Category Archives: Corona Virus

I need to take a trip that would be either a few hours flying or multiple days driving. Which is safer?

As lockdown orders are relaxed to some capacity in countries around the world, travel is starting to see an uptick for the first time since mid-March. But when it comes to taking a longer trip, is it better to travel by car or by plane?

Dr. Henry Wu, a professor of infectious disease medicine at Emory University and director of its TravelWell Center, says there is no definite answer but it all comes down to planning ahead.

Regardless of whether you fly or drive, Wu says that the first thing to keep in mind is that until a vaccine is developed and proven effective, it's impossible to fully mitigate all the coronavirus risks, including those associated with traveling.

That means that in accordance with the Centers for Disease Control and Prevention's guidance, travel should still be limited to circumstances in which it's absolutely necessary. And for people who are immunocompromised or at high risk of developing severe illnesses, it should be avoided as much as possible.

If you feel you need to take a trip, one main benefit of driving is that it gives you a greater sense of control over your surroundings although that doesn't mean it's necessarily safer than flying.

Lawrence Gostin, director of the O'Neill Institute for National and Global Health Law at Georgetown University, says the key to staying safe is taking measures like wearing a mask and carrying hand sanitizer when in public spaces. He worries, from a behavioral point of view, that people are less likely to follow hygiene protocols over the course of several stops on a long drive.

Here are some essential steps Wu and Gostin suggest to prepare for a road trip:

However, both Wu and Gostin point out that there are certain unavoidable risks that come with driving like the chances of getting in an accident or having car trouble. And you should always consider your own comfort level with long road trips and unknown highways.

If I decide to take an overnight road trip, how should I choose my lodging?

Gostin says the safest option would be camping sleeping in your car or on camping grounds with your own tent and supplies. That eliminates the risks of staying in an indoor space where you could come into contact with others. If camping isn't an option, there are other steps to lower the risks of an overnight stay.

Wu and Gostin recommend choosing a hotel or motel option without elevators or other confined spaces like a crowded breakfast buffet that could force you to come in close contact with employees and other guests.

"The more people, the smaller the space, the less [air] circulation and the longer you're there, your risk goes up," says Gostin.

Ask ahead of time that the hotel or Airbnb is using EPA-approved disinfectants to clean all surfaces in the room between guests, and, if possible, try to request rooms that have been unoccupied for several days although there's no way to know for sure that you're getting an honest answer.

"We know that COVID-19 virus viability on environmental surfaces is limited, and it really depends on the type of surface, the temperature and the humidity. But in most situations, [the virus] is not viable after several days," says Wu. "So if you have a room that's been empty for four or five days or even more, [that's] better."

It's also a good idea to bring your own alcohol wipes for the road and, once inside the room, to wipe down areas that could have been touched by prior occupants: door knobs, tabletops and the TV remote. Or just avoid touching these whenever you can.

Gostin also suggests staying in your room as much as possible. If you have a room with windows that can open, wipe them down before opening them to let in fresh air.

What if I'd rather travel by plane?

If driving for several days seems daunting, taking a flight might be preferable.

"Air circulation systems on planes are quite good. They have high-efficiency particulate air (HEPA) filters and high rates of air exchange," says Wu. "But that still doesn't protect you from what is happening immediately around you."

One of the biggest risks of flying is that it's hard to predict how full a flight might be or how much you'll be able to socially distance from other passengers and employees, even as airlines make efforts to minimize close contact.

Read more about the risks of flying and safety precautions you can take here.

Could I take a bus or train instead?

Like airplanes, buses and trains both mean traveling in an enclosed environment. One of Wu's main concerns is the type of air filters used, which may vary from vehicle to vehicle. It might not be possible to find out what type of filter is used in the particular bus or train you are riding or whether it's effectively circulating the air.

Additionally, not all bus and train companies might be able to exert as much environmental controls as airlines in terms of requiring empty seats between passengers and notifying you if your vehicle is expected to be at full capacity.

Greyhound currently requires all passengers and employees except children under two and people with breathing difficulties to wear masks on buses. In addition to requiring face covering, Amtrak is limiting seat capacity to 50% on each train. All caf seating is closed.

The same prevention tactics apply to train or bus travel as flying wash hands often, wipe down surfaces before you touch them and avoid removing your mask.

And when deciding between a train or plane ride, keep in mind the matter of time spent in potentially crowded travel situations matters.

"I would pick whatever's shortest," says Wu.

I live in an apartment building. Could I get the coronavirus through the air conditioning system?

We know that the coronavirus is primarily transmitted through respiratory droplets if an infected person coughs, sneezes or talks near other people, they expel droplets that could get someone else sick.

Could the droplets travel through the air-handling system in an apartment or condo building and into another unit, potentially infecting the neighbors?

There is still no definite answer. The Center for Disease Control and Prevention says that "the contribution of small respirable particles, sometimes called aerosols or droplet nuclei, to close proximity transmission is currently uncertain. However, airborne transmission from person-to-person over long distances is unlikely."

That's not to dismiss the risks of aerosol transmission. One study focused on a case in Guangzhou, China, in which three families contracted COVID-19 from eating in the same restaurant. This infection has been primarily attributed to poor ventilation within that particular restaurant.

But Dr. Abraar Karan, physician at Harvard Medical School, says the chances of getting sick from particles being spread from one room to another through the air conditioning system seems unlikely.

William Bahnfleth, engineering professor at Penn State University and chair of the Epidemic Task Force for American Society of Heating, Refrigerating and Air Conditioning Engineers, says it does not seem likely that you could get sick from the AC in your building.

"If they're small enough, [viral particles] can move through the air. They can move from place to place in a building, either through the air conditioning system or just on air currents under the influence of pressure differences in the building," he says. "But the real important question is, is there enough of that happening that anyone gets an infection from that? And so far, there doesn't seem to be evidence that that has happened."

Dr. Emily Landon, hospital epidemiologist and infectious diseases specialist at University of Chicago Medicine, agrees. She points to places like Hong Kong, Singapore and South Korea, where many people live in high-rises, and there have been no documented reports of infection due to air conditioning between apartments.

What's more, if you live in a building with what's called "once-through ventilation air supply," then the air comes in from the outside, is cooled or heated and does not "intentionally circulate air between units," Bahnfleth says.

If you're still concerned about airflow in your apartment, Bahnfleth suggests opening your windows if possible to bring in fresh air, although this might not be the best option in a high-rise. And although an air purifier or cleaner cannot fully protect you from COVID-19, the Environmental Protection Agency says having one in your home can be a part of your prevention strategy.

"When used along with other best practices recommended by the Centers for Disease Control and Prevention, operating an air cleaner can be part of a plan to protect yourself and your family," the agency said in a statement.

As we learn more about the virus, it's possible that the guidance related to air conditioning systems will change. But for now, Landon says it's not a primary concern for the spread of COVID-19.

"The preponderance of the evidence suggests that [getting infected through air conditioning systems] should not be a problem, but it's a new virus," says Landon. "We don't know everything that there is to know."

Read the original post:

Coronavirus FAQs: Is It Safer To Fly Or Drive? Is Air Conditioning A Threat? - NPR

In 2019, the disease, transmitted by the Aedes aegypti mosquito, had ravaged Latin America, which suffered its worst dengue epidemic on record with more than 3 million cases and more than 1,500 deaths.

The outbreak hit Honduras particularly hard, overwhelming a public health system that had already been weakened by budget cuts and pervasive corruption and was barely equipped to meet usual demands, much less an epidemic of record size. By the end of 2019, Honduras had suffered about 61 percent of the dengue deaths in Central America.

