Category: Corona Virus

The rule of thumb, or rather feet, has been to stand six feet apart in public. Thats supposed to be a safe distance if a person nearby is coughing or sneezing and is infected with the novel coronavirus, spreading droplets that may carry virus particles.

And scientists agree that six feet is a sensible and useful minimum distance, but, some say, farther away would be better.

Six feet has never been a magic number that guarantees complete protection. The Centers for Disease Control and Prevention, one of the organizations using that measure, bases its recommendation on the idea that most large droplets that people expel when they cough or sneeze will fall to the ground within six feet.

But some scientists, having looked at studies of air flow and being concerned about smaller particles called aerosols, suggest that people consider a number of factors, including their own vulnerability and whether they are outdoors or in an enclosed room, when deciding whether six feet is enough distance.

No scientists are suggesting a wholesale change in behavior, or proposing that some other length for separation from another human, like seven, or nine feet, is actually the right one.

Everything is about probability, said Dr. Harvey Fineberg, who is the head of the Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats at the National Academies of Sciences, Engineering and Medicine. Three feet is better than nothing. Six feet is better than three feet. At that point, the larger drops have pretty much fallen down. Maybe if youre out of spitting range, that could be even safer, but six feet is a pretty good number.

One complicating factor is that aerosols, smaller droplets that can be emitted when people are breathing and talking, play some role in spreading the new coronavirus. Studies have shown that aerosols can be created during certain hospital or laboratory procedures like when using nebulizers to help patients inhale medication, which makes such procedures risky for doctors who do them.

If the aerosols that people exhale in other settings are significant in spreading the disease, the six-foot distance would not be completely protective because those are carried more easily by air currents.

Aerosols are generally considered to be particles under 5 microns in diameter, about the size of a red blood cell, and can be spread in the environment by talking and breathing. But some researchers argue that this is a false dichotomy. Infectious droplets cant easily be divided into those that are big enough to fall to the ground quickly and those that stay aloft because so much depends on environmental conditions and how deeply they penetrate into the respiratory tract.

Its really a continuum, said Dr. Donald Milton, who studies bioaerosols at the University of Maryland School of Public Health.

Even without the launching power of a sneeze, air currents could carry a flow of aerosol sized virus particles exhaled by an infected person 20 feet or more away.

In any confined geometry like an office room, meeting room, department store, food store, said Eugene Chudnovsky, a physicist at the City University of New York. In a study not yet peer reviewed, he analyzed air flow and showed how, the vortices in the air are taking the virus to different places.

A preliminary study at the University of Nebraska Medical Center found evidence of coronavirus genetic material on various surfaces in isolation rooms where infected patients were being treated, including on air vents more than six feet from the patients. The research, which has not yet been peer reviewed, indicates that the virus can occasionally travel long distances.

The virus is so small, it can hitch a ride even on tiny, tiny particles, Dr. Fineberg said. But how important is each size and how well they can transmit disease is not fully understood.

It is also unclear how many virus particles it takes to start an infection, how long the viral particles remain viable or if studies like the one in Nebraska simply detected the genetic calling card the virus left behind.

Spacing is an effective solution because it also reduces the number of people in a confined space. That reduces the likelihood of an infected person being in the group. And if there is one, fewer other people might be infected.

Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said the six-foot distance would clearly reduce the number of droplets you come in contact with. I have no doubt about that.

But, he said: The question is what does it take for you to get infected? And that I think is the trillion-dollar question we have.

He said, Maybe all it takes is an aerosol. You dont need any droplets at all. If thats the case, he said, then someone who is at high risk would not want to be in the same room with someone who is infected or might be infected.

Current guidelines already suggest that anyone at high risk should stay home and not be out in public in the first place. And they seem to be working. Places where people reduced travel and started social distancing weeks ago, especially in California, New York and Washington, are starting to show a reduction in the number of new coronavirus cases.

People still need to shop and take care of necessities, Dr. Osterholm said, but reducing the risk of exposure to all possible modes of transmission infected surfaces, droplets and smaller aerosols is important.

Your job is to limit it as much as you can.

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Stay 6 Feet Apart, Were Told. But How Far Can Air Carry Coronavirus? - The New York Times

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Good morning.

Were covering President Trumps decision to withhold funding from the World Health Organization, the lifting of some coronavirus-related restrictions in parts of Europe, and Barack Obamas endorsement of Joe Biden.

Governors from both parties said on Tuesday that, while they were a long way from telling Americans to return to their normal lives, it was not too early to make plans.

Some states, like California, shut down early and entirely, while a few more rural states have yet to adopt stay-at-home orders. Its possible that reopening the country could be similarly ad hoc.

President Trump, who a day earlier made the widely rejected claim that he had total authority to reopen the economy, said on Tuesday that he would work with the states.

Here are the latest updates from the U.S. and around the world, as well as maps of the pandemic.

Were also tracking the viruss growth rate in U.S. metro areas.

In other developments:

Bill Gates, the Microsoft founder who has donated much of his fortune to public health initiatives, was among those who criticized Mr. Trumps decision to halt American funding for the World Health Organization, which the president accused of a series of mistakes over the virus. Last year, the U.S. contributed about $553 million to the W.H.O., which is part of the United Nations and has a two-year budget of about $6 billion.

The details: Weve compiled expert guidance on several subjects, including health, money and travel.

The Times is providing free access to much of our coronavirus coverage, and our Coronavirus Briefing newsletter like all of our newsletters is free. Please consider supporting our journalism with a subscription.

Dr. Helen Ouyang has recorded her experiences for The Times Magazine, starting at the beginning of March, when New York State recorded its first coronavirus case.

Six weeks later, amid daily conversations about death, she wrote: Ive never felt less useful as a doctor. The one thing I can do what I think will matter most, in the end is just to be a person first, for these patients and their families.

Related: New York City sharply increased its death toll on Tuesday, after officials said they would include over 3,700 people who were presumed to have died of the virus but had never tested positive for it. The new figures appeared to increase the overall U.S. death toll by 17 percent, to more than 26,000.

Closer look: One of our writers visited a 68-bed field hospital in Central Park operated by the evangelical Christian relief group Samaritans Purse. Its the organizations first medical deployment in the U.S.

Public health experts have encouraged people to stay six feet from others, which is supposed to be a safe distance if a cough or sneeze spreads droplets that may carry coronavirus particles.

While no scientists are suggesting that another distance is actually the right one, some say longer is better. Sneezes, for instance, can launch droplets a lot farther than six feet, according to a recent study.

Quotable: Dr. Michael Osterholm, at the University of Minnesota, said he had no doubt that the six-foot distance would clearly reduce the number of droplets you come in contact with. But, he added: The question is what does it take for you to get infected? And that I think is the trillion-dollar question.

