While the world continues to cope with COVID-19, it is clear that the decisions our public officials make today will have far-reaching consequences on peoples lives. It is for that reason that we need to make absolutely sure that our decisions are supported by robust science.
Scientists around the world have been working long hours identifying potential new treatments and diagnostic tools to handle the threat that SARS-CoV-2 (the virus that causes COVID-19) poses. Many of these new treatments, such as the 70 vaccines currently in development, provide hope that we will soon be able to stop this pandemic in its tracks.
However, there have also been a number of exaggerated claims about early scientific data found in pre-prints a kind of initial posting of results prior to evaluation by scientific experts and peer-reviewed journal articles.
Some of these claims, such as the lauding of hydroxychloroquine as a miracle-cure for COVID-19, have led people to self-medicate with fatal consequences. To be clear, the effectiveness of hydroxychloroquine for the treatment of COVID-19 is very much still under investigation.
This is why it is so alarming to hear public officials in Canada, namely Alberta Premier Jason Kenney, openly talking about moving ahead of Health Canada approval for similar treatments.
While it may seem counter-intuitive, even in times of desperate measures and rapid response, science still requires time to make rigorous and robust conclusions. There are real consequences to rushing ahead of rigorous scientific data.
A potent example of this is the use of thalidomide in Canada to treat nausea associated with pregnancy. Thalidomide was available in Canada in the early 1960s. This drug was approved in other jurisdictions, including West Germany and the United Kingdom. It was subsequently pulled from markets in both countries in 1961 and in Canada shortly after, when it became abundantly clear that the drug caused fetal malformations.
Notably, a Canadian-born American physician by the name of Dr. Frances Kelsey saw the scientific data on the use of thalidomide and was deeply concerned about the lack of scientifically reliable evidence of its safety. As such, in her role as an advisor to the Food and Drug Administration, she blocked its approval for use in the United States. Her actions prevented the damaging and sometimes fatal consequences seen elsewhere.
Dr. Kelsey took a slow science approach. Instead of pushing ahead with a drug that had been approved in other countries, she actively sought out evidence of its safety, and evaluated it for herself. This extra step, the extra interpretation of the data in her hands, helped to identify that the drug might not be safe and should not be approved without more evidence.
Read more: How 'slow science' can improve the way we do and interpret research
This highlights why having robust scientific data about a drug treatment is so vital. Health Canadas approval of medications and diagnostics is one part in a slow science framework, which protects Canadians and their health from the use of diagnostic tests and treatments that are not validated to be safe and effective.
Treatments and diagnostics for COVID-19 must follow this framework. Treatments that dont work (or worse, are harmful) or diagnostic tests that provide many false positives (or worse, false negatives) will only serve to hasten the spread and impact of COVID-19 on Canadians.
Read more: The US is fast-tracking a coronavirus vaccine, but bypassing safety standards may not be worth the cost
Slow science will necessarily take more time than we might be immediately comfortable with. However, it is important that public officials, scientists and the public understand that treatments and diagnostics that work will require science that is rigorous, accurate and peer-reviewed. This requires time. Slow science will provide fewer opportunities for mistakes and more time for science to get it right.
The coverage on this live blog has ended but for up-to-the-minute coverage on the coronavirus outbreak, visit the live blog from CNBC's Asia-Pacific team.
The data above was compiled by Johns Hopkins University.
President Donald Trump said that he believes some states will be able to lift the strict social distancing measures that have strained their economies before the end of April.
"The plans to reopen the country are close to being finalized," Trump said at a press briefing on the virus in the Rose Garden.
"I will be speaking to all 50 governors very shortly," Trump said, "And I will then be authorizing each individual governor of each individual state to implement a reopening and a very powerful reopening plan of their state at a time and in a manner as most appropriate."
"The day will be very close because certain states as you know are in a much different condition and are in a much different place than other states. It's going to be very very close. Maybe even before the date of May 1st," he said.Kevin Breuninger
San Francisco is canceling its annual Pride Parade, which celebrates the city's LGBTQ+ communities, for the first time. It typically takes place in June and this year was the event's 50th anniversary.
"It will be incredibly disappointing to not be able to celebrate Pride in person this year but we need to do what is best for the health and safety of everyone involved," Mayor London Breed tweeted Tuesday afternoon.
Event organizers have decided to participate in "Virtual Global Pride" on Saturday, June 27 in its place.Jennifer Elias
President Donald Trump addresses the daily coronavirus task force briefing in the Rose Garden at the White House in Washington, April 14, 2020.
Leah Millis | Reuters
The Trump administration will halt funding to the World Health Organization as it evaluates the agency's "role in severely mismanaging" the coronavirus pandemic, President Donald Trump announced.
"Today I'm instructing my administration to halt funding of the World Health Organization while a review is conducted to assess the World Health Organization's role in severely mismanaging and covering up the spread of the coronavirus," Trump said at a press conference.
Trump criticized the international agency's response to the outbreak, saying"one of the most dangerous and costly decisions from the WHO was its disastrous decision to oppose travel restrictions from China and other nations."Berkeley Lovelace Jr., Noah Higgins-Dunn
When the economy shut down, consumers also shut down.
Despite hoarding of groceries, toilet paper and other necessities, the abrupt drop in consumer spending last month at restaurants, stores and gas stations is expected to have resulted in the largest decline ever in monthly retail sales, according to Diane Swonk chief economist at Grant Thornton.
Economists expect a decline of 8% in March retail sales, according to Dow Jones. That compares to a half percent decline in February. If autos are excluded, sales were expected to be down 5.2% in March.
The retail sales data, expected at 8:30 a.m. ET Wednesday, is one of the most important readings of consumer activity. The consumer makes up about 70% of the U.S. economy and since mid-March, many Americans have been at home.
Many have lost their jobs with 17 million workers filing for unemployment over the three weeks ending April 4.
"The risk is to the downside," Swonk said. "We could get worse than we are expecting. As things shut down, people are also pulling in."Patti Domm
Junior's Cheesecakeowner Alan Rosen said that the money the restaurant company has received through the Treasury Department'ssmall business loan program is not enough to immediately bring workers off furlough.