The highest number of dengue cases occurred in the department of Corts, where efforts to control its transmission were further hampered by a lack of trained personnel and by the regions ubiquitous criminal gangs, which for months blocked government health care workers from gaining access to some of the hardest-hit neighborhoods.

Dengue remains a major concern in Latin America and the Caribbean this year. According to the latest statistics from the Pan American Health Organization, about 1,426,000 cases have been recorded in the region so far, fewer than during the same period last year. But regional health officials fear this may be an undercount caused by the focus on the coronavirus and the disease it causes, Covid-19.

Covid has been able to sometimes deviate attention from other pressing problems, said Dr. Marcos Espinal, director of the department of communicable diseases at the Pan American Health Organization, based in Washington, D.C.

On Tuesday, Dr. Carissa F. Etienne, the director of the Pan American Health Organization, said the Americas, with more than 2.4 million Covid-19 cases and more than 143,000 deaths, had become the epicenter of the pandemic.

Original post:

In Some Nations, Coronavirus Is Only One of Many Outbreaks - The New York Times

The coronavirus that caused SARS was hosted by bats and palm civets. It jumped to humans because we had been pushing and pushing high-density urban population centers more deeply into wilderness areas, destroying that natural buffer and replacing it with monoculture crops and concrete.

When you simultaneously accelerate development in ways that destroy more and more natural habitats and then hunt for more wildlife there, the natural balance of species collapses due to loss of top predators and other iconic species, leading to an abundance of more generalized species adapted to live in human-dominated habitats, Johan Rockstrom, the chief scientist at Conservation International, explained to me.

These include rats, bats, palm civets and some primates, which together host a majority of all known viruses that can be passed on to humans. And when these animals are then hunted, trapped and taken to markets in particular in China, Central Africa and Vietnam, where they are sold for food, traditional medicine, potions and pets they endanger humans, who did not evolve with these viruses.

SARS jumped from mainland China to Hong Kong in February 2003, when a visiting professor, Dr. Liu Jianlun, who unknowingly had SARS, checked into Room 911 at Hong Kongs Metropole Hotel.

Yup, Room 9-1-1. I am not making that up.

By the time he checked out, The Washington Post reported, Liu had spread a deadly virus directly to at least eight guests. They would unknowingly take it with them to Singapore, Toronto, Hong Kong and Hanoi, where the virus would continue to spread. Of more than 7,700 cases of severe acute respiratory syndrome tallied so far worldwide, the World Health Organization estimates that more than 4,000 can be traced to Lius stay on the ninth floor of the Metropole Hotel.

It is important to note, though, that SARS was contained by July 2003 before becoming a full-fledged pandemic thanks in large part to rapid quarantines and tight global cooperation among public health authorities in many countries. Collaborative multinational governance proved to be a good buffer.

Alas, that was then. The latest coronavirus is aptly named SARS-CoV-2 with emphasis on the number 2. We dont yet know for sure where this coronavirus that causes the disease Covid-19 came from, but it is widely suspected to have jumped to a human from a wild animal, maybe a bat, in Wuhan, China. Similar jumps are bound to happen more and more as we keep stripping away natures natural biodiversity and buffers.

Read more here:

Coronavirus Showed How Globalization Broke the World - The New York Times

New York City, long the epicenter of the global coronavirus crisis, is poised to start reopening in slightly more than a week, setting the stage for a slow and tentative recovery after two months of suffering, social isolation and economic hardship.

Gov. Andrew M. Cuomo said on Friday that he expected the city to meet several benchmarks that would permit millions of virus-weary residents to enjoy the first signs of a normal life as early as June 8. Retail stores could open for curbside or in-store pickup, and nonessential construction and manufacturing could resume, part of an initial phase that could send as many as 400,000 people back to work.

As other parts of the nation, including less populated sections of New York State, have reopened, New York City, which lost more than 20,000 lives to the virus, has taken longer to recover. It required a gargantuan effort to even reach the point where officials were comfortable with loosening the restrictions on movement and commerce that were put in place in March.

Deaths in New York have dropped to only dozens a day, rather than the 700 or 800 a day that were taking place in April, and the number of virus patients on intensive care in the citys public hospitals has fallen by more than half.

That progress largely came because many New Yorkers followed the rules, and have been wearing face coverings and maintaining social distance as requested. The rewards of vigilance have been manifest not only in decreasing fatalities, but also in the declining number of people testing positive for the virus and of those requiring hospital stays because of it.

I am proud of the way New York is figuring it out, Mr. Cuomo said.

But even with the strides the city has made, the road to normalcy will no doubt be steep and rocky. Since February, nearly 900,000 local jobs have vanished and thousands of businesses have closed their doors some forever. Revenues from sales taxes are expected to drop by $1 billion, part of an estimated $9 billion budget shortfall that could push officials into risky borrowing and force drastic cuts to essential city services.

Even as summer nears, once bustling swaths of Midtown Manhattan remain all but abandoned, marred by vacant streets and shuttered storefronts. The subway system is limping along at record low ridership. Tourism has evaporated. Broadway theaters plan to remain dark at least until Labor Day, and many industry leaders say they may stay closed until January.

Under the first phase of reopening, much of the city would still be shut down, with restaurants and bars limited to takeout and delivery service, and offices, gyms, movie houses and grooming salons all closed.

Mayor Bill de Blasio, appearing virtually with Mr. Cuomo on Friday, seemed optimistic as he called the plan to begin reopening in June the gateway to the next big step. But neither he nor the governor has figured out certain crucial details yet, perhaps most notably how to get millions of commuters safely back onto public transit.

On Thursday, Mr. de Blasio said that between 200,000 and 400,000 people in New York could return to work under the first phase of recovery. But when questioned on Friday if the city was prepared for the coming spike in commuters, he appeared to dodge the issue, saying that many city dwellers would simply walk or bike to their jobs while others would drive or take taxis.

For the next few months, people are going to make their own choices, the mayor said. Some people are going to be comfortable with mass transit, some are not. We just have to be honest and real about that.

While Mr. Cuomo insisted that the subways were safe, he also said that it would be up to riders themselves not to create a public health risk by violating social distancing protocols.

We will need a cooperative public where if youre on a subway platform and you see it is crowded, OK, wait for the next one, he said.

Both leaders cautioned that while the dangers of the virus had receded, New Yorkers needed to continue taking measures to keep its spread in check. More than 5,000 people in the city tested positive for infection last week alone a steep drop from early April, when 40,000 people a week were testing positive, but still a significant number.

Officials have required each of the states 10 regions to meet seven health-related metrics before beginning the reopening process. New York City, the only region that has yet to do so, has not reached the benchmark of having 30 percent of its hospital beds available it was close, at 28 percent nor has it deployed enough contact tracers to adequately track the spread of the disease.

The city currently has 1,700 contact tracers in place who will act as disease detectives, getting in touch with those who came in contact with a person with the virus in order to map potential vectors of infection. Having a robust contact tracing program is crucial to quelling the outbreak and paving the way to reopening. But in a sharp departure from tradition, the city took the project away from public health officials and gave it to the public hospital system.

Despite such lingering problems, New York has come a long way since the first dark days of the pandemic, when ambulance sirens wailed around the clock and hospitals were so swamped with incoming patients that some were dying untreated in emergency rooms.

Updated May 28, 2020

States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you arent being told to stay at home, its still a good idea to limit trips outside and your interaction with other people.

Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus whether its surface transmission or close human contact is still social distancing, washing your hands, not touching your face and wearing masks.

Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

More than 40 million people the equivalent of 1 in 4 U.S. workers have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.

