(CBS News)
COVID-19 might raise stroke risk in young and middle-aged adults, with virus-linked blood clots causing severe damage to their brains, doctors warn.
Word has already spread that the novelcoronavirusappears toincrease clottingin some patients, experts say.
Now, a series of five cases at the Mount Sinai Health System in New York City indicate that those clots might cause strokes in young patients, according to a new report in the April 28 issue of theNew England Journal of Medicine.
The cases came during a two-week period from March 23 to April 7. The patients ranged in age from 33 to 49, and all were COVID-19 positive when they came to the hospital for care, Mount Sinai researchers said.
The youngest, a 33-year-old woman, developed numbness and weakness in her left side in the course of a day, after suffering cough, headache and chills for a week, the report said.
The woman tested positive forCOVID-19, and doctors found a blood clot lodged in a cerebral artery. She was treated with blood thinners and anticoagulant drugs, and after 10 days was released to a rehabilitation center.
The lead author of the report, Dr. Thomas Oxley, spoke to theWashington Postabout treating another patient in the report, a 44-year-old man.
Oxley, an interventional neurologist with Mount Sinai Beth Israel Hospital in New York City, said as he gently worked to remove a large blood clot from the mans brain, he saw new clots forming in real time around it.
Two other large medical systems, Thomas Jefferson University Hospitals in Philadelphia and NYU Langone Health in New York City, also are reporting COVID-related strokes, according to the Post.
Those centers said that 12 of their patients with clot-caused strokes had COVID-19; 40% of those were younger than 50 and had few to no stroke risk factors.
Other medical centers are on the lookout for COVID-related strokes, but havent observed any common pattern, said Dr. Fadi Nahab, an associate professor of neurology and pediatrics at Emory University School of Medicine in Atlanta.
Its definitely reasonable that the coronavirus may have an impact on the risk ofhaving stroke, Nahab said. Weve noticed there is definitelyincreased clotting riskassociated with the virus thats not typically seen in otherviral infections.
However, Nahab said he and his colleagues more typically find deep veinclots in the legsand arms associated with COVID-19, or clots in the lungs.
Its unclear to me at this point if COVID-19 is definitely increasing the rate of stroke, based on these small numbers, Nahab said.
Dr. Mark Harrigan, with the University of Alabama-Birmingham Stroke Center, said nurses have shared personal reports of blood clotting related to COVID-19.
They say that COVID-19 patients intubated with advanced disease seem to have stringier and lumpier blood, Harrigan said.
But theres been no COVID-related increase in stroke cases at his hospital, which treats 2,000 strokes a year, given its location on the buckle of the stroke belt in the southeast United States, Harrigan said.
In fact, weve had a 50% decrease in our stroke volume over the last month or so, Harrigan said.
Harrigan suspects that trend is also COVID-related, but in a different way people arent seeking medical treatment for stroke symptoms because theyre afraid theyll become infected with the coronavirus at the hospital.
Thats what happened with the 33-year-old female Mount Sinai patient in New York. Doctors report she delayed seeking emergency care because of fear of COVID-19.
This is a real problem because every extra second a stroke persists means more lost brain for the patient, Nahab said.
We are clearly seeing patients are coming to emergency rooms later, after their stroke symptoms, than they normally would, Nahab said. Many patients, even if theyre having stroke symptoms, are too afraid to actually call 911 or go to the emergency room out of fear they may get the virus.
Nahab and Harrigan encourage people to seek immediate treatment for stroke symptoms. Stroke is so devastating, and treatment is so important to get early on, Nahab said.
Editors note: The Salt Lake Tribune is providing readers free access to critical local stories about the coronavirus during this time of heightened concern. See more coverage here. To support journalism like this, please consider donating or become a subscriber.
Utah will on Friday begin relaxing some restrictions put in place in March to contain the spread of the coronavirus allowing in-restaurant dining, the reopening of businesses such as gyms and salons, and gatherings of up to 20 people, Gov. Gary Herbert announced Tuesday.
The testing capacity, medical supplies and other resources Utah has built up in the past six weeks have been pretty remarkable, Herbert said, while the willingness of residents to stay home has helped bend the curve of infections.
This has allowed the state to move from the red high risk level, described in his Utah Leads Together 2.0 Plan, to an orange, or moderate, risk level, he said. Red indicates there is a high risk of COVID-19 for everyone; orange means theres a moderate risk for everyone, and a high risk for those in vulnerable groups.
These are uncertain, challenging times, but Utahns have stepped up," Herbert said. This is a good news day for us today, as we transition from red to orange. And it only happens because of the spirit of collaboration and cooperation, which we have uniquely so in the state of Utah, the public-private partnerships, everybody working together.
