Category: Corona Virus

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Alabama saw its largest jump in coronavirus cases – and tests – to date: Week in review – AL.com

May 24, 2020

Alabama added more confirmed coronavirus cases in the week leading up to Memorial Day weekend than in any previous week, but that may not be as bad as it sounds. The state also vastly increased the number of tests it performed, and the percentage of tests performed that came back positive decreased slightly.

Also, fewer Alabamians died this week due to the virus than in any week in the last month.

Signs may be pointing up in some parts of the state, but things are still far from normal. Alabama is continuing the process of reopening its economy, even as some areas are experiencing the worst of the outbreak. Officials in Montgomery County reported hospitals were strained, and many other rural Alabama counties, especially in the Black Belt, are seeing spikes in cases.

In the last week, as of late Friday afternoon, the Alabama Department of Public Health confirmed 2,260 cases of the virus. More than 1,000 of those were in just five counties - the only five counties to add more than 100 cases over that time.

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Montgomery saw nearly 300 new cases in that time, as the outbreak there continues. Mobile County, which saw a large spike in cases a few weeks ago, continues to see large growth in cases. It added 252 cases last week, and still has the most virus cases and deaths in the state. Jefferson County, home to Birmingham and the most populous county in the state, added 232 cases. It also performed the most tests of any of these five counties, and saw the lowest case-to-test ratio last week of those same counties.

Tuscaloosa County, which has had relatively low numbers to this point, added 133 new cases this week, a 44 percent increase. Franklin County, in northwest Alabama, added 117 cases, for a total of 413. Franklin is home to just 31,000 people, and now has the fourth highest virus rate in the state at 131 cases per 10,000 people.

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Overall, the states 2,200 new cases was the highest weekly total since the pandemic started. But other metrics suggest that raw case number isnt as stark as it may first appear. The state performed more than 33,000 tests this week. Thats by far the most of any week so far this year.

The 2,200 positives equate to a 6.7 percent positive rate, which is down from the previous two weeks, meaning the state is finding fewer cases per test, which suggests reduced community spread.

Across Alabama, 52 people died this week because of the virus. Thats the fewest virus-related deaths for any week since April 17.

[Cant see the chart? Click here.]

A few rural areas, especially in the Black Belt, are seeing more serious indications of spread than elsewhere in Alabama.

Franklin County, which saw a large increase in cases relative to its size, also saw a low number of tests performed, especially compared to the other counties with the most new cases. Just 403 tests were done there over the last week, resulting in a case-to-test ratio of 29 new cases per 100 tests. That was third highest in the state last week behind Choctaw county at 41 cases per 100 tests, and Lowndes County with 36 cases per 100 tests.

Lowndes County has the highest per capita rate of infections in Alabama, with 171 cases per 10,000 people. And numbers are not falling there. Lowndes, next door to Montgomery County, added 47 cases this week, for a total of 166.

Lowndes saw a rate of 48.3 new cases per 10,000 people this week, second in the state behind Bullock County, which saw a new case rate of 48.5 per 10,000. They were followed by Sumter, Choctaw and Franklin counties in terms of new cases per capita over the last week.

[Cant see the map? Click here.]

Do you have an idea for a data story about Alabama? Email Ramsey Archibald at rarchibald@al.com, and follow him on Twitter @RamseyArchibald. Read more Alabama data stories here.

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Alabama saw its largest jump in coronavirus cases - and tests - to date: Week in review - AL.com

From near disaster to success story: how Japan has tackled coronavirus – The Guardian

May 24, 2020

A little over a month ago, health experts were saying Japan risked becoming one of the worlds coronavirus disaster zones.

Its government was already facing criticism over its decision to quarantine passengers and crew aboard the Diamond Princess cruise liner, and had been accused of underplaying the Covid-19 threat while it clung to the increasingly faint hope of hosting the Olympics this summer.

Japan was testing too few people, critics said, opting instead to focus on clusters of cases rather than overburden its healthcare system with patients displaying no or only mild symptoms who, by law, had to be admitted to hospital. One of the worlds richest countries, they said, was bungling its response.

But today, Japan can make a strong case for being another coronavirus success story, albeit one that has failed to resonate globally in the same way as those in South Korea, Hong Kong and Taiwan.

So far, Japan a country of 126 million people with one of the biggest elderly populations in the world has confirmed 16,433 infections and 784 deaths, out of a global death toll of more than 300,000 people.

In Tokyo, where almost 14 million people live, new cases have remained below 40 for more than a fortnight, with just five cases reported on two consecutive days this week. That compares with a peak of 206 new cases reported on 17 April. On Friday, the public broadcaster NHK reported just three new cases in the capital in the previous 24 hours.

Achieving such low figures barely seemed possible in early April when, just as the number of cases began to rise sharply in Tokyo and other major cities, neighbouring South Korea with its widely praised regime of testing, tracing and treating was flattening the curve.

On 7 April, the prime minister, Shinzo Abe, belatedly declared a state of emergency in the capital and other affected areas that was later expanded to include all 47 of the countrys prefectures.

But Japans version of lockdown requests to avoid unnecessary outings, work from home and observe social distancing came across as a timid response to a situation that risked spiraling out of control. The dispatch of two reusable masks to every household was met with derision, as people posted photographs on social media of the small, and in some cases dirty, Abenomasks a play on the leaders economic policy dubbed Abenomics.

Abes performance throughout the crisis has been uneven, according to Tobias Harris, an expert on Japanese politics at Teneo consultancy. I think he has struggled to stay ahead of events since the beginning, has not communicated effectively, and has been poorly served by his lieutenants.

Japan has skirted a coronavirus surge with room to spare, after new cases slowed markedly when Abe, who does not have the legal powers to declare a European-style lockdown, called on people to beat the virus by avoiding the three Cs: confined and crowded spaces, and close human contact.

The Abe administration has gained few political dividends for its response; instead, most plaudits have gone to the quiet determination shown by the public, armed with virus-challenging habits formed long before the pandemic.

Masks are a common sight during the winter flu season, and in spring among people with hay fever. The custom of bowing rather than shaking hands or hugging, generally high standards of personal hygiene, and the removal of shoes when entering homes have all been held up as possible explanations for Japans low infection rate.

Experts have pointed to universal healthcare, low obesity rates and expertise in treating pneumonia. More fanciful theories have gained traction the consumption of foods, such as natto, that boost the immune system and, according to an unscientific experiment conducted by a TV network, the relatively low number of airborne droplets generated by spoken Japanese.

I dont think the falling number of infections is due to government policies, said Ryuji Koike, the assistant director of Tokyo Medical and Dental university hospital. I think it looks like Japan is doing well thanks to things that cant be measured, like daily habits and Japanese behaviour.

Personal habits and cultural traits, however, tell only part of the story. While Japan hesitated before imposing restrictions on overseas visitors, it was quick to recognise the dangers of mass gatherings.

Museums, theatres, theme parks and other attractions have been closed for months. Japans professional football league suspended matches three weeks before 150,000 people attended the four-day Cheltenham horse racing festival in Britain.

