Professional sports came to a standstill in March when an NBA player tested positive for COVID-19. Most leagues around the world have stopped games altogether. The question many of them face now isn't when games will come back but how. Apu Gomes/AFP via Getty Images hide caption
Professional sports came to a standstill in March when an NBA player tested positive for COVID-19. Most leagues around the world have stopped games altogether. The question many of them face now isn't when games will come back but how.
On this broadcast of The National Conversation, an epidemiologist and infectious disease specialist answers your questions about the available coronavirus data and when you can return to certain parts of your routines. We'll also answer your questions about professional sports and furloughed health care workers.
Here are five things you need to know about the coronavirus outbreak this Monday evening. We'll have another update on Tuesday morning.
Everyone aged five and over in the UK with symptoms can now be tested for coronavirus, Health Secretary Matt Hancock has announced. The government was "expanding eligibility for testing further than ever before", he said. Meanwhile, Dominic Raab, leading the daily No 10 briefing, said it was "not sustainable" to keep the lockdown "permanently" but ministers needed to watch the impact of every change made "very closely". A further 160 coronavirus deaths have been recorded in the UK, taking the total to 34,796 - the highest figure in Europe.
Loss of smell or taste have now been added to the UK's list of coronavirus symptoms that people should be aware of and ready to act upon. Scientific advisers told the government to update its advice, which already warned the public to look out for either a new, continuous cough or a fever. People with any of the symptoms, including loss of smell or taste, should self-isolate. It comes as the first hints that a vaccine can train people's immune system to fight coronavirus have been reported by US company Moderna.
Coronavirus lockdown measures in Scotland could begin to be lifted from 28 May, First Minister Nicola Sturgeon has announced. She said this would mean people could meet someone from another household as long as social distancing is maintained. And ministers in Northern Ireland have agreed to ease more lockdown restrictions, including allowing groups of up to six people who do not share a household to meet outdoors from Tuesday.
It is 10 days since all Isle of Wight residents were invited to test the NHS app at the heart of the government's test, track and trace strategy. So how's it going? Mixed would probably be a fair verdict, according to BBC technology correspondent Rory Cellan-Jones. One concern is that the app does not yet let users know if the person they have had contact with ends up testing positive. Instead, it has only let them know if the contact has developed symptoms. However, Foreign Secretary Dominic Raab defended the government's record on the app, telling the No 10 briefing "good progress" was being made.
The first ever virtual Chelsea Flower Show has begun, after the coronavirus lockdown forced the event to the event to be cancelled for the first time since World War Two. It usually takes place at London's Royal Hospital Chelsea, but instead content including tours of gardens by designers like Monty Don are being posted online. Organisers are billing it as being "about sharing gardening knowledge".
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Here's some advice about the easing of the lockdown measures.
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Doctors have identified a group of blood compounds that may help to reveal which children are most at risk of developing a rare but life-threatening immune reaction to coronavirus.
The new syndrome emerged last month after hospitals in London admitted a number of children to intensive care units with symptoms that resembled toxic shock mixed with an inflammatory disorder known as Kawasaki disease.
The World Health Organization (WHO) guidance on face masks has remained consistent during the coronavirus pandemic. It has stuck to the line that masks are for healthcare workers not the public.
Wearing a medical mask is one of the prevention measures that can limit the spread of certain respiratory viral diseases, including Covid-19. However, the use of a mask alone is insufficient to provide an adequate level of protection, and other measures should also be adopted, the WHO has stated.
Nevertheless, as some countries have eased lockdown conditions, they have been making it mandatory to wear face coverings outside, as a way of trying to inhibit spread of the virus. This is in the belief that the face covering will prevent people who cough and sneeze ejecting the virus any great distance.
There is no robust scientific evidence in the form of trials that ordinary masks block the virus from infecting people who wear them. There is also concerns the public will not understand how to use a mask properly, and may get infected if they come into contact with the virus when they take it off and then touch their faces.
Also underlying the WHOs concerns is the shortage of high-quality protective masks for frontline healthcare workers.
Nevertheless, masks do have a role when used by people who are already infected. It is accepted that they can block transmission to other people. Given that many people with Covid-19 do not show any symptoms for the first days after they are infected, masks clearly have a potential role to play, especially on crowded public transport as people return to work..
Sarah BoseleyHealth editor
Hospitals around the world have since reported hundreds of similar cases that many doctors believe are caused by the immune system overreacting to the virus sometimes weeks after infection.
About 100 children in Britain have been treated for the disease. Many have been admitted with a persistent fever, skin rashes, abdominal pain and cold hands or feet. At least two children in the UK have died of the disorder, one of whom was an eight-month-old baby at Plymouths Derriford hospital in April.
