Category: Corona Virus

Coronavirus testing in the U.S. has run into a number of snags, from a lack of nasal swabs to not enough chemicals needed to run the tests.

Now there's a new bottleneck emerging: A shortage of the machines that process the tests and give results.

Civilian labs and the Pentagon say they've had trouble getting the sophisticated, automated machines that can run hundreds of diagnostic tests at once. Three machine manufacturers Hologic Inc., Roche and Abbott Laboratories have confirmed to NPR that demand is outstripping supply.

Public health experts say the machine shortages are upending a complicated supply chain just as the shortages of swabs, chemicals and other testing materials have begun to ease.

Experts warn the lack of machines will hold the U.S. back from ramping up diagnostic testing to better understand where the coronavirus is spreading and how to stop outbreaks.

"We're gonna get stuck again," said Ashish Jha, director of the Harvard Global Health Institute. "We keep sort of fixing one bottleneck, and testing gets a bit better, and then we get stuck with the next bottleneck."

The Trump administration has released a plan to ramp up testing, saying it would provide strategic direction and technical assistance, but mostly leaving responsibility for executing the plan to the states. Coronavirus testing in the U.S. is carried out by a patchwork of commercial labs, hospitals, local health departments and other institutions.

The administration's coronavirus testing coordinator, Admiral Brett Giroir, says that plan is working.

"Right now in America anybody who needs a test can get a test in America with the numbers we have. ... That's over three million tests per week," Giroir said at a White House briefing earlier this month.

Jha and other public health experts say that may be enough tests in some places but only because not enough people are getting tested.

"It is not nearly enough, certainly not enough to open up safely and remain open," Jha said.

At a minimum, Jha says the U.S. needs to be testing twice as many people 7 million per week. That means the country is going to need more swabs, more testing kits, and more testing machines to run them. Four months into the pandemic, Jha says, the nation still isn't ready.

Heather Pierce, senior director for science policy for the Association of American Medical Colleges, says labs at teaching hospitals have reported difficulties in getting testing machines. She says that has exacerbated supply chain problems.

"Those machines have been part of the bottleneck," she said. "In fact, even institutions that had ordered those machines prior to the pandemic found their orders were cancelled or delayed, and some still haven't been shipped."

Even the U.S. Army is finding it can't get some coveted testing instruments.

The Chief of Staff of the Army, Gen. James McConville, told NPR the Army has been unable to secure more of the machines that can handle a greater volume of tests.

More testing is needed to get back to training large numbers of troops. McConville toured the Fort Irwin National Training Center in California earlier this month, where he questioned the base staff about their capacity to test for the coronavirus.

The soldiers told him they want a machine known as the Panther, a top-of-the-line, automated testing instrument made by the pharmaceutical company Hologic. It can run more than 1,100 tests a day.

General McConville called it the "granddaddy" of testing machines.

But McConville said there aren't enough of them on the market. He told the soldiers: "Realistically, you won't get Panther."

Three manufacturers confirmed they have not been able to meet the demand for new testing machines. One of them was Hologic, the company that makes the Panther.

"Given the unprecedented demand, we cannot provide new instruments to every lab that wants one, at least not right away," Mike Watts, Hologic's vice president of investor relations and corporate communications said in an email.

Watts stressed that there are already more than 1,000 Panther machines, which are used for other medical tests as well, installed in labs in all 50 states.

"So overall, we believe availability of Panthers is accelerating, not constraining, national testing," Watts said.

Roche and Abbott Laboratories say they've also had trouble filling orders for some big instruments. All three companies say they're doing everything they can to scale up production.

Roche spokesman Mike Weist said the company is even shipping out demonstration and training models. "Every available instrument, including instruments repurposed from internal use (such as training, demonstration, clinical trials), has been shipped or allocated for shipment in order to increase testing capacity worldwide," Weist said in an email.

Still, Harvard's Jha says more needs to be done.

"This is a classic market failure," Jha said. "This is not something that the market is going to sort out onto itself."

It's not just about ramping up production of these machines, Jha says. To get testing to more than double where it is today, he says labs need to invest even more in a lot more equipment.

But the testing machines are expensive. And the pandemic has caused an economic meltdown. Now some labs are saying they're not sure they can justify the expense of adding more instruments.

What if infection rates decline? What if people don't come forward to get tested, or think they don't need to unless they're really sick? That is, after all, what many public health officials were saying for months when tests were scarce.

"This is a place where I think the government just needs to step in and pay companies buy the machines for companies, or pay large amounts for these tests," Jha said. "This is what many of us have been asking for from the federal government. ... And it's very frustrating."

He's not the only one who is looking to the federal government to play a bigger role.

"There's broad agreement about the need for testing," said Julie Khani, president of the American Clinical Laboratory Association, which represents commercial labs.

"There has been something of a disconnect, however, between the need for testing and providing the necessary support and resources for laboratories to grow and expand that testing," Khani said.

Khani's organization wrote to the Trump administration in April, asking for $10 billion in emergency relief funds to buy more testing machines for their labs. The group is still waiting for a response.

NPR Correspondent Tom Bowman and Senior Producer Walter Ray Watson contributed to this report.

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Coronavirus Testing Machines Are Latest Bottleneck In Troubled Supply Chain - NPR

The coronavirus still has a long way to go. Thats the message from a crop of new studies across the world that are trying to quantify how many people have been infected.

