Category Archives: Corona Virus

Three young children have died in New York of a mysterious, toxic-shock inflammation syndrome with links to the coronavirus, Gov. Andrew M. Cuomo said on Saturday.

The illness has taken the lives of three young New Yorkers, Mr. Cuomo said during his daily briefing in Manhattan. This is new. This is developing.

As of Saturday, more than 73 children in New York have been sickened by the rare illness, which has some similarities to Kawasaki disease. Governor Cuomo said many of these children did not show respiratory symptoms commonly associated with the coronavirus when they were brought to area hospitals, but all of them tested positive either for Covid-19 or for its antibodies.

So it is still very much a situation that is developing, but it is a serious situation, he added.

The state will be working with New York Genome Center and Rockefeller University to determine what is causing the illness that Governor Cuomo described on Saturday as truly disturbing.

When the coronavirus pandemic began ravaging the New York area two months ago, the state found solace in the initial evidence that children would be largely unaffected, Mr. Cuomo said. That sense of relief was shattered this week when a 5-year-old died in New York City of the newly discovered disease, which doctors described as a pediatric multisystem inflammatory syndrome.

Mr. Cuomo did not elaborate on the death of the two additional children.

We were laboring under the impression that young people were not affected by Covid-19, and that was actually good news, Mr. Cuomo said. We still have a lot to learn about this virus.

Mr. Cuomo has asked parents to be vigilant in looking for symptoms such as prolonged fever, severe abdominal pain, change in skin color, racing heart and chest pain.

Overall deaths from Covid-19 remained a stubborn problem in the state, Mr. Cuomo said Saturday. He announced 226 more deaths due to the disease, 10 more deaths than the number reported a day earlier.

That number has been infuriatingly constant, he said. We would like to see that number dropping at a faster rate that it is currently dropping.

Despite the setbacks, New York continued to make inroads in its fight against the coronavirus, Mr. Cuomo said.

New hospitalizations for Covid-19 patients had remained relatively flat, hovering in the 600s. On Saturday that trend held true, with 572 new patients being treated at city hospitals for the coronavirus. On Friday, 604 people were hospitalized.

Last weekend, a kind of split-screen photo montage of New York City circulated widely on social media.

One image showed a dense crowd of mostly white people sunbathing in Hudson River Park in Manhattan, apparently flouting social-distancing rules. Another showed a police officer beating a black man in a confrontation that began over an attempt to enforce those rules.

Many people pointed to the two images as evidence that the police were engaged in a racist double standard.

The notion gained further traction Thursday after the Brooklyn district attorney revealed that 35 of the 40 people arrested in the borough for social-distancing violations as of May 4 were black.

On Friday, Mayor Bill de Blasio said the city would address both concerns.

Mr. de Blasio said that the police would limit crowds at two piers at Hudson River Park and another popular park, Domino Park in Brooklyn, starting this weekend.

And concerning the lopsided race numbers in arrests, Mr. de Blasio wrote on Twitter that while summons and arrests were tools for saving lives, The disparity in the numbers does NOT reflect our values. We HAVE TO do better and we WILL.

The M.T.A., which operates the citys subway and bus system, began shutting down the subway system overnight on Wednesday, forcing those who otherwise would have ridden throughout the night to accept shelter offered by city employees or find their own.

The M.T.A. is providing 40 buses at 30 stations, and the vehicles will be controlled by the Police Department after they are dropped off, the transit agency said.

In a statement announcing the move, transit officials reiterated that the M.T.A. is not a social services agency and stressed that the buses were a short-term solution. They called on the city, which requested the buses, to to step up and take responsibility for providing safe shelter for those individuals experiencing homelessness.

To hop on the train, any train, earbuds intact, alone in the crowd on the way somewhere else. To walk out of the Metropolitan Museum of Art, exhausted as if from a march. The sweet-potato fries and a beer at Tubby Hook Tavern in Inwood; the coffee-cart guy on West 40th Street who remembers you take it black.

Sunday Mass and the bakery after. Seeing old friends in the synagogue. Play dates. The High Line. Hugs.

Ask New Yorkers what they miss most, nearly two months into isolation. To hear their answers is to witness a perfect version of the city built from the ground up, a place refracted through a lens of loss, where the best parts are huge and the annoyances become all but invisible.

The cheap seats in the outfield, the shouting to be heard at happy hour. Meeting cousins with a soccer ball in Brooklyn Bridge Park. The din of the theater as you scan the Playbill before the lights go down.

I miss my gym equipment, said Barbara James of Brooklyn.

The lamb over rice from the food cart by my office, at Seventh and 49th, said Chris Meredith of East Harlem.

Just everything, sighed a police officer sitting behind the wheel of his vehicle in Williamsburg, Brooklyn, last week. I miss everything.

As The New York Times follows the spread of the coronavirus across New York, New Jersey and Connecticut, we need your help. We want to talk to doctors, nurses, lab technicians, respiratory therapists, emergency services workers, nursing home managers anyone who can share whats happening in the regions hospitals and other health care centers.

A reporter or editor may contact you. Your information will not be published without your consent.

Reporting was contributed by Michael Gold, Andy Newman, Sarah Maslin Nir, Joel Petterson, Andrea Salcedo, Edgar Sandoval, Matt Stevens and Michael Wilson.

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Three Children Have Died in N.Y. of Illness Linked to Virus: Live Updates - The New York Times

That's not because the virus is particularly widespread in this community in north central New Mexico, nestled between a national forest and an Apache Nation reservation.

It's because in New Mexico, tests are free and plentiful. Some residents of Tierra Amarilla went to a one-day free testing event in town a few weeks ago, and if they missed that they can drive to a permanent testing center 45 minutes away. If residents don't have transportation, the Department of Health will come and test them in Tierra Amarilla.