Herberts announcement came as the Utah Department of Health announced that four more Salt Lake County residents with underlying medical conditions had died from COVID-19, bringing the states death toll to 45. The state added 110 new cases, bringing its overall tally to 4,343, with 21 more people hospitalized.
Moving from red to orange wont change some aspects of life in Utah. For example, Herbert said, schools will remain closed for the rest of the academic year.
Utahns should continue working from home where possible and avoid travel, Herbert said, though were not restricting travel as weve done before. He did say people should avoid traveling out of state, and self-quarantine for 14 days if they have visited places that have been viral hotspots.
As for everyday behavior, Herbert said, "social distancing is going to be a way of life.
The governor called it his pet peeve that more people dont wear masks in public. Im a little disappointed when I go into the grocery store to do shopping for [my wife] Jeanette, Herbert said. We have a mask on when we go in. The employees have masks on. But too many of the customers dont have masks.
Herbert invoked one of his Western movie heroes: Like Tonto said to the Lone Ranger, Never take off the mask.
To that end, Herbert and Lt. Gov. Spencer Cox announced a campaign, A Mask for Every Utahn, that has enlisted 20 Utah manufacturers to make 2 million reusable masks available free for people across the state. The program was funded as part of the federal stimulus bill, the CARES Act.
People can order a mask online, at coronavirus.utah.gov/mask. Cox said any household can place one order, with a maximum of six masks per order. Residents who already have a mask should let others order theirs first, Cox said. Once the supply of 2 million is exhausted, Cox said, there wont be any more.
Cotopaxi, the Park City-based outdoor-gear manufacturer, is making 500,000 masks, CEO and founder Davis Smith said. The Utah Manufacturers Association has partnered with Utah companies to make the rest, said Todd Bingham, president and CEO of the group.
While personal behavior should stay constant, Herbert said, other parts of life will start to change gradually, including:
Shopping will open up, Herbert said, but people are advised to get in and out, shop infrequently and combine trips.
Dine-in restaurant services may be available, where the restaurants follow rules including reconfiguring tables and chairs, screening employees at the start of their shifts, and screening customers. Restaurateurs, Herbert said, must be ready to tell diners who have COVID-19 symptoms that you can get some curbside service, but you cant dine inside.
The maximum number of people allowed in a mass gathering will go up from 10 to 20 which wont allow for rock concerts or Jazz games, but will permit some extended-family events. People who gather in such groups should maintain hygiene, like hand-washing, hand sanitizer and masks.
Personal care facilities such as gyms and salons can reopen, if they follow strict protocols to ensure safety.
Utahs state parks are opening up, though Herbert warned that playgrounds are still off limits. Use common sense and dont let your children play on the playground equipment, he said.
Herbert hopes national parks will open soon. Herbert said hes talking with managers of the Glen Canyon National Recreation Area, and he hopes Lake Powell will open as soon as Friday, though thats yet to be determined, Herbert said.
This is not going back to business as usual. We are not at that point yet, Herbert said. But it opens up some more economic opportunity, he said.
Local government and health officials can work with the state health department to be able to vary from the state directive, Herbert said, and remain at red or move to yellow, depending on their circumstances..
If Utahns continue to work together, he added, "good news is going to continue to happen, and pretty soon were going to be back into full-blown recovery.
Utah is seeing a flattening of its curve, and a slow reopening is a good idea, agreed state epidemiologist Dr. Angela Dunn. But people should still follow social distancing guidelines, wear masks and stay home, she echoed Herbert.
Before announcing the changes, the governor noted Utah now has the ability to test 6,000 people per day and for labs to process 9,000 tests per day. Utah has set up 62 different testing sites throughout the state and has done about 102,000 tests for COVID-19. There are also three mobile test collection sites, with one deployed at the Navajo Nation.
"Weve talked about testing ad nauseam, he said, but added, were not reaching that capacity.
Only about 70% of intensive care unit beds are being used in Utah right now, Herbert noted; a total of 370 Utahns have been hospitalized for COVID-19.
After seeking help from her doctor, she says she was offered a place on an outpatient treatment program, where she took part in therapy groups and ate three meals a day under supervision. But when the UK government announced a lockdown to help prevent the spread of coronavirus, the service was closed down for 12 weeks.
"It's been really difficult because a lot of what we are doing there is meal support," she says. Without that help, "I'm just having to wing it at home by myself."
The coronavirus pandemic has left Lisette and many others suffering with eating disorders facing new challenges and exacerbated pre-existing problems for others.
The National Eating Disorders Association (NEDA), a leading US eating disorder nonprofit, reports that it has seen a 56% increase in its instant messaging service over the past week. The service provides people with an alternative to having to speak over the phone.
