The city of Matamoros, Mexico, sits directly across the border from Brownsville, Tex. Over 2,500 people have gathered there since the Trump administration rolled out the Remain in Mexico policy, in a squalid encampment along the U.S.-Mexico border, while they wait for their asylum hearings. They live in cramped, unsanitary quarters some in tents, others in makeshift shelters without electricity or running water. They are increasingly susceptible to respiratory illness and malnutrition.
On April 1, the U.S. Department of Homeland Security and the Executive Office for Immigration Review announced that they would be postponing all hearings because of the coronavirus outbreak. They live in constant threat of the virus, all for exercising their human right to claim asylum.
Volunteers and nonprofit groups have all but vanished. UNICEF left. Doctors Without Borders still offers some services, but Global Response Management, an international nonprofit organization, is the only consistent presence. Its volunteer doctors, nurses and medics, in some cases asylum seekers, have been doing their best.
But the agencys best is limited to distributing vitamins, masks and moving tents apart. Under normal circumstances, if you can call any of this normal, doctors and nurses cant do much aside from tending to a wound that requires stitches, and diagnosing strep throat or the flu. They arent able to get tests to diagnose Covid-19.
The executive director of G.R.M., who is a nurse, reports that within the camp there were five patients with Covid-19 symptoms. The agency reported these to local authorities but were refused testing. It asked that these migrants be taken away from the camp to nearby hotels, but Mexican immigration authorities have not authorized the move.
Matamoros is the second largest city in the state of Tamaulipas, with a population of over 520,000. While there are no confirmed cases of Covid-19 in the camps, there are some eight confirmed cases in the city. People with mild or moderate cases could be quarantined in their tents and more severe cases sent to local hospitals. But, according to G.R.M., the citys five public hospitals have 10 ventilators and 40 intensive care unit beds between them. An outbreak would be catastrophic.
Mexico has been slow to react to the coronavirus threat. In mid-March, President Andres Manuel Lpez Obrador told reporters, I have faith that were going to move our dear Mexico forward, that these misfortunes, pandemics will not harm us. He has defiantly kissed and hugged supporters at recent events. Mexico has reported at least 4,219 cases of Covid-19 and 273 deaths. Medical workers have protested against the lack of protective gear.
Western news organizations are abuzz with worry over migrants on our southern border. They fret over what will happen if an outbreak were to erupt in the camp. But the plight of the migrants is nothing but a morbid concern. Were treated to images, taken from helicopters, of bodies lying on top of each other, swollen by the sun, and drowned children and their parents, embracing. Its the classic voyeuristic Jonestown footage. This is a mass killing of vulnerable people of color, preyed on because they dreamed of a better life. Despite the worry now about the asylum-seekers in Matamoros, no one is rushing to help them. People are just rushing to read about this impending mass grave.
As the mounting toll of the coronavirus comes into view, its clear that migrants around the world are among the most vulnerable. They often lack health insurance, struggle to make ends meet and are often in poor health. They dont have the luxury or the freedom to socially distance themselves from others. The undocumented men and women in our communities are on the front lines often with no protective equipment or safety net risking their lives to do the jobs most Americans wont. They are disinfecting hospitals and doctors offices, delivering your food and taking care of your elderly relatives.
President Trump believes the medical communitys insistence on quarantine is a conspiracy to destroy his presidency. My parents are among the aging, immunocompromised and undocumented in New York City. If they get sick, they will die. The Trump administration will not help us. We migrants, on the border, or here in New York, are left to fend for ourselves.
Do you know about crows? As an undocumented migrant, Ive always felt an affinity for them. Research has shown that they are as smart as a 7-year-old child. And yet, they are considered pests, undesirable birds, by most. People shoot them, or lay down barbed wire so they will not roost. If you hurt a crow, and it gets a good look at your face, generations of that crow flock could swoop and swerve and attack you. Crows never forget if you hurt them or one of their own.
As one of the fulfilled prophecies of the American dream, Ive earned the right to foretell one. If the American and Mexican governments let us die en masse, we will haunt your children, and your childrens children, and their children too. They will never sleep in peace, and they will come to know our names.
I believe the last option is our best option. Heres what that will require from us:
The C.D.C. leads the world in the classic disease detective work that is needed to understand and contain Covid-19.
Yes, the agencys initial test kits failed. But for nearly two months C.D.C. has provided working tests to public health laboratories throughout the country; this doesnt meet the need for testing in local communities, doctors offices or hospitals. The White House, many parts of the federal government, and commercial labs and hospitals need to make testing much more widely available. In a structured response, one knowledgeable and trusted spokesperson would regularly provide systematic information not only on the number of tests but the actual turnaround time from test to results. Its now unacceptably slow in many areas.
In hospitals and communities, we are weeks if not months away from having sufficient test capacity. Testing for antibodies may help, particularly if people who recover from Covid-19 are immune from repeat infection and can safely work and travel. The C.D.C.s National Center for Immunization and Respiratory Diseases, which Dr. Messonnier leads, has the laboratories, epidemiologists and experience to help determine the accuracy, role and implications of antibody testing.
Health care workers are the front line of our response, and theyre being sickened in droves. C.D.C.s division of health care quality promotion has the worlds leading experts in health care safety. They can figure out how disease is spreading to these workers and collaborate with the Centers for Medicare and Medicaid Services and hospitals on how to stop it. They can also guide efforts to secure safe and attractive spaces to isolate infected people and others they may have infected if they dont require hospitalization and cannot be safely cared for at home.
The C.D.C. should also guide what must become a giant public health effort to trace and track contacts of Covid-19 patients. In Wuhan, China, there were 1,800 contact tracing teams of five people, each led by an epidemiologist. The U.S. equivalent would number 300,000, working in the communities they live in and led by public health specialists. Recruits could include Peace Corps volunteers who were brought home when the pandemic spread, furloughed public employees, phone bank staff (since so much tracing work is done by phone), workers from health organizations, social service and nonprofit agencies, and recent graduates. Community and religious organizations, Meals-on-Wheels programs, businesses and others are well placed to provide services for cases and contacts who must remain in isolation or quarantine.
If this sounds like assembling an army, it is. Dr. Robert Redfield, the C.D.C.s director, notes that the agency has begun this work, an encouraging sign. But the agency will need to accelerate its effort to establish the protocols, structure and supervision of this army and begin training the recruits now.
Disease surveillance is wartime intelligence, and C.D.C. conducts surveillance better than any other agency in the world. Its relevant centers, working with its Center for Surveillance, Epidemiology and Laboratory Services, began releasing more of this information recently, including emergency department visits, test results, hospitalizations and deaths. The C.D.C. needs to continuously improve the quality, geographic precision and timeliness of this information, including by publicly sharing data on emergency room visits an early indicator of changing disease rates.
When will life return to normal, or at least a new normal? A major answer to the question of when and how Americans can return to public places like work and school could depend on something called an antibody test, a blood test that determines whether someone has ever been infected with the coronavirus.
