Category: Corona Virus

Now the economy is traveling sideways, as business failures mount and the virus continues to maim and kill. New applications for unemployment insurance, for instance, are leveling off at more than 1 million a weekmore than double the highest rate reached during the Great Recession, a sign that more job losses are becoming permanent. After rising when the government sent stimulus checks and expanded unemployment-insurance payments, consumer spending is falling again, down 10 percent from where it was a year ago. Homebase, a provider of human-resources software, says that the rebound has hit a plateau, in terms of hours worked, share of employees working, and number of businesses open.

The next, terrifying phase of the coronavirus recession is here: a damaged economy, a virus spreading faster than it was in March. The disease itself continues to take a bloody, direct toll on workers, with more than 60,000 Americans testing positive a day and tens of thousands suffering from extended illness. The statistical value of American lives already lost to the disease is something like $675 billion. The current phase of the pandemic is also taking an enormous secondary toll. States with unmitigated outbreaks have been forced to go back into lockdown, or to pause their reopening, killing weakened businesses and roiling the labor market. Where the virus spreads, the economy stops.

That is not just due to government edicts, either. Some consumers have rushed back to bars and restaurants, and resumed shopping and traveling. Young people, who tend to get less sick from the coronavirus than the elderly, appear to be driving todays pandemic. But millions more are making it clear that they will not risk their life or the life of others in their community to go out. Avoidance of the virus, more so than shutdown orders, seems to be affecting consumer behavior. Places without official lockdowns have seen similar financial collapses to those with them, and a study by University of Chicago economists showed that decreases in economic activity are closely tied to fears of infection and are highly influenced by the number of COVID deaths reported in a given county.

Read: A devastating new stage of the pandemic

In other ways, the spread of COVID-19 is keeping Americans from going back to work. The perception of public transit as unsafe, for example, makes it expensive and tough for commuters to get to their jobs. Schools and day-care centers are struggling to figure out how to reopen safely, meaning millions of parents are facing a fall juggling work and child care. This is a disaster. The lingering uncertainty about whether in-person education will resume isnt the result of malfeasance, but utter nonfeasance, the former Department of Homeland Security official Juliette Kayyem has argued in The Atlantic. Four months of stay-at-home orders have proved that, if schools are unavailable, a city cannot work, a community cannot function, a nation cannot safeguard itself.

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The Terrifying Next Phase of the Coronavirus Recession - The Atlantic

One woman who was waiting to be tested said came because her daughter-in-law recently tested positive for the virus.

>> PHOTOS: Lines form early in Huber Heights

Though they hadnt seen each other for 12 days, the woman said she just wanted to be sure.

The woman, who said shes dealing with cancer, added that she was in favor of wearing face masks.

Its going to be here to stay, she said. We might as well just get used to it.

Public health is also hosting free pop-up testing sites at Trotwood Madison High School on Friday and at the Montgomery County Fairgrounds in Jefferson Twp. on Monday.

>> DeWine pleads with Ohioans to mask up to slow virus spread

Anyone with questions can call public healths COVID-19 information line at 937-225-6217.

Following pop-up testing in Xenia and Dayton in June, 62 people tested positive for coronavirus.

Nine people who were tested in Xenia received positive positive results and 948 were negative, according to Five Rivers Health Centers.

In Dayton, 53 people tested positive and 1,268 were negative.

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Free coronavirus testing available in Huber Heights today - Dayton Daily News

Since the beginning of the pandemic, the World Health Organization has stressed that, primarily, Covid-19 spreads through very close personal contact. The virus-laden droplets exhaled from a sick persons mouth and nose, the thinking goes, are heavy, and fall to the ground before they can get much farther than 6 feet.

But as the pandemic has unfolded, contact tracing studies have shown this isnt always the case. In China, an air conditioner pushed virus-laden air across three tables in a restaurant, infecting people seated at each one. Researchers reviewed video from the restaurant and saw many of these patrons were more than 6 feet apart from one another, suggesting that the virus traveled through the air.

In Washington state, one person at a choir practice infected 52 of the other participants; its thought the singing could have led more virus to linger in the air. Carefully controlled laboratory studies are also suggesting that under the right indoor conditions, SARS-CoV-2, the virus that causes Covid-19, can float in the air and, to a certain degree, spread that way.

Last Thursday, the WHO changed its language to recognize that fact. Short-range aerosol transmission, particularly in specific indoor locations, such as crowded and inadequately ventilated spaces over a prolonged period of time with infected persons cannot be ruled out, the WHO now states. Previously, the organization maintained that airborne transmission was unlikely to occur outside the hospital setting, where some procedures can generate super-small particles that linger in the air longer than large respiratory drops.

This change comes after a letter appeared in the journal Clinical Infectious Diseases, co-signed by 239 scientists and engineers, which implored WHO and other public health agencies that its time to address airborne transmission of Covid-19. With the WHOs recognition of this mode of transmission, the authors hope, communities can think more about the ventilation of indoor spaces and perhaps engineer solutions to make these spaces safer.

It turns out scientists have been debating whether respiratory diseases like the flu and coronavirus should be labeled airborne for a century. More commonly, the airborne designation is only applicable to extremely contagious diseases, like measles.

A lot of these terms are confusing (even to the scientists), and they dont answer the question laypeople care about: Which air is safe to breathe in during the Covid-19 pandemic, and which air is not safe?