Official case counts often substantially underestimate the number of coronavirus infections. But even in results from a new set of studies that test the population more broadly to estimate everyone who has been infected, the percentage of people who have been infected so far is still in the single digits. The numbers are a fraction of the threshold known as herd immunity, at which the virus can no longer spread widely. The precise herd immunity threshold for the novel coronavirus is not yet clear; but several experts said they believed it would be higher than 60 percent.

Even in some of the hardest-hit cities in the world, the studies suggest, the vast majority of people still remain vulnerable to the virus.

Some countries notably Sweden, and briefly Britain have experimented with limited lockdowns in an effort to build up immunity in their populations. But even in these places, recent studies indicate that no more than 7 to 17 percent of people have been infected so far. In New York City, which has had the largest coronavirus outbreak in the United States, around 20 percent of the citys residents have been infected by the virus as of early May, according to a survey of people in grocery stores and community centers released by the governors office.

Similar surveys are underway in China, where the coronavirus first emerged, but results have not yet been reported. A study from a single hospital in the city of Wuhan found that about 10 percent of people seeking to go back to work had been infected with the virus.

Viewed together, the studies show herd immunity protection is unlikely to be reached any time soon, said Michael Mina, an epidemiologist at the Harvard T.H. Chan School of Public Health.

The herd immunity threshold for this new disease is still uncertain, but many epidemiologists believe it will be reached when between 60 percent and 80 percent of the population has been infected and develops resistance. A lower level of immunity in the population can slow the spread of a disease somewhat, but the herd immunity number represents the point where infections are substantially less likely to turn into large outbreaks.

We dont have a good way to safely build it up, to be honest, not in the short term, Dr. Mina said. Unless were going to let the virus run rampant again but I think society has decided that is not an approach available to us.

The new studies look for antibodies in peoples blood, proteins produced by the immune system that indicate a past infection. An advantage of this test is that it can capture people who may have been asymptomatic and didnt know they were sick. A disadvantage is that the tests are sometimes wrong and several studies, including a notable one in California, have been criticized for not accounting for the possibility of inaccurate results or for not representing the whole population.

Studies that use these tests to examine a cross section of a population, often called serology surveys, are being undertaken around the country and the world.

While these studies are far from perfect, said Carl Bergstrom, a professor of biology at the University of Washington, in aggregate they give a better sense of how far the coronavirus has truly spread and its potential for spreading further.

The herd immunity threshold may differ from place to place, depending on factors like density and social interaction, he said. But, on average, experts say it will require at least 60 percent immunity in the population. If the disease spreads more easily than is currently believed, the number could be higher. If there is a lot of variation in peoples likelihood of becoming infected when they are exposed, that could push the number down.

All estimates of herd immunity assume that a past infection will protect people from becoming sick a second time. There is suggestive evidence that people do achieve immunity to the coronavirus, but it is not yet certain whether that is true in all cases; how robust the immunity may be; or how long it will last.

Dr. Mina of Harvard said to think about immunity in the population as a firebreak, slowing the spread of the disease.

If you are infected with the virus and walk into a room where everyone is susceptible to it, he said, you might infect two or three other people on average.

On the other hand, if you go in and three out of four people are already immune, then on average you will infect one person or fewer in that room, he said. That person in turn would be able to infect fewer new people, too. And that makes it much less likely that a large outbreak can bloom.

Even with herd immunity, some people will still get sick. Your own risk, if exposed, is the same, said Gypsyamber DSouza, a professor of epidemiology at Johns Hopkins University. You just become much less likely to be exposed.

Diseases like measles and chickenpox, once very common among children, are now extremely rare in the United States because vaccines have helped build enough herd immunity to contain outbreaks.

We dont have a vaccine for the coronavirus, so getting to herd immunity without a new and more effective treatment could mean many more infections and many more deaths.

If you assume that herd protection could be achieved when 60 percent of the population becomes resistant to the virus, that means New York City is only one-third of the way there. And, so far, nearly 250 of every 100,000 city residents has died. New York City still has millions of residents vulnerable to catching and spreading this disease, and tens of thousands more who are at risk of dying.

Would someone advise that people go through something like what New York went through? said Natalie Dean, an assistant professor of biostatistics at the University of Florida. Theres a lot of people who talk about this managed infection of young people, but it just feels like hubris to think you can manage this virus. Its very hard to manage.

In other cities, serology surveys are showing even smaller shares of people with antibodies. The quality of these studies is somewhat varied, either because the samples werent random or because the tests were not accurate enough. But the range of studies shows that most places would have to see 10 or more times as many illnesses and possibly, deaths to reach the point where an outbreak would not be able to take off.

The serology studies can also help scientists determine how deadly the virus really is. Currently, estimates for whats called the infection fatality rate are rough. To calculate them precisely, its important to know how many people in a place died from the virus versus how many were infected. Official case rates, which rely on testing, undercount the true extent of infections in the population. Serology helps us see the true footprint of the outbreak.

In New York City, where 20 percent of people were infected with the virus by May 2, according to antibody testing, and where more than 18,000 had died by then, the infection fatality rate appears to be around 1 percent.

For comparison, the infection fatality rate for influenza is estimated at 0.1 percent to 0.2 percent. But the way the government estimates flu cases every year is less precise than using serology tests and tends to undercount the number of infections, skewing the fatality number higher.

But even if the fatality rates were identical, Covid-19 would be a much more dangerous disease than influenza. It has to do with the number of people who are at risk of getting sick and dying as the disease spreads.

With the flu, only about half the population is at risk of getting sick in a given flu season. Many people have some immunity already, either because they have been sick with a similar strain of flu, or because they got a flu shot that was a good match for the version of the virus they encountered that year.