"It seems like people don't feel as comfortable to make phone calls when they are in quarantine with others," said Kylee Siaw, a spokesperson for NEDA.
"Everyone who is contacting us is talking about coronavirus and how that's impacting their eating disorders," says Quinn.
Quinn says the charity has been contacted by many people who had previously considered themselves "recovered" from their eating disorder, but who fear that the pandemic has put them at risk of relapsing.
'Shopping is really difficult'
Megan Birchall, 18, from Oldham in northern England, has had anorexia since she was 15. She says the food-related panic sparked by coronavirus has been "so triggering."
Before the pandemic, she says she was making good progress, and considered herself to be in recovery. But under lockdown, her eating disorder has once again come to the fore.
Birchall lives at home with her father, who she cares for part-time, alongside her job working at an archive. As a result, she does most of the grocery shopping.
"Shopping is really difficult," she says, explaining that standing in line gives her anxiety "because there's so many people about."
Like many people with anorexia, Birchall relies heavily on so-called "safe foods," which are items people with anorexia consider safe to eat based on food group, fat and sugar content, and calorie count.
For each individual, safe foods differ. For Birchall, they are yogurt and dairy products. Because the lockdown sparked panic-buying and stockpiling across the UK, she says she has been unable to find any at her usual store. That means she has to shop around, which "triggers" her anxiety, she says.
She's also struggled to find vegetables and fresh food, forcing her to turn to frozen food and snacks.
"It feels like I'm forcing myself to eat cardboard for the sake of it," she says. The limited options available have put her off eating altogether.
"Anything around food, it's just been so much more stressful than it normally is," she says.
Birchall had been seeing counselors every two weeks, but now, under lockdown, all of her appointments are over the phone. That's hard for her to do quietly, especially since her father doesn't know the extent of her eating disorder. "The walls are so thin," she explains.
Stressful to rely on others
Like Birchall, Lisette, from Southampton on the south coast of England has found it near-impossible to get hold of the "safe foods" that would enable her to stick to her prescribed meal plan during the lockdown.
Her safe foods -- baked beans, spaghetti and other canned and packaged food -- all sold out quickly as panic-buying spread. She says this made her want to buy multiples of the same product when they became available. But having lots of food in the house makes her anxious.
"If I find some things that I'll eat, I want to buy them because I don't know when they'll be next available," she explains. But she also worries that she is "taking it away from other people that need it."
As an asthma sufferer, Lisette is following the UK government's guidance to self-isolate for 12 weeks to protect herself from coronavirus. As a result, she has to rely heavily on her boyfriend to do the shopping, which she says is "really stressful."
"I just have to give him a list of things that I want and hope that he can find them, not necessarily knowing what the alternatives are going to be," she says. "Today I was eating something different for lunch and ... I was thinking about it for about four hours in the night."
These illnesses thrive in isolation, says Cynthia Bulik, founding director of the University of North Carolina's Center of Excellence for Eating Disorders.
"Individuals who are sheltering at home can find themselves stuck in the whirlpool of their own eating-disordered thoughts, without social support of lifelines to help anchor them in a recovery mind-set," she explains.
"People's lives have been interrupted and disrupted," she adds. "People's treatment and recovery plans have been interrupted."
Bulik says that amid the coronavirus pandemic, many people with eating disorders are concerned about weight gain, gym closures and getting regular exercise.
Lisette says being at home gives her a lot of time with her thoughts to think about food, calories and exercise. "I find having a lot of time on my hands makes me want to exercise more. One, because of the eating disorder and two, because [it's] a way to pass time. I'm probably exercising more now."
Bulik says that for their part, clinicians are trying to be "extremely careful" to ensure their patients are eating healthy, balanced meals.
"When you are not able to weigh someone in your office and you are working with them virtually, you need to develop new strategies to ensure that they are safe and continuing to work toward recovery," she adds.
While Lisette speaks to a nurse, occupational therapist, and support workers several times a day, and has weekly video calls with her therapist and dietician, not being able to visit the clinic in person has affected her "massively," she said.
Birchall was on dietician-supervized meal plans before the pandemic but says the uncertainty it has sparked means she doesn't want to eat.
"We have no control right now, so you sort of latch on to the one thing you can [control]," she explains. "It really is just awful to feel completely like you've just been knocked back ... I definitely do think I'm losing weight."
If you or someone you know has an eating disorder, Beat (in the UK) has phone and chat services available on its website and NEDA (in the US) has phone, text, and chat services available on its website.
