Category: Corona Virus

This image made by a scanning electron micrograph shows SARS-COV-2 virus particles (colorized pink) from a patient sample. There are various studies looking at changes to the virus genome and the possible impact on how the virus affects humans. NIAID/NIH hide caption

This image made by a scanning electron micrograph shows SARS-COV-2 virus particles (colorized pink) from a patient sample. There are various studies looking at changes to the virus genome and the possible impact on how the virus affects humans.

This week, the question of mutation has been front and center in coverage of the coronavirus from controversial claims about changes that make the virus more contagious to reassurances that any mutations are not yet consequential.

Here are some of the questions being raised and what the specialists can (and can't yet) say to answer them.

Is the coronavirus mutating?

Researchers say the coronavirus is making small changes to itself as they would expect it to at a relatively predictable and steady rate of around one to two changes per month.

"Viruses mutate naturally as part of their life cycle," says Ewan Harrison, scientific project manager for the COVID-19 Genomics UK Consortium. The coronavirus is no different.

When a virus infects a person, it enters their cells and makes copies of itself, which then circulate through the body or are transmitted respiratory droplets is one method to other humans.

Inevitably, viruses "make mistakes in their genomes" as they copy themselves, Harrison says. Those changes can accumulate and carry over to future copies of the virus. Mutations are akin to typos in text most typos are nonevents, but some can change the meaning of a word or sentence. Likewise, many mutations will be dead ends with no effect on people who are infected. But some of these mutations in a virus may change how quickly it infects people and replicates, or what kind of damage it does to cells.

These small, cumulative changes are useful to researchers, because they act as identification cards that help trace the pathway of the virus through groups of people over time. For instance, in a surveillance study on the Arizona State University campus, researchers found that the people who were showing up sick in mid-March with the coronavirus had different versions of the virus from each other. Comparing the virus genomes helped them figure out that the spike in mid-March cases probably didn't signify an outbreak on campus; the cases had had likely caught this version of the virus elsewhere, perhaps when they traveled for spring break, and brought it back. So tracking virus genomes is valuable in tracing how and where the virus is spreading.

Is the coronavirus becoming more transmissible?

Twitter lit up this week when a draft research paper posted to the preprint server bioRxiv got picked up by the media. The paper suggests in the title that their analysis of coronavirus mutations "reveals the emergence of a more transmissible form of SARS-CoV-2."

The study was conducted by researchers at Los Alamos National Laboratory, The University of Sheffield and Duke. They analyzed publicly available genome sequences from around the world posted on GISAID, a global research platform that has amassed over 16,000 coronavirus sequences to date.

The researchers found that a version of the virus, which was first detected in Europe in early February, appears to have become the most common strain in the U.S., Australia, parts of Africa basically, anywhere it spread. The study authors hypothesize that a mutation in this virus strain, which changes one amino acid in the part of the coronavirus that finds and binds to cells, could cause the virus to spread more easily.

"I think that it is an important observation," says Angela Rasmussen, a virologist at Columbia Mailman School of Public Health, "We have seen in other virus epidemics, such as the Ebola epidemic, that there are these mutations that seem to persist and become the dominant form of the virus."

However, Rasmussen says, there's no clear evidence that the mutation referenced in the paper does anything to change how the virus spreads.

Other factors could also account for why the virus from Europe is dominant, says Justin Bahl, a computational biologist at University of Georgia. It could possibly be explained by the so-called "founder effect," where the European version spread rapidly across international borders and established itself as the dominant strain because countries were slow to lock down.

To prove whether the mutation identified in the paper causes the virus to spread more easily, researchers want to see experimental evidence: for instance, a study where both strains are tested in live cells, to see if the mutated virus replicates faster. If those results show such signs, they'll want to see if one virus spreads more readily in lab animals.

Is the coronavirus mutating to become less harmful?

Another study, published in Journal of Virology, identified one patient in Arizona who was carrying a version of the virus with a chunk of it missing. The deletion was sizable 81 nucleotides long, out of the 30,000 or so that make up the coronavirus' genome sequence (in case you're wondering, a nucleotide is a molecule that forms the building block of a DNA or RNA strand and is too tiny to be seen under most microscopes). It was also found in a location on the genome which, on the classic SARS virus, helped the virus fight the immune system, according to study co-author Efrem Lim, a virologist at Arizona State University.

The researchers hypothesize that the deletion "may potentially reduce virus fitness" a claim Lim says they're now testing in labs.

The paper is based on just one virus genome, out of the 16,000 that have been sequenced and shared, which makes it difficult to generalize to the larger group of circulating versions of the novel coronavirus. "We actually have no idea whether [a virus with this deletion] is transmissible or not," Bahl says. "We don't know whether it was just a one-off event or whether these variants are transmitting and becoming more frequent in the population [of people getting coronavirus]."

More evidence is needed to see if Lim's hypothesis holds and it will emerge as research continues.

Do the mutations we're seeing affect the development of treatments and vaccines?

Not yet. "We're getting the mutations that we're kind of expecting here," says Vineet Menachery, a virologist at the University of Texas Medical Branch, so the research process already accounts for these changes.

Menachery says the European mutation tracked in the Los Alamos paper is adjacent to, but not directly on, the receptor binding domain, which is a specific part area on the virus' protein shell that initiates first contact in attaching to human cells. "If these mutations were there, there'd be a little bit more worry about antibody-based approaches and vaccine approaches," he says, because the shifts might make it harder for antibodies to recognize the virus. But the mutations are not directly on the receptor binding domain, so researchers aren't too worried about those specific changes.

Vaccines are also developed to target multiple sites on a virus, so it's unlikely that a few random mutations to the virus can knock out their power completely, Rasmussen says.

Versions of the virus that are drug- or vaccine-resistant may crop up once therapies are in use, says Lim. If a particular strain is obliterated by drugs or vaccines, then any viruses that survive will be the ones not affected by those treatments and could go on to infect others. But for now, there's no pressure on the virus to change in a way that would help it evade measures that haven't been introduced.

Why are scientists sharing unproven theories?

The main scientific purpose of sharing these papers early and often is to alert other researchers to interesting theories and call attention to potentially meaningful mutations, Lim says.

"It helps us prioritize what mutations should be studied in the lab, because there are so many mutations out there," Lim says. By sharing leads and data-backed theories, scientists are highlighting specific mutations that may be affecting the behavior of the virus, in a sea of all the small changes the virus makes.

So it helps researchers to know that scientists at Los Alamos Lab think that a particular change in the genome is worth additional study, or that a deletion in the virus has been found once and could be found again. The answers may not be definitive, but it feeds the global brain trust of researchers who are all working to understand the coronavirus better and help defeat it.

