Category: Corona Virus

Donald Trumps former lawyer and longtime fixer Michael Cohen will reportedly be released from federal prison to serve the remainder of his sentence in home confinement because of the coronavirus pandemic.

Cohen is currently locked up at FCI Otisville in New York after pleading guilty to numerous charges, including campaign finance fraud and lying to Congress. Cohen began serving his sentence last May and was scheduled to be released from prison in November 2021.

He will remain under quarantine for 14 days before he is released. Federal statistics show 14 inmates and seven staff members at the prison have tested positive for the coronavirus.

After he is released, Cohen will serve the remainder of his sentence at home, according to multiple US media reports citing Cohens lawyer, Roger Adler.

Cohens release comes as prison advocates and congressional leaders have been pressing the justice department for weeks to release at-risk inmates ahead of a potential outbreak, arguing that the public health guidance to stay 6ft (1.8 meters) away from other people is nearly impossible behind bars.

The attorney general, William Barr, ordered the Bureau of Prisons (BOP) earlier this month to increase the use of home confinement and expedite the release of eligible high-risk inmates, beginning at three prisons identified as coronavirus hotspots. Otisville is not one of those facilities.

As of Thursday, 473 federal inmates and 279 Bureau of Prisons staff members had tested positive for the coronavirus at facilities across the US. Eighteen inmates have died since late March.

Many federal inmates have been seeking home confinement as the number of coronavirus cases grows in the federal prison system, but advocates have accused the Bureau of Prisons of moving too slowly to release inmates. The Bureau of Prisons said it had moved more than 1,000 inmates to home confinement since 26 March, when Barr first issued a directive to increase its use in late March. The agency said it was a tremendous logistical lift that was accomplished through the marshaling of all of BOPs resources.

A federal judge had denied Cohens attempt for an early release to home confinement after serving 10 months in prison and said in a ruling earlier this month that it appears to be just another effort to inject himself into the news cycle. But the Bureau of Prisons can take action to move him to home confinement without a judicial order.

Other high-profile inmates have also been released as the number of coronavirus cases soars. Last week, a judge ordered Michael Avenatti the attorney who rose to fame representing porn star Stormy Daniels in lawsuits against Trump to be temporarily freed from a federal jail in New York City and stay at a friends house in Los Angeles.

Avenatti had said he was at high risk of getting the coronavirus because he had recently had pneumonia and his cellmate at the Metropolitan correctional center in Manhattan was removed due to flu-like symptoms.

The former New York state senate leader Dean Skelos, 72, who was also serving a sentence at Otisville, is also expected to be released soon from prison to home confinement after testing positive for the coronavirus, prosecutors told a judge on Wednesday.

CNN first reported Cohen was being released to home confinement.

A spokesman for the US attorneys office in Manhattan declined to comment.

The Associated Press contributed to this report

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Michael Cohen to be released from prison over coronavirus fears report - The Guardian

Security experts are poring over thousands of new Coronavirus-themed domain names registered each day, but this often manual effort struggles to keep pace with the flood of domains invoking the virus to promote malware and phishing sites, as well as non-existent healthcare products and charities. As a result, domain name registrars are under increasing pressure to do more to combat scams and misinformation during the COVID-19 pandemic.

By most measures, the volume of new domain registrations that include the words Coronavirus or Covid has closely tracked the spread of the deadly virus. The Cyber Threat Coalition (CTC), a group of several thousand security experts volunteering their time to fight COVID-related criminal activity online, recently published data showing the rapid rise in new domains began in the last week of February, around the same time the Centers for Disease Control began publicly warning that a severe global pandemic was probably inevitable.

The total number of domains registered per day that contain a COVID-19 related term, according to DomainTools. The red line indicates the count of domains that DomainTools determined are likely malicious. The blue line refers to domains that are likely benign.

Since March 20th, the number of risky domains registered per day has been decreasing, with a notable spike around March 30th, wrote John Conwell, principal data scientist at DomainTools [an advertiser on this site]. Interestingly, legitimate organizations creating domains in response to the COVID-19 crisis were several weeks behind the curve from threat actors trying to take advantage of this situation. This is a pattern DomainTools hasnt seen before in other crises.

Security vendor Sophos looked at telemetry from customer endpoints to illustrate the number of new COVID-related domains that actually received traffic of late. As the company noted, one challenge in identifying potentially malicious domains is that many of them can sit dormant for days or weeks before being used for anything.

Data from security vendor Sophos, published by the Cyber Threat Coalition, shows the number of Coronavirus or COVID-19 themed domains registered per week that received traffic.

We can see a rapid and dramatic increase of visits to potentially malicious domains exploiting the Coronavirus pandemic week over week, beginning in late February, wrote Sophos Rich Harang. Even though still a minority of cyber threats use the pandemic as a lure, some of these new domains will eventually be used for malicious purposes.

CTC spokesman Nick Espinosa said the first spike in visits was on February 25, when group members saw about 4,000 visits to the sites they were tracking.

The following two weeks starting on March 9 saw rapid growth, and from March 23 onwards were seeing between 75,000 to 130,000 visits per weekday, and about 40,000 on the weekends, Espinosa said. Looking at the data collected, the pattern of visits are highest on Monday and Friday, and the lowest visit count is on the weekend. Our data shows that there were virtually no customer hits on COVID-related domains prior to February 23.

Milwaukee-based Hold Security has been publishing daily and weekly lists of all COVID-19 related domain registrations (without any scoring assigned). Heres a graph KrebsOnSecurity put together based on that data set, which also shows a massive spike in new domain registrations in the third week of March, trailing off considerably over the past couple of weeks.