Closer look: Our 3-D simulation helps show why distancing is so important.

Dr. Li Wenliang tried to warn China about the coronavirus but was silenced by the government authorities. He became a hero in the country when his warnings proved true, then a martyr when he died from the virus in February.

Today, people gather, virtually, at his last post on Weibo, the Chinese social media platform, to grieve and seek solace in the comments section.

Our columnist Li Yuan writes: In a largely atheist yet spiritual nation with little tradition of praying, the digital Wailing Wall allows the Chinese people to share their sadness, frustration and aspirations with someone they trusted and loved.

Barack Obamas invisible hand: Mr. Obama, who endorsed Joe Biden on Tuesday, had kept his political distance from his former vice president. But he has been much more engaged in the end of the Democratic presidential primary race than has been previously revealed.

Snapshot: Above, a 150-foot siphonophore a colony of cells that clone themselves to produce an extended, stringlike body spotted off the coast of Western Australia. It could be the longest marine creature on Earth.

Late-night comedy: After former President Barack Obamas endorsement, Jimmy Fallon said, Obama said he knew Biden was the right candidate once he was absolutely sure Michelle wasnt running.

What were reading: This ESPN article about the complex family ties between Bruce Buffer, a mixed martial arts announcer, and Michael Buffer, a boxing announcer. Taffy Brodesser-Akner, a Times Magazine writer, calls it a great story about two long-lost brothers who had the same calling, which was to call things honestly, I couldnt put this down.

Cope: Dont know about the two-hour workouts, but you may be interested in taking up Megan Rapinoes skin-care routine. Maybe a 30-minute workout, no skin care? Heres how to exercise outside while wearing a mask. And Jazmine Hughes discusses how to be your own bartender.

We have more ideas about what to read, cook, watch and do while staying safe at home.

William Broad, a science and health reporter, recently wrote about a decade of health disinformation promoted by President Vladimir Putin of Russia. We spoke to him about his article.

How did you become interested in this story?

Last year, I wrote about how Mr. Putin and his aides were doing their best to scare Americans into thinking the new cellphone technology known as 5G posed dire health threats. In researching that article, I noticed other areas in which the Kremlin was hypocritically ringing false alarms especially on health issues and started gathering string.

Mr. Putin seems to have spent some of his early career as a K.G.B. agent working on foreign disinformation campaigns.

Yes, no question. He was a K.G.B. officer who rose to the rank of lieutenant colonel and worked in foreign intelligence. American experts say such officers had to spend a quarter of their time conceiving and carrying out plans for sowing disinformation. So hes been at this game for a very long time something on the order of four decades.

What do you think have been the biggest successes of this effort?

The Kremlins anti-vaccine campaign has done much to drive Americans away from childhood immunizations, helping to stir a resurgence of measles, a disease once seen as defeated. Last year, the U.S. had 1,282 new cases, with 61 resulting in major complications such as pneumonia and encephalitis.

How might Putins campaign influence coronavirus misinformation?

At worst, it seems as if the false information on the coronavirus may help prolong the pandemic and contribute to new cases of incapacitation and death.

Thats it for this briefing.

Need a lift? Eighteen of our writers shared small moments that recently lightened their mood.

Have a good day, and well see you next time.

Chris

Thank youMelissa Clark provided the recipe, and Theodore Kim and Jahaan Singh provided the rest of the break from the news. You can reach the team at briefing@nytimes.com.

P.S. Were listening to The Daily. Todays episode is about a day in the life of a Brooklyn hospital during the coronavirus pandemic. Heres todays Mini Crossword, and a clue: Misbehave (five letters). You can find all our puzzles here. The editors of our Book Review wrote to those whose livelihoods depend on books: Our hearts go out to the debut authors of the season, many of whom spent years, perhaps a lifetime, waiting for the dream moment when their first book would make its way into the world.

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What You Need to Know Today: Coronavirus, World Health Organization, Retail Sales - The New York Times

DETROIT Paris Banks sprayed the seat with Lysol before sliding into the last row on the right. Rochell Brown put out her cigarette, tucked herself behind the steering wheel and slapped the doors shut.

It was 8:37 a.m., and the No. 17 bus began chugging westward across Detroit.

On stepped the fast-food worker who makes chicken shawarma thats delivered to doorsteps, the janitor who cleans grocery stores, the warehouse worker pulling together Amazon orders.

By 9:15, every available row on the bus was occupied. Strangers sat shoulder-to-shoulder. The city might be spread across 139 square miles, but one morning last week there was no way to socially distance aboard this 40-foot-long New Flyer bus. Passengers were anxious and annoyed. Resigned, too.

I dont like it, but its something you have to do, Valerie Brown, 21, the fast-food worker, said through a blue mask. She was on her way to work at a local Middle Eastern fast-food chain.

This hardscrabble city, where nearly 80 percent of residents are black, has become a national hot spot with more than 7,000 infections and more than 400 deaths. One reason for the rapid spread, experts say, is that the city has a large working-class population that does not have the luxury of living in isolation. Their jobs cannot be performed from a laptop in a living room. They do not have vehicles to safely get them to the grocery store.

And so they end up on a bus. Just like the No. 17 a reluctant yet essential gathering place, and also a potential accelerant for a pandemic that has engulfed Detroit. It is a rolling symbol of the disparity in how this virus is affecting Americans.

After the citys roughly 550 drivers walked off the job for a day in mid-March because of safety concerns, city officials put in effect new measures. Riders had to enter through the back doors. Drivers would be offered gloves and masks. Buses would be cleaned more frequently.

Later, Mayor Mike Duggan said all of the citys front-line employees, including bus drivers, would get $800 a month in hazard pay. He also announced that masks would be made available to riders on all buses.

But on the first day of the mask initiative last week, there were no masks on board the No. 17 bus Rochell Brown was driving.

A manager told her that riders were not required to wear them.

Ms. Brown, 49, shook her head and thought about a colleague who died this month from complications of Covid-19, the disease caused by the coronavirus. It should be mandatory, she said of the masks.

She saw herself at risk of a similar fate. She had a heart attack two years ago and has hypertension. The night before this ride, her doctor suggested she take time off for her safety.

Yet here she was, on a sun-soaked, mild spring morning, performing an essential duty for $19.13 an hour, but without, she felt, the praise and appreciation that police officers and emergency medical workers received. No one was peering out of a window clapping for her. Her bus was not even equipped with masks.

The 17 line cuts a roughly 25-mile path across Eight Mile Road, the infamous dividing line between black Detroit and the white suburbs.