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What We Know About Coronavirus Mutations : Goats and Soda - NPR

That's not because the virus is particularly widespread in this community in north central New Mexico, nestled between a national forest and an Apache Nation reservation.

It's because in New Mexico, tests are free and plentiful. Some residents of Tierra Amarilla went to a one-day free testing event in town a few weeks ago, and if they missed that they can drive to a permanent testing center 45 minutes away. If residents don't have transportation, the Department of Health will come and test them in Tierra Amarilla.

So far, the state has performed 89,032 coronavirus tests. That's more than any other state with around the same population. New Mexico has conducted around the same number of tests or more than states such as Oklahoma, Nevada and South Carolina, which have considerably larger populations.

But not every state is like New Mexico. Months after federal officials said coronavirus testing would be plentiful, the tests are still hard to find in some parts of the country.

"We want to test for this the way we test for HIV, that you can do it without worrying. That's not the case in many parts of the country," said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. "We have a patchwork of testing across the country."

Limited testing, despite promises

More than two months later, that's still not the case.

It's not just a matter of having the tests themselves, but also having supplies like swabs and chemical reagents that are needed to run the tests.

"We've never been able to get to full capacity because we are missing things in the supply chain," Michigan Gov. Gretchen Whitmer on CNN's State of the Union on May 3.

"We don't know how we're going to get that system in place," Davidson said.

Even labs associated with large academic medical centers are experiencing shortages.

"There are limited supplies and there are differences in which labs have been able to order which supplies and how much of the order shows up," said Heather Pierce, the senior director for science policy and regulatory counsel at the Association of American Medical Colleges.

It's a variable situation, she added.

"One lab that has everything that it needs for one week doesn't necessarily know what it's going to get the next week," she said.

Need for more tests

As recorded cases of coronavirus continue to rise in the United States by 20,000 to 30,000 per day, public health officials have emphasized that more testing will bring the numbers down and help the nation find a pathway out of the pandemic.

Once there is widespread testing, health experts say infected people can be identified and isolated, and close contacts can quarantine themselves at home.

Dr. Anthony Fauci, the nation's leading infectious disease expert, estimated on April 25 that the US is conducting approximately 1.5 to 2 million coronavirus tests per week.

"We probably should get up to twice that as we get into the next several weeks," Fauci said the same day during a Covid-19 briefing by the National Academy of Sciences.

Finding fixes

Last week, the White House released a testing blueprint that said the federal government should be the "supplier of last resort."

It's up to the states to come up with testing plans and "to identify and overcome barriers to efficient testing," including "misallocation of supplies" and "logistical failures," according to the blueprint.

Some states have had more success than others.

New Mexico has more than 80 testing sites in all 33 counties. Not all operate at the same time -- some are permanent, others are drive-through or open for a few hours a day.

The state offers free testing to anyone with symptoms of coronavirus, anyone who's been in close contact with someone who's had the virus, or anyone at high risk for contracting the virus, such as an essential worker or a nursing home resident.

"We believe testing is critical. We always have, and so it's a priority," said Kathy Kunkel, New Mexico's secretary of health.

Some other states have also made it relatively easy for people to get tested.

On April 2, Utah launched a website where residents can find out if they qualify for free testing at a drive-through. So far, nearly 20,000 tests have been administered by the "TestUtah" initiative.

Despite the federal blueprint, Michigan hopes to receive some relief from the federal government. On May 3, a senior Trump administration official told CNN that the administration is sending the state 450,000 additional swabs and other supplies to help it meet its goal to perform 450,000 tests in May, which is more than three times the number of tests performed there from the beginning of the outbreak through the end of April.

Others also see reason for optimism.

"Over the last several weeks it's become easier for me to order tests for people," said Adalja, the Hopkins physician. "But the point is doctors and people have to be comfortable ordering tests and not worrying about supply chain issues."

Ryan Nobles and Sara Murray contributed to this story.

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US falls short in coronavirus testing in some areas of the country - CNN

WASHINGTON A federal investigative office has found reasonable grounds to believe that the Trump administration was retaliating against a whistle-blower, Dr. Rick Bright, when he was ousted from a government research agency combating the coronavirus and said he should be reinstated for 45 days while it investigates, his lawyers said Friday.

The lawyers, Debra S. Katz and Lisa J. Banks, said in a statement that they were notified late Thursday afternoon that the Office of Special Counsel, which protects whistle-blowers, had made a threshold determination that the Department of Health and Human Services violated the Whistleblower Protection Act by removing Dr. Bright from his position because he made protected disclosures in the best interest of the American public.

The finding comes just days after the lawyers filed a whistle-blower complaint saying that Dr. Brights removal last month as head of the Biomedical Advanced Research and Development Authority was payback. They said Dr. Bright, who was reassigned to a narrower job at the National Institutes of Health, had tried to expose cronyism and corruption at the Department of Health and Human Services while pressing for a more robust coronavirus response and opposing the stockpiling of antimalaria drugs championed by President Trump.

It will now be up to the secretary of health and human services, Alex M. Azar II, to decide whether to send Dr. Bright back to BARDA during the Office of Special Counsel inquiry.

If Mr. Azar refuses, Dr. Brights complaint would ordinarily be sent to the Merit Systems Protection Board, an independent quasi-federal agency charged with deciding claims of whistle-blower reprisal. But the Senate has not confirmed Mr. Trumps nominees to the board, leaving it with no members. A frequently asked questions document about the lack of members has been removed from the boards website.

Dr. Bright should not be denied the right to have his complaint investigated fully and fairly before he is formally transferred to N.I.H. a move that will harm not only him, but the country as well, the lawyers statement said. This country is in an unprecedented health crisis and needs the expertise of Dr. Bright to lead the nations efforts to combat Covid-19. A spokeswoman for the Health and Human Services Department, Caitlin Oakley, declined to say what Mr. Azar would do.

This is a personnel matter that is currently under review, she said. However, H.H.S. strongly disagrees with the allegations and characterizations in the complaint from Dr. Bright.

Ms. Banks and Ms. Katz said it was a common occurrence for agencies to heed the Office of Special Counsels requests to stay personnel actions when it finds evidence that retaliation occurred. In its budget request to Congress for the 2021 fiscal year, the office reported negotiating 31 stays with federal agencies in the last year and said it had achieved 27 disciplinary actions, upholding accountability and sending a clear message that the government does not tolerate whistle-blower reprisals.

Dr. Bright is scheduled to testify next week before a House panel led by Representative Anna G. Eshoo, Democrat of California, who helped create BARDA and has called for an investigation into his removal. Ms. Eshoo has said she would also like to hear from Dr. Robert P. Kadlec, the assistant secretary for preparedness and response, and Mr. Azar.