That number isnt high enough to fully reach herd immunity and the flu still circulates every year. But there are benefits to partial immunity in the population: Only a fraction of adults are at risk of catching the flu in a normal year, and they can spread it less quickly, too. That means that the number of people at risk of dying is also much lower.

Covid-19, unlike influenza, is a brand-new disease. Before this year, no one in the world had any immunity to it at all. And that means that, even if infection fatality rates were similar, it has the potential to kill many more people. One percent of a large number is bigger than 1 percent of a smaller number.

There arent 328 million Americans who are susceptible to the flu every fall at the beginning of the flu season, said Andrew Noymer, an associate professor of public health at the University of California, Irvine. But there are 328 million Americans who were susceptible to this when this started.

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The World Is Still Far From Herd Immunity for Coronavirus - The New York Times

The staggering American death toll from the coronavirus, now approaching 100,000, has touched every part of the country, but the losses have been especially acute along its coasts, in its major cities, across the industrial Midwest, and in New York City.

The devastation, in other words, has been disproportionately felt in blue America, which helps explain why people on opposing sides of a partisan divide that has intensified in the past two decades are thinking about the virus differently. It is not just that Democrats and Republicans disagree on how to reopen businesses, schools and the country as a whole. Beyond perception, beyond ideology, there are starkly different realities for red and blue America right now.

Democrats are far more likely to live in counties where the virus has ravaged the community, while Republicans are more likely to live in counties that have been relatively unscathed by the illness, though they are paying an economic price. Counties won by President Trump in 2016 have reported just 27 percent of the virus infections and 21 percent of the deaths even though 45 percent of Americans live in these communities, a New York Times analysis has found.

The very real difference in death rates has helped fuel deep disagreement over the dangers of the pandemic and how the country should proceed. Right-wing media, which moved swiftly from downplaying the severity of the crisis to calling it a Democratic plot to bring down the president, has exacerbated the rift. And even as the nations top medical experts note the danger of easing restrictions, communities across the country are doing so, creating a patchwork of regulations, often along ideological lines.

Why has the virus slammed some parts of the country so much harder than others? Part of the answer is population density. Nearly a third of Americans live in one of the 100 most densely populated counties in the United States urban communities and adjacent suburbs and it is there the virus has taken its greatest toll, with an infection rate three times as high as the rest of the nation and a death rate four times as high.

In a country deeply segregated along racial, religious and economic lines, density also aligns with political divisions: Urban America tilts heavily blue. In the 2016 presidential election, Mr. Trumps vote share increased as population density fell in almost every state.

But the divide in infections has been exacerbated by the path the virus has taken through the nation, which is not always connected to density. In some parts of red America, cities have been virtually unscathed and the sparsely populated outlying areas have been hardest hit. Researchers have also found links between the viruss effects and age, race and the weather, and have noted that some of the densest cities globally have not been hit as hard.

If seeing is believing, the infection has simply come to some areas of the country on a far different scale than others. As of Friday, Alabama had experienced 11 deaths per 100,000 residents and New Jersey had lost 122 per 100,000. Both states have had a huge spike in unemployment claims.

Texas, solidly Republican territory and the second most populous state in the nation, had one of the countrys hottest economies before the outbreak. The states biggest cities have so far escaped the worst of the damage. More than 200 metro areas in the United States have higher infection rates than both Dallas and Houston, which may explain why Texas residents are particularly frustrated by the shutdown.

The cure is worse than the disease, no doubt, said Mark Henry, a Republican who oversees the Galveston County government in southeast Texas. There are businesses that were shut down that are never going to open again.

Over all, the infection rate is 1.7 times as high in the most urban areas of the country compared with nearby suburbs, and 2.3 times as high in the suburbs as in exurban and rural areas.

Amid the pandemic, there are densely populated red counties near major cities with high infection rates Suffolk County in New York, Jefferson Parish in Louisiana, and Monmouth County in New Jersey, for example.

But those are true outliers.

A recent spate of outbreaks in meat plants, prisons and nursing homes has created hot spots in 245 counties that supported Mr. Trump, double the number at the beginning of the month. Some of those outbreaks are hitting subsets of the population that historically have not voted for Republicans. In Iowa, for example, Latinos make up 6 percent of the population but nearly a third of those infected. The population is 4 percent black, but 12 percent of those infected are black.

Over all, African-Americans and Latinos have had higher infection and death rates from the virus, and are far more likely to identify as Democrats than as Republicans.

Several companies have studied social distancing metrics based on anonymized cellphone location data, including the mobility research firms Unacast and Descartes Labs. While the companies do not break down findings by political party, the underlying data they collect shows less social distancing in counties that supported Mr. Trump than in those that supported Hillary Clinton.

Rural and exurban county residents, who tend to favor Republicans, do have to travel more for essential services and are less likely to have jobs that allow for working from home. Yet even in more densely populated suburban areas, there was less evidence of social distancing in counties that voted for Mr. Trump.

Matthew Gentzkow, a Stanford University economist who is leading a group of researchers tracking partisanship in the virus response, said his team initially thought that a health crisis would minimize differences assuming that people who disagree over taxes or guns would agree about a pandemic. But instead they found that Republicans were more skeptical about the effectiveness of social distancing than Democrats and have been traveling more outside their homes.

We initially saw partisanship and thought maybe by the time we looked at the data it would be gone, Dr. Gentzkow said. But it turns out that no, this is pretty serious and what we see is that the gap got bigger and bigger. These are real belief differences that should have us really concerned.