The route tells the story of these bizarre times. It traces streets devoid of traffic, winds through the completely empty parking lot of a temporarily shuttered mall and dips into the bustling parking lot of a grocery store, one of the few businesses that can still attract big crowds.

Thats where Demetrius Jordan, 37, hops off to work his job as a janitor. First order of business at work: wash his hands. The trip was a necessary risk for Mr. Jordan, who said he worried most about the people whose only respite from the elements was a seat on the bus.

My concern is about the homeless people on the bus, he said, adding that they were endangering themselves and others. Are they being checked out?

A notice on the Detroit Department of Transportation website asks that customers limit nonessential bus travel.

Drivers and passengers going to work say that is not happening. This trip on the No. 17 attracted riders headed to the store, to visit friends and family, and at least one homeless man.

Riders should be required to present proof that they are performing essential duties, Ms. Brown said.

I would appreciate that show some paperwork why youre out here, what Im risking my life for, she said. To me, too many people dont care.

A rider stepping off another No. 17 bus vented her frustration.

Im an essential worker, she yelled. I have to get out here and get the bus, but Im tired of getting on this bus with people that want to visit other people because they aint working and theyre at home and theyre bored.

Ms. Brown, the fast-food worker, boarded at the corner of East Eight Mile and Kelly Roads shortly before 9 a.m. to a bus that was still relatively empty. She sat at a window on the left. But within 20 minutes, a man sidled up right next to her.

It was kind of irritating because there was a lot of space, she said later. I was like, why do you want to sit right next to someone when there are so many seats?

With roughly the front third of the bus blocked off to protect the driver, passengers that morning were left with 29 seats to choose from. At peak ridership, there were 21 people on board at a single time.

Despite a statewide stay-at-home order, the buses are often packed, Ms. Brown said. If a bus is too crowded, she will sometimes wait for the next one. She does not like taking chances.

She lives with her mother, who is 46 and recently battled pneumonia. Ms. Brown does not want to bring the coronavirus home to her, or to her father and three siblings who also live in the four-bedroom house in the neighboring town of Eastpointe.

Im risking bringing it home, said Ms. Brown, who rides the bus seven days a week. And I work at a restaurant. Its a high risk for it, and you cant do anything about it really if your job is still open.

The bus made it to the end of the line in a brisk hour and 38 minutes. It headed back the other direction, and as more and more passengers piled on most wearing masks tensions rose.

When a rider tried to take a seat next to a young man with an American flag bandanna tied around his neck, the young man stopped him and pointed him to another seat. He then pulled the bandanna over his nose and mouth and tightened it.

An older woman carrying two shopping bags wedged herself into a seat in front of two riders. One of those riders recoiled, wondering why the woman had come so close. Excuse me, she said, the six-feet distance.

The older woman pointed across the aisle to where she had been sitting and said the woman behind her had been coughing. She wanted no part of that. The woman who had coughed was close enough to hear, and she mumbled a few choice words beneath her yellow mask.

Ms. Banks, who sprays her seat with Lysol before sitting, wondered whether the reduced service contributed to the packed buses. During the week, the buses are running on the Saturday schedule, meaning they come less frequently.

I take my own precaution by disinfecting; I still dont think its safe, she said.

She was a little scared about riding the bus, she said, and sometimes asked her co-workers for a ride. Ms. Banks, 27, said she worried that if she became infected, she would pass on the virus to others because her job with the National Guard often has her around a lot of people.

The crowds do not faze all passengers.

John Porter spread out on the back seat in black sweatpants and an unzipped brown jacket, his mustachioed face uncovered. He was headed home after his wife took the car to work.

I believe in the Lord, Mr. Porter, 63, said. If its going to happen, its going to happen.

A.J. Harris, 24, wore a mask but said he was not concerned about riding the bus. His attitude seemed more of resignation than bravado.

These buses have been dirty long before the coronavirus was going on, said Mr. Harris, on his way to work at an Amazon warehouse. You got on the bus every day with people having H.I.V. and bedbugs, all types of diseases. Its just another dirty bus coming along.

Ms. Brown, the driver, does what she can to manage the crowds.

She does not allow anyone to stand most other drivers do, so passengers tend to gripe when she tells them to sit. She will pass up stops when her bus is full, though she is loath to do that because she knows that some people need to get to work on time.

As she zoomed past a couple of stops, waiting riders threw their arms in the air. One person threw a plastic shopping bag at the bus.

Ms. Brown sees the disgruntled reactions and hears the snide comments coming from the back of the bus. On her way back to the beginning of the line, a man cursed her because she would not let him off between stops.

She arrived back to the first stop on a wide road between a hospital and brick bungalows at 11:57 a.m. Three hours and 20 minutes, and she had had enough.

Shortly after she stepped off the bus, a couple of passengers came asking for masks. Another driver who did not have masks on his bus would not let them get on without one. She did not have any, she told them, and they vented their frustration.

This is stressful, Ms. Brown said, and right there she decided it was best she followed her doctors advice. She was taking a two-week medical break.

This week, things were getting worse for riders, Valerie Brown, the fast-food worker, said in a text message. Officials had put signs on some seats, asking passengers to leave them vacant, but the message was being ignored, she wrote. It was standing room only on one ride, she said, yet the driver continued to pick up riders.

Ms. Brown texted two face-slapping emojis. Its never going to get better here.

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These Detroit Workers Have to Ride the Bus During the Coronavirus Pandemic - The New York Times

LONDON As Britain closes in on 100,000 reported cases of the coronavirus a solemn milestone in a contagion that has ravaged its political leadership a raft of new statistics suggests that the government is undercounting the human, and economic, cost of the epidemic.

The governments Office of National Statistics released data on Tuesday revealing that the death toll from the virus could be at least 10 percent higher than the official toll of 12,107 because that number does not take into account people who die in nursing homes or in their own residences.

At the same time, the Office for Budget Responsibility, a fiscal watchdog group, said the lockdown could shrink Britains economy by 35 percent in the second quarter and throw two million people out of work a prediction even worse than the governments darkest warnings.

Taken together, these new numbers cast a grim shadow over Britains response to the epidemic, which has already been dogged by shortfalls in testing and questions about the supply of ventilators and protective gear.

And the government, buoyed by the release of Prime Minister Boris Johnson from the hospital after his bout with coronavirus, found itself on the defensive about how it was handling both the surge in cases and the economic fallout.

It is important that we be honest with people about what might be happening, the chancellor of the Exchequer, Rishi Sunak, acknowledged at a briefing on Tuesday. These are tough times, and there will be more to come.

As in the United States and other countries, nursing homes in Britain have become hot zones for the virus. Two major operators have reported 521 deaths in their homes in recent weeks, many of which have not yet been reflected in the official statistics because of a lag in recording the deaths.