Data are coming in, and their import is clear. The coronavirus pandemic is not and never was a threat to society. COVID-19 poses a danger to the elderly and the medically compromised. Otherwise, for most who present symptoms, it can be nasty and persistent, but is not life-threatening. A majority of those infected do not notice that they have the disease. Coronavirus presents us with a medical challenge, not a crisis. The crisis has been of our own making.
On March 16, Neil Ferguson of Imperial College London predicted a coronavirus death toll of more than two million in the United States alone. He arrived at this number by assuming that infection would be nearly universal and the fatality rate would be higha terrifying prospect. The next day, Stanford epidemiologist John Ioannidis sifted through the data and predicted less widespread infection and afatality rate of between 0.05 and 1.0 percentnot that different from the common flu. The coronavirus is not the common flu. It has different characteristics, afflicting the old more than the young, men more than women. Nevertheless, all data trends since mid-March show that Ferguson was fantastically wrong and Ioannidis was largely right about its mortal threat.
But Fergusons narrative has triumphed, helped by our incontinent and irresponsible media. A young doctor in Wuhan diedCOVID-19 must be dangerous and deadly for everybody. Hospitals in Italy are overwhelmedwe are witnessing a pandemic of epic proportions. China succeeded with draconian methods of mass quarantinethese must be our only hope of protection against the coming disaster.
By the end of March, most of the United States had been locked down. Tens of millions of Americans have lost their jobs. More than $6 trillion has been spent to save society from complete collapse. Relentless warnings have whipped the populace into frenzies of fear. All of this to contain a disease that, as far as we can tell at this point, is not significantly more fatal than the flu. Moreover, given how rapidly the coronavirus spreads, it seems likely that the radical and untested method of lockdown does little to control it.
In other words, the science increasingly shows that the measures we have taken in the last few weeks have been both harmfulwith freedoms lost, money spent, livelihoods destroyedand pointless.
This statement will provoke outrage. Most will insist that it is not true. But a study from the Oise region of France found an infection rate of 25 percentwhich, if it is true for France as a whole, suggests that the virus fatality rate in that country (which is considered hard-hit) is 0.13 percent. Studies of Santa Clara and Los Angeles County likewise show rates of infection far higher than experts imagined possible, indicating fatality rates of 0.1-0.2 percent, again in line with Ioannidiss analysis. A study of women at a New York hospital who gave birth during the pandemic, and a study of a homeless shelter in Boston, likewise point to a disease far more widespread than testing has identifiedand therefore with a far lower fatality rate than previously thought.
Researchers reported that more than 30 percent of the densely populated town of Chelsea in the Boston area likely already had the virus. There the death toll has been significant, leading to higher fatality rates, though still within the range identified by Ioannidis. The same holds for studies done in Delaware and Miami, as well as Geneva, Switzerland.
In epidemiology, nothing is certain. The facts may change in the future. But as of now, this much is certain: Current data point to a disease that is far less deadly than was feared when our country hurled itself over the cliff of mass lockdown. The WHO was at that time issuing warnings that presumed a death rate 20-30 times higher than what now appears realistic.
We need fact-based policies. COVID-19 spreads rapidly, and any fast-spreading disease can strain medical resources as incidences rise. Long recovery times increase patient loads in hospitals. Careful planning and resource allocation are therefore essential. They were accomplished successfully in New York, much to the credit of medical professionals here. The American people need to be told of that success, which, given the density of New York, shows that we can and will succeed everywhere in our country.
We need to be told the truth about COVID-19s effect. It is not a uniquely perilous disease; for people under 35, it may be less dangerous than the flu. We have every reason to take prudent measures to protect vulnerable people from the disease, but we cannot reasonably expect to contain the coronavirus. The high proportion of asymptomatic carriers defeats strategies of testing and tracing contacts. In all likelihood, it also defeats such radical measures as lockdowns, as the example of Sweden seems to suggest.
These truths point toward clear and urgent action. We need to allocate resources for protecting vulnerable populations. We need rigorous testing of nursing home workers (a five-country study in Europe reported that 50 percent of coronavirus fatalities occurred in elder-care facilities) and others who care for vulnerable populations. We need to allocate funding for at-risk poor people to move to hotels or other places where they can self-isolate.
We can do this without closing every restaurant and bar. We can do this without locking churches, without requiring everybody to stay at home, without throwing tens of millions of Americans out of work. The lockdowns can and must end.
But I doubt that truth will guide decision-making. There is too much fear. Fear of the virus is compounded by the (reasonable) fear of experts, policy-makers, and politicians that if they change course they will be exposed as poorly informed, reckless, and cowardly. Our entire ruling class, which united behind catastrophism and the untested methods of mass shutdown, is implicated in the unfolding fiasco.