Public opinion polls do show widespread support for stay-at-home orders, but also indicate that Republicans are less likely to see the virus as a significant threat to their health. Some skepticism around the impact of the pandemic can be traced to a distrust of the government that has grown among conservatives in the last decade, according to Arlie Hochschild, a sociologist at the University of California, Berkeley, and the author of a 2016 book about the American right called Strangers in Their Own Land.

In the absence of trust, you just believe your eyes and the information that you see in your Facebook feed, she said.

The experience of residents in Texas underscores how much direct evidence of the viruss toll has shaped how people view the measures taken to mitigate it.

At the onset of the crisis, Gov. Greg Abbott, a Republican, tried to appeal to both sides of the political spectrum, allowing local governments to make their own decisions until Texas became one of the last states to issue stay-at-home orders and one of the first to roll them back last month.

In Hardin County in southeast Texas, where the population is about 57,000, there have been just 125 cases and five deaths. Kent Batman, 60, the county Republican chairman, who has spent his life in the region, said he had heard of only two fatalities, both of which he dismissed as anomalies.

To Mr. Batman, like many other Republicans in East Texas, the health crisis has felt far away, like a big city plague. Were not New Orleans, were just not like that, he said.

Interviews with dozens of Republicans in southeast Texas and other parts of the country over the past month found a pervasive its-not-coming-for-my-neighborhood attitude, with many seeing themselves as a world apart from the regions that have been overwhelmed by the virus. They are enthusiastic backers of rolling back restrictions not just as a way to spur the economy, but also based on the belief that individuals should make their own decisions about risk. They dismiss factual reports from the news media as exaggerated and trying to incite panic, because the reports dont align with their own experience.

Toward the end of March, Judy Nichols, 60, began monitoring charts daily to see how many people near her had the virus. She lives in Jefferson County, not far from Beaumont, and serves as the chair of the county Republican Party. After two weeks, she stopped keeping tabs on the numbers as her worry subsided.

Over the past several weeks, Ms. Nichols said, she has felt like the winner of a product lottery. She owns several Papa Johns pizza franchises, and business has increased nearly 80 percent pizza in a time of anxiety seeming to be one thing many people can agree on. But nearly everyone she knows is struggling to pay the bills.

On the other side of the partisan divide in Texas, Lina Hidalgo, a Democrat and the top elected official in Harris County, which includes Houston, put in place stay-at-home orders before the governor did in March. Last week, she extended her stay home, work safe guidelines until June 10.

She is concerned about the economic impact. She just doesnt see a safe alternative. When you have a political system, there are going to be attacks, she said. But lets debate the politics when this is over.

Jim Meadows, a 60-year-old refrigeration parts repairman in Nederland, Texas, who describes himself as an extreme conservative, doesnt think the economic question can be set aside. He is upset by the unemployment and financial devastation, which is clearer to him than what he called this invisible plague.

Through his work he has, however, begun taking orders for plexiglass partitions that many businesses around him want to use. He said he was pandering to the uninformed.

Rashell Collins Bridle, a 42-year-old mother of five who also lives in Nederland and makes her living selling items on eBay, said a minister she knew had died after contracting the virus. Even so, she said she and her friends were more focused on freedom than on health.

I guess other people expect us to set our futures on fire to keep their fear warm, she said. I think thats incredibly selfish if youre that fearful, then just stay home.

For Professor Hochschild, who studies division, sentiments like this in a crisis reinforce what she has seen across the country.

There is an underlying stoicism that was there before the pandemic that is really getting tapped, she said. Theres a notion of snowflake liberals who cant take it, who are too dainty and fragile and not hearty like us.

On the first weekend that Texas lifted the stay-at-home orders, Ms. Bridle took her family to a state park on the Gulf of Mexico. She said American flags were flying from many cars and trucks on the road as if it were the Fourth of July.

She said that if schools open with hefty restrictions on recess or how far desks must be spaced together, she will instead place her daughter in a Christian home school co-op.

And if there is another stay-at-home order this year?

We probably wont stand for that again, she said. I myself wont comply. I will never comply with anything else like this ever.

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What the Coronavirus Revealed About Life in Red vs. Blue States - The New York Times

ASHEVILLE - With a budget deadline a month away the City Council is zeroing in on a $185 million spending plan.

The proposed operating budget represents a year-over-year decrease forced by declining taxes and other public revenues.

City Manager Debra Campbell proposed the austerity budget at a May 26 council meetingamid the economic fallout of the coronavirus. It includes no tax or fee increases.

The council is set to hold a public hearing on the proposalJune 9 with a final vote June 23. By state law local governments must pass balanced budgets by June 30.

City Manager Debra Campbell(Photo: Angeli Wright/awright@citizen-times.com)

"This is essentially a continuation budget," Campbell told the seven council members who attended through video links. "There are very, very limited service enhancements not because we don't want to enhance services, but we just cannot afford to do it. And it would be generally, considering what is happening in our community and country, not a good thing at this time."

- The current year's budget was expected to be $192 million, but end of year revenue losses, including $1.6 million less in sales taxes, caused city budget officials to slash that. Federal assistance filled some of the holes bringing this current year'sbudget to $189million.

- Next year the biggest revenue loss will actually not be from the pandemic. The settlement of a class action lawsuit means the city must eliminate its water capital fee, causing a $7.4 million drop.

- Harrah's Cherokee Center - Asheville has been closed, though staff hope for "strong third and fourth quarters with numerous rescheduled and annual events," according to the proposed budget. Still, next year center is anticipated to be down $1 million in spending. A$100 million renovation of the center's Thomas Wolfe Auditorium planned before the pandemic is in limbo.