Researchers at Imperial College London analysed blood from some of the sickest children and found they had high levels of five compounds that can be measured in routine tests. Two of the compounds, ferritin and C-reactive protein or CRP, are common blood markers for inflammation. The others are linked to heart damage and blood clotting, namely troponin, BNP and so-called D-dimers.
We know that these markers are present in the very sick patients and at lower levels in some patients with normal Kawasaki disease, said Michael Levin, a professor of paediatrics and international child health at Imperial.
We think they can help us decide which children are at risk of progressing to cardiac failure. Essentially what were doing is using the blood markers to try and pick out the children that we need to move from district hospitals to specialist centres and then to intensive care units if needed.
It will take more research to work out if the markers are reliable. If they are, doctors could potentially identify children most at risk from the condition with a simple blood test.
To investigate further, the researchers have been granted permission from Englands chief medical officer, Prof Chris Whitty, to recruit children into a European-funded trial called Diamonds that was already underway to study inflammatory disorders. Doctors around the UK and in various hospitals in Europe are now collecting blood samples for the study to learn which markers may help them predict the severity of disease and to understand the genetics of the disorder.
This is a rapidly changing situation and we desperately need to learn how to manage it because we are now seeing quite significant numbers of children being admitted to district hospitals all over the place, Levin said.
What we dont know when were seeing a child for the first time, or hearing about them if theyre at another hospital, is which children are going to get better on their own and which are going to progress to having Kawasaki disease and are therefore at risk of getting coronary artery aneurysms, and who are the small number who will progress to multi-organ failure.
The condition, named paediatric inflammatory multisystem syndrome, resembles a mix of toxic shock and Kawasaki disease, the latter of which overwhelmingly affects children. The disease causes inflammation of the blood vessels and in some cases attacks the heart. The most serious complications are coronary aneurysms which can be fatal when they clot. Doctors typically intervene swiftly with anti-inflammatory drugs or immune-suppressing medicines.
Doctors do not have time to run a formal trial to learn which treatments work best. Instead, plans have been drawn up for an international database they will use to enter anonymous information on children in their care, including blood test results and what treatments are given when. Its not as good as a randomised trial, but its the next best thing in a pandemic. Because the numbers will be so big, it might give us a signal as to which treatments are best, Levin said.
Prof Russell Viner, the president of the Royal College of Paediatrics and Child Health, said it was too early to know how beneficial blood biomarkers might be for stratifying children with the new inflammatory disease.
This peak will tail off as the whole Covid peak tails off and we are already seeing that, Viner said. But if Covid is going to be with us for a while, and theres going to be a rise in Covid cases, we are going to see more of these cases. So we absolutely need ways of identifying early on which children might have this as opposed to a child who just presents with a fever, so biomarkers might be exceptionally helpful in the longer term.
Top 50 metropolitan destinations
outside New York City
Miami-
Fort Lauderdale-
West Palm Beach
Top 50 metropolitan destinations
outside New York City
Miami-Fort Lauderdale-
West Palm Beach
Top 50 metropolitan destinations
outside New York City
Miami-Fort Lauderdale-
West Palm Beach
Top 50 metropolitan destinations
outside New York City
Miami-
Fort Lauderdale-
West Palm Beach
By The New York TimesArrows are sized by the proportion of requests for that destination.
New York City has long been a cheek-to-jowl town with cramped apartments and determined strivers. But starting in March, as the coronavirus outbreak here began, parts of the city emptied out, with many leaving from New York's wealthiest neighborhoods. Mail-forwarding requests show where a number of them went. Some abandoned the Upper West Side for sunny Miami. Others left Gramercy Park for New Jersey. Some left Brooklyn apartments for California.
In March, the United States Post Office received 56,000 mail-forwarding requests from New York City, more than double the monthly average. In April, the number of requests went up to 81,000, twice the number from a year earlier. Sixty percent of those new requests were for destinations outside the city.
By The New York TimesSource: U.S. Postal Service
The empty feeling is the most pronounced in Manhattan. In April, a little more than half of those requests for destinations outside New York City originated in Manhattan, led by neighborhoods on the Upper West and Upper East Sides.
The data from neighborhoods that saw the most requests mirrors cell phone data showing that the city's wealthiest areas saw the most movement.
Right after Covid hit, everyone just blasted out of here, Councilwoman Helen Rosenthal said of the Upper West Side. You could walk just in the middle of Columbus Avenue. And I often did.
Miles of normally cramped streets are empty, and garbage collection is lower in those neighborhoods than in recent years. In Times Square, you can practically hear the hum of electronic signs glowing above empty sidewalks.
Many New Yorkers who fled their homes in the city moved to nearby areas in Long Island, New Jersey and upstate New York.
The Hamptons are a summer
home destination for many
New York City residents.
The Hamptons are a summer
home destination for many
New York City residents.
The Hamptons are a summer
home destination for many
New York City residents.