Data: Hold Security.

Not everyone is convinced were measuring the right things, or that the current measurements are accurate. Neil Schwartzman, executive director of the anti-spam group CAUCE, said he believes DomainTools estimates on the percentage of new COVID/Coronavirus-themed domains that are malicious are too high, and that many are likely benign and registered by well-meaning people seeking to share news or their own thoughts about the outbreak.

But theres the rub, he said. Bad guys get to hide amidst the good really effectively, so each one needs to be reviewed on its own. And thats a substantial amount of work.

At the same time, Schwartzman said, focusing purely on domains may obscure the true size and scope of the overall threat. Thats because scammers very often will establish multiple subdomains for each domain, meaning that a single COVID-related new domain registration could eventually be tied to a number of different scammy or malicious sites.

Subdomains can not only make phishing domains appear more legitimate, but they also tend to lengthen the domain so that key parts of it get pushed off the URL bar in mobile browsers.

To that end, he said, it makes perhaps the most sense to focus on new domain registrations that have encryption certificates tied to them, since the issuance of an SSL certificate for a domain is usually a sign that it is about to be put to use. As noted in previous stories here, roughly 75 percent of all phishing sites now have the padlock (start with https://), mainly because the major Web browsers display security alerts on sites that dont.

Schwartzman said more domain registrars should follow the example of Los Angeles-based Namecheap Inc., which last month pledged to stop accepting the automated registration of website names that include words or phrases tied to the COVID-19 pandemic. Since then, a handful of other registrars have said they plan to manually review all such registrations going forward.

The Internet Corporation for Assigned Names and Numbers (ICANN), the organization that oversees the registrar industry, recently sent a letter urging registrars to be more proactive, but stopped short of mandating any specific actions.

Schwartzman called ICANNs response weak tea.

Its absolutely ludicrous that ICANN hasnt stepped up, and they will bear significant responsibility for any deaths that may happen as a result of all this, Schwartzman said. This is a CYA response at best, and dictates to no one that they should do anything.

Michael Daniel, president of the Cyber Threat Alliance a cybersecurity industry group thats also been working to fight COVID-19 related fraud agreed, saying more pressure needs to be applied to the registrar community.

Its really hard to do anything about this unless the registrars step up and do something on their own, Daniel said. Its either that or the government gets involved. That doesnt mean some [registrars] arent doing what they can, but in general what the industry is doing is nowhere near as fast as the bad guys are generating these domains.

The U.S. government may well soon get more involved. Earlier this week, Senators Cory Booker (D-N.J.), Maggie Hassan (D-N.H.) and Mazie K. Hirono (D-Hawaii) sent letters to eight domain name company leaders, demanding to know what they were doing to combat the threat of malicious domains, and urging them to do more.

As cybercriminals and other malevolent actors seek to take advantage of the Coronavirus pandemic, it is critical that domain name registrars like yours (1) exercise diligence and ensure that only legitimate organizations can register Coronavirus-related domain names and domain names referencing online communications platforms; (2) act quickly to suspend, cancel, or terminate registrations for domains that are involved in unlawful or harmful activity; and (3) cooperate with law enforcement to help bring to justice cybercriminals profiting from the Coronavirus pandemic, the senators wrote.

Tags: CAUCE, Centers for Disease Control, COVID-19, Cyber Threat Alliance, Cyber Threat Coalition, domaintools, Hold Security, John Conwell, Michael Daniel, Neil Schwartzman, PhishLabs, Rich Harang, Sen. Cory Booker, Sen. Maggie Hassan, Sen. Mazie K. Hirono, sophos

This entry was posted on Thursday, April 16th, 2020 at 12:23 pmand is filed under Latest Warnings, The Coming Storm, Web Fraud 2.0.You can follow any comments to this entry through the RSS 2.0 feed.You can skip to the end and leave a comment. Pinging is currently not allowed.

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Sipping from the Coronavirus Domain Firehose - Krebs on Security

As many as 29 people from the Philippines or with Filipino heritage including a Grenfell Tower fire survivor are believed to have died from Covid-19, as the pandemic exerts a heavy toll on a community that helps form the backbone to Britains healthcare sector.

Some 18 of those who have lost their lives worked in the health sector, in roles including NHS nurses and porters, healthcare assistants and care home staff. A number of others are critically ill in intensive care.

Among members of the Filipino community to have died is Virgilio Larry Castro, 63, who survived the Grenfell Tower fire less than three years ago, the Guardian has learned. He died on 9 April.

Castro, who had worked as a maintenance supervisor and at a bar, initially tried to fight the blaze and escaped in shorts and a T-shirt. He told the inquiry that he often thought about it and had suffered breathing problems since.

In evidence to the inquiry into the fire in which 72 people died, Castro told how he had lost many people he knew. The Grenfell Tower fire is such a tragedy; it shouldnt have been allowed to happen and I want the public inquiry to ensure it can never happen again, said Castro, whose daughter is a doctor.

Castro lived with his family on the 17th floor of the 24-storey tower for 26 years. He and his wife Lina, who died a decade ago, moved into the tower in April 1991 just after their daughter, Christabel, was born. She would go on to become a doctor, and was not at the tower on the night of the fire in June 2017.

I have watched my daughter grow up in that flat and have many fond memories of living there as a family, he told the inquiry. He said that he had cried at a CCTV image, provided by police, of him leaving the tower in only a white T-shirt and yellow shorts. I still find it difficult to look at that photograph.