To answer that question, its helpful to understand two different scientific perspectives on the matter. One is: What physically happens when a sick person breathes, sneezes, or coughs into a room? The other is: What patterns have epidemiologists observed in the way people are exposed to the virus and get sick?

Lets start with the first.

Theres a relatively simple, if outdated, way of thinking about how respiratory diseases can spread.

It starts like this: When you exhale, sneeze, or cough, you release a cloud of gas and liquid droplets.

If those droplets are relatively big, theyre heavy and fall to the ground before evaporating, like raindrops do. Others are smaller, and made smaller still by evaporation. These smaller droplets can linger in the air longer, drifting on air currents for perhaps hours. If a droplet is small enough, the moisture in it evaporates before it has the chance to reach the ground (provided the humidity in the room is average). If theres stuff like germs in that droplet, they become light enough to float on air currents, like the dust you can see suspended in the air. These particles are often called aerosols.

This framework is old, and it comes from William Wells, a scientist who studied tuberculosis transmission in the 1930s. In a 1934 paper, Wells concluded: It appears, therefore, that transmission of infection through air may take one of two forms depending upon the size of the infected droplet.

When it comes to Covid-19, one of the first questions epidemiologists tried to answer was: Is the virus spread in the dust that floats or the big drops that fall?

If its the small dust, alarm bells go off. These are the prototypical airborne diseases. They include measles, chickenpox, and tuberculosis, and they are extremely contagious. On average, one person infected with measles will infect 12 to 18 others.

If its the big drops, its still concerning. Diseases like the flu, whooping cough, the common cold, and coronaviruses are primarily large droplet-borne. With these diseases, only the closest contacts to an infected person get infected because large droplets quickly fall to the ground (within 6 feet or so). Its also possible for these big drops to fall on surfaces, and those surfaces can become contaminated too. Luckily, in the case of Covid-19, theres a growing consensus that getting sick from touching contaminated surfaces is rare. But keep washing your hands!

(Interestingly, theres no one reason a new virus, like SARS-CoV-2, would go one route or the other. Its possible, says University of Leicester virologist Julian Tang, that there may be a difference in the immune response with these airborne diseases that makes saliva and mucous less viscous, leading to more virus in small drops. Also, Tang writes in an email, it is possible (though no one has studied this yet) that exhaled breath from measles/chickenpox cases may just be shedding much more virus (maybe millions of virus per minute) compared to respiratory viruses, which only exhale 100s to 1000s of viruses per minute.)

A part of why the terminology here is so confusing, and theres so much debate about it, is that the words aerosol and droplet mean different things to different scientific disciplines.

An aerosol is a particle in the air, said Lidia Morawska, an engineer and the director of the International Laboratory for Air Quality and Health at Queensland University of Technology. A droplet is a liquid aerosol. To her, the distinction between droplets and aerosols doesnt make any sense. To her, they are all aerosols.

Wells outlined a clear distinction between droplets and aerosols according to their size. Big drops fall, and little aerosolized drops float. Its now appreciated that the actual picture is a lot more complicated.

Were always exhaling, in fact, a gas cloud that contains within it a continuum spectrum of droplet sizes, says Lydia Bourouiba, an MIT researcher who studies the fluid dynamics of infections. And, as she explained in a March paper in JAMA, the conditions of the cloud itself can affect the range of some of the droplets. If propelled by a cough or sneeze, Bourouiba finds, droplets can travel upward of 20 feet. The cloud mixture, not the drop sizes, determines the initial range of the drops and their fate in indoor environments.

The speed of the cloud, the temperature and humidity of the environment, and the individual droplet makeup of each cloud determines how long the droplets persist in the air, Bourouiba explained in JAMA.

Which is to say: There are conditions (coughing and sneezing) under which large drops dont immediately fall to the floor and can spread more than 6 feet away from a person, and they can linger in the air for longer.

Theres growing theoretical evidence for the airborne spread of the coronavirus. Lab studies, in idealized conditions, also show that the virus can live in an aerosolized form for up to 16 hours (the scientists in this case intentionally created aerosolized droplets with a machine).

Another study tracked with lasers the various droplets expelled from a human mouth during speech. It found normal speech generates airborne droplets that can remain suspended for tens of minutes or longer and are eminently capable of transmitting disease in confined spaces.

Some studies, the WHO reports, have found evidence of the viruss RNA in the air of hospital rooms, but notes no studies have found viable virus in air samples, meaning the virus was either incapable of infecting others or was in very small quantities unlikely to infect others.

What we are trying to say is, well, lets not worry about whether you call it aerosol or whether you call it a droplet, Morawska, the co-author of the recent commentary imploring the WHO and others to address airborne transmission of Covid-19, says. It is in the air, she says, and you inhale it. Its coming from our nose from our mouths. Its lingering in the air and others can inhale it.

That the WHO updated its language is a sign that its starting to appreciate this perspective.

But this perspective is limited. These lab studies cant perfectly generalize to the real-world conditions in which the virus spreads and infects others. Just because a virus travels far in a drop doesnt mean it can infect people across great distances. Viruses can degrade quickly outside the body. Also, dose matters. Small exposures to the virus may not be enough to get a person sick.

So to find out how people actually get sick with Covid-19, we need contact tracing studies.

Lab studies note the theoretical possibility of airborne transmission. But thats only one part of the answer to the question which air is safe to breathe? Epidemiologists come at this question from another angle, looking at patterns of virus spread observed in the real world and working backward to determine if airborne spread factors in.

