Category: Corona Virus

This post will be updated as news about the coronavirus in New Jersey breaks.

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LIVE UPDATES: Tracking the coronavirus in New Jersey - NJ Spotlight

PARIS In the early days of the pandemic, President Emmanuel Macron exhorted the French to wage war against the coronavirus. Today, his message is to learn how to live with the virus.

From full-fledged conflict to cold war containment, France and much of the rest of Europe have opted for coexistence as infections keep rising, summer recedes into a risk-filled autumn and the possibility of a second wave haunts the continent.

Having abandoned hopes of eradicating the virus or developing a vaccine within weeks, Europeans have largely gone back to work and school, leading lives as normally as possible amid an enduring pandemic that has already killed nearly 215,000 in Europe.

The approach contrasts sharply to the United States, where restrictions to protect against the virus have been politically divisive and where many regions have pushed ahead with reopening schools, shops and restaurants without having baseline protocols in place. The result has been nearly as many deaths as in Europe, though among a far smaller population.

Europeans, for the most part, are putting to use the hard-won lessons from the pandemics initial phase: the need to wear masks and practice social distancing, the importance of testing and tracing, the critical advantages of reacting nimbly and locally. All of those measures, tightened or loosened as needed, are intended to prevent the kind of national lockdowns that paralyzed the continent and crippled economies early this year.

Its not possible to stop the virus, said Emmanuel Andr, a leading virologist in Belgium and former spokesman for the governments Covid-19 task force. Its about maintaining equilibrium. And we only have a few tools available to do that.

He added, People are tired. They dont want to go to war anymore.

Martial language has given way to more measured assurances.

We are in a living-with-the-virus phase, said Roberto Speranza, the health minister of Italy, the first country in Europe to impose a national lockdown. In an interview with La Stampa newspaper, Mr. Speranza said that though a zero infection rate does not exist, Italy was now far better equipped to handle a surge in infections.

There is not going to be another lockdown, Mr. Speranza said.

Still, risks remain.

New infections have soared in recent weeks, especially in France and in Spain. France recorded more than 10,000 cases on a single day last week. The jump is not surprising since the overall number of tests being performed now about a million a week has increased steadily and is now more than 10 times what it was in the spring.

The death rate of about 30 people a day is a small fraction of what it was at its peak when hundreds and sometimes more than 1,000 died every day in France. That is because those infected now tend to be younger and health officials have learned how to treat Covid-19 better, said William Dab, an epidemiologist and a French former national health director.

The virus is still circulating freely, were controlling poorly the chain of infections, and inevitably high-risk people the elderly, the obese, the diabetic will end up being affected, Mr. Dab said.

In Germany, too, young people are overrepresented among the rising cases of infections.

While the German health authorities are testing over a million people a week, a debate has started over the relevance of infection rates in providing a snapshot of the pandemic.

At the beginning of September, only 5 percent of confirmed cases had to go to the hospital for treatment, according to data from the countrys health authority. During the height of the pandemic in April, as many as 22 percent of those infected ended up in hospital care.

Hendrik Streeck, head of virology at a research hospital in the German city of Bonn, cautioned that the pandemic should not be judged merely by infection numbers, but instead by deaths and hospitalizations.

Weve have reached a phase where the number of infections alone is no longer as meaningful, Mr. Streeck said.

Much of Europe was unprepared for the arrival of the coronavirus, lacking masks, test kits and other basic equipment. Even nations that came out better than others, like Germany, registered far greater death tolls than Asian countries that were much closer to the source of the outbreak in Wuhan, China, but that reacted more quickly.

National lockdowns helped get the pandemic under control across Europe. But infection rates began rising again over the summer after countries opened up and people, especially the young, resumed socializing, often without adhering to social-distancing guidelines.

Even as infections have been rising, Europeans have returned to work and to school this month, creating more opportunity for the virus to spread.

We control infection chains better compared to March or April when we were completely powerless, said Mr. Dab, the former French national health director. Now the challenge for the government is to find a balance between reviving the economy and protecting peoples health.

And its not an easy balance, Mr. Dab added. They want to reassure people so theyll go back to work, but at the same time, we have to make them worried so that theyll keep respecting preventive measures.

Among those measures, masks are now widely available across Europe, and governments, for the most part, agree on the need to wear them. Early this year, faced with shortages, the French government discouraged people from wearing masks, saying they did not protect wearers and could even be harmful.

Wearing a face covering has become part of the lives of Europeans, most of whom last March still regarded with suspicion and incomprehension mask-wearing tourists from Asia, where the practice has been widespread for the past two decades.

Instead of applying national lockdowns with little regard to regional differences, the authorities even in a highly centralized nation like France have begun responding more rapidly to local hot spots with specific measures.

On Monday, for example, Bordeaux officials announced that, faced with a surge in infections, they would limit private gatherings to 10 people, restrict visits to retirement homes and forbid standing at bars.

In Germany, while the new school year has started with mandatory physical classes around the country, the authorities have warned that traditional events, like carnival or Christmas markets, may have to be curtailed or even canceled. Soccer games in the Bundesliga will continue to be played without fans until at least the end of October.

In Britain, where mask wearing is not especially widespread or strictly enforced, the authorities have tightened the rules on family gatherings in Birmingham, where infections have been rising. In Belgium, people are restricted to limiting their social activity to a bubble of six people.

In Italy, the government has sealed off villages, hospitals or even migrant shelters to contain emerging clusters. Antonio Miglietta, an epidemiologist who conducted contact tracing in a quarantined building in Rome in June, said that months of battling the virus had helped officials extinguish outbreaks before they got out of control, the way they did in northern Italy this year.

We got better at it, he said.

Governments still need to get better at other things.

At the peak of the epidemic, France, like many other European nations, was so desperately short of test kits that many sick people were never able to get tested.

Today, though France carries out a million tests a week, the widespread testing has created delays in getting appointments and results up to a week in Paris. People can now get tested regardless of their symptoms or the history of their contacts, and officials have not established priority tests that would speed up results for the people at highest risk to themselves and others.

We could have a more targeted testing policy that would probably be more useful in fighting the virus than what were doing now, Lionel Barrand, president of the Union of Young Medical Biologists, said, adding that the French government should restrict the tests to people with a prescription and engage in targeted screening campaigns to fight the emergence of clusters.

Experts said that French health officials must also greatly improve contact-tracing efforts that proved crucial in reining in the spread of the virus in Asian nations.

After the end of its two-month lockdown in May, Frances social security system put in place a manual contact-tracing system to track infected people and their contacts. But the system, which relies greatly on the skills and experience of human contact tracers, has produced mixed results.

At the start of the campaign, each infected person gave the contact tracer an average of 2.4 other names, most likely family members. The campaign improved steadily as the number of names rose to more than five in July, according to a recent report by the French health authorities.

But since then, the average figure has fallen gradually to less than three contacts per person, while the number of Covid-19 confirmed cases has increased tenfold in the meantime, rising from a seven-day average of about 800 new cases per day in mid-July to an average of some 8,000 per day currently, according to figures compiled by The New York Times.

At the height of the epidemic, most people in France were extremely critical of the governments handling of the epidemic. But polls show that a majority now believe that the government will handle a possible second wave better than the first one.

Jrme Carrire, a police officer who was visiting Paris from his home in Metz, in northern France, said it was a good sign that most people were now wearing masks.

In the beginning, like all French people, we were shocked and worried, Mr. Carrire, 55, said, adding that two older family friends had died of Covid-19. And then, we adjusted and went back to our normal lives.

Reporting was contributed by Constant Mheut and Antonella Francini from Paris, Matt Apuzzo from Brussels, Gaia Pianigiani and Emma Bubola from Rome, and Christopher F. Schuetze from Berlin.

Here is the original post:

Even as Cases Rise, Europe Is Learning to Live With the Coronavirus - The New York Times

After months of complaints about testing delays, New York City officials on Thursday are set to announce that they have opened a lab in Manhattan that should significantly cut down on wait times as the city prepares for its most ambitious period of reopenings, with public school classes and indoor dining scheduled to begin this month.

Rather than depend on the big laboratory companies which have been inundated with demand from across the country as the virus continues to spread, leading to backlogs the new facility will prioritize New York City residents, meaning turnaround times within 24-48 hours, officials said.

Within a few weeks it is expected to be able to process more tests for city residents than any other lab, a rare bright spot for New Yorkers, who since March have experienced numerous woes in trying to get tested for the coronavirus.

It will give us more capacity just in terms of sheer numbers, said Dr. Jay Varma, a City Hall adviser who is playing a leading role in the citys coronavirus response. It will also give us control because this is a laboratory really dedicated to New York City.