There is an uptick in people reporting symptoms of chilblains, which are painful red or purple lesions that typically appear in the winter on fingers or toes. The lesions are emerging as yet another symptom of infection with the new coronavirus. Chilblains are caused by inflammation in small blood vessels in reaction to cold or damp conditions, but they are usually common in the coldest winter months. Federal health officials do not include toe lesions in the list of coronavirus symptoms, but some dermatologists are pushing for a change, saying so-called Covid toe should be sufficient grounds for testing.

The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people dont need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks dont replace hand washing and social distancing.

If youve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.

After an initial shock, New Yorkers accustomed themselves with unexpected speed to the new realities of wearing nitrile gloves to walk their dogs and standing on strips of masking tape spaced six feet apart while waiting to pay for their groceries.

Reopening the city could prove tricky, however, especially if residents inured to social distancing rules are suddenly thrust back into contact with their neighbors in coffee shops or on packed subway platforms. Tensions have already emerged from time to time as prickly city dwellers have gotten used to policing one another about their sense of personal space and mask-wearing habits.

Under Mr. Cuomos plan, New York City will have to remain at Phase 1, the lowest level of openness, for at least two weeks as health officials make sure that new infections do not creep up and that hospitals maintain their state of readiness. State officials are planning to distribute free face coverings to businesses in the city that are preparing to reopen and to set up a hotline that employers can call for what the governor described as practical questions.

Much of upstate New York was given permission on Friday to enter Phase 2, which allows most stores, offices and hair salons to open, with restrictions on capacity and social distance.

New York City, however, was nowhere near such freedoms, and it remained unclear how and when it could get there.

Nobody has been here before, Mr. Cuomo said, acknowledging that even he was unsure how the city would move forward.

Nobody can give you the answers, he confessed. They dont even know the questions.

Azi Paybarah and Katie Van Syckle contributed reporting.

The rest is here:

Battered by Coronavirus Outbreak, NYC Finally Moves Toward Reopening - The New York Times

Back at home after his harrowing month in the hospital, ODonnell has set his sights on competing in an Ironman race in Arizona this fall. He acknowledged it was a lofty goal.

Updated May 28, 2020

States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you arent being told to stay at home, its still a good idea to limit trips outside and your interaction with other people.

Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus whether its surface transmission or close human contact is still social distancing, washing your hands, not touching your face and wearing masks.

Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

More than 40 million people the equivalent of 1 in 4 U.S. workers have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.

There is an uptick in people reporting symptoms of chilblains, which are painful red or purple lesions that typically appear in the winter on fingers or toes. The lesions are emerging as yet another symptom of infection with the new coronavirus. Chilblains are caused by inflammation in small blood vessels in reaction to cold or damp conditions, but they are usually common in the coldest winter months. Federal health officials do not include toe lesions in the list of coronavirus symptoms, but some dermatologists are pushing for a change, saying so-called Covid toe should be sufficient grounds for testing.

The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people dont need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks dont replace hand washing and social distancing.

If youve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.

Theyre not sure if Ill ever get full lung capacity back, he said. I may or may not.

Had he not contracted the virus, ODonnell, an executive at a chemical company, would be doing three runs, three swims and three bicycle workouts per week at this point in his training cycle. But the virus derailed his life plans.

After returning home, he needed a walker just to go out to the mailbox at the end of the driveway. In his first attempt to exercise, two days after he left the hospital, he walked for seven minutes at a speed of 1.2 miles per hour using supplemental oxygen. He has been trying to add a minute of time, and a bit of speed, each day.

ODonnell said he was struggling with a fair amount of doubt about his ability to get back in shape for the race. But he has motivated himself with the secondary goal of raising money for coronavirus relief, and he has been repeating the same mantra ever since he was struggling in his hospital bed: Dont stop. Dont quit. Keep moving forward.

This mentality has helped other athletes who have been hit with serious symptoms.

The 29 days Tsang Yee-ting spent in the hospital were the most she had been away from a karate mat since being introduced to the sport at age 6. A member of the Hong Kong national team, Tsang, 27, contracted the coronavirus in March while preparing to qualify for the Summer Olympics.

For the next month, she battled a range of symptoms, the worst a searing pain that engulfed the lower half of her body. Walking was a struggle. Lying down offered no relief. As she fought a virus that doctors were still learning about, all sorts of thoughts about her body and about her future spiraled through her mind, she said.

Of course I was worried, Tsang said. Karate is my life.

But even as the virus and isolation from her family levied an emotional toll on her, Tsang resolved to stay as active as possible to keep herself sane. She acquired elastic bands and, on days when her body felt strong enough, completed mini-workouts in the tight confines of her hospital room.

More here:

These Athletes Had the Coronavirus. Will They Ever Be the Same? - The New York Times

Teachers are doing now what theyve always done: pulling out all the stops to spark students interest and imagination. This time, though, theyve had to do it at a distance, and immediately.

Schools had been easing into the digital age before the COVID-19 crisis struck, investing in iPads and Chromebooks, and posting lessons on Google Classroom. After the pandemic hit, however, they hurtled ahead into distance learning, building virtual schools on the fly.

How can you bring engaging experiences to students when youre not all in the same classroom? said Rebecca McKinney, a science teacher at San Pasqual High School in Escondido.

To start, teachers pared down class content to the most essential standards, recognizing that students would not likely log into online classes for seven hours per day. They had to re-engineer their lessons for digital media, and learn a host of new apps and programs to make that happen.

Then came a more elusive task: finding creative ways to grab and hold students attention.

The challenge is for us to make it engaging, high interest, said Dave Peterson, a fifth-grade teacher at Juniper Elementary in Escondido, who created digital badges inspired by gaming rewards, which students could earn for completing assignments. We also have to give them some incentive to show up.

Its perhaps fitting that this generation of students, often referred to as iGen because of their familiarity with digital media, should be the ones to beta test online education on a large scale. For some districts, its hastening changes that were already in the works.

In Vista Unified School District, which began a transition to personalized learning years ago, it was a relatively smooth transition, Superintendent Matt Doyle said. The district had already invested heavily in mobile devices such as Chromebooks and hotspots, and had retooled classrooms so that students could be more active in their own educations.

Its accelerating teachers thinking about whats possible with students at the center, as drivers of their education, he said. Its accelerating the possibilities for student to take control of their learning. It has to be. Theyre at home alone, not in the classroom.

Although most students miss the social and interpersonal aspects of in class education, teachers said some have found a silver lining in school closures, through the flexibility of online learning.

I think that this has worked well in allowing students to work at their pace, said San Pasqual High School teacher Jennifer Medeiros. Its really created these opportunities for students to engage with the content in the way that works best for them.... Now that we have learned the tools that allow that to happen, theres no reason that cant happen in a classroom setting, or an online setting, or a blended learning setting.

Photography students at Carlsbad High documented their experience with social distancing, through a remote learning assignment that used the COVID-19 pandemic as a teachable moment.

(Daisy Liotine)

Recognizing that students might be suffering from cabin fever during the closures, Natalie Smith, a seventh-grade language arts teacher at Del Dios Academy in Escondido, got kids out of their houses, figuratively speaking.

I started doing field trip Friday, she said. Every Friday, I would have somewhere for them to go from their home. We were doing a unit on the ocean, and used webcams from an aquarium. They could choose Georgia Aquarium or the Monterey Bay Aquarium. We used it as a chance for them to work on descriptive writing skills.

Students were to employ vivid language, and use various senses to record their observations.

I was captivated how graceful the fishes were, fishes swam calmly, my hands softly touched the cold glass, mesmerized, one student wrote about those brief moments of escape from life in the time of coronavirus.