Rugby and baseball leagues followed suit, delaying the start of their seasons, while sumo authorities decided to hold the recent spring tournament without spectators for the first time in the sports history. Abe was criticised for calling for unnecessary school closures in early March, yet many other countries then did the same.

Rob Fahey, a research associate at the Waseda Institute of Political Economy in Tokyo, believes declaring Japans ability to contain the outbreak a mystery ignores the role of individual and collective action.

Acknowledging this, however, requires looking beyond the usual set of policy actors and recognising that Japans response overall can still have been exemplary even if the performance of its central government left much to be desired, Fahey wrote in the Tokyo Review this week.

Japans incremental exit from the state of emergency continues. Last week, Abe ended the measure in 39 prefectures, adding another three this week. Tokyo and four other prefectures could join them as early as Monday, according to media reports.

But experts are warning against complacency given that the low rates of testing may be distorting the extent of infections a hazard recognised by the governments own expert, Shigeru Omi, who admitted that nobody knows whether the true number of coronavirus cases could be 10 times, 12 times or 20 times more than reported.

As Tokyos backstreet bars and restaurants started filling up again this week with some staying open beyond the 8pm closing time requested by the citys governor Abe sought to balance cautious optimism with a dose of post-pandemic reality.

The weeks ahead would not mark a return to the days before the outbreak, he said, but the beginning of a challenge to create a new normal.

Agence France-Presse contributed to this report

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From near disaster to success story: how Japan has tackled coronavirus - The Guardian

May 22 morning update: The latest on the coronavirus and Maine – Bangor Daily News

May 22, 2020

Robert F. Bukaty | AP

Robert F. Bukaty | AP

The rocky coast attracts visitors to a scenic overlook in South Portland on Monday.

Today is Friday. There have now been 1,877 confirmed and likely cases of the new coronavirus in all of Maines counties since the outbreak began here in March, according to the Maine Center for Disease Control and Prevention.

No new deaths were reported Thursday, leaving the statewide death toll at 73. The Maine CDC has not confirmed any deaths since Tuesday.

So far, 235 Mainers have been hospitalized with COVID-19, the illness caused by the coronavirus, while 1,145 people have fully recovered from the virus, meaning there are 659 active and likely cases in the state, according to the Maine CDC. Thats up from 636 on Wednesday.

Heres a roundup of the latest news about the coronavirus and its impact in Maine.

The Maine CDC will provide an update on the coronavirus this afternoon. The BDN will livestream the briefing.

The Maine Center for Disease Control and Prevention announced Thursday evening that 57 cases of coronavirus were confirmed at Cape Memory Center, a residential care facility for individuals with Alzheimers disease or dementia. As of Thursday evening, 45 residents and 12 staff at the facility had tested positive for the virus, with additional results pending. Jessica Piper, BDN

Memorial Day weekend traditionally marks the beginning of Maines summer tourist season, which typically draws millions of visitors to Acadia National Park annually from late May through mid-October. Visitors to Mount Desert Island who expect to hike or play on Sand Beach this weekend face unprecedented restrictions because of precautions aimed at reducing the spread of COVID-19. Access to much of the parks facilities is expected to remain closed for the next couple of weeks if not longer. But the parks semi-closure is not stopping visitors from showing up. Bill Trotter, BDN

Sunny weather and looser business restrictions might lead Mainers to head out over Memorial Day weekend, which typically starts the tourist season. But everyday activities are going to look different as the state cautiously moves forward in its economic reopening. Here is your guide to planning your day, night or weekend out while abiding by current coronavirus-related public health precautions. Jessica Piper, BDN

Aaron Harris sighs as he talks about the changes afoot at the 84-year-old A1 Diner located inside a historic Worcester Lunch Car next to the bridge over the Cobbosseecontee Stream in Gardiner. Before the coronavirus hit, regular customers huddled into the tiny, renowned diner, which can seat 45 people at six booths and 16 counter stools, to enjoy cheeseburgers with local beef and more eclectic fare, including Korean barbecue sliders. Even with takeout, revenue is down 75 percent since the coronavirus restrictions were put into place. But what worries Harris almost as much are the lost connections between customers and staff. Lori Valigra, BDN

The federal government has awarded Maine $52.7 million to help it control the coronavirus pandemic by completing an expansion of its public health laboratory in Augusta, boosting laboratory capacity in the states rural hospitals and opening more satellite testing sites, according to the office of Gov. Janet Mills. The funds will help the state to expand its staffing and testing capacity at the Maine Center for Disease Control and Prevention laboratory in Augusta, as well as to accelerate the construction of a new lab at the Greenlaw building of the former Augusta Mental Health Institute campus. Charles Eichacker, BDN

After record sales last year that continued into early this year, Maine home sales are feeling the effects of the coronavirus pandemic, declining 15.41 percent in April compared to the previous April, according to figures released Thursday by Maine Listings. Lori Valigra, BDN

Both of Maines U.S. senators rolled out different bipartisan bills on Thursday aiming to reform the Paycheck Protection Program, which has given forgivable loans to small businesses to keep workers on payroll but has been criticized by some as inflexible. The massive program, which was originally created as part of a $2.2 trillion stimulus package at the end of March and was later renewed, has sent more than $2.5 billion in loans to Maine businesses. But many business owners have expressed concerns about the terms. Jessica Piper and Michael Shepherd, BDN

Reconsideration of jobless aid is fast becoming the focus of congressional debate over the next virus aid package After the Senate decided to take a pause on new pandemic proposals, senators faced mounting pressure to act before leaving town for a weeklong Memorial Day break. Republicans are staking out plans to phase out coronavirus-related unemployment benefits to encourage Americans to go back to work. The Senate also began efforts to fast-track an extension of a popular small business lending program. Lisa Mascaro, The Associated Press

As of early Friday morning, the coronavirus has sickened 1,577,758 people in all 50 states, the District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands and the U.S. Virgin Islands, as well as caused 94,729 deaths, according to Johns Hopkins University of Medicine.

Elsewhere in New England, there have been 6,148 coronavirus deaths in Massachusetts, 3,583 in Connecticut, 556 in Rhode Island, 199 in New Hampshire and 54 in Vermont.

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May 22 morning update: The latest on the coronavirus and Maine - Bangor Daily News

Texas coronavirus testing included antibody tests, state admits – The Texas Tribune

May 22, 2020

Texas health officials made a key change Thursday to how they report data about the coronavirus, distinguishing antibody tests from standard viral tests and prompting slight increases in the states oft-cited daily statistic known as the positivity rate.

The positivity rate is the ratio of the confirmed cases to total tests, presented by the state as a seven-day rolling average. The Texas Department State of Health Services disclosed for the first time Thursday that as of a day earlier, it had counted 49,313 antibody tests as as part of its "total tests" tally. That represents 6.4% of the 770,241 total tests that the state had reported through Wednesday.

Health experts have warned against conflating the tests because they are distinctly different. Antibody tests detect whether someone was previously infected, while standard viral tests determine whether someone currently has the virus.