New York City has one of the most ambitious coronavirus testing programs in the country, swabbing more than 200,000 people a week, more than 2 percent of all city residents. The new lab, which began processing tests this week, should eventually help significantly expand on that.

The laboratory, on the 12th floor of a building on First Avenue and East 29th Street, is run by Opentrons, a small robotics firm. But New York City has played a significant role in the laboratorys creation, city officials said. For now, the city and its public hospital system are the labs only customer.

At first, the new laboratory, which is being called the Pandemic Response Lab, will handle just a few thousand tests a day, mainly from samples collected at testing sites run by the citys public hospital system, officials with City Hall and Opentrons said.

But the expectation is that the laboratory will eventually be able to test more than 40,000 samples a day, possibly including some from public school students and teachers, depending on the need.

By Wednesday morning, the lab had returned results on the first 712 samples it had been sent, and is currently able to handle about 3,000 samples a day, a number that is expected to rise dramatically over the next week, a spokesman for the lab said.

Public health officials are hopeful that testing will for the first time since the coronavirus arrived in New York City no longer be a scarce resource.

The new laboratory is the latest chapter in the citys long-running efforts to fix a series of problems plaguing testing efforts. The problems go back to February and March, when a series of missteps and disastrous decisions by the federal government meant that few people qualified for a test even when they exhibited clear Covid-19 symptoms as the virus began circulating across New York City and its suburbs.

At first, the federal government had a monopoly over testing, and the city scrambled to develop the ability to test on its own. Early on, the effort was hamstrung by shortages of test kits, chemical reagents and even the swabs used to collect samples.

In the months that followed, the largest national laboratories dramatically increased their testing capacity, and New York City began to rely on them to handle most local testing. But some of these laboratories, like Quest Diagnostics, grew overwhelmed this summer amid worsening outbreaks elsewhere in the country.

That contributed to wait times as long as 2 to 3 weeks for test results in New York. To public health officials, it was clear New York City needed more testing infrastructure that it could control or at least rely on.

Well be getting into the scale of testing capacity that we feel is critical, Dr. Varma said.

The additional capacity could come in handy amid the coming push for students and teachers to get tested as in-class instruction resumes for hundreds of thousands in the public school system. And as flu season begins and colds began circulating in greater numbers, the demand for testing may increase as New Yorkers contend with symptoms that might or might not mean Covid-19.

We knew that we really needed our testing capacity to be at the maximum in the fall, Dr. Varma said.

Opentrons, the robotics company that will run the lab, specializes in automating research laboratories. Jonathan Brennan-Badal, the companys chief executive officer, said three robotic arms will move trays, each containing some 380 samples, between different testing stations.

The laboratory expects to start pooling samples, a method where a number of samples are grouped together and tested as one.

James Patchett, the president of the citys economic development corporation, expressed hope that with pooling the laboratory would be able to eventually test 40,000 to 60,000 samples a day.

The push for the laboratory goes back to early April, at the height of outbreak, when City Hall realized it faced shortages of critical supplies.

Month after month, the citys testing program remained a weak link in its ability to respond to the coronavirus.

The city itself has had limited capacity to process tests. There was the Health Departments own public health laboratory, as well as rapid testing equipment at various city-run sexual health clinics and public hospitals. All told, the city could process about 10,000 tests a day on its own, Jeff Thamkittikasem, the director of the mayors office of operations, said.

Mayor Bill de Blasio has spoken of the citys ambition to test 50,000 New Yorkers per day by summers end.

For months now, City Hall and the citys economic development agency have been speaking with lab companies and start-up firms about building more lab capacity devoted to handling tests for New York City.

The new laboratory will rely in part on a process that was developed by genetic researchers at NYU Langone Medical Center, Mr. Brennan-Badal, the chief executive of Opentrons, said. In addition to allowing for high-volume testing, the process also consumes comparatively fewer reagents and other supplies that have been scarce at various points in the pandemic, he said.

The city will pay Opentrons $28 for each test, which Mr. Brennan-Badal said was less than a third of what some other laboratories were charging.

Mr. Thamkittikasem, the mayors operations aide, said that the plan was for the lab to eventually test samples for influenza as well.

Here is the original post:

NYC Is Opening Its Own Coronavirus Testing Lab - The New York Times

High school parties force some Northeast schools in the U.S. to delay the return to classes.

Several K-12 school districts in the U.S. Northeast have delayed the start of in-person classes in recent days after high school students attended large parties, leading to concern about increased spread of the virus.

After several weeks of partying college students complicating their schools reopening plans, high school students are now creating the same disruptions, underscoring the yawning gap between policy and enforcement and the limitations of any school to control the behavior of young people.

Lincoln-Sudbury Regional High School in Sudbury, Mass., just west of Boston, delayed opening classrooms by two weeks, to Sept. 29, after the police broke up a party involving 50 to 60 students from the school on Saturday, local officials said.

The Board of Health said the police had reported that the students were not wearing masks or practicing social distancing, and that many had either fled when the police arrived or given false names to officers.

Although there were no known cases of the virus among students at the party, the board said that without complete information about who had attended, the risk to the school community cannot be adequately assessed.

In nearby Dedham, Mass., the school district also delayed in-person instruction after an uptick of cases in the town, which local health officials attributed to two recent gatherings of young people, including a party attended by high school students.

In Pelham, N.Y., high school students partying during and after the Labor Day weekend led the school district to postpone the start of in-person learning for all students and to require that high school students either be tested before coming to school or quarantine for 14 days.

The superintendent, Cheryl H. Champ, wrote in a letter to families that more than 100 teenagers appeared to have attended the parties and that video showed students engaging in risky behavior, failing to practice physical distancing, and not wearing masks or face coverings.

Also in New York, Carle Place Union Free School District on Long Island delayed bringing students back to school after end-of-summer parties led to positive cases.

As we are learning the hard way, the actions of a few can impact the many, the superintendent, Christine A. Finn, wrote to families.

Trump defends his indoor rally, but some aides are concerned.

President Trump and his campaign are defending his right to rally indoors after they held one on Sunday in Nevada. But some aides have privately called the move a game of political Russian roulette amid growing concern that such gatherings could prolong the pandemic.

Im on a stage, and its very far away, Mr. Trump said in an interview with The Las Vegas Review-Journal on Monday, after thousands of his supporters gathered on Sunday night inside a manufacturing plant in a Las Vegas suburb, flouting a state directive limiting indoor gatherings to fewer than 50 people.

The president did not address health concerns about the rally attendees, a vast majority of whom did not wear masks or practice any social distancing. When it came to his own safety, he said, Im not at all concerned.

The decision to hold a rally indoors, officials said, was something of a last resort for a campaign that had tried to procure five different outdoor locations. A Trump campaign official said they all faced pressure from state officials not to host the rally. The plant where the rally was ultimately held, Xtreme Manufacturing, has been fined $3,000 by the city of Henderson, Nev., the local news media reported.

Upcoming rallies in Wisconsin and Minnesota are planned for outdoor airport hangars, the kind of gathering the president recently resumed scheduling with little fanfare but which still violates state guidelines limiting gatherings to fewer than 50 people. But some states, including North Carolina, where Mr. Trump held an outdoor rally in Winston-Salem last week, have a First Amendment exemption permitting crowds to gather in the name of freedom of speech.

Tim Murtaugh, a Trump campaign spokesman, defended the decision to carry on with an indoor rally.

No one bats an eye at people gambling in casinos or tens of thousands of people protesting shoulder to shoulder, he said. People should be able to gather peacefully under the First Amendment to hear from the president of the United States.

But the decision to forge ahead created a wave of internal backlash, including from a top Trump adviser who said the campaign was taking a cavalier approach to the pandemic that could backfire politically. The adviser requested anonymity so as not to anger Mr. Trump.

More than 100 people, a majority of them not wearing masks, packed into a hotel ballroom in Arizona for an event on Monday.

A sweeping initiative to test and screen all 700,000 students and 75,000 employees in the Los Angeles public schools for the virus has started, with five cases detected last week among more than 5,400 children and adults tested, the districts superintendent said.

All were among adults who work for the district. Up to 20,000 more employees are to be tested this week, said Austin Beutner, the superintendent, whose Los Angeles Unified School District is the nations second largest, behind New York Citys.

Some 700 small children in district-provided child care were also tested, Mr. Beutner said, but none were infected.

With the exception of certain special-needs students, who recently received the go-ahead to return to classrooms for very limited instruction, classes at Los Angeles Unified have been remote.

The $150 million program, announced last month amid national alarm over inadequacies in testing, is expected to be among the largest and most comprehensive school-based initiatives in the nation by the time Los Angeles classrooms fully reopen, which will depend on positivity rates.