By The New York TimesSource: U.S. Postal Service
In most locations, the United States Postal Service allows individuals and families who normally get mail at a given location to temporarily forward their mail somewhere new, for up to a year.
Now, mail that used to go to Hells Kitchen in Manhattan is going to Maine and Connecticut. Lower East Side letters are being rerouted to Florida and Pennsylvania. Packages meant for Park Slope, Brooklyn, are going to Texas and Rhode Island.
New York City
region excluding
the city
32% of requests
Miami-
Fort Lauderdale-
West Palm Beach
N.Y.C. region
excluding
the city
32% of
requests
Miami-
Ft. Lauderdale-
W. Palm Beach
N.Y.C. region
outside the city
Miami-Ft. Lauderdale-
West Palm Beach
New York City
region excluding
the city
32% of requests
Miami-
Fort Lauderdale-
West Palm Beach
By The New York TimesSource: U.S. Postal Service
After being laid off from his job as a theater stage hand, Kurt Gardner, his wife and their young daughter left their crowded two-bedroom apartment in the Windsor Terrace section of Brooklyn for the familys three-bedroom summer home in eastern Suffolk County, on Long Island.
Mr. Gardner, 50, said he hears about friends in the city who have to wait outside an hour for Trader Joes. The Gardners now live near a well-stocked supermarket with practically no lines. Theyre surrounded by open space, and their daughter doesnt have to worry about socially distancing at Prospect Park, he said.
As for their mail, it comes maybe once a week, Mr. Gardner said. He and his wife filed mail-forwarding requests in mid-March, but he said much of his mail from March never arrived.
Brooklyn had the second-highest number of mail-forwarding requests, which were concentrated in neighborhoods like Dumbo and Brooklyn Heights.
Mail-forwarding requests
by ZIP code in April
Mail-forwarding
requests by ZIP
code in April
By The New York TimesSource: U.S. Postal Service
Black and Hispanic neighborhoods, including many areas where essential workers live, tended to have far fewer mail-forwarding requests. Roman Suarez works for a union in New York City and travels on weekends doing stand-up comedy. He was in Texas when his boss in New York called to say things were shutting down. I immediately rushed home, said Mr. Suarez, 42, who lives in the Bronx. He picks up medication and groceries for about three dozen family members who live nearby. I just stayed and made myself available for my family, he said.
His neighbors, many of whom work for the city, or in health care, stayed too, he said. His neighborhood, just east of the Bronx Zoo, had fewer than a quarter as many mail-forwarding requests as the Upper East or Upper West Sides.
My father was a cab driver. My mom was a hairdresser, so I understood service to your community, Mr. Suarez said. He recalled living through other challenging times in the city, from Hurricane Gloria in 1985 to the Sept. 11 terror attacks in 2001. Whenever New York goes through stuff, the best thing to do is just be there.
Metropolitan area
Mail-forwarding requests
New York-Newark-Jersey City
16,041
Miami-Fort Lauderdale-West Palm Beach
1,830
Philadelphia
1,456
Bridgeport-Stamford-Norwalk, Conn.
1,456
Washington-Arlington-Alexandria
1,298
Los Angeles-Long Beach-Anaheim
1,131
Boston-Cambridge-Newton
1,092
Kingston, N.Y.
963
Atlanta
710
Torrington, Conn.
Then-President Obama and then-President-elect Donald Trump shake hands during a transition planning meeting in the Oval Office at the White House in November of 2016. Jim Watson/AFP via Getty Images hide caption
Then-President Obama and then-President-elect Donald Trump shake hands during a transition planning meeting in the Oval Office at the White House in November of 2016.
With Joe Biden on the ballot, so is the legacy of Barack Obama, and it appears we're about to see a throwdown between the last president and the current one and their polar opposite worldviews.
Amid criticism of his handling of the coronavirus pandemic, President Trump has been falsely laying blame on Obama for leaving the "cupboard bare" when it comes to the national stockpile of emergency medical supplies and equipment.
And lately, Trump and conservatives have been running with allegations of potentially criminal activity by Obama administration officials for their handling of surveillance that later led to the investigation and guilty plea of Michael Flynn, Trump's three-week national security adviser. (The Department of Justice now wants to drop its case against Flynn.)
In the past week, Trump has tweeted "Obamagate" (on its own, as a retweet or as a hashtag) 18 times. Three times, he's tweeted simply "Obamagate!" with nothing else.
Neither Trump nor White House officials have been able to identify a specific crime, but it sure helps fire up the base.
Obama, for his part, seemed to reply with one word of his own Thursday: "Vote."
And then, on Saturday, he had more words during two virtual commencement addresses.
"[T]his pandemic has fully, finally torn back the curtain on the idea that so many folks in charge know what they're doing," Obama told graduates of historically black colleges and universities. "A lot of them aren't even pretending to be in charge."