The daily death toll, which is published by Public Health England, has become the main barometer for measuring Britains handling of the crisis. But it covers only patients who died in hospitals, which has aroused suspicions that the government is trying to improve its performance relative to neighbors like France, which includes nursing home deaths in its statistics.

British officials said Tuesday that they would work to include the nursing home death statistics in the overall death figures, but noted it was difficult to do so because, unlike with hospitals, there is no centralizing reporting system for nursing homes.

Britains chief medical officer, Chris Whitty, estimated this week that 13 percent of the countrys nursing homes, or more than 2,000 facilities, had been struck by outbreaks. The nursing staff in many of those homes have complained about an acute shortage of masks, gloves, and other protective gear.

Critics said the government, in its intense focus on shoring up the National Health Service, was neglecting the nursing industry, which is more dispersed and run mainly by private companies and charities.

Its almost as if the system has been stacked against them, Baroness Ros Altmann, a member of the House of Lords who campaigns on behalf of the elderly, said to the BBC. Weve got to realize whats happening and step up the measures were taking to protect vulnerable elderly people.

In the data released on Tuesday, the Office of National Statistics reported that from the beginning of the year until April 3, there were 217 deaths from the coronavirus in nursing homes in England and Wales; 136 in private homes; and 33 deaths in hospices.

It estimated that 90.2 percent of deaths from the virus occurred in hospitals, while the rest occurred in nursing homes, hospices, or at home. The statistics do not include Scotland or Northern Ireland.

But for the week of March 28 to April 3, the office reported 16,387 deaths in England and Wales, the largest weekly total since it began compiling data in 2005, and 6,082 more than the five-year average death toll for that week. It reported that 3,475 deaths were registered as involving coronavirus.

This suggests either that people are dying of other illnesses at significantly greater than normal rates or that coronavirus is killing even more people than is being accounted for. Medical experts say the lockdown, and the strains on the National Health Service, are leading some people to put off elective surgery or treatments for chronic illnesses, which in turn leads to higher death rates.

Devi Sridhar, the director of the global health governance program at Edinburgh University, said the fuzziness in the data was further evidence of the governments failure to ramp up testing.

When you cant test, theres no way you can determine if the cause of death was coronavirus, she said.

While the government has promised to conduct 100,000 tests a day by the end of the month, it performed only 14,506 during the 24-hour period ending on Monday morning. That was lower than the 18,000 tests performed during a comparable period the previous weekend.

Mr. Sunak, the chancellor of the Exchequer, did not dispute the economic figures from the Office for Budget Responsibility, though he highlighted its assertion that this was just one scenario and that the economy could bounce back quickly from a deep trough once the lockdown was lifted. But some economists said they were skeptical of a rapid return to normality.

I dont buy that the U.K. is going to recover as strongly as the O.B.R. data would suggest, said Simon Tilford, director of research at Forum New Economy, an economic research institute. It assumes that a shock of this magnitude is not going to do any lasting damage to the economy.

Making up for lost consumption, particularly in the services sector, would be difficult, said Mr. Tilford, who described the long-term projections as overly optimistic. The report assumes that it is possible to put the economy into deep freeze and for it to jump straight back to life, he added.

Playing down reports of tensions within the government over when to reopen the economy, officials rejected reports that the Treasury is pushing for a speedy end to the lockdown. Mr. Sunak said the key to returning to economic health lies in first overcoming the medical crisis.

The lockdown is likely to extend well into next month.

In a sign of troubles to come, companies are showing greater than expected interest in the governments program to avert job losses by paying 80 percent of the wages of people unable to work because of the lockdown. In a survey, about 44 percent of companies said at least half their staff would be paid through the program.

The lockdown will clearly have a very significant impact on the economy including increased unemployment, lower government revenues and a higher level of national indebtedness, said Mel Stride, chairman of the House of Commons Treasury select committee.

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Is Britain Undercounting the Human and Economic Toll of Coronavirus? - The New York Times

Spread across 4,216 square miles of mostly wild country, including Grand Teton and Yellowstone National Parks, Teton County is nearly 3 times the size of Rhode Island. For all that space, only about 23,000 people live there year round. The countys sole hospital, St. Johns Health, has 24 ventilators and a dwindling supply of personal protective equipment.

Pete Muldoon, the mayor of Jackson, the county seat, says that the extreme wealth of some of the valleys part-time residents makes it more difficult for local people to stomach job losses from the lockdown, especially when they are wondering if the communitys health care resources will instead go to someone who might only have a house here to avoid paying taxes. Despite a great temptation to point fingers at the rich, Mr. Muldoon says, he reminds people that tax policies enable a small number of people to hoard all of the wealth.

It is difficult to know how many wealthy people have moved to Teton County to shelter in their mansions. Early on, the county urged outsiders to stay away. In late March, the countys health officer, Dr. Travis Riddell, was explicit, saying, Nonresident homeowners are strongly encouraged to leave or not travel to Teton County.

But a pharmacist reported to local health officials recently that he was processing a lot of prescription transfers from other states for three-month refills. And an employee for a company that provides services for the ultrawealthy (few people were willing to be quoted by name) told me that she estimated there are 30 percent more of those families around than usual at this time of year.

Weve done all we can to provide for them, such as grocery shopping and other services, she told me. Many came for spring break, went home, and then came right back. I know one family of six from Manhattan that has rented a house until August.

She said she feared going to work. I cant believe everyone is flocking here just to be safe, she said. I know you want to get out of New York and California. But I shouldnt be working, and you shouldnt be here either.

One physician told me, I know a doctor in town who was asked to go to someones property once the private ventilator arrived, to make sure it was operational. Disturbed by this hoarding of medical supplies, this person said, the doctor refused.

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Jackson Hole: Where the Rich Hide From Coronavirus - The New York Times

The United States has responded to the economic havoc wrought by the coronavirus with the biggest relief package in its history: $2 trillion. It essentially replaces a few months of American economic activity with a flood of government money every penny of it borrowed.

And where is all that cash coming from? Mostly out of thin air.

The traditional view of economic theory holds that governments and central banks have distinct responsibilities. A government sets fiscal policy spending the money it raises through taxes and borrowing to run a country. And a central bank uses various levers of monetary policy like buying and selling government securities to change the amount of money in circulation to ensure the smooth operation of the countrys economy.

But the relief package, called the CARES Act, will require the government to vastly expand its debt at the same time that the Federal Reserve has signaled its willingness to buy an essentially unlimited amount of government debt. With those twin moves, the United States has effectively undone decades of conventional wisdom, embedding into policy ideas that were once relegated to the fringes of economics.