Last weeks tests, conducted on Thursday and Friday, were among principals, custodians and others working in sanitized school buildings, as well as children in the districts child care program.

The next round will be for all employees, whether or not theyre at a school site, and then well roll into testing students, Mr. Beutner said.

The positivity rate about 0.1 percent of tests conducted was far lower than the 3.4 percent overall rate in Los Angeles County, said Mr. Beutner, who said that was to be expected. Los Angeles Unifieds tests are being administered regardless of symptoms, whereas the more than 11,000 tests conducted each day in the county have tended to be among people who have sought testing because of symptoms or fear of exposure.

In other education news:

Twenty-three fraternity and sorority houses and seven other homes at Michigan State University were ordered to quarantine by the county health department. If they dont comply with the orders, which require that residents distance themselves and wear masks within the homes and return calls and text messages from officials within two business hours, they could face up to six months in prison, a fine of $200 or both.

Some low-income K-12 students had depended on visits by dental hygienists to school gyms and nurses offices for their dental care, but with many schools closed, oral health care providers are concerned that children could have a mouthful of cavities without their parents knowing.

With universities largely putting the onus on students not to spread the virus, students are using platforms like Twitter and Reddit to argue against their schools pandemic policies. When James Madison University in Virginia hosted an outdoor movie night, a student posted a photo of the events crowded lawn in a Twitter thread highlighting the schools failure in handling this pandemic.

A federal judge strikes down virus safety measures that had been put in place by Pennsylvanias governor.

A federal judge in Pennsylvania ruled on Monday that several restrictions ordered by Gov. Tom Wolf to combat the pandemic in the state were unconstitutional. The decision struck down stay-at-home orders and the closure of non-life-sustaining businesses, directives that were issued in March and have since been suspended.

The judge also declared that a current order limiting the size of gatherings no more than 25 people indoors and 250 outdoors violated the right of assembly enshrined in the First Amendment.

A spokeswoman for Mr. Wolf, a Democrat, said the administration was seeking a stay of the decision and an appeal. William Shaw Stickman IV, the judge who ruled on the case, was nominated to the bench by President Trump in 2019.

Mr. Trump, at an event in Arizona, celebrated the decision, calling it a great ruling.

As in other states, many Republican politicians in Pennsylvania have been steadfastly opposed to their states pandemic mitigation strategy, with some in Pennsylvania urging the governors impeachment. In July, the State Supreme Court rejected a suit filed by Republican legislators seeking to end Mr. Wolfs emergency authority.

Some of the most vocal opponents of the governor, including Representative Mike Kelly, a Republican whose district is in western Pennsylvania, were among the plaintiffs in the suit that was decided on Monday.

The court believes that defendants undertook their actions in a well-intentioned effort to protect Pennsylvanians from the virus, Judge Stickman wrote. However, good intentions toward laudable ends are not alone enough to uphold governmental action against a constitutional challenge. Indeed, the greatest threats to our system of constitutional liberties may arise when the ends are laudable, and the intent is good especially in a time of emergency.

In a statement, the governors spokeswoman said that the actions taken by the administration were mirrored by governors across the country and saved, and continue to save, lives in the absence of federal action.

A senior Chinese health official said a coronavirus vaccine could be available to the public in China as early as November, the state news media reported on Tuesday.

Dr. Wu Guizhen, the chief expert for biosafety at the Chinese Center for Disease Control and Prevention, told the state broadcaster CCTV that ordinary people in China could be given the vaccine in November or December. Current progress has been very smooth for vaccine candidates in the final stage of clinical trials, she said.

China now has five vaccine candidates in late-stage clinical trials, including one being developed in collaboration with other countries, Dr. Wu said. Two production factories have been approved for manufacturing, and a third is in the approval process, she said. China, the worlds largest vaccine producer, has put the prospect of a Covid-19 vaccine at the center of a diplomatic charm offensive.

China has already approved at least two experimental vaccines under an emergency use program, which began this summer with soldiers and employees of state-owned companies and has quietly expanded to include health care and aviation workers.

Dr. Wu, who said she was still doing well after receiving one of the experimental vaccines in April, said she expected them to remain effective for one to three years.

Dr. Wus estimate that a vaccine could be ready in November is not far off from predictions made by President Trump. His administration has told state officials to be ready to start distributing one as soon as late October. That would be just before the U.S. presidential election, and the timing raised concerns that a vaccine could be rushed for political reasons. A group of drug companies racing to develop a vaccine has pledged not to release anything that does not meet efficacy and safety standards.

A vaccine approved by Russia in August was met with skepticism from experts who warned against rushing normal procedures, and Russian and Chinese vaccines have been criticized over their designs. Health officials have warned against thinking of a vaccine as a silver bullet, saying that even if one is approved before the end of the year, it will take time to produce and distribute and will not mean an immediate end to pandemic restrictions.

The French cities of Marseille and Bordeaux significantly tightened restrictions on public gatherings on Monday after officials pointed to a concerning surge of cases in the cities and surrounding areas.

The two cities were among several areas where the French government, amid a nationwide rise in cases, has identified a worrying spread of the virus, including among older people.

Officials in both cities imposed a new ban on gatherings of more than 10 people in public places like parks, riverbanks and beaches and canceled school outings and student parties. Visits to retirement homes will also be more restricted.

In Marseille, a city on the Mediterranean coast, officials banned the selling and consumption of alcohol after 8 p.m. And in Bordeaux, in the countrys southwest region, the authorities banned bars from having standing customers or playing music on the street, and made it illegal to drink alcohol in public areas.

The limit for large outdoor gatherings in Gironde, the area that encompasses Bordeaux, had been 5,000 the same as the limit for the rest of the country. Now public gatherings are limited to 1,000 people, and events like carnivals and antiques sales will be banned, local officials said in a news conference on Monday.

Fabienne Buccio, the prefect for the Nouvelle-Aquitaine region, which includes Bordeaux, said at the news conference that venues that usually organized dancing parties like weddings would no longer be allowed to do so.

The idea is not to no longer get married, but to postpone big festivities tied to weddings, Ms. Buccio said, adding that public transportation would be bolstered during rush hours to avoid overcrowding in buses and trains.

In other developments around the world:

The Australian state of Victoria, the center of the countrys outbreak, on Tuesday reported no new coronavirus deaths for the first time in more than two months. The states capital, Melbourne, remains in lockdown, but restrictions have been loosened in the rest of the state as cases continue to fall.

New Zealand on Tuesday reported zero new cases of community transmission as it begins to loosen restrictions that were imposed after an outbreak last month in Auckland, its largest city.

Hong Kong on Tuesday reported zero new cases of community transmission for the first time since a third wave of infections began in early July. Bars, nightclubs, karaoke parlors, theme parks and swimming pools will be allowed to reopen starting Friday, officials said. Carrie Lam, Hong Kongs chief executive, also praised a two-week mass testing program that ended on Monday but drew fewer participants than the government had hoped. Almost 1.8 million people, or about a quarter of the population, signed up for the testing, which uncovered 32 cases, or about two per 100,000 people tested.

The United States relaxed its travel advisory for China and Hong Kong on Monday, warning Americans to reconsider travel but not outright advising against it, as the State Department had previously done because of the virus. In its updated guidance, the department said China and Hong Kong had resumed most business operations.

In Jordan, schools will be closed for in-person classes, restaurants will be open only for delivery and takeout, public markets will shut down and houses of worship will suspend prayers for two weeks starting Thursday in an attempt to curb the spread of the virus, the countrys state-run news agency said on Monday.

Silvio Berlusconi, the former Italian prime minister, left a Milan hospital on Monday, nearly two weeks after he was admitted for pneumonia caused by Covid-19. In a short speech, he warned Italians not to underestimate the gravity of the virus. Cases have been growing in Italy in recent weeks, and Mr. Berlusconi most likely contracted the virus while vacationing on the island of Sardinia, which became a viral hot spot in August.

Starting Monday, Britain has lowered the limit on the number of people allowed to meet to six from 30. The country recorded 3,330 new infections on Sunday, the third consecutive day of new case counts surpassing 3,000, a level not seen in Britain since May.

Antarctica, the only continent free of the coronavirus, is preparing for an influx of researchers in the coming months as a change of season makes studies on the icy South Pole more feasible. The first researchers, from the United States, arrived on Monday after quarantining in New Zealand.

A health official in Australia said on Monday that she was under police protection because of death threats amid rising opposition to her pandemic policies. Dr. Jeannette Young, the chief health officer of Queensland, had been criticized over a requirement that travelers from other parts of Australia quarantine for two weeks, especially after a woman in quarantine was not allowed to attend her fathers funeral.