The deaths of at least 21 Filipinos in the UK have been confirmed by the Guardian where Covid-19 was contracted or where they had been suffering from symptoms prior to death. A further eight people are on a list which community leaders have been compiling, where Covid-19 is believed to have been a factor.

Echoing concern elsewhere, there is anger that Filipino workers are among those bearing the brunt of a shortage of personal protective equipment (PPE) for healthcare workers.

There are about 200,000 Filipinos in the UK, and 18,500 of them in the NHS according to House of Commons library data from 2019, making them the most numerous nationality working in the health service after Britons and Indians.

It is breaking our hearts because we are talking about friends, family and close colleagues, said Emily Barrameda of United Filipino Global (UFG), an organisation which represents Filipino overseas workers.

Like so many others, we dont know what is happening and its hard in some cases not to believe that there is also some discrimination. In some hospitals where there is a British person who is positive with Covid-19 and a Filipino one it seems that they will choose to prioritise the British one.

She referred to the death of a friend, Amor Padilla Gatinao, 50, who worked as a nurse at St Charles hospital, in west London, and died after falling ill on Mothers Day. The nurses husband has reportedly told how an ambulance crew refused to take her to hospital nine days before she died of coronavirus, after he took her there himself by car.

Other Filipinos who have died include John Alagos, 23, who become the third UK nurse to die after caring for coronavirus patients and is believed to have become the youngest British medic to succumb to the virus.

His mother, Gina Gustilo, has spoken of how her son fell ill at Watford general hospital after a 12-hour shift.

Other victims included Oscar King Jr and Elbert Rico, two porters at Oxfords John Radcliffe hospital who died last weekend weekend. King Jr, who was described as a devoted father to his 10-year-old daughter, died on Saturday an hour after being brought to hospital after isolating at home with symptoms consistent with the virus. King Jrs wife, Twilight, has been recovering after she was also taken to hospital.

The partner of Leilani Medel, 41, a nurse in Bridgend, South Wales, who died on 10 April has also been treated after being brought to hospital with severe symptoms of the virus. Medel had worked in care homes and hospitals for more than 10 years.

Among others were Linette Cruz, a senior head nurse at the Brynteg dental practice in Sketty, Swansea. The married mother of one was described by colleagues as a woman who brought love, light and joy to everyone she met.

Cruz, who trained in the Philippines and came to the UK several years ago, died on 14 April after being treated for coronavirus in the intensive care unit at Morriston hospital in Swansea.

Elvira Bucu, an NHS care worker and mother of three whose husband was also infected, died on 3 April. Leilani Dayrit, a clinical nurse sister at the hospital of St Cross in Rugby, died of suspected Covid-19 on 7 April.

Members of the community who were not healthcare workers include Arnel Ganias, a courtesy driver at Heathrow airport, and Romeo Castillo Jr, 34. Known to friends as Romy, he died after contracting Covid-19 on a work trip to Mauritius, which he had won as a reward for his good work.

Antonio Lagdameo, the Philippine ambassador to the UK, said: We are are deeply saddened by reports of Filipino staff at the NHS who are either infected by Covid-19 or have succumbed to the disease. Our thoughts are with their loved ones.

Filipino health workers have served tirelessly and courageously at the frontlines of the war against this pandemic, and their contribution to the ongoing effort to save lives is nothing but immense.

The escalation of confirmed Covid-19 cases and Covid-19-related deaths point out the undeniable truth that this disease is an existential threat even to the most healthy and fit among us. I urge everyone to follow government advice, stay home and help protect the NHS heroes who put their lives on the line for all of us.

Read more here:

Coronavirus exerts heavy toll on Filipino community in UK - The Guardian

OAKLAND, Calif. In one of the most far-ranging attempts to halt the spread of the coronavirus, Apple and Google said they were building software into smartphones that would tell people if they were recently in contact with someone who was infected with it.

The technology giants said they were teaming up to release the tool within several months, building it into the operating systems of the billions of iPhones and Android devices around the world. That would enable the smartphones to constantly log other devices they come near, enabling what is known as contact tracing of the disease. People would opt in to use the tool and voluntarily report if they became infected.

The unlikely partnership between Google and Apple, fierce rivals who rarely pass up an opportunity to criticize each other, underscores the seriousness of the health crisis and the power of the two companies whose software runs almost every smartphone in the world. Apple and Google said their joint effort came together in just the last two weeks.

Their work could prove to be significant in slowing the spread of the coronavirus. Public-health authorities have said that improved tracking of infected people and their contacts could slow the pandemic, especially at the start of an outbreak, and such measures have been effective in places like South Korea that also conducted mass virus testing.

Yet two of the worlds largest tech companies harnessing virtually all of the smartphones on the planet to trace peoples connections raises questions about the reach these behemoths have into individuals lives and society.

It could be a useful tool but it raises privacy issues, said Dr. Mike Reid, an assistant professor of medicine and infectious diseases at the University of California, San Francisco, who is helping San Francisco officials with contact tracing. Its not going to be the sole solution, but as part of a robust sophisticated response, it has a role to play.

Timothy D. Cook, Apples chief executive, said on Twitter that the tool would help curb the viruss spread in a way that also respects transparency & consent. Sundar Pichai, Googles chief, also posted on Twitter that the tool has strong controls and protections for user privacy.

With the tool, people infected with the coronavirus would notify a public health app that they have it, which would then alert phones that had recently come into proximity with that persons device. The companies would need to get public-health authorities to agree to link their app to the tool.

President Trump said on Friday that his administration planned to look at the tool.