- City parking fees are down after being suspended. The parking fund which was set to bring in$7.2 million this year and normally helps subsidize transit is now losing $500,000 a month. Some recovery next year couldbring it to $6.6 million.

Cots are lined 6 feet apart in a hallway as Harrah's Cherokee Center is prepared to house homeless in the midst of the coronavirus pandemic Asheville April 8, 2020.(Photo: Angela Wilhelm/awilhelm@citizentimes.com)

More: Pandemic shelter for homeless moved from Harrah's Center to hotel

- Sales tax, a top revenue source after property taxes and water, is estimated to be $27.3million next year. This year's original estimate was $28.5 million (though that has been reduced to $26.8 million)

- Interest earnings will be down $1.1 million due to rate decreases.

- A slowdown in development will mean a 7% drop in city development fees, a loss of $250,000

- Alcoholic Beverage Control revenues will be down 10% or $200,000 due to closure of bars and restaurants, the biggest customers.

- Across-the-board city pay increases are frozen, except for a raise to $31,200 ($15 an hour) for 92 lowest-paid city workers.That, plus increases for slightly betterpaid workers with higher positions or longer tenure, will cost $574,000.

- Despite the freeze, firefighters are continuing to push for a raise for the 77 lowest-paid firefighters. They make $33,935, but because of the time they spend overnight in fire stations, they work the equivalent of 56 hours a week,Asheville Fire Fighters Association President Scott Mullins said. "Every city employee makes $15 an hour except 77 fire fighters," Mullins said. City Manager Campbell has said she first wants to see the results of a pay and compensation study before making any recommendations. The study is scheduled to be finished by early June.

- Hiring is also frozen with the exception of seven new positions to maintain the River Arts District transportation improvements:three laborers, an equipment operator, atradesworker, a labor crew supervisor, and a labor crew coordinator.

- Property taxes, the biggest source of city revenue, are expected to rise from $68.5 million to $71.4 million. That's because of personal property belonging to the formerly nonprofit Mission Hospital becoming taxable now that the hospital's owned by the private company HCA.

- Transit has faced losses after the city made buses fare free and limited passenger numbers and service to reduce the chance of infection. But federal CARES Act funding has and will continue to bolster the system. Spending is set to grow from $11million to $12.3 million next year. That includes a $1.7 million increase from property taxes and other general fund revenues.

An Asheville Regional Transit driver wears a mask while driving down Haywood Road in West Asheville March 26, 2020. ART buses began limiting riders to 10, including the driver, March 25.(Photo: Angela Wilhelm/awilhelm@citizentimes.com)

- General fund money that goes to nonprofits should be reallocated to "support equity and address opportunity gap goals," Asheville Chief Financial Officer Barbara Whitehorn who gave much of the May 26 budget presentation to the council. Specifics:$35,000 to support Asheville City Schoolsafter-school coordinator; $43,000 to Parks and Recreation for extended community center hours andsummer youth and teen programming; $15,000 to Pisgah Legal Services Tenant Eviction Response Team.

Joel Burgess has lived in WNC for more than 20 years, covering politics, government and other news. He's written award-winning stories on topics ranging from gerrymandering to police use of force. Please help support this type of journalism with asubscriptionto the Citizen Times.

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Asheville zeroes in on $185M coronavirus austerity budget; Here's what's in it - Citizen Times

The headline of the March 10 Palo Alto Online story didnt leave much room for hope: In bold-faced letters, it stated that Taste, a Sichuan restaurant in downtown Palo Alto, was on the brink of permanently shutting down amidst coronavirus spread. The owner, Sandy Liu, told the publication that the restaurants revenue was down to as little as $600 a day and said she might be forced to shut the entire operation down in a matter of days.

Basically nobody is dining out for my restaurant, a Chinese restaurant, Liu said at the time. Who can afford to keep losing money every day? This, of course, was a week before the region-wide shelter in place went into effect. If Taste had called it quits at that point, it would have been one of the very first Bay Area restaurants to shutter specifically because of coronavirus-related financial losses.

What happened next was somewhat unexpected: Even as other restaurants up and down University Avenue temporarily closed, Taste stayed open. It didnt even close for a single day.

Everything is changing, but fortunately our business is still okay, Liu tells Eater SF. Its not very good, but it still can survive. It can still pay the rent. It can still make a little bit of profit.

According to Liu, there wasnt any single moment that helped the restaurant turn the tide on its miserable February and March, but rather a combination of factors. Once the shelter in place went into effect, the demand for takeout increased, though Liu stresses that business goes up and down: One day will be very good, one day will be very bad. She was also able to secure a federal stimulus loan through the Paycheck Protection Program (PPP), but that, too, has been a mixed blessing: Since she isnt in a position to hire all of her workers back, she isnt expecting that the loan will be forgiven.

Perhaps the most important factor is that Liu hasnt had to pay her full rent a make-or-break issue during the crisis, according to restaurant owners who are pushing for rent abatement legislation. In Lius case, her landlord was willing work with her on a month-to-month basis, and didnt expect her to pay more than she could handle based on the revenue the restaurant was generating. As Taste landlord John Felt tells Eater SF, I didnt come to Sandy and say its full rent or its no rent. Each month we said, what can we do? Where can we meet?

Liu has only been in the restaurant business for two years, taking over Taste from two friends in March of 2018 after spending the previous decade in financial services. Her previous job also helped cushion the blow, as she has cashed out some of the retirement funds that shed built up.

