EL CENTRO, Calif. For 32 years, Judy Cruz has cared for patients who showed up in the emergency room in the arid, agrarian valley that straddles Mexico along the California border.
There have been bad flu seasons that caused hospitalizations to spike; weekends when off-road vehicle collisions in the desert resulted in traumatic injuries and scorching summer days when overheated farm workers required intensive resuscitation. Among the patients was always a smattering of Americans who lived across the border.
We are a teeny tiny hospital but have always been able to manage, calling in staff on their days off or transferring one or two patients out a day to bigger facilities, said Ms. Cruz, director of the emergency department of the El Centro Regional Medical Center. Wed get a surge for 24 or 48 hours that required all hands on the deck.
Then came the coronavirus.
The hospital, which has a 20-bed intensive-care unit, has been overwhelmed with ailing residents of the Imperial Valley, as well as Americans and U.S. green card holders fleeing overcrowded clinics and hospitals in Mexicali, a city of 1.1 million on the other side of the border.
To alleviate the pressure, hospitals in nearby San Diego and Riverside counties began accepting transfers in April. But the intensifying crisis prompted California last week to activate an extraordinary response, enlisting hospitals as far north as Santa Barbara, San Francisco and Sacramento to accept patients from this remote southeastern corner of the state.
Last week, a patient was being transferred from the hospital in El Centro every two to three hours, compared to 17 in an entire month before the Covid-19 pandemic, Ms. Cruz said on a recent morning as a helicopter prepared to airlift a patient and five ambulances dropped off patients near a trio of tents erected outside the hospital to triage new arrivals.
The swelling numbers of Covid-19 patients entering the United States from Mexico comes as many parts of California have pushed down their infection rates, enabling many counties to lift stay-at-home restrictions and reopen businesses.
We worked hard to flatten the curve in California, said Carmela Coyle, president of the California Hospital Association, who issued an appeal to hospital systems across the state for help. Now we have a surge in the Imperial Valley because the situation is so severe in Mexicali.
Other parts of the border, including San Diego County, also have been scrambling with a wave of patients from Baja California, the state adjacent to California. Border towns in Arizona are experiencing an increase in infections that health officials believe is tied to people coming in from Sonora state.
Our E.R. is used to receiving patients from Mexico for things like complications from bariatric surgery and plastic surgery, and alternative cancer care, but this pandemic has brought a whole different dynamic, said Juan Tovar, physician operations executive at Scripps Mercy Hospital in Chula Vista, across the border from Tijuana, which has been hard hit by the pandemic.
Were seeing Covid patients arrive at our E.R. who are very ill, whose disease has progressed to an advanced stage because care wasnt readily available in Baja California, he said.
The border influx is likely the reason that Chula Vista has more cases per capita than San Diego, a city five times larger.
Chris Van Gorder, the president of Scripps Health, a nonprofit health system in San Diego, reported that nearly half of virus patients who checked into the Chula Vista hospital between May 24 and May 30 had recently been in Mexico. That share rose to 60 percent between May 31 and June 2.
Mr. Van Gorder and other hospital administrators have called on federal authorities to take temperatures at border entry points and to advise quarantine for those with virus symptoms.
Its pretty obvious that while the overall county is managing things well, sick people are crossing the border every day, he said.
A spokesman for U.S. Customs and Border Protection said the agency was following guidelines from the Centers for Disease Control and Prevention and referring travelers who require screening to local health authorities.
The number of cases in Imperial County reached 2,540 on Friday, up from 1,076 two weeks before. The county has the highest infection rate in California, with one in every 71 residents having contracted the virus. Per capita, the El Centro area has reported the second-most cases of any American metropolitan area over the past two weeks.
In nearby Yuma County, Ariz., which also touches the border, cases have more than doubled since Memorial Day, rising to 1,510 by Friday. The county has fewer cases per capita than some eastern Arizona counties where there are severe outbreaks on Native American reservations, but higher rates than the counties that include Phoenix and Tucson.
The health crisis along the border has underscored the deep interconnection between the United States and its neighbor to the south. Billions of dollars worth of goods and millions of people move in both directions each year.
Asylum seekers and other migrants have been barred from entering the United States since March, when President Trump closed the border to all but essential travel. But many among the 275,000 Americans and green card holders who live in Baja California, including retirees and working adults, continue to travel back and forth.
I am afraid there are no borders when it comes to a pandemic like this, said Adolphe Edward, chief executive officer of the El Centro hospital. We are together as one community, whether Americans, dual citizens or Mexicans.
Among longtime residents of the border communities, there is a sense of shared destiny.
We are bound together by our economies, families and culture, said Efrain Silva, the mayor of El Centro, who was born across the border in Mexico and still has family there. That is mainly positive for us, but also sometimes has negative consequences, like with Covid.
Mexicali, a manufacturing hub, has been buckling under a spiraling caseload of patients.
A full-blown crisis erupted in late May, about two weeks after families on both sides of the border gathered in large numbers for Mothers Day. The El Centro hospital was alerted by Mexicali hospital administrators that American patients were going to be diverted to the United States.
We see individuals who managed to walk or drive themselves to the border crossing, said Sergio A. Beltrn, the U.S. officer in charge of the ports of entry in Calexico, the California town that abuts the border. Some had arranged for an ambulance to meet them, he said; others called 911.
Paramedics from the Calexico fire department rushed to collect patients. With its intensive-care unit quickly filling up, the regional hospital in El Centro erected tents outside. Those who needed hospitalization sometimes have had to wait two or three hours for a vacant bed.
Updated June 5, 2020
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nations job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, start at no more than 50 percent of the exercise you were doing before Covid, says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. When you havent been exercising, you lose muscle mass. Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
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.)
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.
On a single day in May, the hospital had 65 Covid-19 patients. We were absolutely hammered, Ms. Cruz said. Wed had a small surge after Easter, but this was an explosion.
Mr. Edward, a retired colonel who helped oversee medical operations for the U.S. Air Force in Iraq, requested a federal disaster medical assistance team to help cope with the influx. But the lengthy hospital stay of Covid-19 patients, up to three weeks, quickly proved overwhelming.
Amid the escalating crisis, the leadership of the California Hospital Association sent an email appealing to hospitals elsewhere in the state for help.
The state is averaging 40 phone calls to place just one of these Covid patients in need thats at least 400 phone calls daily searching for a receiving hospital, the email said.
It noted that on May 27, the city of Mexicali had reported 180 deaths, twice the number in all of California.
Ron Werft, the chief executive of Cottage Hospital, a 400-bed teaching hospital in Santa Barbara, which has flattened its curve, was conducting a virtual Zoom meeting with his board and chief medical officer when the email landed.
We decided in one second we would do it, he said. Within 20 minutes we committed to taking one patient per day for the next six days.
The states emergency medical services authority has also transferred patients to Los Angeles, Newport Beach, San Francisco, Sacramento and Palm Springs.
We prepared for a surge that we didnt experience, said Randall McCafferty, a neurosurgeon at the Desert Care Network of hospitals in Palm Springs who is coordinating the transfers there. Now we are quite capable of helping them out with their struggle.
On a recent day, El Centro Regional was already caring for 49 Covid-positive patients, and helicopters had transported 14 people to other hospitals when the words Trauma Code Activation blared over the loudspeaker. A medical team quickly assembled.
Outside, where the temperature surpassed 105 degrees, paramedics in hazmat suits, masks, double gloves and goggles unloaded yet another patient from an ambulance and then another call came in over the ambulances radio.
Diego Favila, chief of the Calexico Fire Department, said his crew members had been working overtime to keep up.
This Covid crisis is taking a toll emotionally and physically, and its not letting up, he said.
Mitch Smith contributed reporting from Chicago.
Robert F. Bukaty | AP
Robert F. Bukaty | AP
In this May 29, 2020, file photo, Eric Pray unpacks a lobster on a wharf in Portland. Pray is one of many fishermen and farmers who have pivoted quickly to sell to directly to consumers after the coronavirus shutdown cut out usual sales options.
Today is Sunday. There have now been 2,524 confirmed and probable cases of the new coronavirus in all of Maines counties since the outbreak began here in March, according to the Maine Center for Disease Control and Prevention.
No new deaths were reported Saturday, leaving the statewide death toll at 98.
So far, 296 Mainers have been hospitalized at some point with COVID-19, the illness caused by the coronavirus, while 1,845 people have fully recovered from the virus, meaning there are 581 active and likely cases in the state, according to the Maine CDC. Thats down from 587 on Friday.
Heres a roundup of the latest news about the coronavirus and its impact in Maine.
The Maine CDC will provide an update on the coronavirus later today. Watch the BDN for the latest update.