There is too much uncertainty about when the coronavirus pandemic will subside and when people will be comfortable to "sit shoulder to shoulder in our restaurants" again, Rosen said on CNBC's "Power Lunch."
"Until that time it would be, in my opinion, wasted money to start spending it.We have to wait until we have a very clear pathway to success," said Rosen, whose grandfather founded Junior's in Brooklyn, New York, in 1950.
The family owned business has grown now to three restaurants in New York City and a location in Connecticut. It also has a bakery outlet in Burlington, New Jersey, and an e-commerce business.
Rosen said he applied for loans separately for its four restaurant locations. The company furloughed 650 employees across its restaurants, which have been closed since March 16.Kevin Stankiewicz
U.S. airlines and the Treasury Department have reached an agreement in principle on billions in government aid aimed at softening the blow from the coronavirus, sources told CNBC.
The agreement comes as the virus and harsh measures to stop it from spreading, such as stay-at-home orders, have driven air travel demand to the lowest in decades. Carriers have raced to cut costs by grounding hundreds of jetliners and asking thousands of employees to take voluntary unpaid leave.
U.S. airlines including American, Delta, United, Southwest and others applied for portions of $25 billion in payroll grants that require airlines not to furlough or cut the pay rates of any employees through Sept. 30. The grants were part of the more than $2 trillion coronavirus relief package Congress passed last month.Leslie Josephs, Lauren Hirsch
California governor Gavin Newsom
Rich Pedroncelli | Pool | AP
California Gov. Gavin Newsom announced Tuesday a guide to how California will reopen society and the economy across the state as officials weigh lifting restrictive orders meant to curb the spread of the coronavirus.
Newsom became the first governor to issue a statewide stay-at-home order on March 19. He said Tuesday that the order and similar policies have successfully minimized California's Covid-19 outbreak, which has infected more than 22,348 people across the state and killed at least 687 people in California as of Sunday, according to California Health and Human Services.
"While Californians have stepped up in a big way to flatten the curve and buy us time to prepare to fight the virus, at some point in the future we will need to modify our stay-at-home order," Newsom said in a statement. "As we contemplate reopening parts of our state, we must be guided by science and data, and we must understand that things will look different than before."Will Feuer
Emergency room and other doctor's visits at hospitals in Seattle, New York and elsewhere across the U.S. have tumbled in recent weeks, reflecting a broader trend across the U.S. as people steer clear of hospitals for sometimes necessary and emergency care, even for mild heart attacks.
At Providence St. Joseph Health in the Seattle-area, the volume of heart attack patients at its 51 hospitals fell by about 50% in March compared with the same month last year, CEO Dr. Rod Hochman said, adding that the notion that people have just stopped having heart attacks is "too good to be true." He and other physicians suspect patients that have mild heart attacks or strokes that would have normally sent them to the emergency room in the past are seeking treatment from family doctors, outpatient clinics or foregoing it altogether as Covid-19 patients inundate hospitals across the country.The consequences could last years, he said.Will Feuer
Kroger, the nation's largest supermarket chain, and United Food and Commercial Workers International Union, its largest food and retail union, have teamed up to call on elected leaders to designate grocery workers as first responders.
In a joint statement, they said federal and state officials must act quickly, so grocery workers can get priority access to masks and gloves. They said the employees need the gear to stay safe as they continue to go to work and try to reduce risk of getting sick with Covid-19. "Thisurgentcall fortemporaryfirst responder or emergency personnel status is not just about protectinggrocerystore workers; it is also about protecting the customers they serve and our nation's food supply in general," they said in the statement.
The labor union, which represents 1.3 million workers at major grocery chains, meatpacking plants and more, isalso urging customers to change how they shopand to wear a cloth masks or face covering during every trip to the store.Melissa Repko
The nation's 3.3 million home health-care workers are the other front-line heroes in the war against thecoronavirus. While hospitals' physicians and nurses tend to the sickest Covid-19 victims, the in-home workforce is caring for millions of the most vulnerable Americans. Demand for their services is growing as more of the elderly leave nursing facilities for fear of infection and hospitals release noncritical patients for home care.
Yet they lack personal protective equipment, too. According to a March survey of 1,200 in-home workers by the Home Care Association of America, 77% don't have enough masks and 57% don't have enough gloves. Many are underpaid and lack health insurance and paid sick leave. The pandemic is putting additional pressure on a workforce already in crisis suffering from shortages, especially in hard-hit states such as New York, New Jersey, Louisiana and Washington.In response, the largest home health-care union, industry providers and advocacy groups are urging Washington to respond to this crisis.
The risks to in-home caregivers extends beyond the scarcity of PPE to screening for coronavirus, said William Dombi, president of the National Association for Home Care and Hospice, a Washington-based industry advocate mostly for nurses, therapists and other medically trained in-home workers. "I can't speak for every location and employer," he said, "but the protocol under way is for screening of every worker before going into the home, so they don't create a risk for their clients, and it's also screening clients to see that there's no risk to the workers."
Even so, according to the HCAOA survey, nearly 90% of respondents reported clients canceling one or more visits, because they fear aides may spread the disease. Despite those worries, however, 80% said that no clients or employees had reported Covid-19 symptoms.Lori Ioannou
Nearly 7.5 million small businesses are at risk of closing their doors permanently over the next several months if the coronavirus pandemic persists, according to a survey.
Around two-thirds of entrepreneurs said they may have to shut forever if business disruption continues at its current rate for up to five months, according to a survey by Main Street America, a network of more than 1,600 commercial districts comprising 300,000 small businesses.
More than 30% are at risk if the status quo persists for two months, according tothe survey, which polled in excess of 5,850 small business owners.
These figures point to 3.5 million small businesses closing permanently in the next two months, and 7.5 million over the next five months, according to Main Street America.Greg Iacurci
Cisco announced a financing program that will let customers defer 95% of their payments for new products until 2021.Ciscois committing $2.5 billion to cover financing for the effort.
The offerings could help customers preserve cash amid reduced economic activity while people stay at home to avoid further spread of the coronavirus. Then, once conditions have improved, they'll be in a better position to pay what they owe.