Its an epic moment in terms of breaking down the orthodoxy of church-and-state separation of the fiscal and monetary authority, said Paul McCulley, a former chief economist of Pimco, a giant asset management shop.

Playing out in the background of this shift is a debate over what is known as modern monetary theory, which says countries that control their own currency can run much larger budget deficits than they typically do, in part because of the power of central banks to create new money to help finance the shortfall.

But to the theorys adherents, the lock-step maneuvers by the Fed and the government were not the arrival of a far-out idea but the removal of a fig leaf.

What its doing is just making more transparent a relationship between the Treasury and the Fed that has always existed, said Stephanie Kelton, a professor of economics at Stony Brook University and one of the theorys major advocates.

For those not attuned to the wonky worlds of monetary policy and government debt, the parallel policy changes might have been easy to miss.

On March 23, facing a roughly 30 percent stock market crash and growing dysfunction in key bond markets, the Fed announced its latest, and most significant, plan to pump cash into the financial system. The central bank said it would basically buy an unlimited amount of Treasury bonds and government-backed mortgage bonds whatever was necessary to support smooth market functioning.

In the world of central banking, this muted statement qualified as seriously radical. The new policy didnt put a number on the bonds the Fed would buy, a tacit nod to the idea that it could buy unlimited amounts.

Then, within days, President Trump signed a $2 trillion economic rescue package into law. That package alone equaled about half of what the federal government spent in all of 2019.

Nobody knows exactly how much the relief bill will add to the national debt; it was cobbled together so quickly that there wasnt time for the Congressional Budget Office to carry out an analysis, though one is expected to be published this week. But the Fed will be the biggest buyer by far of the bonds the government will sell to fund this spending.

Goldman Sachs analysts estimate the Fed will buy $2.4 trillion in Treasury securities as part of its recently reintroduced bond-buying programs. Economists at Morgan Stanley put the number at around $2.5 trillion in 2020 alone, rising to as much as $3 trillion for the entirety of the bond-buying program.

But the Fed isnt an ordinary bondholder: By law, it has to pay its profits to the Treasury.

That means when the Treasury makes payments on bonds held by the Fed either paying interest or paying it off at maturity almost all the money eventually moves back to the Treasury.

When a government bond is involved, the cash moves from one government pocket to another.

Once the central bank buys them, its as if the Treasury never issued them in the first place, said Dr. Kelton, who was an adviser to Senator Bernie Sanderss 2016 presidential campaign. For all intents and purposes, theyre retired.

The CARES Act borrowing is, in many ways, the natural result of an evolution that began with the 2008 financial crisis. The bond-buying programs that central banks undertook around the world helped ensure low-cost financing for governments running giant deficits as policymakers contended with a deep recession and a prolonged period of lackluster growth. And despite constant, high-decibel warnings that such an approach would surely ignite a surge of inflation, it never happened.

That was a legitimate concern: Financial historians often point to disastrous periods when a central bank printed money for the government to pay its debts. A common example is Weimar Germany, when the central bank churned out banknotes that allowed the fragile government to repay onerous World War I reparations with essentially worthless marks, impoverishing most of the country in the process.

But at other times, the idea has worked just fine: Japans central bank has been buying huge chunks of the governments bonds effectively financing the central government of the worlds third-largest economy for years without triggering the kind of inflation that traditional economic views would expect.

Adherents of M.M.T. have long argued that the United States can and probably should run much larger budget deficits than it did already. In recent years, this belief has been most often associated with left-leaning politicians such as Mr. Sanders and Representative Alexandria Ocasio-Cortez of New York.

But the ideas have found broader currency in some unlikely places, such as Wall Street. In recent years, some at huge money management firms and gold-plated investment banks have increasingly turned to M.M.T. as a useful analytical framework to understand the strong links between central banks and markets that have grown since the financial crisis.

M.M.T. has been invoked so many times by completely mainstream people and politicians, said L. Randall Wray, a professor of economics at Bard College who has written seminal papers on modern monetary theory. Even Trump used almost word for word what weve been saying all along. (You never have to default because you print the money, Mr. Trump said as a candidate in 2016.)

Other experts counter that coordination between the Fed and the Treasury may be justified in a national crisis, but that a continuing large-scale expansion of government deficits could have negative consequences, such as higher inflation.

I think the Treasury did the right thing. I think the Fed is doing largely the right thing, said Glenn Hubbard, a professor of finance and economics at Columbia University. There shouldnt be an ongoing dance of borrowing money and printing money. This isnt the lesson to learn from this episode.

Even so, the growing comfort with the Treasury Departments relying on the Fed to buy its bonds and help finance large deficits is an important shift in the conventional thinking of politicians and policymakers, said Mr. McCulley, who retired from Pimco in 2015 and now teaches at Georgetown University.

What this crisis has brought to the forefront is that this isnt an academic debate anymore whatsoever, he said.

Mr. McCulley said the speed with which the crisis took hold and the unique circumstances of a nearly nationwide lockdown of consumers meant political leaders had little choice but to vastly expand deficits. And, he said, those who usually question how deficits will be paid for have been rendered mute.

How do we pay for it? Mr. McCulley said. We print the damn money.

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How the Government Pulls Coronavirus Relief Money Out of Thin Air - The New York Times

The German zoo, which is struggling financially due to a lack of any patrons, said the plan was a worst-case scenario.

Posted on April 15, 2020, at 2:55 p.m. ET

Verena Kaspari, director of the Tierpark Neumnster, at the zoo.

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A zoo in Germany made international headlines on Wednesday after its director said staff may be forced to feed some of the park's animals to other animals as they confront possible financial ruin as a result of the coronavirus pandemic.

Tierpark Neumnster, which sits between Hamburg and the Danish border in Germany's north, has been closed to paying guests since March 15 as a result of a government order to shut down non-essential businesses in the country.

Director Verena Kaspari told the German Press Agency (DPA) and the Die Welt newspaper that as her zoo struggles to feed its roughly 700 animals amid the financial fallout they have drawn up emergency plans that involve some tough decisions.

"If and this is really the worst, worst case of all if I no longer have any money to buy feed, or if it should happen that my feed supplier is no longer able to deliver due to new restrictions, then I would slaughter animals to feed other animals," she said.

Representatives from the zoo did not respond to a request for comment, but a spokesperson confirmed Kaspari's comments to the New York Times. The spokesperson also told the newspaper that the zoo's 12-foot-tall polar bar, Vitus, would sit at the top of the proverbial food chain and be spared.

Kaspari told German public broadcaster Deutsche Welle that endangered animals would not be killed, but that any goats and deer would be first on the slaughter list.