The special counsels finding is a first step but a victory nonetheless for Dr. Bright, who was transferred to N.I.H., he has said, after he tried to put controls on the use of a malaria drug, hydroxychloroquine, that Mr. Trump had heralded as a treatment for the coronavirus but was unproven for that use.

In his 89-page complaint, Dr. Bright said his boss at the Health and Human Services Department, Dr. Kadlec, repeatedly pressured him to steer millions of dollars worth of contracts to the clients of a well-connected consultant. He also described what he called opposition from department superiors including Mr. Azar when he pushed as early as January for the necessary resources to develop drugs and vaccines to counter the emerging coronavirus pandemic.

John Clerici, the health care consultant singled out, has said the allegations are baseless. Dr. Kadlec and Mr. Azar have not responded directly, though Mr. Trump has called Dr. Bright disgruntled.

On Tuesday, after Dr. Brights complaint was filed, Ms. Oakley, the spokeswoman for the Department of Health and Human Services, said that Dr. Bright had been transferred to N.I.H. to work on diagnostics testing critical to combating Covid-19 where he has been entrusted to spend upward of $1 billion to advance that effort.

We are deeply disappointed that he has not shown up to work on behalf of the American people and lead on this critical endeavor, she added.

Dr. Bright, an influenza expert, ran BARDA for nearly four years. The tiny agency, created in 2006 as a response to the Sept. 11, 2001, attacks, teams up with industry in developing medical countermeasures that can be stockpiled by the federal government to combat biological or chemical attacks and pandemic threats.

BARDA has spent billions of dollars on contracts with dozens of different suppliers, including major pharmaceutical companies and smaller biotechnology firms. In February, it awarded $456 million to Janssen Pharmaceuticals, a part of Johnson & Johnson, to develop a coronavirus vaccine.

In a brief statement when the whistle-blower complaint was filed, Dr. Bright said the last several years of working under Dr. Kadlec, who became his boss after Mr. Trump became president, had been beyond challenging.

Time after time, I was pressured to ignore or dismiss expert scientific recommendations and instead to award lucrative contracts based on political connections, Dr. Bright said.

The tensions between the two culminated last month when Dr. Bright, alarmed at the administrations push to make the malaria drug widely available, leaked emails to a reporter for Reuters. Dr. Bright was removed in days.

I believe this transfer was in response to my insistence that the government invest the billions of dollars allocated by Congress to address the Covid-19 pandemic into safe and scientifically vetted solutions, and not in drugs, vaccines and other technologies that lack scientific merit, he said in a statement at that time. I am speaking out because to combat this deadly virus, science not politics or cronyism has to lead the way.

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Federal Watchdog Says Coronavirus Whistle-Blower Should Be Reinstated as It Investigates - The New York Times

Covid-19 has upended daily life in much of the world for so long that the idea of traveling to another country or state seems like the stuff of dreams. But in the last week or so, as the idea of opening up to travelers has gained traction, some countries are taking concrete steps. Yesterday, Australia announced a three-stage plan to reopen the economy, which includes a focus on tourism. And some countries are forming regional alliances designed to minimize the risk of the virus, including an Australia-New Zealand travel bubble, and, in Europe, a travel corridor shared by Estonia, Latvia and Lithuania.

But for many places, international flights carrying leisure travelers remain on hold or are banned outright, and the process of reopening remains speculative. The focus, instead, is on internal tourism, to be followed at some point by foreign tourism.

Here is a look at 10 top tourist destinations and the beginnings of their plans for reopening in the weeks and months ahead.

On May 8, Prime Minister Scott Morrison of Australia announced a three-step plan for reopening, in which the country will gradually take steps to resume normal life. The third and final step of that plan includes the trans-Tasman bubble, which will eventually allow for travel between Australia and New Zealand. The alliance, in addition to geographic proximity, stems from their similarly successful handling of Covid-19 both countries continued to report low total case numbers, deaths and growth rates (New Zealand has declared the coronavirus eliminated, meaning the small number of new cases can all be tracked and traced).

Is there an opening date? On May 7, Jacinda Ardern, the prime minister of New Zealand, announced the possibility of reducing the countrys lockdown measures to Level 2 as soon as next week, pending cabinet approval. This would allow many Kiwis to go back to work, visit friends and family, and for businesses like markets, museums and dine-in restaurants to reopen, provided social distancing and hypervigilant hygienic practices are followed. Travel within the country will be allowed.

What are the current restrictions? New Zealand and Australia have both shut their borders to all international travel and non-residents, in addition to greatly restricting movement within the countries themselves. The countries have since begun to slowly open up; in New Zealand, thats meant allowing outdoor exercise, small family gatherings and takeout and delivery service at restaurants and cafes.

In Australia, restrictions vary by state in New South Wales, for example, cafes and restaurants are open for takeout only, gatherings in public places are limited to two people and parklands are open for socially distant exercise. Disobeying current rules is considered a criminal offense and can lead to fines or imprisonment.

Australias stage one allows a gradual reopening of retail stores, parks and outdoor sporting facilities. Dine-in restaurants and cafes can reopen, but are limited to 10 patrons at a time, and social distancing of four square meters per person. Hotels and hostels may reopen and travel within states will be allowed, though state borders will likely remain closed. All reopening timelines will be determined by individual states and territories currently, Queensland plans to begin its stage one May 15 and Tasmania on May 18.

As of now, there is no firm date for the proposed trans-Tasman Bubble, or for more advanced phases of opening in both countries. Per Prime Minister Morrisons recent remarks, he is hopeful that Australia will reach its third phase, which may include trans-Tasman travel, by July. When travel within the trans-Tasman Bubble has been deemed safe, both nations are interested in potentially expanding to include other Pacific island countries.

How will they open safely? When trans-Tasman travel is allowed, its likely that a 14-day quarantine will be required following any travel between the two nations.

What are the major obstacles? Much of Australia and New Zealands success in containing Covid-19 can be attributed to the strictness of their lockdowns. Any easing of these measures comes with the possibility that the virus could begin circulating again. Proceeding with extreme caution, while attempting to effectively reopen their economies, will guide the coming weeks and months.

Thanks to fast action and restrictions put in place before a major outbreak, Greece has avoided the major outbreaks of nearby Italy as of May 6, the country has reported 2,663 cases and 147 deaths.

Is there an opening date? The first phase of Greeces two-month plan began May 4, with the opening of some shops and services, according to VisitGreece.gr. More businesses are expected to open on May 11 and 18; next steps will be announced on May 18, with the opening of other businesses, including restaurants and hotels, starting June 1.

What are the current restrictions? As restrictions continue to lift, Greeks are required to wear masks on public transit, in hospitals and in shops. Residents are still not allowed to travel beyond their wider region of residence; travel from outside the European Union, plus Italy, Spain, the Netherlands and Germany, is banned. All arrivals are subject to a 14-day quarantine.

