Category: Corona Virus

Cave nectar bat (Eonycteris spelaea) from Singapore. Justin Ng/Linfa Wang hide caption

Cave nectar bat (Eonycteris spelaea) from Singapore.

Updated at 11 a.m. ET

Dr. Linfa Wang, a virologist at the Duke-National University of Singapore, has been working around the clock to help Singapore fight this coronavirus. He hasn't hugged his daughter in over two months.

"We're in a war zone right now. Everything comes to me very fast," Wang said in an interview with NPR's Short Wave podcast. He's given over 100 interviews since January, when international reports first surfaced of a new coronavirus.

Since then, scientists have learned a great deal about the coronavirus, now called SARS-CoV-2. And one of the mysteries they're still trying to untangle is where the virus came from in the first place. Scientific evidence overwhelmingly points to wildlife, and to bats as the most likely origin.

Wang is an expert in emerging zoonotic diseases, or diseases hosted in animals that spread to humans. The CDC estimates that six out of ten infectious diseases in people come from animals. Among them are Lyme disease, Rabies, West Nile, and diseases caused by coronaviruses, including this coronavirus and the SARS virus.

The 2003 outbreak of SARS was eventually traced to horseshoe bats in a cave in the Yunnan province of China, confirmed by a 2017 paper published in the journal Nature. It was a detective hunt that took over a decade, sampling the feces, urine, or blood of thousands of horseshoe bats across the country and seeing if those samples are a genetic match to the virus.

The work of virus hunting of tracking an outbreak to its origin point can take years. Wang stresses that pinpointing the true origin of this coronavirus will take time as well. "Of course, the technology and everything is much more advanced 17 years later [since the 2003 SARS outbreak]. But, for us to try to solve everything in two to three months is just not feasible."

'This is a product of nature'

In early January 2020, Chinese scientists sequenced the entire genome for SARS-CoV-2 and published it online. Researchers at the Wuhan Institute of Virology in China compared its genome to a library of known viruses and found a 96% match with coronavirus samples taken from horseshoe bats from Yunnan.

"But that 4% difference is actually a pretty wide distance in evolutionary time. It could even be decades," says Dr. Robert F. Garry, professor of microbiology and immunology at Tulane University School of Medicine.

That extra 4% suggests the SARS-CoV-2 may not have evolved from bats alone, but may include viral material from another animal. In that case, the virus would have continued to evolve through natural selection in that animal. Moreover, that other animal may have acted as an "intermediate host," ultimately transmitting the virus to humans.

With this coronavirus, scientists aren't fully clear on whether an intermediate host was involved nor the chain of cross-species transmission to humans. Studies have found a genetic similarity between this coronavirus and coronaviruses found in pangolins, also called scaly anteaters, which are vulnerable to illegal wildlife trade.

Given that some China's earliest COVID-19 patients were connected to the Hunan Seafood Wholesale Market in Wuhan, it is likely the seafood market played a role in amplifying the virus. However, there is not enough evidence to prove that is where the virus transmitted from animals to humans. There is also evidence emerging that among the first 41 patients hospitalized in China, 13 had no connection to this particular marketplace. The path of the pathogen is still unknown.

As for clues the virus holds about its animal origins, Robert Garry and fellow researchers have hypothesized that SARS-CoV-2 could be a blend of viruses from bats and another animal.

"The receptor binding domain actually shares a lot of sequence similarity to a virus that's found in the pangolin" Garry said, referring to the receptor-binding mechanism that allows the virus to form a strong attachment to human cells. "So, those sequences probably did arise from a virus like the pangolin coronavirus, or maybe some other coronavirus that can circulate in pangolins or some other animals." Further genetic analysis is needed to figure this out.

In studying the genome, Garry also confirms the virus came from wildlife. "This is a product of nature. It's not a virus that has arisen in a laboratory by any scientist, purposely manipulating something that has then been released to the public," he said.

'It's A Billion Dollar Question'

So, why are bats such good hosts for viruses?

"I used to say it's a million dollar question. Now I say it's a billion dollar question," said Wang, speaking to NPR's Short Wave podcast on Tuesday.

Bats are critically important for pollinating flowers and dispersing seeds. They catch bugs, the same ones that bite us and eat some of our crops. But bats also harbor some of the toughest known zoonotic diseases.

The Rabies virus, the Marburg virus, the Hendra and Nipah viruses all find a natural reservoir in bats, meaning those viruses live in bats without harming them. The Ebola outbreak in West Africa was traced to a bat colony. The SARS virus originates in bats, along with other coronaviruses. And now, SARS-CoV-2 is linked to bats too.

Wang believes bats' high tolerance for viruses may have to do with the fact that they are the only mammal that's adapted for flight.

"During flight, their body temperature goes all the way to 42 degrees (or 108 degrees Fahrenheit). And their heartbeat goes up to 1000 beats per minute," Wang said.

Flying several hours a day, bats burn a great deal of energy. This creates toxic free radicals that damage their cells, but Wang's research has shown that bats have also evolved abilities to repair and minimize that cellular damage. Those same defensive abilities may help them not only tolerate flight, but also to fight infectious diseases in a way that human bodies cannot.