Forty years ago, when the Belfast Farmers Market first started to connect farmers and producers with customers, the community around it was at an economic low ebb. stalwart members of the market have seen a lot over the years. Thats why theyre confident that the Belfast Farmers Market will be able to weather the pandemic, too a reality that makes it challenging to mark the markets big anniversary. Abigail Curtis, BDN
A $16,000 food bill finally forced restaurateur Wendyll Caisse to throw in the towel on her Bucks Naked BBQ restaurant in Windham. The rustic restaurant in Cumberland County had stocked up on brisket and other foods for what it expected to be a June 1 opening for indoor dining. But five days before, Gov. Janet Mills postponed reopenings of restaurant dining rooms in three counties, including Cumberland. Caisse was one of a dozen business people who detailed their struggles to the committee and made recommendations to help businesses survive and even thrive after the pandemic. Lori Valigra, BDN
Officials still arent sure how the novel coronavirus made its way into Maines second largest prison last month, infecting four inmates who have all since recovered, the states corrections chief said. Many suspected the universal testing would reveal a positive case among at least one staff member or vendor, who, unlike the inmates, come and go from the penitentiary and may have carried the virus inside. Since the pandemic began, officials have severely limited admissions to the prisons from county jails to prevent the spread of the virus, and the sick prisoner had been admitted months before he fell ill. It can take up to two weeks for people to show symptoms of COVID-19 after being exposed. But the testing only found positive cases among three more inmates, none of whom had entered the prison recently either. Callie Ferguson, BDN
Yard sales are a Maine summer tradition. However, this Memorial Day which is usually the kick-off to yard and garage sale season in the Pine Tree State saw fewer garage sales than usual due to fears and restrictions surrounding COVID-19 However, there are things that yard sale planners and attendees can do to make sure their event is pandemic friendly. Sam Schipani, BDN
Bangor Pride will go virtual this year, complete with a live streamed Pride Parade. But with contributions to the virtual parade from community members statewide, this years event has become Pride Across Maine. Nina Mahaleris, BDN
Mike Cushing, president of the Maine Harness Horsemens Association, predicted there will be racing at Bangor Raceway in Bass Park this year but he is not sure when. Larry Mahoney, BDN
As of early Sunday morning, the coronavirus has sickened 1,920,061 people in all 50 states, the District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands and the U.S. Virgin Islands, as well as caused 109,802 deaths, according to Johns Hopkins University of Medicine.
Elsewhere in New England, there have been 7,289 coronavirus deaths in Massachusetts, 4,055 in Connecticut, 772 in Rhode Island, 283 in New Hampshire and 55 in Vermont.
TOKYO When the coronavirus arrived in Japan, people did what they normally do: They put on masks.
Face coverings are nothing new here. During flu and hay fever seasons, trains are crowded with commuters half-hidden behind white surgical masks. Employees with colds, worried about the stigma of missing work, throw one on and soldier into the office. Masks are even used, my hairdresser once told me, by women who dont want to bother putting on makeup.
In the United States, where masks only recently arrived on the scene, they have been a less comfortable fit becoming an emblem in the culture wars. A vocal minority asserts that nobody can force anyone to put a mask on. Protesters have harassed mask-wearing reporters. The president himself has tried to avoid being seen in one.
As Japan has confounded the world by avoiding the sort of mass death from coronavirus seen in the United States, I began to wonder whether the cultural affinity for masks helped explain some of this success. It also got me thinking about the evolution in my own feelings about face coverings.
A decade ago, before we moved to Tokyo when I became The New York Times bureau chief, my husband, two children and I visited Japan to see family and friends. I had picked up a cough on the plane, and my Japanese godfather pointedly dropped into a convenience store to buy me a packet of masks.
Shame on me, but I declined to wear one they seemed unsightly and uncomfortable.
Fast forward to early this year, when news of a strange virus started emerging from China, and Japan soon reported its first case.
Advice on masks that I was reading from international experts was mixed, if not outright skeptical. The surgeon general of the United States implored the public in a tweet to STOP BUYING MASKS! The Centers for Disease Control and Prevention initially said it was not necessary to wear one if I wasnt sick.
Still, living in Tokyo, I had grown accustomed to seeing them everywhere. I decided it was better to buy some for me and my family. By then, masks were sold out in most Japanese drugstores, but the Tokyo bureau of The Times managed to procure a small supply that we had to ration.
I was sometimes confused about when to wear one, though I did so when reporting near the Diamond Princess, the cruise ship that was the site of a large coronavirus outbreak, or when I attended crowded news conferences in unventilated rooms.
It took some getting used to. The mask made my glasses fog. I didnt like the feeling of my own breath on my face.
But Im now a convert, especially since Tokyo was placed under a state of emergency in mid-April. I bought handmade cloth face coverings from a Facebook friend in Okinawa. We wash them daily and line them with coffee filters. Even though the emergency declaration was lifted in late May, I still wont let anyone in my family leave our apartment without putting on a mask.
With paper masks sold out everywhere, the Japanese government sent cloth masks in the mail in April. The initiative, which cost about $400 million, became the butt of jokes, when people discovered the masks were too small to cover most adults mouths and noses.
The masks became a symbol of failings in the governments coronavirus response. In the early months of the pandemic, Japan seemed not to follow much of the conventional epidemiological wisdom, deliberately restricting testing and not ordering a lockdown.
Yet a feared spike in cases and deaths has not materialized. Japan has reported more than 17,000 infections and just over 900 deaths, while the United States, with a population roughly two and a half times as large, is approaching 1.9 million cases and 110,000 deaths.
Japan, I think a lot of people agree, kind of did everything wrong, with poor social distancing, karaoke bars still open and public transit packed near the zone where the worst outbreaks were happening, Jeremy Howard, a researcher at the University of San Francisco who has studied the use of masks, said of the countrys early response. But the one thing that Japan did right was masks.
But one of Japans most visible responses has been near-universal mask wearing, seen here as a responsible thing to do to protect oneself and others, and as a small price to pay to be able to resume some semblance of normalcy.
Japans experience with masks goes back hundreds of years. Mining workers started using them during the Edo period, between the 17th and 19th centuries, to prevent inhalation of dust. The masks were often made from the pulp of plums, said Kazunari Onishi, author of The Dignity of Masks and an associate professor at St. Lukes International University in Tokyo.
Dr. Onishi said that early in the 20th century, the Japanese viewed masks as unattractive, but were persuaded to wear them during the 1918 flu pandemic. More recently, the Japanese public has used masks during the SARS and MERS outbreaks which also left Japan relatively unscathed as well as to protect against pollution and pollen.
During the current pandemic, scientists have found a correlation between high levels of mask-wearing whether as a matter of culture or policy and success in containing the virus.
Updated June 5, 2020
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nations job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, start at no more than 50 percent of the exercise you were doing before Covid, says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. When you havent been exercising, you lose muscle mass. Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
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.)
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.
I think there is definitely evidence coming out of Covid that Japan, as well as other countries which practice mask-wearing, tend to do much better in flattening the curve, said Akiko Iwasaki, a professor of immunobiology at Yale.
The scientific evidence on whether a mask protects the wearer from infection is mixed. But experiments show that masks can be effective in blocking the emission of respiratory droplets that may contain the virus, even when someone has no symptoms of illness. And there is some evidence that infected people with no symptoms can still transmit the coronavirus.
A study published last month suggested that just talking can launch thousands of small droplets.
Wearing a simple cloth mask could significantly block speech droplets from being released, two of the studys authors, Philip Anfinrud and Adriaan Bax of the National Institutes of Health, wrote in an email.
Dekai Wu, a professor of computer science and engineering at Hong Kong University of Science and Technology, has modeled the potential for mass mask-wearing to significantly reduce infections.
While it may be possible to establish only correlation, not causation, he said, if the downside is nothing, and the upside is huge, then you take the bet.
Still, most scientists say, masks alone are not enough; social distancing is also needed.
Many people think that just covering their mouth and nose is enough, Dr. Onishi said. If they wear a mask, they think they can go to crowded areas, but that is still very dangerous.
My family and I have seen that kind of thinking in action. On a recent weekend, we masked up and went for a bicycle ride in Tokyo. After miles of coasting down quiet residential streets and along a flower-lined path, we took a turn into a surprisingly crowded shopping arcade.
As we wove through the crowds, I spotted a long, tightly packed line for coffee at a cafe. Inside a grocery store, nobody was paying much attention to the distance between customers. At a food stand, a huddle formed around the servers window.
But nearly everyone was wearing a mask.
Hikari Hida contributed reporting.
The only thing it wants is targets, a George Mason University Ph.D. candidate in computer science, Adam Elkus, wrote of the coronavirus in March.
It does not think, he went on, it does not feel, and it lies totally outside the elaborate social nuances humans have carved out through patterns of communication, representation and discourse. And this, above all else, makes it a lethal adversary for the West. It has exposed how much of Western society is permeated with influential people who have deluded themselves into thinking that their ability to manipulate words, images and sounds gives them the ability to control reality itself.
In each stage of the American response to the coronavirus, this delusion has been at work. In the first stage it was liberals and portions of the public health establishment (including, fatefully, key decision-makers in New York City) who treated the virus as something to be spun or narrativized away, trying to define the real contagion as xenophobia or racism rather than the disease itself.
By the time this effort at reality-denial collapsed, the baton of narrative delusion had been passed to President Donald Trump, who spent crucial weeks behaving as though the power of positive thinking could suffice to keep his glorious economy afloat.
Eventually the plunging stock market and the rising infection rate forced even Trump to adapt somewhat to reality. But the next delusion belonged to some of his conservative supporters, who embraced the idea that the economic carnage was just the result of misguided government policy even though many stay-at-home orders only happened after steep drops in dining and shopping and travel, not before and that if the government simply spoke the right magic words of reopening, something close to normal life would immediately resume.
Now finally, amid the wave of protests against police brutality, the baton of words-against-reality has been passed back to the public health establishment, many of whose leaders are tying themselves in ideological knots arguing that it is not only acceptable but essential, after months circumscribing every sort of basic liberty, to encourage mass gatherings to support one particular just cause.
With this last turn, weve reached the end of the progression, because it means the original theory behind a stern public health response that the danger to life and health justified suspending even the most righteous pursuits, including not just normal economic life but the practices and institutions that protect children, comfort the dying, serve the poor has been abandoned or subverted by every faction in our national debate.