How will they open safely? In addition to maintaining a gradual cadence of openings over the next one to two months, there are no plans to resume sporting events, festivals, concerts or other large, crowded gatherings. According to a government presentation on the easing of restrictions, May and June will be dedicated to a coordinated return to a new normal with continuous monitoring, while the focus in July and beyond will be on sustaining the new normal yet remaining alert, while simultaneously preparing for a second wave in the fall.

Still, according to Prime Minister Kyriakos Mitsotakis, the country hopes to open to tourists in the fall, using extensive testing and contact tracing, and placing emphasis on more easily distanced accommodations and activities, including agritourism and boating.

What are the major obstacles? Balancing the need for tourism with safety. While Greece has fared better than many European nations, its economy, having only just recovered from years of debt and collapse, is at great risk. Tourism has been a major part of the recent economic improvements, welcoming more than 34 million visitors in 2019 while employing 20 percent of Greek workers.

After requiring some of the strictest confinement measures in the United States, including a nightly curfew, Puerto Rico is beginning to look forward; in addition to a gradual easing of the lockdown and reopening of businesses, the Puerto Rican Tourism Company announced a new two-step program that will allow businesses to be recognized for exercising high standards of cleanliness and safety. As of May 6, Puerto Ricos confirmed case count is 1,757, with 95 deaths.

Is there an opening date? If the first round of openings, which started May 4, goes well, restaurants may be allowed to open between May 18 and 25. The curfew is still in place, until at least May 25.

What are the current restrictions? Puerto Ricos initial lockdown restrictions, which went into effect March 16, included a closure of most businesses, the curfew and threats of fines or imprisonment for anyone who violated its terms. As of May 4, restrictions are loosening somewhat some smaller businesses are allowed to open, as long as they enforce social distancing and provide protective gear to employees. Parks and beaches remain closed (though exercise is allowed), and a curfew is still in effect between 9 p.m. and 5 a.m. All visitors to the island are being screened for symptoms and are also requested to self-quarantine for 14 days.

What are the major obstacles? Puerto Ricos population of older people, and a shaky health care system that was strapped during Hurricane Maria. Fears of a similar collapse make the possibility of a surge even more worrisome, particularly one occurring in concert with hurricane season. A recent earthquake disturbed residents, too, damaging some buildings and briefly knocking out power.

Thanks to an extensive program of testing and contact tracing, Icelands response has been quite successful, with about 1,800 cases, 10 deaths and no new cases as of May 6. With an economy thats hugely reliant on tourism, the island nation is eager to find ways to safely reopen to the rest of the world.

Is there an opening date? Travel restrictions banning most foreigners are in place until May 15; there is currently not a final decision on extending those restrictions or beginning the process of reopening on or after that date.

What are the current restrictions? Iceland, more so than many countries, has remained relatively open two-meter (about 6.5 feet) social-distancing rules are emphasized, but many businesses and primary schools have remained open, and residents may go outside. As of May 4, high schools and universities have reopened and gatherings of 50 people and under are allowed, with expectations for gatherings under 100 to be allowed by the end of May. Since March 20, most foreign nationals have been banned from entering the country (with the exception of citizens of the European Union, Britain and the European Free Trade Association); as of April 20, all visitors were required to quarantine for 14 days.

How will they open safely? Details are scarce, but the government has deployed a task force to determine how to safely reopen the country this spring or summer.

What are the major obstacles? Obstacles are all health-related, Elias Bj. Gislason, the director of the Icelandic Tourism Board, said. Can we open up the borders only for citizens from countries that have had success in handling the spread of the virus? And so on.

Tourism is a major industry in Mexico the country saw close to 50 million visitors in 2018, with the vast majority from the United States. But with a steady rise of Covid-19 cases and a health care system that is at risk of being overwhelmed, a return to normal may be far off.

Is there an opening date? There is no official opening date for tourist services, said Enrique Vega Vzquez, the publisher of VisitMexico.com, but many hotels and restaurant owners are hoping to open by June 1. Although everyone is confident that they will be able to reopen, the reality is that it is only what they have in mind, he said. While President Andrs Manuel Lpez Obrador has expressed his desire to reopen parts of the country by May 17, and the country in full by June 1, details of how that will happen remain scarce.

What are the current restrictions? All citizens and visitors are encouraged to stay home, maintain social distance and wash hands frequently. Gatherings over 100 people have been banned, and schools are closed until May 30. As of March 21, Mexico and the United States entered a joint agreement limiting all movement between the U.S.-Mexico land border to essential travel. Air travel, however, is still operational all travelers entering the country are subject to health screenings. Hotels were ordered to cancel new and existing reservations on April 3, save those made by people carrying out essential business (with a letter from their employer stating their purpose); those hotels must limit occupancy to 15 percent. Restrictions also vary by state and municipality.

How will they open safely? A joint statement from Miguel Torruco Marqus, the secretary of tourism, and Jorge Alcocer Varela, the secretary of health, was published on April 23 and laid out details for the hospitality industry to insure cleanliness and safety, and to allow hotels and restaurants to safely function once the threat of Covid-19 has waned. Details include how frequently to disinfect spaces, procedures for disinfection and cleanliness requirements for employees, including providing them with protective equipment.

What are the major obstacles? Mr. Vzquez is unsure how these protocols will be enacted. In reality, they are only plans, he said, because business owners do not really know how they will apply these measures.

One of the harder hit European nations, Frances early Covid-19 surge has slowed, as the number of patients requiring hospitalization has steadily decreased. But while movement within the country may become less restricted in the coming weeks, international travel will take much longer to resume.

What are the current restrictions? A containment and confinement program was announced on March 17, and further extended on April 28 until May 11. Residents are not allowed to leave their homes without a written certificate stating that they are engaging in one of a few approved activities, including purchasing food, assisting a family member or limited exercise. Borders outside of the European/Schengen area were also closed.

How will they open safely? The opening process will be gradual, said Kate Schwab, the media relations manager at Atout France, Frances national tourism development agency. Small museums, libraries, stores and open-air markets will be allowed to open first, starting on May 11, with social distancing rules in place, but restaurants, cafes, major museums and beaches will be closed until early June. Masks will be required on public transportation, and gatherings will be limited to 10 or fewer people. Travel between regions in France will continue to be limited. Each region will be classified as either red (high infection zone/not safe to relax confinement) or green (OK to relax confinement) but the ultimate decision will rest with the local authorities, Ms. Schwab said. Paris, Calais, Strasbourg and Dijon are currently classified as red areas.