People who are believed to be immune may be able to safely return to work. It would be especially important to know which health care workers are protected from getting infected and could continue to care for sick people.
The Centers for Disease Control and Prevention recently announced that it would begin using antibody tests to see what proportion of the population has already been infected. On Friday, the National Institutes of Health announced it would test 10,000 healthy volunteers around the country for the presence of antibodies.
Within a period of a week or so, we are going to have a rather large number of tests that are available, Dr. Anthony Fauci, the leading infectious disease expert in the U.S., said Friday morning on CNN.
He said the White House coronavirus task force was discussing the idea of certificates of immunity, which could be issued to people who had previously been infected.
As we get to the point of considering opening the country, Fauci said, it is very important to understand how much that virus has penetrated society. Immunity certificates, he said, had some merit under certain circumstances.
The idea of providing proof of immunity to allow workers to return to their jobs is being considered in many countries, including Britain and Italy. But as with any test, they are not perfect, and there have been problems with their accuracy.
Heres what we know and dont know about these tests.
What exactly is a serology test?
A serology test looks for signs of an immune response in this case, to the new coronavirus.
When your body encounters a virus, it takes some time for it to recognize the invader and begin to scale up an immune response. Immune molecules called antibodies are a crucial part of this response.
The first type of antibody to appear is called immunoglobulin M, or IgM, and its levels spike within a few days of infection. But IgM is a generic fighter. To target and destroy a specific virus, the body refines it into a second type of antibody, called immunoglobulin G, or IgG, that can recognize that virus.
As IgG levels rise, IgM levels drop; IgG levels peak around 28 days after the onset of infection.
There is a third type of antibody, called IgA, which is present in mucosal tissues like the inner lining of the lung. IgA is known to be important for fighting respiratory infections such as influenza and is likely to be central in coronavirus infections, too.
Many of the tests being developed look for levels of all three antibodies; some look for just IgM and IgG, and still others test for only one type.
What can these tests tell us? And what cant they?
Lets begin with what they cant tell us. Because the antibodies come up so late, these tests are not helpful for diagnosing an early infection. For that they are useless, said Dr. Florian Krammer, a virologist at the Icahn School of Medicine at Mount Sinai in New York.
The tests are more effective at detecting the presence of antibody responses across large numbers of people, not just to determine who is immune but how widely the virus has spread in the population.
Between 25 per cent and 50 per cent of people who become infected may never develop symptoms, and some may become only mildly ill. Others may have known they were sick but could not get tested. Serology tests would be able to identify these people and help scientists better estimate the death rate of COVID-19, the disease caused by the virus.
We dont currently have good numbers for the numbers of people who are infected now, much less people who were infected before who were never tested, said Dr. Angela Rasmussen, a virologist at Columbia University in New York. So its really important from an epidemiological perspective to do these types of serology assays.
Governments around the world are also hopeful that serology tests can tell them which people are protected from reinfection and can safely go back to work. Knowing the full scope of the pandemic would help them decide when to end social isolation measures and allow businesses and schools to reopen.
Tracking the rise and fall of antibody levels may also enable scientists to back-calculate the dates of infection and help them predict whether the virus shows seasonal fluctuations.
Im pretty sure I had the coronavirus already. Can I take a test and go back to work?
Not yet. Most of the tests being developed offer a simple yes-no answer to the question of who has antibodies and who was exposed to the virus. But simply having antibodies is no guarantee of immunity.
Being immune means that if youre exposed to the virus, your immune system will clear the virus out before it can establish a productive infection, Rasmussen said.
Some people because they had mild or no symptoms, for example might have developed antibodies that are too weak to prevent reinfection. Conversely, others who have low levels of IgG may still be protected.
Thats because antibodies are just one well-understood piece of the immune response. Immune cells called T-cells may also be involved. A lot less is known about how these different parts of the immune system work together to provide protective immunity, Rasmussen said.
Some tests, like one developed by Krammer, offer not just a yes-no answer but a clearer picture of the antibodies ability to neutralize the virus.
Plasma from people who have strong antibodies is being used to treat people who are unable to mount an immune response.
When will serology tests be widely available?
Some are already available and being used, but its the early days, and its unclear how good they are. Last week, the Food and Drug Administration granted an emergency use authorization to one such test. But others are being used in research projects and by hospitals.
But serological tests are plagued with issues, Rasmussen said, and problems are surfacing even as these tests proceed.
In the U.K., for example, the tests are plagued with false negatives (not picking up antibodies when theyre present) and with false positives (indicating antibodies when there are none). Some of the tests may not be specific enough to the new coronavirus; they may pick up a signal from antibodies made in response to infections with the coronaviruses that cause common colds.
False positives in particular are dangerous because they can lull people into believing they are immune when they are not and becoming exposed to the virus. Certainly if somebody thinks that theyre protected and theyre not, that would be a problem, Rasmussen said.
If someone is immune to the virus, how long will the immunity last?
We dont know. This is a new virus, and so we have no way of knowing exactly how long immunity to the virus will last. Our best guess comes from looking at its cousins, the common cold coronaviruses as well as the more dangerous ones that caused severe acute respiratory syndrome and Middle East respiratory syndrome. Immunity to these viruses persists anywhere from one to eight years.
The best way to find out, Krammer said, is to follow people with and without the antibodies and see when they might become re-infected. Those are the studies that are now needed, he said. They will take time.
Apoorva Mandavilli and Katie Thomas c.2020 The New York Times Company
Comparing how the Covid-19 outbreak is playing out in Ireland and the UK is a complex task, researchers have said after a Twitter thread by a former historian on the issue went viral.
Writer and researcher Dr Elaine Doyle penned a series of tweets comparing the situations in the UK and Ireland, noting that both countries had similar numbers of intensive care beds per 100,000 people before the crisis began.
But, she wrote, as of Saturday 11 April, there have been 6.5 deaths per 100,000 people in Ireland. There have been 14.81 deaths per 100,000 people in the UK. Doyle went on to suggest that the difference in the way the pandemic is progressing in the two countries is that Ireland took stronger action sooner.
While Boris [Johnson] was telling the British people to wash their hands, our taoiseach was closing the schools. While Cheltenham was going ahead, and over 250,000 people were gathering in what would have been a massive super-spreader event, Ireland had cancelled St Patricks Day, she wrote, adding that watching British media was like living in bizarro-world compared with the messages on Irish TV news.
In the UK, the government urged against socialising, mass gathering and non-essential travel from 16 March and went into full lockdown on 23 March.
Technically, the UK went into lockdown *before* Ireland; but thats not a fair comparison, as we were already operating our delay phase from 12-27 March, Doyle wrote.
She also noted that, at the time of her post, figures suggested Ireland had performed 8.69 tests per 1,000 people, while the UK had performed four tests per 1,000 people with 269,598 people tested in total as of 11 April in the UK.