Calavera Hills Middle School in Carlsbad took students on a virtual voyage to Africa, working with researchers from the San Diego Zoo Wild Animal Park on a citizen science project. Students and teachers pored over images from camera traps at Kenyan game preserves to quantify animal behavior, human activity and vehicle traffic. Starting around Earth Day, the middle schoolers categorized about 20,000 images, helping scientists track conditions at the preserve, Principal Michael Ecker said.

Especially now, they need eyes on whats happening there, and help with the total count, he said.

At San Pasqual High School in Escondido, language arts teachers brought spoken word performance into students homes. Each year the school hosts a poetry workshop for sophomore students, featuring local artists. They didnt want this years class to miss out, so they held it digitally, inviting Southern California poets to share their work live, online.

We wanted to provide that opportunity for our students, and also support the local artists, who are also struggling right now, Medeiros said."So we worked with them to develop this online poetry slam workshop.

Artists including Gill Sotu, a San Diego musician, writer, and playwright for the Old Globe Theatre, and Kat Magill, a Los Angeles based poet and producer, spent 30 minutes sharing their poems with students. For the next hour, students split into Zoom breakout rooms with a teacher and poet to try writing their own verse, with feedback from the artists. Moving the event online had pros and cons, Medeiros said.

A lot of the spoken word poetry is the feeling in the room, she said. And the audience wasnt able to respond in that teleconferencing format. It was different, but there was the benefit of everyone having the poets right in front of them. Students were able to see their faces. They were able to be closer to them, and see all of the nuances that come with the performance of the poem.

The school held two sessions, and students were asked to participate in one, Medeiros said. Most came back a second time.

Students said they enjoyed it, and it was one of the best things weve done, since we started distance learning, she said.

McKinney said shes always brought an element of performance to her classes, although she teaches science, not language arts. Students look forward to their McKinney time, as they call her class lectures, so she transferred them online, using a social messaging app called Loom, which includes a virtual whiteboard.

Her homepage on the app, titled McKinney LABS, featured a head shot of her, and a portrait of astrophysicist Neil DeGrasse Tyson. In her intro, she scooted the photos closer together for a fangirl tribute: Hi Mr. Tyson, how you doing? Thank you for your wisdom. Describing the genetic phenomena of incomplete dominance in snapdragon flowers, she scribbled a rough sketch of a dragon on the screen.

She even met her quaranteens where theyre at, on the popular video app TikTok, challenging them to make TikToks on biology or chemistry topics. Students responded with short science videos inspired by movies, pop music and rap.

The COVID-19 pandemic was a surreal theme for her biology class, she said: first a topic of discussion, and then a life-changing event.

In January and February, we had been talking about this pandemic in my class, weekly, she said. I was showing them the sequences of the RNA virus. I was saying, look how this is mutating.

Other instructors have also used the pandemic as a teachable moment, aligning course assignments with the global outbreak.

Krista King, a photography at teacher Carlsbad High, saw a precedent for todays crisis in iconic Depression-era portraits by photographer Dorothea Lange. She asked students to study those images, and take photos depicting social distancing in their own lives. Students showed their families in masks, on porches and behind windows, capturing the stark, black-and-white reality of isolation.

Its good to compare that, King said. It feels like were going through something scary together.

On a lighter note, they had fun with images of the home-schooling experience, snapping photos of their pets - cats, dogs, lizards and a guinea pig - doing homework for them.

Photography students at Carlsbad High documented their experience with social distancing, through a remote learning assignment that used the COVID-19 pandemic as a teachable moment. On a lighter note, students shot images of their pets doing home-school work for them.

(Jordan Stevens)

Doug Green, the video broadcasting instructor at Carlsbad High and Valley Middle School is guiding students through weekly news segments, recorded remotely from home. Amid the closures, with campus studios empty, students have taught themselves cutting-edge broadcast techniques, including new green-screen systems, and magic camera technology that allows a reporter to swipe through images at a touch. The crisis, he said, has been a lesson in ingenuity and resourcefulness for his students.

Together, as this thing started, we were figuring out, how do you continue telling stories while youre social distancing, Green said. Where do you put the microphone? And how do you set up your home studio?

For educators, Doyle said, it has tested the ability to be nimble and flexible in the face of adversity.

Whenever youre hit with something unexpected, you can view that as a challenge or difficulty, or as an opportunity to move to the next level in a personalized learning environment, he said.

Still, there are aspects of education that teachers say they cant fully recreate online. Worse than any technical obstacle is the emotional challenge; at one of the toughest times in students young lives, teachers cant be there for them in person.

Teachers adore their students, McKinney said. Theyre our kids. So not being able to give them a hug because theyre sad, or make a silly joke to make them smile, that has been the hardest part.

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Teaching in the time of coronavirus: Finding creative ways to engage students - The San Diego Union-Tribune

Every Thursday at 8pm, millions of Britons have opened their front doors or stood on balconies to applaud the NHS. The ritual has been a weekly expression of gratitude to medical workers, and national pride in a state-run health service said to be the envy of the world.

Lets not forget, Boris Johnson said in early March, near the start of the coronavirus crisis, we already have a fantastic NHS, fantastic testing systems and fantastic surveillance of the spread of disease.

Yet those who have experienced the governments emerging testing and tracing operations for Covid-19 have had limited contact with the NHS. Instead, Britons with symptoms are directed to a network of 50 drive-through testing centres, set up by management consultants at Deloitte.

Upon arrival, patients are marshalled not by NHS staff, but workers in hi-vis jackets supplied by outsourcing companies, such as Serco, G4S, Mitie and Sodexo. Those who cannot make the drive have received postal test kits, processed by the private diagnostics company Randox and delivered by Amazon.

When contact tracing to stop the spread of the virus finally moved up the agenda in late April, the health and social care secretary, Matt Hancock, said the job would be done with an asyet unproven NHS app. The app has been developed by private firms for NHSX, the technology wing of the health service, which is also responsible for a Covid-19 government data operation involving tech companies Palantir, Faculty, Amazon, Google and Microsoft.

On Thursday the government finally launched its long-awaited NHS Test and Trace Service. But despite the name, many of the 25,000 contact tracers tracking those potentially exposed to Covid-19 and advising them to self-isolate will be working not for the NHS, but rather the outsourcing firms Serco and Sitel.

The governments reliance on private contractors during the public health emergency comes after a decade of public sector reorganisation, marketisation and deep cuts to services and local government in England. The Guardian has interviewed dozens of public health directors, politicians, experts in infectious disease control, government scientific and political advisers, NHS leaders and emergency planners about the years leading up to the pandemic.

They described how an infrastructure that was once in place to respond to public health crises was fractured, and in some places demolished, by policies introduced by recent Conservative governments, with some changes going as far back as Labours years in power.

The undermining of our responsiveness to a pandemic was one of my major concerns, said Gabriel Scally, a professor of public health at the University of Bristol and a former regional director of public health in the NHS for almost 20 years. There has been a destruction of the infrastructure that stops England coping with major emergencies. It absolutely explains why youre now seeing private companies being brought into these functions.

Local authorities are the Cinderellas of government, their work often overlooked. But in the middle of a public health crisis, counties, districts and boroughs traditionally become the foot soldiers of national response. Few have been as badly hit as the east London borough of Newham, the local authority with the highest Covid-19 mortality rate in England and Wales.

Yet Newhams director of public health, Jason Strelitz, was left in the dark at the start. He had no official notification that the virus had arrived in his area in mid-March, and only found out when he logged on to the governments public coronavirus tracker web page to make his daily check on the declared numbers. Strelitz did not know who in Newham had Covid-19, where they had been tested, or which part of the borough they came from.

Were really concerned about the way national testing has been set up, Strelitz said. We still dont have a clear picture of who is being tested in our area nor of the extent of community transmission in Newham.

