the age of 10 had antibodies against the coronavirus, according to the Indian Council of Medical Research. The survey was conducted from mid-August to mid-September.

Antibody tests, also known as serology tests, check for proteins called antibodies in the immune system, which indicate if someone has been exposed to the virus.

Of the country's 1.3 billion citizens, more than 966 million are aged 10 or above, according to the government's most recent census in 2011. If one in 15 people of this group have been infected with Covid-19, that's a total of 63.78 million people.

As of Wednesday, India has reported more than 6.1 million cases and 96,000 deaths, according to data compiled by Johns Hopkins University.

The survey suggests that for everyone infection officially reported, there are actually 26 to 32 people infected who slip through the cracks, said Dr. Balram Bhargava, director of the medical council, at a news conference on Tuesday.

This falls in line with what many experts have warned for months -- that India's coronavirus crisis may be much more dire than official figures suggest.

There are numerous reasons for this: People simply aren't getting tested enough. There are sometimes errors in reporting and registering cases. Changing government strategies can muddle the numbers and paint a misleading picture of the situation.

The government began rolling back restrictions in May after a months-long lockdown, with ministers turning their attention to reopening the economy and public services. But experts, including Bhargava, warn that it's too soon to relax.

Since a large proportion of the population is still susceptible, prevention fatigue has to be avoided," Bhargava said, adding that the risk of infection was highest in urban slums where millions live in crowded conditions, often with limited sanitation or running water.

Slum residents had a seroprevalence -- meaning they carried antibodies -- of 15.6%, almost double the 8.2% detected in residents of non-slum urban areas. The figure drops in rural areas to 4.4%, according to the survey.

The survey shows how important it is for the Indian public to continue taking coronavirus precautions like social distancing and personal hygiene, said Bhargava on Tuesday -- especially during Diwali, the festival of lights. The festival, which this year falls on November 14, is one of India's biggest annual holidays.

"In light of the upcoming festivities, in light of the winter season and mass gathering, containment strategies must be implemented by the states and the use of masks cannot be underlined more than after this seroprevalence survey," he warned. "That is very, very essential."

Ramanan Laxminarayan, a senior research scholar at Princeton University, predicted that the country may be undercounting infections by a factor of 50 to 100 -- meaning the "true" number could be upwards of 100 million.

One simple reason behind the discrepancy is insufficient testing. India has stepped up its testing, almost doubling the amount of tests conducted during the month of August -- but it still lags far behind other major countries.

Only about 82 of every 100,000 people in India are being tested per day, according to Johns Hopkins University -- compared to about 284 in the US and 329 in the United Kingdom.

India has one of the world's lowest Covid-19 mortality rates. But the numbers don't tell the whole story

"All the other countries test two times, three times, 10 times what India is testing," community medicine specialist Dr. Hemant Shewade told CNN earlier this month.

Meanwhile, India's mortality rate of 1.6% looks much lower than other countries -- compared to 2.9% in the US, 9.5% in the UK, and 11.5% in Italy, according to Johns Hopkins University. But coronavirus deaths, too, are likely being undercounted.

Even when India isn't facing a pandemic, its underfunded public health infrastructure means that only 86% of deaths nationwide are even registered in government systems. And only 22% of all registered deaths get an official cause of death, certified by a doctor, Shewade said.

And even if a coronavirus patient tested positive before dying, they might not be counted as a Covid-19 death if they had other preexisting conditions, such as diabetes or cancer, which could be recorded as the cause of death instead, he added.

Half of World’s 34 million COVID Cases and 1 Million Deaths are in the Americas

Since 31 December 2019 and as of 02 October 2020, 34,350,717 cases of COVID-19 (in accordance with the applied case definitions and testing strategies in the affected countries) have been reported, including 1,023,876 deaths.

Africa: 1,489,809 cases; the five countries reporting most cases are South Africa (676,084), Morocco (126,044), Egypt (103,317), Ethiopia (76,098) and Nigeria (59,001).