"Our hypothesis is that bats have evolved a different mechanism to get the balance right for defensive tolerance. And that favors the virus to live peacefully with bats," said Wang.

Peter Daszak, President of the U.S.-based non-profit Ecohealth Alliance, says that even if bats are the origin, they are not to blame for the pandemic.

"It's not bats. It's us. It's what we do to bats that drives this pandemic risk," Daszak said. His research demonstrates how interactions between wildlife and livestock, food and agriculture practices, as well as humans close proximity to animals in densely populated areas, create the conditions for viral outbreaks.

"One of the positive things about finding out that we're actually behind these pandemics is that it gives us the power to do something about it. We don't need to get rid of bats. We don't need to do anything with bats. We've just got to leave them alone. Let them get on, doing the good they do, flitting around at night and we will not catch their viruses," Daszak said.

Given that infectious and zoonotic diseases have been on the rise for decades, Wang is frustrated by the fact that countries around the world failed to understand the impact this novel coronavirus outbreak would have.

"I'm so angry right now. This COVID-19 outbreak, before January 20th, you could say it's China's fault. The Chinese government. But after January 20th, the rest of the world is still not taking it seriously. Our political system, our diplomatic system, our international relationship system is just not ready," Wang said.

January 20th is when Chinese health officials confirmed the new coronavirus could be transmitted between humans and the World Health Organization kicked into high gear to evaluate the global risk. There were more than 200 cases then. Now, the confirmed case count is nearing 2 million worldwide.

Email the show at shortwave@npr.org.

This episode was produced by Brit Hanson, edited by Viet Le, and fact-checked by Emily Vaughn.

Originally posted here:

Where Did This Coronavirus Originate? Virus Hunters Find Genetic Clues In Bats - NPR

The whole nationalist populist surge was connected to an historical moment where you could afford to play with fire, she noted. But now the situation is really bad, so much more dangerous, and people dont want the easy nonsense from media-savvy populists.

She cited polls showing that Matteo Salvini, the noisy Italian populist, has been losing support on the right, while another far-right opposition politician, Giorgia Meloni, on the rational, coolheaded, nonpopulist right, has done better.

Much of the public reaction may ultimately depend on how long the sense of crisis lasts, the onslaught of the virus being uncertain and open-ended. The unlocking of the lockdown will itself be fraught with political danger.

Though we see these leaders making decisions, theyre not making them from a position of strength, but from uncertainty and weakness, said Nicholas Dungan, a Paris-based senior fellow at the Atlantic Council.

Theyre not leading so much as administering, he said. And once people are out and about, and not confined anymore doing their duty, people are going to be quite angry, and this will lead to greater instability.

Tony Travers, professor of government at the London School of Economics, noted that Winston Churchill was revered for having presided over the victory over Hitler, but was summarily tossed out of office in 1945.

Winning a war is absolutely no recipe for staying in office, Mr. Travers said. When the threat of illness goes away, then the consequences of being protected from the threat are very different.

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Coronavirus Has Lifted Leaders Everywhere. Dont Expect That to Last. - The New York Times

Countries under coronavirus lockdowns should only ease those restrictions if they can control new infections and trace contacts, the World Health Organization says. Here, Hashim, a health care worker, recently greeted his daughter through a glass door as they maintained social distance due to the COVID-19 outbreak in New Rochelle, N.Y. Joy Malone/Reuters hide caption

Countries under coronavirus lockdowns should only ease those restrictions if they can control new infections and trace contacts, the World Health Organization says. Here, Hashim, a health care worker, recently greeted his daughter through a glass door as they maintained social distance due to the COVID-19 outbreak in New Rochelle, N.Y.

For the billions of people now living under some form of stay-at-home or lockdown orders, experts from the World Health Organization have new guidance: We should be ready to "change our behaviors for the foreseeable future," they say, as the agency updates its advice on when to lift COVID-19 lockdown orders.

The question of when to ease shutdowns is a hot topic, as economic output is stalled in many countries including the U.S., now the epicenter of the global pandemic.

"One of the main things we've learned in the past months about COVID-19 is that the faster all cases are found, tested, isolated & care for, the harder we make it for the virus to spread," said WHO Direct0r-General Tedros Adhanom Ghebreyesus via Twitter as the guideline was released. "This principle will save lives & mitigate the economic impact of the pandemic."

The coronavirus has killed tens of thousands of people. It has also reshaped society and disrupted daily life for people around the world including 1.4 billion children whose educations are now derailed by shutdowns, WHO says. The pandemic has triggered massive losses for big companies and small businesses, and forced millions of people out of work.

While full national lockdowns remain uncommon, at least 82 countries have some form of lockdown in place, according to UNICEF.

The global economy is now predicted to shrink by 3% this year, the International Monetary Fund says in its most recent analysis. That includes a contraction of nearly 6% for the U.S. economy.

Despite all the personal and economic pain the coronavirus has caused, WHO officials say that in many places, it's too soon to get back to normal. And because any premature attempts to restart economies could trigger secondary peaks in COVID-19 cases, they warn that the process must be deliberate and widely coordinated.