Yes, there are ongoing liberal attempts (including from the ridiculous, disastrous Bill de Blasio) to prop up a distinction between mass protests and other forms of non-distanced human life. But these attempts will fall apart: There is no First Amendment warrant to break up Hasidic funerals while blessing Black Lives Matters protests, and there is no moral warrant to claim that only anti-racism, however pressing its goals, deserves a sweeping exception from rules that have forbidden so many morally important activities for the last few months.
For the record, I still believe those rules were mostly right. The lockdowns lasted too long and imposed too much in certain places, and the George Floyd protests reflect pent-up energies that had to be released. But the rules bought time for warmer weather and social adaptations and hopefully a slower spread, they bought time for hospitals and masks and medical equipment, they brought us at least some distance closer to a vaccine and on the evidence of the stock market and the jobs numbers, they did so without creating the total economic calamity that many on the right were prophesying.
That the rules are now dissolving amid ideological double talk from health authorities says something important about the American capacity for political delusion. But it doesnt prove that we were wrong to implement them not when there are thousands of people who are still alive, and whose lives emphatically matter, because we sustained restrictions for a time.
The progression Ive described, though, in which all sides have embraced delusions or found something to value more than public health, does signal that there will be no further comprehensive attempt to fight the virus. Trump and conservatism wont support it, the public health bureaucracy wont be able to defend it, and we didnt use the time the lockdowns bought to build the infrastructure to sustain a campaign of actual suppression.
So in this sense we are back with Elkuss original point. All the virus wants is targets, and if it doesnt ultimately find another hundred thousand victims, or more than that in some autumn second wave, it will not be political decisions or public health exhortations that save us. On the left and right weve exhausted those possibilities, and like the earthlings unexpectedly preserved from alien domination at the end of The War of the Worlds, now only some inherent weakness in our enemy can save us from many, many deaths to come.
Maria Banderas (left) answers questions from medical assistant Dolores Becerra on May 18 before getting a coronavirus test at St. John's Well Child and Family Center in South Los Angeles, one of the LA neighborhoods hit hard by COVID-19. Al Seib/LA Times via Getty Images hide caption
Maria Banderas (left) answers questions from medical assistant Dolores Becerra on May 18 before getting a coronavirus test at St. John's Well Child and Family Center in South Los Angeles, one of the LA neighborhoods hit hard by COVID-19.
Mass protests against police violence across the U.S. have public health officials concerned about an accelerated spread of the coronavirus. But even before the protests began May 26, sparked by the May 25 death of George Floyd in Minneapolis, several states had been recording big jumps in the number of cases.
The head of the Centers for Disease Control and Prevention, Dr. Robert Redfield, registered his concern at a congressional hearing Thursday. He shook his head as a congresswoman showed him photos of throngs of people at the Lake of the Ozarks in Missouri over Memorial Day weekend and crowds in Florida that had assembled to watch the May 30 launch of the SpaceX Dragon crew capsule.
"We're very concerned that our public health message isn't resonating," Redfield said. "We continue to try to figure out how to penetrate the message with different groups. The pictures the chairwoman showed me are great examples of serious problems."
The U.S. is still seeing roughly 20,000 new cases a day. There's a wide range from state to state, from one case a day, on average, last week in Hawaii all the way up to to 2,614 new cases a day in California. Specific areas in the Golden State have become hot spots, along with certain counties in every Southern state.
The northeastern states of New York, New Jersey and Massachusetts which among them accounted for a quarter of all COVID-19 deaths in the U.S. are seeing a substantial slowing of new cases.
A closer look at these hard-hit areas highlights some of the common and unique challenges states face as they manage protests and begin efforts to reopen the economy amid the risks of more disease and death.
Tennessee and the Carolinas among Southern states showing jumps
In the South, the timing of new cases appears to be linked to the reopening of restaurants, barber shops and gyms, which started in most states more than a month ago. Figures tracked by NPR show the number of cases in North Carolina and South Carolina this week is up by roughly 60% from two weeks ago. In Tennessee, that increase is 75%.
Georgia and Louisiana look steadier, but they experienced some of the highest cases counts and fatalities in the region in recent weeks, at the height of the pandemic.
In Southern states that were quick to reopen, officials sometimes felt the need to explain big increases in case counts on some days. In Georgia, for example, a state health official said a big one-day increase was because of a backlog of reporting cases from a commercial lab. In Tennessee this week, a daily jump of 800 cases was blamed partially on an ongoing prison outbreak that yielded 350 new positive test results.
California case counts driven by populous Los Angeles County
In California, counties are continuing to allow businesses to reopen even as newly confirmed coronavirus cases climb. The state experienced a 40% jump in cases over the last week. Large metro areas like Los Angeles and San Francisco have gradually lifted restrictions and Californians have responded by traveling to beaches and neighboring areas, blurring the effectiveness of the varying degrees of restrictions between adjacent counties.
Los Angeles County, home to more than 10 million people, has the highest number of cases in the state. Numbers tracked by NPR show that, on average, health officials report around 1,300 new cases daily. The county has blamed slow lab results for a backlog, while acknowledging that community transmission has been ticking up, especially among communities of color.
In the Northeast, where New York City became the U.S. epicenter of the pandemic for weeks, there are still thousands of new cases every day, although the rate of increase has slowed. It's down 41% in New Jersey over the past two weeks, down 33% in New York and down 13% in Massachusetts. But health officials caution that doesn't mean the coronavirus is under control in these three states. New York is still seeing more than 1,000 new cases a day; over the past week, Massachusetts averaged just over 500 a day, and New Jersey had close to 800.
Ethnic disparities persist across the country
In Los Angeles, elderly people, particularly those who live in nursing homes have been disproportionately impacted. Almost half the people who have died from COVID-19 in the county were nursing home residents. County health officials were slow to test for the virus in nursing homes, and recent data reported by the health department shows that two-thirds of the Los Angeles County health care workers who died from the virus worked in nursing homes.
People of color have been disproportionately affected in California, as elsewhere: Latinos make up over half of the COVID-19 cases in California, where they are about 40% of the state's population. In Los Angeles County, the highest COVID death rates have been among native Hawaiians, Pacific Islanders and black residents. Minorities have an increased risk of developing underlying health conditions like high blood pressure and diabetes, making them more likely to develop a more severe illness if infected with the virus.
In Tennessee, which has one of the nation's fastest-growing case counts, neighborhoods that are home to large immigrant populations have emerged as persistent hot spots. Nashville's public health department has hired specialized community outreach workers, in partnership with immigrant advocacy organizations, to conduct contact tracing and connect families with coronavirus testing.
"We knew we had to do something different, and that's what we're doing now," says Leslie Waller, a city epidemiologist who oversees the project.
Waller acknowledges that many of the people at risk work in jobs that have been deemed essential or own businesses that can't be run remotely. Public health officials also express concern that co-workers in close-knit immigrant communities often carpool to the same jobs, and some job sites have experienced large outbreaks.
But in Southern states, rising case counts have not slowed the momentum for further lifting of restrictions. On Thursday, Tennessee announced additional loosening of restrictions for community events, allowing fairs, expos and parades. Instead of limiting the number of people who can gather, the focus has shifted to ensuring everyone can maintain social distance.
"Thanks to the continued hard work of Tennesseans and business owners operating responsibly, we're able to further reopen our state's economy," Tennessee Gov. Bill Lee said in a written statement. "These new guidelines provide useful information so that we can enjoy the events that connect us to our neighbors and communities."
There's virtually no public discussion of reinstating business restrictions, so long as hospitals can handle any uptick in illness.
Northeast states take a slower, more cautious approach to reopening
Some states in the Northeast have found ways to bring down infection rates, though many of them have put much stricter rules on businesses and public spaces.
You still can't sit down in a restaurant in New York City or anywhere in Massachusetts and New Jersey. That may be allowed in the coming weeks, but only outdoors. These states are all still in the early stages of reopening, after residents were told to stay home for almost two months and all but the most essential businesses were closed.
While most states do not have broad requirements for face coverings, rules requiring them are more common in the Northeast. In Massachusetts, some kind of face covering is required indoors and outside, if you can't stay at least 6 feet away from other people. In New York and New Jersey, masks are required in public and while riding buses or trains. Within some states, counties have varying rules, which can cause confusion. In Los Angeles County, health officials made cloth face coverings mandatory at all times when outside your home, while San Diego County only requires masks when you are within 6 feet of another person.
Residents everywhere are chafing at the rules, but in the hardest-hit states, there's a wider acceptance of social-distancing rules. A poll out last week found twice as many New York residents were worried about opening too quickly, compared with the number of New Yorkers who were worried about it happening too slowly. Polls in New Jersey and Massachusetts also have shown better than majority support for gradual, phased openings.
This story comes from NPR's reporting partnership with WBUR, Nashville Public Radio, Southern California Public Radio and Kaiser Health News.
In Europe, the virus has taken some of the last witnesses of its grim history.
For years, Gildo Negri visited schools to share his stories about blowing up bridges and cutting electrical wires to sabotage Nazis and fascists during World War II. In January, the 89-year-old made another visit, leaving his nursing home outside Milan to help students plant trees in honor of Italians deported to concentration camps.
But at the end of February, as Europes first outbreak of the coronavirus spread through Mr. Negris nursing home, it fatally infected him, too.
The virus, which is so lethal to the old, has hastened the departure of these last witnesses and forced the cancellation of anniversary commemorations that offered a last chance to tell their stories to large audiences. It has also created an opportunity for rising political forces who seek to recast the history of the last century in order to play a greater role in remaking the present one.
Throughout Europe, radical right-wing parties with histories of Holocaust denial, Mussolini infatuation and fascist motifs, have gained traction in recent years, moving from the fringes and into parliaments and even governing coalitions.