Dr William Hanage, an associate professor of epidemiology at Harvard University, said Doyle had made some good points, noting that he and many of his colleagues had been concerned about the UKs early response to coronavirus, but cautioned that it was still too early to draw definitive conclusions.
We are early on in the pandemic and it will remain to be seen how this will all pan out. However, it is unquestionable that major events such as the Cheltenham festival were major opportunities for super-spreading to occur, he told the Guardian. And the resulting surge can reasonably be expected to have been more severe than it would have been otherwise.
But Prof Sheila Bird, a former programme leader at the MRC Biostatistics Unit, stressed there were many factors to consider when attempting to compare countries, including whether deaths were reported in the same way, and whether delays in reporting deaths had been taken into account.
Third, she said, [is] urbanisation versus rurality of the respective populations 83% urban for UK, 63% for Ireland. In other words, a greater proportion of people in the UK live in towns or cities, which may contribute to the spread of a disease.
Bird said it was also important to consider how well people adhered to social distancing and lockdowns in different countries, while age was also a factor: older people are known to be at greater risk of death from Covid-19. In the UK, Bird noted, 18% of the population was aged 65 or older, compared with only 13% in Ireland.
Paul Hunter, a professor in medicine at the University of East Anglia, said the UK might have had proportionately more cases, which would mean more deaths. While he accepted that the later implementation of social distancing measures in the UK might have contributed to the different outcomes, he said there were other factors to consider, including that the UK had a higher proportion of people from BAME communities who have been found to be at higher risk from coronavirus and that the UK was also more densely populated, had many areas of high poverty, and hospitals in London were stretched.
Keith Neal, an emeritus professor in epidemiology of infectious diseases at the University of Nottingham, added that the UK probably encountered its first infections earlier.
The risk of introduction is related to the number of travellers coming back with an infection, he said. Although Ireland may have the same number of international travellers per head of population, your risk of first introductions is related to the number of travellers. The UK is 13 times larger in population than Ireland and London is much more of an international centre and hub than Dublin.
That, said Neal, could be significant: With doubling times of every two to three days, even a later introduction of the first infections by a week can have a very large effect.
Professor Samuel McConkey, an infectious disease expert at RCSI University of Medicine and Health Sciences in Dublin, said it was premature to compare Ireland and the UK. Id reserve judgment on this for two or three years, he said.
He said Irelands earlier adoption of restrictions, as well as Londons population density, may partly explain greater mortality rates in the UK. We closed restaurants, pubs, creches, schools weeks before the UK. We had quite significant political cohesion. We had our national leader tell us, folks this is really bad.
Sen LEstrange, a University College Dublin sociologist who has compared international testing figures, challenged Irelands claim to be in the top tier. Ireland claimed to follow South Koreas model of test, track, trace, isolate but was in fact uncomfortably close to countries most removed from the strategy, such as the UK, he said.
There are very clear differences between the ROI and UK responses. They are not, however, as large or as pronounced as Irish authorities imagine and would like its public to believe.
Donald Trumps response to the coronavirus pandemic, which he once dismissed as a hoax, has been fiercely criticised at home as woefully inadequate to the point of irresponsibility.
Yet also thanks largely to Trump, a parallel disaster is unfolding across the world: the ruination of Americas reputation as a safe, trustworthy, competent international leader and partner.
Call it the Trump double-whammy. Diplomatically speaking, the US is on life support.
The Trump administrations self-centred, haphazard, and tone-deaf response [to Covid-19] will end up costing Americans trillions of dollars and thousands of otherwise preventable deaths, wrote Stephen Walt, professor of international relations at Harvard.
But thats not the only damage the United States will suffer. Far from making America great again, this epic policy failure will further tarnish [its] reputation as a country that knows how to do things effectively.
This adverse shift could be permanent, Walt warned. Since taking office in 2017, Trump has insulted Americas friends, undermined multilateral alliances and chosen confrontation over cooperation. Sanctions, embargoes and boycotts aimed at China, Iran and Europe have been globally divisive.
For the most part, oft-maligned foreign leaders such as Germanys Angela Merkel have listened politely, turning the other cheek in the interests of preserving the broader relationship.
But Trumps ineptitude and dishonesty in handling the pandemic, which has left foreign observers as well as Americans gasping in disbelief, is proving a bridge too far.
Erratic behaviour, tolerated in the past, is now seen as downright dangerous. Its long been plain, at least to many in Europe, that Trump could not be trusted. Now he is seen as a threat. It is not just about failed leadership. Its about openly hostile, reckless actions.
The furious reaction in Germany after 200,000 protective masks destined for Berlin mysteriously went missing in Thailand and were allegedly redirected to the US is a case in point. There is no solid proof Trump approved the heist. But its the sort of thing he would do or so people believe.
We consider this to be an act of modern piracy. This is no way to treat transatlantic partners. Even in times of global crisis, we shouldnt resort to the tactics of the wild west, said Andreas Geisel, a leading Berlin politician. Significantly, Merkel has refused to give Trump the benefit of the doubt.
Europeans were already outraged by Trumps reported efforts to acquire monopoly rights to a coronavirus vaccine under development in Germany. This latest example of nationalistic self-interest compounded anger across the EU over Trumps travel ban, imposed last month without consultation or scientific justification.
US reputational damage is not confined to Europe. There was dismay among the G7 countries that a joint statement on tackling the pandemic could not be agreed because Trump insisted on calling it the Wuhan virus his crude way of pinning sole blame on China.
International action has also been hampered at the UN security council by US objections over terminology.
Trump has ignored impassioned calls to create a Covid-19 global taskforce or coalition. He appears oblivious to the catastrophe bearing down on millions of people in the developing world.
Trumps battle against multilateralism has made it so that even formats like the G7 are no longer working, commented Christoph Schult in Der Spiegel. It appears the coronavirus is destroying the last vestiges of a world order.
Trumps surreal televised Covid-19 briefings are further undermining respect for US leadership. Trump regularly propagates false or misleading information, bets on hunches, argues with reporters and contradicts scientific and medical experts.
While publicly rejecting foreign help, Trump has privately asked European and Asian allies for aid even those, such as South Korea, that he previously berated. And he continues to smear the World Health Organization in a transparent quest for scapegoats.
To a watching world, the absence of a fair, affordable US healthcare system, the cut-throat contest between American states for scarce medical supplies, the disproportionate death toll among ethnic minorities, chaotic social distancing rules, and a lack of centralised coordination are reminiscent of a poor, developing country, not the most powerful, influential nation on earth.
Thats a title the US appears on course to lose a fall from grace that may prove irreversible. The domestic debacle unleashed by the pandemic, and global perceptions of American selfishness and incompetence, could change everything. According to Walt, Trump has presided over a failure of character unparalleled in US history.