"You can't replace lockdown with nothing," Dr. Mike Ryan, executive director of WHO's emergencies program, said at a recent briefing. Stressing the importance of a well-informed and committed population, he added, "We are going to have to change our behaviors for the foreseeable future."

Any government that wants to start lifting restrictions, said Tedros of WHO, must first meet six conditions:

1. Disease transmission is under control

2. Health systems are able to "detect, test, isolate and treat every case and trace every contact"

3. Hot spot risks are minimized in vulnerable places, such as nursing homes

4. Schools, workplaces and other essential places have established preventive measures

5. The risk of importing new cases "can be managed"

6. Communities are fully educated, engaged and empowered to live under a new normal

The worldwide number of COVID-19 cases is quickly approaching the 2 million mark, including more than 120,000 people who have died, according to a COVID-19 dashboard created by Johns Hopkins University's Whiting School of Engineering.

The number of new cases continues to rise sharply in the U.S., where disagreements over the potential restarting of economies recently prompted at least 10 states to band together in regional coalitions. The governors of those states say they not President Trump or the federal government will determine when to resume normal activities, based on health statistics and science.

Even in instances where governments can lift some lockdown conditions, Ryan said, "Health workers are going to have to continue to have protective equipment and we're going to have to continue to have intensive care beds on standby, because as we come out of these lockdown situations, we may see a jump back up in cases."

The goal is to taper restrictions so governments in communities, cities and nations can avoid a cycle of new COVID-19 outbreaks.

"We don't want to lurch from lockdown to nothing to lockdown to nothing," Ryan said. "We need to have a much more stable exit strategy that allows us to move carefully and persistently away from lockdown."

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New Guidance From WHO On When To End A Coronavirus Lockdown : Goats and Soda - NPR

A priest in Innsbruck, Austria, views photographs of his absent congregation. Austria easedsocial distancing today.

By Kai KupferschmidtApr. 14, 2020 , 4:10 PM

Sciences COVID-19 reporting is supported by the Pulitzer Center.

The world is holding its breath.

After the novel coronavirus made its way from China around the world, one country after another adopted harsh measures to stop SARS-CoV-2 from spreading and overwhelming hospitals. They have hit the pause button on their economies and their citizens lives, stopping sports events, religious services, and other social gatherings. School closures in 188 countries affect more than 1.5 billion students. Borders are closed and businesses shuttered. While some countries are still seeing daily case numbers increase, othersfirst in Asia but increasingly in Europehave managed to bend the curve, slowing the transmission of COVID-19.

But what is the exit strategy? Weve managed to get to the life raft, says epidemiologist Marc Lipsitch of the Harvard T.H. Chan School of Public Health (HSPH). But Im really unclear how we will get to the shore.

As they seek a path forward, governments around the world must triangulate the health of their citizens, the freedoms of their population, and economic constraints. Could schools be reopened? Restaurants? Bars? Can people go back to their offices? How to relax the lockdown is not something around which there is a scientific consensus, says Caroline Buckee, an epidemiologist at HSPH. Most researchers agree that reopening society will be a long haul, marked by trial and error. Its going to have to be something that were going to have to take baby steps with, says Megan Coffee, an infectious disease researcher at New York University.

The number to watch in the next phase may no longer be the actual number of cases per day, but what epidemiologists call the effective reproduction number, or R, which denotes how many people the average infected person infects in turn. If R is above 1, the outbreak grows; below 1 it shrinks. The goal of the current lockdowns is to push R well below 1. Once the pandemic is tamed, countries can try to loosen restrictions while keeping R hovering around 1, when each infected person on average infects one other person, keeping the number of new cases steady.

To regulate R, Governments will have to realize that there are basically three control knobs on the dashboard, says Gabriel Leung, a modeler at the University of Hong Kong: isolating patients and tracing their contacts, border restrictions, and social distancing.

Singapore, Hong Kong, and South Korea have all managed to keep their epidemics in check through aggressive use of the first control. They identify and isolate cases early and trace and quarantine their contacts, while often imposing only light restrictions on the rest of society. But this strategy depends on massively scaling up testing, which has been hampered by a scarcity of reagents and other materials everywhere. The United States will be able to do millions of tests per week, says Caitlin Rivers of the Johns Hopkins Center for Health Security. Although our testing capacity has grown a lot in the last couple of weeks, we are not where we need to be yet, she says.

Contact tracing is another hurdle, and it is labor intensive. Massachusetts is hiring 500 contact tracers, buta recent report by Rivers and othersestimates that the United States as a whole needs to train about 100,000 people.

Mobile phone apps could help by automatically identifying or alerting people who recently had contact with an infected person. (Public health departments, not generally known anywhere in the world to be at the forefront of technological innovation, will have to adapt very quickly, Leung says.) But Western countries have yet to implement these systems. Google and Apple have teamed up to incorporate a contact tracing app in their operating systems. Germany, France, and other countries are developing apps based on a protocol calledPan-European Privacy Preserving Proximity Tracing. It relies on short-range Bluetooth signals to gauge the proximity between two devices without logging their exact locations, which helps sidestep some privacy concerns.