The Alternative for Germany is looking to capitalize on the economic frustration the coronavirus crisis has triggered. In France, the hard-right National Rally had the countrys strongest showing in the last European Parliament elections. And in Italy, the birthplace of fascism, the descendants of post-fascist parties have grown popular as the stigma around Mussolini and strongman politics has faded.
KEY DATA OF THE DAY
The United States reported 21,614 new infections on Thursday, and while that number is below its April peak, the daily average has been rising slightly in recent days as the continued improvement in Northeast is offset by new outbreaks in the South and parts of the West.
The uptick appears to represent a combination of increased testing, the coronavirus taking hold in more regions and outbreaks in localized hot spots. It comes during a convergence of two developments that health officials are watching warily: states and cities pressing ahead with plans to allow more businesses to reopen, and masses of people gathering around the country in large-scale protests against police brutality and racism.
More states have seen an increase in new virus cases over the past two weeks than have seen a decline, according to a New York Times database: 18 have seen a rise in new cases over that period, 17 have seen the count of new cases stay largely the same, and 15 have seen decreases.
Nationwide the number of deaths recorded each day has fallen to less half of what it was at the peak, but the daily toll still averaged 938 a day over the past week. All told there have been 108,813 known deaths in the United States, more than any other nation in the world.
There are continuing signs that the geography of the outbreak is shifting.
The hardest hit state in the nation, New York, reported 42 new virus deaths on Friday, Gov. Andrew M. Cuomo said on Friday, the states lowest figure since March. Some localities elsewhere have reported greater death tolls in recent days: Los Angeles County reported 44 deaths on Thursday, and Cook County, Ill., which includes Chicago, reported 66.
The death toll in Arizona passed 1,000 this week. Maricopa County, which includes Phoenix, has been reporting a steady increase in new virus cases, which the public health department said showed increased spread in the community. There have been at least 22,818 cases in the state.
Texas, one of the earliest states to move forward with reopening, reported 1,784 new cases on Thursday, one of its highest tallies yet. Dallas County reported 285 new cases on Thursday, a new high. There have been at least 71,330 cases of the virus in Texas, and at least 1,793 deaths.
Trump tells governor of Maine: You better get the state open.
Speaking to the employees of a production facility that manufactures swabs for Covid-19 test, President Trump continued a war of words with the states Democratic governor, Janet Mills.
You have a governor that wont let you open up, Mr. Trump said Friday during a speech at Puritan Medical Products. I might as well say it while Im up here: You better get the state open, Governor.
Ms. Mills had told the president earlier in the week that his planned trip to the medical swab factory north of Bangor may cause security problems. Mr. Trump responded by dismissing her caution and saying he was even more determined to go.
During his speech, Mr. Trump suggested Maine was missing out on crucial tourism dollars
This is your time, this is your big month, this is your Christmas, Mr. Trump said. How can you be closed?
Earlier in the day, Mr. Trump had applied similar pressure to all of the nations governors in a speech in the Rose Garden, telling Americans to do social distancing, and you wear masks if you want. He equated the pandemic to a hurricane that goes away, and within two hours, everyone is rebuilding and fixing and cleaning and cutting their grass.
The president was not subtle in his desire to move on from lingering questions about the pandemic. Even you, Mr. Trump said to reporters assembled there, I notice youre starting to get much closer together, looks much better, not all the way there yet but youll be there soon. The White House Correspondents Association said later that White House officials violated federal social distancing guidelines by moving chairs in the Rose Garden closer together before the event.
The health of the press corps should not be put in jeopardy because the White House wants reporters to be a prop for a news conference where the president refused to answer any questions, said Jonathan Karl of ABC News, the president of the White House Correspondents Association.
China warns against travel to Australia, citing fears of racial violence.
China has warned its citizens against traveling to Australia because of what it describes as rampant racial discrimination and violence in the country in the wake of the coronavirus outbreak.
The move was mostly symbolic, given that most foreign nationals are barred from traveling to Australia and that tourism has plummeted across the world because of the pandemic. It follows a series of economic punishments by China against Australia, after Australian officials led a call for an independent investigation into the spread of the coronavirus, which first emerged in the Chinese city of Wuhan.
In its announcement on Friday, the Chinese Ministry of Culture and Tourism said that racial discrimination and violence against Chinese and Asians in Australia has increased significantly.
Attacks against people of Asian descent have risen sharply across the world during the pandemic as xenophobia spreads. Asian Australians say they have endured harsh verbal harassment as well as physical attacks, including being spit on and coughed upon.
Relations between Australia and China have worsened significantly in recent weeks, as Australian officials have pushed China to allow an investigation into the virus. In response, China suspended some Australian beef imports and raised tariffs on Australian barley. China has denied that its decisions were politically motivated.
The travel warning on Friday stirred patriotic feelings in China, with many people criticizing racism in Australia.
Dont go, dont go, a Chinese internet user wrote on Weibo, a popular social media site. The motherland is the safest place.
While the early response of the French government could be faulted for some sluggishness and a shortage of masks, and more than 29,000 people died, the country has fared better than many in the pandemic, especially when compared with the United States, Italy, Spain and especially Britain.
On Friday the head of the governments scientific council, the immunologist Jean-Franois Delfraissy, declared Frances epidemic under control in an interview on French radio. Many experts credit the governments tightly enforced lockdown, mobilization of technology like high-speed trains to save patients, and closely followed counsel from scientists.
Just dont tell that to the French, who resent President Emmanuel Macron more than ever.
As they celebrated their provisional release from lockdown this week with the much-anticipated partial reopening of cafes and restaurants, the coronavirus has only reinforced the paradox of the presidents uneasy relationship with his own citizens.
On average, over half of Europes citizens outside of France even in countries with far worse records view their governments virus response favorably. In France, 66 percent have an unfavorable view, according to a recent Figaro poll.
In some ways, Mr. Macron is his own worst enemy, with a style that can come off as imperious. His speeches during the crisis were lengthy and literary, both trademarks. He reproached the French for lacking a sense of responsibilities, then later praised them for their discipline.
Asked recently on French television about his unpopularity, Mr. Macron stiffened and looked impatient.
Look, I dont sit around feeling sorry for myself, he said. Im looking ahead.
In New York City, concerns are growing that mainly peaceful protests are exposing many people to the possibility of infection, as many police officers and protesters, who are often in close quarters, were not wearing face coverings. Mayor Bill de Blasio emphasized on Friday that officers are supposed to be wearing face coverings.
It has not been happening consistently, Mr. de Blasio said on WNYC radio, adding that he was frustrated and had asked his police commissioner multiple times to address the laxness. It has to be fixed.
The mayor reiterated that the city was set to start reopening on Monday, with nonessential retailers open for curbside pickup, construction at more than 30,000 sites allowed to restart, and manufacturing resuming. Here are some other important developments around the country.
In New York, Gov. Andrew Cuomo signed an executive order late Friday afternoon allowing necessary in-person special education instruction to resume but it was not immediately clear how individual school districts would choose to implement such an order. The order also did not include specifics on where this in-person instruction would take place or what safety protocols would be implemented to protect students, teachers and parents.
In California, several new economic sectors will be allowed to reopen beginning June 12 including restaurants, gyms, museums and day camps. The states public health department released detailed guidance for reopening emphasizing maintaining social distancing, face coverings and limiting patrons. Music, film and television production and professional sports without live audiences would also be allowed to resume pending safety protocols agreed upon by labor unions, management and county health officials.
Gov. Tim Walz of Minnesota signed an executive order Friday easing restrictions on bars and restaurants, gyms, entertainment venues and salons beginning Wednesday. As a condition for reopening, businesses must maintain social distancing between patrons and limit occupancy. Workers and customers will also be required to wear masks whenever possible.
Coronavirus cases at two correctional facilities and an ICE detention center in Otero County, New Mexico swelled to 583, according to the states department of health. Otero County has become a growing hot spot in recent days, according to a New York Times database, and cases in the state have continued to rise amid efforts to reopen.
In Michigan hair and nail salons will be allowed to reopen in June 15, under an executive order issued Friday by Gov. Gretchen Whitmer.
In Louisiana, where Tropical Storm Cristobal is expected to make landfall on Sunday, the governor has declared a state of emergency and warned that the pandemic will complicate efforts for people seeking shelter. Along with the typical preparations residents would make ahead of a major storm, he has urged them to also prepare a supply of face coverings, hand sanitizer and disinfectant wipes.
Airlines say passengers must wear masks. But the rules arent enforced.
As airlines try to convince Americans to fly again, they have touted their policies for keeping passengers safe, including the requirement that everyone onboard a plane wear a mask.
But travelers on recent flights said the rules are not being enforced. And flight attendants said they have been told not to confront passengers who opt to not follow them.
Airlines have said follow the guidelines, but dont enforce them, dont tackle people to the ground and dont turn flights around if they dont listen, said Sara Nelson, president of the Association of Flight Attendants union. That gets around to the public then its, I dont have to do this. There are no consequences if I dont do this. That, too, can lead to conflict, not just with the flight attendants, but with other passengers, who get angry and all of a sudden we have to break up a fight.
On social media and in emails to The Times, travelers described facing scenarios of having to choose between confronting fellow passengers about wearing masks and possibly encountering hostility, or sitting on a flight for hours potentially being exposed to the coronavirus.
After one doctors Twitter post about the lack of social distancing on a United Airlines flight went viral, another United traveler said shed had to ask a gate agent to put on a mask before getting on a full flight to Chicago from New Jersey.