Contact tracing studies show us that while droplets being inhaled by people within 6 feet of an infected person explains most of the transmission of Covid-19, there are limited times and environments in which SARS-CoV-2 can behave a bit like an airborne virus.

So we need to define which types of contact, which type of environments, lead to that type of transmission, Muge Cevik, a physician and virology expert at the University of St. Andrews, says. In households, she says, an infected person can be isolated in one room and not spread the virus to others in the home (if they remain isolated). A systematic review of studies in The Lancet of both SARS-CoV-2 and similar viruses found large reductions in risk if people just stay 1 meter (3 feet) away from one another. This suggests a lot of the risk of catching Covid-19 is from the large drops that fall quickly to the ground.

But then there are cases where people are packed together in an enclosed space like a church, with singing or shouting where the transmission looks a little more like airborne transmission.

The infamous choir practice in Washington state is an example of where airborne transmission might have happened. But what made this event so risky was the convergence of many risk factors: the singing activity (during which the infected person released viral particles into the air), the time spent together (the practice was 2.5 hours), and the interaction between the choir members in an enclosed space (not only did they all practice together, they also split up into smaller groups and shared cookies and tea).

Another study from China investigated an outbreak that started at a Buddhist temple event, tracing much of the spread to the confines of one of the buses transporting people to the function. The bus had one sick person aboard, and 24 out of 67 people on that bus got sick, possibly indicating airborne transmission. Those who sat by the windows fared better, indicating the importance of ventilation.

I think we just need to get away from this terminology and give much more clear definitions, Cevik says. For her, its about getting people to think critically about which situations are riskier than others. Risk is a spectrum. Its not only the distance, but its about timing, what type of activities youre involved in. I know its a bit complex, but thats the reality.

Perhaps part of the reason the WHO has been slow to address the airborne transmission of Covid-19 is because in a health care setting, airborne means a very specific thing.

Though infection prevention experts know theres a fuzzy boundary between drops that fall and specks that float, the dichotomy between airborne and droplet-borne is baked into how health care workers are trained to respond to outbreaks. Weve trained [health care workers] for decades to say, airborne is tuberculosis, measles, chickenpox, droplet is flu and pertussis and meningitis, Saskia Popescu, a hospital epidemiologist in Arizona, says. And thats, unfortunately, kind of antiquated. But thats how weve always done it.

They do it because there are very specific sets of guidelines in place to deal with extremely contagious airborne diseases in a hospital setting. For instance, a patient with a dangerous airborne disease often needs to be put in a room with an air pressure lower than the rest of the rooms in the building. That way, no virus in the air of that room can escape it (since air flows from high pressure to low pressure).

For droplet transmission, health care workers can be a little more lax; they can wear simple surgical masks during routine care and can save high-filtration (and sometimes scarce) respirators for the most dangerous procedures and cases.

In this light, it makes some sense that the WHO has been hesitant to label Covid-19 an airborne infection. Its not an airborne infection like measles is. It is not as contagious. Contact tracing studies consistently find that Covid-19 is spread most readily among people in the closest physical contact to one another. Airborne means something very specific, very resource-intensive, and very scary for hospitals and the people who work in them. And Covid-19 doesnt match that definition.

The debate often isnt very nuanced because of these rigid categories, Daniel Diekema, an infectious diseases physician and epidemiologist at the University of Iowa, says. As soon as you say airborne in the hospital infection prevention world, it brings to mind pathogens like tuberculosis, measles, chickenpox. Its clear the respiratory viruses, influenza, coronaviruses, are not airborne in the same way that the measles, varicella [chickenpox] become airborne.

But at the same time, with Covid-19 and other respiratory viruses, there definitely are small-particle aerosols produced, he says. And in the right setting, where theres poor ventilation, indoors, and a crowded environment, there is a risk for transmission among individuals, even if they may be more than 6 feet apart.

Neither contact tracing studies nor lab studies can perfectly answer the question of which air is safe? But thats science for you. Scientists use imperfect methods, attacking from many angles, to try to arrive at the truth, which can take a while to nail down precisely.

Overall, the recognition that Covid-19 can spread through the air shouldnt really change how we, individually, protect ourselves and others against it. Six feet of distance between people is still a good barrier to prevent spread via large drops. Mask-wearing could help prevent both large drops and small drops from being released in the first place. Time matters too: the longer we spend in an enclosed, poorly ventilated space with others, the greater the chances of being exposed to an infectious dose of the virus.

The bottom line, as a trio of engineers from Clarkson University writes in the Conversation, is that while staying six feet from other people reduces exposure, it might not be sufficient in all situations, such as in enclosed, poorly ventilated rooms.

We still need to think about the environments were in: Indoors is much riskier than outdoors (where greater airflow can disperse drops and aerosols more quickly, and where the environment is less conducive to SARS-CoV-2 survival). And indoors, ventilation can make a big difference. An indoor space where the air is constantly refreshed with air from the outdoors is better than one where the air is stagnant. (The American Society of Heating, Refrigerating and Air-Conditioning Engineers has published extensive guidelines on how to reopen buildings with increased ventilation during the pandemic.)

We also still need to think about the activity were engaging in. Shouting, singing, and other such activities produce more droplets (of any size) than just sitting quietly.

Morawska hopes that in bringing attention to airborne spread of Covid-19, there can be more attention paid to engineering solutions for indoor spaces to mitigate the spread of the pandemic.