Cisco customers won't have to pay for software, hardware or services they buy for 90 days, so long as orders are placed between Tuesday and July 25. After the 90-day period, they pay 1% in the total contract value per month until the end of 2020, according to the company's website. They'll have to make monthly payments in line with the terms of their agreements after that. Pre-owned Cisco products are also available for payment deferrals through 2021.Jordan Novet
U.S. President Donald Trump will hold a video teleconference with G7 leaders on Thursday to coordinate national responses to the coronavirus pandemic, the White House said.
Trump, who is head of the G7 this year, had to cancel the group's annual summit, which he had planned to hold at the presidential retreat of Camp David, Maryland, in June.
The Group of Seven nations include the United States, France, Britain, Italy, Canada, Japan and Germany, and all seven of them have been hit hard by the virus. British Prime Minister Boris Johnson was released from a London hospital this week after treatment for the virus, which left him in the intensive care unit for several days.
"Working together, the G7 is taking a whole-of-society approach to tackle the crisis across multiple areas, including health, finance, humanitarian assistance, and science and technology," said White House spokesman Judd Deere.
The Thursday session is a followup to their March 16 video conference, the first time G7 leaders had met in that format, to go over efforts to defeat the coronavirus. In addition to the meeting this week, another session is expected in May to lay the groundwork for the June video conference.Reuters
California has signed up more than 58,000 people for health coverage on the state's Affordable Care Act exchanges during the first three weeks of the special enrollment period launched in response to the Covid-19 pandemic.
The enrollment window began on March 20, and the state is allowing previously uninsured residents to sign up for Obamacare plans through June 30.
California, New York, Washington state and the District of Columbia are among nearly a dozen state-run exchanges that have opened up special enrollment periods for the uninsured.
The Trump administration has resisted opening up a special enrollment period on the federally run exchanges and has proposed using money from the $100 billion hospital relief funding to reimburse health systems for treating Covid-19 patients who are uninsured.Bertha Coombs
Jamie Dimonsaid that American companies will start bringing back employees who are working remotely by June at the earliest.
TheJPMorgan ChaseCEO said that the business world's return to normalcy will occur in phases and be determined by the conditions in regions and at specific companies. Many businesses have sent employees home or furloughed them amid shutdowns tied to the coronavirus pandemic.
"A rational plan to get back to work is a good thing to do, and hopefully it will be sooner rather than later," Dimon said in a conference call with analysts. "But it won't be May. We're talking about June, July, August, something like that."Hugh Son
The coronavirus has now infected more than 200,000 people across New York state as the Covid-19 outbreak begins to slow and the country continues to ramp up its testing capacity.
New cases across the state rose by 7,177 on Monday, bringing the total number of confirmed infections to 202,208, according to New York State Department of Health data gathered as of midnight. Some 10,834 people have died so far, including one child under 10 years old and six kids between 10 and 19, according to the data. One of the kids had diabetes, but the rest didn't have any underlying medical conditions, the data shows.Will Feuer
A worker walks through a baggage claim area at a nearly-empty O'Hare International Airport on April 2, 2020 in Chicago, Illinois.
Scott Olson | Getty Images
The Department of Transportation says $10 billion in grants are now available for airports as they struggle with the coronavirus pandemic, which as driven down the number of air travelers in the U.S. to levels not seen in decades after states issued shelter-in-place orders and other restrictions.
Airports can use the funds, outlined in the $2 trillion CARES Act, for capital expenditures, payroll, utilities and other operating costs and debt payments. Airports make money from airline fees, parking, retail and other revenue streams.Leslie Josephs
Here's one reason for self-employed people to start their 2019 tax return: The bank might want it when you apply for the Paycheck Protection Program.
The federal government's $349 billion forgivable loan program opened to independent contractors and self-employed people on April 10, a week after the bumpy April 3 roll out to small businesses.
Just because the loan window is open to entrepreneurs doesn't mean that they can easily tap the funds.
Currently, banks are asking small businesses to submit payroll expense documents, including payroll tax reports, plus health insurance premium and retirement plan funding data.
Lenders have also limited their PPP applicants to entrepreneurs who already have existing business accounts or loans with them.
This doesn't sync with the way independent contractors operate and it's why some accountants are talking about pushing through tax returns for 2019.Darla Mercado
New York State Governor Andrew Cuomo during a press conference.
New York Gov. Andrew Cuomo said he will not engage in a fight with President Donald Trump as tension escalated between the two this week over who has authority to reopen the U.S. economy. Trump said he has "total" authority over the states.
"This is not time for politics and it is no time to fight. I put my hand out in total partnership and cooperation with the president. If he wants a fight he's not going to get it from me. Period," Cuomo said at a press conference in Albany, adding that Trump is "wrong on the law."
On Monday, Cuomo announced a formal working group with several other Northeastern governors to coordinate the region's Covid-19 mitigation efforts as well as any plans to reopen the states for business. Trump, later in the day, told reporters that only he had that power: "When somebody's the president of the United States, the authority is total, and that's the way it's got to be," which prompted a sharp rebuke from Cuomo.Noah Higgins-Dunn
Dr. Anthony Fauci, the government's top infectious disease expert, saidthe U.S. does not yet have the critical testing and tracing procedures needed to begin reopening the nation's economy, adding a dose of caution to increasingly optimistic projections from the White House.
"We have to have something in place that is efficient and that we can rely on, and we're not there yet," Fauci said in an interview with The Associated Press.
Fauci's comments come as President Donald Trump and others in the administration weigh how quickly businesses can reopen and Americans can get back to work weeks after thefast-spreading coronavirusessentially halted the U.S. economy.Trump has floated the possibilityof reopening some areas by May 1 and said he could announce recommendations as soon as this week.
Fauci said a May 1 target is "a bit overly optimistic" for many areas of the country. Any easing off the strict social-distancing rules in place in much of the country would have to occur on a "rolling" basis, not all at once, he said, reflecting the ways Covid-19 struck different parts of the country at different times.Associated Press
There's a reason you can't get a refund from Ticketmaster for a postponed concert the online ticket seller doesn't have your money. The venue does.
"I think there's a lot of misperception about Ticketmaster," Joe Berchtold, the president of Live Nation, the company that owns Ticketmaster, said on CNBC's "Squawk Alley." "Ticketmaster doesn't sell these tickets and sit on a mountain of cash. Ticketmaster sells tickets and gives the cash over to the venues where the events are held."