If youre traveling right now, be prepared to advocate for yourself, she wrote, adding that, United did not follow their own social distancing guidelines, and many travelers were not wearing masks.
Public health experts in the United States reacted to Mr. Trumps announcement with alarm.
We helped create the W.H.O., Dr. Thomas Frieden, the former director of the Centers for Disease Control and Prevention, told The New York Times.
Turning our back on the W.H.O. makes us and the world less safe, Dr. Friedan said.
Experts argued that global cooperation would be crucial to containing the virus, as it did six years ago during the Ebola outbreak that was raging through West Africa.
At the time, President Barack Obama sent 3,000 American troops to the region to help with the response on the ground. And Samantha Power, former ambassador to the U.N., convened the U.N. Security Council for its first ever meeting over a public health crisis and helped pass a resolution declaring the outbreak a threat to international peace and security a step that led to an infusion of funds and resources for the response effort.
Like so many 21st-century challenges, Ebola was not a zero-sum fight in which some countries could win by pursuing their interests in a vacuum, Ms. Power wrote in her book The Education of an Idealist.
The Timess Alisha Haridasani Gupta spoke to Ms. Power about what the W.H.O. would look like without the United States.
The federal government undercounted the number of virus deaths in U.S. nursing homes.
In data published for the first time on Thursday, the federal government counted 32,465 deaths of residents and workers in nursing homes, but the tally is missing thousands of deaths that occurred in facilities for the elderly and excludes some of the most notorious episodes.
The Times has been tracking outbreaks in all types of long-term care centers for the elderly, based on data provided by states, counties and nursing home operators. As of Thursday, at least 46,000 workers and residents have died of the virus.
For example, the federal account of the Life Care nursing center in Kirkland, Wash., which in late February became the first U.S. nursing home to report a major outbreak, listed one suspected infection and zero virus deaths. Health officials in Washington State have tied at least 45 deaths to that facility, dating back to February.
Though nursing homes were allowed to report infections dating back to January, the federal Centers for Medicare and Medicaid Services only required data on cases from May onward, after the virus had already peaked in the United States.
Seema Verma, the administrator of the C.M.S., said her agency was not able to require nursing homes to report infections and deaths from prior months, but that many nursing home operators had chosen to do so.
We are prohibited to do retroactive rule-making, and so we couldnt require them to do so, but we feel pretty comfortable that thats what theyve done, Ms. Verma said.
Some unemployed people in New York City are waiting hours to reach a single A.T.M.
The line started small about two months ago with a handful of people who had recently been laid off. But now, nearly three months into the economic crisis, it stretches 50 or 60 people long throughout the day and down almost an entire Manhattan block.
They are all waiting to access the same thing: the lone A.T.M. inside the only New York City branch for KeyBank, a regional Ohio bank in charge of distributing unemployment benefits to out-of-work New Yorkers.
The state provides benefits through direct deposit or on KeyBank debit cards. KeyBank has higher one-time withdrawal limits than other banks and doesnt charge a fee, making it a better option for many unemployed.
Its terrible, said Mandy Zaxanz, who spent 45 minutes traveling from her Brooklyn home to the A.T.M. It took her more than two-and-a-half hours to reach the machine.
Ms. Zaxanz, who lost her job at a Manhattan hotel in March, said she needed money to pay rent and buy food.
KeyBank officials said they would step up efforts, including stationing employees outside the branch to let people know that they can withdraw money at other banks. But state officials criticized the bank for not doing more sooner.
As Ms. Zaxanz waited, she prayed the A.T.M. would not run out of money, as it had when she tried to use it last week. It also ran out on Wednesday afternoon, which led to furious people punching nearby windows.
So far this year, more than 2.5 million unemployment claims have been filed in the state. About 500,000 people in the state receive their benefits on a KeyBank card.
Mexico is starting to bustle again, as restrictions ease in virus-free communities, the mining, construction and auto industries, and thousands of select businesses.
But many Mexicans, including medical experts, fear even the countrys gradual reopening is coming too early, and will lead to more illness and death under a pandemic that has not been brought under control in Mexico and is surging across Latin America.
Dr. Francisco Moreno, who heads the Covid unit of ABC Medical Center, one of Mexico Citys top private hospitals, said that despite doubling capacity, patients were having to be turned away.
The governments message may lead many people to think the worst is over, he said, but we are at the peak of the epidemic.
President Andrs Manuel Lpez Obrador has struggled to balance a pandemic response with the economic needs of a country in which over half of the population lives hand-to-mouth.
Early on, he played down the severity of the viruss threat, allowing soccer tournaments, concerts and preparations for the busy spring tourist season to continue.
But the relaxation of restrictions comes at a moment when the disease appears to be peaking. On Wednesday, Mexico reported 1,092 deaths, its highest daily toll to date, though the Lpez Obrador administration said the increase was caused by an administrative delay in reporting deaths. By Friday morning, the total number of dead in the country was 12,545. More developments from around the world:
Britain became the second nation to suffer more than 40,000 deaths from the coronavirus on Friday, according to British public health authorities. The country has confirmed at least 283,300 cases of coronavirus and is surpassed only by the United States in both cases and deaths.
The head of Frances governments scientific council declared Frances epidemic under control. Many experts credit the governments tightly enforced lockdown, mobilization of technology like high-speed trains to save patients, and closely followed counsel from scientists.
South Korea reported 39 new cases in and around Seoul, where a recent wave of infections had been traced to nightclubs and an e-commerce warehouse.
Prime Minister Scott Morrison of Australia warned people against attending protests this weekend organized in sympathy with American protests against racism and police brutality, saying that a large gathering could sabotage the countrys efforts to control the outbreak. Lets find a better way, and another way, to express these sentiments rather than putting your health at risk, the health of others at risk, he said.
In Indonesia, mosques opened for midday prayer in the capital, Jakarta, for the first time in more than two months, with social-distancing protocols, temperature checks, face masks and plenty of hand sanitizer.
President Recep Tayyip Erdogan of Turkey revoked a much-debated weekend lockdown, citing social and economic consequences. The countrys Interior Ministry had said residents would be confined to their homes during the weekend, but Mr. Erdogan said complaints from citizens had made him re-evaluate.
Las Vegas reopens with a new ethos: Think dirty thoughts but keep your hands clean.
Roulette wheels spun. One-armed bandits coughed out payouts. Customers erupted in cheers at hot blackjack tables. But at Las Vegass famed casinos, which reopened for business on Thursday after a 78-day shutdown, it was anything but business as usual.
Showgirls in the gambling capital of the world strutted their stuff wearing face masks. Hotel guests had their temperatures taken at check-in. Plexiglass partitions separated dealers from players, and dice were doused in sanitizer between throws.
A huge neon sign on the Aria Resort and Casino summed up Sin Citys new ethos: Think dirty thoughts but keep your hands clean.
Updated June 5, 2020
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nations job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, start at no more than 50 percent of the exercise you were doing before Covid, says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. When you havent been exercising, you lose muscle mass. Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
Covid-19 has now been afflicting humans for six months first in China and later in other nations as the virus embarked on its global conquest.The experience has been a grim one for our species. To date, more than six million people have been infected and an estimated 400,000 have died, a toll that will inevitably continue to rise for years to come.
Our world has been transformed in the process. Lockdowns have been imposed, borders have been closed, care homes for the elderly have been ravaged by illness, and national economies placed under extreme strain.
Epidemics of infectious diseases behave in different ways but the1918 influenza pandemicthat killed more than 50 million people is regarded as a key example of a pandemic that occurred in multiple waves, with the latter more severe than the first. It has been replicated albeit more mildly in subsequent flu pandemics.
How and why multiple-wave outbreaks occur, and how subsequent waves of infection can be prevented, has become a staple of epidemiological modelling studies and pandemic preparation, which have looked at everything from social behaviour and health policy to vaccination and the buildup of community immunity, also known as herd immunity.
Is there evidence of coronavirus coming back in a second wave?
This is being watched very carefully. Without a vaccine, and with no widespread immunity to the new disease, one alarm is being sounded by the experience of Singapore, which has seen a suddenresurgence in infectionsdespite being lauded for its early handling of the outbreak.
Although Singapore instituted a strong contact tracing system for its general population, the disease re-emerged incramped dormitory accommodationused by thousands of foreign workers with inadequate hygiene facilities and shared canteens.
Singapores experience, although very specific, has demonstrated the ability of the disease to come back strongly in places where people are in close proximity and its ability to exploit any weakness in public health regimes set up to counter it.
What are experts worried about?
Conventional wisdom among scientists suggests second waves of resistant infections occur after the capacity for treatment and isolation becomes exhausted. In this case the concern is that the social and political consensus supporting lockdowns is being overtaken by public frustration and the urgent need to reopen economies.
The threat declines when susceptibility of the population to the disease falls below a certain threshold or when widespread vaccination becomes available.
In general terms the ratio of susceptible and immune individuals in a population at the end of one wave determines the potential magnitude of a subsequent wave. The worry right now is that witha vaccine still months away, and the real rate of infection only being guessed at, populations worldwide remain highly vulnerable to both resurgence and subsequent waves.
Peter Beaumont
Yet we have only reached the halfway point of the diseases progress towards its first anniversary, timing that raises a host of concerns and questions about our ability to navigate our way through this pandemic. What exactly have we learned about Covid-19 over the past six months? How quickly and how well have we responded to the challenges posed by it?
And, much more importantly, what questions do we most urgently need to answer over the next six months? Answers from researchers and doctors should tell us how we might survive one of the worst crises to affect humanity in modern times.
Were we ready?