So far, the state has performed 89,032 coronavirus tests. That's more than any other state with around the same population. New Mexico has conducted around the same number of tests or more than states such as Oklahoma, Nevada and South Carolina, which have considerably larger populations.

But not every state is like New Mexico. Months after federal officials said coronavirus testing would be plentiful, the tests are still hard to find in some parts of the country.

"We want to test for this the way we test for HIV, that you can do it without worrying. That's not the case in many parts of the country," said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. "We have a patchwork of testing across the country."

Limited testing, despite promises

More than two months later, that's still not the case.

It's not just a matter of having the tests themselves, but also having supplies like swabs and chemical reagents that are needed to run the tests.

"We've never been able to get to full capacity because we are missing things in the supply chain," Michigan Gov. Gretchen Whitmer on CNN's State of the Union on May 3.

"We don't know how we're going to get that system in place," Davidson said.

Even labs associated with large academic medical centers are experiencing shortages.

"There are limited supplies and there are differences in which labs have been able to order which supplies and how much of the order shows up," said Heather Pierce, the senior director for science policy and regulatory counsel at the Association of American Medical Colleges.

It's a variable situation, she added.

"One lab that has everything that it needs for one week doesn't necessarily know what it's going to get the next week," she said.

Need for more tests

As recorded cases of coronavirus continue to rise in the United States by 20,000 to 30,000 per day, public health officials have emphasized that more testing will bring the numbers down and help the nation find a pathway out of the pandemic.

Once there is widespread testing, health experts say infected people can be identified and isolated, and close contacts can quarantine themselves at home.

Dr. Anthony Fauci, the nation's leading infectious disease expert, estimated on April 25 that the US is conducting approximately 1.5 to 2 million coronavirus tests per week.

"We probably should get up to twice that as we get into the next several weeks," Fauci said the same day during a Covid-19 briefing by the National Academy of Sciences.

Finding fixes

Last week, the White House released a testing blueprint that said the federal government should be the "supplier of last resort."

It's up to the states to come up with testing plans and "to identify and overcome barriers to efficient testing," including "misallocation of supplies" and "logistical failures," according to the blueprint.

Some states have had more success than others.

New Mexico has more than 80 testing sites in all 33 counties. Not all operate at the same time -- some are permanent, others are drive-through or open for a few hours a day.

The state offers free testing to anyone with symptoms of coronavirus, anyone who's been in close contact with someone who's had the virus, or anyone at high risk for contracting the virus, such as an essential worker or a nursing home resident.

"We believe testing is critical. We always have, and so it's a priority," said Kathy Kunkel, New Mexico's secretary of health.

Some other states have also made it relatively easy for people to get tested.

On April 2, Utah launched a website where residents can find out if they qualify for free testing at a drive-through. So far, nearly 20,000 tests have been administered by the "TestUtah" initiative.

Despite the federal blueprint, Michigan hopes to receive some relief from the federal government. On May 3, a senior Trump administration official told CNN that the administration is sending the state 450,000 additional swabs and other supplies to help it meet its goal to perform 450,000 tests in May, which is more than three times the number of tests performed there from the beginning of the outbreak through the end of April.

Others also see reason for optimism.

"Over the last several weeks it's become easier for me to order tests for people," said Adalja, the Hopkins physician. "But the point is doctors and people have to be comfortable ordering tests and not worrying about supply chain issues."

Ryan Nobles and Sara Murray contributed to this story.

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US falls short in coronavirus testing in some areas of the country - CNN

This image made by a scanning electron micrograph shows SARS-COV-2 virus particles (colorized pink) from a patient sample. There are various studies looking at changes to the virus genome and the possible impact on how the virus affects humans. NIAID/NIH hide caption

This image made by a scanning electron micrograph shows SARS-COV-2 virus particles (colorized pink) from a patient sample. There are various studies looking at changes to the virus genome and the possible impact on how the virus affects humans.

This week, the question of mutation has been front and center in coverage of the coronavirus from controversial claims about changes that make the virus more contagious to reassurances that any mutations are not yet consequential.

Here are some of the questions being raised and what the specialists can (and can't yet) say to answer them.

Is the coronavirus mutating?

Researchers say the coronavirus is making small changes to itself as they would expect it to at a relatively predictable and steady rate of around one to two changes per month.

"Viruses mutate naturally as part of their life cycle," says Ewan Harrison, scientific project manager for the COVID-19 Genomics UK Consortium. The coronavirus is no different.

When a virus infects a person, it enters their cells and makes copies of itself, which then circulate through the body or are transmitted respiratory droplets is one method to other humans.

Inevitably, viruses "make mistakes in their genomes" as they copy themselves, Harrison says. Those changes can accumulate and carry over to future copies of the virus. Mutations are akin to typos in text most typos are nonevents, but some can change the meaning of a word or sentence. Likewise, many mutations will be dead ends with no effect on people who are infected. But some of these mutations in a virus may change how quickly it infects people and replicates, or what kind of damage it does to cells.

These small, cumulative changes are useful to researchers, because they act as identification cards that help trace the pathway of the virus through groups of people over time. For instance, in a surveillance study on the Arizona State University campus, researchers found that the people who were showing up sick in mid-March with the coronavirus had different versions of the virus from each other. Comparing the virus genomes helped them figure out that the spike in mid-March cases probably didn't signify an outbreak on campus; the cases had had likely caught this version of the virus elsewhere, perhaps when they traveled for spring break, and brought it back. So tracking virus genomes is valuable in tracing how and where the virus is spreading.

Is the coronavirus becoming more transmissible?