Public health officials have continually stressed social distancing, mask-wearing, and hand-washing as ways to stop the spread of Covid-19. But have you ever heard a restaurant reopening announce theyve improved ventilation or increased ventilation? No. This is really the point, Morawska says. If Covid-19 is in indoor air, we should also be doing something about the air.

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Read the original:

Is the coronavirus airborne? The latest guidance from the WHO, explained. - Vox.com

MILAN In February, he said the directors of the nursing home where he worked kept him from wearing a mask, fearing it would scare patients and their families. In March, he became infected and spoke out about the coronavirus spreading through the home. In May, he was fired amid claims that he had damaged the companys image.

Hamala Diop, a 25-year-old medical assistant, challenged the decision in a lawsuit that was first heard in court on Monday. The proceedings will raise the issue of whether whistle-blowers have paid a price in raising alarms about dangerous conditions at medical facilities.

After successfully lowering the curve of new cases after a devastating initial outbreak, Italy is now bracing for a potential second wave.

The country, with the oldest population in Europe, was affected especially deeply by the coronavirus, and nearly half the infections reported in April happened in nursing homes, according to the Italian National Institute of Health. The breadth of the outbreak put the management of nursing homes under judicial and media scrutiny.

As the country fears the emergence of new clusters, some worry that Mr. Diops experience could have a chilling effect on those seeking to raise early warnings about potentially dangerous behaviors.

Nobody protected us from catching the virus, Mr. Diop said, and nobody protected us from getting fired.

On Feb. 26, as officials had already sealed off towns in the northern region of Lombardy, a director at the Palazzolo Institute of the Don Gnocchi Foundation, a nursing home in Milan where Mr. Diop worked, walked to the ward where Mr. Diop and his colleagues were tidying up the dining room. Mr. Diop said in an interview the director told them not to wear masks, that the building was safe and that they should not scare the residents. When presented with this account, the foundation said that they had always rejected any accusation that the employees were kept from using masks as serious and baseless.

For more than two weeks, while the coronavirus epidemic was exploding in the region, Mr. Diop said that he and his colleagues washed, changed and fed the residents without wearing masks or other protection. More than 150 residents would die in March and April, according to Milans prosecutors investigating the case. Asked if that figure was accurate, nursing home officials declined to comment.

They watched TV and saw what was going on outside, he said of the residents, but I had to reassure them and tell them that the virus will never come into our safe place.

The human resources director encouraged managers to place on leave employees who polemicized or insisted on wearing protective gear even when they are not required to, according to an email submitted as evidence. Mr. Diop said that he received his first mask on March 12, when more than 15,000 people in the country had already been infected and days after the government had imposed nationwide restrictions on movement and work.

That same day, Mr. Diop fell ill. A week later, his swab test came back positive for the virus. His mother, who also works at the home, was infected, too.

Eleven days after becoming sick, he filed his complaint along with 17 colleagues, most of whom also had the virus. In it, they argued that management had covered up the first coronavirus cases among the staff and prevented them from using the necessary protective gear, contributing to the spread in the nursing home.

We are their arms and their legs and they all become like our grandpas and grandmas, Mr. Diop said of the residents. And they kept us from protecting them, he said in reference to the management.

In a statement, the foundations lawyers said the home had followed the instructions of the Italian National Institute of Health on the use of masks, and that communications about the infections among workers took place according to privacy laws.

After news of the lawsuit was published by Italian newspapers, dozens of victims families filed similar complaints. Milanese prosecutors opened a criminal investigation into the homes management. On May 7, Mr. Diop was fired by the cooperative that employed him, a subcontractor for the foundation, for talking to reporters about the lawsuit, and many of his colleagues have also been transferred or dismissed.

Mr. Diop challenged the decision, and his lawyer, Romolo Reboa, argues in court filings that Italian and European laws on whistle-blowers should protect workers who raise alarms about situations that put lives at risk. Mr. Reboa cited a similar case of a nurse in Rome who was fired after anonymously speaking on the radio about the lack of masks in his hospital.

In nursing homes, the politics of Covid was if you speak, you get sanctioned, Mr. Reboa said. And this created a climate of intimidation that had a direct impact on the number of deaths.

Mr. Diop, originally from Mali, lives with his parents and two siblings in Cormano, a small town north of Milan. He said that losing his job was a serious financial setback and that he was worried he would not find new work given his record.

While he had expected to face some consequences for his actions, he said he did not think he would lose his job, since the government had imposed a freeze on layoffs during the emergency and health care workers were particularly in demand.

We only are heroes when they like it, he said.

Read more:

A Health Worker Raised Alarms About the Coronavirus. Then He Lost His Job. - The New York Times

The evidence that this type of transmission is happening with SARS-CoV-2arguably already exists.Several big studiespoint to airborne transmission of the virus as a major routefor the spread of covid-19. Other studies have suggested the virus can remain in aerosolized droplets for hours. One new study led by Roy and his team at Tulane shows that infectious aerosolized particles of SARS-CoV-2 could actually linger in the air for up to 16 hours, and maintain infectivity much longer than MERS and SARS-CoV-1 (the other big coronaviruses to emerge this century).

We still dont know what gives SARS-CoV-2 this airborne edge. But it may be one reason this is a pandemic, and not simply a small outbreak like any other coronavirus, says Roy.

Whether the virus is airborne isnt simply a scientific question. If it is, it could mean that in places where the virus has not been properly contained (e.g., the US), the economy needs to be reopened more slowly, under tighter regulations that reinforce current health practices as well as introducing improved ones. Our current tactics for stopping the spread wont be enough.