Do Americans realise how far their countrys moral as well as financial stock has fallen? Perhaps at this time of extreme stress, it seems not to matter. But it will matter later on for them and for the future international balance of power.
Heiko Maas, Germanys foreign minister, said he hoped the crisis would force a fundamental US rethink about whether the America first model really works. The Trump administrations response had been too slow, he said. Hollowing out international connections comes at a high price, Maas warned.
Lasting resentment over how the US went missing in action in the coronavirus wars of 2020 may change the way the world works.
WASHINGTON As the coronavirus emerged and headed toward the United States, an extraordinary conversation was hatched among an elite group of infectious disease doctors and medical experts in the federal government and academic institutions around the nation.
Red Dawn a nod to the 1984 film with Patrick Swayze and Charlie Sheen was the nickname for the email chain they built. Different threads in the chain were named Red Dawn Breaking, Red Dawn Rising, Red Dawn Breaking Bad and, as the situation grew more dire, Red Dawn Raging. It was hosted by the chief medical officer at the Department of Homeland Security, Dr. Duane C. Caneva, starting in January with a small core of medical experts and friends that gradually grew to dozens.
The Red Dawn String, Dr. Caneva said, was intended to provide thoughts, concerns, raise issues, share information across various colleagues responding to Covid-19, including medical experts and doctors from the Health and Human Services Department, the Centers for Disease Control and Prevention, the Homeland Security Department, the Veterans Affairs Department, the Pentagon and other federal agencies tracking the historic health emergency.
Here are key exchanges from the emails, with context and analysis, that show the experts rising sense of frustration and then anger as their advice seemingly failed to break through to the administration, raising the odds that more people would likely die.
One of the most active participants in the group was Dr. Carter E. Mecher, a senior medical adviser at the Veterans Affairs Department who helped write a key Bush-era pandemic plan. That document focused in particular on what to do if the government was unable to contain a contagious disease and there was no available vaccine, like with the coronavirus.
The next step is called mitigation, and it relies on unsophisticated steps such as closing schools, businesses, shutting down sporting events or large public gatherings, to try to slow the spread by keeping people away from one another. As of late January, Dr. Mecher was already discussing the likelihood that the United States would soon need to turn to mitigation efforts, including perhaps to close the colleges and universities.
Dr. James Lawler, an infectious disease doctor at the University of Nebraska who served in the White House under President George W. Bush and as an adviser to President Barack Obama, was also a regular participant in the email chain. He stayed in regular communication with federal officials as the United States attempted to figure out how to respond to the virus. From the beginning he predicted this would be a major public health event.
Convincing governors and mayors to intentionally cause economic harm by ordering or promoting mitigation efforts such as closing businesses is always a difficult task. That is why it is so important, these medical experts said, for the federal government to take the lead, providing cover for the local officials to kick off the so-called Nonpharmaceutical Interventions, such as school and business closures. Again, this group of doctors and medical experts recognized from early on that this step was all but inevitable, even if the administration was slow to recognize the need.
Strong evidence was emerging as of mid-February with the first cases of Covid-19 already in the United States that the nation was about to be hit hard. These doctors and medical experts researched how quickly the virus spread on the Diamond Princess cruise ship, which was quarantined in the port of Yokohama, Japan, on Feb. 3 before hundreds of United States citizens on the ship returned home.
Dr. Eva Lee, a researcher at Georgia Institute of Technology who has frequently worked with the federal government to create infectious disease projections, helped the Red Dawn group do modeling, based on the virus spread on the cruise ship. (Dr. Lee is facing sentencing on federal charges that she falsified the membership certificate behind a $40,000 National Science Foundation grant for unrelated research.)
The concern these medical experts had been raising in late January and early February turned to alarm by the third week in February. That was when they effectively concluded that the United States had already lost the fight to contain the virus, and that it needed to switch to mitigation. One critical element in that shift was the realization that many people in the country were likely already infected and capable of spreading the virus, but not showing any symptoms. Here Dr. Lee discusses this conclusion with Dr. Robert Kadlec, the head of the virus response effort at the Department of Health and Human Services and a key White House adviser.
Dr. Kadlec and other administration officials decided the next day to recommend to Mr. Trump that he publicly support the start of these mitigation efforts, such as school closings. But before they could discuss it with the president, who was returning from India, another official went public with a warning, sending the stock market down sharply and angering Mr. Trump. The meeting to brief him on the recommendation was canceled and it was three weeks before Mr. Trump would reluctantly come around to the need for mitigation.
This slow pace of action was confusing to the medical experts on the Red Dawn email chain, who were increasingly alarmed that cities and states that were getting hit hard by the virus needed to move faster to take aggressive steps.
When Mr. Trump gave a speech to the nation on March 11 in which he announced limits on flights from Europe to the United States but still no move to curb gatherings in cities where the virus had spread the experts on the email chain grew angry and fearful. Among those questioning Mr. Trumps decision was Tom Bossert, who had previously served as Mr. Trumps homeland security adviser.
The Red Dawn participants were even more upset when the Centers for Disease Control and Prevention, in mid-March, questioned the value of closing schools, at least for short periods of time. Soon enough, governors ignored this advice, and most schools in the United States were shut. But it happened largely without federal leadership.
The New York Times has collected more than 80 pages of these emails, from January through March, based in part on Freedom of Information Act requests to local government officials. Some of the emails were reported on last month by Kaiser Health News. Here is a fuller collection, arranged by The Times in chronological order. This file includes a list of many of the medical experts on the email chains. It also contains related emails from certain state government medical experts who were reaching out to the federal government during the same time period.