Journalists continue to sustain the pandemic narrative. Ioannidis is still ignored, though the evidence I outlined above has been building for weeks. Scientists who should know better are either gullible or too cowardly to speak.
Weve been stampeded into a regime of social control that is unprecedented in our history. Our economy has been shattered. Ordinary people have been terrorized by death-infused propaganda designed to motivate obedience to the limits on free movement. We have been reduced to life as medical subjects in our condition of self-quarantine. As unemployment numbers skyrocket and Congress spends trillions, the political stakes rise.
The experts, professionals, bureaucrats, and public officials who did this to us have tremendous incentives to close ranks and say, It is not wise to tell people that the danger was never grave and now has passed. Sustaining the coronavirus narrative will require many lies. It will be up to us to insist on the truth.
R. R. Reno is editor of First Things.
Photo by NurseTogether via Creative Commons. Image cropped.
JetBlue Airways aircrafts are pictured at departure gates at John F. Kennedy International Airport in New York.
Fred Prouser | Reuters
Airlines are stepping up policies to ensure that passengers and employees wear face masks on board.
Starting Monday, allJetBlue Airwayspassengers will be required to wear a face covering, the strictest policy so far in the U.S. and one that follows the New York-based airline's requirement that flight attendants wear a mask or face covering while on duty.
"Wearing a face covering isn't about protecting yourself, it's about protecting those around you," said JetBlue President Joanna Geraghty. "This is the new flying etiquette."
American Airlinesand Delta Air Linessaid they will require thousands of employees to wear face masks and will provide masks for passengers.
Airline labor unions have repeatedly demanded stronger protections against coronavirus. While air travel in the U.S. is down some 95% from a year ago, flight crews have raised concerns about catching the virus on the job and have sought federally mandated procedures.
"All airlines should follow JetBlue's lead, including its efforts to fully communicate the change before it becomes effective next week so that Flight Attendants are not put in the position of being enforcers without information and backing from the airline," said Sara Nelson, president of the Association of Flight Attendants, which represents some 50,000 cabin crew members, including those at UnitedandSpirit.
American said it will start handing out face masks and sanitizing wipes for passengers next month and require that its roughly 30,000 mainline and regional flight attendants wear masks while on duty.
Fort Worth, Texas-based American is also going to step up cleaning procedures to disinfect areas including tray tables, seat belt buckles, window shares and seat-back screens, galleys, jump seats and surfaces in the cockpit.
"Our team members on the front line are truly going above and beyond during this time," said Kurt Stache, American's senior vice president of customer experience. "Their commitment is nothing short of incredible and we will continue to work with them to make sure they have the equipment they need to feel safe."
Delta said it will require employees to wear masks or face coverings any time it's impossible to keep a distance of 6 feet between themselves and a customer or another employee, starting on Tuesday. It will reevaluate the policy by June 30.
"We are strongly encouraging our customers to wear masks and will make them available at ticket counters, gates and onboard airplanes," four Delta officials said in a staff memo, which was seen by CNBC.
United Airlineslast week started mandating masks or other face coverings for flight attendants, following similar moves byJetBlue and budget carrier Frontier Airlines.
A beloved 30-year-old middle school social studies teacher from Brooklyn has died of COVID-19 following a month-long battle, after twice being turned away for testing before eventually being diagnosed with the virus.
Rana Zoe Mungin, who had been clinging to life in the hospital for more than a month, died on Monday afternoon, her mother confirmed to ABC News.
Despite repeated pleas for help and exhibiting various symptoms of the virus, Mungin was twice denied COVID-19 testing at Brooklyn's Brookdale Hospital, according to her family.
It was the same hospital where her older sister died of an asthma attack 15 years earlier.
Rana Zoe Mungin, a 30-year-old teacher from Brooklyn, New York, is pictured during a trip to the Grand Canyon in Arizona in 2018.
According to one of her friends, her condition was also dismissed as a "panic attack" by an EMT.
Mia Mungin, a registered New York City nurse, has been chronicling her sister's journey across social media for more than a month, and said "she fought a long fight but her body was too weak."
"Racism and health disparities still continues [and] the zip code in which we live still predetermines the type of care we receive," Mia Mungin wrote on Facebook about the racial disparities in the health care system and the care received by her sister, who was black.
Rana Zoe Mungin taught at Ascend Academy in East New York, Brooklyn, an area of New York City that's among the hardest-hit by the coronavirus pandemic, according to data from the state's health department.
She was a first-generation college student who received a Bachelor of Arts in Psychology from Wellesley College and later earned a Master of Fine Arts from The University of Massachusetts, Amherst, in Creative Writing.