Twitter lit up this week when a draft research paper posted to the preprint server bioRxiv got picked up by the media. The paper suggests in the title that their analysis of coronavirus mutations "reveals the emergence of a more transmissible form of SARS-CoV-2."

The study was conducted by researchers at Los Alamos National Laboratory, The University of Sheffield and Duke. They analyzed publicly available genome sequences from around the world posted on GISAID, a global research platform that has amassed over 16,000 coronavirus sequences to date.

The researchers found that a version of the virus, which was first detected in Europe in early February, appears to have become the most common strain in the U.S., Australia, parts of Africa basically, anywhere it spread. The study authors hypothesize that a mutation in this virus strain, which changes one amino acid in the part of the coronavirus that finds and binds to cells, could cause the virus to spread more easily.

"I think that it is an important observation," says Angela Rasmussen, a virologist at Columbia Mailman School of Public Health, "We have seen in other virus epidemics, such as the Ebola epidemic, that there are these mutations that seem to persist and become the dominant form of the virus."

However, Rasmussen says, there's no clear evidence that the mutation referenced in the paper does anything to change how the virus spreads.

Other factors could also account for why the virus from Europe is dominant, says Justin Bahl, a computational biologist at University of Georgia. It could possibly be explained by the so-called "founder effect," where the European version spread rapidly across international borders and established itself as the dominant strain because countries were slow to lock down.

To prove whether the mutation identified in the paper causes the virus to spread more easily, researchers want to see experimental evidence: for instance, a study where both strains are tested in live cells, to see if the mutated virus replicates faster. If those results show such signs, they'll want to see if one virus spreads more readily in lab animals.

Is the coronavirus mutating to become less harmful?

Another study, published in Journal of Virology, identified one patient in Arizona who was carrying a version of the virus with a chunk of it missing. The deletion was sizable 81 nucleotides long, out of the 30,000 or so that make up the coronavirus' genome sequence (in case you're wondering, a nucleotide is a molecule that forms the building block of a DNA or RNA strand and is too tiny to be seen under most microscopes). It was also found in a location on the genome which, on the classic SARS virus, helped the virus fight the immune system, according to study co-author Efrem Lim, a virologist at Arizona State University.

The researchers hypothesize that the deletion "may potentially reduce virus fitness" a claim Lim says they're now testing in labs.

The paper is based on just one virus genome, out of the 16,000 that have been sequenced and shared, which makes it difficult to generalize to the larger group of circulating versions of the novel coronavirus. "We actually have no idea whether [a virus with this deletion] is transmissible or not," Bahl says. "We don't know whether it was just a one-off event or whether these variants are transmitting and becoming more frequent in the population [of people getting coronavirus]."

More evidence is needed to see if Lim's hypothesis holds and it will emerge as research continues.

Do the mutations we're seeing affect the development of treatments and vaccines?

Not yet. "We're getting the mutations that we're kind of expecting here," says Vineet Menachery, a virologist at the University of Texas Medical Branch, so the research process already accounts for these changes.

Menachery says the European mutation tracked in the Los Alamos paper is adjacent to, but not directly on, the receptor binding domain, which is a specific part area on the virus' protein shell that initiates first contact in attaching to human cells. "If these mutations were there, there'd be a little bit more worry about antibody-based approaches and vaccine approaches," he says, because the shifts might make it harder for antibodies to recognize the virus. But the mutations are not directly on the receptor binding domain, so researchers aren't too worried about those specific changes.

Vaccines are also developed to target multiple sites on a virus, so it's unlikely that a few random mutations to the virus can knock out their power completely, Rasmussen says.

Versions of the virus that are drug- or vaccine-resistant may crop up once therapies are in use, says Lim. If a particular strain is obliterated by drugs or vaccines, then any viruses that survive will be the ones not affected by those treatments and could go on to infect others. But for now, there's no pressure on the virus to change in a way that would help it evade measures that haven't been introduced.

Why are scientists sharing unproven theories?

The main scientific purpose of sharing these papers early and often is to alert other researchers to interesting theories and call attention to potentially meaningful mutations, Lim says.

"It helps us prioritize what mutations should be studied in the lab, because there are so many mutations out there," Lim says. By sharing leads and data-backed theories, scientists are highlighting specific mutations that may be affecting the behavior of the virus, in a sea of all the small changes the virus makes.

So it helps researchers to know that scientists at Los Alamos Lab think that a particular change in the genome is worth additional study, or that a deletion in the virus has been found once and could be found again. The answers may not be definitive, but it feeds the global brain trust of researchers who are all working to understand the coronavirus better and help defeat it.

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What We Know About Coronavirus Mutations : Goats and Soda - NPR

SARS-CoV-2 is highly contagious, but a few dozen imported cases would probably not be enough to spark many major undetected outbreaks. Based on related diseases such as SARS and MERS, epidemiologists suspect that the coronaviruss spreading potential is irregular. In all likelihood, some sick people infect many others, but most infect just a handful. Alessandro Vespignani, a network scientist and public-health professor at Northeastern University, estimates that in each American city that later became a hot spot for COVID-19, perhaps 10 to 20 local transmission events occurred in January. Aside from the one or two infections that did seed major outbreaks in places such as Seattle and New York, most infections that arrived from outside the country in January would have been transmitted to at most a few people, then quickly fizzle out, Bedford told me.

Read: Why America is uniquely unsuited to dealing with the coronavirus

Establishing a more precise number of how many sick people carried SARS-CoV-2 to the U.S. early this year would require data that can be difficult or impossible to collect, especially during a major global-health crisis. For one: how many people were actually sick with COVID-19 around the world in January (or earlier). The official data out of Wuhan have been unreliable from the start. And countries that have since ramped up their coronavirus-detection efforts were not looking as carefully for cases at the beginning of the year. The World Health Organization did not declare a global-health emergency until January 30.