Of course, Liu recognizes that her restaurant is far from out of the woods. Known for chile-laden dishes like its spicy fish fillet with pickled veggies, Taste used to get a lot of catering and lunch business from the tech companies in the area tech companies whose employees will be working from home for the foreseeable future. Liu doesnt know how shell make up that income, but shes fairly upbeat given the circumstances. Her business went right up to the brink of complete disaster, after all, and its still standing.

Since March, how many people got infected millions of people and how many people died? she says. The whole world, all the news is very, very negative. But we keep going.

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Coronavirus Pushed This Palo Alto Chinese Restaurant to the Brink, But It Never Closed - Eater SF

The lungs of people who smoke may contain more of the receptors that the new coronavirus uses to invade cells. This could explain why people with the virus who also smoke appear to be particularly vulnerable to severe illness.

The majority of people who acquire SARS-CoV-2, the virus that causes COVID-19, experience mild-to-moderate symptoms and will fully recover without hospital treatment.

However, several studies suggest that people who smoke are significantly more likely than people who do not to develop a severe form of the illness.

For example, according to a recent study of COVID-19 cases in hospitals in mainland China, 11.8% of people who smoked had a nonsevere form of the disease, while 16.9% had severe disease.

To break into cells and start replicating itself, the virus latches onto a protein receptor called angiotensin-converting enzyme 2 (ACE2), which is present in the cells membranes.

Researchers at Cold Spring Harbor Laboratory in New York wanted to find out if people who smoke have more of these receptors in their lungs. This would potentially make them more vulnerable to the infection.

Their results have undergone peer review and will appear in the journal Developmental Cell. A preprint of the paper is available on bioRxiv.

We started gathering all the data we could find, says senior study author Dr. Jason Sheltzer. When we put it all together and started analyzing it, we saw that both mice that had been exposed to smoke in a laboratory and humans who were current smokers had significant upregulation of ACE2.

First, the researchers reviewed data from a genetic study that exposed mice to diluted cigarette smoke for 2, 3, or 4 hours per day for a period of 5 months.

They found that the longer the mice had exposure to cigarette smoke, the more ACE2 receptors were expressed in their lungs.

The scientists later investigated whether or not the same dose-dependent relationship between smoking and ACE2 applied in humans.

They analyzed two existing genetic datasets: one based on lung tissue samples from people who smoke who are undergoing thoracic surgery, and one based on lung tissue from people in the National Cancer Institutes Cancer Genome Atlas Program.

The researchers report that lung samples from those who smoked most heavily expressed the highest levels of ACE2. Even after accounting for the participants age, sex, ethnicity, and body mass index (BMI), there remained a strong association between smoking and ACE2.

They also discovered that quitting smoking reversed the increase in ACE2 expression. Among those who had not smoked for a year, quitting was associated with a decrease in ACE2 expression of around 40%, compared with those who currently smoke.

Dr. Sheltzer and colleagues managed to trace the additional ACE2 receptors in people who smoke to goblet cells. These are lung cells that secrete mucus. Smoking increases the number of goblet cells, which helps protect the airways from the irritants in smoke.

An unfortunate consequence of this may be to make people who smoke more vulnerable to severe SARS-CoV-2 infections. Having more goblet cells means that they have more of the ACE2 receptors that the virus uses to invade cells.

There is a debate, however, over whether smoking is protective or harmful in the context of COVID-19.

For example, a study in The Lancet Infectious Diseases found that people who smoke and who have symptoms of influenza or a respiratory infection were less likely than people who do not smoke to test positive for SARS-CoV-2 in primary care.

However, the authors of this study point out that this may be because people who smoke are more likely to have a cough and may be more likely than others to submit themselves for testing. This would lower their apparent risk of testing positive.

Another study, which has not undergone peer review, claims that people who smoke were underrepresented among patients hospitalized with the infection in China. On the basis of this, the authors speculate that the nicotine in cigarettes protects people who smoke.

In his review of this study, Dr. Sheltzer questions the validity of a figure for the prevalence of smoking in China that the scientists rely upon to make their conclusions.

The claim that smoking protects against COVID-19 has gotten so much press attention largely because its counterintuitive, but its very likely to be wrong, Dr. Sheltzer told Medical News Today. An abundance of data including high-quality meta-analyses demonstrate that smokers tend to have more severe cases of COVID-19 than non-smokers do.

Dr. Sheltzer and colleagues acknowledge that their own study also had some limitations. For example, it relied on data for the expression of the gene that makes ACE2, rather than direct measurements of the amount of the receptor within cell membranes.

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People who smoke may have more receptors for the new coronavirus - Medical News Today

This essay is part of The Big Ideas, a special section of The Timess philosophy series, The Stone, in which more than a dozen artists, writers and thinkers answer the question, Why does art matter? The entire series can be found here.

Since I wrote the first draft of this essay in early March, the world has turned upside down. I have revised the original text, guided by a single question: Does art matter when we are facing a global crisis such as the current Covid-19 pandemic?

Obviously, there is a great deal of art that doesnt matter. This includes the work issuing from those university art programs that every year pump out thousands of graduates, taught only to speak in tongues about formal, conceptual and theoretical issues few people care about or can comprehend. Then there is the art created for a global market that has convinced too many people that a pieces selling price is more important than the content it conveys.

But when art is meaningful and substantive, viewers can become enlightened, inspired and empowered. And this can lead to change, which we urgently need.