The top communications official at the powerful cabinet department in charge of combating the virus accused career government scientists on Sunday of sedition in their handling of the pandemic and warned that left-wing hit squads were preparing for armed insurrection after the election.

Michael Caputo, 58, the assistant secretary of public affairs at the Department of Health and Human Services, said without evidence that the Centers for Disease Control and Prevention was harboring a resistance unit determined to undermine President Trump. He also suggested that he personally could be in danger.

You understand that theyre going to have to kill me, and unfortunately, I think thats where this is going, Mr. Caputo, a Trump loyalist installed by the White House in April, told followers in a video he hosted live on his personal Facebook page.

In a statement, the department said Mr. Caputo was a critical, integral part of the presidents coronavirus response, leading on public messaging.

Mr. Caputo delivered his broadside against scientists, the news media and Democrats after a spate of news reports over the weekend that detailed his teams systematic interference in the C.D.C.s official reports on the pandemic. Former and current C.D.C. officials described to Politico, The New York Times and other outlets how Mr. Caputo and a top aide routinely demanded the agency revise, delay and even scuttle the C.D.C.s core public health updates, called Morbidity and Mortality Weekly Reports, which they believed undercut Mr. Trumps message that the pandemic was under control.

Those reports have traditionally been so shielded from political interference that political appointees see them only just before they are published.

Mr. Caputo on Sunday complained on Facebook that he was under siege by the news media and said that his physical health was in question and his mental health has definitely failed.

In his Facebook video, Mr. Caputo ran through a series of conspiracy theories, culminating in a prediction that Mr. Trump will win re-election, but his Democratic opponent, Joseph R. Biden Jr., will refuse to concede.

And when Donald Trump refuses to stand down at the inauguration, the shooting will begin, he said. He added: If you carry guns, buy ammunition, ladies and gentlemen, because its going to be hard to get.

Wisconsin is facing its highest level of new daily cases during the pandemic, averaging more than 1,000 new cases a day in the last week, with college towns driving the troubling surge.

On Sunday, the state reported a new daily record of 1,582 cases and a 20 percent positivity rate. Most of the cases have been among people between the ages of 20 and 29, a health department spokeswoman said.

Wisconsin has reported more than 1,700 cases linked to college campuses, according to a New York Times database, with over 1,000 of those at the University of Wisconsin-Madison, the schools flagship campus. La Crosse County, home to University of Wisconsin-La Crosse, had one of the highest per capita case counts in the state over the last seven days, while some large counties like Milwaukee, Waukesha and Racine have not seen a major uptick in cases and remain below the state average.

On Sunday afternoon, the chancellor at University of Wisconsin-La Crosse announced shelter in place restrictions for all residence halls on campus. And in Madison, the faculty senate voted on Monday afternoon to shorten spring break to a three-day weekend.

Wisconsin was not hit as hard as some other states early on in the pandemic, but it has not made it through unscathed. Just over 1,200 people have died of the coronavirus, with some of the highest daily death reports coming in late May.

In other news around the United States:

Instead of its usual two-and-a-half-mile journey through Manhattan, the 94th Macys Thanksgiving Day Parade will be confined to the Herald Square area and broadcast for viewers to watch, the company announced on Monday. This years event is basically the end portion of our traditional march, said Orlando Veras, a Macys spokesman.

South Carolinas lieutenant governor, Pamela Evette, said Monday that she had tested positive, but has had only mild symptoms. She was last in close contact with Gov. Henry McMaster on Sept. 6, a spokesman said, adding that Mr. McMaster received a negative test result on Sunday.

Treasury Secretary Steven Mnuchin said on Monday that he was prepared to negotiate with Speaker Nancy Pelosi with no conditions on an economic stimulus plan, as talks between the White House and Democrats on such a package remained stalled. Speaking to CNBC, Mr. Mnuchin said that while he believed a robust recovery was underway, parts of the economy, particularly small businesses, needed more help. But Ms. Pelosi accused Republicans of merely pretending to want to provide additional aid, saying a plan they brought up in the Senate last week was relief in name only.

As wildfires tore through huge areas of Oregon this week, prison inmates were hurried away from the encroaching flames not to freedom but to an overcrowded state prison, where they slept shoulder to shoulder in cots, and in some cases on the floor. Food was in short supply, showers and toilets few, and fights broke out between gang members.

They were safe from one catastrophe, but delivered to another: the coronavirus pandemic, which has spread at an alarming rate in Americas prisons.

From what we know about Covid-19, how quickly it can spread and how lethal it can be, we have to prepare for the worst, said Bobbin Singh, the executive director of the Oregon Justice Resource Center, a prisoner advocacy organization.

Twin crises of the pandemic and a devastating wildfire season have taken a significant toll in prisons along the West Coast. Virus outbreaks have spread through cellblocks Oregons state prison system has had 1,600 infections over the past three months and poor ventilation systems have whipped in smoke from the fires.

Kristina Boswell, a prisoner in Oregon who was moved overnight on Friday, described a chaotic evacuation in an audio recording her lawyer shared with The Times.

She said prisoners were bound together with zip-ties and loaded into buses in the middle of the night, without their medications or water. When they arrived, she said, there was a shortage of mattresses and no chance of social distancing.

Were all in dorm settings, said Ms. Boswell, who was among more than 1,300 female prisoners moved to Deer Ridge Correctional Facility in Madras, Ore. Everyone is crammed in.

An arthritis drug that suppresses the immune system may slightly improve recovery times in severely ill Covid-19 patients, the drugs makers announced on Monday.

The drug, baricitinib, was tested in a large clinical trial sponsored by the National Institute of Allergy and Infectious Diseases. More than 1,000 hospitalized patients were randomly assigned to receive either the arthritis drug plus remdesivir, an antiviral shown to modestly speed recovery, or remdesivir plus a placebo.

Those taking the two-drug combination recovered on average one day sooner than those taking remdesivir alone, said Eli Lilly and Incyte, the makers of baricitinib. But the companies provided no data.

The N.I.A.I.D. confirmed that the Eli Lilly announcement is accurate but would not comment further, as government researchers analyze the trial results and prepare a paper for publication.

Their priority is assuring scientific rigor in how the data are disclosed, said Dr. Daniel Skovronsky, the chief scientific officer of Eli Lilly. Ours is that when we have potentially material information, we get it out to our shareholders.

Baricitinib is used in an attempt to quell the so-called cytokine storm, an overreaction of the immune system occurring in some severely ill Covid-19 patients. In a cytokine storm, the immune system itself may cause illness and death.

Citing the drugs benefit, Eli Lilly said it would ask the Food and Drug Administration for emergency use authorization, allowing it to sell baricitinib at a 40-milligram dose before the company formally submits an application for marketing.

The news poses a problem for doctors and hospitals. While the baricitinib trial was underway, researchers in Britain reported that a cheap generic steroid, dexamethasone, can improve recovery and reduce the death rate in Covid-19 patients. That drug also works to tamp down the immune systems overreaction.

The studies arent entirely comparable, however. Doctors and patients knew who was getting the drug in the British study, but not in the American trial, and the study populations differed. The death rate among patients in Britain was also four times that of patients in the United States.

View original post here:

Covid-19 Live Updates: Thousands Attend a Trump Rally Indoors - The New York Times

Members of conservative right-wing and Christian groups take part in an anti-government rally in Seoul on Aug. 15. Ed Jones/AFP via Getty Images hide caption

Members of conservative right-wing and Christian groups take part in an anti-government rally in Seoul on Aug. 15.

A decade ago, building cleaner Noh Il-soon was in the market for a new church. She had previously moved within Seoul, and when she did, she looked for a local congregation to join.

A missionary introduced her to a Presbyterian church called Sarang Jeil, Korean for "love comes first." Noh says she was immediately captivated by the sermons of the charismatic pastor, Jun Kwang-hoon.

"If my previous way of knowing Jesus, during 50 years in other churches, was like licking the outside of a watermelon," she says, "then knowing Jesus through our pastor was like splitting open the watermelon and tasting the sweet and juicy fruit inside."

The church had become increasingly visible and influential among fundamentalist Christian groups in South Korea, but its fortunes recently soured.

Authorities say the church has become the main cluster in a new wave of COVID-19 infections that has threatened to reverse the country's early success in controlling the virus. In addition, Jun, the charismatic pastor, is now in jail, accused of illegal election campaigning and libeling South Korean President Moon Jae-in by calling him a North Korean spy.