Over the last week, Ticketmaster has faced backlash from consumers seeking refunds for postponed live events.
Berchtold explained that in order for Ticketmaster to issue refunds it needs to work with the event venues, but those venues are closed due to the coronavirus outbreak.Sarah Whitten
Unilever, the London-based consumer products giant, is not benefiting overall from the coronavirus crisis even though many of its soap and hand-washing brands are seeing increased demand, CEO Alan Jope told CNBC.
"Coronavirus is not good news for Unilever. We're seeing shift in demand for sure," he said in a "Squawk on the Street" interview. "We're seeing a big reduction in out-of-home food consumption of ice cream and restaurant products."
Unilever makes Breyers and Ben and Jerry's ice cream as well as Hellmann's mayonnaise and Lipton and Pure Leaf teas. The conglomerate also makes consumer staples such as Dove and Lifebuoy antibacterial soaps.
"Yes, we're seeing increases in demand in some of the hygiene products," Jope said. However, the net effect of the outbreak for the company at large is "certainly not good news for us on a commercial basis," he added.
Jope said panic buying and hoarding of supplies is largely an American phenomenon. "Only in the U.S. are we seeing this kind of dramatic pantry loading. I think the U.S. consumer has typically a bigger house and more appetite for credit card debt than elsewhere in the world."Matthew J. Belvedere
As the impact of the coronavirus pandemic hits businesses and their ad spend, advertising holding companies are preparing for a drop in demand, and some are telling their employees to expect staff cuts and furloughs.
The advertising industry is bracing for a wider impact of any economic fallout on client spending, since marketing is often one of the first items that businesses cut during a financial downturn.Some brand advertisers have said they've alreadydramatically reduced spending.
In an internal weekly email to employees that was viewed by CNBC, Omnicom Group CEO John Wren wrote that the pandemic has had an impact on the economy, clients' businesses, "and in turn, on ours." He wrote that the company has solidified internal measures to meet the changing needs of its clients. The holding company operates agencies across the advertising world, including BBDO, DDB and TBWA.
"Regrettably, this will include furloughs and staff reductions across many of our agencies," Wren wrote. "We are doing everything we can to limit staff reductions, and to take care of those who are affected."Meg Graham
Apple shipped roughly 2.5 million iPhones in China in March, a slight rebound after one of its worst months in the country ever, according to government data published on Friday.
Smartphone companies are hoping for a strong recovery in demand in China, where the deadly coronavirus is subsiding, just as it spreads overseas and looks set to trigger a global recession.
Mobile phone shipments in China in March totaled 21 million units, according to data from the China Academy of Information and Communications Technology (CAICT), a government think tank.
That was a more than three-fold increase from February, yet still down roughly 20% compared with March 2019.Reuters
A French National Centre for Scientific Research (CNRS) researcher holds a test tube rack containing cells to be infected with Covid-19 during coronavirus vaccine research work inside the Pasteur Institute laboratories in Lille, France, March 9, 2020.
Adrienne Surprenant | Bloomberg | Getty Images
Experts from the World Health Organization say they gave explicit warnings about the risks of the COVID-19 outbreak in early January. They said this after President Trump this week accused the agency of obscuring the truth. Above: the WHO's headquarters in Geneva. Fabrice Coffrini/AFP via Getty Images hide caption
Experts from the World Health Organization say they gave explicit warnings about the risks of the COVID-19 outbreak in early January. They said this after President Trump this week accused the agency of obscuring the truth. Above: the WHO's headquarters in Geneva.
"We regret the decision of the president of the United States to order a halt in funding to the World Health Organization," WHO Direct0r-General Tedros Adhanom Ghebreyesus said Wednesday in response to President Trump's plan to stop U.S. money from going to the agency.
The U.S. is the top contributor to the WHO, which is leading the fight against the COVID-19 global pandemic.
On Tuesday, Trump accused the WHO of "severely mismanaging and covering up the spread of the coronavirus." He also said the organization is overly influenced by China and was too trusting of that country, particularly in the early phase of the outbreak.
Through the middle of January, the president said, the WHO "parroted and publicly endorsed the idea that there was not human-to-human transmission happening despite reports and clear evidence to the contrary."
The president also said the health agency had delayed raising the alarm on the threat posed by the new coronavirus, which is now confirmed to have infected more than 2 million people.
Responding on Wednesday to a question about the U.S. accusations, Dr. Mike Ryan, executive director of the WHO's Health Emergencies Programme, said, "In the first weeks of January, the WHO was very, very clear."
"We alerted the world on January the 5th," Ryan said. "Systems around the world, including the U.S., began to activate their incident management systems on January the 6th. And through the next number of weeks, we've produced multiple updates to countries, including briefing multiple governments, multiple scientists around the world, on the developing situation and that is what it was, a developing situation."
Trump said the WHO had "deprived the scientific community of essential data," accusing it of failing to obtain virus samples.
To that charge, Ryan replied, "The virus was identified on January the 7th. The [genetic] sequence was shared on the 12th with the world."
As for the guidance about human-to-human spread of the new virus, Ryan noted that in initial reports, there was no mention of human-to-human transmission. But he also said, "There is always a risk with respiratory pathogen that it can move from person to person."
"When WHO issued its first guidance to countries, it was extremely clear that respiratory precautions should be taken in dealing with patients with this disease," Ryan said, "that labs needed to be careful in terms of their precautions and taking samples, because there was a risk that the disease could spread from person to person in those environments."
At that point in the looming outbreak, Ryan said, the main question was still whether the virus would be able to efficiently spread in community environments an ability it has since proved to have, to tragic effect.
In early January, the disease was known only through a cluster of atypical pneumonia cases pneumonia with an unknown origin.
"There are literally millions and millions of cases of atypical pneumonia around the world every year," Ryan said, adding that in the middle of an influenza season, it was "quite remarkable" that a cluster of 41 confirmed cases was singled out in Wuhan, China.
Questions about advice from the WHO during the early days of the outbreak recently prompted Maria Van Kerkhove, an emerging-disease expert who is the agency's technical lead on COVID-19, to review her first news conference about it, on Jan. 14. In that session, she discussed the questions that researchers were trying to answer about the virus, from the modes of transmission to the extent of infection in patients.