But short of making these technologies compulsory, as China has done, how can a country ensure that enough people download an app for it to provide reliable information and influence the spread of disease? And what exactly counts as a contact? If I live in a big apartment block, am I going to be getting dozens of notifications a day? asks epidemiologist Nicholas Davies of the London School of Hygiene & Tropical Medicine (LSHTM). Davies adds that widespread use of the apps will further drive up the demand for testing.

As to the second control knob, border restrictions, most countries have already banned entry to almost all noncitizens. Quarantining returning citizens, as New Zealand and Australia began to do in the past few weeks, further minimizes the risk of new introductions of the virus. Such measures are likely to remain in place for a while; the more a country reduces transmission domestically, the greater the risk that any new outbreaks will originate with travelers. And foreign visitors are generally harder to trace than citizens and more likely to stay at hotels and visit potential transmission hot spots, says Alessandro Vespignani, a disease modeler at Northeastern University. As soon as you reopen to travelers, that could be something that the contact tracing system is not able to cope with, he says.

The third dashboard dial, social distancing, is the backbone of the current strategy, which has slowed the spread of the virus. But it also comes at the greatest economic and social cost, and many countries hope the constraints can be relaxed as case isolation and contact tracing help keep the virus in check. In Europe, Austria took the lead by opening small shops today. Other stores and malls are scheduled to follow on 1 May, and restaurants maybe a few weeks later. A13 April report from the German National Academy of Sciencesargued for slowly reopening schools, starting with the youngest children, while staggering break times and making masks mandatory. But French President Emmanuel Macron has said Frances lockdown will remain in place until 11 May.

Choosing a prudent path is difficult, Buckee says, in part because no controlled experiments have compared the effectiveness of different social distancing measures. Because we dont have really strong evidence, she says, its quite hard to make evidence-based policy decisions about how to go back. But Lipsitch says that as authorities around the world choose different paths forward, comparisons could be revealing. I think theres going to be a lot of experimentation, not on purpose, but because of politics and local situations, he says. Hopefully the world will learn from that.

Lockdowns lower the number of new cases as well as R, the effective reproduction number. If R drops below 1, the epidemic shrinks.

Centre for mathematical modeling of infectious diseases/CC BY 4.0; ADAPTED BY X. LIU/SCIENCE

Finding out how any particular measure affects R is not straightforward, because infections that occur today can take weeks to show up in disease reports. In 2004, mathematician Jacco Wallinga of the Dutch National Institute for Public Health and the Environment and colleagues published a statistical method to estimate R in real time, which is now used around the world. Researchers are also incorporating data on mobility patterns and peoples behavior to make the estimates more accurate. Having real-time estimates of R is important, says Adam Kucharski, a modeler at LSHTM: If governments put a measure in or lift it, they can get a sense of what the immediate implications are, rather than having to wait, he says.

Theres one other, unknown factor that will determine how safe it is to loosen the reins: immunity. Every single person who becomes infected and develops immunity makes it harder for the virus to spread. If we get 30% or 40% of the population immune, that really starts to change that whole picture, it helps us a lot, because it would bring R down by the same percentage, says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, Twin Cities.

Immunity will inevitably build up as more people become infected, but some researchers argue for ramping up immunity more quickly, by letting the virus spread in younger people, who are less susceptible to severe illness, while cocooning more at-risk patients, such as the elderly. The United Kingdom floated this herd immunity idea in February but backed away from it, as did the Netherlands. If you get to herd immunity any way other than through widespread vaccination, it is devastating, says Jeremy Konyndyk, a senior policy fellow at the Center for Global Development. Even briefly considering it left the United Kingdom in a dramatically worse place than they needed to be, he says.

But some scientists say other countries should consider it once the strain that the first wave of cases has put on their health care systems eases. Is it better to have a controlled burn in younger populations right now than it is to prevent it? I think thats a very important conversation to have, Osterholm says.

Skeptics doubt that vulnerable populations could really be protected. In many countries, multiple generations live under one roof, and young people work at nursing homes. Nor are scientists certain that COVID-19 produces robust, long-lasting immunity. Several studies seek to address these questions.

For now, the most likely scenario is one of easing social distancing measures when its possible, then clamping down again when infections climb back up, a suppress and lift strategy that both Singapore and Hong Kong are pursuing. Whether that approach can strike the right balance between keeping the virus at bay and easing discontent and economic damage remains to be seen.

Even Singapore and Hong Kong have had to toughen some social distancing measures in recent weeks after a surge of cases, Lipsitch notes; Singapores social distancing regime is no longer very different from that in New York City or London. And both cities strategies are much harder to implement across a big country like the United States. We have to have every single town and city and county be as good as Singapore for this to work, he says.

Jeremy Farrar, head of the Wellcome Trust, says a path out of the dilemma now facing the world will come from research. It might take the form of an effective treatment for severely ill patients, or a drug that can prevent infections in health care workers, orultimatelya vaccine. Science is the exit strategy, Farrar says.

With reporting by Kelly Servick.

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Ending coronavirus lockdowns will be a dangerous process of trial and error - Science Magazine

Trump Halts U.S. Funding of World Health Organization  The New York Times

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Trump Halts U.S. Funding of World Health Organization - The New York Times

The IRS declined to comment about whether the payments to the deceased would have to be repaid to the government. Generally the agency has said that recipients will not have to pay back any of the money.