Its very new, new technology. Its very interesting, he said. But a lot of people worry about it in terms of a persons freedom.

Privacy is a concern given that Google, in particular, has a checkered history of collecting peoples data for its online advertising business. The internet search company came under fire in 2018 after it said that disabling peoples location history on Android phones would not stop it from collecting location data.

Apple, which has been one of the biggest critics of Googles collection of user data, has not built a significant business around using data to sell online advertising. Still, the company has access to a wealth of information about its users, from their location to their health.

There are already third-party tools for contact tracing, including from public health authorities and the Massachusetts Institute of Technology. In March, the government of Singapore introduced a similar coronavirus contact-tracing app, called TraceTogether, that detects mobile phones that are nearby.

But given the number of iPhones and Android devices in use worldwide, Apple and Google said they were hoping to make tracing efforts by public health authorities more effective by reaching more people. They also said they would provide their underlying technology to the third-party apps to make them more reliable.

Daniel Weitzner, a principal research scientist at M.I.T.s Computer Science and Artificial Intelligence Laboratory and who was one of those behind the schools contract tracing app, said Google and Apples partnership will help health officials save time and resources in developing their own applications to track the virus spread.

One challenge for third-party apps is that they must run constantly 24 hours a day, seven days a week to be effective. Google said some Android smartphone manufacturers shut down those applications to save battery life.

Apple and Google said their tool would also constantly run in the background if people opt to use it, logging nearby devices through the short-range wireless technology Bluetooth. But it would eat up less battery life and be more reliable than third-party apps, they said.

Once someone reports his or her infection to a public-health app, the tool will send the phones so-called broadcast beacons, or anonymous identifiers connected to the device, to central computer servers.

Other phones will constantly check those servers for the broadcast beacons of devices they had come near in the past 14 days. If there is a match, those people will receive an alert that they had likely come into contact with an infected person.

Apple and Google said they were discussing how much information to include in those alerts with health officials, aiming to strike a balance between being helpful while also protecting the privacy of those who have the coronavirus.

This data could empower members of the general population to make informed decisions about their own health in terms of self-quarantining, said Dr. Reid. But it doesnt replace the public health imperative that we scale up contact tracing in the public health departments around the world.

Apple and Google said they would make the tools underlying technology available to third-party apps by mid-May and publicly release the tool in the coming months. The companies said the tool would not collect devices locations it only tracked proximity to other devices and would keep people anonymous in the central servers.

Google and Apples approach aims to resolve one of the hurdles facing government and private efforts to create contact tracing applications: a lack of common technical standards. The European Commission, the executive of the 27-nation bloc, said on Wednesday that a fragmented and uncoordinated approach risks hampering the effectiveness of such apps.

Ashkan Soltani, an independent cybersecurity researcher, cautioned that surveillance tools that start as voluntary often become required through public policy decisions. China, for instance, has introduced a color-coded coronavirus surveillance app that automatically decides whether someone must stay at home or may go outside and use public transportation.

The danger is, as you roll out these voluntary solutions and they gain adoption, its more likely that they are going to become compulsory, said Mr. Soltani, a former chief technologist for the Federal Trade Commission.

Mr. Soltani said the tool could also be a way for the tech companies to pre-empt efforts by governments in the United States or elsewhere to mandate a more invasive collection of data to combat the pandemic.

The tool permits them to address the administrations ask to do something while also relieving them of the responsibility of building the app and collecting the data themselves, he said.

Natasha Singer and Jennifer Valentino-DeVries contributed reporting from New York, Adam Satariano contributed reporting from London and David McCabe from Washington.

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Coronavirus Contact Tracing: Apple and Google Team Up to Enable Virus Tracking - The New York Times

A good example of the genre is an op-ed co-authored by former Education Secretary William Bennett and talk radio host and author Seth Leibsohn . It is titled, tendentiously and not very accurately, Coronavirus Lessons: Fact and Reason vs. Paranoia and Fear. Bennett and Leibsohn are intelligent and public-spirited men whom Ive known for years, but theyve got this wrong, and in rather elementary ways.

They cite the latest estimate of the Institute for Health Metrics and Evaluation in Washington state that the current outbreak will kill 68,000 Americans. Then, they note that about 60,000 people died of the flu in 2017-18. For this, they thunder, weve scared Americans and imposed huge economic and social costs on the country.

This is such an obviously flawed way of looking at the question, its hard to believe that Bennett and Leibsohn dont realize it.

If we are going to have 60,000 deaths with people not leaving their homes for more than a month, the number of deaths obviously would have been highermuch higherif everyone had gone about business as usual. We didnt lock down the country to try to prevent 60,000 deaths; we locked down the country to limit deaths to 60,000 (or whatever the ultimate toll is) from what would have been a number multiples larger.

By Bennett and Leibsohn s logic, we could just as easily ask: Why did we expend all that blood and treasure fighting Hitler when he couldnt even take Britain or conquer Moscow? Why did we adopt tough-on-crime policies, when crime rates are at historic lows? Why did we work so hard to find a treatment for HIV/AIDs, when so many of the people with the disease now have normal life expectancies?

Of course, it was precisely the actions we took that caused those welcome outcomes.

Consider the perversity of their line of reasoning a different way. If we had shut down the country a month sooner and there had been, say, only 2,000 deaths, then on their terms theyd have even a stronger argument, i.e., We did all this and there were only a couple of thousand fatalities?

In other words, the more effective a lockdown would have been, the more opposed Bennett and Leibsohn would be to it.