Her case echoes startling data released by the CDC showing that African Americans are being severely impacted by COVID-19 nationwide, accounting for 30% of coronavirus cases in the U.S. despite only comprising approximately 13% of the population.
"She died not only because of COVID-19, but because we live in a world that is racist and anti-black," her friend for more than a decade, Nohemi Maciel, told ABC News. "We know that black people are dying at disproportionate rates. This cannot be left out of the conversation."
"I'm heartbroken and don't know how to live in a world without Zoe. But I'm also angry. I'm angry that her students lost a wonderful and committed teacher, because representation matters," Maciel added.
Lauren Calihman, who met Mungin during her freshman year at Wellesley College, said that people who live in areas where city hospitals are underfunded are implicitly being told that "their lives don't matter, that they don't matter."
"Imagine if Zoe had received treatment consistent with the severity of her symptoms, rather than receiving treatment consistent with her origins," said Calihman.
Rana Zoe Mungin, a 30-year-old teacher from Brooklyn, New York, is pictured with Nohemi Maciel during a trip to the Grand Canyon in Arizona in 2018.
"She was the kind of person so captivating and sincere in her dealings with others and her writing that she naturally attracted a following, and scores of friends and admirers recently fought tooth and nail for her without ever having met her," Calihman added.
"Zoe was my rock," Maciel added "I cheered her on through grad school and she did the same for me years later. Every accomplishment and setback, Zoe was one of the first to know. She was a fierce and loyal friend."
Wellesley College President Dr. Paula Johnson, founder and former executive director of the Connors Center for Women's Health and Gender Biology as well as chief of the Division of Women's Health at Brigham and Women's Hospital, called the disproportionate impact of COVID-19 on black and Latinx families a "moral and systemic failure."
"Rana touched the lives of so many members of our community during her time here at Wellesley and beyond," Johnson, the first black woman to serve as the university's president, told ABC News in statement. "As a social studies educator in Brooklyn, Rana and her love of teaching exemplified Wellesley's mission to make a difference in the world, and our motto of Non Ministrari sed Ministrare, 'not to be ministered unto, but to minister.'"
Earlier this month, New York City Mayor Bill de Blasio announced that the city would open five additional sites to prioritize the needs of low-income communities of color as an effort to address the racial disparity in coronavirus cases.
"For Zoe, Mayor de Blasio's efforts are too little and too late, but they may not be for someone else like her," Calihman said. "I can only hope her story ignites sweeping change."
Tune into ABC at 1 p.m. ET and ABC News Live at 4 p.m. ET every weekday for special coverage of the novel coronavirus with the full ABC News team, including the latest news, context and analysis.
The NIO Inc. ES6 electric sport utility vehicle (SUV) stands on display at the Auto Shanghai 2019 show in Shanghai, China, on Tuesday, April 16, 2019.
Qilai Shen | Bloomberg | Getty Images
ForChinese electric vehicle company Nio, the worst of the coronavirus impact is pretty much over, CEO William Li said Wednesday.
"Nio hasn't lowered its annual forecast as a result of the virus," Li said in a call with reporters, according to a CNBC translation of his Mandarin-language remarks. "There was certainly some impact in the first quarter, but for the second quarter, right now we don't think there is much of an impact to the original plan."
He said the virus had primarily affected Nio's supply chain, which has been fine since the second half of March. The company's product release schedule and research and development haven't been affected that much, Li added.
The upbeat tone comes after Nio's U.S.-traded shares lost more than a third of their value last year amid financial struggles and a slump in the domestic auto market, while Elon Musk's electric car company Teslamade progress on its factory in Shanghai.
Nio announced Wednesday that strategic investors would inject 7 billion yuan ($1 billion) into the company, likely this quarter, as part of a previously announced plan to establish its China headquarters in Hefei, Anhui province.
"This raise can certainly resolve Nio's capital needs for a relatively long period of time, Li said.He added he hopes the company can reach profitability sooner rather than later, but patience is needed.
Shares of Nio spiked more than 15% in pre-market trading.
The highly contagious disease, Covid-19, first emerged late last year in the Chinese city of Wuhan. The outbreak has stalled domestically, but has since become a global pandemic, infecting more than 3 million people worldwide and killing over 217,000 people. Attempts to control the spread of the coronavirus have severely disrupted economic activity.
In New York, one of the hardest hit states, rates of hospitalization, intubation and deaths are down, Gov. Andrew Cuomo said Sunday.
He said the state is planning for a phased reopening, starting with construction and manufacturing activities at "those businesses that have a low risk."
The earliest the state will begin its first phase of reopening is May 15 but only in regions that have seen a 14-day decline in hospitalizations.