Representative Thomas Massie, a Kentucky Republican, said he was alerted to the situation by a text message from a friend whose late father received a payment.

This stimulus program is ripe for waste, fraud and abuse and this dead person receiving a check is just the tip of the iceberg, Massie, one of the few lawmakers who opposed the $2.2 trillion economic rescue bill, said in an interview. He said the government should move away from stimulus payments and reopen the economy.

Errors such as payments to the recently departed are a consequence of lawmakers trying to balance accuracy with getting the money into bank accounts and mailboxes quickly, said Gordon Gray, director of fiscal policy at the American Action Forum, a conservative policy research group.

Congress erred on the side of speed, which nearly everyone agreed was the right answer in this case, said Gray, a former tax counsel in the U.S. Senate. The mechanisms we have to get money to people mean that some people have died since they last interacted with Treasury and as far as Treasury knows, that person should get a check.

Michael Zona, a spokesman for the Senate Finance Committee, said the panel was looking into the issue.

The payments to the deceased were one of the glitches with the program as the payments began hitting bank accounts and the IRS launched a web page to let recipients see when their money will be sent and whether they will receive it by direct deposit or a mailed check.

Phyllis Jo Kubey, a tax preparer in New York City, said several of her clients received error messages after trying to access the IRSs Get My Payment tool earlier Wednesday. The website said high demand was causing some delays.

The IRS said in a statement that the website is operating smoothly and more than 6.2 million taxpayers have successfully received their payment status while almost 1.1 million taxpayers have successfully provided banking information.

If the site volume gets too high, users are sent to an online waiting room for a brief period until space becomes available. The IRS said in a statement that the online tool will be updated once a day.

The IRS urges taxpayers to only use Get My Payment once a day given the large number of people receiving Economic Impact Payments, according to the statement.

The IRS began sending more than 80 million payments via direct deposit this week to middle- and low-income households. Mailed checks for those who dont have bank account information on file will start going out next week, but it could take months for all the payments to be distributed.

Individuals earning up to $75,000 or couples earning up to $150,000 are eligible for a $1,200 payment per adult and $500 per child under 17. The payments phase out above that income level, and individuals earning more than $99,000 or couples with a combined income of $198,000 dont get anything.

To see when payments will be sent, people will need to provide their Social Security number, date of birth and mailing address. Those wishing to submit bank account information also need to upload the adjusted gross income on their most recent tax return, as well as the amount of their most recent refund or amount owed.

People who filed tax returns in 2018 or 2019 can add bank account information to receive direct payments instead of waiting to receive a paper check.

The IRS released a separate website last week to allow people who arent required to file tax returns to provide their bank account information.

The agency will send recipients a notification about two weeks after they were scheduled to receive their payment with the details of how they should have received the money and how to report payments that dont arrive.

To see when payments will be sent, people will need to provide their Social Security number, date of birth and mailing address. Those wishing to submit bank account information also need to upload the adjusted gross income on their most recent tax return, as well as the amount of their most recent refund or amount owed.

People who filed tax returns in 2018 or 2019 can add bank account information to receive direct payments instead of waiting to receive a paper check.

The IRS released a separate website last week to allow people who arent required to file tax returns to provide their bank account information.

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Recipients of coronavirus stimulus checks include the recently deceased - The Boston Globe

BERLIN Slowly, tentatively, a handful of European countries began lifting constraints on daily life this week for the first time since the start of the coronavirus crisis, providing an early litmus test of whether Western democracies can gingerly restart their economies and restore basic freedoms without reviving the spread of the disease.

On Tuesday, Italy, the epicenter of Europes crisis, reopened some bookshops and childrens clothing stores. Spain allowed workers to return to factories and construction sites, despite a daily death toll that remains over 500. Austria allowed thousands of hardware and home improvement stores to reopen, as long as workers and customers wore masks.

In Denmark, elementary schoolteachers readied classrooms so young children could return to school on Wednesday, while in the Czech Republic, a restless public relished the reopening of sports centers and some shops.

When Lukas Zachoval, a sales manager in the Czech Republic, lost a tennis match to his father this week in a 6-4, 6-3 drubbing defeat had seldom tasted sweeter. After all, it was his first match since the Czech government began lifting sweeping restrictions on society, including a ban on communal sports, that had been in place for nearly a month.

I cannot live without sports, Mr. Zachoval explained.

The easing of the lockdowns was watched with interest and trepidation across Europe and beyond, and posed profound and knotty questions.

How much are we willing to pay in order to save peoples lives? asked Jana Puglierin, director of the Berlin office of the European Council on Foreign Relations, an independent research group. And when do we do more damage when we keep the lockdown in place, or when we open it up early?

The fledgling, country-by-country loosening, enacted without any coordination between nations, underscored the absence of any common agreement, or even understanding, about the challenge of keeping economies alive while stemming the disease. The International Monetary Fund has warned that the global economy is headed for its worst performance since the Great Depression.

A similar debate over how to reopen society is taking place in the United States, where President Trump has insisted that he calls the shots on the matter, prompting objections from the leaders of several states. Mr. Trump, himself under fire and his poll numbers falling as the dispute intensified, said Tuesday that he would halt funding to the World Health Organization, which he accused of making mistakes that allowed the virus to spread.