"All of our guidance that was out before we did that press conference was about limiting exposure to people and to prevent transmission, particularly in health care settings," Van Kerkhove said.
"We wanted to ensure that front-line workers were protected," she added, "so our guidance that was put out was about respiratory droplets and contact protection."
"All of that was out on the 10th and the 11th of January," she said.
Tedros did not dwell on Trump's accusations. Instead, he referred to the WHO's origins in the first years of the United Nations' existence and its mission of protecting public health. And while he called the U.S. "a long-standing and generous friend," Tedros also said the WHO is committed to working with all nations, "without fear or favor."
"COVID-19 does not discriminate between rich nations and poor, large nations and small. It does not discriminate between nationalities, ethnicities or ideologies," Tedros said. "Neither do we. This is a time for all of us to be united in our common struggle against a common threat a dangerous enemy."
After the pandemic has finally been corralled, Tedros said, there will be time to review the WHO's performance a process he said is routine after any disease outbreak.
"No doubt, areas for improvement will be identified, and there will be lessons for all of us to learn," he said. "But for now, our focus my focus is on stopping this virus and saving lives."
Critics are saying that by attacking the WHO, Trump is seeking to deflect blame away from his own administration's problems in containing COVID-19. The U.S. has more than 610,000 confirmed coronavirus cases far more than any other country, according to Johns Hopkins University's COVID-19 dashboard.
As the U.S death toll from COVID-19 soared past 26,000 on Wednesday, the White House issued a statement reiterating Trump's complaints about the WHO.
When Tedros was asked what kind of financial impact the U.S. stance could have, he declined to give specifics, saying the WHO is now reviewing how its work might be affected by a withdrawal of U.S. funding.
He added, "We'll work with our partners to fill any financial gaps we face and to ensure our work continues uninterrupted."
A look at the WHO's most recent financial update suggests that lack of U.S. money would have a profound impact. In that report, the WHO lists some $5.6 billion in total contributions from members and foundations.
The U.S. is responsible for nearly 15% of the WHO's funding in "specified voluntary contributions," which is by far the largest funding category, supporting specific disease programs and regional initiatives. The U.S. also accounts for 22% of the $1 billion that the WHO brings in through "assessed contributions" from member nations.
After the first positive coronavirus test at a Virginia nursing home in mid-March, its administrator said, the staff restricted visitors, conducted temperature checks at the end of every workers shift and isolated residents who had tested positive into separate areas.
Even so, there suddenly was another case. Within two weeks, dozens of others inside were falling ill.
Now, about a month after the first case, at least 46 residents are dead at the nursing home, the Canterbury Rehabilitation & Healthcare Center in Richmond more than a quarter of the facilitys population and one of the highest known death tolls in the United States.
The facilitys medical director, Dr. Jim Wright, said he had asked the state health department how to test a suspected case before the outbreak began. But even as the situation grew dire, it took almost two weeks for all the facilitys residents to be tested for the coronavirus.
You cant fight what you cant see, Dr. Wright said.
Virginia had only about 300 test kits available in mid-March, said Dr. Danny Avula, the Richmond health director, and to get one at the time, residents of long-term care facilities first needed to test negative for the flu and other respiratory viruses.
We could have limited the spread in Canterbury had we been able to test more, he said.
The lack of widespread testing and the difficulty in retaining staff members were additional challenges for the nursing home, where residents, who are older and therefore more vulnerable to the coronavirus, live in close quarters.
The New York Times has tracked hundreds of clusters of coronavirus cases across the country, and the 10 deadliest have been in nursing homes and long-term care centers. More than 21,000 residents and staff members at nursing homes and other long-term-care facilities have contracted the virus, and more than 3,800 have died.
Some involved in the crisis at Canterbury described a nightmarish scenario in which the casualty count climbed as health workers and family members tried to determine whether sick residents should go to hospitals or receive palliative end-of-life care inside the home. More than half of the Canterbury residents who died from the virus did so at the facility.
The nursing homes first positive test came on March 18, Dr. Wright said, and within days the number of symptomatic patients was climbing fast. One resident who had been sent to a hospital with a bladder infection later tested positive for the virus. Around the same time, another resident developed a high fever and respiratory symptoms.
Still, it took precious time for those in charge to act.
Canterbury requested the Henrico County Health Departments assistance in testing all residents and employees on March 26. Around that time, a Richmond laboratory gained the ability to start testing, and by March 30, everyone at the facility was finally tested.
The results were frightening.
More than 60 of the 160-some residents tested positive. About 50 of them had no symptoms, though some developed symptoms later.
We were shocked, Dr. Wright said. We thought we had it relatively contained until the results started coming in. And that revealed to us how far behind we were.
The number of calls to the county fire department about problems at Canterbury also started to climb. Dispatchers asked the facilitys staff members to bring patients into the front lobby, where a paramedic in protective clothing could assess the situation. Some residents were taken to nearby hospitals, which were coming under stress themselves.
Canterbury has acknowledged that it was understaffed as the crisis was intensifying. Jeremiah Davis, the facilitys administrator, said in a statement that Canterbury had temporarily doubled nursing staff wages and had tried to hire employees through third-party staffing agencies.
Notably, nearly a dozen Canterbury employees recovered from Covid-19 have returned to work and are caring exclusively for Covid-19 positive residents, Mr. Davis said.
Margo Turnage, whose 77-year-old father, Frank Bonarrigo, has lived in Canterbury for about three years, said she had been impressed with the facilitys willingness to help her frequently FaceTime with her father.
She said he had tested positive for the virus but was currently asymptomatic. She said she worried that the staff members would be blamed for the outbreak even though they have been putting themselves at risk on the front lines.
The staff are putting in so many hours, she said. Their friends, who they have been working with for years, are dying on them. Its heartbreaking.
In late March, the facility made a plea for more nurses, offering a bonus and an elevated pay rate. The job posting, which is still active, encouraged applicants to contact a recruiter for immediate consideration.
DOUBLE-TIME PAY RATE and $2500 sign on bonus, the post read. All Shifts available.
Vanessa Swales and Robert Gebeloff contributed reporting.