As for the flu comparison, it isnt as telling as Bennett and Leibsohn believe. The flu season stretches as long as from October to April, although it usually peaks between December and February. The 2017-18 season, with 60,000 flu-related deaths, was particularly bad. But the coronavirus might kill a similar number of peoplewith the country on lockdown.

In the 2011-12 season, 12,000 people died of the flu in the entire country. New York alone has eclipsed that in a little more than a month, and recorded roughly 9,000 deaths the first 15 days of April (again, while on lockdown). In 2018-19, there were 34,000 flu-related deaths in the United States. We are going to surpass that number nationally sometime soon (yet again, while on lockdown).

Why have people reacted so dramatically to this virus, despite the fact that is supposedly comparable to the run-of-the-mill flu? Bennett and Leibsohn have a theory: New York City is where the epidemic has struck the hardest. The media is centered in New York City.

Theres no doubt that New York is always going to get disproportionate attention. But New York City is the biggest in the country, and New York state accounts for 8 percent of the U.S. economy. If New York were an independent state, it would rank as the 11th-biggest economy in the world. What happens there matters.

New York is also, as all of us had no hesitation in recognizing on Sept. 11, 2001, part of America.

If the disease struck smaller heartland cities like Omaha, Kansas City and Witchita would Bennett and Leibsohn hope that the story got ignored and no one took any precautions based on major media companies not being headquartered in those places?

Bennett and Leibsohn ignore the key fact that the economy began to shut down before there were widespread official shutdown orders. People voted with their feet, because they were fearful of a highly transmissible, virulent disease. Bennett and Leibsohn may want to portray Americans as lemmings of the media, cowering in their homes, but they acted rationally. If everything had gone on as normal, the outbreak would have been much worse, and we would have shutdowns anyway, just with even worse health outcomes.

The most objectionable part of the Bennett and Leibsohn posture is its sneering attitude toward frenzied, panicked ordinary Americans who have sacrificed so much during this crisis to protect their families and their neighbors.

By all means, lets open up the economy as soon as we can, but it will require more careful thought than the most fervent critics of the shutdowns have demonstrated during the peak of this epidemic.

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Opinion | The Absurd Case Against the Coronavirus Lockdown - POLITICO

The next day, Minnoli Aya returned from the University at Buffalo, where she was a freshman. She believed her mother had pneumonia and hoped to surprise her. Instead, she learned her mother had contracted the coronavirus.

I was just on the floor, and I was broken, Minnoli said.

Over the next week, she texted with her mother, who continued to deteriorate. Doctors called Mr. Aya daily. By the end of the week, his wife was increasingly having trouble breathing.

By the morning of March 29, doctors got ready to put Ms. Aya on a ventilator. But there was a life-threatening complication, and they asked Mr. Aya if he wanted to see his wife for what could be the last time. He worried that his heart condition would put him at risk if he caught the virus, and Minnoli could be left without a parent.

The decision not to go, he said, has haunted him. That afternoon, the hospital called to say that his wife had died.

Minnoli, her father and grandmother could not hug each other, because they were required to stay six feet apart, even though they lived in the same house. Nor did they want to plan a funeral service that almost no one would attend, one where they would not be able to view Ms. Ayas body. They decided to have her cremated.

Even after her mother died, Minnoli still texted, trying to stay connected.

I miss u, she wrote before going to bed that night. When she woke the next morning, Minnoli texted, Thank you for coming to me last night in my dreams.

Mr. Aya, concerned about Minnoli, arranged for her to speak to a therapist by video after his wifes death. But he is not sure how long he can afford the expense because Ms. Ayas health care plan had covered the family. A representative of her union benefit fund told him by email that benefits would end 30 days after his wifes death. My heart is broken for you, the representative wrote in the email, which was reviewed by The New York Times.

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The Last Words of a Health Care Worker Who Died of Coronavirus - The New York Times

After the first positive coronavirus test at a Virginia nursing home in mid-March, its administrator said, the staff restricted visitors, conducted temperature checks at the end of every workers shift and isolated residents who had tested positive into separate areas.

Even so, there suddenly was another case. Within two weeks, dozens of others inside were falling ill.

Now, about a month after the first case, at least 46 residents are dead at the nursing home, the Canterbury Rehabilitation & Healthcare Center in Richmond more than a quarter of the facilitys population and one of the highest known death tolls in the United States.

The facilitys medical director, Dr. Jim Wright, said he had asked the state health department how to test a suspected case before the outbreak began. But even as the situation grew dire, it took almost two weeks for all the facilitys residents to be tested for the coronavirus.

You cant fight what you cant see, Dr. Wright said.

Virginia had only about 300 test kits available in mid-March, said Dr. Danny Avula, the Richmond health director, and to get one at the time, residents of long-term care facilities first needed to test negative for the flu and other respiratory viruses.

We could have limited the spread in Canterbury had we been able to test more, he said.

The lack of widespread testing and the difficulty in retaining staff members were additional challenges for the nursing home, where residents, who are older and therefore more vulnerable to the coronavirus, live in close quarters.

The New York Times has tracked hundreds of clusters of coronavirus cases across the country, and the 10 deadliest have been in nursing homes and long-term care centers. More than 21,000 residents and staff members at nursing homes and other long-term-care facilities have contracted the virus, and more than 3,800 have died.

Some involved in the crisis at Canterbury described a nightmarish scenario in which the casualty count climbed as health workers and family members tried to determine whether sick residents should go to hospitals or receive palliative end-of-life care inside the home. More than half of the Canterbury residents who died from the virus did so at the facility.