How much longer to stay at home
Officials at all levels of government are weighing how to proceed and when to reopen their communities.
Miami-Dade County Mayor Carlos Gimenez will explain emergency orders Monday on the reopening of parks, waterways and golf courses, his press office said Sunday. But at the state level, Florida Gov. Ron DeSantis said he is not putting a date on the state reopening, even though the Florida's stay at home orders are set to expire Thursday.
"We are going to do everything in a smart way," DeSantis said in a news conference Sunday. "I am less concerned about the date and more concerned about getting it right."
Reports of overexposure to disinfectants
In Michigan, there were 65 reported overexposure cases between April 1 and April 25, a 400% increase from the same time last year. In addition to cleaning supply overexposure, Tennessee's poison control center has seen a jump in the number of people hospitalized from exposure to hydrogen peroxide, a common ingredient in disinfectants, according to the Tennessean newspaper.
In Illinois calls to poison control included someone who used a detergent based solution for a sinus rinse and another who gargled a mixture of mouthwash and bleach to kill germs, Illinois Public Health Director Dr. Ngozi Ezike said during a Saturday afternoon news conference.
"All I know is this, when the person with the most powerful position on the planet is encouraging people to think about disinfectants whether it was serious or not, people listen," Michigan Gov. Gretchen Whitmer told ABC's "This Week." "I want to say unequivocally, no one should be using disinfectants to digest it to fight Covid-19, please don't do it."
Hope in antibodies and treatments
Researchers across the country are working to find effective methods to fight the virus.
"We don't know if it has any benefit. We really don't. I swear we don't," he said. "People are hoping for anything. But we need to do this clinical trial."
Physicians at a hospital in Orlando, Florida, said Sunday that at least two patients are seeing "drastic improvements" after convalescent plasma transplants, which uses the antibodies from recovered patients to treat those who are currently sick.
Testing of antibodies will also help Boston to evaluate exposure to the virus in the city. Mayor Martin Walsh announced that 1,000 asymptomatic residents will undergo diagnostic and antibody testing, which is expected to be done by Friday.
More outbreaks at meat plants
The ongoing pandemic, meanwhile, has led to the closure of another meat production plant.
A JBS USA beef production plant in Green Bay, Wisconsin, will temporarily close due to the pandemic, the company announced Sunday. The county where the plant is located has at least 776 confirmed cases and two deaths as of Sunday.
Processing plants and slaughterhouses have been shutting their doors in recent weeks. Smithfield Foods in Sioux Falls, South Dakota, JBS pork processing in Worthington, Minnesota, and Tyson Fresh Foods in Waterloo, Iowa, three of the largest pork processing plants in the country, have already closed indefinitely while smaller ones have done so temporarily.
"The closure of this facility, combined with a growing list of other protein plants that have shuttered across our industry, is pushing our country perilously close to the edge in terms of our meat supply," Smithfield Foods CEO Ken Sullivan said. "It is impossible to keep our grocery stores stocked if our plants are not running."
CNN's Holly Yan, Devan Cole, Chuck Johnston, Elizabeth Cohen, Sheena Jones, Laura Ly and Erica Henry contributed to this report.
Iowa will allow elective surgeries to resume and farmers markets to reopen starting Monday.
Tennessee restaurants can welcome customers at 50% capacity, and retail stores can reopen under those same guidelines Wednesday, Tennessee Gov. Bill Lee said.
States forge ahead
Some states have already started reopening. Hawaii has reopened beaches for visitors to fish and exercise, but loitering will not be allowed, Gov. David Ige said Saturday.
And Alaska has allowed many salons and restaurants to open, though they can't exceed 25% capacity.
In Oklahoma, salons, barbershops, spas and pet groomers took appointments Friday, and some state parks and outdoor recreation areas also reopened.'
In New York -- the hardest-hit US city -- the goal is get people back to work, Mayor Bill de Blasio said.
De Blasio announced the formation of a "Fair Recovery Task Force, which will deliver a preliminary road map by June 1 for the state's recovery from the economic effects of the pandemic.
Gov. Andrew Cuomo said New York state has seen a rise in domestic violence, alcoholism, drug use and demands for mental health treatment. But the earliest the state will begin its first phase of reopening is May 15, and then only in regions that have seen a 14-day decline in hospitalizations, he said.
If everything goes well, Cuomo said he expects to see parts of upstate New York open first, and the construction and manufacturing sectors open first with "certain precautions."
New Jersey, the only other state beside New York with more than 100,000 cases, is "still a number of weeks away" from reopening, Gov. Phil Murphy told NBC's "Meet the Press" on Sunday.