The next day, Minnoli Aya returned from the University at Buffalo, where she was a freshman. She believed her mother had pneumonia and hoped to surprise her. Instead, she learned her mother had contracted the coronavirus.
I was just on the floor, and I was broken, Minnoli said.
Over the next week, she texted with her mother, who continued to deteriorate. Doctors called Mr. Aya daily. By the end of the week, his wife was increasingly having trouble breathing.
By the morning of March 29, doctors got ready to put Ms. Aya on a ventilator. But there was a life-threatening complication, and they asked Mr. Aya if he wanted to see his wife for what could be the last time. He worried that his heart condition would put him at risk if he caught the virus, and Minnoli could be left without a parent.
The decision not to go, he said, has haunted him. That afternoon, the hospital called to say that his wife had died.
Minnoli, her father and grandmother could not hug each other, because they were required to stay six feet apart, even though they lived in the same house. Nor did they want to plan a funeral service that almost no one would attend, one where they would not be able to view Ms. Ayas body. They decided to have her cremated.
Even after her mother died, Minnoli still texted, trying to stay connected.
I miss u, she wrote before going to bed that night. When she woke the next morning, Minnoli texted, Thank you for coming to me last night in my dreams.
Mr. Aya, concerned about Minnoli, arranged for her to speak to a therapist by video after his wifes death. But he is not sure how long he can afford the expense because Ms. Ayas health care plan had covered the family. A representative of her union benefit fund told him by email that benefits would end 30 days after his wifes death. My heart is broken for you, the representative wrote in the email, which was reviewed by The New York Times.
A good example of the genre is an op-ed co-authored by former Education Secretary William Bennett and talk radio host and author Seth Leibsohn . It is titled, tendentiously and not very accurately, Coronavirus Lessons: Fact and Reason vs. Paranoia and Fear. Bennett and Leibsohn are intelligent and public-spirited men whom Ive known for years, but theyve got this wrong, and in rather elementary ways.
They cite the latest estimate of the Institute for Health Metrics and Evaluation in Washington state that the current outbreak will kill 68,000 Americans. Then, they note that about 60,000 people died of the flu in 2017-18. For this, they thunder, weve scared Americans and imposed huge economic and social costs on the country.
This is such an obviously flawed way of looking at the question, its hard to believe that Bennett and Leibsohn dont realize it.
If we are going to have 60,000 deaths with people not leaving their homes for more than a month, the number of deaths obviously would have been highermuch higherif everyone had gone about business as usual. We didnt lock down the country to try to prevent 60,000 deaths; we locked down the country to limit deaths to 60,000 (or whatever the ultimate toll is) from what would have been a number multiples larger.
By Bennett and Leibsohn s logic, we could just as easily ask: Why did we expend all that blood and treasure fighting Hitler when he couldnt even take Britain or conquer Moscow? Why did we adopt tough-on-crime policies, when crime rates are at historic lows? Why did we work so hard to find a treatment for HIV/AIDs, when so many of the people with the disease now have normal life expectancies?
Of course, it was precisely the actions we took that caused those welcome outcomes.
Consider the perversity of their line of reasoning a different way. If we had shut down the country a month sooner and there had been, say, only 2,000 deaths, then on their terms theyd have even a stronger argument, i.e., We did all this and there were only a couple of thousand fatalities?
In other words, the more effective a lockdown would have been, the more opposed Bennett and Leibsohn would be to it.
As for the flu comparison, it isnt as telling as Bennett and Leibsohn believe. The flu season stretches as long as from October to April, although it usually peaks between December and February. The 2017-18 season, with 60,000 flu-related deaths, was particularly bad. But the coronavirus might kill a similar number of peoplewith the country on lockdown.
In the 2011-12 season, 12,000 people died of the flu in the entire country. New York alone has eclipsed that in a little more than a month, and recorded roughly 9,000 deaths the first 15 days of April (again, while on lockdown). In 2018-19, there were 34,000 flu-related deaths in the United States. We are going to surpass that number nationally sometime soon (yet again, while on lockdown).
Why have people reacted so dramatically to this virus, despite the fact that is supposedly comparable to the run-of-the-mill flu? Bennett and Leibsohn have a theory: New York City is where the epidemic has struck the hardest. The media is centered in New York City.
Theres no doubt that New York is always going to get disproportionate attention. But New York City is the biggest in the country, and New York state accounts for 8 percent of the U.S. economy. If New York were an independent state, it would rank as the 11th-biggest economy in the world. What happens there matters.
New York is also, as all of us had no hesitation in recognizing on Sept. 11, 2001, part of America.
If the disease struck smaller heartland cities like Omaha, Kansas City and Witchita would Bennett and Leibsohn hope that the story got ignored and no one took any precautions based on major media companies not being headquartered in those places?
Bennett and Leibsohn ignore the key fact that the economy began to shut down before there were widespread official shutdown orders. People voted with their feet, because they were fearful of a highly transmissible, virulent disease. Bennett and Leibsohn may want to portray Americans as lemmings of the media, cowering in their homes, but they acted rationally. If everything had gone on as normal, the outbreak would have been much worse, and we would have shutdowns anyway, just with even worse health outcomes.
The most objectionable part of the Bennett and Leibsohn posture is its sneering attitude toward frenzied, panicked ordinary Americans who have sacrificed so much during this crisis to protect their families and their neighbors.
By all means, lets open up the economy as soon as we can, but it will require more careful thought than the most fervent critics of the shutdowns have demonstrated during the peak of this epidemic.
Countries under coronavirus lockdowns should only ease those restrictions if they can control new infections and trace contacts, the World Health Organization says. Here, Hashim, a health care worker, recently greeted his daughter through a glass door as they maintained social distance due to the COVID-19 outbreak in New Rochelle, N.Y. Joy Malone/Reuters hide caption
Countries under coronavirus lockdowns should only ease those restrictions if they can control new infections and trace contacts, the World Health Organization says. Here, Hashim, a health care worker, recently greeted his daughter through a glass door as they maintained social distance due to the COVID-19 outbreak in New Rochelle, N.Y.
For the billions of people now living under some form of stay-at-home or lockdown orders, experts from the World Health Organization have new guidance: We should be ready to "change our behaviors for the foreseeable future," they say, as the agency updates its advice on when to lift COVID-19 lockdown orders.