One emphatic response from scientists stresses that it is now clear we were very badly prepared for the arrival of Covid-19. This disease has turned out to be much worse than any of the pandemics that we had been anticipating and making plans to counter, said Martin Hibberd, professor of emerging infectious diseases at the London School of Hygiene & Tropical Medicine.
It has a 1% death rate and it is highly transmissible, features that were considered to be highly unlikely for any new emerging disease we thought we might face. Such features represent the worst possible realistic scenario that we could envisage and lie at the very limit of what we thought we should expect. So the pandemic we have got now is about as bad as we thought it could ever get. It is a very sobering prospect.
This point was also stressed by David Nabarro, professor of global health at Imperial College London, and an envoy for the World Health Organization on Covid-19. When we first encountered this disease, we thought it was just a respiratory illness that affected the upper part of the chest. Now it is clear that it can cause illnesses of the sinus; can affect the lining of blood vessels and can lead to blood clots developing. The disease has also been linked to extreme fatigue, kidney damage and heart attacks and quite oftenin relatively young people. This is not a disease to be underestimated.
Nor is it likely to disappear in the near future, added Mark Woolhouse, professor of infectious disease epidemiology at Edinburgh University. Having lived with Covid-19 for six months now, the most important thing we have learned is that we are going to have to live with it for an awful lot longer. Essentially we are six months into a lifelong relationship.
In such circumstances, lockdown which Woolhouse described as a panic measure but a necessary one is no longer sustainable and the problem we face over the coming months is to find ways to keep the disease at bay without recourse to imposing lockdown restrictions and their associated economic and emotional harm. And that will not be easy as has been made clear from other lessons learned over the past six months, Woolhouse added.
Disease of old age
The one key feature that we have come to appreciate about Covid-19 is that it is a disease of old age, he said. The chance that a person over 75 will die from it is actually 10,000 times greater than it is for a 15-year-old who gets infected. It is really striking.
The problems concerning the diseases impact on adults start when a person reaches 50 and get exponentially greater for each additional year of age. That means a significant proportion of our population those over 75 need protecting from this virus because its consequences for them are extremely serious, added Woolhouse. But is it right to lock up grandchildren to save their grandparents? In a sense that is what we have been doing up until now.
One idea would be to put extremely strict biosecurity systems around care homes to ensure the coronavirus never gets into them. Staff from cleaners to carers would be tested constantly for the presence of the virus. Nobody would be allowed to enter without a same-day test, said Woolhouse. It is as simple as that.
But as Woolhouse acknowledged, the vast majority of those over 75 dont live in care homes. They live in their own houses. That means we are going to have to invent the concept of household biosecurity for these people. That is one of the most urgent tasks we now face.
Test, test, test
Implementing such ideas has only become feasible because virus testing technology has improved both in accuracy and scale over the past couple of months. And that offers other advantages and opportunities to understand other questions about Covid-19, said Anne Johnson, professor of epidemiology at University College London.
Until now we have been relying heavily on mathematical models to try to understand how the virus is behaving and spreading through communities. However, mathematical models are only as good as the data that underpins them.
With the development of new virus and antibody tests, there should therefore be far greater, data-based understanding of the appearance and spread of Covid-19 cases in Britain. She said: Simple details of time, place and person we are crying out for that information in order to really understand this epidemic. We have got to be forensic in our efforts to pinpoint chains of transmission so we can stamp them out.
Mathematical models are only as good as the data that underpins them
A major problem in trying to track and control Covid-19 has arisen because infections are often being spread by symptomless carriers, Johnson added. At first we did not realise that people could be transmitting unwittingly. That has been a key lesson of the past few months.
Collecting detailed epidemiological data should now be a priority for coming months, said Johnson. What is the age, gender, ethnicity and the postal code of people who test positive? And is that infected person a healthcare worker, or are they a relative of one, or are they living with one? Once you can establish these facts quickly, then you will make an enormous difference in closing down the disease. In effect, we are entering the realm of the bug detective.
Immunity
And then there is the critical issue of the kind of immunity that has been acquired by those already infected by the virus. Studies suggest antibodies are raised in patients blood after they are infected and these could provide protection against future Covid-19 infections, said Hibberd. Reasonable estimates suggest protection might last for periods of between six months to a couple of years. However, we need to find out exactly how long such protection will last because it will have an important bearing on how the disease progresses through a population.
The longer that antibodies provide protection then the slower the disease will spread. As a result, scientists are asking that those individuals who were among the first to be infected have their blood sampled and their antibody levels tested. Have numbers of antibodies in their blood held steady or have they started to go down after only a few months? That is key research and it needs to be done now, said Hibberd.
For those who were on the front line dealing with Covid-19 cases when significant numbers began to arrive in hospitals in April, the battle to save patients overwhelmed by critical breathing difficulties was a fraught and often bewildering business. Slowly doctors and nursing staff have improved treatments, however. We are much better now at pinpointing those who will need intensive care and those who can be sent home, said Tom Wingfield, a clinician based at the Liverpool School of Tropical Medicine.
And some promising techniques have emerged in the interim such as the potential for continuous positive airway pressure machines, respirators that fit round your face, to help patients breathe. These are showing encouraging results.
However, Wingfield stressed there were still many unknowns about the impact of Covid-19 on patients. For example, it has become clear that many patients are having blood clots, and the sicker you are the more likely it is you have one. But what we dont know yet is which patients should be given blood thinners from the day they arrive to counter this clotting. Nor do we know how long we should continue that treatment.
The crucial point is that we are gathering data all the time from blood tests, oxygen levels, respiratory rates and hopefully that will help us to predict who is likely to have the worst reaction to the virus and who should be given the most intense treatments. In another six months, we should be much better informed.
Room for optimism
In the long term a vaccine may emerge as humanitys saviour. However, most scientists believe it is a relatively far-off prospect one that is unlikely to reach us for a year or two at best. As Woolhouse put it: A vaccine is a hope, not a strategy.
This point was also stressed by Nabarro: We have got to get out of this mirage sense that all will be resolved when a vaccine appears at the end of this year to save us. That is not going to happen. And even when we do get a vaccine that is safe and works, there is still the issue of how we get it to the 7.8 billion people who inhabit our planet. The global eradication of a disease is a very, very difficult business. We managed it with polio eventually, but we are still trying to get rid of measles.
However, there is still some room for optimism, say scientists. Yes, a vaccine is some way off but antiviral therapies look more hopeful, said Hibberd. Trials are now under way for a number of antiviral drugs that were developed to deal with other diseases but which are now being repurposed in the hope that they can be used to tackle Covid-19. Results are expected in a few months.
If successful, some of these could help cut death rates. We might get it from 1% right down to 0.1%. In combination with improved testing and greater understanding of our immune systems and antibody level responses to Covid-19, then I think we would find ourselves in a very different, much better position in six months. I am hopeful.
This is part of a series looking at pressing coronavirus questions of the week. We'd like to hear what you're curious about. Email us at goatsandsoda@npr.org with the subject line: "Weekly Coronavirus Questions."
What risks are there in attending a protest rally?
Modelers say it's difficult to assess how the protests will influence COVID-19 infections. But it's clear that a key ingredient for transmission is present at many of these rallies: close contact.
The images of protesters standing shoulder to shoulder some wearing face masks, others not raise concerns, especially in cities with higher rates of infection. Earlier this week Washington, D.C., Mayor Muriel Bowser said she was concerned about what mass gatherings in the streets "could mean for spikes in our coronavirus cases later." She urged protesters to consider their exposure and consider being tested.
Denver Mayor Michael Hancock announced free tests for demonstrators this week. Officials in Atlanta and New York have suggested testing as well.
"Testing everyone that participated in demonstrations would be useful in communities where many new cases are being reported every day. These new cases indicate that transmission is occurring at a high rate in the communities," said Bill Miller, an epidemiologist and physician at Ohio State University. He said there are several scenarios that could give rise to the spread of the virus or even a superspreader event, where a number of people become infected. For instance, "you might have a small number of infected people who are particularly active, moving around in the crowd. If one or more of these people are shouting often and not wearing a mask, the situation is a setup for a superspreader event," he said.
He said an alternative to testing everyone would be active contact tracing. "With new cases, the tracers could ask about demonstration participation, including days and times," Miller said. Then, if cases are linked to a demonstration, a call could go out to get everyone who participated in that event to be tested.
Being outdoors seems to reduce the risk of exposure because the virus can't survive long in sunlight and there's better air circulation, but it's no guarantee against infection. So, to reduce your own risk, it's best to continue practicing social distancing and wear a face mask. There have been family-friendly events where protesters sit in a public space such as a park or library grounds, remaining 6 feet apart.
And, of course, remember to wash your hands or use hand sanitizer after touching others or shared surfaces.
If I tested positive for the coronavirus, how long should I wait before going back out into the world?
The first thing to keep in mind when it comes to COVID-19 is that all advice is preliminary based on studies and cases experts have looked at so far. There is still a lot we don't know so guidelines and precautions may change, said Lawrence Gostin, director of the O'Neill Institute for National and Global Health Law at Georgetown University.
That said, if someone was infected with COVID-19, here are recommended guidelines for when it's safe to start going out to the grocery store and other public settings again.
The U.S. Centers for Disease Control and Prevention recommends waiting at least 10 days after the date symptoms started and at least three days after you've recovered to discontinue isolation.
Which raises a question: How do you know if you're recovered? "Recovery," according to the CDC, is defined as a resolution of fever, coupled with a progressive improvement in other symptoms without reliance on fever-reducing medication.