Now that DSHS is reporting the number of antibody tests, it has recalculated its daily positivity rates starting Tuesday to exclude such tests. That led to a 0.41 percentage-point increase in Tuesday's rate and a 0.55 point increase in Wednesday's rate, according to DSHS calculations.

DSHS acknowledged last week that it was reporting an unknown quantity of antibody tests as part of the "total tests" figure. Despite that, Gov. Greg Abbott incorrectly claimed Monday that the state was not "commingling" the numbers while promising the state would soon break out the antibody test count.

During a TV interview Thursday evening, Abbott attributed the lag in disclosing antibody tests as their own category to "about a 10-day period or so during which some antibody tests were coming it could have been a bit longer than that [when] there was the inability for the counties to separate that out as it was received by" DSHS. The new data provided by the state Thursday gives a daily breakdown of antibody and viral tests going back to May 13.

Of the 49,313 antibody tests, 2,114 or 4.3% have come back positive, according to the new data.

Abbott emphasized the relative smallness of the changes in the positivity rates as he argued in the TV interview that Texas is still seeing an overall downward trajectory in its positivity rate.

"The trends are exactly the same with or without the antibody tests," Abbott said.

Still, the preciseness of the positivity rate is important, especially when it comes to understanding Abbott's decisions to reopen the economy. As the raw number of cases has continued to climb each day, Abbott has said he is far more concerned with the positivity rate which takes into account increases in testing as well as hospitalizations.

Texas is not the only state that has come under scrutiny recently for mixing together the two types of tests in its data. Pennsylvania, Georgia and Vermont have also been conflating the tests, according to The Atlantic.

When public health agencies combine antibody testing figures with viral testing figures, "I want to scream," said Seema Yasmin, an epidemiologist and director of the Stanford Health Communications Initiative.

Viral tests, usually taken from nasal swabs, can detect an active coronavirus infection. If a person's biological sample is found to have traces of the virus's genetic material, public health workers can order them to self-isolate and track down any of their contacts who may have been exposed.

Antibody tests "are like looking in the rearview mirror," Yasmin said, because they may show if a person has recovered from a coronavirus infection. That can be useful for public health surveillance, but it does not offer much insight about where the virus is currently spreading. Another issue is that many antibody tests have been shown to have high rates of inaccuracy, she said.

"As an epidemiologist, this level of messiness in the data makes your job so much more difficult, and it misleads the public about whats really happening," Yasmin said. "Weve been talking about the capacity for testing increasing over the last few weeks, but now we might have to tell the public that might not be true."

And dumping antibody testing data into the pool of viral testing data brings the overall positivity rate down, reflecting "a deceptive misuse of the data," analysts for the COVID Tracking Project wrote last week. That's because the numbers may make it seem like the state has grown its testing capacity even if a state's viral testing capacity remains flat.

"This is crucial as we need increased capacity for viral testing before reopening to identify active infections even in the pre-symptomatic or asymptomatic stages," the analysts wrote.

The mixing of the two testing numbers first came to light last week, days before Abbott announced the latest business reopenings. Democrats said the revelation continued to show that Abbott is moving too carelessly in allowing businesses to reopen.

"We all want life to get back to normal," Texas Democratic Party spokesman Abhi Rahman said in a statement Tuesday. "However, Texans dont feel safe, and manipulating the data isnt going to help Texans feel comfortable going outside."

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Texas coronavirus testing included antibody tests, state admits - The Texas Tribune

Coronavirus Live: Updates From Around the Globe – The New York Times

May 22, 2020

Other key goals of the National Peoples Congress in Beijing include pushing back against growing international criticism over Chinas early missteps in Wuhan, and outlining plans to ramp up government spending.

Yet President Xi Jinpings government faces a new outbreak in Jilin, a northeastern province of 27 million people that sits near Chinas borders with Russia and North Korea. Jilin has been put under a Wuhan-style lockdown as it has reported an outbreak that is still small about 130 cases and two deaths but has the potential to become a big explosion, experts say.

At present, the epidemic has not yet come to an end, while the tasks we face in promoting development are immense, Premier Li Keqiang told lawmakers at the congress on Friday. We must redouble our efforts to minimize the losses resulting from the virus.

The virus which has resulted in more than five million infections worldwide, according to data compiled by The New York Times was also presenting logistical challenges for organizers of the congress. Delegates have been made to take nucleic acid tests for the virus before being allowed to travel to Beijing; windows were to be opened to improve ventilation; and most journalists must cover the event by video link.

Every morning before dawn for the past few weeks, Yasser al-Samak, a Bahraini man, has roamed the streets in his village outside Manama, the capital, waking his neighbors for the predawn suhoor meal that observant Muslims eat during the holy month of Ramadan before their daylong fast.

Stay home with your family, and blend your suhoor with hope, because those who rely on God, he will protect them, he sings, according to Agence France-Presse. Make yourself strong with prayer and wear the mask as a shield against the pandemic.

In villages and cities around the Middle East, some Ramadan drummers still keep alive a tradition that in recent years has given way to alarm clocks and smartphone alerts. But under the coronavirus cloud, almost everything else about Ramadan and the usually joyful holiday that marks its end, Eid al-Fitr, which begins this weekend has been new, and not in a good way.

As a nod to the holy month, and in part because Covid-19 caseloads seemed to be lightening, several Arab countries slightly relaxed restrictions on gathering and commerce only to clamp down again as cases suddenly mounted.

The Eid holiday will pose a sharp challenge to the authorities: Instead of taking part in communal prayer, feasts and parties, many people in the Middle East and across the Muslim world will be more confined than they have been in weeks.

Saudi Arabia has announced a 24-hour curfew from Saturday through Wednesday, covering the entire holiday period. Omani authorities have banned all Eid gatherings, saying that residents have still been meeting in groups in defiance of social-distancing orders. Qatar has suspended all but a few business activities during Eid. The United Arab Emirates is shifting its nightly curfew earlier.

Egypt, which never shut down its economy to the extent that other countries in the region did, is also tightening up for Eid. The national curfew will be moved up four hours to 5 p.m.; restaurants, cafes, beaches and parks will be closed.

As for prayers, the religious authorities in Egypt and Saudi Arabia have ruled that they should be performed at home.

The displacement comes weeks after Antnio Guterres, the United Nations secretary general, called for a global cease-fire to focus attention on the pandemic and lower the risk for those caught up in conflicts. But instead, hundreds of thousands of people have been pushed from their homes since mid-March, often into overcrowded and unsanitary conditions where the coronavirus can spread more easily.

The highest number of displaced by far was in the Democratic Republic of Congo, where more than 480,000 people fled their homes in recent weeks during clashes between armed groups and the military.

Yemen has also experienced a surge in displacement despite the Saudi-led coalitions unilateral cease-fire, but it has not suspended airstrikes, and armed operations by other parties to the conflict have continued. At least 24,000 people in Yemen have fled their homes since mid-March.

In Afghanistan, the Central African Republic, Syria, Somalia and Myanmar, more than 10,000 people were displaced in each nation in the same period.