My education about the potential power of art began in the early 1970s, when I delivered a lecture in Grand Forks, N.D. It was not a place where I would have assumed art would matter. Nonetheless, more than 200 women and men attended my talk. I showed images from Great Ladies, my series of abstract portraits of some important and forgotten women in history, such as Christina of Sweden, the 17th century queen and patron of the arts who widely influenced European culture. At that time, womens studies as an academic field was in its infancy; I had discovered those figures through my own research, driven by a desperate need to find out about women before me who had faced obstacles like the ones I had encountered in my career.

After my talk, I did something artists rarely do; I asked the audience what they thought of my work. After a few minutes, someone said my stated aim of depicting significant women in history was interesting, but that without my spoken explanation people would never have been able to understand my work. That interaction was a revelation, and it inspired me to figure out how to make my imagery more accessible, starting with The Dinner Party, my symbolic history of women in Western civilization. Since its premiere in 1979, countless people have told me that seeing it changed their lives.

Communities across the United States, Canada, Europe and even Australia mounted a phenomenal grass-roots movement, as was documented by Dr. Jane Gerhard in her 2013 book The Dinner Party: Judy Chicago and the Power of Popular Feminism, 1970-2007. Those who participated in it raised money, pressured public institutions and, when unsuccessful, moved to find alternative spaces to exhibit The Dinner Party. Millions of people viewed my piece as a result of these worldwide efforts.

One might ask what this has to do with the global pandemic afflicting us. The answer lies in arts power to shed light on the problems we are confronted with at this difficult time.

Much of my art has been directed at interrogating issues related to abuses of power, as well as the victimization and erasure of certain groups. PowerPlay focused on the ways that toxic masculinity is literally Driving the World to Destruction, as the title and imagery of one painting in the series suggests. Holocaust Project: From Darkness into Light, created with my husband, the photographer Donald Woodman, was an effort to warn the world about the global system of injustice and oppression that had produced the Holocaust, which Virginia Woolf once aptly described as patriarchy gone mad.

I am not citing my own art as an egocentric exercise. Rather, I am pointing out that I have been trying to use it to educate, inspire and empower viewers to effect change. Significant change can only occur if we shift our focus to the work of those artists who have had the courage to show us who we are and what we are doing. Artists like Goya, whose masterpiece series The Disasters of War is a powerful reminder that those who have the least to say about human events suffer the gravest of consequences. Or Kthe Kollwitz, whose vivid portraits of the effects of poverty on the working classes should be viewed as part of any discussion of income inequality to more powerfully illustrate what those words really mean.

Art that raises awareness of the state of our planet can be especially important in todays world. One example of this is the work of the contemporary artist and illustrator Sue Coe, whose pieces on animal mistreatment have been ignored or, at best, marginalized by an art community that seems to privilege meaninglessness over consequential work. My most recent project, The End: A Meditation on Death and Extinction, also sought to bring attention to what we humans do to other sensate creatures on our shared planet.

This is the kind of art that matters most as we confront the devastating force of the coronavirus. The philosopher David Benatar recently wrote in The New York Times that the pandemic is a consequence of our gross maltreatment of animals. As the primatologist Jane Goodall put it in a YouTube video addressing the outbreak: All over the world weve been destroying the places where animals live in order to get materials to build our homes, our cities and to make our own lives more comfortable.

We must wake up; this pandemic offers us the opportunity to realize that the path we as humans have taken a path that has rendered our leaders unable to confront, let alone reverse, climate change or to alter the way we treat our fellow creatures will result in endless havoc. Art matters if artists use their talents to help us find our way.

Judy Chicago is an artist, author, feminist and educator.

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Judy Chicago: Art in the Time of Coronavirus Should Wake Us Up - The New York Times

Reporting was contributed by Julfikar Ali Manik, Ian Austen, Peter Baker, Nicholas Bogel-Burroughs, Jos Mara Len Cabrera, Stephen Castle, Damien Cave, Michael Cooper, Steven Erlanger, Tess Felder, Jacey Fortin, Jeffrey Gettleman, Abby Goodnough, Denise Grady, Maggie Haberman, Christine Hauser, Mike Ives, Jennifer Jett, Yonette Joseph, Sheila Kaplan, Annie Karni, Gina Kolata, Anatoly Kurmanaev, Mark Landler, Judith Levitt, Ernesto Londoo, Louis Lucero, Sarah Mervosh, Raphael Minder, Zach Montague, Sharon Otterman, Richard C. Paddock, Tariq Panja, Elian Peltier, Daniel Politi, Suhasini Raj, Adam Rasgon, Stanley Reed, Luis Ferr Sadurn, Edgar Sandoval, Choe Sang-Hun, Marc Stein, Matt Stevens, Sheryl Gay Stolberg, Sabrina Tavernise, Katie Thomas, Anton Troianovski, Hisako Ueno, Shalini Venugopal, James Wagner, Sui-Lee Wee, Noah Weiland, Jin Wu and Elaine Yu.

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Coronavirus Live Updates: U.S. and World News - The New York Times

From a spike in domestic violence and restricted access to family-planning services to disproportionate economic impact, the lockdown measures put in place to stop the outbreak are hurting women and their basic rights a lot more than men. Previous epidemics of Ebola and Zika have resulted in major setbacks for women and girls in the regions most affected by the outbreaks -- and experts and activists are warning the same thing is happening globally right now.

A CNN analysis earlier this year found that in the countries for which data was available, men were 50% more likely than women to die after being diagnosed with Covid-19. But experts say focusing purely on health data is dangerous.

"We think about this crisis in very narrow terms, only focusing on the health impacts, but we're missing the bigger picture," said Julia Smith, a researcher at the Simon Fraser University in Canada. Smith is working on a multi-year project looking at the wider impact of the pandemic.