"It's a worst-case scenario," she said. "We don't see it getting that way yet, but we have to think of it early enough."

Other animals at the zoo, according to its website, include alpacas, dingoes, deer, lynxes, seals, reindeer, wildcats, turtles, and chinchillas.

Vitus the polar bear swimming in his tank.

Germany's Association of Zoological Gardens, of which the Neumnster zoo is a member, clarified on Twitter that they did not support the idea.

"The proposal expressed by one animal park to kill animals because of financial losses due to the coronavirus does not represent our association's opinion," the group tweeted. "We are working on financial solutions to support our zoos until they're allowed to open their gates again."

On March 31, the association called for a government bailout of more than $100 million for its 56 member zoos in Germany. "Unlike other facilities, we cannot simply shut down our farm," Leipzig zoo director and association president Jrg Junhold said in a statement. "Our animals still have to be fed and cared for."

A zoo director in Hanover told German magazine Der Spiegel it costs more than $68,000 a day to run the zoo, but the park currently has no income.

Jan Philipp Albrecht, the environment minister for the state of Schleswig-Holstein, in which the Neumnster zoo sits, said the emergency slaughtering of zoo animals should not happen, noting that federal and state aid was available.

Kaspari said her zoo had applied for government assistance, but had received nothing so far and was relying solely on donations.

Germany currently has more than 130,000 confirmed cases of the coronavirus, but there have been around 3,600 deaths in the country a comparatively lower rate than countries with the same rate of infections. Germany and the UK both recorded their first cases on the same day in January, but Chancellor Angela Merkel moved quickly to scale up testing and contact tracing.

[Read more: The Coronavirus Hit Germany And The UK Just Days Apart But The Countries Have Responded Differently. Heres How]

While zoos in the US are also feeling economic pressure as a result of the coronavirus, Dan Ashe, president and CEO of the Association of Zoos and Aquariums (AZA), told BuzzFeed News he was confident that member zoos were still taking good care of their animals.

"While all AZA members are currently operating under severe economic stress, none is in a position where animal care is compromised," he said.

"If a similar situation [as the Neumnster zoo] were to occur at an AZA-accredited facility, I am confident AZA and its members would find a way to provide assistance," he said, "including by moving any animals the facility could not care for.

Kaspari, the Neumnster zoo director, said moving animals was also an option at her zoo, although that was easier for some animals than other larger predators, like Vitus the polar bear.

"If things get really tough here and the zoo has to be dismantled, I can't just put it in a box and transport it somewhere else," she said.

Kaspari doesn't believe her team will be forced to carry out its worst-case scenario because other animal parks have offered to send fish and meat to feed her zoo's predators should it come to it.

But, Kaspari noted, the slaughter of some animals to feed others is standard practice at zoos around the world.

"We have carnivorous animals," she said, "so that's nothing new."

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A Zoo That Closed Due To The Coronavirus Said It May Feed Some Animals To Others - BuzzFeed News

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Uncertainty has been the trademark of both the economic and public health crises caused by the coronavirus. Occasionally thats not a bad thing like in the emerging consensus that the initial models for case fatality rates and ICU beds needed were too high. But over the last few days, several new reports on the nature of the coronavirus showed how much more we need to learn about the virus before the effects of reopening the country can be fully anticipated. Below are four such alarming studies though approach with some caution, as the clinical understanding of the outbreak continues to change as testing expands.

Lets begin with the most morbid detail: Thailand is now reporting the first fatal case of coronavirus that was transmitted from a deceased patient to a medical examiner. Not just the medical examiners, but morgue technicians and the people in funeral homes need to take extra care, Angelique Corthals, a professor of pathology at CUNYs John Jay College of Criminal Justice, told BuzzFeed News. With the high daily death count pushing the capacity of morgues in cities across the country, the concern that bodies could transmit the virus is especially alarming, considering pictures from Sinai-Grace Hospital in Detroit showing bodies piled in vacant spaces in the facility.

For the vast majority of those who contract the virus and live, the Los Angeles Times reported on some potential and distressing long-term effects of COVID-19 coming out of a study published in China:

In a study posted this week, scientists in China examined the blood test results of 34 COVID-19 patients over the course of their hospitalization. In those who survived mild and severe disease alike, the researchers found that many of the biological measures had failed to return to normal.

Chief among the worrisome test results were readings that suggested these apparently recovered patients continued to have impaired liver function. That was the case even after two tests for the live virus had come back negative and the patients were cleared to be discharged.

At the same time, as cardiologists are contending with the immediate effects of COVID-19 on the heart, theyre asking how much of the damage could be long-lasting. In an early study of COVID-19 patients in China, heart failure was seen in nearly 12% of those who survived, including in some who had shown no signs of respiratory distress.

While concerning, the size of the study is far too small to draw a big-picture, epidemiological understanding of COVID-19s long-term effects on the body. Another caveat noted by the LA Times: The assessment of organ failure in coronavirus survivors is complicated by that fact that patients with disorders that affect the heart, liver, blood and lungs face a higher risk of becoming very sick with COVID-19 in the first place. That makes it difficult to distinguish COVID-19 after-effects from the problems that made patients vulnerable to begin with especially so early in the game.

Another study from researchers at Fudan University in Shanghai and the New York Blood Center provides more harrowing evidence for the long-term consequences of contracting the virus. According to the findings published in the journal Cellular & Molecular Immunology, when the researchers initiated contact between COVID-19 and lab-grown T lymphocytes better known as T cells the virus disabled the cells, which help identify and eliminate pathogens in the body. The researchers also found that SARS, a related coronavirus, could not infect T cells. The study found that COVID-19s damage to the T lymphocytes resembled that caused by HIV.

Though some doctors in the U.S. are stockpiling hydroxychloroquine for personal and family use, a small study in Brazil casts doubt on its efficacy for widespread use to treat the coronavirus. Countering some preliminary evidence that the antimalarial drug touted by the president effectively treats COVID-19, a study on its use on 81 hospitalized patients was halted after those taking a higher dose experienced irregular heart rates and increased risk of fatal heart arrhythmias. Like in U.S. hospitals, hydroxychloroquine was being administered with the antibiotic azithromycin commonly known as Z-Pak which also increases the risk of fatal heart arrhythmias in some patients.

But a trace of good news aside from the significant progress of decreased hospitalizations in New York is the anticipated hiring spree for contact tracing, which determines who confirmed patients interacted with while they were infected, simply by asking them. If federal and state governments are able to employ the vast number of tracers needed to determine the full level of community spread, it will have a significant impact on both the economic and public health crises. This will be the only way to contain further spread of COVID-19 once the initial surge is past, and get into the suppression phase, Tom Frieden, a former director of the Centers for Disease Control and Prevention, told STAT News. We need an army of 300,000 people.