What are the major obstacles? Keeping gatherings small and avoiding crowded public transportation. French destinations are working at implementing sanitary measures to adapt their cultural offerings to allow smaller groups, Ms. Schwab said. A 20 million euro (about $21.6 million dollars) government initiative to encourage cycling over using public transportation was recently announced, with particular focus on opening up Paris. Mayor Anne Hidalgo has announced that 30 miles of streets normally used for cars will be reserved for cyclists, including Rue de Rivoli and Boulevard Saint-Michel, said Ms. Schwab. Furthermore, another 30 streets will be pedestrian only, particularly around schools to avoid groups of people.

Singapores early success in containing Covid-19 was upended in April with news of major outbreaks in migrant worker dormitories. Still, while the countrys positive case number climbs at more than 20,000, its currently the highest in Southeast Asia aggressive testing and contact tracing has kept the death toll low (with 20 reported as of May 6).

Is there an opening date? Currently, restrictions are in place until June 1, though select services, including barbers and hairdressers, laundry services and cake and confectionary shops, will be permitted to open May 12.

What are the current restrictions? All foreign, short-term visitors have been denied entry into Singapore since March 23. On April 7, strict circuit breaker measures were enacted throughout the country all meetings and large gatherings are canceled; residents are to stay home as much as possible (face coverings are mandatory when leaving the house for essentials or emergency medical services); schools and nonessential businesses are closed; and dining establishments are restricted to delivery and takeout.

How will they open safely? According to Rachel Loh, the Singapore Tourism Boards regional director of the Americas, the board is working with the National Environmental Agency to create an SG Clean certification process for hotels, food and beverage establishments, tourist attractions and more. Starting May 12, the government is also requiring open businesses to participate in the SafeEntry system, which will track all employees and visitors who enter and exit a location, to continue contact tracing efforts. The country is also testing the efficacy of using a robot dog to enforce social distancing.

What are the major obstacles? Opening up safely, Ms. Loh said, will be dependent on ramping up testing and harnessing technology for faster contact tracing. But tourism comes with its own brand of risk. We recognize that tourism businesses attract high human traffic and social interactions.

While cases remain relatively low 625 total with 17 deaths as of May 5 the states government has proceeded cautiously. The economic losses from tourism are worrisome, too, in a place that relies so heavily on the industry. A 2020 Strategic Plan published by the Hawaii Tourism Authority at the beginning of this year credited tourism with $17.75 billion spent in the state in 2019, and 216,000 local jobs.

Is there an opening date? On May 7, the first wave of nonessential businesses were allowed to open, including astronomical observatories, carwashes and some retail services. The required 14-day quarantine for air arrivals was also extended until at least May 31.

What are the current restrictions? Residents and visitors to Hawaii are asked to stay home, or in their place of residence, as much as possible, venturing out only for essential business or activities. Outdoor exercise, including running, walking and surfing, is allowed, as long as social distancing is practiced. While there is not currently an active ban on traveling to Hawaii, it is strongly discouraged. Visitors and residents who arrive by airplane are required to self-quarantine for 14 days (some of those who havent followed the rules have received a free ticket home); the same applies to travel between the Hawaiian islands.

How will they open safely? Gov. David Iges reopening plan differs by island. For example, retail establishments will not open on Oahu until May 15; retail in Maui still does not have a targeted opening date. All openings may be rolled back or paused if cases begin to sharply increase.

Few countries have been hit harder by Covid-19 than Italy (the United States being a notable exception), which, as of May 6, has seen well over 200,000 cases and some 30,000 deaths. As the country cautiously begins to reopen, tourism officials insist that tourism in Italy will start again this year.

Is there an opening date? Following the recent limited openings of some establishments, further openings are planned for May 18 namely, additional shops, museums and libraries and June 1, when bars and restaurants may be allowed to reopen for eat-in service, if infection rates continue to slow.

What are the current restrictions? This week, Italys lockdown, which began March 10, slowly began to lift, as parks reopened along with bars and restaurants for takeout. Some Italians are allowed to return to work, and while group gatherings are still banned, family visits are allowed. Residents may travel across different provinces to return home, but cannot go back and forth. In a televised statement on April 26, Prime Minister Giuseppe Conte urged Italians to maintain one-meter social distancing, or about three feet. Anyone who enters Italy from outside the country must self-quarantine for two weeks. Travelers from the United States have not been explicitly banned, but travelers must prove that they are returning to their residence or entering the country for justifiable work reasons, special needs or health emergencies.

How will they open safely? Social distancing rules stand, and masks are required, even for the family visits mentioned above. Schools are expected to remain closed until September.

What are the major obstacles? Again, the need to balance health considerations and a desperate need to boost the economy. Italys already suffering economy has taken an enormous hit following nearly two months of shutdown and a 95 percent drop in tourism (the national tourism industry is predicting 20 billion euros in losses from tourism this year in comparison to 2019).

Lauren Sloss is a San Francisco-based writer who covers travel, food and music. Follow her on Instagram: @lsloss and Twitter: @laurensloss

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Travel Reopenings Amid the Coronavirus Pandemic - The New York Times

SARS-CoV-2 is highly contagious, but a few dozen imported cases would probably not be enough to spark many major undetected outbreaks. Based on related diseases such as SARS and MERS, epidemiologists suspect that the coronaviruss spreading potential is irregular. In all likelihood, some sick people infect many others, but most infect just a handful. Alessandro Vespignani, a network scientist and public-health professor at Northeastern University, estimates that in each American city that later became a hot spot for COVID-19, perhaps 10 to 20 local transmission events occurred in January. Aside from the one or two infections that did seed major outbreaks in places such as Seattle and New York, most infections that arrived from outside the country in January would have been transmitted to at most a few people, then quickly fizzle out, Bedford told me.

Read: Why America is uniquely unsuited to dealing with the coronavirus

Establishing a more precise number of how many sick people carried SARS-CoV-2 to the U.S. early this year would require data that can be difficult or impossible to collect, especially during a major global-health crisis. For one: how many people were actually sick with COVID-19 around the world in January (or earlier). The official data out of Wuhan have been unreliable from the start. And countries that have since ramped up their coronavirus-detection efforts were not looking as carefully for cases at the beginning of the year. The World Health Organization did not declare a global-health emergency until January 30.

Researchers would also need to know where people traveled around the world in the early weeks of the pandemic. One of the big challenges of looking at actual global spread of this disease is that, from January on, travel patterns have been massively disrupted, Gardner said. When researchers dont have perfect travel data for a time and place theyre studying, she explained, they often substitute or extrapolate from data in the recent past. Sometimes you can say, Well, I dont have 2016 data, but Im using 2015 data. Thats representative. That does not apply anymore. The Chinese government shut down Wuhan on January 23; even before then, individual peoples movement patterns might have begun to shift in ways that are difficult to track.