Sarang Jeil Church pastor Jun Kwang-hun speaks outside a detention center in Uiwang, South Korea, in April. Jun tested positive for the coronavirus last month, two days after he took part in an anti-government rally in Seoul. Ko Jun-beom/Newsis via AP hide caption

Sarang Jeil Church pastor Jun Kwang-hun speaks outside a detention center in Uiwang, South Korea, in April. Jun tested positive for the coronavirus last month, two days after he took part in an anti-government rally in Seoul.

Authorities have linked more than 1,100 cases of infection including Jun and 60-year-old Noh, who is now a deaconess to the Sarang Jeil Church. The numbers are second only to those linked to the Shincheonji Church of Jesus, a nationwide organization whose 5,200 cases were at the center of South Korea's first wave of infections in February.

Seoul city authorities say the Sarang Jeil Church failed to provide complete membership lists, prompting police to raid its headquarters. Some members refused to get tested. Some questioned the accuracy of the tests, and others fled quarantine after testing positive.

The clash between the church and the government over disease control has become the latest flashpoint in a wider conflict between a right-wing coalition, including fundamentalist churches, and the liberal administration of President Moon.

"Christian fundamentalism has been the mainstream of South Korea's Christianity, which has been very political since its early days," observes Kim Jin-ho, a pastor and researcher at the Christian Institute for the 3rd Era, a Seoul-based religious research institute.

That fundamentalism includes a tradition of charismatic preachers like Jun Kwang-hoon, who trace their roots back to Protestant American missionaries who worked in Korea more than a century ago.

"A political holy movement"

Before the pandemic hit, Jun and his followers were a common sight at weekend anti-government marches in downtown Seoul. Conservative demonstrators, including evangelical Christians and military veterans, waved Korean and American flags and held banners praising President Trump and decrying North Korean leader Kim Jong Un.

Jun also led prayer rallies on the streets, with crowds of followers dancing in a state of religious ecstasy and speaking in tongues.

"They are not there for money or benefits," Noh says proudly. "When they are there, the Holy Spirit inside them dances."

Jun built up his following among older, lower-income South Koreans like Noh in the late 1990s, Kim says. Many of them had moved from the countryside to the cities beginning in the 1970s. Then, some two decades ago, as other Protestant churches began to target affluent urban professionals, Jun's following strengthened amid an increasing sense of alienation among the less privileged.

"These people took the ostracization they experienced amid the changes South Korean Protestantism went through in the late '90, and turned it into a political holy movement led by Jun Kwang-hoon," Kim says.

Noh, dressed plainly, carrying bags of journals about her religious life and wearing a face mask as she speaks with NPR in a residential neighborhood near the Sarang Jeil Church, says she's not terribly concerned about her material well-being.

"Our pastor tells us, 'Don't bet everything on 100 years of good life here on this Earth'," she explains. "Instead, invest in the heaven up there."

Many pastors of small churches in South Korea subsist on donations from members, Kim says, which they're unable to collect now because the government has required them to move religious services online during the pandemic.

This situation "creates an economic burden on the churches, which makes the churches strongly resist the government's recommendations," Kim says.

"Undermining the credibility of all of Korea's churches"

Authorities accuse Jun and his followers of attending a banned anti-government rally last month, to which more than 500 COVID-19 cases have been linked. Jun was among those who tested positive for the virus after the rally.

Jun and his followers in turn accuse the government of intentionally infecting church members with the coronavirus and faking COVID-19 test results to frame them as the epicenter of the current wave of infections. As of Tuesday, South Korea had nearly 24,000 cases; it had almost 15,000 on Aug. 12, when the first church member tested positive.

In a speech last month, President Moon said the church should apologize to the public instead of spreading conspiracy theories.

"The lack of common sense among a very small group," he said, "is undermining the credibility of all of Korea's churches."

Noh, who has recovered from her COVID-19 infection, insists that Sarang Jeil Church members have cooperated with the government's disease control efforts, including by telling members to stay home and get tested.

She also insists that her patriotism is a natural result of her religious convictions and that by holding street prayer rallies and demonstrations, she and her church are just trying to prevent Moon, who has worked to improve relations with North Korea, from taking the country down the wrong path.

"The gospel cannot coexist with communism," Noh says. "We're still in conflict with North Korea, and there are remnants of North Korean sympathizer, leftist forces in this country."

She believes that South Korea was meant to embody the vision of Syngman Rhee, a U.S.-educated Christian who became the South's first president in 1948. He envisioned South Korea "standing on the four pillars of liberal democracy, free market economy, the alliance with the U.S., and a Christian state," she says.

South Korea has no officially designated religion.

Noh is bitter that South Korean media coverage of the Sarang Jeil Church, including Christian media coverage, has been overwhelmingly critical, while ignoring, she says, the suffering of church members.

Noh also complains that after she tested positive for the coronavirus, she felt that Seoul city and public health officials "treated me like a ball of germs, not a citizen of the country. I was so angry."

NPR's Se Eun Gong contributed to this story from Seoul.

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The Volatile Mix Of A South Korean Church, Politics And The Coronavirus - NPR

Ukrainian government video from the scene showed hundreds of men and boys waiting along a highway in Belarus to try to enter Ukraine. Some have set up tents, apparently after having waited overnight.

Border guards in helmets and body armor policed a row of barricades blocking them from coming into the country. Ukraine has been closed to foreigners since August.

The pilgrims have been given food and water, the Ukrainian border service said.

Avraham Shapira, an Israeli pilgrim who is at the border with his children, told CNN that he'd booked a direct flight from Tel Aviv to Kiev four weeks ago, because he heard the border would be closed.

When he got to the airport, he said, the flight was canceled and he booked new tickets to Kiev via London. In London, his next flight was canceled too, but he was able to book a ticket to Belarus.

He praised the Belarus government for providing "all the services" needed by the pilgrims crossing the border, saying the Belarusians have offered to provide buses to bring the pilgrims directly to Uman, stay two days and return to Belarus.

Shapira added the group would not "see any citizen of Ukraine. It's not a danger for anybody. I come to pray for the world, I don't come to pray only for me."

"Our country is ready to take responsibility on all these functions and, of course, organize the process as safely as possible, for instance it will not affect the situation with the Covid disease rate," said President Alexander Lukashenko's press secretary Natalia Eismont said in a statement.

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More than 1,000 Jewish pilgrims blocked from entering Ukraine over coronavirus fears - CNN

The week America lost the fight against the new coronavirus, the nations premier health agency promised local officials it had the virus under control.

It was the third week in February. Senior leaders at the Centers for Disease Control and Prevention repeatedly brushed off calls to take COVID-19 more seriously.

They dismissed concerns from Minnesota to Hawaii that their plan to contain the outbreak by screening overseas travelers was riddled with inconsistencies.

They punted questions from state officials worried that returning travelers could spread the coronavirus when they showed no symptoms.

For days, they refused to test a California woman because she had not traveled overseas. When she tested positive, the CDC downplayed the fact that the patient who became known as Patient Zero proved the virus was spreading within the USA.

At the beginning of the coronavirus outbreak, CDC Director Robert Redfield insisted the national threat was low.Pool, Getty Images

Instead, CDC Director Robert Redfield went on national television and repeated seven times that the threat to the nation remained low.

The American public needs to go on with their normal lives, he said.

As the virus raced across America, state and local authorities sought help from the CDC, the $7billion federal agency established to lead the nation through pandemics.

Instead of answers, many received slow, confusing and conflicting information or no response at all a USA TODAY investigationfound. Reporters reviewed 42,000 pages of emails and memos obtained from health departments and interviewed more than 100 community leaders and public health experts, including current and former CDC officials.

Theagency has received widespread scrutiny for yielding topolitical pressure from the White House. These interviews and records provide the most extensive look yet at how the CDC, paralyzed by bureaucracy, failed to consistently perform its most basic job: giving public health authorities the guidance needed to save American lives during a pandemic.

Communities were left to make life-or-death decisions about testing, personal protection and reopening.

Health officials flooded the CDC with hundreds of phone calls and emails. Many questions went unanswered. In other cases, the agency response amounted to you decide.

In Nevada, the states top infectious disease scientist called the CDC begging for a list of travelers coming from China. A flustered agency representative hung up on her.

In Kentucky, a CDC official recommended that visitors continue to be allowed into nursing homes because they might not get another chance to visit family members. In an email,he wrote, Let people choose.

Authorities in at least 13 states questioned CDC guidance that contradicted either scientific evidenceor information put out by the CDC itself, records show. At times, rank-and-file CDC representatives, aware of their own leaderships lagging response,told state health departments to consider adopting guidance from academic studies or other states.

In more than two dozen news briefings, congressional hearings and other public statements from January to April, the CDC downplayed the potential harm from the virus.