As the slow, piecemeal approach in Europe suggests, restrictions on daily life will probably not end in one clean break. Instead, people can expect a series of staggered interventions and loosening, probably over a period of weeks or months, if not considerably longer.

At the start of the crisis, many people had the feeling that we could shut down Denmark for two to three weeks and then we could reopen, free of the virus, said Peter Munk Christiansen, head of political science at Aarhus University in Denmark.

But theres been a gradual realization that that wont happen, he said. People accept we have to have a gradual opening, and also that this wont have gone away by the summer. It will stay here perhaps for years.

On a continent where the supply chains are closely interconnected, economic gains may be slowed by the asymmetric approaches taken by European governments.

Relieved as Mr. Zachoval was by the easing of some measures in the Czech Republic, his income remains stymied by restrictions still in force elsewhere.

Like many Czech companies, Mr. Zachovals saw factory depends heavily on buyers in Western Europe. But most countries there have kept their borders shut, even as the Czech Republic partly opens its own, or their sales rooms closed, even as Mr. Zachoval hopes to step up production.

On Tuesday, Mr. Zachoval fielded a few orders from his home country, but nothing from his main markets in Germany, France and Italy.

A lot of other states are not working fully, Mr. Zachoval said in a telephone interview. And were an exporter, so we dont feel the change too much.

If it continues, he said, in a few weeks I think well have to stop production, because orders are just not coming.

At a summit meeting in late March, the 27 heads of states in the European Union acknowledged the need for their countries to emerge from their respective lockdowns in a coordinated exit strategy, and called on the blocs leadership to create a joint plan.

But so far, such a plan has yet to be agreed upon. Last week, the president of the blocs administrative arm, Ursula von der Leyen, postponed a news conference at which she had been expected to announce it.

The absence of a united approach has long-term implications for Europes economic revival, said Derek Beach, an academic who researches European integration at Aarhus University.

If Germany, for example, takes a different approach to constraining the virus than its neighbors, the government might not risk fully reopening its borders for fear of undermining its public health efforts. Yet without open borders, the Continents economy will not properly function.

The lack of coordination here is such a big issue, Professor Beach said. Unless you have a common strategy, you have to keep the borders closed. But if the borders are closed, then do the supply chains still work over an extended time period?

Even within individual countries, the easing of restrictions has lacked a cohesive approach.

In Spain, workers could nominally return to factories, but many were not needed because of a lack of demand. And those who did return were sometimes fearful for their health.

I dont agree with it, but what else can you do? said a 52-year-old electrician in Barcelona, who asked to be identified only by his first name, Jos. If my bosses call me, and I say no, they wont call me again.

In Italy, booksellers cited a lack of clarity about whether people could now travel from neighboring towns to visit their shops, or only from the surrounding district.

Mauro Marrani, who works at his wifes bookstore in Florence, said he had written to the president of his region for an answer. Mr. Marrani was also confused by a requirement that the bookshop provide customers with disposable gloves which are almost impossible to find.

Amid this uncertainty, he said, he had made only one sale in five hours.

Its all very vague, Mr. Marrani said. If it remains this way, I think were better off closing altogether, and waiting until all stores reopen.

Among economists, there were also questions on Tuesday about whether they wield the right tools to assess Europes post-lockdown economy.

Its a new world, said Carl-Johan Dalgaard, one of four Danish economics professors who form the presidency of the Danish Economic Councils, known informally as the Wise Men.

Denmarks decision to reopen some schools and kindergartens makes sense, said Professor Dalgaard, who teaches at the University of Copenhagen, since it should allow parents to be more professionally productive.

But in general, the relationship between how the economy functions and how the coronavirus spreads is not yet fully understood, he said.

There will need to be a conversation between epidemiologists and economists to understand this two-way street between the epidemiology and the economics, said Professor Dalgaard. These tools are not yet available.

Elisabetta Povoledo contributed reporting from Rome, Raphael Minder from Madrid, and Elian Peltier from Barcelona.

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Coronavirus Restrictions Are Eased in Europe - The New York Times

Major League Baseball employees, from players to stadium workers to executives, are participating this week in a 10,000-person study aimed at understanding how many people in various parts of the United States have been infected with the coronavirus.

Each participant will have a finger pricked to produce blood that will be tested for the presence of antibodies, which indicates a past infection even in people who have never displayed symptoms of Covid-19, the disease caused by the coronavirus. The test for the virus itself can reveal only a current infection.

One of the biggest hurdles in determining when to reopen parts of the United States is the uncertainty about the number of people who have been infected over all and who, as a result, may now have some sort of immunity.

Teams of researchers from Stanford University, the University of Southern California and a prominent antidoping lab in Salt Lake City are collaborating on the study involving M.L.B. They believe it is the first and most extensive research of its kind in the United States.

This kind of study would have taken years to organize outside of this setting, said Dr. Jay Bhattacharya, a professor of medicine at Stanford who is leading the study. With the help of M.L.B., weve managed to do this in a matter of weeks.