The nursing homes first positive test came on March 18, Dr. Wright said, and within days the number of symptomatic patients was climbing fast. One resident who had been sent to a hospital with a bladder infection later tested positive for the virus. Around the same time, another resident developed a high fever and respiratory symptoms.

Still, it took precious time for those in charge to act.

Canterbury requested the Henrico County Health Departments assistance in testing all residents and employees on March 26. Around that time, a Richmond laboratory gained the ability to start testing, and by March 30, everyone at the facility was finally tested.

The results were frightening.

More than 60 of the 160-some residents tested positive. About 50 of them had no symptoms, though some developed symptoms later.

We were shocked, Dr. Wright said. We thought we had it relatively contained until the results started coming in. And that revealed to us how far behind we were.

The number of calls to the county fire department about problems at Canterbury also started to climb. Dispatchers asked the facilitys staff members to bring patients into the front lobby, where a paramedic in protective clothing could assess the situation. Some residents were taken to nearby hospitals, which were coming under stress themselves.

Canterbury has acknowledged that it was understaffed as the crisis was intensifying. Jeremiah Davis, the facilitys administrator, said in a statement that Canterbury had temporarily doubled nursing staff wages and had tried to hire employees through third-party staffing agencies.

Notably, nearly a dozen Canterbury employees recovered from Covid-19 have returned to work and are caring exclusively for Covid-19 positive residents, Mr. Davis said.

Margo Turnage, whose 77-year-old father, Frank Bonarrigo, has lived in Canterbury for about three years, said she had been impressed with the facilitys willingness to help her frequently FaceTime with her father.

She said he had tested positive for the virus but was currently asymptomatic. She said she worried that the staff members would be blamed for the outbreak even though they have been putting themselves at risk on the front lines.

The staff are putting in so many hours, she said. Their friends, who they have been working with for years, are dying on them. Its heartbreaking.

In late March, the facility made a plea for more nurses, offering a bonus and an elevated pay rate. The job posting, which is still active, encouraged applicants to contact a recruiter for immediate consideration.

DOUBLE-TIME PAY RATE and $2500 sign on bonus, the post read. All Shifts available.

Vanessa Swales and Robert Gebeloff contributed reporting.

Originally posted here:

Virginia Nursing Home Had Plenty of Coronavirus Patients but Few Tests - The New York Times

Experts from the World Health Organization say they gave explicit warnings about the risks of the COVID-19 outbreak in early January. They said this after President Trump this week accused the agency of obscuring the truth. Above: the WHO's headquarters in Geneva. Fabrice Coffrini/AFP via Getty Images hide caption

Experts from the World Health Organization say they gave explicit warnings about the risks of the COVID-19 outbreak in early January. They said this after President Trump this week accused the agency of obscuring the truth. Above: the WHO's headquarters in Geneva.

"We regret the decision of the president of the United States to order a halt in funding to the World Health Organization," WHO Direct0r-General Tedros Adhanom Ghebreyesus said Wednesday in response to President Trump's plan to stop U.S. money from going to the agency.

The U.S. is the top contributor to the WHO, which is leading the fight against the COVID-19 global pandemic.

On Tuesday, Trump accused the WHO of "severely mismanaging and covering up the spread of the coronavirus." He also said the organization is overly influenced by China and was too trusting of that country, particularly in the early phase of the outbreak.

Through the middle of January, the president said, the WHO "parroted and publicly endorsed the idea that there was not human-to-human transmission happening despite reports and clear evidence to the contrary."

The president also said the health agency had delayed raising the alarm on the threat posed by the new coronavirus, which is now confirmed to have infected more than 2 million people.

Responding on Wednesday to a question about the U.S. accusations, Dr. Mike Ryan, executive director of the WHO's Health Emergencies Programme, said, "In the first weeks of January, the WHO was very, very clear."

"We alerted the world on January the 5th," Ryan said. "Systems around the world, including the U.S., began to activate their incident management systems on January the 6th. And through the next number of weeks, we've produced multiple updates to countries, including briefing multiple governments, multiple scientists around the world, on the developing situation and that is what it was, a developing situation."

Trump said the WHO had "deprived the scientific community of essential data," accusing it of failing to obtain virus samples.

To that charge, Ryan replied, "The virus was identified on January the 7th. The [genetic] sequence was shared on the 12th with the world."

As for the guidance about human-to-human spread of the new virus, Ryan noted that in initial reports, there was no mention of human-to-human transmission. But he also said, "There is always a risk with respiratory pathogen that it can move from person to person."

"When WHO issued its first guidance to countries, it was extremely clear that respiratory precautions should be taken in dealing with patients with this disease," Ryan said, "that labs needed to be careful in terms of their precautions and taking samples, because there was a risk that the disease could spread from person to person in those environments."

At that point in the looming outbreak, Ryan said, the main question was still whether the virus would be able to efficiently spread in community environments an ability it has since proved to have, to tragic effect.

In early January, the disease was known only through a cluster of atypical pneumonia cases pneumonia with an unknown origin.

"There are literally millions and millions of cases of atypical pneumonia around the world every year," Ryan said, adding that in the middle of an influenza season, it was "quite remarkable" that a cluster of 41 confirmed cases was singled out in Wuhan, China.

Questions about advice from the WHO during the early days of the outbreak recently prompted Maria Van Kerkhove, an emerging-disease expert who is the agency's technical lead on COVID-19, to review her first news conference about it, on Jan. 14. In that session, she discussed the questions that researchers were trying to answer about the virus, from the modes of transmission to the extent of infection in patients.

"All of our guidance that was out before we did that press conference was about limiting exposure to people and to prevent transmission, particularly in health care settings," Van Kerkhove said.