In the most extreme cases, the CDC undermined health officials advocatinga more aggressive approach to controlthe spread.

The agency went so far as to edit a government science journal in late March to remove a Washington state epidemiologists call fortesting throughout senior assisted-living facilities. I would be careful promoting widespread testing, the CDC editor noted, according to drafts obtained by USA TODAY.

The CDC declined to make senior leaders available forinterviews and did not answer detailed questions about USA TODAYs findings.In a statement emailed by CDC spokesman Tom Skinner,the agency said it has executed its mission to protect Americans and worked to support state and local health departments with accurate information.

CDC has based decisions on known science and data available and has been clear that, as more became known about the virus, guidance and recommendations would evolve and change, the statement said.

The pandemic has presented unprecedented challenges, and many health officials told USA TODAY they were grateful for the CDCs help. CDC has been an incredible partner to us,said Dr. Kathy Lofy, the health officer in Washington state.

The White Househandicapped the agency from the start. Last week, journalist Bob Woodward disclosed that President Donald Trump told him in early February that his administration knew the virus was spreading through the air and killing people at a higher rate than the flu, but Trump publicly minimized the risks.

Former CDC officers who held senior leadership roles under Republican and Democratic presidents told USA TODAY the agency that once commanded global respect collapsed when communities needed it most.

They are incapable of responding to the emergency, said Dr. Pierre Rollin, former deputy chief of a CDC branch on viral pathogens and one of the worlds most renowned infectious disease experts.

Nearly 200,000 have died of COVID-19in the USA, and more than 6.6 million have been infected. The CDC suspects 10 times more Americans have caught the virus, but official counts remain skewed by its inability to fix chronic testing issues.

Without a national plan to guide them,authorities lost months debating whether to require face masks and when best to reopen businesses and schools.

Last month, the CDC reversed critical testing guidance for people exposed, saying those without symptoms did not need to be tested. Health officials and even the staunchest CDC champions lambasted the move. Some states are choosing to ignore it.

The CDCs own scientific advisersfear the agencys multiplefailures since February have destroyed the publics confidence, which will be crucial to successfully roll out a vaccine.

The leadership role of the CDC didnt hold firm,Dr. Brent Pawlecki, the chief healthofficer at Goodyear, told agency leaders in July as a panel of independent scientists reviewed the agencys early response. It has created a lot of confusion and unfortunately a lot of distrust.

Cynthiana, Kentucky, a community of 6,400 residents without a four-lane road, took the CDCs advice to continue life as normal.

No one paid much attention when the tenor with the best voice in thechurch choir called in sick after Sunday practice. Then, alto Julia Donohues migraine turned into a fever. The 28-year-old Walmart cake decorator, who liked to bake brownies for her church family, was airlifted to intensive care as her oxygen levels plunged.

Donohues positive test for COVID-19 was the first confirmed case in the state. Kentucky joined more than 20 states reporting their earliest brushes with coronavirus during the first week of March.

Show captionHide captionJulia Donohue, 28, a cake decorator from Cynthiana, Ky., was the first in her state to test positive for COVID-19. The rural town, which has...Julia Donohue, 28, a cake decorator from Cynthiana, Ky., was the first in her state to test positive for COVID-19. The rural town, which has a population of about 6,000, saw an early outbreak of the virus.Jack Gruber, USA TODAY

As Kentuckys case count ballooned, so did the fallout from the CDCs missteps.

The areas highest elected official, Harrison County Judge Alex Barnett, spent the next two weeks on a lunch tour to support businesses, visiting restaurants with his family. He snapped pictures posing with meals and posted them to Facebook to show people it was safe.

From the CDCs news briefings, the new coronavirus related to the viral family that causes the common cold sounded like a concern mostly for Americas distant big cities.

In public statements, leaders from Connersville, Indiana;Hudson, New York; andWinston-Salem, North Carolina, all repeated the CDCs low risk talking points.

The Kentucky hospital where Donohue first went to the ER had received no urgent warnings about community spread. More than 50 hospital workers did not wear masks or other protective gear, already in short supply, when they came into close contact with her.

I dont think people understood, Crystal Miller, health director for four counties in the area, told USA TODAY. We didnt know.

For the two weeks from when Donohue fell ill until the governor shut down the state, Barnett said he did not realize how much the small city of Cynthiana was at risk.

I am no expert in health when it comes down to it. I am a farmer, Barnett told USA TODAY. I am an expert on growing cattle and tobacco. I rely on the CDC for guidance.

Harrison County Judge Alex Barnett, center, recites the Pledge of Allegiance before a virtual meeting of court magistrates in Cynthiana, Ky. Joining him are Treasurer Melody McClure and 7th District Magistrate Dwayne Florence.Jack Gruber, USA TODAY

Within weeks, the confirmed case count in the county, pop. 19,000, climbed to 11. An outbreak engulfed a nursing home.

Miller sent constant updates around the state about her areas cases, tracking new information first on sticky notes, then a spreadsheet. She worked 15-hour days, responding to text messages from colleagues until 2 a.m.

In email exchanges, Kentucky officials questioned nonsensical directives from the CDC, such as to tell doctoroffices when testing for coronavirus to make sure the air does not mix with other air.

This is next to impossible for provider practices to accomplish, Andrea Flinchum in Kentuckys Health Department told the CDC in an email March 10.

Later that month, Flinchum asked CDC headquarters for advice on when and how to reuse respirators.A local representative shared several studies, but more than a week went by without official word from the agency. Waiting patiently to see this, Flinchum wrote.

In another email exchange,Dr. Kevin Spicer, a federal CDC medical officer stationed in Kentucky, acknowledged that he had been waiting two weeks for the agency to update its guidance on when and how to release people with COVID-19 from hospitals and isolation.

Lacking anything official, Spicer shared a link to a Washington state document outlining more up-to-date practices. It was not consistent with current CDC guidance, he noted.

Long-term care facilities, especially vulnerable, became another point of confusion during the first wave of Kentuckys outbreak in March. Matthew Penn, director of the CDCs public health law program, told a lawyer in the states Health Department not to ban nursing home visitors outright.

Persuasion by education strategy may work best, he wrote in an email. Let people choose.

Two days later, Gov.Andy Beshear banned nonessential visits at nursing homes. That week, the Centers for Medicare and Medicaid Services, which regulates the facilities, advised nursing homes nationwide to do the same.

More than 2,600 nursing home residents have tested positive in Kentucky since March. At least 530 have died, according to CMS data. Across the country, more than 53,000 residents have died.

Dr. Muhammad Babar, a geriatrician at the University of Louisville advising the state on coronavirus care at long-term care facilities, told USA TODAY that following the CDC lawyers advice would have resulted in a disaster.

In its statement to USA TODAY, the CDC noted that the agencysent approximately 1,300 public health experts to conduct more than 2,000 investigations in states to combat the pandemic. The agency said its guidance was tailored around keeping communities informed of the evolving science and changes to guidance through routine, direct and transparent engagements.

Kentuckys first recognized victim, Donohue, recovered but still suffers from migraines and shortness of breath.

Another singer in her choir died after being infected with COVID-19. For that, Donohue carries guilt that she might have unwittingly spread disease.

I thought I didnt have to worry about a killer virus, she told USA TODAY.

The CDC was created 75 years ago to fight malaria. Americans pay billionsfor its protection against outbreaks of disease and chronic conditions.

Headquartered in Atlanta, removed from the direct line of politics, the federal agency employs thousands of public health experts, many embedded in local health departments. Though it's not primarily a regulatory agency, its science guides national medical practice.

When the novel coronavirus surfaced last winter, the CDC spent weeks repeating assurances that the risk to Americans was low. Many local authorities, however, realized a crisis was coming and they were unprepared.

I just cant see how this outbreak will be contained, theNebraska state epidemiologist wrote Jan. 23.I think this is going to be a big pandemic.

In Kansas, the health director wrote to his staff Feb. 19:Are we behind the power curve on planning?

The CDC missed the early spread of the new coronavirus, blinded by its own decision to limit screening for the virus after its initial testing kit failed. That was one of the agencys most consequential scientific errors.

In California, Solano County public health officer Dr. Bela Matyas, working alongside CDC experts, had seen how people without symptomscould spread the disease in February, at an early quarantine site at Travis Air Force Base.

Bela Matyas is health officer for Solano County, Calif., which treated the first confirmed case of community spread of the coronavirus.Martin E. Klimek for USA TODAY

He said it was clear the agencys travel screenings focused on obvious symptoms such as fever were not going to work.

By definition, it was going to be a failure, Matyas told USA TODAY.