To not have any control over anything, to just be waiting and on the edge of your seat, its mind blowing at this point. Janettes fiance, Michael, is detained on Rikers Island. Hes serving time because he failed to check in with his officer, violating his parole for drug possession. Now Michael, and hundreds like him, are at the center of a public health crisis experts have been warning about for weeks. Two months owed to the city, its not worth somebodys life. Youre giving people a life sentence leaving them there. TV announcers: An inmate who tested positive for Covid-19 died yesterday at Bellevue Hospital. Rikers is one of the largest correctional facilities in the world, and right now, the infection rate there is seven times that of New York City. Is our prison system equipped to handle an outbreak? When the coronavirus seeped into the jails, public officials, public advocates all rushed to address the situation. We will continue to reduce our jail population. Were releasing people who are in jails because they violated parole. When the virus was first identified in New York, there were 5,400 inmates in city jails. To combat the spread of the virus, the Board of Correction recommended the release of 2,000 inmates. Parole violators, people over 50, those medically at risk and inmates serving short sentences. But two weeks later, government officials have released just half. Prisons, jails, are acting as incubators for the virus. Think about the jails as the worlds worst cruise ship. If we get a real situation here, and this thing starts to spread, its going to spread like wildfire, and New York is going to have a problem on their hands. Thousands of employees travel through the citys jails every day, forming a human lifeline to the city. Inmates also come and go. So its particularly urgent to get this under control because its not just about who is in the jails right now, its really about the city. This is Kenneth Albritton. He was being held on Rikers as Covid-19 spread through the city. Its scary in there, thats what I would tell you. When I was in there, you had guys making their own masks with their shirts. They didnt want to breathe in the air with the same people thats in the dorm with them. Kenneth was on parole after serving time for second-degree manslaughter when he was 18. I was brought to Rikers Island on Feb. 5 for a curfew violation. For me reading a paper and watching the news, and Im seeing that theyre saying no more than 10 to a group. But you have 50 guys thats in a sleeping area. Its impossible to tell us to practice social distancing there when theyre being stacked on top of each other. After someone in his dorm tested positive, Kenneth says he was quarantined. But less than 24 hours later, he was released. He was given a MetroCard, but no guidance about how to deal with the potential spread of Covid-19. If they would have tested me on my way out, then I would have felt like, OK, they took the proper steps. When I left the pen to come home, they told us nothing about how we should handle situation. Even though nobody told me nothing, I felt I should quarantine myself. Not much has been considered in terms of what happens to inmates after their release, and once theyre back in the communities and in their homes. When we asked about the pace of releases, the mayors office agreed it was slow, but said they dont have full control of the process. The states Department of Corrections said its working as quickly as possible. My fiance whos on Rikers, we had our son in September and about two weeks after that, he found out that he had a warrant for his arrest. Oh, you got those boogies. I told you that baby likes that camera Oh my goodness. This is a person with nonviolent charges. Its like a real health care disaster. The parolees is like the easiest thing they do. Right. Yeah, they said about 500 or 700 parolees. I just had read it last night. Yes, that he signed off on it. The outbreak at city jails doesnt just pose a threat to inmates. On March 27, Quinsey Simpson became the first New York City corrections officer to die from Covid-19. Correction officers every day, despite harm to themselves and their family, are rolling on this island to do this job. Officer Husamudeen criticizes the citys response, though hes arguing for improving jail conditions not releasing inmates. Thats not the answer to solving this problem. They havent served their time. If they served their time, they wouldnt be on parole. But his opposition is in the minority. While the overall population at Rikers has decreased, theres an unusual consensus from public defenders, prosecutors and corrections officials that the releases arent happening quickly enough. We need to reframe our thinking around public safety right now to accommodate the fact that public safety includes trying to prevent viral spread. My brother whos a New York City schoolteacher contracted the coronavirus. Are you OK? Oh, I love you. Oh, you scared? Whats the matter? Oh, God. Dont get into your head that its going to beat you. Youre going to beat this. OK? OK, I love you. OK, Ill call you in a little while. OK. As a teacher, he had a lot of precautions, and thought he was following everything he was supposed to be doing, and he contracted the coronavirus going into a school. This is why Im so adamant about fighting for Michael to get home. The person standing right next to you can have it and you wouldnt even know it. Across city jails, hundreds of inmates and corrections workers have tested positive, and half of all inmates are now under quarantine. Covid-19 and the pandemic has exposed pretty rapidly sort of all of the weakest places in our social safety nets. And it is no surprise that one of those is the ways that jails put people at risk. I know, love This is just ridiculously scary.
Is it possible to be infected with the coronavirus and show no symptoms? Or go through a period of several days before symptoms kick in?
And even in this stage with no cough, no fever, no sign of illness, could you be transmitting the virus to others?
"There is evidence that SARS-CoV-2 has this ability to spread silently," says Shweta Bansal, an infectious disease modeler at Georgetown University.
Indeed, cases of COVID-19 among nursing home residents, choir groups and families fuel a growing concern about people who are infected, yet feel generally OK and go about their daily lives, giving the virus to friends, family members and strangers without knowing that they themselves have it.
But there are wide gaps in our understanding of how many people fit this category of "silent spreaders" as they're called by some public health researchers and how much they contribute to transmission of the disease.
Silent spreaders can be divided into three categories: asymptomatic, presymptomatic and very mildly symptomatic. Here's what we know about these variations.
Asymptomatic: people who carry the active virus in their body but never develop any symptoms
"Nothing at all," says Tara C. Smith, an epidemiologist at Kent State University's College of Public Health. "No fever, no gastrointestinal issues, no breathing issues, no coughing, none of that."
As you might imagine, it's hard to figure out when someone has a disease but shows no signs of it.
Some cases of asymptomatic carriers have been confirmed by finding and testing people who were in close contact with COVID-19 patients. For those who tested positive without symptoms, follow-up exams confirmed that about 25% continued to show no signs, World Health Organization officials said on April 1, citing data from China.
No one can truly determine the impact of asymptomatic cases on spread until there's more testing. But so far, they have made up a sliver of the total number of people who've tested positive. And the affected individuals seem to skew young. A small clinical study from Nanjing, China, followed 24 people who tested positive but didn't show overt symptoms at the time. In the one to three weeks after diagnosis, seven continued showing no symptoms. Their median age was 14.
"Can those people who are completely asymptomatic, who never develop any symptoms, transmit the infection? That's still kind of an open question," says Smith.
Presymptomatic: people who have been infected and are incubating the virus but don't yet show symptoms
After infection, symptoms might not develop for five to six days or even two weeks, according to the Annals of Internal Medicine. The time between catching the virus and showing symptoms is called the presymptomatic phase.
How do these individuals figure into transmission?
People appear to be most infectious right around the time when symptoms start, said Maria Van Kerkhove, technical lead for the WHO's Health Emergencies Programme, at an April 1 news conference. However, "we do have evidence, from testing and modeling studies, that suggest people who are presymptomatic can definitely transmit this virus," says Smith, the epidemiologist, most likely in the one to three days before they start showing symptoms, according to the WHO.
So far, presymptomatic is a much more common category than asymptomatic. About 75% of people who test positive without showing symptoms turn out to be presymptomatic, displaying coughing, fatigue, fever and other signs of COVID-19 in a later follow-up exam, said Van Kerkhove.
At a nursing home in King County, Washington, about a third of its 82 residents tested positive for the coronavirus in mid-March. Half of those were free of fever, malaise and coughing when they were swabbed for the virus, though most went on to develop symptoms. The coronavirus spread rapidly through the facility just two weeks after it was introduced by a health care provider, despite the nursing home's policy of isolating residents with signs of COVID-19. This suggests that "transmission from asymptomatic and presymptomatic residents, who were not recognized as having SARS-CoV-2 infection and therefore not isolated, might have contributed to further spread," according to research published in the CDC's April 3 "Morbidity and Mortality Weekly Report."
A study in Singapore found similar evidence of presymptomatic spread among people who went to church, took singing classes or puttered at home with their spouses.
Very mildly symptomatic: people who feel a little unwell from a COVID-19 infection but continue to come in close contact with others
"We're very lucky that this isn't a severe infection for everyone, but because of that, some people feel a little sick and power through," says Seema Lakdawala, a flu researcher at the University of Pittsburgh.