Researchers would also need to know where people traveled around the world in the early weeks of the pandemic. One of the big challenges of looking at actual global spread of this disease is that, from January on, travel patterns have been massively disrupted, Gardner said. When researchers dont have perfect travel data for a time and place theyre studying, she explained, they often substitute or extrapolate from data in the recent past. Sometimes you can say, Well, I dont have 2016 data, but Im using 2015 data. Thats representative. That does not apply anymore. The Chinese government shut down Wuhan on January 23; even before then, individual peoples movement patterns might have begun to shift in ways that are difficult to track.

When the living cannot be fully accounted for, one way to move forward is to tally the dead. Testing shortages mean that some COVID-19 deaths have gone undetected, but researchers can get a better handle on just how many people the virus killed during a given time period by looking at the excess mortality: how many more people died than would have been expected to under normal circumstances.

Last week, the National Center for Health Statistics published preliminary data on weekly excess deaths since January 2017, which will be updated as the pandemic wears on. Bob Anderson, the chief of the NCHSs mortality-statistics branch, told me that its the first time weve done something like this before the data were final. The hope is that researchers can use the gross numbers to estimate how many Americans died of COVID-19 over a particular period, and from there estimate how many Americans were infected. But picking out excess deaths in the first few weeks of this year will be difficult. Compared with the hundreds of thousands of deaths the country experiences in a typical month, a handful of COVID-19 deaths would hardly be a blip. Indeed, by the NCHSs count, the United States did not exceed the expected number of deaths by a significant margin until the week of March 22.

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Youll Probably Never Know If You Had the Coronavirus in January - The Atlantic

"It's one of the most basic forms of exercising your power as an individual," Gragston told CNN. "My grandmother taught me that."

Gragston's grandmother June Gragston, like many older black women, dutifully voted in person -- early, on the first day she could. Her sister, Gragston's great aunt Vera Mundy, preferred to walk herself there.

"Every election I would call her and say: 'Hey auntie do you need a ride to the polls?' She'd say: this is my exercise. This is the one thing I know I'm going to do on this day," Gragston said.

For millions of black voters across the country, like Gragston's grandmother and great aunt, voting in person has been a guarded tradition -- a right earned after decades of strenuous and bloody fights.

And with social distancing measures in place across the country, face-to-face community based get out the vote efforts that are crucial to Democrats' outreach to these voters are no longer an option.

Gragston, an Iraq war veteran and a former candidate for state office in Ohio, has helped organize "Souls to the Polls" drives in Cincinnati for past presidential and midterm elections -- working with the help of national organizations like the NAACP and his fraternity Alpha Phi Alpha Inc., to encourage voters to take advantage of early voting in the state of Ohio.

This year, because of the threat of coronavirus, he plans to offer to deliver absentee ballot applications to voters rather than drive them to the polls.

"It will be a hard turn for a lot of people," said Gragston. "For people who lack access to the internet, they can't get online to apply for their absentee ballot. And then there are older folks who are not as technologically savvy."

All of this has raised concerns among Democrats that in order to maintain or increase black turnout in November, they will need to ensure that there are safe in-person voting options and dramatically ramp up absentee ballot education targeted at minority voters.

"It's not the silver bullet that's going to make sure that everyone who wants to vote, will," Tory Gavito, co-founder and president of Way to Win, a progressive group that channels donor money into grassroots organizing efforts across the county. "It's a tactic that we have that we still have to build education around."

Way to Win has spent $3.7 million in the last few weeks on Covid-related measures, including digital organizing and vote-by-mail outreach targeted at minority voters.

Among them, digital voter engagement efforts in North Carolina and Arizona, two states that Democrats see as critical to their presidential and Senate hopes. But the two states present radically different challenges. In Arizona, 75% of voters use mailed-in ballots in 2016. But in North Carolina, just 4% of voters cast their ballots that way.

States like North Carolina, which is 22% black, present a challenge for Democrats who hope demographic trends will allow them to keep the Tar Heel state competitive in 2020.

Voting by mail is more restrictive in North Carolina. The state requires absentee ballots to be witnessed by two people or a notary public.

There and in other parts of the country, the act of physically going to the polls individually or as group -- sometimes literally leaving the church pews to drive on buses to the polling place -- is a communal tradition among some black Americans. It has also become key to get out the vote efforts among non-partisan voter mobilization groups and Democratic organizations across the country.

"Culturally voting in our community is a big deal to the point that some elderly people in our community dress up to go vote," said LaTosha Brown, founder of Black Voters Matter. "We want to make sure that we have mail-in ballot voting as an option."

"We also want to make sure that there are additional options as well -- that there are some sites throughout our communities that remain open so that those that want to vote in person can vote," she added.

Beyond the challenge of coaxing voters to break long-held habits, there is also the issue of trust. Minority voters are skeptical of trusting mail delivery services and ballot verification processes with their ballots. And for good reason.

A study by researchers at the University of Florida and Dartmouth College found that in Florida, non-white voters, younger voters and voters needing assistance were more likely to have their vote-by-mail ballots rejected than white voters, based on a review of vote by mail ballots cast in 2018.

"They have concerns about the confusion. People have concerns about their ballots not being collected," said Adrianne Shropshire, executive director of BlackPAC, a progressive super PAC that has helped fund black voter outreach in states across the country. "People have concerns and would prefer to vote in person."

BlackPAC made a name for itself mobilizing black voters with face-to-face appeals that powered Democrat Doug Jones to victory in the Senate special election in ruby red Alabama in 2017, and helping elect Virginia Gov. Ralph Northam that year as well.