The question of when to ease shutdowns is a hot topic, as economic output is stalled in many countries including the U.S., now the epicenter of the global pandemic.
"One of the main things we've learned in the past months about COVID-19 is that the faster all cases are found, tested, isolated & care for, the harder we make it for the virus to spread," said WHO Direct0r-General Tedros Adhanom Ghebreyesus via Twitter as the guideline was released. "This principle will save lives & mitigate the economic impact of the pandemic."
The coronavirus has killed tens of thousands of people. It has also reshaped society and disrupted daily life for people around the world including 1.4 billion children whose educations are now derailed by shutdowns, WHO says. The pandemic has triggered massive losses for big companies and small businesses, and forced millions of people out of work.
While full national lockdowns remain uncommon, at least 82 countries have some form of lockdown in place, according to UNICEF.
The global economy is now predicted to shrink by 3% this year, the International Monetary Fund says in its most recent analysis. That includes a contraction of nearly 6% for the U.S. economy.
Despite all the personal and economic pain the coronavirus has caused, WHO officials say that in many places, it's too soon to get back to normal. And because any premature attempts to restart economies could trigger secondary peaks in COVID-19 cases, they warn that the process must be deliberate and widely coordinated.
"You can't replace lockdown with nothing," Dr. Mike Ryan, executive director of WHO's emergencies program, said at a recent briefing. Stressing the importance of a well-informed and committed population, he added, "We are going to have to change our behaviors for the foreseeable future."
Any government that wants to start lifting restrictions, said Tedros of WHO, must first meet six conditions:
1. Disease transmission is under control
2. Health systems are able to "detect, test, isolate and treat every case and trace every contact"
3. Hot spot risks are minimized in vulnerable places, such as nursing homes
4. Schools, workplaces and other essential places have established preventive measures
5. The risk of importing new cases "can be managed"
6. Communities are fully educated, engaged and empowered to live under a new normal
The worldwide number of COVID-19 cases is quickly approaching the 2 million mark, including more than 120,000 people who have died, according to a COVID-19 dashboard created by Johns Hopkins University's Whiting School of Engineering.
The number of new cases continues to rise sharply in the U.S., where disagreements over the potential restarting of economies recently prompted at least 10 states to band together in regional coalitions. The governors of those states say they not President Trump or the federal government will determine when to resume normal activities, based on health statistics and science.
Even in instances where governments can lift some lockdown conditions, Ryan said, "Health workers are going to have to continue to have protective equipment and we're going to have to continue to have intensive care beds on standby, because as we come out of these lockdown situations, we may see a jump back up in cases."
The goal is to taper restrictions so governments in communities, cities and nations can avoid a cycle of new COVID-19 outbreaks.
"We don't want to lurch from lockdown to nothing to lockdown to nothing," Ryan said. "We need to have a much more stable exit strategy that allows us to move carefully and persistently away from lockdown."
The whole nationalist populist surge was connected to an historical moment where you could afford to play with fire, she noted. But now the situation is really bad, so much more dangerous, and people dont want the easy nonsense from media-savvy populists.
She cited polls showing that Matteo Salvini, the noisy Italian populist, has been losing support on the right, while another far-right opposition politician, Giorgia Meloni, on the rational, coolheaded, nonpopulist right, has done better.
Much of the public reaction may ultimately depend on how long the sense of crisis lasts, the onslaught of the virus being uncertain and open-ended. The unlocking of the lockdown will itself be fraught with political danger.
Though we see these leaders making decisions, theyre not making them from a position of strength, but from uncertainty and weakness, said Nicholas Dungan, a Paris-based senior fellow at the Atlantic Council.
Theyre not leading so much as administering, he said. And once people are out and about, and not confined anymore doing their duty, people are going to be quite angry, and this will lead to greater instability.
Tony Travers, professor of government at the London School of Economics, noted that Winston Churchill was revered for having presided over the victory over Hitler, but was summarily tossed out of office in 1945.
Winning a war is absolutely no recipe for staying in office, Mr. Travers said. When the threat of illness goes away, then the consequences of being protected from the threat are very different.
Cave nectar bat (Eonycteris spelaea) from Singapore. Justin Ng/Linfa Wang hide caption
Cave nectar bat (Eonycteris spelaea) from Singapore.
Updated at 11 a.m. ET
Dr. Linfa Wang, a virologist at the Duke-National University of Singapore, has been working around the clock to help Singapore fight this coronavirus. He hasn't hugged his daughter in over two months.
"We're in a war zone right now. Everything comes to me very fast," Wang said in an interview with NPR's Short Wave podcast. He's given over 100 interviews since January, when international reports first surfaced of a new coronavirus.
Since then, scientists have learned a great deal about the coronavirus, now called SARS-CoV-2. And one of the mysteries they're still trying to untangle is where the virus came from in the first place. Scientific evidence overwhelmingly points to wildlife, and to bats as the most likely origin.
Wang is an expert in emerging zoonotic diseases, or diseases hosted in animals that spread to humans. The CDC estimates that six out of ten infectious diseases in people come from animals. Among them are Lyme disease, Rabies, West Nile, and diseases caused by coronaviruses, including this coronavirus and the SARS virus.
The 2003 outbreak of SARS was eventually traced to horseshoe bats in a cave in the Yunnan province of China, confirmed by a 2017 paper published in the journal Nature. It was a detective hunt that took over a decade, sampling the feces, urine, or blood of thousands of horseshoe bats across the country and seeing if those samples are a genetic match to the virus.
The work of virus hunting of tracking an outbreak to its origin point can take years. Wang stresses that pinpointing the true origin of this coronavirus will take time as well. "Of course, the technology and everything is much more advanced 17 years later [since the 2003 SARS outbreak]. But, for us to try to solve everything in two to three months is just not feasible."
'This is a product of nature'
In early January 2020, Chinese scientists sequenced the entire genome for SARS-CoV-2 and published it online. Researchers at the Wuhan Institute of Virology in China compared its genome to a library of known viruses and found a 96% match with coronavirus samples taken from horseshoe bats from Yunnan.