Spreading COVID-19 while having a cough or very mild fever doesn't fully count as silent transmission, says Bansal, the infectious disease modeler: "There's some signal there at least."
But people who continue to frequent communal and public places with a light cough or mild fever may unwittingly spread the disease in the early days of symptom onset the time they're thought to be most infectious.
Even when a person's own symptoms remain mild, others they infect can become very sick. In mid-January, a man returned to his home in Nanjing from a trip to Hubei province, the epicenter of China's epidemic. Ten days later, his wife started running a fever and vomiting; soon, she developed severe pneumonia and required care in the intensive care unit. The man was tested for the coronavirus, and the test came back positive; he's presumed to have spread the virus to his wife. X-ray scans showed signs of the virus in his lungs but he consistently reported feeling fine, according to epidemiological research published in Science China Life Sciences.
What we don't yet know
How many people are mingling in the population without knowing they've been infected with the coronavirus?
It's simply too soon to say. In one of the places where there has been extensive testing, the nursing home in Washington state, 56% of those who tested positive had no symptoms when they got tested. Aboard the Diamond Princess cruise ship docked in Japan, February data showed that up to 50% of the people who tested positive showed no symptoms at the time and that an estimated 18% remained asymptomatic.
Are asymptomatic and presymptomatic cases responsible for a lot of transmission?
Uncertainties abound.
Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, told NPR in an interview on April 9 that while he thinks "asymptomatic spread was and is more significant than was appreciated back in January, the relative contribution of asymptomatic spread to symptomatic spread has not been clearly defined."
A modeling paper in Science suggests that in China before the lockdown, undiscovered cases mainly people with "mild, limited or no symptoms" were less infectious than known cases but were still possibly responsible for 79% of transmission, because so many of them continued to congregate or travel while contagious. Other papers from Singapore and China suggest that presymptomatic cases account for 6% to 13% of transmission.
To start answering these questions about spread, "we really need more testing and more follow-up," says Smith.
The National Institutes of Health announced Friday that it's recruiting up to 10,000 volunteers for blood testing to look for antibodies to COVID-19 a sign that a person was infected in the past. "This study will ... [tell] us how many people in different communities have been infected without knowing it, because they had a very mild, undocumented illness or did not access testing while they were sick," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, in a news release.
Even though there is still much to learn about silent spreading, the concerns about this mode of transmission give more weight to the advice we've been hearing all along: Keep a 6-foot distance from others, wash hands often and wipe down surfaces. "Don't wait for symptoms to protect those around you," Bansal of Georgetown University says, because there's mounting evidence that a person with the coronavirus could look and feel as healthy as ever but still be spreading it to others.
The model, from the Institute for Health Metrics and Evaluation at the University of Washington, was created by Dr. Christopher Murray, who told CNN Monday the country can essentially stop coronavirus transmission this summer.
"The one thing we absolutely know for sure is that social distancing measures work," Murray said. "It leads to a situation where every case is infecting less than one other case, and that means if you keep the course, you'll get transmission essentially down to zero."
Murray cited Italy and China as places where this was happening.
According to Murray's model, Monday was the peak day for daily deaths in the United States. It projected about 2,150 Covid-19 deaths Monday, which are expected to decline moving forward.
New York, one of the hotspots for the virus, hit its peak number of deaths three days ago, according to the model, but hundreds of deaths are still expected daily for the coming week.
By August, the model predicts, a total of 68,841 people will have died in the United States, which is up from Friday's projection of 61,500 deaths.
States on both coasts are now banding together to fight the pandemic. On the East Coast, the Northeastern states of New York, New Jersey, Connecticut, Pennsylvania, Delaware, Rhode Island and Massachusetts are coordinating to reopen the economy. Out West, the governors of California, Oregon and Washington agreed on a regional pact.
The number of infections -- which stood at more than 580,000 on Monday afternoon -- was also down Saturday and Sunday.
This comes as US Surgeon General Dr. Jerome Adams says cases in some of the country's hotspots -- New York, New Jersey, Detroit and New Orleans -- appear to be "leveling off" or even declining. The situations in California and Washington, meanwhile, remain stable.
Still, many states are in the throes of an intense effort to stem the illness' spread. New York crossed the 10,000-death threshold Monday, as its cases topped 190,000, Gov. Andrew Cuomo said. New Jersey and Michigan also have frightening death tolls, with more than 2,300 and 1,400 respectively.
The upside to New York's numbers is that the three-day average for hospitalization, new hospitalizations, intensive care admissions and intubations are all down, Cuomo said Monday morning.
States band together to fight Covid-19
Cuomo announced Monday the beginning of a "geographically coordinated" reopening plan in conjunction with leaders in New Jersey, Connecticut, Pennsylvania, Delaware, Rhode Island and Massachusetts. Each state will name health and economic officials to join the governors' chiefs of staffs to a working group, which will begin discussions Tuesday.
The group will come up with "parameters to go forward," Cuomo said, and while they may not agree on every aspect of the strategy, finding areas where they can coordinate will be important, especially given the states' close economic, health and transportation ties.
Calling the commuter thoroughfare from his state of Connecticut to New York the "Covid corridor," Gov. Ned Lamont said it was vital that "you don't pull the trigger too early," but applauded the partnership.
"The reality is this virus doesn't care about state borders, and our response shouldn't either," Rhode Island Gov. Gina Raimondo said.
"By working, sharing our information and intelligence, I think will help each of us make better decisions," Delaware Gov. John Carney added, while Pennsylvania Gov. Tom Wolf said, "We can do anything better when we work together in this region."
On the West Coast, California, Oregon and Washington are joining forces "on a shared approach for reopening our economies," a joint statement from California Gov. Gavin Newsom, Oregon Gov. Kate Brown and Washington Gov. Jay Inslee said.
The public health leaders in the three states will focus on four main goals, the statement read. These goals include: Protecting vulnerable populations at risk like those in nursing homes, ensuring care for those who may contract Covid-19, mitigating the non-direct health impacts of the virus on disadvantaged communities and protecting the public by ensuring the lifting of restrictions comes with adequate testing.
"The states will work together to share best practices and coordinate a framework to get it done," Inslee tweeted.
Minnesota Gov. Tim Walz told reporters Monday he'd contact the governors of Michigan and Wisconsin to begin thinking regionally in terms of opening up the economies in each state.
Colorado Gov. Jared Polis said that he would welcome a national approach to the timing of reopening the states.
"I do hope there is a focus on a better national uniformity about how we can combat this because we do have a lot of commerce and travel between our states just as we do within our state," Polis said during a Monday news conference. "We border different states that have different policies. We border different states that have different trajectories of the infection."
On the federal level, planning is underway for a federally supported "public health force" to carry out the state-level epidemiology "that's going to be necessary to open the country back up," a federal health official with knowledge of the planning told CNN.