Last month, BlackPAC conducted their own research to gauge attitudes among black voters toward mail-in voting and found black voters largely had little or no prior experience with voting by mail and nearly half worried that their mail ballots would not be counted.

Shropshire said there are potential "unintended consequences" of overly emphasizing mail-in voting alone, which could result in lower turnout among critical constituencies for the Democrats.

"Elections and voter mobilization in black communities are a communal collective activity. There is a cultural dynamic that is at play here that is being affected, that's part of the challenge with vote by mail," Shropshire said. "We have to find ways to recreate that collective political action."

This reality has increased the pressure on Democrats to ensure that while they push in courts and legislatures for expanded access to mail-in voting -- especially for vulnerable populations -- they must also push a multi-faceted approach that addresses all the potential barriers to voting no matter which method voters choose.

That includes pushing for changes to physical voting locations that make voting in person safer, expanded in-person early voting options, drive-through voting and appointment voting for vulnerable populations.

"While Democrats champion vote by mail, we do think that for some voters, some of our most loyal voters, African American voters, there's a clear history of not using it as much," said David Pepper, chairman of the Ohio Democratic Party. "One of the lessons for the fall has to be that we have to eliminate unnecessary hoops to get the ballot. A ballot should be sent to every registered voter. Postage should be prepaid. And there needs to be as much public education about the process as possible."

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Coronavirus threatens a guarded tradition for many black Americans: Voting in person - CNN

While this years Mothers Day weekend promises warm weather, Seattle officials are restricting hours in city parks out of fears that large crowds hoping to enjoy the sun could further spread the novel coronavirus.A recent report shows the COVID-19 transmission rate in Western Washington may be steadily increasing, suggesting that the number of virus cases could potentially rise, while the number of COVID-19 cases in Eastern Washington is expected to increase based on current transmission rates.

New figures continue to show evidence of the damage coronavirus has done to a declining economy. Nationally, theunemployment rate hit 14.7% in April, the highest rate since the Great Depression. Washington also grapples with a tsunami of legitimate unemployment claims more than 100,000 last week thought the state also is seeing a rise in attempts by fraudsters to siphon off a portion of the benefits.

Throughout Saturday, on this page, well be posting updates from Seattle Times journalists and others on the pandemic and its effects on the Seattle area, the Pacific Northwest and the world. Updates from Friday can be found here, and all our coronavirus coverage can be foundhere.

The following graphic includes the most recent numbers from the Washington State Department of Health, released Friday.

As the coronavirus pandemic has decimated small businesses across the country, shell-shocked owners have turned to their insurance carriers to cover devastating financial losses thrust on them by state shutdown orders.

In many cases, the response from insurers has been: We dont cover viruses.

Tacoma dentist Arnell Prato was among those who got that answer. That drove him to join a growing number of small-business owners locally and nationally who are suing their insurers, alleging breach of contract after paying their premiums for years.

Ive never seen or experienced anything like this, said Prato, who has practiced dentistry in Washington for 10 years.

He is now in the middle of a battle pitting people like him against a powerful industry that insists it is sympathetic to the plight of small-business owners, but not legally on the hook for hundreds of billions of dollars in losses that were never anticipated to be covered under a catastrophic economic standstill.

Pandemic outbreaks are uninsured because they are uninsurable, David Sampson, president of the American Property Casualty Insurance Association, recently said.

Read the whole story here.

Steve Miletich

One of the hottest debates in the coronavirus pandemic is whether the malaria drugs promoted as possible treatments by President Donald Trump really work. But Americans dont seem overly eager to help answer the question.

Enrollment in several clinical trials of chloroquine and hydroxychloroquine including two by the University of Washington has been anemic so far. Fewer than 260 volunteers, out of a target of 2,000, have signed up for a $9.5 million UW study being conducted in Seattle and six other sites across the country. Another multi-site project coordinated by the UW has only about 30 patients enrolled.

Researchers say enrollment in the trials plummeted after preliminary reports of possible heart arrhythmias associated with the drugs, followed by a U.S. Food and Drug Administration warning that they should be administered only in hospitals or clinical trials.

"Once that news came out, our enrollment fell almost down to zero," said UW epidemiologist Dr. Ruanne Barnabas, whos leading a study to find out if hydroxychloroquine can prevent infection in people like health-care workers who have been exposed to the virus.

Read the whole story here.

Sandi Doughton

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Coronavirus daily news updates, May 9: What to know today about COVID-19 in the Seattle area, Washington state and the nation - Seattle Times

As I write, the contest for explanation is well under wayDonald Trump is to blame, or Barack Obama, or the Centers for Disease Control and Prevention, or China, or the U.S. militarys biowarfare experiments, or Bill Gates. Nobody has yet invoked eight-legged worms. But in our age of social media, the engines of rumor, prejudice, and superstition may have even greater power than they did in the era of the Black Death.

Christopher Columbuss journey to the Americas set off the worst demographic catastrophe in history. The indigenous societies of the Americas had few communicable diseasesno smallpox, no measles, no cholera, no typhoid, no malaria, no bubonic plague. When Europeans imported these diseases into the Western Hemisphere, it was as if all the suffering and death these ailments had caused in Europe during the previous millennia were compressed into about 150 years.

From March 2002: Charles C. Mann on the year 1491

Somewhere between two-thirds and nine-tenths of the people in the Americas died. Many later European settlers, like my umpteen-great-grandparents, believed they were coming to a vacant wilderness. But the land was not empty; it had been emptieda world of loss encompassed in a shift of tense.

Absent the diseases, it is difficult to imagine how small groups of poorly equipped Europeans at the end of very long supply chains could have survived and even thrived in the alien ecosystems of the Americas. I fully support banning travel from Europe to prevent the spread of infectious disease, the Cherokee journalist Rebecca Nagle remarked after President Trump announced his plan to do this. I just think its 528 years too late.