In normal times, a Public Health England (PHE) representative would be expected to contact Strelitzs environmental health teams if a case of a notifiable disease was found in the area that needed following up, enabling them to set to work tracing contacts and containing an outbreak. But the government had just abandoned community testing and tracing so local authorities were not being contacted at that point.

Newham is among the most deprived boroughs in the country. Like all the public health directors interviewed by the Guardian, Strelitz has deep knowledge of the characteristics of his patch that make its health inequalities so stark and its residents so vulnerable to the disease. About 30,000 people have been identified by the council as being at high risk many of them over 70, living alone and isolated.

Even now, with large-scale community testing resumed, Strelitz said he was not receiving useful test data from the centralised, privately contracted operation created by Hancock. He also has concerns about the contact-tracing operation being set up.

In addition to the contact-tracing app, the government has once more turned to outsourcing companies, including Serco and Sitel, to recruit and train 25,000 contact tracers. Working on a salary just above minimum wage, the majority will have no medical training. Using scripts, they will contact those who have tested positive, trace people they have been in contact with, and advise them on how to isolate.

Contact tracing is a sensitive issue Im not sure how well it can be done with a remote call centre with no understanding of peoples local context, Strelitz said.

Dominic Harrison, the director of public health for Blackburn and Darwen, has similar concerns. Speaking earlier this month he said there was a huge disconnect between different branches of government, with some functions of the local public health system having been disabled in recent years.

People like environmental health officers, community and neighbourhood teams, youth services workers the people who you could deploy in a crisis, who already know where the vulnerable are and how to reach them those were the kind of staff they used during 2009 swine flu to work closely with the NHS, but they have been lost, Harrison said.

The Labour leader of Nottingham city council, David Mellen, said Conservative ministers had spent so many years shrinking the state locally they have forgotten what local authorities can do. Nottingham has had its central government support grant cut by 80% since 2013 and, like many other councils, no longer has reserves for emergencies such as coronavirus. The Ministry of Housing, Communities and Local Government has made an emergency grant of 3.2bn to councils for Covid-19 costs, which the communities secretary, Robert Jenrick, has defended as fair and generous. Mellen disagrees. Nottingham, he said, had been given 19.8m as its share of the exceptional grant, but had already spent well over 12m extra on Covid-19 while losing at least 19m in revenue because of the lockdown.

A Department of Health and Social Care (DHSC) spokesperson did not dispute that cuts to central government grants could have had an impact on local public health networks. However, she pointed to the 3.2bn emergency funding for councils, which she said was in addition to an increase of 2.9bn in councils core spending power this year. Protecting the publics health is, and has always been, a priority for the UK government, she said.

Next month, Britain will mark an anniversary many Conservative ministers would rather forget. Shortly after 12.30pm on 22 June 2010, George Osborne stepped up to the dispatch box as chancellor of the new coalition government and announced the longest and deepest period of cuts to public service spending since the second world war.

Ushering in a new age of austerity to a raucous Commons, Osborne outlined 81bn of cuts over five years. His aim was twofold: to eliminate the governments budget deficit and to reduce its debt as a share of GDP. The emergency budget would, he said, bring the country back from the brink of ruin. It pays for the past. It plans for the future. And it protects the most vulnerable in our society, Osborne told MPs.

It was the prime minister, David Cameron, who had the previous year introduced the notion of the age of irresponsibility giving way to the age of austerity. He said he expected the public spending cuts would be permanent as the private and voluntary sectors stepped in to deliver public services better than the state could. Some government departments would be cut by a third and most public sector workers would have to accept a pay freeze.

Along with welfare, some of the most brutal reductions were imposed on local government in England as Osborne transferred the political risk of austerity to councils. Over the next decade, local authorities had 60% of their funding from central government cut, according to the Local Government Association. At the same time their ability to increase council tax, to try to replace the lost revenue, was capped. The cuts fell disproportionately on those authorities with the poorest populations.

Cameron promised he would cut the deficit, not the NHS and Osborne ringfenced its budget. It got cash increases, but these were less than 1% a year, and failed to keep pace with growing demand from an ageing population.

Approximately 32,000 overnight beds have been lost from hospitals in England in just over a decade, including some lost under Labour. Allyson Pollock, a professor of public health at Newcastle University, points out that the number of beds lost is roughly the same as the beds the NHS had to scramble to free up for Covid-19 patients.

When the coronavirus spread to Europe earlier this year, the UK ranked 24th among European countries for its numbers of critical care beds, with 6.6 per 100,000 population, compared with Germany, which topped the league with 29.2 per 100,000.

Two years after Osbornes announcement, with austerity beginning to bite, the then health secretary, Andrew Lansley, embarked on a complete market-oriented restructuring of the NHS. Despite Camerons pre-election promise that there would be no more pointless, disruptive top-down reorganisations, critics argue that Lansleys 2012 Health and Social Care Act did just that.

Labour had done its fair share of subjecting the NHS to upheaval. Its programme of building new hospitals under the private finance initiative required other hospital and community health services to close, and shrank bed numbers to help cover the high annual fees to private companies. It accelerated changes brought in by the Conservatives to mimic a market, and created NHS trusts that could operate as semi-autonomous corporate bodies. By 2006, Labours reorganisations had created 152 primary care trusts (PCTs). Overarching priorities were set by regional strategic health authorities and the Department of Health.

But every area still had a Public Health Observatory, which included infectious disease control teams. Under government pandemic plans, each had to identify rapid response teams for testing and tracing, and these were activated during the swine flu outbreak in 2009.

Health authorities also had consultants in communicable disease control appointed at senior level on a par with NHS hospital consultants. An independent public body, the Health Protection Agency (HPA), provided specialist support on the threat of emerging diseases. There were critics of the structures, but in planning for emergencies there was, at least, a clear chain of command and control. Labour started the process of fragmenting public health but it was at least still integrated with communicable disease control and the NHS, Pollock said.

Lansleys legislation did away with much of that. He abolished PCTs and strategic health authorities. Instead, existing public health structures were stripped out of the NHS and redistributed, along with their budgets and staff. In a dramatic shift, local authorities were given responsibility for public health for their areas, with larger ones being required to appoint a director of public health.

They took a perfectly well-functioning public health system and fractured it, said Julie Hotchkiss, a PCT director with responsibility for emergency pandemic response who moved to York city council during the changes. She said it took her a year to work out where her infectious disease control nurses had gone. No one knew and there was no one to ask.

Dr Jeanelle de Gruchy, the president of the Association of Directors of Public Health, argues it was right for local authorities to have a key role in tackling health inequalities, which tend to relate to peoples living circumstances and socio-economic status. She regards the transfer of public health to local authorities as incredibly important and positive. But she adds: Its a very big job and the transition came at a time of cuts to the public sector, not just to local government, although those were huge.

Lansleys act also created an entirely new agency that has been at the centre of the response to the coronavirus outbreak: Public Health England. It was given two primary responsibilities: improving health and reducing inequalities by tackling lifestyle diseases, such as obesity; and protecting the public from infectious diseases and environmental hazards.

The HPA, which had previously taken a lead on infectious disease control, was folded into PHE. Martin McKee, a professor of European public health at the London School of Hygiene and Tropical Medicine, argues the result of all these new arrangements was a hugely weakened and fragmented public health system with consequences writ large in Covid-19.