When the living cannot be fully accounted for, one way to move forward is to tally the dead. Testing shortages mean that some COVID-19 deaths have gone undetected, but researchers can get a better handle on just how many people the virus killed during a given time period by looking at the excess mortality: how many more people died than would have been expected to under normal circumstances.

Last week, the National Center for Health Statistics published preliminary data on weekly excess deaths since January 2017, which will be updated as the pandemic wears on. Bob Anderson, the chief of the NCHSs mortality-statistics branch, told me that its the first time weve done something like this before the data were final. The hope is that researchers can use the gross numbers to estimate how many Americans died of COVID-19 over a particular period, and from there estimate how many Americans were infected. But picking out excess deaths in the first few weeks of this year will be difficult. Compared with the hundreds of thousands of deaths the country experiences in a typical month, a handful of COVID-19 deaths would hardly be a blip. Indeed, by the NCHSs count, the United States did not exceed the expected number of deaths by a significant margin until the week of March 22.

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Another 44 cases of the new coronavirus have been detected in the state as of Saturday morning and one more Mainer has died after testing positive for COVID-19.

There have now been 1,374 confirmed and likely coronavirus cases across all of Maines counties, according to the Maine Center for Disease Control and Prevention.

[Our COVID-19 tracker contains the most recent information on Maine cases by county]

The most recent death was a resident of Hancock County, according to the Maine CDC. Its the first death reported in that county. The statewide death toll now stands at 63.

So far, 194 Mainers have been hospitalized at some point with COVID-19, the illness caused by the coronavirus. Of those, 44 people are currently hospitalized, with 23 in critical care and 10 on ventilators, according to the Maine CDC.

Meanwhile, another 836 people have fully recovered from the coronavirus, meaning there are 475 active and likely cases in the state. Thats down from 481 on Thursday.

Heres the latest on the coronavirus and its impact on Maine.

With Maine aiming to triple its coronavirus testing capacity by the end of next week, doctors are relieved that more will be diagnosed while warning that more protective equipment will be needed to treat an influx of patients. But doctors are still awaiting new state guidelines on testing and their top Maine advocacy group said supplies of testing equipment and protective gear will need to increase simultaneously as more sick patients come into offices and other restrictions on care lift.

With tentative promises of a slow re-opening to Maines economy, businesses which rely on summer tourism must find creative ways to keep things running, despite mounting uncertainty of whats to come.

Mike Pences press secretary, Katie Miller, tested positive for coronavirus on Friday, President Donald Trump said, delaying the vice presidents departure for a trip to Iowa. She is the second person working at the executive residence to contract the virus this week.

Maine is in line to get $20 million to help its fishermen weather the COVID-19 storm, the fifth-highest amount of money out of the 31 states to receive fishing-industry bailout funding.

Up to 221,000 Maine residents could lose the health insurance they receive through their jobs if unemployment levels this year reach Great Depression heights, ultimately increasing the ranks of Maines uninsured by almost 50 percent, a new analysis shows.

The decision to wear a mask in public is becoming a political statement a moment to pick sides in a brewing culture war over containing the coronavirus. While not yet as loaded as a Make America Great Again hat, the mask is increasingly a visual shorthand for a debate pitting those willing to follow health officials guidance and cover their faces against those who feel it violates their freedom or buys into a threat they think is overblown.

On Friday, Gov. Janet Mills announced that in 12 of the states more rural counties, retail establishments would be able to reopen on Monday and restaurants would be able to open for limited dine-in service on May 18, so long as they follow a number of new health guidelines.

A group of Maine business owners on Friday sued Gov. Janet Mills over her unprecedented shutdown orders to limit the spread of the coronavirus, claiming they are unconstitutional.

Read the full lawsuit from Maine business owners against Gov. Janet Mills.

While the full extent of the economic impact that all the licensed sugarhouses around Maine will face from the pandemic is still unknown, its likely to take a big bite out of maple syrup consumption this year.

To survive coronavirus lockdowns, this Richmond food truck set up shop in its owners front yard. Then the complaints began.

As of early Thursday morning, the coronavirus has sickened 1,283,929 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 77,180 deaths, according to the Johns Hopkins University of Medicine.

Elsewhere in New England, there have been 4,702 coronavirus deaths in Massachusetts, 2,874 in Connecticut, 399 in Rhode Island, 121 in New Hampshire and 53 in Vermont.

Watch: Janet Mills shares changes for rural businesses

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May 9 morning update: The latest on the coronavirus and Maine - Bangor Daily News

The U.S. workforce has transformed in a matter of weeks, with millions of Americans now working from home full time and many places closed. On this broadcast of The National Conversation, we answer your questions about navigating the changing workplace. Johannes Eisele/AFP via Getty Images hide caption

The U.S. workforce has transformed in a matter of weeks, with millions of Americans now working from home full time and many places closed. On this broadcast of The National Conversation, we answer your questions about navigating the changing workplace.

On this broadcast of The National Conversation, a therapist answers some of your questions about taking care of your mental health during the pandemic. We'll also answer your questions about mutations of the virus and the future of work.

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Answering Your Coronavirus Questions: Virus Mutations And The Future Of Work - NPR

As I write, the contest for explanation is well under wayDonald Trump is to blame, or Barack Obama, or the Centers for Disease Control and Prevention, or China, or the U.S. militarys biowarfare experiments, or Bill Gates. Nobody has yet invoked eight-legged worms. But in our age of social media, the engines of rumor, prejudice, and superstition may have even greater power than they did in the era of the Black Death.

Christopher Columbuss journey to the Americas set off the worst demographic catastrophe in history. The indigenous societies of the Americas had few communicable diseasesno smallpox, no measles, no cholera, no typhoid, no malaria, no bubonic plague. When Europeans imported these diseases into the Western Hemisphere, it was as if all the suffering and death these ailments had caused in Europe during the previous millennia were compressed into about 150 years.

From March 2002: Charles C. Mann on the year 1491

Somewhere between two-thirds and nine-tenths of the people in the Americas died. Many later European settlers, like my umpteen-great-grandparents, believed they were coming to a vacant wilderness. But the land was not empty; it had been emptieda world of loss encompassed in a shift of tense.

Absent the diseases, it is difficult to imagine how small groups of poorly equipped Europeans at the end of very long supply chains could have survived and even thrived in the alien ecosystems of the Americas. I fully support banning travel from Europe to prevent the spread of infectious disease, the Cherokee journalist Rebecca Nagle remarked after President Trump announced his plan to do this. I just think its 528 years too late.

For Native Americans, the epidemic era lasted for centuries, as did its repercussions. Isolated Hawaii had almost no bacterial or viral disease until 1778, when the islands were discovered by Captain James Cook. Islanders learned the cruel facts of contagion so rapidly that by 1806, local leaders were refusing to allow European ships to dock if they had sick people on board. Nonetheless, Hawaiis king and queen traveled from their clean islands to London, that cesspool of disease, arriving in May 1824. By July they were deadmeasles.