As the coronavirus pandemic spread and sidelined sport after sport, Daniel Eichner, the president of the Sports Medicine Research and Testing Laboratory in Salt Lake City, realized that his facility would have few, if any, antidoping responsibilities for quite a while.

So, Eichner said, his laboratory redirected its focus and ordered large quantities of antibody tests that had been used successfully in some Asian countries.

To carry out representative testing, the researchers needed a large group of people who were spread all over the country. Bhattacharya said that he had reached out to an array of corporations, and that M.L.B., which already had a relationship with Eichner, was the quickest to agree. The major leagues, in response to the pandemic, shut down spring training on March 12 and have no specific plans to resume play.

Theres nothing in it for the teams or M.L.B. on this one, Eichner said. This is purely to drive public health policy.

Bhattacharya said M.L.B.s pool of employees offered a big swath of the American population. He added that nearly all of M.L.B.s 30 teams were participating and that it was up to each team to distribute the tests.

Because many M.L.B. employees and players live in areas with shelter-in-place rules in effect, many kits have been mailed to participants. The test can produce results in 15 minutes, Bhattacharya said, and photographs documenting the results can be submitted electronically to the researchers.

A spokesman for the baseball players union said the study was voluntary, strictly part of independent research aimed at gathering data its not connected to resumption of play and players identities will be separated from the data.

In addition to studying the M.L.B. populations, the researchers are using the tests Eichner provided to conduct antibody screening in Los Angeles and in Santa Clara County, Calif.

Bhattacharya said he hoped to analyze the data from M.L.B.s employees and players and write a paper as soon as possible, to help guide the easing of stay-at-home restrictions.

Id love to be able to go to Fenway Park someday again, he said. But thats not really the main purpose. The main purpose is so that we can inform nationwide policy in every community about how far along we are in this epidemic and if it is safe enough to open up the economy.

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M.L.B. Employees Become the Subjects of a Huge Coronavirus Study - The New York Times

SAN FRANCISCO California has been ahead of the rest of America in confronting the coronavirus pandemic, locking down its citizens early and avoiding, so far, the worst-case scenarios predicted for infections and deaths.

But as the national conversation begins to shift to reopening and President Trump beats the drum of economic revival, Californias extremely cautious approach toward the virus is a measure of how complicated it will be to restart the country.

Were not going to flip the switch and suddenly have the economy return to what it was and everyone come out of their homes simultaneously, Mayor Eric Garcetti of Los Angeles said in an interview. Peoples physical interactions, peoples spatial understandings, peoples risk-taking will come slowly.

As Americas premier gateway to China, California was, early in the pandemic, seen as one of the most vulnerable states to the spread of the virus. In January, close to 600 direct flights from China carrying around 150,000 people landed in the state, more than twice as many as landed in New York.

But two and a half months after the first cases were detected in Southern California, scientists are scrambling to explain the California conundrum: The state, despite its large, globe-traveling population, ranks 30th in the nation in coronavirus deaths per capita and has a fraction of the mortality rate that New York and New Jersey have suffered. As of Monday, San Francisco had recorded 15 deaths.

Much remains unknown about the coronavirus, and experts are still trying to understand why it is affecting some areas more than others. But figuring out why it has spread much less intensely in Americas most populous state than initially feared will be important in planning next steps, experts say.

As it has with so many other policies, California went its own way on confronting the virus. In moving toward recovery its leaders are inching forward, having repeatedly said that success can quickly turn to failure.

How the nations largest economy calibrates the reopening will have huge ramifications for the rest of the country, providing examples of what works, and what does not, especially given limits on testing capacity.

Gov. Gavin Newsom said on Tuesday that the state would eventually replace its broad-based stay-at-home orders with more localized and less restrictive measures. But he did not give a time frame, saying he would revisit the question in two weeks.

Ask me the question then. I know you want the timeline but we cant get ahead of ourselves, Mr. Newsom said. Lets not make the mistake of pulling the plug too early.

We want to see hospitalization numbers flatten and start to decline, the governor said, adding that the state would also have to build up its testing capacity, better protect older and more vulnerable people and ensure that hospitals have enough supplies.

Face coverings will likely remain a feature of public life, at least for a time, he said. Patrons of restaurants will likely have their temperature taken before being seated, and servers will wear masks and gloves. Large gatherings over the summer were not in the cards, he said, and in the fall, students may attend school in shifts to avoid crowded classrooms.

Normal it will not be, he said.

The reasons for the early promising signs in California are numerous, experts say. The state was the first to issue stay-at-home measures, and even before the orders came down, Californians were beginning to keep their distance from one another, while New Yorkers were still packing bars and restaurants.

Other factors include a work-from-home culture at many companies, spurred by the tech industry; a dry and sunny February that brought people away from crowded spaces and into the outdoors; and even the fact that the San Francisco 49ers lost the Super Bowl, avoiding a crowded victory parade.

Californias deep experience confronting natural disasters has also helped it address the pandemic. Not only does the state have a vast government machinery in place to handle disasters, but its populace has experience following orders at a time of calamity.

Several experts are advancing another explanation, too: Features that have long been viewed as liabilities the states solitary car culture and traffic-jammed freeways, a dearth of public transportation and sprawling suburban neighborhoods may have been protective.