Asia: 10,702,442 cases; the five countries reporting most cases are India (6,394,068), Iran (461,044), Iraq (367,474), Bangladesh (364,987) and Saudi Arabia (335,097).

America: 16,915,337 cases; the five countries reporting most cases are United States (7,277,814), Brazil (4,847,092), Colombia (835,339), Peru (818,297) and Argentina (764,989).

Europe: 5,208,834 cases; the five countries reporting most cases are Russia (1,185,231), Spain (778,607), France (577,505), United Kingdom (460,178) and Italy (317,409).

Oceania: 33,599 cases; the five countries reporting most cases are Australia (27,096), Guam (2,550), French Polynesia (1,790), New Zealand (1492) and Papua New Guinea (539).

Other: 696 cases have been reported from an international conveyance in Japan.

Deaths have been reported from:

Africa: 36,086 deaths; the five countries reporting most deaths are South Africa (16,866), Egypt (5,946), Morocco (2,229), Algeria (1,741) and Ethiopia (1,205).

Asia: 195,327 deaths; the five countries reporting most deaths are India (99,773), Iran (26,380), Indonesia (10,856), Iraq (9,231) and Turkey (8,262).

America: 566,374 deaths; the five countries reporting most deaths are United States (207,808), Brazil (144,680), Mexico (78,078), Peru (32,535) and Colombia (26,196).

Europe: 225,102 deaths; the five countries reporting most deaths are United Kingdom (42,202), Italy (35,918), France (32,019), Spain (31,973) and Russia (20,891).

Oceania: 980 deaths; the five countries reporting most deaths are Australia (888), Guam (49), New Zealand (25), French Polynesia (7) and Papua New Guinea (7).

Other: 7 deaths have been reported from an international conveyance in Japan

Geographic distribution of 14-day cumulative number of reported COVID-19 cases per 100 000 population, worldwide, as of 2 October 2020

Cases Surging in Spain

Madrid is going back under city-wide lockdown measures after a surge in coronavirus cases in the Spanish capital, in a dramatic move that illustrates the growing intensity of Europe's battle against a snowballing surge of infection.

People will not be able to leave or enter their area except for work, education or health reasons, gatherings will be limited to six people and stores, bars and restaurants will have to reduce capacity by 50% and close by 10 p.m.

"Madrid is special because the health of Madrid is the health of Spain," Spanish Health Minister Salvador Illa told a news conference Wednesday as he announced the measures, calling the situation "complex" and "worrying."

The restrictions will apply to municipalities with more than 500 cases per 100,000 people in the past 14 days, where the number of positive cases surpasses 10% of all diagnostic tests or where Covid-19 patients make up more than 35% of occupied ICU beds.

Madrid reported 1,586 new infections Wednesday, or 40% of the national increase. Its regional government opposed the measures, arguing that the outbreak was under control.

UK has Areas of Increased Cases

UK Health Secretary Matt Hancock on Thursday announced a ban on households mixing indoors for Liverpool and several other cities in northern England following a rapid rise in cases. The new measures also recommend against non-essential travel, amateur sports watching and care home visits except in exceptional circumstances.

Prime Minister Boris Johnson said Wednesday that this was a "critical moment," adding that if the evidence requires it, he will not hesitate to take "more costly" measures.

There were 7,108 new cases in the UK on Wednesday after a record rise on Tuesday. Hancock warned that the R (reproduction) number remains above 1, meaning the virus "continues to spread," but he told Parliament that there were "early signs" increased measures were having a positive impact.

An interim report from the UK's largest community Covid-19 testing program released Thursday estimated that more than 1 in 200 people in England have coronavirus, or 0.55% of the population, compared to 0.13% active case in the previous round of testing. Over 65s saw a seven-fold increase, the biggest rise in cases, while young people continued to have the highest rates of infection, with 1 in 100 estimated to have coronavirus.