Daily news about the politics, business, and technology shaping our world.

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Theres More Bad News on the Long-Term Effects of the Coronavirus - New York Magazine

WASHINGTON A crew member from the aircraft carrier Theodore Roosevelt who had the novel coronavirus died on Monday, in a poignant punctuation to the plea from the ships captain two weeks ago for help from the Navy because sailors dont need to die.

The death of the sailor came as Navy officials continued to struggle to combat the infection that has crippled the nuclear-powered ship, now docked in Guam. The name of the sailor is being withheld until 24 hours after family members are notified, Navy officials said.

The entire department is deeply saddened by the loss of our first active-duty member to Covid-19, Defense Secretary Mark T. Esper said in a statement. Adm. Michael M. Gilday, the chief of naval operations, called the death a great loss for the ship and for our Navy.

The death is already wrapped up in what has become a story of disjointed leadership in the Navy, where top officials pitted themselves against the ships captain and medical crew in the battle to contain the disease. Pleading for more help from the Navy to swiftly evacuate the ship as the virus spread, Capt. Brett E. Crozier implored officials to put concerns for the health of the sailors ahead of concerns for the ships ability to maintain military readiness should a war crop up.

We are not at war, Captain Crozier said in a March 30 letter to officials. Sailors dont need to die. Three days later, Captain Crozier was fired by Thomas B. Modly, the acting Navy secretary. Mr. Modly resigned five days later.

As of Monday, 585 Roosevelt crew members had the coronavirus, including Captain Crozier.

The same day that Captain Crozier was writing his letter, the sailor tested positive for Covid-19, Navy officials said. He was evacuated from the ship and placed in isolation on the American naval base on Guam, along with four other sailors.

On April 5, the sailor was admitted to the emergency department at the Guam naval hospital with respiratory issues and was discharged shortly afterward, military officials said. He returned to the isolation house, where health care providers did twice-daily checks, officials said.

At 8:30 a.m. on April 9, the sailor was found unresponsive during one of the checks and taken to the hospitals intensive care unit.

On Monday, military officials said that there were at least four other sailors from the Roosevelt in the hospital and that they were in stable condition.

The fate of Captain Croziers career now lies in the hands of Admiral Gilday, the Navys top uniformed official. He told reporters last week that the investigation of the Roosevelt matter, which he ordered, was complete and that he had started to review the findings.

Results could be made public this week, Navy officials said on Monday.

The inquiry, conducted by Adm. Robert P. Burke, a former submarine captain who is the vice chief of naval operations, relied on interviews with more than a dozen Navy personnel aboard the Roosevelt and in Captain Croziers chain of command, according to people familiar with the scope of the investigation.

Admiral Gilday said he had not ruled out any courses of action, including the potential of reinstating Captain Crozier, if that was where the investigation led.

I am taking no options off the table, Admiral Gilday said, adding that he had not spoken to the captain, who is in quarantine on Guam after testing positive for the coronavirus.

The pivotal issue, Admiral Gilday said, is why Captain Crozier felt compelled to send his four-page letter outside normal communications channels, and whether it illustrated a breakdown in communications with his chain of command.

Before the results are made public, Admiral Gilday will consult with Mr. Esper; the new acting Navy secretary, Jim McPherson; and Gen. Mark A. Milley, the chairman of the Joint Chiefs of Staff, Pentagon officials said on Monday.

Former top Navy officials said the service would probably be criticized regardless of what actions it took.

No matter the direction recommended, the critics of the action will align, said Sean OKeefe, who was the Navy secretary under President George Bush. The investigation will force actions regardless of whether they are popular or not.

Meanwhile, health care providers at the naval hospital on Guam have been directed by top levels of the Navy to begin a research project on the quarantined Roosevelt sailors that examines the serology of the coronavirus, to learn more about how the immune system responds to the infection, according to military officials.

The project has drawn anger from some of the providers because of a lack of any defined research protocol, compounded by safety concerns over the amount of protective equipment required and their already strained reserves. Some have refused to participate on ethical grounds.

In another sign of how the coronavirus has upended military deployments, the Navy said on Monday that the aircraft carrier Harry S. Truman, wrapping up a five-month tour to the Middle East, would remain at sea off the East Coast for at least three more weeks in case the warship and its Covid-free crew were needed elsewhere before returning to its home port in Norfolk, Va.

John Ismay contributed reporting.

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Sailor on Roosevelt, Whose Captain Pleaded for Help, Dies From Coronavirus - The New York Times

ATLANTA Twelve days before New Orleans celebrated Mardi Gras Day, the citywide pre-Lenten bash that would pack thousands of visitors onto the streets, Sarah A. Babcock, the director of policy and emergency preparedness for the city health department, prepared a list of bullet points about the troubling disease that had already sickened thousands in China but had only infected 13 known patients in the United States.

The chance of us getting someone with coronavirus is low, Ms. Babcock advised community health providers, according to internal emails obtained by Columbia Universitys Brown Institute for Media Innovation and reviewed by The New York Times.

The projection proved to be terribly off base, as New Orleans would soon erupt into one of the largest hot spots for the coronavirus in the U.S., with one of the nations highest death rates. Experts now believe that the multiweek Mardi Gras festivities likely served to accelerate the spread of the highly contagious disease in the New Orleans area.

In recent days, city officials, including Mayor LaToya Cantrell, have pushed back forcefully against any suggestion that they had erred by not canceling the celebrations. And they have found support among public health experts, who note that no major events were being canceled around the country in the run-up to Mardi Gras Day, on Feb. 25, when there were still only 15 confirmed cases of the coronavirus in the country.

I think we all were thinking that this was not going to be a huge issue, quite frankly, and then exponential growth started, said Dr. Carlos del Rio, Chair of the Hubert Department of Global Health at the Rollins School of Public Health of Emory University.

At the time, he added, I think the mayor would have been executed if she would have said, Lets cancel Mardi Gras.

Still, the emails, more than 2,200 pages in all, offer insight into how one major American city began planning in mid-January for the viruss eventual arrival, even as it continued to prepare for its signature annual party.

The plans were predicated on a misunderstanding one seen not just in New Orleans of how widely the virus had potentially already spread in the city and across the country.

Dr. Jennifer Avegno, director of the New Orleans Health Department, said that the citys focus before Mardi Gras was on visitors who might bring the virus with them. But there was no way for us to know if we had community spread, she said, because we could not test for it.