Roy would like to see aggressive mandates on strict mask use for anyone leaving home. This virus sheds like crazy, he says. Masking can do an incredible amount in breaking transmission. I think anything that can promote the use of masking, to stop the production of aerosols in the environment, would be helpful.

Brosseau, however, says that though masks can limit the spread of larger particles, they are less helpful for smaller ones, especially if they fit only loosely. I wish we would stop relying on the idea that face coverings are going to solve everything and help flatten the curve, she says. Its magical thinkingits not going to happen. For masks to really make a difference, they would need to be worn all the time, even around family.

Brosseau does believe the evidence is trending toward the conclusion that airborne transmission is the primary and possibly most important mode of transmission for SARS-CoV-2. She says, I think the amount of time and effort devoted to sanitizing every single surface over and over and over again has been a huge waste of time. We dont need to worry so much about cleaning every single surface we touch. Instead, the focus should be on other factors, like where we spend our time.

One of the biggest questions we still have about covid-19 is how much of a viral load is needed to cause infection. The answer changes if we think it is aerosols that we need to worry about. Smaller particles wont carry as large a viral load as bigger ones, but because they can linger in the air for much longer, it may not mattertheyll build up in larger concentrations and get distributed more widely the longer an infected person is around to expel aerosolized virus.

The more people you have coming in and out of an indoor space, the more likely it is that someone who is infected will show up. The longer those infected individuals spend in that space, the higher the concentration of virus in the air over time. This is particularly bad news for spaces where people congregate for hours on end, like restaurants, bars, offices, classrooms, and churches.

Airborne transmission doesnt necessarily mean these places must stay closed (although that would be ideal). But wiping down surfaces with disinfectant, and having everyone wear masks, wont be enough. To safely reopen, these spots will not just need to reduce the number of people allowed inside at any given moment; they will also need to reduce the amount of time those people spend there. Increasing social distancing beyond six feet would also help keep people safer.

Ventilation needs to be a higher priority too. This is going to be a big problem for older buildings that usually have worse ventilation systems, and areas with a lot of those might need to remain closed for much longer. The impact ofasymptomatic spread(transmission by people who dont feel ill) andsuperspreadersonly compounds the problem even further. Butresearchconducted by the US Department of Homeland Security has shown that in the presence of UV light, aerosolized particles of the size the Tulane researchers studied would disappear in less than a minute.A number of businesseshave begun deploying UV-armed robots to disinfect hospital rooms, shopping malls, stores, public transit stations, and more.

For many places, considerable delays in economic reopening might ultimately be the price of getting the virus under control. Otherwise the kind of thing that happened when a single open bar in Michiganled to an outbreak of more than 170 new casescould become commonplace.

Heading into the fall, "the implications are profoundbut not that hard to grasp," says Donald Milton, an aerobiology expert at the University of Maryland and one of the authors who spearheaded the letter to WHO. "We need to subsidize bars and restaurants to stay closed. We need to increase ventilation where we can and start making as widespread as possible use of air sanitation with upper-room germicidal UV and maybe far UV in those places that must be open, like elementary schools. We need to stagger hours of starting work and keep density on public transport low, or open windows. And we need to wear masks."

This post has been updated with additional comments from Donald Milton.

Read more from the original source:

If the coronavirus is really airborne, we might be fighting it the wrong way - MIT Technology Review

Most of the new cases are young people between the ages of 15 and 25, the Washtenaw County Health Department said in a press release Monday.

It is believed that the party took place between July 2 and 3, and health officials are now asking anyone who attended the party to self quarantine and monitor themselves for symptoms of the virus for 14 days.

There were an additional 66 people who are believed to have had face-to-face contact with a confirmed case. That number does not include family members who are immediate household contacts of the newly identified cases, the release said.

Over the weekend, Louisiana Gov. Bel Edwards said may new cases had been linked to casual gatherings in people's backyards. The governor issued a restriction mandating gatherings be under 50 people as a result.

Local health officials said this cluster in Michigan highlights how easily and rapidly the virus can infect people.

Spread from the party has impacted people outside the county and even the state, according to the release.

The party and subsequent events have led to additional exposures at retail stores, restaurants, businesses, canoe rentals, clubs, camps, athletic teams and a retirement community, the release said.

"None of us wants to be the reason someone in our community or county becomes seriously ill or dies," says Brian D. Marl, Mayor of the City of Saline. "We have the opportunity to work together and with our local health department to contain this as quickly as possible. We know what we need to do, and we can certainly do it."

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43 new coronavirus cases have been linked to one large house party in Michigan - CNN

She looked to her husband for help. He immediately called an ambulance -- and Briones was admitted at a hospital in South Texas, where she stayed for almost a month to recover from what she came to learn was Covid-19. She described contracting the virus as the worst experience she's ever had.

"It's just a horrible experience to go through," she told CNN, through tears. "I wish upon no one to go through it."

Briones is one of thousands of people who identify as Latinx who have suffered from the Covid-19 pandemic.

And as coronavirus cases continue to rise across the US, many Latinos say they are growing more concerned for their lives and their community.

Texas border communities hit hard

In Texas' Hidalgo County -- where 92.5% of the county's 860,000 residents identify as Latinx -- data shows just how hard Covid-19 has hit the Latinx community.