The Norwegian Refugee Council, in a statement released with the report, called on world leaders to rise to the occasion and jointly push parties to cease their fire and unite in protecting all communities from Covid-19.

As schools in China slowly reopen, teachers have found novel ways to protect students from the coronavirus and enforce social distancing.

In one school, that meant giving the children wings. Photos showing fourth-graders in Taiyuan, in Chinas northern Shanxi province, wearing colorful wings on their backs, with the message, Because I love you, lets keep one-meter distance.

The wings were designed and created by students and their parents from recycled materials. One wore wings fashioned from green cardboard and decorated with heart-shaped notes, and another was adorned with fabric feathers.

We organized this activity as a tribute to the most beautiful people the angels in white, Zhao Gailing, the principle of Xinghualing District Foreign Language Primary School, told the Chinese newspaper Southern Metropolis Daily, referring to health care workers. She said it also helped students better understand social distancing as they adapt to their newfound wingspan.

The school has also arranged breathing classes, that allow children to take off the mandatory face masks and get fresh air outside the classroom. In late January, as the coronavirus outbreak spread in China, elementary schools were closed, but most reopened in April with strict measures to prevent the spread of the virus.

In a similar move, first graders in an elementary school in Hangzhou are wearing one-meter hats with plumes made of cardboard and even balloons to remind each other of social distancing.

Plans for a potential Nordic travel bubble that would see the neighboring nations open their borders to travel among their residents has one major sticking point: Sweden.

Allowing Swedish visitors to enter Finland could run the risk of undermining that countys coronavirus containment measures, Finlands top infectious disease expert said on Friday, arguing that the high numbers of cases and deaths in Sweden posed a greater threat than others.

But months into the pandemic, it has seen an extraordinary increase in deaths, throwing its strategy into question. With nearly 3,900 deaths as of Friday, Sweden has registered more than three times the number of deaths in Denmark, Norway, and Finland combined.

Mika Salminen, director of health security at Finlands National Institute for Health and Welfare, told the Swedish broadcaster SVT that it would be risky to receive Swedish tourists.

It is a political decision, but the actual difference in the spread of infection is a fact, said Mr. Salminen, one of the experts leading Finlands response to the coronavirus pandemic.

Mr. Salminens message echoed concerns of Finlands interior minister, Maria Ohisalo, who has said that a travel bubble encompassing Nordic countries may be difficult to enact because the situation was more worrying in Sweden than in the others.

The members of Malaysias Parliament, wearing face masks to match their crisp white uniforms, convened this week in the vast lower house chamber for the first time this year.

Malaysias king, Sultan Abdullah Sultan Ahmad Shah, sat on an ornate golden throne and spoke for half an hour. No questions were allowed. No votes were taken. Afterward, Parliament was adjourned until July.

Muhyiddin Yassin, the newly appointed prime minister, and his allies have benefited from restrictions intended to slow the spread of the virus, but that have also limited the ability of opponents to organize and challenge them. Mr. Muhyiddins government imposed social distancing measures that slowed the viruss spread but also, conveniently, minimized opportunities for his opponents to mobilize.

He canceled Parliaments March session because of the pandemic, and limits on public gatherings have prevented the kind of protests seen in the Najib era, when tens of thousands of people took to the streets demanding his resignation.

Mr. Muhyiddins office announced that he had entered quarantine at home on Friday after attending a meeting on Wednesday with an official who later tested positive for the coronavirus, but he has so far tested negative for the virus.

None of the others who attended the postcabinet meeting were identified, but all were ordered to go undergo preliminary testing and 14-day quarantines.

Were stuck, said Daniela Vassallo, 52, as she walked the field and steered clear of Giulio, the escaped camel.

A former contortionist-turned-administrator, Ms. Vassallo is a member of a family that has worked in the circus for at least six generations and has owned this particular show for 29 years. The last period has been perhaps the least eventful, as she and her relatives and assorted circus performers have passed the months here hunkered down in trailers next to peppermint-striped tents.

In reality, the Rony Rollers arent trapped so much as unwilling to go their separate ways. Like other dynasties in Italys vibrant, 60-circus strong big-top culture, the Vassallos own homes and property about an hour south in Latina, a town that is to circus people what Tampa, Fla., is to professional wrestlers.

At the end of Italys coronavirus lockdown, one of the camels broke free.

On a narrow field surrounded by low-rise apartments, bus stops and a tangled ribbon of highway ramps, the camel scampered past lions, which leapt against their cage. It distracted the acrobats practicing their flips on an aerial hoop and sauntered toward the languid, pregnant tiger, and stalls of horses and African Watusi bulls.

An animal tamer, wearing a welding helmet as he attended to repairs, quickly chased down the camel.

While the easing of travel restrictions has left circus members free to leave with menagerie and tents since early this month, Ms. Vassallo said that Latina was packed with other circus acts and animals, and that her performers dreaded the solitude of home isolation. She said the troupe had agreed it was preferable to keep renting this land across from a cornfield and pass the lockdown training together.

Better in the company, she said was the consensus, with my people.

The British government confirmed on Friday that it would quarantine everyone flying into the country, including citizens, to fight the spread of the coronavirus.

On arrival at an airport, travelers will have to provide an address where they will be staying. Northern Ireland Secretary Brandon Lewis told the broadcaster Sky News on Friday that international travelers would face spot checks by public health officials and fines of 1,000 pounds, or about $1,200, if they failed to self-isolate for 14 days.

Citizens of Ireland would be exempt, Sky reported, but not arrivals from France, as had been previously reported.

Britains move comes more than seven weeks after Prime Minister Boris Johnson announced a stay-at-home order that has since been shifted to stay alert and is in line with measures by other countries. The chief executive of the budget airline Ryanair, Michael OLeary, has described the new plans as hopelessly defective, idiotic and unimplementable, saying that Britain does not even have enough police officers to enforce the lockdown. Airlines UK has said the measure would effectively kill international travel to and from Britain.

But Jonathan Ashworth, the opposition Labour Partys shadow health secretary, told Sky that many people had asked why we did not do this sooner, adding, Not taking all the measures that we should be taking is the idiotic position.

More than 250,000 people have tested positive for the virus in Britain, with over 36,000 deaths.

Home Secretary Priti Patel was to set out more details about the new measures at a briefing later Friday, but they are not expected to come into effect until next month.

Concerns about coronavirus infections have added new dimensions to an already polarizing global debate over migration.

On Thursday in Guatemala, for example, President Alejandro Giammattei voiced frustration over U.S. deportations of people infected with the virus, saying it was causing serious problems for his nations health system.

Guatemala is an ally of the United States, but the United States is not Guatemalas ally, Mr. Giammattei said. They dont treat us like an ally.

There have been 119 confirmed cases of Covid-19 among people deported from the United States to Guatemala, The Associated Press reported. Some deportees have became a point of contention in Guatemala, where several community councils last month threatened to burn a government building where migrants were quarantined over concerns that they posed a health risk.