The DHSC rejected the suggestion that the system was fragmented and that changes had affected the governments ability to respond. Lord Lansley did too. He told the Guardian that an independent review of the public health changes from 2013 published by the the Kings Fund thinktank in January, concluded that they were the right reforms, but were not supported subsequently by the right level of resources. Combating health threats, such as pandemics, was no more or less fragmented after 2013, Lansley said, and the problem was not the new structures or moving public health to local government but money. Our intention was for a real-terms increase in public health budgets alongside those for the NHS, but this was not followed through from 2015 onwards, he said.

The ringfenced annual grant for public health from central government to local authorities currently about 3.2bn has been cut by a cumulative 850m in real terms since 2015-16, according to the Kings Fund review.

During his two-decade career in government, Scally had been involved in emergency responses for swine flu, foot and mouth, BSE, and the fuel crisis. For previous epidemics, he said, the government took a public health approach; go in quick and hard, test, trace, isolate, throw everything at it. But, he said, the whole system was demolished by Lansleys changes, which led him to resign.

He then worked as an adviser for Labours former shadow health secretary, Andy Burnham, who is now the mayor of Greater Manchester. Burnham recalls Scally constantly warning him as Lansleys bill was going through parliament that we were losing pandemic preparedness.

No branch of government appears to have received more flak over its handling of the Covid-19 outbreak than Public Health England. The governments chief scientific adviser, Sir Patrick Vallance, suggested it had failed to expand testing at the right moment. Its top executive has been criticised by leading public health experts, such as Prof Anthony Costello of University College London, for being invisible.

Even before the outbreak, the agency was a target of complaints from across the spectrum. Leftwing critics have accused PHE of failing to be tough enough in its role of promoting better health. The right has accused it of being the instrument of a nanny state with a bloated budget. PHE has had precious few political friends. But even those who might be natural allies like Prof John Ashton, the former regional director of public health for north-west England suggest it has had a bad Covid war.

Some of this might be down to bad luck. Its chief executive, Duncan Selbie, caught the virus along with key advisers in Westminster, and itsemeritus medical director and director for health protectionuntil 2019, Prof Paul Cosford, has cancer and has been self-isolating, although both have been working throughout.

However, there have also been structural challenges. The Lansley act created an agency that lacked independence from government, in contrast to its predecessor, the HPA. That has led to suspicions that some PHE decisions were politically influenced, such as the varying guidance on what kind of personal protective equipment (PPE) was needed for frontline staff treating Covid-19 patients. In late March, PHE said a lower specification of protective gowns than previously advised could be used, leading unions to accuse it of basing decisions on shortages of PPE, rather than evidence. This month, it downgraded the type of masks NHS workers should use as a pragmatic approach for times of severe shortage.

PHE disputes that it was slow off the mark, and Selbie points out that it rolled out the details for its first diagnostic test in January, making it the fastest deployment of a novel test in recent UK history. It says the guidance on PPE has been misunderstood: it was offering a solution in the event of extreme shortages.

Our track record speaks for itself, a PHE spokesperson said. During 2018-19 alone, we responded to more than 10,000 disease outbreaks and emergencies across England, including meningitis, measles, E coli and the first ever UK case of monkeypox. Our flu vaccination programme grows every year and cases of TB have fallen to the lowest level since records began. They said that far from being invisible, Selbie had been at the coalface, helping to advise government on its decision-making.

The DHSC spokesperson cited a positive report by the International Association of National Public Health Institutes, which described PHE as a strong, capable, coordinated, united and efficient public health agency. The report only examined PHE and not the public health systems devolved to local authorities. The same report pointed out that there is scope for greater clarity in the responsibilities of PHEs local partners.

In its defence, PHE has had to absorb disparate functions since its creation in 2013. And it too has been struck by austerity: a public health source said PHEs operational budget sustained a 40% real-terms cut between 2013 and 2019.

It was PHE that initially had responsibility for testing, tracing and advising isolation for those who became infected. It was a huge and complicated task, but one the World Health Organization has made clear from the outset was the single most important thing countries could do to suppress the disease. The governments decision to abandon large-scale testing and tracing on 12 March remains one of its most controversial decisions.

PHE says it reprioritised limited resources rather than abandoning tracing completely. When the lockdown began, our contact-tracing resource was refocused on to complex outbreaks in care homes, prisons and immigration centres, Selbie said. The good news is, now that we have testing capacity in place and are working towards recovery, we can start mass contact tracing through the NHS test and trace programme.

PHEs contact tracing during the contain phase of the pandemic bought several weeks of time for the government and the NHS to prepare for what was to come, and has undoubtedly saved lives, he said.

Greg Clark, the chair of the Commons science and technology select committee, accused PHE of choosing to concentrate tests in its own limited number of labs rather than expanding capacity rapidly by using university and private labs, as the Germans and South Koreans had done, even though the need for mass testing was identifiable from the beginning. PHE responded by blaming the DHSC, saying it was responsible for decisions on testing policy.

The DHSC spokesperson said: Although Britain had a world-class pharmaceutical industry, it did not have the existing diagnostic base necessary to test hundreds of thousands of people each week for a new virus. She said the government had more than doubled the capacity of NHS and PHE laboratories since early March, with more than 3m tests carried out by mid-May, and that anyone with symptoms could now book a test.

The government boasts that its new Test and Trace programme will mobilise an army of contact tracers. But in the two months leading up to 12 March, PHEs team resembled no more than a small platoon. The Guardian has established it consisted of just 70 staff in its field services, 120 in local health protection teams, and 20 specially recruited clinical staff. In total, the contact tracing operation to manage the pandemic consisted of just 210 people.

Documents released on Friday by the governments Scientific Advisory Group on Emergencies (Sage) suggest the contact-tracing operation initially only envisaged the need to deal with a handful of cases a week. Minutes from an 18 February meeting of the group said: Currently PHE can cope with five new cases a week (requiring isolation of 800 contacts). The minutes added: Modelling suggests this capacity could be increased to 50 new cases a week (8,000 contact isolations) but this assumption needs to be stress-tested with PHE operational colleagues.

Rather than rampup capacity, the government scientists instead agreed in the same meeting they would need data to feed into trigger points for decisions on when the current monitoring and contact-tracing approach is no longer working. The minutes added: When there is sustained transmission in the UK, contact tracing will no longer be useful.

PHE saidthe reference to five cases a week was based on modelling of how it would cope with tracking the contacts of imported cases of Covid-19. In a statement, it added:PHEcould deal with 5 new cases a weekand the associated isolation of 800 contacts which was sufficient capacity at the time andmodelling suggested it had the capacity to scale up significantly as needed.

However, two days later, at another Sage meeting, the advisers acknowledged individual cases could already have been missed and again discussed when it would be appropriate to abandon the nascent operation. Appearing to acknowledge such a move would be controversial, the minutes said: Any decision to discontinue contact tracing will generate a public reactionwhich requires consideration with input from behavioural scientists.

By the time community tracing was shelvedin midMarch, PHE had contact traced only 3,500 people who were likely to have been in close proximity with infected people on flights, cruises or other places where there were known outbreaks. Of those, only 3% tested positive for Covid-19 and were advised to self-isolate.

In other words, PHE had managed to identify and warn about 100 people with Covid-19 who might otherwise have spread the disease a tiny fraction of the infected people. Vallance said there were 5,000 confirmed Covid cases when the community testing and tracing programme stopped, but epidemiologists at Imperial College London estimated 1.8 million people in Britain were infected by the end of March.

William Hanage, a professor of infectious disease epidemiology at Harvard University, said the numbers of PHE staff dedicated to contact tracing in Britain in the weeks leading up to mid-March was shocking. I am sure that the people involved in this programme worked incredibly hard, and I have the utmost respect for them, tasked with doing this in the face of a global pandemic, he said. But it beggars belief to see these numbers held up as adequate.