Then, when speaking to graduating high school students, he said: "Do what you think is right. Doing what feels good, what's convenient, what's easy that's how little kids think. Unfortunately, a lot of so-called grownups, including some with fancy titles and important jobs, still think that way which is why things are so screwed up."
Wow.
And a week earlier, when talking to former officials from his administration, leaked audio revealed that Obama called Trump's handling of the coronavirus an "absolute chaotic disaster" and an example of what happens when a "what's in it for me" mindset "is operationalized in our government."
Pressed about Obama's remarks Sunday, Trump said he hadn't heard them, but noted, "Look, he was an incompetent president, that's all I can say, grossly incompetent."
Welcome to the 2020 presidential campaign. Reelections are always a referendum on the sitting president. But with Biden, Obama's vice president, at the top of the Democratic ticket, it's somewhat of a referendum on Obama, too.
And there's reason for Trump to want or even need to try and take Obama down a few pegs. Currently, Obama is among the most popular politicians in the country and one of the highest-polling political figures (besides his wife, Michelle.)
It's a clear and stark choice offered up to voters and one Trump seems to want front and center. He even tweeted at Republican Senate Judiciary Chair Lindsey Graham, who says he wants to hold hearings on the Flynn case, to call Obama to testify.
"Do it @LindseyGrahamSC, just do it," Trump tweeted. "No more Mr. Nice Guy."
Graham responded, telling reporters he thinks that would "be a bad precedent" to compel a former president to testify and would "open up a can of worms."
"I understand President Trump's frustration," Graham said, before warning, "but be careful what you wish for. Just be careful what you wish for."
1. Coronavirus death toll approaches 90,000: About 90,000 people are now confirmed to have died from COVID-19 in the United States, and though new cases are slowing, the country is still on pace for 100,000 deaths from the coronavirus before the end of the month.
That slowing of new cases is good news, but with two-thirds of states significantly relaxing stay-at-home restrictions, experts are concerned about a potential resurgence.
"We're seeing a decline; undoubtedly, that is something good to see," Jeffrey Shaman, an epidemiologist at Columbia University, told The New York Times. "But what we are also seeing is a lot of places right on the edge of controlling the disease."
Another good sign, though: New York Gov. Andrew Cuomo tweeted on Sunday that his state now has "more testing capacity than New Yorkers are using." And he wants not only symptomatic New Yorkers to get tested, but also those who "have been in contact with someone with COVID." That's a first step in what experts say is one of the most important things to do to try and contain the virus test as many people, including those without symptoms, as often as possible.
President Trump and Vice President Pence look on as a video plays of New York Gov. Andrew Cuomo giving a press conference in April. Jim Watson/AFP via Getty Images hide caption
President Trump and Vice President Pence look on as a video plays of New York Gov. Andrew Cuomo giving a press conference in April.
2. Will the Senate make a push for another relief package? Health versus the economy has been the tension since the beginning of the lockdowns. Unemployment has hit almost 15%, the highest since the Great Depression. And as deaths spiked in April, 20 million jobs were lost. Congress has passed four relief packages; the Democratic-led House has passed another, but Senate Republicans and the White House have balked at a fifth major package. "We have not yet felt the urgency of acting immediately," Senate Majority Leader Mitch McConnell, R-Ky., said last week.
On Tuesday, there could be more clarity on the state of the economy and what more the administration is planning to do to support people and the economy in the coming weeks when Treasury Secretary Steven Mnuchin and Federal Reserve Chair Jerome Powell appear before the Senate Banking Committee, as required by the CARES Act.
3. Watching for fallout from inspectors general firings: The firing of the State Department's inspector general, Steve Linick announced on a Friday night, which is where bad news goes to be buried in Washington is raising more questions than answers. Linick is the fourth inspector general the Trump administration has sought to remove in the past six weeks. A Democratic congressional aide told NPR's Michele Kelemen that Linick was looking into Secretary of State Mike Pompeo's conduct.
The move triggered Republican Sens. Mitt Romney, Susan Collins and Chuck Grassley to question Trump's motives. Romney said the move "chills" the IGs' essential independence and called the moves "a threat to accountable democracy." Collins said Trump had not provided "the kind of justification for the removal ... required" by law. Grassley pointed out that "written reasons" are "required" and that "A general lack of confidence simply is not sufficient." But what does the Republican Senate do to maintain the accountability that they say Trump is threatening or not abiding by? So far, during the Trump presidency, it's done little to hold him in check.
4. Senate Republicans move ahead with Hunter Biden probe: On Wednesday, the Senate Homeland Security Committee will vote on a subpoena to Blue Star Strategies. That's a company that worked with the Ukrainian energy company Burisma, which hired Biden's son Hunter to sit on its board. Republican senators are looking into whether Blue Star "sought to leverage Hunter Biden's membership on the board of directors for Burisma." Call it the impeachment backlash.