In Hungary, the government on Thursday shut down transit zones along the Serbian border where thousands of migrants have been stuck for a year or more. It freed about 300 refugees from the zones, Reuters reported, while also effectively barring future ones from applying for asylum.

Reuters quoted President Viktor Orbans chief of staff, Gergely Gulyas, as saying that the zones were emptied after an E.U. court ruled that the practice of keeping migrants inside them was unlawful.

And in Britain, Prime Minister Boris Johnsons government agreed to scrap a policy that requires staff from overseas in the countrys vaunted National Health Service to pay a surcharge nearly $500 per year for migrants who arent from the European Union to help fund the system in which they work.

Mr. Johnson had previously resisted calls to exempt the workers, saying on Wednesday that his government must look at the realities of funding the N.H.S.

But after public pressure mounted, Britains health secretary, Matt Hancock, said on Thursday that the workers would be exempted as soon as possible. Keir Starmer, the leader of the opposition Labour Party, called it a victory for common decency.

Correction: An earlier version of this briefing misidentified Matt Hancock, a British official. He is the health secretary, not the prime ministers spokesman.

For many, baking serves as a respite from chaos. One of the ways to interrupt anxiety is to let other senses take over, the British culinary author and television star Nigella Lawson told The Guardian.

For the Wessex Mill in Oxfordshire, that has meant an unprecedented boom in production. The family-owned mill found itself fielding nearly 600 calls a day in mid-March, and it has ramped up its output fourfold during the crisis.

Emily Munsey, who runs the business with her father, has hired more staff and added shifts to keep the mill running 24 hours a day, seven days a week, for the first time in its 125-year history.

Its been very challenging as a company. The amount of work weve all had to do has increased a huge amount, said Ms. Munsey, who has also had to scramble to source packaging to hold the flour. Demand remains consistently obscene.

Of course, the outbreak has also ignited demand for flour in other countries. In France, market research by Nielsen showed that demand doubled in March. In Italy, it reached its highest level since World War II.

As Britain begins to ease restrictions, Ms. Munsey hopes that new customers will continue to use the mills flour, find new skills and maybe take up more home baking.

The packages were opened by border officers in Sydney in early May. In the first, about two pounds of methamphetamines were hidden under boxes of face masks and bottles of hand sanitizer. In the second, the drugs were stashed inside sanitizer bottles.

It was no surprise that criminals were taking advantage of the pandemic to smuggle drugs into the country, officials said. We are continuing to detect and stop illicit substances coming into Australia, no matter how theyre being concealed, said John Fleming, a Border Force superintendent who oversees mail and cargo.

Two weeks ago, much of Australia kicked off a three-stage reopening plan, in which many schools are reopening and cafes, restaurants and pubs are allowed to seat limited numbers of patrons. Officials said today in New South Wales, the countrys most populous state, that the number will be increased to 50 by June 1.

Travel restrictions in the region will also be lifted on that date, they said earlier this week, for the first time in two months.

The call to prayer rang on a recent afternoon from Jamia Mosque, a landmark in downtown Nairobi with green and silver domes and multiple minarets. There should be worshipers converging there during this sacred month of Ramadan, but the mosques doors remained shut, its prayer halls empty since closing in March because of the coronavirus pandemic.

With no congregation to join, I sat in the car, rolled down the windows and listened to the muezzins voice, a mellifluous sound that instantly made me cry.

This is a Ramadan like no other. The pandemic, which in Kenya has infected at least 1,109 people and killed at least 50 others, has given us the gift of loneliness. Isolated under a partial lockdown in Nairobi and a nationwide curfew that stretches from dusk to dawn, millions of Muslims in Kenya and beyond have exchanged sprawling banquets for dining alone and observing the evening taraweeh prayers from home.

I chafe at the imposed restrictions sometimes because, with 21 siblings and 17 nephews and nieces, the iftar meal to break the daily fast has always for me been a bustling family affair. We would start with dates, then gorge on spicy samosas and chicken biryani, pass around my mothers legendary camel meat, and share cakes and sweet chai.

Many times, particularly when we were young, we would even watch an episode or two of the historical epics or weepy melodramas that are a mainstay of Arab television during Ramadan. But this year, we are getting more than enough drama from real life.

And so we stay physically apart but find unity in the rituals of fasting and feasting. Things might be falling apart, but I have come to find comfort and continuity in the small things: the paneer samosas sent by a friends mom, the afternoon runs at a nearby, almost-empty forest, the messages from loved ones checking in from all over the world and the sound of the azan, the call to prayer, broadcast from the tops of minarets.

President Trump, who has defiantly refused to wear a mask in public despite the recommendations of federal health officials, toured a Ford plant in Michigan on Thursday with his face uncovered. That was against the factorys guidelines and the direct urging of the states attorney general.

During his visit, Mr. Trump continued to press for the further easing of social-distancing restrictions. He blamed Democrats for keeping the economy closed and suggested voters would punish them in the presidential election and view it as a November question.

Heres what else happened on Thursday in the United States:

Reporting contributed by Elian Peltier, Megan Specia, Jason Horowitz, Bella Huang, Vivian Wang, Austin Ramzy, Yonette Joseph, Vivian Yee, Geneva Abdul, Evan Easterling, Isabella Kwai, Abdi Latif Dahir, Javier C. Hernndez, Keith Bradsher, Chris Buckley, Mike Ives, Nicholas Bogel-Burroughs, James Gorman, Cade Metz and Erin Griffith.

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Coronavirus Live: Updates From Around the Globe - The New York Times

Researchers: Nearly Half Of Accounts Tweeting About Coronavirus Are Likely Bots – NPR

May 22, 2020

Researchers from Carnegie Mellon University say nearly half of all accounts tweeting about the coronavirus appear to be bot accounts. Jeff Chiu/AP hide caption

Researchers from Carnegie Mellon University say nearly half of all accounts tweeting about the coronavirus appear to be bot accounts.

Updated at 7:55 p.m. ET

Nearly half of the Twitter accounts spreading messages on the social media platform about the coronavirus pandemic are likely bots, researchers at Carnegie Mellon University said Wednesday.

Researchers culled through more than 200 million tweets discussing the virus since January and found that about 45% were sent by accounts that behave more like computerized robots than humans.

It is too early to say conclusively which individuals or groups are behind the bot accounts, but researchers said the tweets appeared aimed at sowing division in America.

"We do know that it looks like it's a propaganda machine, and it definitely matches the Russian and Chinese playbooks, but it would take a tremendous amount of resources to substantiate that," said Kathleen Carley, a professor of computer science at Carnegie Mellon University who is conducting a study into bot-generated coronavirus activity on Twitter that has yet to be published.

Researchers identified more than 100 false narratives about COVID-19 that are proliferating on Twitter by accounts controlled by bots.

Among the misinformation disseminated by bot accounts: tweeted conspiracy theories about hospitals being filled with mannequins or tweets that connected the spread of the coronavirus to 5G wireless towers, a notion that is patently untrue.

Such bogus ideas on the Internet have caused real-world harm. In England, dozens of wireless towers have been set on fire in acts officials believe have been fueled by false conspiracy theories linking the rollout of 5G technology to the coronavirus.