For Native Americans, the epidemic era lasted for centuries, as did its repercussions. Isolated Hawaii had almost no bacterial or viral disease until 1778, when the islands were discovered by Captain James Cook. Islanders learned the cruel facts of contagion so rapidly that by 1806, local leaders were refusing to allow European ships to dock if they had sick people on board. Nonetheless, Hawaiis king and queen traveled from their clean islands to London, that cesspool of disease, arriving in May 1824. By July they were deadmeasles.

Kamehameha II and Kammalu had gone to Britain to negotiate an alliance against the United States, which they correctly believed had designs on their nation. Their deaths scuttled the talks, and their successor, 12-year-old King Kamehameha III, could not resume them. The results changed the islands political destiny. Undeterred by the British navy, the U.S. annexed Hawaii in 1898. Historians have seldom noted the connection between measles and the presidency of Barack Obama.

As a rule, epidemics create what researchers call a U-shaped curve of mortalityhigh death rates among the very young and very old, lower rates among working-age adults. (The 1918 flu was an exception; a disproportionate number of 20-somethings perished.) For Native peoples, the U-shaped curve was as devastating as the sheer loss of life. As an indigenous archaeologist once put it to me, the epidemics simultaneously robbed his nation of its future and its past: the former, by killing all the children; the latter, by killing all the elders, who were its storehouses of wisdom and experience.

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How Will the Coronavirus Change Us? - The Atlantic

Researcher Francois Balloux of the University College London Genetics Institute and his colleagues in the United Kingdom pulled viral sequences from a giant global database that scientists around the world are using to share data.

They looked at samples taken at different times and from different places, and said they indicate that the virus began infecting people at the end of 2019.

"Our results are in line with previous estimates and point to all sequences sharing a common ancestor towards the end of 2019, supporting this as the period when SARS-CoV-2 jumped into its human host," the team wrote in a report, published in the journal Infection, Genetics and Evolution.

Balloux told CNN his team is "really, really, really confident" about when the host jumped.

They also found genetic evidence that supports suspicions the virus was infecting people in Europe, the United States and elsewhere weeks or even months before the first official cases were reported in January and February.

One US community is checking to see whether there were cases there that went undiagnosed in 2019.

In Chicago, the Cook County Medical Examiner's Office said it will review deaths involving heart attacks and pneumonia for indications of Covid-19 as far back as November, Cook County spokesperson Natalia Derevyanny told CNN.

The first known coronavirus death in the county was March 16.

The office will look at viral pneumonia cases along with heart attacks caused by arteries being blocked (arterial thrombosis), as opposed to cases brought on by heart failure.

"The goal is to see if this virus was present before we knew of it," Derevyanny said.

While Derevyanny called the decision to look back to November an arbitrary timeframe, if a positive case is discovered it will prompt the office to look back even further.

The investigation may include additional testing of preserved tissue samples, Derevyanny said.

Cuomo: It comes down to how much you value life

New York Gov. Andrew Cuomo on Tuesday said debates on how soon states should ease social distancing restrictions come down to the value of human life -- and that policymakers are avoiding saying so explicitly.

"The fundamental question, which we're not articulating, is how much is a human life worth?" Cuomo said at a news conference.

"The faster we reopen, the lower the economic cost. But, the higher the human cost, because (of) more lives lost," Cuomo said in a news conference. "That ... is the decision we are really making."

But easing restrictions now may come with a heavy price.

"It's the balance of something that's a very difficult choice," Dr. Anthony Fauci, the country's leading infectious disease expert, told CNN Monday night. "How many deaths and how much suffering are you willing to accept to get back to what you want to be some form of normality, sooner rather than later?"

At least 42 states will have eased restrictions by Sunday, ranging from simply opening state parks to allowing some businesses to restart. That includes California -- the first state to implement a sweeping stay-at-home order -- where some stores will be allowed to reopen this week.

So far, the US has recorded more than 1,200,000 infections and at least 71,043 deaths.

Poll: Majority prioritizes preventing illness over economy

A majority of Americans who answered a Monmouth University poll, meanwhile, indicated they prioritize preventing illnesses over long-term economic concerns.

In the poll, conducted Thursday though Monday, adults were asked which should be the more important factor in deciding whether to lift outbreak restrictions -- ensuring as few people as possible get sick from the coronavirus, or ensuring the economy doesn't enter a deep and lengthy downturn.

About 56% answered the former; 33% said the latter; 9% said both equally. The poll of 808 adults in the United States has a margin of error of +/- 3.5 percentage points, Monmouth said Tuesday.

More vaccine candidates tested in the US

Researchers continue to race for a potential coronavirus vaccine -- and another group of candidates is being tested on people in the United States.

US pharmaceutical giant Pfizer and German biotechnology company BioNTech have begun testing four coronavirus vaccine candidates in humans in New York and Maryland, the companies said Tuesday.

The first stage of the US trial will enroll up to 360 healthy adults, starting with ages 18 to 55 and eventually including ages 65 to 85, the companies said.

These companies aren't the first with a vaccine program this far along.

The World Health Organization says 108 potential Covid-19 vaccines are in development around the world -- up from 102 on April 30. Eight of the potential vaccine programs have been approved for clinical trials, WHO says.

How governors are moving forward

California was one of the states where crowds gathered over the weekend as thousands of protesters descended on the state's Capitol and an Orange County beach to protest social distancing orders.

The governor on Monday announced retail shops in the state -- including clothing stores, florists and bookstores -- can begin to reopen Friday, after health officials said the state was meeting important metrics including sufficient test and tracing capacity.