"We wanted to ensure that front-line workers were protected," she added, "so our guidance that was put out was about respiratory droplets and contact protection."

"All of that was out on the 10th and the 11th of January," she said.

Tedros did not dwell on Trump's accusations. Instead, he referred to the WHO's origins in the first years of the United Nations' existence and its mission of protecting public health. And while he called the U.S. "a long-standing and generous friend," Tedros also said the WHO is committed to working with all nations, "without fear or favor."

"COVID-19 does not discriminate between rich nations and poor, large nations and small. It does not discriminate between nationalities, ethnicities or ideologies," Tedros said. "Neither do we. This is a time for all of us to be united in our common struggle against a common threat a dangerous enemy."

After the pandemic has finally been corralled, Tedros said, there will be time to review the WHO's performance a process he said is routine after any disease outbreak.

"No doubt, areas for improvement will be identified, and there will be lessons for all of us to learn," he said. "But for now, our focus my focus is on stopping this virus and saving lives."

Critics are saying that by attacking the WHO, Trump is seeking to deflect blame away from his own administration's problems in containing COVID-19. The U.S. has more than 610,000 confirmed coronavirus cases far more than any other country, according to Johns Hopkins University's COVID-19 dashboard.

As the U.S death toll from COVID-19 soared past 26,000 on Wednesday, the White House issued a statement reiterating Trump's complaints about the WHO.

When Tedros was asked what kind of financial impact the U.S. stance could have, he declined to give specifics, saying the WHO is now reviewing how its work might be affected by a withdrawal of U.S. funding.

He added, "We'll work with our partners to fill any financial gaps we face and to ensure our work continues uninterrupted."

A look at the WHO's most recent financial update suggests that lack of U.S. money would have a profound impact. In that report, the WHO lists some $5.6 billion in total contributions from members and foundations.

The U.S. is responsible for nearly 15% of the WHO's funding in "specified voluntary contributions," which is by far the largest funding category, supporting specific disease programs and regional initiatives. The U.S. also accounts for 22% of the $1 billion that the WHO brings in through "assessed contributions" from member nations.

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'We Alerted The World' To Coronavirus On Jan. 5, WHO Says In Response To U.S. - NPR

The prevalence of these effects is too great to attribute them solely to the cytokine storm, a powerful immune-system response that attacks the body, causing severe damage, doctors and researchers said.

Almost half the people hospitalized because of covid-19 have blood or protein in their urine, indicating early damage to their kidneys, said Alan Kliger, a Yale University School of Medicine nephrologist who co-chairs a task force assisting dialysis patients who have covid-19.

Even more alarming, he added, is early data that shows 14to 30percent of intensive-care patients in New York and Wuhan, China birthplace of the pandemic have lost kidney function and require dialysis, or its in-hospital cousin, continuous renal replacement therapy. New York intensive care units are treating so much kidney failure, he said, they need more personnel who can perform dialysis and have issued an urgent call for volunteers from other parts of the country. They also are running dangerously short of the sterile fluids used to deliver that therapy, he said.

Thats a huge number of people who have this problem. Thats new to me, Kliger said. I think its very possible that the virus attaches to the kidney cells and attacks them.

But in medicine, logical inferences often do not prove true when research is conducted. Everyone interviewed for this story stressed that with the pandemic still raging, they are speculating with much less data than is normally needed to reach solid clinical conclusions.

Many other possible causes for organ and tissue damage must be investigated, they said, including respiratory distress, the medications patients received, high fever, the stress of hospitalization in an ICU and the now well-described impact of cytokine storms.

It does raise the very clear suspicion that at least a part of the acute kidney injury that were seeing is resulting from direct viral involvement of the kidney, which is distinct from what was seen in the SARS outbreak in 2002, said Paul M. Palevsky, a University of Pittsburgh School of Medicine nephrologist and president-elect of the National Kidney Foundation.

One New York hospital recently had 51 ICU patients who needed 24-hour kidney treatment but had just 39 machines to do it, he said. The hospital had to ration the care, keeping each patient on the therapy less than 24 hours a day, he said.

The virus also may be damaging the heart. Clinicians in China and New York have reported myocarditis, an inflammation of the heart muscle, and, more dangerous, irregular heart rhythms that can lead to cardiac arrest in covid-19 patients.

They seem to be doing really well as far as respiratory status goes, and then suddenly they develop a cardiac issue that seems out of proportion to their respiratory issues, said Mitchell Elkind, a Columbia University neurologist and president-elect of the American Heart Association. This seems to be out of proportion to their lung disease, which makes people wonder about that direct effect.

One review of severely ill patients in China found that about 40percent suffered arrhythmias and 20percent had some form of cardiac injury, Elkind said. There is some concern that some of it may be due to direct influence of the virus, he said.

The new virus enters the cells of people who are infected by latching onto the ACE2 receptor on cell surfaces. It unquestionably attacks the cells in the respiratory tract, but there is increasing suspicion that it is using the same doorway to enter other cells. The gastrointestinal tract, for instance, contains 100 times more of these receptors than other parts of the body, and its surface area is enormous.

If you unfurl it, its like a tennis court of surface area this tremendous area for the virus to invade and replicate itself, said Brennan Spiegel, co-editor in chief of the American Journal of Gastroenterology.

In a subset of covid-19 cases, researchers have found, the immune system battling the infection goes into hyperdrive. The uncontrolled response leads to the release of a flood of substances called cytokines that, in excess, can result in damage to multiple organs. In some severely ill covid-19 patients, doctors have found high levels of a pro-inflammatory cytokine called interleukin-6, known by the medical shorthand IL-6.