"We're seeing up to two times as much bot activity as we'd predicted based on previous natural disasters, crises and elections," Carley said.

Using a so-called bot-hunter tool, researchers flagged accounts that tweet more than is humanly possible or claim to be in multiple countries within a few hours' period. Researchers say they examine a Twitter account's followers, frequency of tweeting and how often the user is mentioned on the platform in determining whether the tweeter is a bot account.

"When we see a whole bunch of tweets at the same time or back to back, it's like they're timed," Carley said. "We also look for use of the same exact hashtag, or messaging that appears to be copied and pasted from one bot to the next."

In response to the Carnegie Mellon findings, a Twitter spokesman pointed to the company's previous statements arguing that the term bot can be used to describe a wide range of behavior on the platform, not all of which is in violation of Twitter's rules.

"People often refer to bots when describing everything from automated account activity to individuals who would prefer to be anonymous for personal or safety reasons, or avoid a photo because they've got strong privacy concerns," the Twitter spokesman said, adding that describing an account as a bot can be deployed by "those in positions of political power to tarnish the views of people who may disagree with them or online public opinion that's not favorable."

Nonetheless, Twitter says it has removed thousands of tweets containing misleading or potentially harmful information about the coronavirus.

Twitter says its automated systems have "challenged" 1.5 million accounts that were targeting discussions about COVID-19 with malicious or manipulative behavior.

Last week, Twitter unveiled new labels that will accompany misleading, disputed or unverified tweets about the coronavirus, an effort that attempts to tamp down the rapid spread of tweets carrying harmful and false information about the global health crisis.

Where in the world most of the bot accounts are based is still being probed by researchers, though some reports have implicated Russian actors in the spread of misinformation in the U.S. amid the pandemic.

Reuters reported in March that Russian media have recently deployed a widespread disinformation campaign against the West to worsen the impact of the coronavirus to create panic and distrust.

Efforts to fight back against the spread of false information about COVID-19 come just as the federal government and election security experts keep a watchful eye on the November election.

American intelligence agencies concluded that Russia interfered in the 2016 presidential election. Experts believe Russian actors will try to influence the 2020 vote as well, including by using social media to amplify their messages.

Carley with Carnegie Mellon said countering bot accounts on Twitter is not a simple task. Blocked accounts can resurface, and the disinformation networks are sophisticated and difficult to completely root out.

She offers this advice, though: Look out for subtle typos, for tweets being sent out very quickly, or profile images and usernames that appear suspicious.

"Even if someone appears to be from your community, if you don't know them personally, take a closer look, and always go to authoritative or trusted sources for information," Carley said. "Just be very vigilant."

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Researchers: Nearly Half Of Accounts Tweeting About Coronavirus Are Likely Bots - NPR

Bill Gates Is the Right Tycoon for a Coronavirus Age – The New York Times

May 22, 2020

It tires me to talk to rich men, said Teddy Roosevelt, himself a product of wealth. You expect a man of millions, the head of a great industry, to be a man worth hearing. But as a rule, they dont know anything outside their own businesses.

Had T.R. spent time with Bill Gates, the polymath who predicted the pandemic in a TED Talk, he likely would have made an exception.

Gates is everywhere these days, a lavender-sweatered Mister Rogers for the curious and quarantined. With the United States surrendering in the global war against a disease without borders, Gates has filled the void. The U.S. is isolated, pitied, scorned. Gates, by one measure, is the most admired man in the world.

Beyond the $300 million that the Bill and Melinda Gates Foundation has given to blunt the spread of the virus, Gates has made himself a spokesman for science. It needs one. While President Trump spouts life-threatening nonsense, Gates calmly explains how a spike protein of coronavirus fits into the urgent hunt for a vaccine.

Hes the prophet who warned in 2015 that a pandemic was a greater risk to humankind than nuclear war. Five years before that, he challenged the world health community to commit to a decade of vaccines, and anted up $10 billion to get it started.

In 2018, he took the stage in Beijing with a jar of human poop. This, at the Reinvented Toilet Expo, was his way of stressing that about 500,000 young children die every year from diseases linked to poor sanitation a problem his foundation has tackled.

He appears on both Fox News and MSNBC. He talks regularly with Dr. Anthony Fauci and peddles pandemic notes to Stephen Colbert. He recommends A Gentleman in Moscow, the Amor Towles novel about a hotel prisoner in Soviet Russia, on his personal blog, where he also praises the honesty of These Truths, Jill Lepores magisterial telling of our nations history.

Do I need to know that he and Melinda enjoy This is Us, the sap-heavy television series? No. But as theyve already given away more than $50 billion as self-described impatient optimists working to reduce inequality, Ill take their gloss on pop culture over an update on Kim Kardashians lip gloss.

Big Philanthropy can be about diplomatic power and muscle under the guise of charity. But theres an inescapable truth about the worlds second-richest mans decision to give away his fortune: The Gates Foundation has helped save millions of lives.

With the coronavirus, which Gates has called the most dramatic thing ever in my lifetime by a lot, his approach is to inject a turbocharger of money at many different levels. The foundation calls it catalytic philanthropy. To speed up the steps needed to get a vaccine to the world, for example, hes funding the construction of factories to manufacture seven possible coronavirus vaccines, even if most of them fail.

Many tycoons tend to get miserly and coldhearted as they age. Gates has evolved in the opposite direction. Early on, the co-founder of Microsoft was arrogant, insufferable, whiny and socially distant when that was considered offensive a monopoly capitalist without the imagination of his rival and friend Steve Jobs.

His initial efforts at philanthropy giving computers away to underserved libraries and schools opened him up to criticism (largely unfair) that the donations were part of a scheme to expand the market for Microsoft products. Gates soldiered on, making himself an expert in infectious diseases. He helped to create a market for lifesaving drugs that are often ignored by Big Pharma.

Its uncanny how spot on he was in that 2015 speech. The greatest threat to the world was not missiles but microbes, he said. You have a virus where people feel well enough while theyre infected so they get on a plane, he said.

The first major American outbreak, in a nursing home just 11 miles from Gatess house near Seattle, made him regret that he had not spoken out even more. He had warned Trump, just before he took office, of the seismic dangers of a pandemic.

Now, of course, Gates is the boogeyman in the fevered minds of many a delusional Trumper. The global lunacy community anti-vaxxers, science-deniers, Russian agents has spread so many conspiracy theories regarding Gates that misinformation about him is now among the most widespread of all coronavirus falsehoods.

The world needs a strong American response precisely because the disease has become a huge American problem. With less than 5 percent of the worlds population, the United States accounts for more than 30 percent of the planets coronavirus cases. When Trump snubs the World Health Organization, he hurts American citizens.

The safer route for a billionaire trying to avoid social media predators is idle-rich vacuity. But Gates, who had urged nations to simulate germ games not war games, will not sit this one out from the safety of a yacht. Hes smart enough to see that this virus does not pick sides.