"While our latest findings show some early evidence that the growth of new cases may have slowed, suggesting efforts to control the infection are working, the prevalence of infection is the highest that we have recorded to date," said Professor Paul Elliott, director of the REACT (REal-time Assessment of Community Transmission) program at Imperial College London.

Prevalence increased in all parts of the country, with the northwest remaining the highest at 0.86%, and cases increased five-fold in London, from 0.10% to 0.49%. Black and Asian people were again found to be twice as likely to be infected compared to White people.

Chief scientific adviser Patrick Vallance warned Wednesday there was "fast growth" in cases in parts of the country, adding: "Things are definitely headed in the wrong direction." Chief medical officer Chris Whitty said there was "a significant uptick in the number of people who are entering intensive care."

Germany Experiences Highest Daily Case Numbers Since April

Germany's coronavirus cases rose by 2,503 to 291,722 Thursday, its second highest increase since April. German Chancellor Angela Merkel on Wednesday appealed to citizens to "obey the rules" going into winter. "I am sure: life as we know it will return, but now we have to be reasonable."

Merkel on Tuesday announced an array of new measures aimed at stopping a recent spike in infections in the country. She said that gatherings in public venues would be limited to no more than 50 people in areas with a large number of cases.

We know that a more difficult time is coming, fall and winter," Merkel told a news conference as she explained the restrictions, which also include fines of at least 50 euros for patrons in bars and restaurants who provide false contact data to authorities for tracing.

Merkel also issued warned that if action wasn't taken, Germany could see up to 19,200 new cases per day in the winter months. "This underscores the urgency to act," Merkel said.

Netherlands Cases Spiking

Cases are also spiking in the Netherlands, where 3,025 infections were reported Tuesday. On Wednesday, the government was into a U-turn on masks -- they must now be worn in all public indoor areas such as shops, museums and petrol stations. The government had previously said masks were not necessary if other measures were followed.

The Dutch government announced Tuesday that it was introducing stricter measures after the daily rate of reported infections doubled the levels seen during its first wave in the spring. These include working from home where possible and pubs and restaurants closing at 10 p.m.

France has Rising Cases in Paris as Well as Marseille

The head of the Paris regional health authority said Wednesday that the data from hospitals was not looking positive.

Aurelien Rousseau told France Inter radio that 34% of intensive care beds were occupied by Covid-19 patients in the region. He added the incidence rate is very high for people between 20 and 30, with 450 cases per 100,000 people. Rousseau said the incidence rate for people over 65 was more than 100 per 100,000 inhabitants.

With worsening numbers the government may decide that Paris, like Marseille and the overseas department of Guadeloupe, classifies as a zone of "maximum alert," meaning bars and restaurants would be forced to close.

The European Center for Disease Prevention and Control said that high case levels (at least 60 per 100,000) or a sustained increase in the 14-day Covid-19 case notification rates had been observed in 20 countries in the EU and UK, calling the situation in many countries "concerning."

Envirco HEPA Filter System for Isolation Rooms

The IsoClean® 800 is a portable, self-contained high efficiency particulate air (HEPA) filtration system designed to easily and economically create a negative pressure isolation room/environment that will meet OSHA and CDC TB guidelines.

The IsoClean® 800 can be used as a positive pressure clean air recirculating system in clinics, waiting rooms, hospital emergency rooms and other confined areas or as a partial or complete exhausting system to create a negative pressure isolation room for possible use with patients known or suspected of having TB, SARS or other infectious diseases. As a recirculating unit, the IsoClean®’s powerful motor/blower can deliver from 560 CFM (951 m3/hr) up to 800 CFM (1359 m3/hr) to provide a large number of room air changes per hour to minimize the spread of airborne diseases to patients and health care workers.

As a negative pressure unit, the air passing through the HEPA filter is cleansed of 99.99% of particles as small as 0.3 micron and may be exhausted directly to the exterior through a window, or through a wall simply by connecting flexible ducting to the 6 in. (152 mm) collar located on the top of the IsoClean® 800.