Kamehameha II and Kammalu had gone to Britain to negotiate an alliance against the United States, which they correctly believed had designs on their nation. Their deaths scuttled the talks, and their successor, 12-year-old King Kamehameha III, could not resume them. The results changed the islands political destiny. Undeterred by the British navy, the U.S. annexed Hawaii in 1898. Historians have seldom noted the connection between measles and the presidency of Barack Obama.

As a rule, epidemics create what researchers call a U-shaped curve of mortalityhigh death rates among the very young and very old, lower rates among working-age adults. (The 1918 flu was an exception; a disproportionate number of 20-somethings perished.) For Native peoples, the U-shaped curve was as devastating as the sheer loss of life. As an indigenous archaeologist once put it to me, the epidemics simultaneously robbed his nation of its future and its past: the former, by killing all the children; the latter, by killing all the elders, who were its storehouses of wisdom and experience.

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How Will the Coronavirus Change Us? - The Atlantic

Homeless communities are one of the most vulnerable amidst the COVID-19 pandemic, and people are on the frontlines to ensure their health and safety. USA TODAY

Transgender singer and actress Mizz June was coughing up blood and wheezing. Her ribs hurt when she breathed. She had painful migraines.

But when she called 911, the telecommunicator kept putting her on hold. When someone got on the line, they told hershe shouldnt go to the emergency roomunless she was really sick.

"I said I needed to go. I'm in pain. It hurts to breathe," she said. "They were like, you're just going to sit there. So do you want to at three o'clock in the morning, go to this emergency room and just sit there?"

Mizz June pushed back. I can't breathe, she told them.

They began questioning me, but I was so angered that I demanded to go to the hospital, she said. If I had not been the kind of woman that I am, a black transgender woman who has been through so much adversity. I would be dead.

The coronavirus outbreak is pummeling LGBTQ Americans, especially those of color, leaving a population already vulnerable to health care and employment discrimination suffering from high job losses and a growing rate of positive cases, according to preliminary data collected from multiple LGBTQ advocacy groups.

Many LGBTQ Americans live in states that have seen the highest number of coronavirus cases, including California, New York and Washington. These areas have also been hit by job losses driven by economic shutdowns.

In this Oct. 8, 2019 file photo, supporters of LGBT rights stage a protest on the street in front of the U.S. Supreme Court in Washington.(Photo: Manuel Balce Ceneta, AP)

As a result, many more LGBTQ people are struggling with unemployment, homelessness and food insecurity compared with other Americans, while simultaneously facing increased rates of health issues stemming from bias, mental illness and lack of insurance.

Scout, a transgender activist and deputy directorat the National LGBT Cancer Network, a non-profit organization based in New York City,said many LGBTQ Americans already face discrimination when seeking health care, and are worried these barriers could make it hardertoget treatment during the pandemic. Scott cited a recent controversy over afield hospital in New York's Central Park that requiredemployees to sign a pledge against same-sex marriage.

"Imagine if you were in New York City and you're queer and your partner gets COVID. Your closest hospital might be that one in Central Park that is very anti-LGBT," he said."Can you imagine what kind of fear you might have to send your partner to the hospital knowing you couldn't visit them again, right, because you can't visit the hospitals. And you can't be there to protect them and to make sure that they get the kind of care they deserve."

Advocates said the U.S. needs more comprehensive data on who is being tested for COVID-19. So far, many states have collected COVID-19 data based on age, race and ethnicity, but are not collecting sexual orientation and gender identity data.

That's prompted activists to try to create their own data onpositive cases in the LGBTQ community, while alsosurveying respondents onhealth care disparities stemming from discrimination from medical providers, including being turned away because of their sexual orientation and gender identity.

"I would say that there is definitely not as much research out there as other communities because so few surveys ask questions about sex orientation and gender identity," said Naomi Goldberg, policy research director of the Movement Advancement Project, a non-profit think tank that provides LGBTresearch in Colorado.

Scout saidthe health care system needs to take into accountprior medical histories, as well as societal issues, while treating Americans for coronavirus, especially LGBTQ people.

"No one's measuring our outcomes, which, in my mind, is people in the health care system forcing us back in the closet," he said. "They're hiding the way this pandemic is going to play out our extra vulnerabilities and have a disproportionate impact on us."

More: Fauci guided US through AIDS crisis, too. Survivors say it's a roadmap for coronavirus.

Experts agreethat LGBTQ people may have health complications that could put them at higher risk of contracting COVID-19 or heighten complications after contraction. For example, LGBTQ people are more likely to be smokers than other Americans, according to the Human Rights Campaign. They also are more likely to have asthma. LGBTQ Americans, especially those who are non-white, are also more likely to have chronic medical conditions such as HIV or AIDS.

Access to health care can also be contributing to high cases of COVID-19 among LGBTQ Americans. Roughly 17% of LGBTQ adults do not have any kind of health insurance coverage, compared with 12% of non-LGBTQ Americans, according to the National Center for Transgender Equality based in Washington, D.C.

"We need to be talking about disparities, especially around race and class, recognizing that people of color have less access to health care,"said Daniel Ramos, executive director of One Colorado, a LGBTQ advocacy group based in Denver.

Participants wave rainbow flags during the 2015 New York City Pride march in New York on June 28, 2015.(Photo: JEWEL SAMAD, AFP/Getty Images)

Stigma and discrimination can also deter LGBTQ people from seeking medical care, even when they do have health insurance. One in fourLGBTQ people reported experiencing discrimination, while 8% of lesbian, gayand bisexual adults and 29% of transgender adults reported that a health care provider refused to see them because of their sexual orientation or gender identity, according to a national survey by the Center for American Progress, a policyresearch organization in Washington, D.C.

Sean Cahill, director of health policy research at the Fenway Institute, a center for research and advocacy in Massachusetts, said there is stillanti-LGBTQ stigma in health care.

"This affects their health, well being and affects their sense of safety," he said.

Michael Adams, chief executive officer at SAGE, a non-profit organization focused on LGBTQ aging in New York, suspects that many older Americans dying from COVID-19 could be part of the LGBTQ community.LGBTQ older adults are twice as likely to be living alone and four times less likely to have children compared to non-gay people their same age, which means that older LGBTQ people are especially at risk to lack care or support from family during COVID-19, according to a study by SAGE.

In a public health crisis like this there are very thin support networks among LGBT older adults, Adamssaid.

To help raise awareness, activists plan to host virtual pride events starting June 1, the beginning ofgay pride month, saidBrian Hujdich, executive directorof HealthHIV, one of the largest national HIV nonprofit organizations in Washington, D.C.