The Times is committed to publishing a diversity of letters to the editor. Wed like to hear what you think about this or any of our articles. Here are some tips. And heres our email: letters@nytimes.com.

Follow The New York Times Opinion section on Facebook, Twitter (@NYTopinion) and Instagram.

Timothy Egan (@nytegan) is a contributing opinion writer who covers the environment, the American West and politics. He is a winner of the National Book Award and author, most recently, of A Pilgrimage to Eternity.

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Bill Gates Is the Right Tycoon for a Coronavirus Age - The New York Times

New data suggest people arent getting reinfected with the coronavirus – Science News

May 22, 2020

People who test positive again for the coronavirus, despite having already recovered from COVID-19, arent being reinfected, a new study finds.

Reports of patients dischargedfrom hospitals in South Korea testing positive after their apparent recovery hadraised concerns that people could get infected by the virus in the short term morethan once or that the infection could come back. But diagnostic tests for the coronavirus that causes COVID-19 rely on detecting theviruss genetic material (SN: 4/17/20).A positive result does not indicate whether a person is shedding virusescapable of infecting cells which would signal an active infection.

Now, a May 19 report from theKorean Centers for Disease Control and Prevention shows that samples fromreinfected patients dont have infectious viruses. The finding hints that the diagnostic tests are picking upon the genetic material from noninfectious or dead viruses. That lack of infectious virus particles meansthese people arent currently infected and cant transmit the coronavirus toothers, the researchers say.

Its good news, says AngelaRasmussen, a virologist at Columbia University. It appears people are notbeing reinfected, and this virus is not reactivating.

In thestudy, researchers tried to isolate infectious coronaviruses from samples takenfrom 108 people who retested positive. All of those samples tested negative. When the scientists examined 23 of those patients for antibodiesagainst the coronavirus, almost all had neutralizing antibodies that can stop the virus from getting intocells (SN: 4/28/20). That immuneresponse may protect a person from getting reinfected, at least in the short term.

The team also tracked down790 contacts of 285 people who retested positive. Of those contacts, 27 testedpositive for the coronavirus. Twenty-four of those were cases that officialshad previously confirmed. Officials also identified three new cases, all ofwhom either had contact with the Shincheonji religious group which was hit particularly hard inthe early days of the pandemic or aconfirmed case in their family. No new cases appeared to stem from repeatpositive patients, a sign those patients arent contagious.

Now, we can largely stopworrying about reinfection and address the next big questions, Rasmussen says.How protective are immune responses in recovered patients, and how long doesimmunity last?

Scientists and journalists share a core belief in questioning, observing and verifying to reach the truth. Science News reports on crucial research and discovery across science disciplines. We need your financial support to make it happen every contribution makes a difference.

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New data suggest people arent getting reinfected with the coronavirus - Science News

Coronavirus in Texas: Driver’s license offices to gradually reopen – The Texas Tribune

May 22, 2020

Thursdays biggest developments:

[7:25 p.m.] Texas reported 945 more cases of the new coronavirus Thursday, bringing the total number of known cases to 52,268. No new counties reported their first cases Thursday; over 85% of the states 254 counties have reported at least one case.

For the first time Thursday, the state reported separately the number of antibody tests that it was previously counting with viral tests. As of a day earlier, it had counted 49,313 antibody tests as as part of its total tests tally. That represents 6.4% of the 770,241 total tests that the state reported Wednesday.

Harris County has reported the most cases, 10,095, followed by Dallas County, which has reported 7,904 cases. See maps of the latest case numbers for each county and case rates per 1,000 residents.

The state has reported 21 additional deaths, bringing the statewide total to 1,440 an increase of about 1% from Wednesday. Harris County reported three additional deaths, bringing its total to 210 deaths, more than any other county.

As of Thursday, 1,680 patients are known to be hospitalized in Texas. Thats a decrease of 111 patients from Wednesday. Darla Cameron

[1:32 p.m.] Texas driver's license offices will gradually reopen with limited services starting Tuesday, Gov. Greg Abbott announced Thursday.

The first reopening phase includes Northwest and West Texas offices, followed by South and Central Texas offices May 29 and North and Southeast Texas offices June 3, according to a news release.

The limited services that will be offered include applying for a Texas driver's license, learners permit or ID card, and scheduling a driving test. Services will only be offered with an appointment, according to the release.

The Texas Department of Public Safety which runs the driver's license offices will launch an appointment system Friday through which people can book an appointment up to six months in advance.

"This phased opening of our driver license offices and the launch of DPS' online appointment system prioritizes the health and safety of our communities and ensures Texans have access to the services they need at their local driver license offices," Abbott said in a written statement. Stacy Fernndez

[11:15 a.m.] Texas Supreme Court Justice Debra Lehrmann is the first high-ranking state official with a known case of COVID-19, The Dallas Morning News reported Thursday.

Lehrmann and her husband, Greg, who also tested positive for the virus, got tested at one of Austins drive-thru testing centers last week after experiencing fevers and body aches, the News reports.

Lehrmann called her infection perplexing since she and her husband strictly adhered to stay-at-home orders since early March. The pair have been working from home and wearing masks and gloves when they venture out to the grocery store.

We were just extremely careful and then we get it, Lehrmann told the News. How in the world would that happen? We have no idea. All I know is it must be very contagious. Stacy Fernndez

[9:55 a.m.] A Houston-area water park said it will defy Gov. Greg Abbotts orders and reopen Saturday for Memorial Day weekend, the Houston Chronicle reported.

While indoor and outdoor pools can operate at 25% occupancy, the governors directives specifically say people should continue to avoid interactive amusement venues like water parks.

The Big Rivers Waterpark in New Caney will host up to 2,020 people daily through May. Thats almost 20% of its maximum capacity, said Monty Galland, CEO and developer for the parks parent company, in a Facebook video.

The purpose of that is to make sure its comfortable and everybody has plenty of space to practice social distancing, Galland said.

Abbott has said the state is exploring ways to safely reopen amusement parks, specifically looking at how Disney is opening up its parks. Still, the governor has not provided a timeline yet for when such venues could reopen in Texas. Stacy Fernndez and Patrick Svitek

[7:35 a.m.] Another 134,381 Texans filed for unemployment last week. Since the week ending March 14, just shy of 2.1 million Texans have filed for benefits.

This weeks claims are down 5.1% from the week ending May 9, when just over 140,000 Texans filed for unemployment. Across the nation, 2.4 million Americans filed for unemployment last week.

On Monday, Gov. Greg Abbott announced the latest phase of reopening the states economy. Child care centers were allowed to open Monday, and bars and bowling alleys among other select businesses are permitted to open their doors starting Friday.

But as some Texans return to work, itll likely take some time before the economy rebounds. Not all business owners are opting to reopen their doors, and many customers remain hesitant over whether it's safe to return to restaurants, retail stores and other businesses.