The official, who is directly involved in the day-to-day national coronavirus response, told CNN the plan was part of discussions of next steps by the White House Task Force.
"Hundreds of millions of dollars are going out to the state health departments right now," the official said. "They are who are going to hire people to do this work. This is to beef up our public health infrastructure through individuals that the CDC hires and places in state health departments, as well as the state health departments themselves hiring people. This plan would really beef up capabilities for if in fact we reopen and we start to see a re-emergence of cases."
The federal health official told CNN that the "large-scale" push for epidemiology is part of the recent initiative led by eight "community protection" CDC field teams deployed in recent weeks. Those CDC teams were sent to states where transmission rates are low to assist state and local health departments with contact tracing and testing.
Neither the Task Force nor the US Centers for Disease Control and Prevention responded to CNN's request for comment.
The United States is also expected to receive about 750,000 more coronavirus tests from South Korea, according to the Federal Emergency Management Agency.
FEMA awarded contracts to manufacturers in South Korea last week to provide the tests, according to a FEMA spokesperson and federal records.
Over the weekend, the first shipment of 150,000 tests was delivered to the United States. The next shipment of 600,000 tests is expected to arrive April 15.
Trump is scheduled Tuesday to announce the formation of the "Opening our Country Council," which is expected to focus on ways to stimulate the economy. Another panel, the White House's coronavirus task force, has been focusing on providing advice to the states on what to do once reopening is advised.
The task force is weighing potential benchmarks that would precede reopening the states, but have yet to settle on specific targets, people familiar with the discussions said.
Governors say their states aren't ready to be reopened fully
Multiple governors across the country said Monday their states aren't ready to reopen their economies.
Louisiana Gov. John Bel Edwards said it was too early to know if his state was ready to loosen social distancing guidelines.
"As Dr. (Anthony) Fauci said last week, it's not like flipping a light switch, where you just go from being dark to light, all at one time. So this is going to be done in some sort of a transition. And we're going to be doing it that way here in Louisiana," Edwards said. "I cannot tell you exactly what that's going to look like yet, but we will be working really hard with all the experts to get that figured out."
Tennessee Gov. Bill Lee on Monday extended the state's stay-at-home order to April 30, which will make way for a "phased reboot" of the economy in May.
"Between now and then, we'll create industry-specific guidance so that businesses can be fully prepared to operate safely and to protect their employees and their customers," Lee said.
Minnesota Gov. Tim Walz extended the state's peacetime emergency until May 13, he announced Monday. Minnesota's stay-at-home order goes through May 4.
Michigan Gov. Gretchen Whitmer on Monday also extended her state's stay-at-home order until April 30.
"By extending these Executive Orders, we ensure that our state continues to do all it can to suppress the spread of COVID-19 by limiting in-person interactions and services as much as possible right now, while also ensuring that vital goods and supplies get to the people who need them most as quickly and safely as possible," Whitmer said in a statement.
In Georgia, Gov. Brian Kemp dismissed the idea of formulating any plans to reopen the state any time soon.
"Our focus is on the hospital surge capacity, the ability to test more, because we are going to need that when we go back to work," Kemp said.
Governors in the Upper Great Plains say they believe the worst has yet to come as far as a peak in Covid-19 cases and deaths. The curve in North Dakota, said Gov. Doug Burgum, may be going up when other parts of the country are going down.
"We have said all along there are going to be different curves for different parts of the country, and so we are not there yet," Burgum said. "That is going to be confusing for people. If wow, New York had all these deaths and they are opening up, why aren't we opening? That will be a communication challenge for us, but we have to just keep monitoring and see where we are going on this."
Doctors in wait-and-see mode
All 50 states are under a federal disaster declaration for the first time in US history. There are more than 29,000 members of the National Guard deployed across the country to deal with the pandemic, according to the National Guard Bureau. Guardsmen have been called to serve a variety of roles, from staffing emergency operations centers to restocking grocery shelves.
Key to how optimistic Americans should be will depend on what comes next. The country's testing trajectory will be hugely important, experts say.
While President Donald Trump says he wants to reopen the country next month -- even telling state governments to "be ready" as he plans to announce a special council to reopen the country -- health officials say they're still in wait-and-see mode even if the numbers look promising.
"It's important to look at the country as many different separate situations," said Dr. Robert Redfield, director of US Centers for Disease Control and Prevention, on NBC's "Today" show.
"This pandemic has affected different parts of the country differently," Redfield said. "We're looking at the data very carefully, county by county by county, and we will be assessing that."
Public health capabilities need to be improved to perform early case detection, isolation and contact tracing, he said, and officials need to "start working to rebuild confidence in the community, so the community has confidence to reopen."
Testing and social distancing
The US is "nearing the peak right now," Redfield told the morning show.
"You'll know when you're at the peak when the next day is less than the day before," he said. "We are stabilizing across the country in terms of the state of this outbreak."
Detroit and Los Angeles reported lower rates of cases Monday.
As for getting the country back to normal, Redfield said it has to be done correctly and "it's going to be a step-by-step, gradual process."
The call for caution is being echoed on the world stage as World Health Organization Director-General Tedros Adhanom Ghebreyesus asked people to remember the virus accelerates faster than it decelerates, so "control measures can only be lifted if the right public health measures are in place."
Redfield concurred with Adams that social distancing is working -- and said the potential death toll "while sadly too high, was far less than we anticipated" -- but said relaxing those guidelines would need to be done carefully.
Testing is still not widely available, and many states have still tested only small percentages of their populations.
Antibody tests, which reveal past coronavirus infection -- an especially important test for health care workers -- will "give us a good idea from a surveillance point of view of how significant the outbreak was."
A majority of the storms were across the South and East Coast, according to the National Weather Service, with at least 34 tornadoes reported in Texas, Louisiana, Mississippi and Georgia as of early Monday. At least 18 people died.
Updated 5:33 p.m.
Gov. Tim Walz on Monday signaled the state planned to move into a more aggressive posture to test for COVID-19 and trace and isolate those infected as part of the next phase of reopening parts of the economy.
Minnesota has tested just under 40,000 Minnesotans since the pandemic began but we need to be testing 40,000 a week or more, Walz told reporters during an afternoon briefing.
The governor tempered his ongoing warnings about an expected surge in cases and frustration over securing laboratory supplies and testing gear with guarded optimism the states health system would be ready to handle the load and that economically there are plans to move us back to a more sustainable place.
He also said he supported allowing bars to sell beer and wine for off-site consumption and would sign a bill once the Legislature approves it.
Walz said his people were also working on guidance about outdoor activities, including golf and fishing, and that he hoped for an answer soon. "The more we're able to open some of these things it will let off a little bit of steam."
Walzs remarks came hours after state health officials reported no new deaths in Minnesota tied to the COVID-19 pandemic compared to Sunday. That means the death toll remains at 70. The number of people in intensive care also remained stable from Sunday at 74.