The agencys own director of global migration and quarantine knew it, too. Dr. Martin Cetron called the airport temperature screening a poorly designed control and detection strategy in internal emails later in the spring, resisting White House pressure to revive the program.

Health authorities trying to protect their communities pushed the CDC to loosen itsrestrictions on early testing.

The CDC controlled the nations first tests for COVID-19. Supplies were limited, and the agency designed restrictive testing guidelines. Fever and respiratoryillness werenot enough. The person had to have traveled to China or had contact with someone with a confirmed case.

Public health experts, including former CDC officials,accused the agency of creating guidelines on crucial measures such as testing based on supply shortages, not science.

We were told you dont need to be tested unless you have symptoms. Thats stupid and its always been stupid, Jim Curran, an epidemiologist at Emory University who led the CDCs research into HIV for 15 years, told USA TODAY. Policy shouldnt be based on scarcity.

One hospital in Seattle, the site of the first major U.S. outbreak, used paper and some spare space at the nurses station to track changes to the CDC testing guidance that often came unannounced and without clarifications, emergency room physician Sachita Shah told USA TODAY.

They taped paper after paper onto a computer monitor. The CDC told the hospital to test patients only if they had symptoms and had traveled to China; then Japan and South Korea; then Iran and Italy.

By the time the agency broadened the criteria to those without travel histories, the hospital had turned away several patients who needed testing.

CDC was too slow, Shah said. They should have been on top of this.

At the center of the first major U.S. outbreak of the coronavirus, Seattle, Dr. Sachita Shah said her hospital struggled to keep up with changing CDC testing guidance.Karen Ducey for USA TODAY

The case in Northern California, known as Patient Zero,exposed how wrong the CDC had been to test so narrowly.

Doctors at UC Davis Medical Centerpleaded for days to test the woman on a ventilator. She suffered from an unexplained respiratory disease yet had not recently traveled. The CDCs testing process did not allow for the possibility that the virus was spreading in the community.

We werent even able to test for it, CEO Dr. David Lubarsky said. It was a failed algorithm.

The CDC said in its statement provided to USA TODAY that the early testing protocol was based on the epidemiology of the disease at the time. CDC senior officer Dr. Nancy Messonnier said in Februarythat the agency greenlighted testing for the patient when it became aware of the case. Clinicians and a health official involved said they lost days pushing for access.

Patient Zero ultimately ledthe agency to rewrite its testing guidance. By then, more than 200 workers at two hospitals that treated her had risked exposure.

So many staff members had to be quarantined that one of the hospitals temporarily shut down its intensive care unit.

The CDCs leadership went on to fail Latino, Black and Native American communities and low-income neighborhoods. Experts said minority populations often were excluded from the policymaking process. They are more than twice as likely to be infected as non-Hispanic whites and nearly five times as likely to be hospitalized.

We were not prepared despite everything we know about public health disparities, K. Vish Viswanath, a health communication professor at Harvard and an independent scientist on the CDCs advisory board, told the agency during a panel review in July. That to me is inexcusable.

Donald Flores, a maintenance worker at the hospital that treated Patient Zero, developed symptoms in quarantine but was never tested. Heworries every workday that he is not protected.

Somebody, Flores said, doesnt give a damn.

The breakdown in the agencys communication with communities contributed to the failure of the Trump administrations signature defense against the pandemic: restrictions on travel from hot spots in China and later around the world.

Authorities expected the CDC to provide basic information names, contact information and arrival time so they could track travelers. Time and again, the CDC failed to do so.

In early February, Nevadastate epidemiologist Melissa Peek-Bullock learned from the local news about an airplane carrying three people who had been traveling in China,which was about to land in Las Vegas. The travelers posed a threat to U.S. cities, based on the CDCs criteria.

When Peek-Bullock called the agency seeking the passengers names and contact information, she was met with hostility, according to interviews and documents from the state Health Department.

At the Los Angeles airport, where the flight had been temporarily redirected, officials with the CDCs quarantine and mitigation division told her they were unaware of the requirements drawn up bytheir own colleagues.

In a call to the CDCs emergency hotline, Peek-Bullock said, she spoke with a representative who refused to identify the passengers, saying they were free to move along their way.

Increasingly desperate, she explained her fear that they could place all of Las Vegas at risk. Then the CDC representative hung up on her, Peek-Bullock said.

Its hard to imagine that would happen, she told USA TODAY. Truly, you just want to get the information that you need to do the right thing.

Afterward, the head of Nevadas Health Department, Richard Whitley, wrote to Redfield,the CDC director, to complain: The lack of communication in this circumstance created frustration and confusion for all those involved.

Senior CDC official Dr. JosMontero responded that the agency was trying to educate all of its divisions on the latest guidelines and requirements to share traveler information. He wrotethat the CDC regrets that Nevada Department of Health and Human Services had difficulty initially obtaining this information.

The shortcomings exposed by a pandemic had been years in the making.

Original post:

How the CDC failed public health officials fighting the coronavirus - USA TODAY

The United States has suffered one of the worst Covid-19 epidemics in the world. But heres a bit of good news: Since late July, the number of new coronavirus cases has steadily declined across most of the country.

Thats not to say the US is beating the coronavirus. Reported cases are still higher than they were in the spring (partly, but likely not entirely, the result of more testing). More than 700 people are still dying from Covid-19 on average every day more daily new Covid-19 deaths than in any other developed country in the world. There are still large epidemics in some states, especially in parts of the Midwest and South.

Still, the decline in Americas Covid-19 cases is real and significant, translating to fewer illnesses and deaths in the next few weeks and, hopefully, months.

So what happened? How did the US turn it around?

The short of it: We cant say for certain (as with many things related to the coronavirus), but it seems as though the USs overall reaction to the July resurgence of Covid-19 in which much of the nation stepped up social distancing and masking has tamed the spread of the virus.

I think the decline is due to the combination of [government] measures taken, Jaime Slaughter-Acey, an epidemiologist at the University of Minnesota, told me. The big outbreaks also led people to be more mindful about integrating social distancing and masks into their everyday norms.

Some of that is a result of state actions, as some state governments mandated masks and closed down risky indoor spaces such as bars. Some of it is due to public action; as the coronavirus surged back, many people had the good sense to reconsider whether they were going out too much and if they needed to be more rigorous about their mask-wearing.

The federal government, however, has not earned much credit. In my conversations with experts, some suggested the decline in Covid-19 is happening despite federal inaction. Between President Donald Trumps magical thinking his administration denied there was a second wave even as it began and Congresss inability to pass another stimulus bill, its been largely left to the public, along with local and state governments, to handle the return of the coronavirus.

Now the US faces the risk of yet another wave as fall and winter arrive. Schools are reopening. When the weather gets cold, more people head indoors, where theres more risk of transmission. Families and friends will gather for the holidays. A flu season is looming. All of these factors increase the risk of a surge in Covid-19.

Some experts also worry that Labor Day celebrations, with families and friends gathered across the country, could mean another wave is already on the way.

In other words: As promising as Americas recent decline in Covid-19 is, that doesnt mean its time to let up. If the past few months have taught the world anything, its that continued vigilance against this virus is necessary, at least until we get a vaccine or similar treatment to really vanquish the disease.

State and local leaders that have been proactive in their attempt to keep the spread of Covid at bay have been successful, Slaughter-Acey said. Others have had to learn by playing with fire, unfortunately. And still, there are leaders at both the state and national level who refuse to acknowledge the gravity of the pandemic and lead in a way that protects the health of the public.

After the initial wave of Covid-19 largely hit the Northeast (particularly the New York City area), Louisiana, and Michigan in March, the virus began to spread in the South and West in May and June really taking off in Arizona, Florida, and Texas before eventually hitting just about the rest of the country.

States reacted as hot spots did in the first round: instituting new measures pushing social distancing, masking, testing, and contact tracing. Thats seemingly led to a drop in Covid-19 cases nationwide, driven largely by lower case counts in California, Florida, and Texas.

One of state governments go-to moves was to shut down risky indoor spaces, particularly indoor dining and bars. Arizona, Florida, and Texas all pulled back their reopenings to close down bars, as did California, Colorado, Illinois, Iowa, and Michigan. Some local and state governments also took stricter measures to close down risky places, including movie theaters.

Based on what we now know about the coronavirus, these indoor spaces are a major source of transmission. The virus seems to spread best in closed-off, poorly ventilated areas where people hang out close together for long periods of time (15 minutes or more). Especially in restaurants or bars, people may not be wearing masks you cant eat or drink with one on further increasing the risk of spread, as some research suggests.