With Romney signaling he will vote in favor of the subpoena, it is expected to pass, NPR's Philip Ewing and Claudia Grisales report.
5. Supreme Court opinions Monday: The Supreme Court is expected to issue opinions Monday. We are keeping an eye out for an LGBTQ employment discrimination case, as well as whether the court thinks the Trump administration acted lawfully in shutting down the Deferred Action for Childhood Arrivals, or DACA, program. When the DACA case was argued last fall, the court's conservative majority appeared it would go along with the Trump administration. Both of these decisions could be released at any time in the next few weeks.
"After much reflection, I've concluded that circumstances don't lend themselves to my success as a candidate for president this year, and therefore I will not be a candidate."
Rep. Justin Amash of Michigan announcing via Twitter the end of his short-lived Libertarian bid for the presidency. There was much Democratic hand-wringing that Amash could cost Biden votes, especially in Michigan.
World Health Organization (WHO) Chief scientist Soumya Swaminathan on January 12, 2020 in Geneva.
FABRICE COFFRINI | AFP via Getty Images
The coronavirus pandemic may continue into the latter half of the decade, a senior global health official has warned, as the death toll of the virus approaches the grim milestone of 300,000.
Dr. Soumya Swaminathan, the World Health Organization's chief scientist, told the Financial Times' Global Boardroom webinar on Wednesday: "I would say in a four to five-year timeframe, we could be looking at controlling this."
Swaminathan said a vaccine appeared to be the "best way out" at present but warned there were lots of "ifs and buts" about its safety, production and equitable distribution.
The development of an effective vaccine and successful confinement measures were both among the factors that would ultimately determine the pandemic's duration, she added, the FT reported.
To date, more than 4.3 million people have contracted the Covid-19 infection, with 297,465 deaths worldwide, according to data compiled by Johns Hopkins University.
A global public health crisis has meant countries have effectively had to shut down, with many world leaders imposing stringent restrictions on the daily lives of billions of people.
The lockdown measures, which vary in their application but broadly include school closures, bans on public gatherings and social distancing, are expected to result in the worst economic downturn since the Great Depression in the 1930s.
In recent weeks, some countries have sought to gradually relax restrictions, allowing some shops and factories to reopen.
People wear a protective mask due to the pandemic of the new coronavirus (Covid-19), this Thursday morning, on Avenida Paulista, in the central region of the city of Sao Paulo.
Fabio Vieira | FotoRua | NurPhoto via Getty Images
However, the emergence of new Covid-19 cases in South Korea and China has exacerbated concerns about the potential for a second wave of infections.
The International Energy Agency on Thursday estimated that the number of people living under some form of confinement measures at the end of May would drop to 2.8 billion people worldwide, down from a recent peak of 4 billion.
At a separate media briefing, Dr. Mike Ryan, executive director of the WHO's emergencies program, said at the organization's Geneva headquarters on Wednesday that the coronavirus "may never go away."
When asked to address Swaminathan's comments earlier in the day, Ryan said no one would be able to accurately predict when the disease might disappear.
He added that trying to control the virus would require a "massive effort," even if a vaccine is found.
For the past four decades, globalization and urbanization have been two of the worlds most powerful drivers. Global trade increased from under 40% of the worlds GDP in 1980 to over 60% today. Over the same period, the number of people living in cities more than doubled to over 4 billion people today more than half the worlds population.
COVID-19 will reverse both of these trends, increasing the distance both between countries and among people. Some will laud these changes for increasing safety and resilience. But a world that is less global and less urban would also be less prosperous, less stable and less fulfilling.
Here are two core predictions about the world after COVID-19:
Less global, more isolated. Even before COVID-19, the decades-long trend toward ever-more globalization of trade, investment, supply chains and people flows was beginning to grind to a halt. We began to look closer to home in terms of the products we produce and consume, the people with whom we interact, and where we get our energy and our money.
In retrospect, we will come to view the years right before the 2008 financial crisis as peak globalization. Since then, the combination of recession, inequality and populism has created a growing anti-globalization and anti-immigration consensus in western countries, exemplified by the U.S. trade war with China.
The reaction of developed economies to the coronavirus will only strengthen this consensus, as all things international will be viewed as incurring unnecessary and dangerous risks. What was a growing anti-globalization consensus is poised to crystalize into a de-globalization reality.
We are being told this de-globalization will make us all more resilient. But it will also make us less prosperous with less choice and higher prices. It may also make us less secure, as international cooperation will decrease and the potential for international conflict will increase.
Less density, more distance. Urbanization is likely to be the other major casualty of the coronavirus. Unlike globalization, the trend of ever greater-urbanization was unaffected by the global financial crisis. Even America the land of all things suburban joined the global march into cities. People were attracted to cities not only for economic opportunity but also for the urban lifestyle.