The unfettered response, also called cytokine release syndrome, has long been recognized in other patients, including those with autoimmune diseases such as rheumatoid arthritis or in cancer patients undergoing certain immunotherapies.

For covid-19 patients, cytokine storms are a major reason that some require intensive care and ventilation, said Jeffrey S. Weber, deputy director of the Perlmutter Cancer Center at NYU Langone Medical Center.

When your cytokines are systemically out of control, bad stuff happens, he said. It can be a complete disaster. It isnt clear why cytokine storms occur in some patients and not others, though genetic factors may play a role, some doctors say.

To treat cytokine storms, some doctors are using anti-IL-6 drugs such as tocilizumab, which is approved for cancer patients who develop cytokine storms as a result of immunotherapy.

Another odd, and now well-known, symptom of covid-19 is loss of smell and taste. Claire Hopkins, president of the British Rhinological Society, said studies of patients in Italy and elsewhere have shown that some lose their sense of smell before they show signs of being sick.

The coronavirus can actually attack and invade olfactory nerve endings, Hopkins said. When these aroma-detecting fibers are disrupted, they cant send odors to the brain.

Anosmia the medical term for the inability to smell was not initially recognized as a symptom of covid-19, Hopkins said. Doctors were so overwhelmed by patients with severe respiratory problems, she said, that they didnt ask the question.

But subsequent data from a symptom-tracking app has shown that 60percent of people later diagnosed with covid-19 reported losing their senses of smell and taste. About a quarter of participants experienced anosmia before developing other symptoms, suggesting it can be an early warning sign of infection.

Intriguingly, Hopkins said, people who lose their sense of smell dont seem to develop the same severe respiratory problems that have made covid-19 so deadly. But a very small number of patients have experienced confusion, low blood oxygen levels and even lost consciousness a sign that the virus may have traveled along their olfactory nerve endings straight to the central nervous system.

Why you get this different expression in different people, nobody knows, she said.

There are also reports that covid-19 can turn peoples eyes red, causing pinkeye, or conjunctivitis, in some patients. One study of 38 hospitalized patients in Hubei province, China, found that a third had pinkeye.

But like many of the non-respiratory effects of the virus, this symptom may be relatively uncommon and may develop only in people already severely ill. The fact that the virus has been found in the mucus membrane that covers the eye in a small number of patients, however, does suggest that the eye could be an entryway for the virus and is one reason that face shields and goggles are being used to protect health-care workers.

The virus also is having a clear impact on the gastrointestinal tract, causing diarrhea, vomiting and other symptoms. One study found that half of covid-19 patients have gastrointestinal symptoms, and specialists have coined a Twitter hashtag, #NotJustCough, to raise awareness of them.

Studies suggest that patients with digestive symptoms will also develop a cough, but one may occur days before the other.

The question is, is it kind of behaving like a hybrid of different viruses? Spiegel said. What were learning is, it seems anyway, that this virus homes in on more than one organ system.

Reports also indicate that the virus can attack the liver. A 59-year-old woman in Long Island came to the hospital with dark urine, which was ultimately found to be caused by acute hepatitis. After she developed a cough, physicians attributed the liver damage to a covid-19 infection.

Spiegel said he has seen more such reports every day, including one from China on five patients with acute viral hepatitis.

A particular danger of the virus appears to be its tendency to produce blood clots in the veins of the legs and other vessels, which can break off, travel to the lung and cause death by a condition known as pulmonary embolism.

Across New York City, blood thinners are being used with covid-19 patients much more than expected, said Sanjum Sethi, an interventional radiologist and assistant professor of medicine at Columbia Universitys Irving Medical Center.

Were just seeing so many of these events that we have to investigate further, he said.

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Coronavirus destroys lungs. But doctors are finding its damage in kidneys, hearts and elsewhere. - Latest News

Do the tiny, everyday things that help you feel better

My wife and I joke that weve been actually training for this pandemic for the past year dealing with Nusaybas cancer. We stopped socializing, abandoned work projects, read science and medical papers, and placed hand sanitizers, masks and gloves throughout the house. Were used to obsessing over any fevers because Nusayba is immuno-compromised.

With life rapidly spiraling, we took ownership over the daily routines we could still control. You can declutter and clean your house. The simple act of making your bed, brushing your teeth, wearing clothes and choosing your breakfast gives you a sense of autonomy.

If youre up for it, take time to cook or eat your favorite meal. The experience will provide a moment of comfort, a delicious taste you savor more during hardship. If you believe in God, then still maintain your prayers. Also, try to stick with the daily push-up routine, and continue reading the newspaper. Reunite with beloved sitcom characters on The Simpsons, flip through an old book or graphic novel, chain saw demons in Doom, or watch Goodfellas for the 12th time.

All of these seemingly mundane habits and activities will keep you spiritually, physically, creatively and mentally alive for the marathon and it will be a marathon.

A crisis like cancer helps us answer the question: What truly matters when we are stripped overnight of our comfort, wealth and plans?

Kindness does. Its the only way our humanity will endure during this crisis. After all, along with medicine, it was a strangers kindness that helped Nusayba survive.

I recommend focusing and investing in people and relationships. Make a list of your elders, your mentors, your friends, your family members, all those who helped you along the way. Spend a few minutes a day to call them, catch up, reconnect, and make amends if you must. A five-minute call can unburden a lifetime of regret and heal wounds.

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My Toddler Survived Cancer. Then Came the Coronavirus. - The New York Times