The IsoClean® 800 filter contains 220 square feet (20.4 square meters) of media to extend its usable lifetime before filter loading occurs, resulting in decreased cost and fewer filter changes. The IsoClean 800UV model comes equipped with an UV-C Light to offer even more protection. UV-C light has been proven to destroy viruses, mold and bacteria. With HEPA air filtration combined with UV-C light, the IsoClean 800UV is an industry leader in portable clean air filtration.

Features

• Low cost isolation room
• Flexible applications: clean air recirculating unit, negative pressure unit, or split system
• Small and portable
• 3-speed adjustable airflow
• 24 room air changes per hour
• Quiet operation: 52 dBA on low, 56 dBA on medium, and 60 dBA on high (measured 30 inches from face of unit)
• Low-high clean air circulation pattern
• Easily accessible HEPA filter and prefilter
• UV-C light equipped on 800uv model
• UL 507 E152685 on standard unit

Envirco Fan Filter Units have Wide Applicability in COVID Battle

The MAC 10 FFUs now used in hospital compounding rooms have applicability as an alternative to partitions in schools, transportation centers, and even restaurants.

While Envirco® has introduced a variety of proprietary products, one of its most successful continues to be the MAC 10® family of fan filter units (FFUs). A second generation FFU, the MAC 10® LEDC, features the most control options and the most versatile control system available on the market today according to the company.

By taking advantage of a unique combination of EC motor technology coupled with Envirco’s proprietary baffling system and backward inclined fan, the LEDC leads the industry in energy-efficiency. Its electronically commutated (EC) motor with internal microprocessor offers high performance and delivers long motor life with energy consumption rates as low as 90W @ 90 fpm.

Utilizing Envirco’s experience in FFU development, the LEDC also features low sound levels of 52 dBA, which are a MAC 10® family benchmark. Envirco® MAC 10® FFUs are used worldwide for a variety of critical clean air applications.

Standard Features

• New Universal Control Card

-Network Speed Control, MODBUS RTU
-Manual Speed Control, On-Board Potentiometer
-Analog Speed Control, Remote 0-10V

• Electronically Commutated (EC) brushless motor with internal microprocessor
• High Efficiency Particulate Air (HEPA) Filter: 99.99% efficient @ 0.3 micron
• 1.0 in. wg (200 Pa) of external static capability
• Backward-inclined centrifugal fan
• Walkable plenum (excluding prefilter), rated to 250 lbs.
• Washable pre-filter
• Manufactured to IEST recommended practices
• Available in 2x2, 2x3, 2x4 and 4x4 sizes
• cUL listed (115V, 208-240V, 277V) with standard UL 900 filter, file number E152685 (UL507).
• Mill finished aluminum exterior

Optional Features

• Room-side Replaceable Filter (RSR)
• Room-side Replaceable Filter and Motor Assembly (RSRE)
• Infrared Speed Control: Room-side airflow adjustment with a hand-held remote control
• Ducted Inlet Connection (shipped loose): 10" (254mm), 12" (305mm), 14" (356mm)
• Direct connection to air conditioning supply
• Flow-through light fixture provides illumination with minimal airflow disruption
• Powder coat white paint or stainless steel housing
• Room-side 3/8” Challenge Ports: Convenient aerosol challenge and HEPA filter testing, standard on RSE and RSRE units
• CE certified on 230V units
• ULPA 99.9995% at 0.12 micron PTFE and low boron
• 3/4” Knife Edge: Permits easy placement in gel track ceiling grid system (available on RSR and RSRE units only)

A Number of Republican Officials have Tested Positive for COVID and More are Anticipated

The web of those exposed by President Donald Trump’s coronavirus diagnosis reads like a who’s who of his peripatetic campaign: his campaign manager, the chair of the Republican National Committee, the leader of the House GOP’s campaign arm, and several high-profile members of Congress.

Now, those officials—not to mention countless supporters of the president—have either contracted COVID-19 or are at high risk for it after a week in which an infected Trump has crisscrossed the country. It also means a wide swath of the GOP’s formal campaign apparatus could be sidelined a month before a pivotal election in which the party is losing ground in its efforts to hold onto the White House, keep the Senate, and recapture the House.