After coronavirus, people will be more fearful of crowded trains and buses, cafes and restaurants, theaters and stadiums, supermarkets and offices. Crowded spaces are the lifeblood of cities. But now crowds are seen as major health risks. People who have the ability to exit the city will increasingly be tempted to do so. People who cannot leave will feel at increased risk, hunker down, and reduce their movements and contacts. It is hard to think about Manhattan without the subway and 10-deep pedestrians on Fifth Avenue. But that may be the increasing post-COVID reality.
De-urbanization would harm economic growth because cities generate enormous scale economies and have proved to be remarkably effective incubators of creativity and innovation. This could be particularly true in developing economies where the movement of people from rural areas to rapidly expanding cities has been perhaps the key driver of poverty reduction. But the shrinking of cities will have other adverse effects too, from reducing cultural vibrancy and cosmopolitanism to exacerbating climate change. In addition to being more productive, cities also tend to be more environmentally sustainable.
A world that is less global and less urban would be far less appealing to me, personally. But it is also a world that would hurt economic prosperity, reduce shared understanding among disparate people, and increase the prospect of conflict among them.
Our immediate reactions to COVID-19 will lead us to want both to de-globalize and to de-urbanize. But we must take fully into account the profound longer-term costs of doing so. Globalization and urbanization generate challenges we must confront, all the more so in a post-coronavirus world. The solution is to manage them, not to reverse them.
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Republished with permission from Knowledge@Wharton, the online research and business analysis journal of the Wharton School of the University of Pennsylvania.
The views expressed in this article are those of the author alone and not the World Economic Forum.
WASHINGTON The Trump administration will announce on Tuesday that it has signed a $354 million four-year contract with a new company in Richmond, Va., to manufacture generic medicines and pharmaceutical ingredients that are needed to treat Covid-19 but are now made overseas, mostly in India and China.
The contract, awarded to Phlow Corp. by the Biomedical Advanced Research and Development Authority, meshes President Trumps America First economic promises with concerns that coronavirus treatments be manufactured in the United States. It may be extended for a total of $812 million over 10 years, making it one of the largest awards in the authoritys history.
This is an historic turning point in Americas efforts to onshore its pharmaceutical production and supply chains, Peter Navarro, Mr. Trumps trade adviser, whose White House portfolio includes the global supply chain, said in a brief interview on Monday evening. The project, he said, will not only help bring our essential medicines home but actually do so in a way that is cost competitive with the sweatshops and pollution havens of the world.
It was unclear why the administration decided to award such a large contract to a new company when an entire industry exists known as contract manufacturing that makes drugs for other companies. However, manufacturers that operate in the United States generally make finished products using raw ingredients imported from elsewhere. They do not make the raw ingredients.
In an interview, Dr. Eric Edwards, the chief executive and president of Phlow, described the company as a public benefit corporation that was dedicated to having a social impact, and he said his firm also intended to create the nations first strategic active pharmaceutical ingredient reserve in essence, a stockpile for pharmaceutical ingredients to be used in the event of drug shortages or an emergency.
There are not a lot of people wanting to bring back generic medicine manufacturing to the United States that has been lost to India and China over decades, said Dr. Edwards, who described himself as a serial entrepreneur as well as a physician. You need someone like the federal government saying this is too important for us not to focus on.
In a statement that the Trump administration plans to release Tuesday morning, Mr. Trumps health secretary, Alex M. Azar II, called the initiative a significant step to rebuild our domestic ability to protect ourselves from health threats.
Phlow will lead a team of private sector entities that includes Civica Rx, a nonprofit created in 2018 by American hospitals to alleviate drug shortages; Ampac Fine Chemicals, a custom manufacturer of pharmaceutical ingredients; and the Medicines for All Institute, a nonprofit arm of the Virginia Commonwealth Universitys College of Engineering that also receives funding from the Bill and Melinda Gates Foundation. Dr. Frank Gupton, the founder and chief executive of Medicines for All, sits on Phlows board.
Martin van Trieste, the chief executive of Civica Rx, is also on Phlows board. And another board member, Rosemary Gibson, is a senior adviser at the Hastings Center, a nonpartisan bioethics institute, who has frequently written and testified about the dangers of the United States reliance on Chinese drug manufacturing.
Dr. Edwards said his company would focus on critical care medicines used to treat hospitalized patients with Covid-19, including medicines that are used for sedation to help patients requiring ventilator support, pain management and certain essential antibiotics. Production has already begun at an Ampac facility, he said, while Phlow builds new plants.
China is the main global supplier of the raw ingredients used in many common drugs, including antibiotics like penicillin and painkillers like ibuprofen and aspirin.