"Several months ago, I warned of a potential tsunami if we did not take this more seriously," Hidalgo County Judge Richard F. Corez said in a news release. "The tsunami is here."

County officials have said in notifications to residents in the past few weeks that hospitals have reached capacity. Residents are strongly encouraged to stay home, as health care facilities race to add more ICU beds in anticipation for more people with complications from the virus.

The South Texas Medical System in Weslaco -- which is also near the border -- converted conference rooms and shelf spaces to ICU areas as it continues to see an influx of coronavirus patients. They also set up a tent to handle any overflow patients, where they can treat up to 20 additional patients on top of the other areas inside the emergency department.

Wesley Robinson, the assistant chief nursing officer of the South Texas Health System, told CNN the medical system "began seeing patients arrive on July 1, by July 3 they were incredibly sick -- now we're at the point where we've reached well over 100% capacity."

Some experts point to Texas Gov. Greg Abbott's decision to prematurely reopen the state's economy as a reason why the virus spread so quickly.

"And that is because at the time that the (Trump) administration insisted on opening the economy where they weren't prepared," Dr. Joseph B. McCormick, an epidemiologist at the Brownsville campus of the University of Texas Health Science Center at Houston, told CNN. "We didn't fit any of the criteria that were recommended when the economy was open."

McCormick said Texas was doing a "pretty good job until everybody decided it was time to reopen the economy."

"And we were not prepared to do that because we didn't have the wherewithal to do the contact tracing," he added. "We didn't have testing to be able to do this."

McCormick emphasized how Covid-19 doesn't just affect someone when they've tested positive -- the virus can have longlasting effects on a person.

'Frontline troops' more at risk

Domingo Garcia, president of the League of United Latin American Citizens, told CNN he's seen his own employees and their families suffer from Covid-19. Even some of his own family members have tested positive for the virus, he said.

The organization, one of the largest and oldest Hispanic organizations, has been working to help its members combat the effects of the virus. The latest effort included asking Abbott to mandate masks in public spaces across the state, a move he made this month.

"The Latino workforce is the essential frontline troops," Garcia said. "They're the ones that are picking the vegetables that we have. They're the ones that are working at the meat packing plants to make sure that you have a steak at your table. They're the ones that are working in the construction areas to make sure our freeways stay open and clear. They're the ones that are the truck drivers. They're the ones that the grocery stores."

Because Latino workers "can't work from home and they're getting sick," he said. "They're out."

He said he's worried about the longterm effects this will have on the community.

"From a health perspective, we're seeing many grandparents and parents pass away, hospitals bursting at the seams in Houston. They've already reached capacity," he said. "This requires immediate federal and state intervention. It can not be done by a nonprofit organization like LULAC. It's going to require a community wide effort."

Frankie Miranda, president of the Hispanic Federation, a national Latino organization that supports Hispanic families and communities, said Latinos are "dying at a higher rate because we have no other choice."

A lack of access to adequate health care

"And that means they don't get the health care primary checkups they need to detect illnesses, and then those illnesses, ultimately with this pandemic, can be more than a serious health challenge, they can become deadly," he said.

According to McCormick, many Latino workers in these essential jobs are also less likely to visit a doctor for a multitude of reasons, including a lack of health insurance or lack of time. But the community also has a high percentage of people with underlying conditions, McCormick said, noting diabetes in Hispanics is especially "quite high."

Dr. Rojelio Mejia, an infectious disease scientist at Baylor College of Medicine, said morbidities -- like diabetes, smoking, obesity and high blood pressure -- which are prevalent in Latinx communities, contribute to the challenges with Covid-19.

"Just looking at the population itself, there's a higher percentage of people who have more comorbidities," Mejia told CNN. "And then when they get, if they get exposed, they get infected, they can have a worse outcome than someone who doesn't have these morbidities or is not a Latino person and they have relatively good health."

For San Antonio native Beverly Barboza-Guerrero, visiting the doctor after being diagnosed with coronavirus in early June didn't really help.

She had followed all proper protocols, but after a social-distanced trip to South Padre Island, she began feeling the symptoms. She visited the emergency room twice, but had no luck getting advice from doctors to help her feel better.

"I mean, we try to think back, like, what did we do wrong?" the 30-year-old told CNN, recalling her symptoms. She said she felt 10 times worse than when she had the flu in November.

"It just felt like I couldn't breathe in," she said. "It felt like if I go to sleep, like I'm not going to wake up. Like, it just felt, it felt ugly," she said. "(One day) I woke up and I told my wife, I need to go to the hospital. There's something not right. I need to go to the hospital. I really cannot breathe."

The ER doctor, she said, told her to "to just take Tylenol and just make sure you're resting, you know, make sure you're quarantining."

Another issue people are encountering, especially in Latinx communities, is false negatives for Covid-19.

In response to the surge in coronavirus cases in these hotspots, including south Texas, the Department of Health and Human Services announced Tuesday the launch of new testing sites in three hotspots -- Jacksonville, Florida; Baton Rouge, Louisiana; and Edinburg, Texas.

Briones said she hopes people make the effort to stay home and educate themselves about the virus.

"You need to do it, you know," she said, "because I have a feeling it's going to be for a long while, we're going to be like this."

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Latinx residents fear the toll coronavirus is taking on their lives and community - CNN

Russell Westbrook of the Houston Rockets, the N.B.A.s most valuable player in the 2016-17 season, said on Monday in a social media post that he had tested positive for the coronavirus. He said he received his test result before the team left for Walt Disney World in Florida, where the N.B.A. is attempting to restart its season.