In Florida, which has more than 31,000 cases and where a stay-at-home order is set to expire Thursday, Gov. Ron DeSantis is not ready to announce a reopening date.
"We are going to do everything in a smart way," DeSantis said. "I am less concerned about the date and more concerned about getting it right."
Mayors call for more caution
Some mayors say their cities shouldn't reopen yet because a surge in coronavirus cases would set the economy back further.
Atlanta Mayor Keisha Lance Bottoms tweeted a chart Saturday showing the numbers of coronavirus cases and deaths in the area.
"If you're getting your nails done right now, please share these noon numbers with your manicurist #StayHomeGeorgia," the mayor tweeted.
In the nearby suburb of Brookhaven, Mayor John Ernst said he would rather nonessential businesses wait until Georgia reaches a 14-day downward trend in cases.
"Even the (business owners) who open up say, 'I don't know if I'm doing the right thing,'" Ernst said.
But the images of crowded beaches were in stark contrast to scenes in Los Angeles County, where beaches remain closed through May 15 under the county's stay-home order. Los Angeles Mayor Eric Garcetti urged residents to stay inside.
"We can't let one weekend reverse a month of work that you have invested in," he said.
In Colorado, Gov. Jared Polis announced he is letting stay-at-home orders expire Sunday but urged residents to stay home "as much as possible."
Polis said while he is worried about a second spike later this year, his administration is targeting a policy of 60% to 65% "social distancing from the way people used to live," he told CNN.
On Monday, April 27, retail businesses can open for curbside delivery, real estate home showings can resume, and elective surgeries are allowed if facilities are following protocols, according to an order Polis signed Sunday.
On May 1, retail businesses can phase in public openings if they are implementing best practices, and personal services can reopen.
On May 4, offices can reopen at 50% staffing capacity if best practices are being implemented, although businesses are still encouraged to continue to allow employees to telecommute when possible.
Asked if he's worried his state's plan could cost lives, Polis said, "What matters a lot more than the date that the stay-at-home order ends is what we do going forward."
In the state's biggest city, nothing will change Sunday, Denver Mayor Michael Hancock said.
"Stay in place and know that none of the locations that were closed during the order will open up," Hancock said.
Fauci says 'we're not there yet' with testing
A key component to safely reopening the economy is adequate levels of testing, health officials have said.
Dr. Anthony Fauci, a member of the White House Coronavirus Task Force, says the US should double the number of diagnostic testing for coronavirus over the next several weeks.
"We're getting better and better at it as the weeks go by, but we are not in a situation where we say we're exactly where we want to be with regard to testing," said Fauci, the director of the National Institute of Allergy and Infectious Diseases.
"I think we're going to get there, but we're not there yet."
The US needs to "have enough tests to respond to the outbreaks that will inevitably occur as you try and ease your way back into the different phases," Fauci said.
The type of tests are important, too, Dr. Deborah Birx of the White House coronavirus task force told "Meet the Press" on Sunday. She said health experts need to be able to conduct tests for antigens -- substances that stimulate the body's immune response -- "rather than constantly trying to detect the actual live virus or the viral particles itself."
"We have to have a breakthrough," she said. "This RNA testing will carry us certainly through the spring and summer, but we need to have a huge technology breakthrough -- and we're working on that at the same time."
It's not just testing the US needs more of, Fauci said. Contact tracing, identification and isolation of those infected are also key elements to helping slow the outbreak.
Antibodies don't necessarily lead to long-term immunity
As of Friday, no study has "evaluated whether the presence of antibodies to (the virus) confers immunity to subsequent infection by this virus in humans," the WHO brief says.
It's not clear how long antibodies might protect against subsequent infection, Birx said.
The US Food and Drug Administration has authorized three coronavirus antibody tests, bringing the total number of FDA-authorized tests to seven.
The tests were approved under emergency-use authorizations, a lower regulatory standard used when the FDA believes a test's benefits could outweigh any risks.
CNN's Alta Spells, Artemis Moshtaghian, Eliott C. McLaughlin, Kristina Sgueglia and Hollie Silverman contributed to this report.
Italy's Conte told La Repubblica that "strategic" businesses, such as companies who export, could restart as early as next week with the approval of local authorities. To reopen, businesses will have to introduce strict safety measures. Conte will present the package by the beginning of next week.
Spain's Snchez said that from May 2, individual physical activity and walks with people from the same household would be authorized. The measures, which will be presented to the Council of Ministers on Tuesday will apply in May and could be extended in June.
The easing of the lockdown will be "gradual and asymmetric, but coordinated," Snchez said, warning that there could be "territorial differences" between the country's regions. The country recorded Sunday the lowest number of coronavirus-related deaths in more than a month.