The Texas Workforce Commission, which handles the states unemployment claims, voted Tuesday to phase out child care subsidies for low-income and essential workers. They will continue making payments for up to three months, but these workers can no longer apply to the subsidy program. Clare Proctor

[5 a.m.] As Texas continues to reopen its economy, Dallas County has seen its hospitalization and new positive test numbers stay relatively steady, County Judge Clay Jenkins told The Dallas Morning News on Wednesday.

On Wednesday, the county began releasing the number of emergency room visits in local hospitals by people suspected to have COVID-19. The first day's number was 409. And the trend line for that statistic has stayed relatively stable for at least the past two weeks, the newspaper reported. Similarly, the county reported 185 new cases Wednesday, down 40 from the day before and part of what the Morning News described as a continued decline.

Itll be a kind of happy story this week as the numbers seem to be going our way, Jenkins told the newspaper in a meeting with its editorial board.

Jenkins and local officials had expressed a desire to keep the economy more closed until a steady decline in new cases occurred over at least two weeks. But the lack of an immediate spike has made him willing to reconsider his assumptions if current trends continue for a couple of weeks, he told the paper.

Were not stuck on some arbitrary political solution or static thing," Jenkins said. Were listening to what the science tells us theyre looking at a novel virus every day and reevaluating.

But, Jenkins told the paper, he's still worried about a potential resurgence in new cases this summer. Matthew Watkins

[4:30 p.m. Wednesday] Texas reported 1,411 more cases of the new coronavirus Wednesday, an increase of about 3% over the previous day, bringing the total number of known cases to 51,323. Hall County reported its first case Wednesday; over 85% of the states 254 counties have reported at least one case.

Harris County has reported the most cases, 9,859, followed by Dallas County, which has reported 7,904 cases. See maps of the latest case numbers for each county and case rates per 1,000 residents.

The state has reported 50 additional deaths, bringing the statewide total to 1,419 an increase of about 4% from Tuesday. Harris County reported two additional deaths, bringing its total to 207 deaths, more than any other county.

As of Wednesday, 1,791 patients are known to be hospitalized in Texas. Thats an increase of 59 patients from Tuesday. At least 770,241 tests have been conducted. Chris Essig

Disclosure: Facebook has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.

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Coronavirus in Texas: Driver's license offices to gradually reopen - The Texas Tribune

Returning to Exercise After Recovery From Coronavirus – The New York Times

May 22, 2020

Is it OK to resume athletic training, even if you have gotten through a bout of Covid-19 or tested positive for coronavirus or suspect you might have been infected? Two new expert-consensus statements from pulmonologists and cardiologists, published separately in The Lancet and JAMA Cardiology, urge caution.

The new statements point out that the always-thorny issue of when injured or ill athletes can return to training is further complicated now, since the novel coronavirus is novel and much about its short- and long-term effects on the body remain unknown. So, the authors of the new statements lay out tentative evaluations and protocols that, ideally, ill or homebound athletes would complete before returning to strenuous exercise. They also highlight a few troubling symptoms that potentially could raise new concerns down the road.

By now, of course, almost all of us recognize that fitness is no guarantee against Covid-19. Marathon runners, competitive cyclists, professional basketball players and other athletes are among the many who have tested positive for the virus, and some reportedly have developed severe illnesses. Untold numbers of other athletes may have been infected but asymptomatic and never realized they carried the virus.

Many of these athletes might now feel ready to resume heavy training. But the usual return-to-play criteria for sick athletes probably do not apply to someone who has been infected with the coronavirus, says Dr. James Hull, a sports pulmonologist at Royal Brompton Hospital in London and co-author of the new statement in The Lancet about athletes and coronavirus.

Since the 1990s, he says, sports medicine physicians typically have relied on the neck check to decide if and when an athlete with a respiratory condition should train. Using this measure, if an athletes symptoms are confined, by and large, to his head meaning, above or in the neck, such as a runny nose, sinus pain and sore throat he or she usually would be cleared to train and play.

But the novel coronavirus worries sports pulmonologists, Dr. Hull says, in part because in some people, the illness can seem benign at first, then rapidly go downhill. We have seen people have some mild symptoms to start with and seem to improve, he says, only to then deteriorate really badly at seven days following their first symptoms.

Because of this potential disease trajectory, he says, it is important that, unlike what people would do with a normal viral infection, such as a head cold, they dont exercise hard while they have symptoms, especially in those first seven days, he says.

Instead, he and other pulmonologists, writing in The Lancet, advise athletes who have tested positive for the coronavirus or suspect they might be positive to rest, without any exercise, for at least 10 days from the point when they first feel symptoms. Then, assuming their illness remains mild, they should continue to rest for another week, even after their symptoms resolve.

This protocol is conservative, but aligns with a new consensus opinion about athletes, coronavirus, exercise and hearts published this month in JAMA Cardiology, with the backing of the American College of Cardiologys Sports & Exercise Cardiology Council.

The cardiologists felt compelled to release this statement in part because the new coronavirus seems sometimes to have unexpected and perilous effects on hearts, even among robust athletes, says Dr. Jonathan Kim, a sports cardiologist at Emory University in Atlanta, and co-author of the new recommendations, with Dr. Dermot Phelan of the Sanger Heart and Vascular Institute in Charlotte, N.C., and Dr. Eugene Chung of the University of Michigan.

With most viral respiratory infections, he says, perhaps 1 percent of people who are infected develop related heart problems, such as myocarditis, which is an inflammation of the heart muscle. But there are indications that people infected with the coronavirus could have a much higher incidence of heart issues, he says, although the actual risks are hard to assess, with so much about the virus still mysterious.

Even so, he and his fellow cardiologists suggest, much like the authors of the Lancet paper, that athletes and committed exercisers who have tested positive for the virus but have mild or no symptoms or who worry they might have been infected, without testing stay home and rest for at least two weeks from the date of their first symptoms or positive test. This time period also is the length of self-isolation mandated by current health guidelines following any possible exposure to the virus.

After a minimum of two weeks of resting at home and assuming symptoms have improved, the pulmonologists and cardiologists advise returning slowly to exercise training, with a wary eye on symptoms. You might have a mild cough and minimal shortness of breath when returning to sport now, Dr. Hull says. But those symptoms should lessen day by day, he says. If they do not or you develop new wheezing or shortness of breath, go to your doc and get your chest examined, he advises, or arrange a telehealth call.

Dr. Kim agrees. For most athletes who have spent weeks at home recovering from the virus, the first few workouts could feel lousy, he says, since any lingering viral effects may combine with general physical deconditioning. So, expect some discomfort. But if you experience considerable or increasing chest tightness or new heart palpitations, stop exercising, contact your doctor and discuss whether you should complete cardiac testing, he says.

Any athletes who have been hospitalized or bedridden by the virus will be likely to need extensive pulmonary and cardiac testing and clearance from their physicians before working out again, he says.

But for those of us who are casual exercisers who have not tested positive for the virus or felt ill during this pandemic, walking, jogging, cycling and other activities remain safe and desirable, he says, with proper social distancing and face covering, of course. Its a good idea to be cautious now, he says, but exercise is still one of the best things you can do for your health.

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Returning to Exercise After Recovery From Coronavirus - The New York Times

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