Im currently feeling well, quarantined, and looking forward to rejoining my teammates when I am cleared, Westbrook said in his statement. He added: Please take this virus seriously. Be safe. Mask up!

Westbrook and Houstons other star guard, James Harden, did not travel with the team on Thursday to the Walt Disney World campus. Luc Mbah a Moute, a veteran forward whom the Rockets signed this month, also did not make the trip. Coach Mike DAntoni did not specify why, in comments to reporters over the weekend, but said he expected the players to arrive soon.

These are things that people are dealing with, DAntoni said. Were not going to get into why not. Theyre on their way.

It was unclear when Westbrook would be able to join the Rockets or when his quarantine period began. According to the N.B.A.s guidebook on health protocols, Westbrook will be allowed to join others on the campus when he tests negatively for the coronavirus in two separate tests at least 24 hours apart. He must also be cleared by a league-approved infectious disease physician and undergo a cardiac screening.

The Rockets were 40-24 and tied for fourth place in the Western Conference before the pandemic suspended the season in March. Westbrook, the teams second-leading scorer, struggled with his shooting throughout the season, but still averaged 27.5 points a game, with eight rebounds and seven assists a game.

The N.B.A. also announced on Monday that two other players had tested positive for the coronavirus upon arriving in Florida. In total, 322 were tested, the league said in a statement. The two players, who were not identified, never cleared quarantine and have since left the campus to isolate at home or in isolation housing.

Shortly before the N.B.A. announced its findings, one player, Richaun Holmes of the Sacramento Kings, said that he had left the campus to pick up a food delivery order and now has eight days left in another quarantine.

Since July 1, according to the N.B.A., 19 players had tested positive for the coronavirus before arriving in Florida. That number includes players like Spencer Dinwiddie and DeAndre Jordan of the Nets, who are skipping the N.B.A. restart entirely as a result. Commissioner Adam Silver had said that the league expected more positive cases as players arrived on campus. But even so, Silver has expressed confidence that the N.B.A. season will be able to conclude and that players will be safer on campus than off.

What would be most concerning is once players enter this campus and then go through our quarantine period, then if they were to test positive or if we had any positive tests, we would know we would have an issue, Silver told Fortune this month.

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Russell Westbrook Says He Tested Positive for the Coronavirus - The New York Times

As the virus works its strange, invisible magic inside me, I watch its outward manifestations: constellations of blood-red spots called petechiae strewn across my stomach, breasts and arms; purple circles under my eyes; eight pounds gone; my first white hairs. Before our travels, Id considered myself a healthy 37-year-old and regularly went on runs around my neighborhood. Now a flight of stairs leaves me breathless. On the oximeter, my pulse races at the slightest stressors.

Over the phone my doctors voice is tired, almost defensive. Shes worried about blood clots, and tries to get me into several labs for tests, but I cant pass their symptom checks. At this stage, she tells me, the only place that will take someone with Covid symptoms is a hospital. If the pain gets worse, I should go to the nearest emergency room in Providence.

A friend whose Covid-19 battle lasted a more typical 14 days drops off groceries; the last rolls of toilet paper in the aisle. For months weve relied on delivery services for supplies.

You can take your mask off, she calls from the sidewalk. Im not scared anymore.

From her undyed part, gray hairs reveal themselves in all their lived wisdom and glory. When she offers to go to the hospital with me, tears drop into the mask dangling from my chin.

At the E.R., seven hours of tests: EKG, CT scan, chest X-ray, ultrasound. I lie on the hospital bed, one arm pinioned by an IV, wires threading from my chest to the heart monitor bleating above my head. A patient moans, and the halls echo with the commands of X-ray technicians shouting Dont breathe! Breathe, a remedial paparazzi.

The doctor comes in with no news. Even from the inside, my pain cannot be seen. What is it? I plead.

I know youre scared, he replies, staring at me over his mask. Im scared too.

The doctors think its post-viral syndrome, I explain to family, friends, co-workers, though the pain is anything but post. Its animate, moving, alive inside me. Instead of the orange cat, I now imagine a pale green dragon stealing out the door, a thick, scaly tail snaking behind, thumping ominously.

Read the original here:

Whipped by the Long Tail of the Coronavirus - The New York Times

Many experts say the huge pool of uninsured people in these states compounds the challenge of coping with the outbreak in several different ways, from leaving a large number of residents with underlying conditions that increase their vulnerability to the disease to extending the outbreak's spread by discouraging the uninsured from seeking early testing and treatment.

The new pressures emerging as the virus migrates to low-insurance Sun Belt states -- after striking first primarily in Northern and Western states that expanded Medicaid, almost all of which have lower uninsured rates than the national average -- is only one of the several respects in which the outbreak is raising the stakes in the debate over the ACA's future.

All of this could make the political debate over health care even more central in 2020 than it was in 2018, when Democratic promises to defend the ACA, and in particular its provisions protecting patients with preexisting conditions, were pivotal in the party's sweeping midterm election gains.

"All the same reasons that it was [important] in 2018 are in effect now, and all the [arguments] in the middle of a pandemic are even more potent," says Democratic pollster Nick Gourevitch.

Republican pollster Gene Ulm disagrees. He says that concerns directly relating to the coronavirus outbreak -- such as whether businesses and schools can reopen safely -- are eclipsing all other issues this year. "All the oxygen has just been squeezed out," he says. "Health care before meant, 'Will I be able to get coverage? How much will I have to pay for it?' Now it's all the Covid."