On 2 April, three weeks after capacity had been overwhelmed and PHE had abandoned testing in the community, Hancock announced a five-pillar testing plan. He pledged to scale up the countrys testing capacity to reach a target of 100,000 tests a day by the end of the month.

But the architecture created in the postwar years to respond to pandemics was no longer standing. In the past, the Public Health Laboratories Service had been tasked with disease control, and with coordinating support and advice to the NHS and others. In 2003, Labour folded it into the HPA. Fifty PHLS labs that existed two decades ago have been merged with hospital labs or consolidated by successive governments to make efficiency savings. As of January this year, just eight laboratories remained under direct PHE control, along with 122 NHS labs in England.

Hancock expected hospital labs testing patients and staff and PHE to make up 25,000 of the ambitious 100,000 target. For the other 75,000 he turned to the private sector. Deloitte, one of the big four accountancy firms, was asked to set up a network of 50 drive-through rapid testing centres, and yet more private companies, such as Serco, Sodexo, Mitie and G4S, would operate and manage the day-to-day running of them.

A lab network to process the tests was also established. Deloitte was again given the coordinating role in the creation of new Lighthouse labs in Milton Keynes, Glasgow, Belfast and Cheshire and a further facility in Cambridge, with day-to-day running entrusted to a coalition of private and public partners, including universities and drug companies.

But Hancocks 2 April announcement made no mention of one of the main purposes of testing: tracking or tracing.

The Guardian soon received reports from people trying to get tested of chaos at some sites, with results going astray, dangerously leaking swab samples arriving at labs, queues of more than three hours and symptomatic people being unable to book a test or told to make round trips of more than 100 miles to test centres. Many still report results taking seven to 10 days to arrive too long to be useful for quarantine purposes but the DHSC maintains that 97% of test results are obtained within 48 hours.

In the last week of April, the government changed its criteria for counting tests to include ones that had been dispatched, even if they had not been received, returned or processed. The date of 30 April came and Hancock missed his 100,000 target; the number of tests conducted that day was 81,611. But the next day, on 1 May, he appeared to smash it, as 122,347 tests were recorded in government data. The magic number had, by Hancocks own admission, included nearly 30,000 postal tests sent out but not yet analysed. By 3 May the number was back down to 76,496, and the government would fail to meet its target for the next seven days, before getting back on track on 11 May.

For Chris Hopson, the chief executive of NHS Providers, which represents foundation trusts in England, Hancocks single-minded focus on reaching an arbitrary number cost the country another precious month. Too much of April was wasted by focusing on the 100,000 tests by 30 April target at the expense of other aspects of a clear strategy, he said. The testing strategy, if there was one, got hijacked on the basis of just meeting that target when there were lots of other things that needed to be done.

Hopson said the saga also illustrates the danger of trying to control testing from the centre. We need to be ready to do test, track and trace in every part of the country. That can only be done effectively with greater local control.

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How a decade of privatisation and cuts exposed England to coronavirus - The Guardian

The coronavirus still has a long way to go. Thats the message from a crop of new studies across the world that are trying to quantify how many people have been infected.

Official case counts often substantially underestimate the number of coronavirus infections. But in new studies that test the population more broadly, the percentage of people who have been infected so far is still in the single digits. The numbers are a fraction of the threshold known as herd immunity, at which the virus can no longer spread widely. The precise herd immunity threshold for the novel coronavirus is not yet clear; but several experts said they believed it would be higher than 60 percent.

Even in some of the hardest-hit cities in the world, the studies suggest, the vast majority of people still remain vulnerable to the virus.

Some countries notably Sweden, and briefly Britain have experimented with limited lockdowns in an effort to build up immunity in their populations. But even in these places, recent studies indicate that no more than 7 to 17 percent of people have been infected so far. In New York City, which has had the largest coronavirus outbreak in the United States, around 20 percent of the citys residents have been infected by the virus as of early May, according to a survey of people in grocery stores and community centers released by the governors office.

Similar surveys are underway in China, where the coronavirus first emerged, but results have not yet been reported. A study from a single hospital in the city of Wuhan found that about 10 percent of people seeking to go back to work had been infected with the virus.

Viewed together, the studies show herd immunity protection is unlikely to be reached any time soon, said Michael Mina, an epidemiologist at the Harvard T.H. Chan School of Public Health.

The herd immunity threshold for this new disease is still uncertain, but many epidemiologists believe it will be reached when between 60 percent and 80 percent of the population has been infected and develops resistance. A lower level of immunity in the population can slow the spread of a disease somewhat, but the herd immunity number represents the point where infections are substantially less likely to turn into large outbreaks.

We dont have a good way to safely build it up, to be honest, not in the short term, Dr. Mina said. Unless were going to let the virus run rampant again but I think society has decided that is not an approach available to us.

The new studies look for antibodies in peoples blood, proteins produced by the immune system that indicate a past infection. An advantage of this test is that it can capture people who may have been asymptomatic and didnt know they were sick. A disadvantage is that the tests are sometimes wrong and several studies, including a notable one in California, have been criticized for not accounting for the possibility of inaccurate results or for not representing the whole population.

Studies that use these tests to examine a cross section of a population, often called serology surveys, are being undertaken around the country and the world.

These studies are far from perfect, said Carl Bergstrom, a professor of biology at the University of Washington. But in aggregate, he said, they give a better sense of how far the coronavirus has truly spread and its potential for spreading further.

The herd immunity threshold may differ from place to place, depending on factors like density and social interaction, he said. But, on average, experts say it will require at least 60 percent immunity in the population. If the disease spreads more easily than is currently believed, the number could be higher. If there is a lot of variation in peoples likelihood of becoming infected when they are exposed, that could push the number down.

All estimates of herd immunity assume that a past infection will protect people from becoming sick a second time. There is suggestive evidence that people do achieve immunity to the coronavirus, but it is not yet certain whether that is true in all cases; how robust the immunity may be; or how long it will last.

Dr. Mina of Harvard suggested thinking about population immunity as a firebreak, slowing the spread of the disease.

If you are infected with the virus and walk into a room where everyone is susceptible to it, he said, you might infect two or three other people on average.

On the other hand, if you go in and three out of four people are already immune, then on average you will infect one person or fewer in that room, he said. That person in turn would be able to infect fewer new people, too. And that makes it much less likely that a large outbreak can bloom.

Even with herd immunity, some people will still get sick. Your own risk, if exposed, is the same, said Gypsyamber DSouza, a professor of epidemiology at Johns Hopkins University. You just become much less likely to be exposed.

Diseases like measles and chickenpox, once very common among children, are now extremely rare in the United States because vaccines have helped build enough herd immunity to contain outbreaks.

We dont have a vaccine for the coronavirus, so getting to herd immunity without a new and more effective treatment could mean many more infections and many more deaths.

If you assume that herd protection could be achieved when 60 percent of the population becomes resistant to the virus, that means New York City is only one-third of the way there. And, so far, nearly 250 of every 100,000 city residents has died. New York City still has millions of residents vulnerable to catching and spreading this disease, and tens of thousands more who are at risk of dying.

Would someone advise that people go through something like what New York went through? said Natalie Dean, an assistant professor of biostatistics at the University of Florida. Theres a lot of people who talk about this managed infection of young people, but it just feels like hubris to think you can manage this virus. Its very hard to manage.

Infections have not been evenly distributed throughout the population, with low-income and minority communities in the United States bearing a greater burden. On Thursday, Gov. Andrew Cuomo announced that antibody testing showed that some neighborhoods in the Bronx and Brooklyn had double the infection rate of New York City in general. Those areas are already approaching the herd immunity threshold, when new outbreaks become less likely. But because they are not isolated from the city at large, where immunity rates are much lower, residents are still at risk.