Life in California is much more spread out, said Eleazar Eskin, chair of the department of computational medicine at the University of California, Los Angeles. Single-family homes compared with apartment buildings, work spaces that are less packed and even seating in restaurants that is more spacious.

Many scientific studies have found a correlation between population density and the spread of flu and other infectious diseases, something that may exist for the coronavirus as well.

Moritz Kraemer, a scholar at Oxford University, conducted a study with 12 other scientists across the world that relies on data from China. The study, which has not yet completed peer review, shows that more crowded areas had both higher coronavirus infections per capita and more prolonged epidemics.

The more space you have, the less probability there is for transmission, said Dr. Kraemer, who is also leading a team of researchers in mapping the global spread of the virus.

But California still has numerous weak points, and experts stress that density is only one of many factors in the spread of a disease that is still poorly understood.

Nursing homes and other settings where people congregate have been hit hard. The authorities discovered 102 cases at a single homeless shelter in San Francisco.

Jeffrey Shaman, a professor of environmental health sciences at Columbia University, where he has been deeply involved in modeling the spread of the disease, said it was likely that some aspects of West Coast culture helped dampen the early spread of the virus. But that does not argue, he said, for car congestion as a cure-all.

Some experts like George Rutherford, a professor of epidemiology at the University of California, San Francisco, put more emphasis on early government action in mitigating the spread of the virus. Dr. Rutherford said the nations first stay-at-home orders by officials in the San Francisco Bay Area, led by the Santa Clara chief health officer, Dr. Sara Cody, were crucial.

Thats where the credit belongs, Dr. Rutherford said.

Dr. Rutherford pointed out that his commute on mass transit in the Bay Area resembled one in New York City more than in Los Angeles.

I easily come within six feet of 200 people a day, he said.

Yet even in San Francisco, the nations second-densest major city, cars are much more common than in New York. San Francisco has one vehicle for every two people while the ratio in New York is one to four, according to data from the Department of Motor Vehicles.

Experts say understanding the dynamics of spread will be crucial for the next phases of the pandemic, as the authorities look for ways to open up the economy while avoiding a wide-scale and deadly second wave of the disease.

Mr. Garcetti, the Los Angeles mayor, has been guided by history, spending his nights and weekends studying how California cities responded to the 1918 flu pandemic. One of his key takeaways is that acting too soon to reopen could be disastrous, citing a second wave of infections in 1918 that proved more deadly than the first.

In 1918, L.A. acted quickly and kept with it, he said. In contrast, San Francisco, he said, had also done really well but then came out of it too quick, and had a second spike in the short term, which killed a lot of people.

Epidemiologists say transmission dynamics will differ by state, city and neighborhood.

In a push to better understand the scope of peoples interactions, Dr. Eskin is leading a survey effort in California and beyond. The survey asks what symptoms the participant has experienced, if any, and the locations of the supermarkets and pharmacies where he or she goes.

We want to give the public health authorities the data that they need for them to make decisions on when they should let people go back to work or the kids go back to school, Dr. Eskin said.

But even as California officials consider data that shows the outbreak here is far less intense than initially feared, they are being cautious in predicting a loosening of restrictions anytime soon.

Mr. Garcetti, for instance, has been touting the idea of using wide-scale testing to determine who is immune, and then allowing those people to resume some measure of normal life.

The idea of folks having an immunity passport, or something that allows them to be able to work, certainly would accelerate for me our economic recovery and my ability as mayor to lift the orders for some people, he said recently.

But that plan would require wide-scale testing, which California does not have.

An immunity passport, Mr. Garcetti said, is still a while off.

Thomas Fuller reported from San Francisco and Tim Arango from Los Angeles. Adam Nagourney contributed reporting from Los Angeles and Matt Richtel from San Francisco. Susan C. Beachy contributed research.

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California's Coronavirus Shutdowns Set the Tone. What's Its Next Step? - The New York Times

Abbott Laboratories announced Wednesday the launch of its third test for the coronavirus and said it could be screening up to 20 million people for antibodies for Covid-19 by June.

Abbott said it plans to distribute 4 million of the new antibody tests by the end of this month, after an initial shipment of 1 million tests this week to US customers, beginning Thursday.

"Antibody testing is an important next step to tell if someone has been previously infected," Abbott said in a press release.

"It will provide more understanding of the virus, including how long antibodies stay in the body and if they provide immunity," the company said.

Abbott's two other coronavirus tests, which only recently were introduced, determine whether a person has Covid-19 now.

One of those tests can tell in 13 minutes or less if a person at a testing site is currently infected, while the other test is performed in labs.

The new antibody test announced Wednesday will reveal if a person also had been infected in the past, even if they were no longer sick.

Infectious disease experts have said that such antibody screenings, also called serological tests, will be needed to track the spread of the coronavirus in the United States and elsewhere, and to develop containment strategies.

"We continue to contribute in a significant and meaningful way by providing new solutions across our diagnostics testing platforms," Abbott CEO Robert Ford said in a statement.

"I'm extremely proud of the many Abbott people who are working around the clock to get as many tests as we can to healthcare workers and patients."

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Abbott announces new coronavirus antibody test that could do up to 20 million screenings in June - CNBC