Last Friday, the president had a packed day on the campaign trail, with events in Miami, Atlanta, and Virginia, with a stop in between at his hotel in Washington for a “roundtable with supporters.” Somewhere along the way, Ronna McDaniel, the RNC chair, was with Trump. It was reported on Friday morning that she had contracted the coronavirus. An RNC spokesperson said that McDaniel had tested for COVID-19 after a member of her family had contracted the virus, and said she’d been at home in Michigan since Saturday.

Over the weekend, Trump traveled to Pennsylvania for a rally, and held a White House event with many notable GOP officials to honor Judge Amy Coney Barrett, his nominee to the U.S. Supreme Court. Sen. Mike Lee (R-UT) was in attendance; video taken of the event by a CNN reporter shows him hugging and greeting other attendees without wearing a mask. He announced Friday that he’d tested positive for COVID-19.

Then, on Tuesday, much of the Trump campaign team, along with a top ally, Rep. Jim Jordan (R-OH), traveled on Air Force One to Cleveland, where they shared a debate hall with Democratic nominee former Vice President Joe Biden and his staff, supporters, and family.

The day after, Trump traveled to Minnesota for a campaign rally, bringing along his top campaign aides as well as Rep. Tom Emmer (R-MN), chairman of the National Republican Congressional Committee, on Air Force One. The president held a private fundraiser beforehand that attracted GOP Reps. Jim Hagedorn and Pete Stauber of Minnesota, as well as Jason Lewis, the GOP nominee in the U.S. Senate race, and a number of key donors and GOP officials in the state. Later, an evening rally outside the Twin Cities featured a speech from Trump that was half his normal length; aides reportedly sensed he was tired.

On Wednesday, Lara Trump, the president’s daughter-in-law, posted photos to social media showing herself mingling with various Trumpworld figures at a campaign event at Trump’s hotel in Washington; she and others were not wearing masks. The day before, she had traveled to the debate in Cleveland on Air Force One with her family.

Many of those who work for Trump or accompanied him during his aggressive week of campaign travel announced on Friday their plans to get tested or that they’d already received a negative result.

But the unprecedented situation has complicated life for a much broader group of people—including Barrett, who Senate Republicans are aiming to confirm to the court within a historically tight timeframe. After she and her family attended the Rose Garden event on Saturday, Barrett met with dozens of U.S. senators on Capitol Hill for closed-door meetings—including with Lee. Photos of their meeting show Lee and Barrett posing with and without face masks.

On Friday, White House spokesperson Judd Deere said that Barrett had tested negative for COVID-19, but said she was following Centers for Disease Control and Prevention guidelines for social distancing and mask-wearing for those exposed. He did not mention if Barrett would be quarantining for 14 days from exposure to someone with the virus—a practice that is, in fact, CDC guidance. Barrett had been scheduled to meet with more lawmakers in the coming days; it’s unclear if those plans will continue, though Majority Leader Mitch McConnell (R-KY) said on Friday morning that he did not see the brewing COVID outbreak as an obstacle to the speedy confirmation process they’ve outlined for Barrett.

Beyond Barrett and the Senate, the House of Representatives has things to worry about, too. After traveling with Trump this week, several Republican lawmakers returned to Washington for multiple votes on the floor of the House. Emmer said on Friday morning that he was not exhibiting COVID-19 symptoms but had gotten a test that morning. Jordan, meanwhile, announced that he’d gotten a test, but planned to work in isolation in his Capitol Hill office until he received a result. And Hagedorn’s office said he planned to continue his official duties—“such as voting on the House floor”—until he gets a negative COVID-19 result back.

“I think people are a bit rattled,” a House GOP aide told The Daily Beast on Friday morning, as lawmakers headed again to the floor for votes. “Things have been a little bit more back to normal the last two weeks, so I think this snaps everyone out of that complacency.”