Los Angeles Mayor Eric Garcetti said he didn't think his city would reopen this week, saying Monday that despite the governor's announcement, different parts of the state may see different timelines for reopening.

In Michigan, Gov. Gretchen Whitmer said the lockdown will continue "until at least May 15," warning that reopening the state too soon could lead to a second shutdown.

Reeves' plan also allows dining service in restaurants, as long as the institutions follow guidelines provided by the state, including a mandatory deep cleaning.

"I don't want to wait if there are steps that we believe we can safely take now to ease the burden on Mississippians fighting this virus," he said.

Protests against masks

CNN's Frederick Pleitgen, Jacqueline Howard, Elizabeth Cohen and Jennifer Henderson contributed to this report.

Continued here:

New evidence indicates coronavirus was infecting people in Europe and the US before the first official cases were reported - CNN

Ventilators have become the single most important piece of medical equipment for critically ill coronavirus patients whose damaged lungs prevent them from getting enough oxygen to vital organs. The machines work by forcing air deep into the lungs, dislodging the fluid and accumulated pus that interfere with the exchange of oxygen, a process orchestrated by tiny air sacs known as alveoli.

Lungs are complex organs that deliver oxygen to the bloodstream and keep organs functioning.

Human lungs are spongy vessels made up of millions of microscopic, balloon-shaped air sacs called alveoli, the workhorse of the respiratory system where the exchange of gases takes place.

A single alveolus, no bigger than the width of a human hair, is ringed by a mesh of tiny capillaries that transport oxygen to the bloodstream.

A single alveolus, no bigger than the width of a human hair, is ringed by a mesh of tiny capillaries that transport oxygen to the bloodstream.

A single alveolus, no bigger than the width of a human hair, is ringed by a mesh of tiny capillaries that transport oxygen to the bloodstream.

Ventilators are not a cure for Covid-19 patients, but mechanical breathing assistance can keep patients alive while they battle the infection.

Critical care ventilators are more than just air pumps. They are finely tuned machines with software that must be constantly adjusted by skilled medical workers to ensure that patients receive the right combination of oxygen level, pressure, breath volume and breathing rate.

Non-coronavirus patients on ventilators have about a 50 percent survival rate. The mortality rate for coronavirus patients on ventilators is not yet clear in part because, with no proven method of treatment for the virus, coronavirus patients are often being kept on these machines for weeks in order to keep them breathing long enough to give their lungs a chance to heal.

Exhaled air is filtered for viral particles

Air supplied to the patient

contains 21-100% oxygen

Air supplied to the patient

contains 21-100% oxygen

Exhaled air

is filtered

for viral particles

Intubation is fraught. Patients must be heavily sedated to allow doctors to insert a breathing tube into the lungs and to prevent them from waking up and pulling out the tubes. Because too much air pressure can damage the lungs, intubated patients must be constantly monitored.

Fears of a ventilator shortage in New York and the poor prognosis for intubated patients have helped spur innovations for sustaining patients without relying on critical care ventilators.

Health care providers have embraced a maneuver that has long been used for ventilated patients periodically turning them on their stomach to increase lung capacity. Proning, as its called, opens up areas of the lungs that are normally compressed by the weight of the heart when lying on ones back. Doctors are currently studying whether using proning for some patients in respiratory distress can allow them to recover without being placed on ventilators.

Flipping over patients in acute respiratory distress, doctors have discovered, can markedly increase oxygenation. The process can be labor-intensive, however, requiring staff to turn over patients several times a day.

Medical workers have increasingly turned to CPAP and BiPAP machines, inexpensive air pumps used by millions of Americans with sleep apnea, chronic obstructive pulmonary disease and other breathing disorders. Hospitals have been repurposing unused machines and using them both with or without intubation to send pressurized air into the lungs of coronavirus patients.

Soft and transparent plastic helmet

holds positive pressure inside

Room oxygen

supply option

Soft collar

seals helmet at the neck

Plastic helmet

holds positive

pressure inside

Room oxygen

supply option

To reduce the risk of infection for hospital workers, doctors have also been fitting patients with jury-rigged helmets that deliver oxygen via CPAP machines while filtering out exhaled viral particles. The helmets were pioneered by Italian doctors forced to improvise because of a shortage of intensive care ventilators.

See more here:

In the Fight to Treat Coronavirus, Your Lungs Are a Battlefield - The New York Times

Among the most important unanswered questions about Covid-19 is this: What role do children play in keeping the pandemic going?

Fewer children seem to get infected by the coronavirus than adults, and most of those who do have mild symptoms, if any. But do they pass the virus on to adults and continue the chain of transmission?

The answer is key to deciding whether and when to reopen schools, a step that President Trump urged states to consider before the summer.

Two new studies offer compelling evidence that children can transmit the virus. Neither proved it, but the evidence was strong enough to suggest that schools should be kept closed for now, many epidemiologists who were not involved in the research said.

Many other countries, including Israel, Finland, France, Germany, the Netherlands and the United Kingdom have all either reopened schools or are considering doing so in the next few weeks.

In some of those countries, the rate of community transmission is low enough to take the risk. But in others, including the United States, reopening schools may nudge the epidemics reproduction number the number of new infections estimated to stem from a single case, commonly referred to as R0 to dangerous levels, epidemiologists warned after reviewing the results from the new studies.

In one study, published last week in the journal Science, a team analyzed data from two cities in China Wuhan, where the virus first emerged, and Shanghai and found that children were about a third as susceptible to coronavirus infection as adults were. But when schools were open, they found, children had about three times as many contacts as adults, and three times as many opportunities to become infected, essentially evening out their risk.

Based on their data, the researchers estimated that closing schools is not enough on its own to stop an outbreak, but it can reduce the surge by about 40 to 60 percent and slow the epidemics course.