On the flip side, this suggests outdoor spaces are relatively safe during this pandemic. The outdoors arent a panacea; its still a good idea to keep more than 6 feet from others and wear a mask. But theyre better. During the recent surge of Covid-19, that knowledge which we simply didnt have early in the pandemic has given many people an outlet to socialize and get out of their houses without putting themselves at as much risk. Thats made the current circumstances and renewal of some social distancing measures a bit more bearable and sustainable.

I think the message that being outdoors is less risky may also play a role in the Covid-19 decline, Tara Smith, an epidemiologist at Kent State University, told me. When people are gathering, Ive anecdotally seen a lot of social media posts noting theyre staying outside as much as possible rather than having indoor events.

At the same time, more states instituted mask mandates. According to the AARP, 34 states and Washington, DC, now require wearing a mask in some form or another. In states that havent instituted mask mandates, some local governments have done so.

Based on what we now know about Covid-19, this too will help: As a respiratory virus, the coronavirus seems to spread when people talk, shout, laugh, breathe, sigh, or do anything else that might spew virus-containing droplets out of their mouths and noses. Putting up a physical barrier, whether through a cloth mask, surgical mask, or respirator, to stop those droplets blocks at least some of the viruss spread.

On top of the government actions, the public continued or stepped up their own social distancing and masking efforts. In Gallups surveys, about 73 percent of polled Americans still reported always or very often practicing social distancing over the previous 24 hours as of August 30. And 92 percent of polled Americans said they wore a mask in the previous seven days when outside their homes, particularly in indoor settings.

Experts cautioned that its not really possible, as of now, to definitively say that all these efforts helped, given that researchers will need time to decisively prove whats going on. Its hard to do the kind of analyses needed to know for sure what all the factors are, Jen Kates, director of global health and HIV policy at the Kaiser Family Foundation, told me.

But theres good reason to believe they helped. A review of the research in The Lancet concluded that evidence shows that physical distancing of more than 1 [meter] is highly effective and that face masks are associated with protection, even in non-health-care settings. Other studies have supported both social distancing and masking measures.

Theres also a bit of common sense to this. As Kates told me, We saw the opposite earlier in the summer. When the public and states eased up on social distancing, especially indoors, and didnt take masking seriously enough, the US saw a surge in Covid-19 cases and deaths. Doing the opposite, unsurprisingly, has helped reduce new cases and deaths.

One thing experts have consistently lamented: the federal government.

From the beginning, Trump has not done a good job with the coronavirus outbreak. Hes downplayed the risk deliberately, as he admitted in recorded interviews with journalist Bob Woodward. He failed to scale up a testing and tracing system like the ones other developed countries, including Germany, New Zealand, and South Korea, used to control their outbreaks, instead punting the issue to the states. Hes given mixed messages on masking, recently mocking Democratic presidential nominee Joe Biden for wearing one. Hes encouraged states to reopen prematurely, calling on residents to LIBERATE themselves.

None of this makes any sense, and it defies the advice that experts have consistently given on Covid-19. There was a failure to realize what an efficiently spreading respiratory virus for which we have no vaccine and no antiviral meant, Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, recently told me. From the very beginning, that minimization set a tone that reverberated from the highest levels of government to what the average person believes about the virus.

Trumps failures were felt during the recent resurgence in coronavirus cases. Although experts had called on the federal government to dramatically scale up nationwide testing capacity in the spring and summer, the Trump administration by and large refused, claiming the federal government was merely a supplier of last resort. This left local and state governments, with far fewer resources than the federal government, to scale up testing and tracing on their own.

The result: As coronavirus cases hit new peaks in various states throughout July and August, there were delays as long as weeks in getting test results back. In many respects, this made the tests useless. Testing is supposed to confirm that someone is sick as early as possible, letting both the infected person and public health officials take steps from isolation to notifying close contacts of the infected and asking them to quarantine to prevent further spread of the disease. But if people can only confirm theyre infected weeks after infection, and subsequently days or weeks after theyre actually transmitting the virus, thats too late.

More broadly, the US has continued to struggle to build up testing. Overall testing numbers each day in the US continue to hover around 600,000 to 900,000, increasing little, if at all, since July. Experts recommend that the percent of tests that come back positive which gauges whether theres enough testing to meet the scope of an outbreak should be below 5 percent or even 3 percent. The USs positive rate is 5.2 percent, and most states are above the 5 percent cutoff, with some as high as 15 percent or 20 percent.

Trump, however, has suggested he doesnt want more testing. Arguing that testing makes the US look bad because it reveals more cases, Trump said he told his people, Slow the testing down, please. Last month, the Centers for Disease Control and Prevention seemed to listen updating a guidance to say that people without symptoms may not need to get tested even after close contact with people known to have Covid-19, effectively recommending fewer people at risk get tested.

For Trump, the single goal appears to be making the US look like its back to normal, as if the pandemic isnt messing up so many peoples lives, before the November election. But the reality is that the virus is here to stay, at least until we have a vaccine or an effective treatment. The countries that have gotten closer to normal, like Germany and South Korea, have taken the aggressive steps Trump has so far rejected or downplayed.

Meanwhile, other parts of the federal government arent doing a good job, either. Though Congress passed a sweeping stimulus package and other measures earlier this year to deal with the initial brunt of Covid-19, its failed to renew those measures as many have expired with the current big proposal caught up in partisan fights over just how large the benefits for people affected by the bad economy should be.

So dealing with the virus, particularly its most recent resurgence, has been left to the public and to state and local governments, even as they face crippling budget shortfalls as a result of the collapsed economy with little support from the federal government.

None of this is to say that the US has, by any means, conquered Covid-19.

I do worry, though, that fatigue is setting in, Saskia Popescu, an infectious disease epidemiologist, told me. I see this in Arizona as the state reopens and the percent positivity [for tests] increases, many might feel the outbreak is over in the US or something we can relax on.

The US continues suffering more Covid-19 deaths each day than any other developed country. As of September 10, the death rate in the US was 2.19 per million people 50 percent higher than second-place Spain (1.42) and third-place Israel (1.4), and more than triple fourth-place Australia (0.66).

That adds to an already grisly statistic: Although the US has not suffered the most Covid-19 deaths of any wealthy nation, its in the bottom 20 percent for total deaths since the pandemic began, and reports about seven times the coronavirus deaths as the median developed country. If America had the same death rate as, for example, Canada, 100,000 more Americans would likely be alive today.

Recent spikes in parts of the Midwest and South particularly in North Dakota, South Dakota, Iowa, and Alabama have also shown that the epidemic in the US is by no means over. If a state gets careless, its very likely to see a big spike. South Dakota, for example, allowed a mass gathering at the Sturgis Motorcycle Rally, and that appeared to contribute to the states recent surge in Covid-19.

William Hanage, an epidemiologist at Harvard, suggested there might be a divide in how well metropolitan areas are doing compared with more suburban and rural places. That could lead to spikes in cases in less densely populated places, Hanage told me: The Midwest is much more sparsely populated, but when the virus comes to town it can still do damage. Its just less predictable when it will come to town.

There are also concerns that recent Labor Day celebrations, in which friends and families gathered, could already have fueled a Covid-19 surge that well see in the next few days or weeks. But they also may not if these gatherings were largely outdoors, and people respected social distancing and masking recommendations.

The next big threat could come in the fall and winter. Schools are now reopening, already leading to outbreaks in universities and K-12 settings. In colder areas, it will become much harder to gather outside. Families are bound to gather for the holidays, from Thanksgiving to New Years Day. Another flu season is coming, which could strain health care systems at a time they might be dealing with a surge in Covid-19.

And some cities and states have started to relax their measures. Even New York, which has been very cautious since its huge outbreak in the spring, will soon reopen indoor dining in New York City. San Francisco, which has been a leader in early action, is also reopening several indoor spaces, including barbershops, churches, and gyms.

The virus spreads when a large number of people gather indoors, Ashish Jha, dean of the Brown University School of Public Health, recently told me. Thats going to happen more in December than it did in July and July was a pretty awful month.

Maybe things wont go so badly. Maybe the safeguards cities and states have in place will keep the virus at bay, even in indoor areas. Maybe the population immunity built up from so many people already getting sick will offer some protection, as long as people continue to practice some social distancing and masking. Maybe the public will keep following social distancing and masking recommendations after seeing two large Covid-19 waves in the US. Maybe continued social distancing will suppress the next flu season (as seemed to happen in the Southern Hemisphere).

Or perhaps things will go badly. Thats the gamble with the coronavirus: As long as we dont have a way to vanquish it through a vaccine or other treatment, it presents a constant risk. So the ongoing decline in coronavirus cases will spare some people from suffering and save lives, but it doesnt mean its time to declare victory just yet.

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