But Democrats are betting heavily that Ulm and other Republicans who share that perspective are wrong. Majority Forward, the issue advocacy arm of the Senate Democratic leadership, and the Senate Majority PAC, its campaign super PAC, are once again stressing health care more than any other issue in their advertising against Republican senators this year.

"I think health care -- to the surprise of a lot of people, maybe most directly Republicans -- is more urgent and even a greater priority than it was two years ago," insists J.B. Poersch, the president and CEO of the Senate Majority PAC.

Many experts believe the pandemic and the ACA could be connected in an even more visceral way in the weeks ahead. The reason: Most expect that insurance companies are likely to define exposure to coronavirus as a preexisting condition. That means many of the millions of Americans who have contracted the disease could face higher premiums and less access to coverage and care if the administration's lawsuit (and Republican legislative proposals throughout Donald Trump's presidency) to repeal the ACA's protections prevails.

"There's no question in my mind that insurance companies would treat Covid-19 as a preexisting condition if they were allowed to," said Larry Levitt, executive vice president for health policy at the nonpartisan Kaiser Family Foundation. That prospect, he adds, "connects the dots in a very tangible way between the ACA and the pandemic."

2018 vs. 2020

Democrats are again stressing the issue of preexisting conditions in House and Senate races this year. Majority Forward and the Senate Majority PAC have run television ads lashing GOP senators from Cory Gardner in Colorado and Martha McSally in Arizona to David Perdue in Georgia, Steve Daines in Montana and Thom Tillis in North Carolina for their votes earlier in Trump's term to repeal the ACA and its measure barring insurers from selling coverage at higher prices to patients with preexisting conditions.

These exchanges largely reprise the debate between the parties from 2018, albeit in the more highly charged atmosphere of the coronavirus crisis. But the outbreak -- combined with the ACA lawsuit -- may also be broadening the health care debate to focus more than in 2018 on the law's efforts to expand coverage to the uninsured.

"When you talk about the sheer number of people that aren't covered in a public health crisis, that is very relevant to the moment. That matters," says Poersch.

Republicans are generally countering Democratic calls to protect the ACA or to expand coverage to the remaining uninsured by accusing the party of seeking a government takeover of health care.

"Democrats showed the entire country what their objectives are on health care during the presidential primary: a government-controlled plan that seeks to eliminate employer-based coverage," Jesse Hunt, communications director for the National Republican Senatorial Committee, said in an email. "All roads lead to that outcome."

The issue of ensuring coverage during a pandemic, particularly by expanding Medicaid, is surfacing in races around the country.

But the issue may be most pointed in the primarily Sun Belt states that have refused to expand Medicaid under the ACA and thus remain among the states coping with the largest share of uninsured residents even as their coronavirus caseloads spike.

How they're campaigning

In North Carolina, where Republican state legislators have repeatedly blocked efforts by Democrats to expand Medicaid eligibility, the Senate Majority PAC has stressed the issue in its advertising against Tillis, who before his election to the US Senate helped lead the fight against Medicaid expansion as the GOP speaker in the state House of Representatives.

In Alabama, Democratic Sen. Doug Jones, who faces a difficult fight for reelection in a state where Trump romped in 2016, is running an ad where he endorses Medicaid expansion for the state and declares: "Too many folks face the Covid crisis without health care coverage."

In Texas, the issue is especially acute, both because it is the largest state that has not expanded Medicaid and because Republican Attorney General Ken Paxton has led the coalition of GOP states suing to invalidate the ACA. Democratic House candidate Sri Preston Kulkarni, who is running strongly for an open Republican seat outside Houston, one of the outbreak's epicenters, has stressed health care throughout his campaign and unequivocally insisted that Texas should expand Medicaid eligibility.

Likewise, Democrats are promising to expand Medicaid in their uphill, but achievable, bid to win control of Texas' state House of Representatives for the first time in years. Texas' coronavirus crisis "has brought in a very crystallized way the reality of what life is with health care, and what life is without it," says Democratic state Rep. Trey Martinez Fischer of San Antonio.

Contrary to the Democrats, Ulm says that in his research voters are not linking the outbreak with either the debate over protecting preexisting conditions or Trump's efforts to repeal the ACA. "It's not how people are looking at it," he says. "It's just not. They are looking at it more like: No one seems to understand this [disease]."

Such repositioning may reflect the enormous pressure that the coronavirus outbreak is imposing on health care systems, particularly in the states already strained by the large number of uninsured. The big uninsured population "makes it exponentially worse" to cope with the surge, says Texas state Rep. Fischer Martinez.

Challenges for non-expansion states

Medical experts say that the Sun Belt states have one big advantage over the states hit earlier this spring: Hospitals have developed more expertise on how to treat victims and reduce mortality. But in many other respects, experts say the large number of uninsured in many of these states complicates their situation. These challenges include:

In the presidential race, the coronavirus outbreak has eclipsed all other issues to the point that the health care debate hasn't been engaged as directly as in many of the Senate and House contests. But the virus' turn into the low coverage states that refused to expand Medicaid could eventually provide a vivid backdrop for one of the sharpest policy differences between Trump and presumptive Democratic nominee Joe Biden.

CNN's Tami Luhby contributed to this report.

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How the coronavirus is shaping health care politics in 2020 - CNN