"But that 4% difference is actually a pretty wide distance in evolutionary time. It could even be decades," says Dr. Robert F. Garry, professor of microbiology and immunology at Tulane University School of Medicine.
That extra 4% suggests the SARS-CoV-2 may not have evolved from bats alone, but may include viral material from another animal. In that case, the virus would have continued to evolve through natural selection in that animal. Moreover, that other animal may have acted as an "intermediate host," ultimately transmitting the virus to humans.
With this coronavirus, scientists aren't fully clear on whether an intermediate host was involved nor the chain of cross-species transmission to humans. Studies have found a genetic similarity between this coronavirus and coronaviruses found in pangolins, also called scaly anteaters, which are vulnerable to illegal wildlife trade.
Given that some China's earliest COVID-19 patients were connected to the Hunan Seafood Wholesale Market in Wuhan, it is likely the seafood market played a role in amplifying the virus. However, there is not enough evidence to prove that is where the virus transmitted from animals to humans. There is also evidence emerging that among the first 41 patients hospitalized in China, 13 had no connection to this particular marketplace. The path of the pathogen is still unknown.
As for clues the virus holds about its animal origins, Robert Garry and fellow researchers have hypothesized that SARS-CoV-2 could be a blend of viruses from bats and another animal.
"The receptor binding domain actually shares a lot of sequence similarity to a virus that's found in the pangolin" Garry said, referring to the receptor-binding mechanism that allows the virus to form a strong attachment to human cells. "So, those sequences probably did arise from a virus like the pangolin coronavirus, or maybe some other coronavirus that can circulate in pangolins or some other animals." Further genetic analysis is needed to figure this out.
In studying the genome, Garry also confirms the virus came from wildlife. "This is a product of nature. It's not a virus that has arisen in a laboratory by any scientist, purposely manipulating something that has then been released to the public," he said.
'It's A Billion Dollar Question'
So, why are bats such good hosts for viruses?
"I used to say it's a million dollar question. Now I say it's a billion dollar question," said Wang, speaking to NPR's Short Wave podcast on Tuesday.
Bats are critically important for pollinating flowers and dispersing seeds. They catch bugs, the same ones that bite us and eat some of our crops. But bats also harbor some of the toughest known zoonotic diseases.
The Rabies virus, the Marburg virus, the Hendra and Nipah viruses all find a natural reservoir in bats, meaning those viruses live in bats without harming them. The Ebola outbreak in West Africa was traced to a bat colony. The SARS virus originates in bats, along with other coronaviruses. And now, SARS-CoV-2 is linked to bats too.
Wang believes bats' high tolerance for viruses may have to do with the fact that they are the only mammal that's adapted for flight.
"During flight, their body temperature goes all the way to 42 degrees (or 108 degrees Fahrenheit). And their heartbeat goes up to 1000 beats per minute," Wang said.
Flying several hours a day, bats burn a great deal of energy. This creates toxic free radicals that damage their cells, but Wang's research has shown that bats have also evolved abilities to repair and minimize that cellular damage. Those same defensive abilities may help them not only tolerate flight, but also to fight infectious diseases in a way that human bodies cannot.
"Our hypothesis is that bats have evolved a different mechanism to get the balance right for defensive tolerance. And that favors the virus to live peacefully with bats," said Wang.
Peter Daszak, President of the U.S.-based non-profit Ecohealth Alliance, says that even if bats are the origin, they are not to blame for the pandemic.
"It's not bats. It's us. It's what we do to bats that drives this pandemic risk," Daszak said. His research demonstrates how interactions between wildlife and livestock, food and agriculture practices, as well as humans close proximity to animals in densely populated areas, create the conditions for viral outbreaks.
"One of the positive things about finding out that we're actually behind these pandemics is that it gives us the power to do something about it. We don't need to get rid of bats. We don't need to do anything with bats. We've just got to leave them alone. Let them get on, doing the good they do, flitting around at night and we will not catch their viruses," Daszak said.
Given that infectious and zoonotic diseases have been on the rise for decades, Wang is frustrated by the fact that countries around the world failed to understand the impact this novel coronavirus outbreak would have.
"I'm so angry right now. This COVID-19 outbreak, before January 20th, you could say it's China's fault. The Chinese government. But after January 20th, the rest of the world is still not taking it seriously. Our political system, our diplomatic system, our international relationship system is just not ready," Wang said.
January 20th is when Chinese health officials confirmed the new coronavirus could be transmitted between humans and the World Health Organization kicked into high gear to evaluate the global risk. There were more than 200 cases then. Now, the confirmed case count is nearing 2 million worldwide.
Email the show at shortwave@npr.org.
This episode was produced by Brit Hanson, edited by Viet Le, and fact-checked by Emily Vaughn.
Do the tiny, everyday things that help you feel better
My wife and I joke that weve been actually training for this pandemic for the past year dealing with Nusaybas cancer. We stopped socializing, abandoned work projects, read science and medical papers, and placed hand sanitizers, masks and gloves throughout the house. Were used to obsessing over any fevers because Nusayba is immuno-compromised.
With life rapidly spiraling, we took ownership over the daily routines we could still control. You can declutter and clean your house. The simple act of making your bed, brushing your teeth, wearing clothes and choosing your breakfast gives you a sense of autonomy.
If youre up for it, take time to cook or eat your favorite meal. The experience will provide a moment of comfort, a delicious taste you savor more during hardship. If you believe in God, then still maintain your prayers. Also, try to stick with the daily push-up routine, and continue reading the newspaper. Reunite with beloved sitcom characters on The Simpsons, flip through an old book or graphic novel, chain saw demons in Doom, or watch Goodfellas for the 12th time.
All of these seemingly mundane habits and activities will keep you spiritually, physically, creatively and mentally alive for the marathon and it will be a marathon.
A crisis like cancer helps us answer the question: What truly matters when we are stripped overnight of our comfort, wealth and plans?
Kindness does. Its the only way our humanity will endure during this crisis. After all, along with medicine, it was a strangers kindness that helped Nusayba survive.
I recommend focusing and investing in people and relationships. Make a list of your elders, your mentors, your friends, your family members, all those who helped you along the way. Spend a few minutes a day to call them, catch up, reconnect, and make amends if you must. A five-minute call can unburden a lifetime of regret and heal wounds.