"The idea is 10 days after your symptoms started, the chance of being able to actually isolate a live virus [in a patient] is so low it's almost zero so the chances of being infectious after that point is [also] very low," said Abraar Karan, a physician at Harvard Medical School.
But you do have to be careful in assessing symptoms and determining if they have truly ended. Sometimes symptoms can be severe for weeks. Some patients may see a brief abatement and then have symptoms recur or become more intense. A doctor's input is critical.
Also, some symptoms, such as loss of sense of smell, can take weeks to resolve fully, said Dr. Davidson Hamer, a professor of global health and medicine at Boston University.
When it comes to risk of contagion, the symptoms to be most concerned about are cough, fever and difficulty breathing, Hamer said and those are the ones that should be completely resolved for at least three days before going out.
"People should not be out in public until at least three days after complete cessation of [these] symptoms," he said. "If they have fever, the fever should be gone, and they should not be taking Tylenol or something to suppress that fever."
The longer you can wait, the better, Gostin noted. He recommends waiting even 10 days after your symptoms are gone and then discussing with your doctor before going back to work or resuming your regular daily activities.
If you tested negative but still feel like you're exhibiting symptoms of the virus, Gostin also said it's a good idea to retest several days later for reassurance. And if you can't get tested for any reason, they said it's a good idea to follow the same 10-day, three-day rule.
If you're asymptomatic but tested positive for the coronavirus, the World Health Organization recommends waiting 10 days from the time of the positive test before discontinuing isolation.
Karan said it's still possible to transmit the virus even after waiting 10 days from the day your symptoms hit but it's pretty unlikely. "Everyone's going to be a little different," he said, "but most people fall within that 10-day window; it's considered to be relatively safe at that point."
And when you do decide to go out, experts said always use precautions such as wearing a face covering and practicing good hand hygiene washing with soap or using hand sanitizer often and using antiseptic wipes to wipe down surfaces such as door handles and grocery store carts before touching them.
If I travel to a new city, should I quarantine or self-isolate once I get there?
Some states and countries have implemented mandatory quarantines for any travelers coming in, so the first thing to do is check the requirements for your destination point and make proper arrangements beforehand. For example, through June 30, Hawaii is requiring that anybody entering the state or traveling between its islands "quarantine for 14 days or the duration of their trip, whichever is shorter," according to a proclamation from Gov. David Ige's office.
If you're not entering an area that requires a quarantine period or would still like some guidance to keep in mind when going to a new city here are some of the most important risks to weigh.
All experts we spoke to, as well as the CDC traveling guidelines, agree that one of the main factors to consider when traveling during the pandemic is the rate of transmission in the area you're coming from and the rate in the area where you're headed. If you're coming from a place with a relatively high number of new cases each day, and you're not self-isolating, you may be infected and not yet realize it.
One precaution to avoid triggering any infections in your destination then is to isolate at home as much as possible for two weeks before departure and practice social distancing measures such as wearing a mask and staying 6 feet away from others anytime you do go out in public spaces. That way you lessen the risk of unknowingly bringing the virus with you into your destination.
"I think that [even] if somebody has been sheltered at home, has been really cautious and is very unlikely to be infected when they enter a new place, then that new place might [still] recommend that they be quarantined," said Boston University's Hamer. "But honestly, their risk of transmitting disease is probably close to zero because they haven't had any exposure [in their local community]."
But there is another way you could become exposed your method of travel. If you drive alone with minimal stops, there's probably a lower chance that you have been exposed to a symptomatic individual than if you board a crowded bus or plane, said Karan of Harvard Medical School. Read more about the risks of driving versus flying here.
Self-isolation measures in a new location also depend on where you bed down once you arrive. If you're staying with friends or family, then you should discuss what precautions they have been taking before your arrival and make sure you're not exposing yourself to additional risk in their home.
"When we move from one place to another, it would be ideal to self-isolate for 14 days. But if not, try for at least five days," said Gostin, the global health specialist at Georgetown. "And when you do begin to relax measures and go back out into the world, take very special care. Be even more rigorous with your hand-washing, disinfecting, mask usage and social distancing."
ROME For years, Gildo Negri visited schools to share his stories about blowing up bridges and cutting electrical wires to sabotage Nazis and fascists during World War II. In January, the 89-year-old made another visit, leaving his nursing home outside Milan to help students plant trees in honor of Italians deported to concentration camps.
But at the end of February, as Europes first outbreak of the coronavirus spread through Mr. Negris nursing home, it infected him, too.
Shut inside, he grew despondent about missing the usual parades and public speeches on Italys Liberation Day, grander this year to mark the 75th anniversary. But the virus canceled the April 25 commemorations. Mr. Negri died that night.
The memory is vanishing, and the coronavirus is accelerating this process, said Rita Magnani, who worked with Mr. Negri, at the local chapter of the National Association of Italian Partisans. We are losing the people who can tell us in first person what happened. And its a shame, because when we lose the historical memory we lose ourselves.
Time and its ravages have already cut down the lives and blurred the memories of a generation that saw close up the ideologies and crimes that turned Europe into a killing field.
The virus, which is so lethal to the old, has hastened the departure of these last witnesses and forced the cancellation of anniversary commemorations that offered a final chance to tell their stories to large audiences. It has also created an opportunity for rising political forces who seek to recast the history of the last century in order to play a greater role in remaking the present one.
Throughout Europe, radical right-wing parties with histories of Holocaust denial, Mussolini infatuation and fascist motifs have gained traction in recent years, moving from the fringes and into parliaments and even governing coalitions.
The Alternative for Germany is looking to capitalize on the economic frustration the coronavirus crisis has triggered. In France, the hard-right National Rally had the countrys strongest showing in the last European Parliament elections. And in Italy, the birthplace of fascism, the descendants of post-fascist parties have grown popular as the stigma around Mussolini and strongman politics has faded.
Italy is especially vulnerable to the loss of memory. It has endured a severe epidemic and has the oldest population in Europe. It is also a politically polarized place where areas of consensus in other countries are constantly relitigated, with recollections of Nazi and fascist atrocities countered with retorts of summary executions by Communist partisans.
In the three-quarters of a century following Italys defeat and de facto civil war with Mussolinis short-lived Nazi puppet state in the north, the people who lived through the war and fascism have offered a living testimony that shined through the muddle. That generation was to get a final close-up and megaphone on the 75th anniversary of the wars end, in Italy and throughout Europe.
To mark the 75th anniversary of the liberation of the Dachau concentration camp, Germany had spent more than a year booking flights and hotels and organizing wheelchairs and oxygen tanks for 72 survivors and 20 American soldiers who liberated the camps. For five days starting on April 29, they were to meet one another and tell their stories. The pandemic made that impossible.
Instead, only four officials took part in the event.
Many survivors had been living for the day, said Gabriele Hammermann, who runs the Dachau concentration camp memorial, and was one of the four participants. In these times of change in which fewer and fewer survivors are able to come to the memorial site, it was of particular importance that the baton of remembrance be handed to the next generations.
On May 8, Victory in Europe day, the BBC broadcast parts of Winston Churchills speech 75 years before (We may allow ourselves a brief period of rejoicing), and Prime Minister Boris Johnson lamented the lack of parades but said that fighting the virus demands the same spirit of national endeavor as the war effort did.
In France, Genevive Darrieussecq, the secretary of state to the Minister of the Armed Forces, said regional ceremonies were canceled especially as former fighters and flag bearers are particularly exposed.
Some veterans groups have said they understood that memorials for the past needed to take a back seat to immediate health risks. Others found the absence devastating.
In Russia, which lost tens of millions of soldiers during a war that forged its national identity, President Vladimir V. Putin had planned a major military parade for May 9, to be attended by President Emmanuel Macron of France and possibly other world leaders in Moscow. Instead he made phone calls of solidarity and rescheduled the event for June 24. We will do this, he said.
In the meantime, as the virus upsets all of modern life, it is also severing connections to the past.
In Spain, Jos Mara Galante, 71, suffered during the regime of the dictator Francisco Franco and spent recent years trying to bring his torturer, Antonio Gonzlez Pacheco, a police officer known as Billy the Kid, to justice. But in March, Mr. Galante died of the virus. Weeks later, the virus also killed Mr. Gonzlez Pacheco, 73.
Its a huge loss for all those who believed that Spain should not silence its past, said Mr. Galantes longtime partner, Justa Montero.
When the virus killed Henry Kichka, a 94-year-old Belgian writer and Auschwitz survivor, on April 25, the Belgian politician Charles Picqu wrote that a great witness of Shoah left us and that it was now up to the young generations to continue his battle against hate.
In Italy, its more than just the memory of the fascist era that risks being shut away, as the country debates what to do with its vulnerable elders.
For months, officials have debated what policy to adopt for the countrys older at-risk population, including those who rebuilt the country after the war, fueled its boom and endured the domestic terrorism of the 1970s itself an echo of the civil war. In a gerontocracy like Italy, proposals to encourage the elderly to stay inside would mean shutting away much of the political, academic, industrial and business elite.
At the beginning of March, the leading health official in Lombardy asked people over 65 to stay home, a suggestion echoed by the national government in a decree.
Grandfathers published open letters to their grandchildren, urging them not to stash away the protagonists of the 1940s as useless burdens. A former president of the countrys highest court noted that the Constitution assures freedom of movement to all citizens. (I know 80- year-olds who are in great shape, he wrote.)
Who can make a society without models taken from the past? said Lia Levi, 88, an Italian writer, who is Jewish and suffered under Italys racial laws as a child. She said that many of the partisans who fought the fascists never wrote a word or became political, but simply lived their lives and told their children and grandchildren what they saw.