My simulation shows that yes, if you reopen the schools, youll see a big increase in the reproduction number, which is exactly what you dont want, said Marco Ajelli, a mathematical epidemiologist who did the work while at the Bruno Kessler Foundation in Trento, Italy.

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The second study, by a group of German researchers, was more straightforward. The team tested children and adults and found that children who test positive harbor just as much virus as adults do sometimes more and so, presumably, are just as infectious.

Are any of these studies definitive? The answer is No, of course not, said Jeffrey Shaman, an epidemiologist at Columbia University who was not involved in either study. But, he said, to open schools because of some uninvestigated notion that children arent really involved in this, that would be a very foolish thing.

The German study was led by Christian Drosten, a virologist who has ascended to something like celebrity status in recent months for his candid and clear commentary on the pandemic. Dr. Drosten leads a large virology lab in Berlin that has tested about 60,000 people for the coronavirus. Consistent with other studies, he and his colleagues found many more infected adults than children.

The team also analyzed a group of 47 infected children between ages 1 and 11. Fifteen of them had an underlying condition or were hospitalized, but the remaining were mostly free of symptoms. The children who were asymptomatic had viral loads that were just as high or higher than the symptomatic children or adults.

In this cloud of children, there are these few children that have a virus concentration that is sky-high, Dr. Drosten said.

He noted that there is a significant body of work suggesting that a persons viral load tracks closely with their infectiousness. So Im a bit reluctant to happily recommend to politicians that we can now reopen day cares and schools.

Dr. Drosten said he posted his study on his labs website ahead of its peer review because of the ongoing discussion about schools in Germany.

Many statisticians contacted him via Twitter suggesting one or another more sophisticated analysis. His team applied the suggestions, Dr. Drosten said, and even invited one of the statisticians to collaborate.

But the message of the paper is really unchanged by any type of more sophisticated statistical analysis, he said. For the United States to even consider reopening schools, he said, I think its way too early.

In the China study, the researchers created a contact matrix of 636 people in Wuhan and 557 people in Shanghai. They called each of these people and asked them to recall everyone theyd had contact with the day before the call.

They defined a contact as either an in-person conversation involving three or more words or physical touch such as a handshake, and asked for the age of each contact as well as the relationship to the survey participant.

Comparing the lockdown with a baseline survey from Shanghai in 2018, they found that the number of contacts during the lockdown decreased by about a factor of seven in Wuhan and eight in Shanghai.

There was a huge decrease in the number of contacts, Dr. Ajelli said. In both of those places, that explains why the epidemic came under control.

The researchers also had access to a rich data set from Hunan provinces Center for Disease Control and Prevention. Officials in the province traced 7,000 contacts of 137 confirmed cases, observed them over 14 days and tested them for coronavirus infection. They had information not just for people who became ill, but for those who became infected and remained asymptomatic, and for anyone who remained virus-free.

Data from hospitals or from households tend to focus only on people who are symptomatic or severely ill, Dr. Ajelli noted. This kind of data is better.

The researchers stratified the data from these contacts by age and found that children between the ages of 0 and 14 years are about a third less susceptible to coronavirus infection than those ages 15 to 64, and adults 65 or older are more susceptible by about 50 percent.

They also estimated that closing schools can lower the reproduction number again, the estimate of the number of infections tied to a single case by about 0.3; an epidemic starts to grow exponentially once this metric tops 1.

In many parts of the United States, the number is already hovering around 0.8, Dr. Ajelli said. If youre so close to the threshold, an addition of 0.3 can be devastating.

However, some other experts noted that keeping schools closed indefinitely is not just impractical, but may do lasting harm to children.

Jennifer Nuzzo, an epidemiologist at Johns Hopkins Universitys Bloomberg School of Public Health, said the decision to reopen schools cannot be made based solely on trying to prevent transmission.

I think we have to take a holistic view of the impact of school closures on kids and our families, Dr. Nuzzo said. I do worry at some point, the accumulated harms from the measures may exceed the harm to the kids from the virus.

E-learning approaches may temporarily provide children with a routine, but any parent will tell you its not really learning, she said. Children are known to backslide during the summer months, and adding several more months to that might permanently hurt them, and particularly those who are already struggling.

Im not saying we need to absolutely rip off the Band-aid and reopen schools tomorrow, she said, but we have to consider these other endpoints.

Dr. Nuzzo also pointed to a study in the Netherlands, conducted by the Dutch government, which concluded that patients under 20 years play a much smaller role in the spread than adults and the elderly.

But other experts said that study was not well designed because it looked at household transmission. Unless the scientists deliberately tested everyone, they would have noticed and tested only more severe infections which tend to be among adults, said Bill Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health.

Assumptions that children are not involved in the epidemiology, because they do not have severe illness, are exactly the kind of assumption that you really, really need to question in the face of a pandemic, Dr. Hanage said. Because if its wrong, it has really pretty disastrous consequences.

The experts all agreed on one thing: that governments should hold active discussions on what reopening schools looks like. Students could be scheduled to come to school on different days to reduce the number of people in the building at one time, for example; desks could be placed six feet apart; and schools could avoid having students gather in large groups.

Teachers with underlying health conditions or of advanced age should be allowed to opt out and given alternative jobs outside the classroom, if possible, Dr. Nuzzo said, and children with underlying conditions should continue to learn from home.

The leaders of the two new studies, Dr. Drosten and Dr. Ajelli, were both more circumspect, saying their role is merely to provide the data that governments can use to make policies.

Im somehow the bringer of the bad news but I cant change the news, Dr. Drosten said. Its in the data.

Read more:

New Studies Add to Evidence that Children May Transmit the Coronavirus - The New York Times