There was also a tragedy of timing: It was on Mardi Gras Day itself, as floats were rolling through the streets, that the Centers for Disease Control and Prevention issued its starkest warning up to that point that the virus would almost certainly spread in the U.S., and that cities should begin planning social distancing measures.

Ms. Cantrell, in a March 26 interview on CNN, defended the decision not to cancel Mardi Gras, noting that no red flags had been raised by federal officials at that point. On the day before Fat Tuesday, in fact, President Trump had tweeted: The Coronavirus is very much under control in the USA.

When its not taken seriously at the federal level, its very difficult to transcend down to the local level in making these decisions, Ms. Cantrell told CNN. But when the experts told me that social gatherings would be an issue, I moved forward with canceling them.

That was long after the last Mardi Gras floats had passed through the city.

On Friday, the C.D.C. released a report stating that Mardi Gras had occurred at a time when canceling mass gatherings was not yet common in the United States. It also described Louisianas elevated number of cases and its temporarily high population density because of an influx of visitors during Mardi Gras celebrations in mid-February.

The Mardi Gras season officially began this year, as it does every year, 12 nights after Christmas, when a 150-year-old carnival krewe, the Twelfth Night Revelers, held an elegant society ball. The next day, Chinese authorities thousands of miles away announced they had isolated the new coronavirus that had been sickening residents of Wuhan, the capital of Hubei Province in China.

By mid-January, according to the internal New Orleans emails, city and state officials were circulating and digesting the latest updates on the disease from the federal government, which advised them to look out for patients with a fever and symptoms of a lower respiratory illness, like a cough or shortness of breath, as well as a history of traveling from Wuhan.

On Jan. 21, Ms. Babcock circulated a statement among colleagues meant for the news media that said the departments emergency preparedness team had been monitoring the coronavirus for the past few weeks and began weekly conference calls with the CDC last week.

At this time, the note continued, the CDC is only recommending screening at airports that receive flights directly from Wuhan, China.

On Jan. 23, Chinese authorities closed off Wuhan, and its 11 million residents, in an effort to curb the spread there. Two days later, Dr. Avegno, the head of the New Orleans Health Department, told colleagues that the uptick in cases in China was coming fast and furious.

From that point, the emails show, the city appeared to go into a more concerted coronavirus preparation mode.

William T. Salmeron, the chief of Emergency Medical Services for the city, told his colleagues that workers should take routine exposure control precautions as they would in dealing with any respiratory illness. Those included getting the travel history of anyone with symptoms, giving patients surgical masks, and moving up to gloves, gown, protective eyewear and an N95 mask if travel history risk factors warrant.

At this time the potential risk of infection in the US is LOW, he wrote.

Collin M. Arnold, director of the citys homeland security office, sent an email to Dr. Avegno and other city officials on Jan. 27, suggesting they should probably get together and discuss public safety concerns during Mardi Gras and on the parade route.

The New Orleans Police Department, he said, had been asking about personal protective equipment and general concerns (they shake a lot of hands and come in contact with a lot of people on the route every day). He suggested putting together a guide sheet for all responders that would offer them common sense mitigation tasks.

That same day, Tyrell Morris, the executive director of the citys 911 service, told city officials about a questionnaire and worksheet that the International Academies of Emergency Dispatch was suggesting they use for all suspected coronavirus patients.

Dr. Emily Nichols, the medical director for the citys emergency medical services, suggested they add a question asking suspected carriers whether they had been within six feet of another person thought to be infected with the virus.

In late January, the city health departments emergency preparedness branch emailed local health care facilities with updates on an active shooter training set for Jan. 30 at Lambeth House, a retirement community in Uptown New Orleans. Lambeth House would eventually emerge as the site of one of the worst outbreaks in the South, with at least 13 residents dying from Covid-19.

The city was alive to the possibility of the virus arriving by air or by sea.

On Jan. 28, Mr. Salmeron proposed a meeting of city, state and airport officials to discuss emergency response actions to ill passengers arriving at the local airport. The president of the Louisiana Maritime Association reminded city officials that the Coast Guard would review incoming ships to the port of New Orleans.

A multiagency meeting was scheduled for Feb. 5, with Ms. Babcock telling state health officials that the city was trying to make sure that everyone is prepared for coronavirus before Mardi Gras.

The day of the meeting, the mayors office posted a news item on the citys website noting that the federal government had not recommended screening at Louis Armstrong New Orleans International Airport, and had begun rerouting all flights with passengers from China to one of 11 other airports where screening was taking place.

Our publichealth and health care systems are ready for Mardi Gras, it said, and the coronavirus poses a very low risk to the Carnival celebrations.

In an email sent Feb. 26, the day after Mardi Gras Day, Dr. Avegno made it clear that, while the city was taking the coronavirus threat seriously, officials were not yet planning to call for strict measures to limit its spread.

Im a little hesitant to put in the social distancing stuff but since CDC mentioned it, we probably should she wrote. I added some words to make it more clear we werent going to run around willy-nilly quarantining people, but would be following state/federal guidance.

Daily sit reps, or situation reports, began going out to New Orleans officials beginning March 3. While acknowledging the spread of the virus was a rapidly evolving situation, the city did not recommend any closures because the state had no confirmed cases.

A few days later, on March 9, the first presumptive coronavirus patient in Louisiana was identified in New Orleans a resident of nearby Jefferson Parish who was in a city hospital. Reports began surfacing of people in other states, including Arkansas, Texas and Tennessee, who had been to Mardi Gras and were testing positive for the virus.

The next day, Ms. Cantrell canceled a number of beloved street-level events that have traditionally served as raucous addenda to Mardi Gras parades celebrating St. Josephs Day and St. Patricks Day, and Super Sunday, in which the citys Mardi Gras Indian tribes display their beaded and feathered suits.

By March 16, three people had died from complications of Covid-19 in Louisiana and there were 136 confirmed cases in the state. Gov. John Bel Edwards ordered the closures of bars, gyms, and cinemas, and limited restaurants to takeout and delivery service.

Dr. Avegno said city and state officials had moved as quickly as they could once they realized what they were facing.

We shut down parades, we shut down schools within a week, completely changing our way of life, Dr. Avegno said. I cant think of anything more drastic than shutting down the bars of New Orleans.

Over the next several weeks, the virus continued its unabated spread across Louisiana.

By Monday, state officials had reported more than 10,500 coronavirus cases in Orleans Parish and the adjacent suburb of Jefferson Parish. Across the state, at least 840 residents infected with the coronavirus have died.

Richard Fausset reported from Atlanta and Derek Kravitz, a data journalist at Columbia Universitys Brown Institute for Media Innovation, from New York.

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Why New Orleans Pushed Ahead With Mardi Gras, Even as It Planned for Coronavirus - The New York Times