"Men are having worse health outcomes if they become infected, but when we think about the secondary impacts, here we see that women are being disproportionately affected," she added.

Smith said that when marginalized groups are underrepresented at the decision-making table, their rights and needs are often forgotten. "And unfortunately, women's rights are almost always an afterthought in any crisis situation," she said.

Many activists say it was painfully obvious that such abuse would increase in a lockdown situation. Numerous studies have shown that stressful events such as economic downturns or natural disasters often lead to higher instances of gender-based violence.

"When we think about pandemic preparedness, the same way we should be thinking of having enough front-line health workers or protective equipment, we should be thinking about any quarantine or social distancing measures having impact on gender based violence, especially within the family."

"But these women have already experienced the violence ... we need to respond to the issue before the rates go up," Smith said.

This has potentially dangerous effects. Studies have shown that the number of stillbirths and maternal deaths increased in some countries hit by Ebola, because women were unable to access the appropriate services.

And the lack of access to family planning has long-term consequences that will be felt beyond the pandemic, according to Lunz. "Whenever women do not have control over their own bodies, over how many children they want and when they want to have a family, these women and their children and their families are kept in poverty."

"A lot of the industries that are being most affected by the outbreak -- tourism and other service industries, care work sector -- those industries tend to be dominated by women," Smith said.

And while many countries have stepped in to provide help to people who lost their jobs, many women are likely slipping through the cracks. "When you think about economic recovery, we'll need to consider that bailout packages focus just on formal employment and women are disproportionately informal workers, so we need to think about how should we be targeting them," O'Donnell said.

At the same time, many more women than men have found themselves on the front lines of the battle against the virus. According to the World Health Organization, 70% of the global health and social care workers are women.

Women around the world are also still responsible for the majority of unpaid childcare and housework. According to estimates by the UN, women spend on average 4.1 hours a day doing unpaid care and domestic work, compared to 1.7 hours spent by men.

Single parents, most of whom are women, are hit hardest by school closures. Lunz said the crisis will likely affect women's careers in the long term, setting back the quest for equality. "What we know from history, when women do not have access to resources and are not independent and cannot sustain themselves, they are dependent on someone else."

"Autocratic leaders and toxic leaders are always the biggest threat to women's rights," Lunz said.

"That is what history shows, and that's what we are seeing now, looking at Viktor Orban for example, it was last week that the parliament in Hungary, where his party has a majority, passed the law which restricts the country from making the Istanbul Convention from becoming law." The Istanbul Convention is the world's first legally binding treaty entirely dedicated to combating violence against women.

"The whole situation is crazy," Marbn Castro said. "Before we put in a measure, we have to think how it's going to affect all the people in our society -- women, children, minorities, homeless people ... this has not happened, the measures have been put in for and by middle-aged men who are not thinking about anyone else."

Continued here:

Coronavirus is killing more men. But the lockdown is disastrous for women and their rights - CNN International

What you need to know this weekend:Texas reports 54,509 cases and 1,506 deaths

[4:45 p.m.] Texas reported 1,060 more cases of the new coronavirus Saturday, an increase of about 2% over the previous day, bringing the total number of known cases to 54,509. Ward County reported its first case Saturday; over 85% of the states 254 counties have reported at least one case.

Harris County has reported the most cases, 10,526, followed by Dallas County, which has reported 8,477 cases. See maps of the latest case numbers for each county and case rates per 1,000 residents.

The state has reported 26 additional deaths, bringing the statewide total to 1,506 an increase of about 2% from Friday. Harris County reported one additional death, bringing its total to 217 deaths, more than any other county.

As of Saturday, 1,688 patients are known to be hospitalized in Texas. Thats an increase of 110 patients from Friday. At least 870,935 tests have been conducted. Chris Essig

[4:05 p.m.] An outbreak at a recently opened immigrant detention center outside of Abilene has left more than one-quarter of its residents infected with COVID-19, the El Paso Times reported Saturday.

The outbreak at the Bluebonnet Detention Center in rural West Texas is the second-largest among the nation's 49 immigration detention centers that have seen positive cases.

The center, originally meant to be a state prison, opened just before Christmas and is run by Management and Training Corp., or MTC, and houses 417 men and women. Of those, 111 have tested positive, along with six of the center's 118 staff members, the newspaper reported.

Previous detention center outbreaks have led to strained relations between local leaders and private contractors in Texas. Earlier this month, Frio County commissioners demanded answers from officials with the GEO Group after the virus took hold at the South Texas ICE Processing Center in Pearsall, south of San Antonio. Jeremy Schwartz

Houstons Museum of Fine Arts will reopen Saturday, becoming the nations first major art museum to do so since the coronavirus pandemic began, Texas Monthly reports. Among the planned safety measures are required masks for visitors older than 2, temperature checks, and museum staff opening and closing all doors. The 300,000-square-foot building will be open to 900 visitors at a time, or 25% of its capacity, and 6 feet of social distancing will be enforced, according to Texas Monthly. Emily Goldstein

Have they been anywhere? Have they been afraid to go out of their house? This is a scam by the Democrats to steal the election.

Texas is expected to release its latest coronavirus figures Saturday afternoon. The state reported 1,181 more cases of the new coronavirus Friday, an increase of about 2% over the previous day, bringing the total number of known cases to 53,449. It also reported 40 additional deaths, bringing the statewide total to 1,480 an increase of about 3% from Thursday. See maps of the latest case numbers for each county and case rates per 1,000 residents.

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Coronavirus in Texas: 53,449 cases and 1,480 deaths - The Texas Tribune