MizzJune said she contracted COVID-19 in mid-March and fears she may get it again. The symptoms initially left her with a dry cough andblood in her mucus. Then she felt constipated for a week.

I had a mild case but still I was coughing up blood, wheezing and I could feel my lungs and ribs hurting when I breathed, she said. Its just a disgusting virus.

She said was she baffled by the claims from the 911 operators that she should avoid going to the emergency room because it was too crowded. Only three other patients were waiting when she arrived.

"They told me I could contract the disease if I went. How could I when there were only three people, I expected at least a full room of 100 coronavirus patients," she said.

She has recovered since her hospital stay, but is worried that other black transgender women might have the same experience where"symptoms weren't taken seriously." She's been encouraging other black transwomen to get tested for the virus.

"I don't think people understand the seriousness of it," she said. "Whenever I go outside I put on gloves and a mask, I keep my distance because I've had it. I don't know if I can still pass it on to people but also I don't want to catch it again."

More: FDA eases restrictions on blood donations from gay and bisexual men during coronavirus pandemic

In this June 26, 2016, file photo, a woman holds a rainbow flag during the NYC Pride Parade in New York.(Photo: Seth Wenig, AP)

For LGBTQ Americans who don't get sick from coronavirus, many are struggling with unemployment or other financial burdens, activists said.

"When we think about the kind of economic earthquake that has happened as a result of COVID-19, with job losses and unemployment benefits, there's a lot of reason to be concerned about the precariousness of LGBTQ people and their families at this moment," said Goldbergof the Movement Advancement Project.

As the economy plummeted, more than 5 million LGBTQ workers were likely to have been impacted by COVID-19, according to recent estimates from the Human Rights Campaign. Jobs in restaurants and food service, hospitals, K-12 and higher education and retail industries have been hit, making up about 40% of all industries where LGBTQ people work, the organization found.More than 33million Americans havesubmittedunemployment claims since March.

"While we do not have official numbers on how many LGBTQ people have contracted coronavirus or have died because of it, we know in addition to health disparities, LGBTQ people are employed in the industries heavily impacted by the pandemic, such as retail, nightlife, restaurants, and they are more likely to live in poverty, be food insecure, and uninsured," said Tyrone Hanley, senior policy counsel of the National Center for Lesbian Rights, the first national LGBTQ legal organization founded by womenin California.

Roughly 9% of LGBT were unemployed, compared with 5% of all Americans, before the outbreak.About 27% LGBT people were food insecure, compared with 15% of all Americans.

LGBTQ Americans are also more likely to be homeless than other Americans. Up to 45% of homeless youth are LGBTQ, while LGBT people ages 18 through 25 are two times more likely to be homeless than their peers,according to the Williams Institute, a leading research center on sexual orientation and gender identity at the University of California, Los Angeles, School of Law.

"We estimate that 139,700 transgender adults were unemployed at the time the coronavirus pandemic began. Recent job losses due to official orders enforcing social distancing practices will likely increase this number and exacerbate existing employment disparities,"said Jody L. Herman, a scholar of public policyat the Williams Institute and co-author of a recent report on COVID-19 and transgender Americans.

A pedestrian walks past graffiti that reads "Rent Strike" Wednesday, April 1, 2020, in Seattle's Capitol Hill neighborhood. With millions of people suddenly out of work, some tenants in the U.S. are vowing to go on a rent strike until the new coronavirus pandemic subsides.(Photo: Ted S. Warren, AP)

LGBTQ people of color tend to face much harsher discrimination compared with their white counterparts because of their ethnicity, in part because of barriers such asinadequate or non-existent non-discrimination protection for LGBT workers, and a lack of mentoring,said Goldberg.

We know that with the economic issues arising many of them wont be able to work at their jobs, or their jobs arent remote, meaning they'll lose a paycheck, Goldberg said.

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LGBTQ Americans are getting coronavirus, losing jobs. Anti-gay bias is making it worse for them. - USA TODAY

Read: Should you get an antibody test?

We have evidence for one strain, says Brian Wasik at Cornell University.

I would say theres just one, says Nathan Grubaugh at Yale School of Medicine.

I think the majority of people studying [coronavirus genetics] wouldnt recognize more than one strain right now, says Charlotte Houldcroft at the University of Cambridge.

Everyone else might be reasonably puzzled, given that news stories have repeatedly claimed there are two, or three, or even eight strains. This is yet another case of confusion in a crisis that seems riddled with them. Heres how to make sense of it.

Whenever a virus infects a host, it makes new copies of itself, and it starts by duplicating its genes. But this process is sloppy, and the duplicates end up with errors. These are called mutationstheyre the genetic equivalent of typos. In comic books and other science fiction, mutations are always dramatic and consequential. In the real world, theyre a normal and usually mundane part of virology. Viruses naturally and gradually accumulate mutations as they spread.

Read: The best hopes for a coronavirus drug

As an epidemic progresses, the virus family tree grows new branches and twigsnew lineages that are characterized by differing sets of mutations. But a new lineage doesnt automatically count as a new strain. That term is usually reserved for a lineage that differs from its fellow viruses in significant ways. It might vary in how easily it spreads (transmissibility), its ability to cause disease (virulence), whether it is recognized by the immune system in the same way (antigenicity), or how vulnerable it is to medications (resistance). Some mutations affect these properties. Most do not, and are either silent or cosmetic. Not every mutation creates a different strain, says Grubaugh. (Think about dog breeds as equivalents of strains: A corgi is clearly different from a Great Dane, but a black-haired corgi is functionally the same as a brown-haired one, and wouldnt count as a separate breed.)

Theres no clear, fixed threshold for when a lineage suddenly counts as a strain. But the term has the same connotation in virology as it does colloquiallyit implies importance. Viruses change all the time; strains arise when they change in meaningful ways.

New strains of influenza arise every year. These viruses quickly acquire mutations that change the shape of the proteins on their surface, making them invisible to the same immune cells that would have recognized and attacked their ancestors. These are clearly meaningful changesand they're partly why the flu vaccine must be updated every year.

Read: Why some people get sicker than others

But influenza is notable for mutating quickly. Coronaviruseswhich, to be clear, belong to a completely separate family from influenza viruseschange at a tenth of the speed. The new one, SARS-CoV-2, is no exception. Theres nothing out of the ordinary here, says Grubaugh. Yes, the virus has picked up several mutations since it first jumped into humans in late 2019, but no more than scientists would have predicted. Yes, its family tree has branched into different lineages, but none seems materially different from the others. This is still such a young epidemic that, given the slow mutation rate, it would be a surprise if we saw anything this soon, Houldcroft says.

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The Problem With Stories About Dangerous Coronavirus Mutations - The Atlantic