In other cities, serology surveys are showing much smaller shares of people with antibodies. The quality of these studies is somewhat varied, either because the samples werent random or because the tests were not accurate enough. But the range of studies shows that most places would have to see 10 or more times as many illnesses and possibly, deaths to reach the point where an outbreak would not be able to take off.

The serology studies can also help scientists determine how deadly the virus really is. Currently, estimates for whats called the infection fatality rate are rough. To calculate them precisely, its important to know how many people in a place died from the virus versus how many were infected. Official case rates, which rely on testing, undercount the true extent of infections in the population. Serology helps us see the true footprint of the outbreak.

In New York City, where 20 percent of people were infected with the virus by May 2, according to antibody testing, and where more than 18,000 had died by then, the infection fatality rate appears to be around 1 percent.

For comparison, the infection fatality rate for influenza is estimated at 0.1 percent to 0.2 percent. But the way the government estimates flu cases every year is less precise than using serology tests and tends to undercount the number of infections, skewing the fatality number higher.

But even if the fatality rates were identical, Covid-19 would be a much more dangerous disease than influenza. It has to do with the number of people who are at risk of getting sick and dying as the disease spreads.

With the flu, only about half the population is at risk of getting sick in a given flu season. Many people have some immunity already, either because they have been sick with a similar strain of flu, or because they got a flu shot that was a good match for the version of the virus they encountered that year.

That number isnt high enough to fully reach herd immunity and the flu still circulates every year. But there are benefits to partial immunity in the population: Only a fraction of adults are at risk of catching the flu in a normal year, and they can spread it less quickly, too. That means that the number of people at risk of dying is also much lower.

Covid-19, unlike influenza, is a brand-new disease. Before this year, no one in the world had any immunity to it at all. And that means that, even if infection fatality rates were similar, it has the potential to kill many more people. One percent of a large number is bigger than 1 percent of a smaller number.

There arent 328 million Americans who are susceptible to the flu every fall at the beginning of the flu season, said Andrew Noymer, an associate professor of public health at the University of California, Irvine. But there are 328 million Americans who were susceptible to this when this started.

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The World Is Still Far From Herd Immunity for Coronavirus - The New York Times

Many leading scientists are surely right to be concerned about the mixed messages sent regarding the easing of lockdown, and the perceived green light to interpret government guidelines using our own discretion. Here, on the riverside in Ely, a bar adjacent to a small green public space has been given a licence by the very benevolent council to sell takeaway food and alcohol.

On Saturday afternoon this meant social distancing was measured in centimetres, while shouting and guffawing, and sharing picnics, made sure the transmission rate had a terrific time. Toilet facilities were provided by local gateways, gardens and plastic pint pots. Friday evening ditto, and the relaxation was not yet even in place. Going back to Thursday evening, this meant everyone present stopped socialising, briefly, to clap for the NHS. Just sheer madness.Jo JacksonEly, Cambridgeshire

With members of the Scientific Advisory Group for Emergencies expressing concerns over the decision to ease the lockdown (Covid-19 spreading too fast to lift lockdown in England Sage advisers, 29 May), has the catchphrase we are following the science been exposed for the convenient cloak it is for the government?Gary NethercottWoodbridge, Suffolk

A week ago Cambridge resembled a ghost town and the few people visible kept at least two metres apart. At the weekend, before the current easing of restrictions, the streets were busy and the social distancing rule was often ignored. The change must be partly attributable to Dominic Cummings. Any spike in deaths from Covid-19 over the next fortnight should cost him his political life.Piers BrendonCambridge

The new socialising rules for Scotland and Wales allow gatherings of up to eight people but only two households. The more gung-ho English rules allow gatherings of only six people but up to six households (UK lockdown rules: what you are allowed to do from Monday, 29 May). Its difficult to square this with Boris Johnsons advice in his 28 May press conference to try to avoid seeing people from too many households in quick succession. Its yet another example of poor strategic thinking, failure to provide serious justification and confusing messaging.Joseph PalleyRichmond, London

It is almost impossible to imagine how those people dropped from the shielding list are feeling now (Text message tells vulnerable people they are dropped from shielding list, 27 May). After more than 10 weeks of following the rules and isolating themselves they have been cast adrift, by text, to take their chance of life or death, with little or no explanation. Does anyone, from our elitist prime minister Boris Johnson and his main man Dominic Cummings to the person at the bottom of the Downing Street hierarchy, care that thousands of mainly elderly people now think they have been thrown on to the not necessary on voyage heap of humanity? Further words have failed.Kathleen HinesWashington, Tyne and Wear

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Covid-19: will the governments mixed messages lead to another surge? - The Guardian

Gov. Gretchen Whitmer provided blunt statements on how Michigan in 2020 has faced crisis after crisis, saying it is hard to believe on a beautiful Sunday that things feel so dark.

She traded statements with Lt. Gov. Garlin Gilchrist in a social media post about how the state has dealt with the COVID-19 outbreak, the Midland dam flooding and this weekend, violence erupting at police brutality protests.

We have collectively been devastated by a global pandemic, Whitmer said. One that has killed 5,463 of our brothers and sisters.

We are grappling with a once-in-500-year flooding event, Gilchrist said next.

And now we are seeing the historic inequities of racial injustice coming to a tipping point in communities across America, including here in Michigan Whitmer said.

As of Sunday, May 31, 56,884 Michiganders have tested positive for COVID-19, according to the statewide database. The 7-day average of daily case increases has fallen for the last three weeks, with the week ending on May 27 showing an average of 360 cases and 34 deaths a day.

More than a week after the Midland floods, peaceful police brutality protests turned violent overnight on Friday, May 29 in Detroit and especially on Saturday, May 30 in Detroit and Grand Rapids. Other protests carried on without much violence in places such as Flint, Kalamazoo and Ann Arbor.

Police brutality protests in Michigan: What you need to know from this weekends rallies, riots

Gilchrist blamed the outbreak of violence on national leadership that has stoked the flames of division in the country, echoing President Donald Trumps comparison of rioters in Minneapolis as thugs.

Where there should be national leadership that inspires leaders at every level to speak to our collective national need for everyone to feel safe, empowered and hopeful, Gilchrist said, there is intolerance, and worse, an apparent desire to fan the flames of division in the country.

Outside of telling communities to find pre-planned areas of protest on Saturday, this is the first time Whitmers administration spoke about the riots that started in Michigan on Friday.

Gov. Whitmer wants designated areas for peaceful protesting as unrest continues nationwide

Whitmer then juxtaposed the peaceful protest of former San Francisco 49er quarterback Colin Kaepernick to the Minneapolis police officers knee that choked the life out of George Floyd.

When a black man simply kneels in peaceful protest and becomes villified, but a white man with a badge and a gun kneels the breath out of George Floyd and does so without compunction, she said, it is wrong, infuriating, devastating and gut-wrenching.

She continued by saying she is angry at rioters in Grand Rapids and Detroit who came into communities of color in the guise of support, but who instigated violence and vandalism, but not at the protesters who demonstrated peacefully.

She reached out to Michiganders throughout the state to provide the relief we need for the problems statewide.

We are the solution to the problems we are confronting, she said. We cannot let this break us spiritually. We cannot let this break us intellectually."

Read more:

We cannot wait for it to happen again: Michigan civil rights department on George Floyd protests

Grand Rapids mayor orders 7 p.m. curfew after night of rioting

Detroit to impose curfew Sunday night starting at 8 p.m., says Mayor Mike Duggan

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Things feel so dark, Gov. Gretchen Whitmer says on riots, coronavirus and Midland flooding - MLive.com