In recent years, observers like Ms. Gibson have warned about dependence on China for raw pharmaceutical ingredients, pointing to the widespread recalls in 2018 of the blood pressure drug valsartan that were traced to problems at a single Chinese factory that made the drugs active ingredient, which was contaminated with a possible carcinogen.
Dr. Edwards said Phlow was incorporated in January, though he began working on it last year, before the emergence of the coronavirus. The aim, he said, was strengthening Americas supply chain and manufacturing American generic medicines at risk of shortage. He planned at first to use advanced manufacturing technology to produce generic drugs for children. But he switched gears, he said, when the pandemic emerged, and responded to a request from the Biomedical Advanced Research and Development Authority for proposals to use advanced manufacturing to assist in the Covid-19 response.
Dr. Edwards is also a founder of the pharmaceutical company Kalo, which he created along with his twin brother, Evan Edwards, to sell the Auvi-Q, a competitor to the EpiPen, the emergency allergy treatment. The Auvi-Q, a talking auto-injectable pen, hit the market in 2013 as part of a partnership with the French pharmaceutical giant Sanofi, but Dr. Edwardss company soon ran into roadblocks.
In 2015, the Auvi-Q was recalled after it turned out the product might not have been delivering the proper dosage of epinephrine, the medicine used to stop a dangerous allergic reaction. In 2016, Sanofi ended its relationship with Kalo and returned the licensing rights. Kalo relaunched the improved Auvi-Q in 2017.
In 2016, Kalo ran into a separate controversy with its other product, Evzio, which was similar to the Auvi-Q but delivered an injection of naloxone, which can stop a drug overdose. That year, Kalo quintupled the price of Evzio, prompting letters from members from Congress who wanted to know why the company had raised the price in the middle of an opioid epidemic. (The company said it did so to cover the cost of a patient assistance program that lowered the out-of-pocket costs for people who could not afford it.)
A spokesman for Phlow said Monday night that Dr. Edwards departed Kalo on good terms over one year ago and had no oversight of drug pricing during the end of his tenure.
The last time the country faced an economic crisis, Congress saw broadband as a significant tool to jumpstart the recovery. Central to that effort was the 2010 National Broadband Plan, which addressed three fundamental questions: (1) How does our country get broadband networks everywhere, (2) how do we get everyone on those networks, and (3) how can we use broadband to improve the delivery of health care, education, public safety, economic opportunity, and other critical services?
The most important sentence in the plan, however, did not directly answer any of those questions. Rather, it addressed how to approach implementation. This plan is in beta and always will be, it read. As the country continues to struggle with persistent digital divides amid a new economic crisis brought on by the COVID-19 pandemic, the ongoing need is clear.
However, the federal government has not reevaluated or updated the plan in nearly a decade. Fortunately, in early May, Senator Ed Markey (D-Mass.) introduced legislation that, if passed, would require the FCC to update the original plan.
An update is long overdue. As the executive director of the 2010 effort, I am proud of how the plan facilitated the development of the more robust broadband networks we now rely on. But our country is far from ensuring that abundant broadband is available and affordable to all, or that we are able to take full advantage of broadbands benefits for our economy and society.
By mandating that the FCC assess the United States progress against the goals of the original plan, Sen. Markeys legislation would accelerate our progress toward those goals. In addition, the legislation adds two more important requirements:
First, it tells the FCC to assess what COVID-19 has taught us about how Americans can use broadband to learn, work, receive medical information and treatment, and participate in civic communications. Right now, Americans are more dependent on broadband access than ever. The country is much better off in this regard than we would have been 10 years ago, but not as prepared as we need to be. Sen. Markeys legislation correctly obligates the FCC to analyze the gaps revealed by the pandemic and develop policies to close them.
Second, the proposed legislation imposes genuine, ongoing accountability by directing the FCC to provide annual reports on the progress of achieving the updated plans goals. The 2010 plan called on the FCC to publish a Broadband Performance Dashboard with metrics designed to track broadband plan goals, but the agency did not do so. A congressional mandate to provide tracking is a much better enforcement mechanism than an internal recommendation.
Our country is far from ensuring that abundant broadband is available and affordable to all, or that we are able to take full advantage of broadbands benefits for our economy and society.
Whoever takes on the task of writing an updated plan will, in some ways, operate in a more hospitable environment than a decade ago. When we were writing the original plan, there was no political consensus that universal broadband was an important policy priority. Now there isas The Wall Street Journal reported last month, the COVID-19 crisis is boosting momentum for major broadband legislation, highlighting the widespread lack of high-speed internet in U.S. homes at a time when it has become more essential than ever. Leading lawmakers of both parties say the long-delayed issue of closing the so-called digital divide is gaining new prominence, as Washington weighs initiatives to help speed economic recovery and improve U.S. competitiveness.