I can tell you when I was kicked out of school, and that I couldnt understand why, that humanizes historical facts, she said, adding, We see each other.
Unlike Germany, which has forced itself to look unflinchingly at its crimes, Italy has often looked away.
Updated June 5, 2020
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nations job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, start at no more than 50 percent of the exercise you were doing before Covid, says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. When you havent been exercising, you lose muscle mass. Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
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.)
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.
Post-fascist parties sprouted after the war, and their direct political descendants are still vibrant, and growing. Nationalism is back in vogue, with leaders purposely echoing Mussolini, whom many here openly admire.
In May, Giorgia Meloni, a rising star on the Italian right and the leader of the increasingly popular Brothers of Italy, the descendant of Italys post-fascist parties, paid tribute to a right-wing politician who once avidly supported Mussolinis racial laws.
The deaths from the virus of those who fought fascism have gotten less attention.
Piera Pattani worked clandestinely as a trusted confidante and liaison for local resistance leaders around Milan during the war. She helped allies escape from fascist Italian guards and watched the German SS take her comrades away.
Into her 90s, she remained healthy and lucid and willing to tell her stories in classrooms. She ended up in a nursing home. But in March she was infected with the virus. She died alone in the hospital at 93.
The virus did what fascism couldnt, said Primo Minelli, 72, the president of Legnano partisan association and her friend. It has brought a lot of people away who could have stayed longer.
That mattered especially now, he said, because of a political climate that he found threatening. Firsthand testimony is valued over indirect testimony, he said. There is already an attempt underway to remove the history of resistance. That effort will be sped up when the witnesses are gone.
The families of other partisans said they themselves only felt the full weight of that history now that the people who lived it had died.
You know how it is, when someones well, it seems like a fable, what they say about the past, said Teresa Baroni, 86, who lost her husband, Savino, to the virus in March. And then they are gone and it doesnt seem like a fable anymore.
She said her husband, 94, hardly ever talked about his time escaping fascists and fighting with the Mazzini brigade in San Leo, on Italys eastern coast. He turned down invitations to speak in classrooms, embarrassed about his bad Italian, and spent his life farming with his wife.
When he tested positive for the virus and ambulance workers prepared to take him to the hospital in March, his wife kept him at home, saying she had slept next to him for 66 years and wouldnt stop now. He died beside her days later, she said, taking his stories with him.
Memory goes away when those directly involved go away, and we are all old, said William Marconi, a partisan who fought Nazis in Tirano in northern Italy. And this virus is killing the old.
Mr. Marconi, 95, still lives in Tirano, where he said his inability to walk has kept him at home and away from the threat of a virus that killed one of his former comrades, Gino Ricetti, on April 26.
Mr. Marconi had written about his experiences, but had grown less than sanguine about the prospect of younger generations learning the lessons of the past.
Im not convinced memory serves, he said. Even those who know history, they do it again and again and again.
Reporting was contributed by Emma Bubola from Milan, Raphael Minder from Madrid, Christopher Schuetze from Berlin, and Monika Pronczuk from Brussels.
After Texas Gov. Greg Abbott began letting businesses reopen on May 1, medical experts and government officials expected new coronavirus cases to rise as more people ventured outside their homes.
A steep surge didnt materialize right away in North Texas, according to data from county health departments and hospitals. Emerging evidence suggests thats partly because many North Texans continued sticking close to home and took precautions when they went out.
Still, experts said, the region is in a delicate balance right now, and could quickly tip into dangerous territory.
Last week, Dallas County reported a series of record-high daily cases of COVID-19. Medical experts said those high numbers could come from expanded testing and do not necessarily signal a new wave of infections. In a news conference Thursday, Dr. Philip Huang, director of the Dallas County Health Department, said some of the recent increases may be tied to an effort to test every nursing home resident and staffer for COVID-19.
Backing up Huangs explanation are forecasts from local experts that project flat or declining COVID-19 hospitalization rates in the area in coming weeks.
The current uncertainty shows how difficult it is to predict even the near term with a brand-new virus. Disease experts know the basics still hold true: More contact means more chance for disease.
But conditions that affect transmission of the coronavirus are changing constantly. Some people wear masks; others dont. Businesses are not back to normal operations, but are gradually letting in more customers.
And its tough for health experts to track the true burden of disease in the community at any given time. Some people dont realize they have COVID-19 symptoms; others dont want to get tested, and the results can take more than a week. Blurring the picture even further is the fact that state data on the number of tests conducted by each county is not up to date.
The number of people hospitalized for COVID-19 stayed relatively flat in May. Hospitalizations are considered the most solid indicator of the course of the epidemic, experts said. Thats because hospitals are sure which patients have the disease. But hospital data reflects only how many people became infected two or three weeks earlier.
Forecasts are more reliable when new infections are rising or falling, said Rajesh Nandy, a statistician at the University of North Texas Health Science Center at Fort Worth.
But once things become stagnant, the models are not that good at predicting, he said.
Part of the reason there wasnt a sudden surge in cases may be that lifting the lockdown didnt suddenly change behaviors. Thats according to an analysis Nandy did using cellphone data that reflects peoples mobility.
Even before Abbott issued stay-at-home orders, Nandy found, people began to put themselves on lockdown: Visits to retail locations dropped and time spent at home climbed.
In the middle of April, halfway through the statewide lockdown, North Texans started to venture out more. That trend didnt suddenly change when the lockdown ended at the end of April it simply continued on the same trajectory. Still, as of last week, visits to retail establishments and restaurants were about 17 percent lower than pre-epidemic levels.
In fact, Nandy said, mobility patterns across the country all look similar over the past few months, no matter when or whether governors issued statewide lockdowns.
What that tells me is that as soon as people realized this was a serious public health issue, they took measures themselves, he said. People are making collective decisions based on how safe they feel.
Its unclear whether the gradually increasing mobility is a harbinger of more infections, Nandy said. Much depends on how people behave when they are out and about. He thinks, however, that people will respond to media coverage of cases and will adjust their behavior. How much that will help limit new infections remains to be seen.
Some worry that the general public is not getting a clear message about the continued importance of social distancing.
Ive noticed a lot of confusion with our patients, because they think that because the state has reopened that means that everything is fine, said Dr. Sharon Davis, chief medical officer of the West Dallas-based Los Barrios Unidos Community Clinic. We try to communicate with patients, saying that we still need to wear masks, and we still need to socially distance.
Davis also is concerned about the recent protests sparked by the death of George Floyd, which brought hundreds of people into the streets at a time when health officials recommend people avoid gathering in groups, could trigger new infections.
My heart is broken for whats happened in the first place, said Davis. [Peoples] voices need to be heard, but its such a terrible time to be out right now.
She said there should be more public messaging around the importance of wearing masks and keeping ones distance from others. I feel like there should be billboards everywhere. It should just become the new normal," Davis said.
Despite the record case counts in Dallas County, medical experts in North Texas continue to project flattened disease curves for now.
We continue to see a flattening or plateau in terms of the number of patients being admitted or requiring ICU care, said Dr. Miguel Benet, chief medical officer of the Medical City Healthcare hospital chain. Projections from those facilities show a plateau with a slight decreasing slope over the next two weeks, he said.
Medical City Healthcares forecast incorporates daily new positive COVID-19 cases reported by county health departments, internal hospital data on admissions, use of intensive care beds, ventilator demand and other data points. The projections cover four D-FW counties Dallas, Tarrant, Denton and Collin and are based on data from the 16 North Texas-based hospitals in Medical City Healthcares network.
Benet attributes the recent increase in positive cases reported by Dallas County to expanded testing. Medical City HealthCare has begun testing all of its surgical and obstetrics patients for the virus as well as residents coming in or out of nursing homes. Its CareNow Urgent Care clinics have expanded testing as well.
Dallas County officials also have said that expanded testing, primarily in nursing homes, could account for the rising cases. Dallas County epidemiologist Wendy Chung said that between May 31 and June 4, about 130 nursing home residents and 70 staff were reported as new cases. New cases in Dallas County have averaged 260 a day over the past seven.
In mid-May, experts at UT Southwestern Medical Center projected that new daily cases could surge more than threefold, to 800 per day, by July in Dallas County. Their latest forecast, updated May 29, shows daily case counts falling to just below 200 by July.
This is good news, said Dr. Trish Perl, chief of the division of infectious diseases at UT Southwestern. She credited government stay-at-home orders and individual social distancing measures for helping keep the disease from skyrocketing so far. But she cautioned that cases could start climbing again quickly as businesses continue to open and if people let down their guard.
The UT Southwestern forecast is based on estimates of how rapidly the disease is spreading from person to person in Dallas County. Social distancing affects how quickly the disease is transmitted.
When the researchers released their forecast, cellphone mobility data showed that encounters between people were climbing steeply. Those interactions had leveled off as of the latest forecast, which was released before the recent protests.
Perl cautioned that North Texas may not have seen the full effects of loosened restrictions. The opening has been done very carefully and slowly, she said. So I just think its going to take a little while.
An analysis of deaths from COVID-19 also signals that the disease is not currently exploding. According to scientists with the UT-Austin COVID-19 Modeling Consortium, Texas deaths peaked in late April or early May and are predicted to decline at least through late June.
Consortium director Lauren Ancel Meyers said in an email that the projections are no guarantee of what lies ahead.
We dont have a crystal ball to predict the decisions that people and policymakers are going to make in the coming weeks and months, she said. If people continue to take steps to protect themselves and others from infections, then Texas cities may not experience a second wave this summer. If we dont, then the virus will begin to spread more rapidly.