The Health Department reported 1,650 people testing positive for COVID-19 since the outbreak began, with just over half recovered to the point they no longer need to be isolated.
While he didnt have details, Walz made it clear that the state was preparing a big push on testing as part of the effort to restart the economy, which has been hit hard the past month.
He cautioned that it was too early to decide if his stay-at-home order will go beyond May 4 and that he could not set a date yet for when restaurants and bars businesses hurt badly by the virus and the stay-at-home order intended to slow its spread but that he said he envisioned a rolling back into the economy as testing efforts jump.
Among the other updates Monday:
Walz and state officials said the states executive branch would put a hiring freeze in place for jobs not directly related to COVID-19 and that the governor and his commissioners would take a 10 percent pay cut through the rest of the year.
The Metro Mobility transportation service in the Twin Cities region would begin offering health care workers free door-to-door transportation to and from work, 24 hours a day.
Health Commissioner Jan Malcolm said data that was provided over the weekend on COVID-19 cases, hospitalizations and deaths did not offer an "apples to apples" comparison of changes from prior days. The current totals have been updated.
The disease continues its spread into rural parts of Minnesota. Red Lake, Todd and Rock counties reported their first confirmed coronavirus cases Sunday, although the Health Department reported no new counties on Monday.
Officials continue to caution the virus is much more widespread than what the daily updates indicate, with yet-undiscovered cases potentially higher than 150,000.
Walz on Monday also extended his peacetime emergency order for another 30 days, through May 13. Walz invoked the peacetime emergency on March 13, allowing him to take executive actions to deal with the coronavirus.
The order extension drew a rebuke from some House Republicans, who say theyll try to overturn it this week in the Legislature.
Cleveland-Cliffs Inc. said Monday it plans to temporarily idle Northshore Mining in northeastern Minnesota. The company plans to temporarily idle production at Northshore by mid-April with a planned restarted by August.
Cliffs said it will work down current inventory levels from the mine and continue to ship iron ore to fulfill its agreements with steel customers.
In a statement, CEO Lourenco Goncalves said the Cleveland-based company has evaluated market conditions and the extraordinary disruptions in manufacturing and steel production in North America due to the impact of the COVID-19 market shock.
Northshore Mining officials said about 470 employees will be laid off, with the remaining 100 employees kept on to maintain the yard and dock crews to load vessels, KBJR-TV reported. The company will also idle Tilden Mine in Michigan by the end of April, with a planned restart in July.
The Associated Press
The Hennepin County Sheriff's Office says the jail has detected its first confirmed case of COVID-19.
In a news release, sheriff's office spokesperson Rob Allen said a man exhibiting symptoms of the virus was booked into the jail last Friday. The man was tested and isolated pending the results of the test. Allen said after the man tested positive, he was notified about his status and was released to isolate at home.
Allen said the jail had already implemented safety precautions to prevent an outbreak including suspending visits, training jail staff on sanitation and the use of personal protective gear and isolating symptomatic inmates or those who may have been exposed to the virus.
The state Department of Corrections said on Monday an inmate at the Willow River correctional facility has also tested positive for the coronavirus.
As of Sunday, 11 inmates at the Moose Lake prison have tested positive. Moose Lake had the first confirmed cases of the coronavirus in a Minnesota adult prison. Corrections Commissioner Paul Schnell has said the release of some state prisoners because of the coronavirus could happen as early as this week.
Brandt Williams | MPR News and The Associated Press
Gov. Tim Walz on Friday signed an executive order directing the state Department of Health to develop a protocol for sharing information about confirmed COVID-19 cases with first responders.
Walz's order allows for the addresses where a COVID-19 case has been identified and only where a patient is still contagious to be disclosed to 911 dispatchers and first responders. Names of affected individuals and other identifying information will not be provided to local officials.
Walz wrote in his order that first responders need to assume everyone they meet could be a coronavirus carrier but the order allows for more protection.
"This decision is not taken lightly," Walz wrote in the order. "We must ensure that this health information is disclosed only to those who have an emergent need to know it, and we must implement safeguards to ensure that no one abuses this data. Minnesota has a strong tradition of protecting the private data of its citizens. This is reflected in the penalties imposed for unlawful use of private data provided by the (Minnesota Government Data Practices Act), which will continue to apply to the data shared under this Executive Order."
The order mandates that "the shared data must remain confidential, be encrypted in transit, (and be) provided only to the minimum number of people necessary."
Minnesota U.S. Rep. Pete Stauber of Minnesota's 8th District, a retired police officer, was among those who had backed such an order.
"As we continue to wage war against COVID-19, it is only right that the law enforcement officers, first responders, and firefighters on the front lines of this fight have all the information they need to protect and prepare themselves," he said in a news release.
MPR News staff
The Minnesota Department of Natural Resources has temporarily closed Grand Portage State Park in far northeastern Minnesota.
That's at the request of the Grand Portage Band of Lake Superior Chippewa, amid concerns about the spread of the coronavirus pandemic. The park is located on the Grand Portage Reservation.
The closure is in effect until at least May 4.
Meanwhile much of Fort Snelling State Park in the Twin Cities is closed due to flooding along the Minnesota and Mississippi rivers.
Other state parks remain open for day use, but state park campgrounds, lodging and visitor centers are closed because of COVID-19.
MPR News staff
Minnesota farmers to feel fallout from closure of major pork processing plant: For Minnesota, one of the biggest pork-producing states in the country, the plant plays a significant role in hog farms' sales. It would be pure speculation as to what the price impact for farmers is going to be starting this coming week, but I see zero scenario that its not negative. Its just a question of how much, said David Preisler, CEO of the Minnesota Pork Producers Association.
Legislature to act on new coronavirus bill with others in works: The Legislature has already passed three bills with financial help for health providers, first responders and small businesses. The latest plan is more policy focused.
Local government goes virtual during pandemic: The coronavirus pandemic, and efforts to slow its spread, has shuttered many government buildings. But cities and counties need to continue providing essential services, so many local governments are moving to remote, virtual meetings.
Minneapolis officials say too many are ignoring posted virus signs: City officials may get tougher on people who ignore social distancing rules. However, Minneapolis police are not eager to issue fines.
Health officials for weeks have been increasingly raising the alarm over the spread of the novel coronavirus in the United States. The disease is transmitted through respiratory droplets, coughs and sneezes, similar to the way the flu can spread.
Government and medical leaders are urging people to wash their hands frequently and well, refrain from touching their faces, cover their coughs, disinfect surfaces and avoid large crowds, all in an effort to curb the virus rapid spread.
The state of Minnesota has temporarily closed schools, while administrators work to determine next steps, and is requiring a temporary closure of all in-person dining at restaurants, bars and coffee shops, as well as theaters, gyms, yoga studios and other spaces in which people congregate in close proximity.