In other ways, however, the task will be harder for the next team. We wrote the 2010 plan in an environment in which nearly everyone thought ofbroadband as being largely positive. While we raised some potential downsides, we largely focused on incentives to do more, rather than constraints on negative activities. Any plan written today would have to reflect on the fact that while the upside of using broadband is greater than ever, those downsidessuch as the loss of privacy and risks related to cybersecuritymust be addressed.
Another challenge for an updated plan will be to address international competition and legal interconnectivity. In 2010, one could reasonably believe that when it came to technology, applications, and regulation, the United States was the dominant internet actor and would continue to be. That is no longer true. Any plan now must acknowledge the global popularity of non-U.S.-based applications, regulatory efforts such as the European Unions privacy law, the limited number of network equipment manufacturers for issues such as cybersecurity, and the potential ramifications of the bifurcation of the internet between China and America, among others.
One challenge from 2010 that I suspect will be shared by the next effort is whether Congress will have an appetite for new expenditures when the plan is completed. There are two big ticket items that would likely follow from any update. First, the new plan would have to address financing deployments in unserved rural areas. Second, the update should support governments at all levels in upgrading their IT facilities to assure the systems can handle surges in broadband demand, such as we have seen during the pandemic. All government services must be available online; waiting in line at an office or filling out paper forms should be historic relics, and not the way people in need obtain help from the government any longer.
Any plan written today would have to reflect on the fact that while the upside of using broadband is greater than ever, those downsidessuch as the loss of privacy and risks related to cybersecuritymust be addressed.
When we wrote the original broadband plan, we were advised not to consider options that required significant new congressional expenditures. That was good political advice, but limited the tools available to address the problems we saw. I hope the next plan will not be so constrained.
Regardless of the challenges, updating the National Broadband Plan and incorporating lessons from the COVID-19 stress test is worth doing. As then-Treasury Secretary Timothy Geithner said during the Obama administration, Plan beats no plan. It was true then, and it is true today.
I hope Congress passes Sen. Markeys legislation to give us the broadband plan we need now. And I hope the effort learns from similar initiatives in the states, such as the one New York Governor Andrew Cuomo has assigned former Google CEO Eric Schmidt to lead. As we knew 10 years ago, and as the COVID-19 situation has made painfully clear, our country must ensure that access to abundant, affordable bandwidth facilitatesand never constrainseconomic growth or social progress. We have made progress, but we need to update our thinking on how to keep moving forward. The beta test should continue.
There are no hard and fast rules about this at this point.
MINNEAPOLIS Pierce County, Wisconsin health officials said they are monitoring a cluster of people in an apartment complex who have tested positive for coronavirus over the weekend.
Pierce County director of Public Health, AZ Snyder said they noticed a pattern after three people tested positive.
"We noticed the addresses were really similar so three confirmed positives in three different households and a total of 14 people in this complex that are experiencing symptoms," Snyder said.
Snyder clarified that the 11 people are a part of the three households with the patients who have tested positive. To address the 11 symptomatic people who haven't tested at all, the county asked for a favor.
"All 11 people have signed voluntary orders of isolation with the health department and they have all been cooperating," Snyder said. "They will stay in their apartments until they are no longer infectious."
That's one county's way of handling a handful of cases in an apartment complex.
Mike Vraa, the managing attorney for HomeLine, a tenant/renter legal help hotline said that in a lot of the calls he's been receiving regarding the Coronavirus, they're talking hypotheticals.
"You have to find answers that didn't exist before and find which ones are the most likely right answers," Vraa said. Because there isn't a precedent that lawyers can reflect on, he said he and the other attorneys are venturing into new territory with COVID-19 and renters issues.
For example, Vraa said right now there are no rules or laws that mandate a tenant who has tested positive for COVID-19 to tell anyone about their positive test result.
"There's no obligation to tell your landlord that you've tested positive and there's no obligation for your landlord to disclose it to neighbors," he said.
Vraa said there are also no specific rules for landlords either. However, he said he's mostly heard of team work among the patient, landlords and neighbors.
"They'll offer to do groceries, 'if you give me your mailbox key, i'll bring your mail up every day so you don't have to be in the communal mail area,'" Vraa said. He said people have also offered others to take their garbage out so the COVID-19 positive folks can stay inside their apartment as much as possible.
In times of uncertainty the motto of 'better safe than sorry,' seems to prevail. That's the approach Pierce County officials are taking so far in Wisconsin.
"What we're asking people to do is avoid public spaces like gyms or playgrounds or lobbies and if you can't avoid a public space it's important that people wear masks and hand wash every time they go in an out of their apartment at a minimum," Snyder said.
Vraa said being honest with your landlord will also be helpful, moving forward if you do get COVID-19.
"I think just opening up lines of communication with the landlord are going to matter a lot in trying to figure out a way to minimize any potential contact with neighbors," he said.
