Category: Corona Virus

BRUSSELS As a poorer, battered south asks a richer, frugal north for solidarity, youd be forgiven for thinking the coronavirus is throwing Europe back into last decades economic catastrophe. Youd be wrong. This time is set to be far worse.

The pandemic and the havoc the coronavirus is wreaking on European economies has echoes of the eurozone debt crisis, but this calamity is hitting everyone, not just smaller wayward nations, and it goes well beyond the economy. It presents a watershed moment for the future shape of the European project.

A growing number of officials and analysts believe the European Union needs an enormous financial response on a scale commensurate with the calamity. Short of that, they warn, the bloc risks inviting an even larger disaster, as well as losing legitimacy.

There are obvious links to the lack of solidarity with the eurozone crisis era of austerity and the handling of the migration crisis, said Janis Emmanouilidis, a senior analyst at the Brussels-based think tank European Policy Center. People now are also asking, What do we have the European Union for?

The very scale of the looming depression is focusing the minds of European leaders, and the fact that this crisis, unlike last time, does not come from some perceived profligacy may ultimately knock down the reluctance to putting up aid. The question is what shape that solidarity will take.

European finance ministers failed to reach an agreement over a list of measures in a marathon meeting that started on Tuesday and broke up Wednesday morning. They will reconvene on Thursday to try to hammer out a consensus on how to stave off the worst of the looming economic maelstrom.

European officials said that there was broad agreement on some measures, for example a loan program valued at 100 billion euros, or $109 billion, that will help member states fund temporary unemployment benefits.

But despite debating for 16 hours, the ministers were unable to reach a consensus on how to use the euro area bailout fund, created to tackle last decades crisis, to distribute loans without the brutal austerity restrictions Greece had to face. The European Investment Bank, it seems likely, will provide billions in support of small businesses.

Once the finance ministers reach an agreement, their bosses, the leaders of the European Union countries, will meet via teleconference to finalize the measures, which in total could amount to hundreds of billions of euros.

But as sweeping as those measures may be, they will disappoint some members.

At least nine of the 19 leaders of the countries in the common-currency bloc, and some leading policymakers in Brussels, believe the euro area needs to issue joint bonds, commonly referred to as Eurobonds or in the context of the current crisis, corona-bonds.

In the acrimonious overnight meeting, finance ministers from those countries demanded at the very least a reference to this approach in any final report, but it proved impossible to get an agreement.

Collective debt would be a first for the bloc, and has been fiercely opposed by wealthier states like Germany and the Netherlands. They argue that, by treaty, every member nation of the European Union is responsible for its own finances. Floating these bonds would also be legally difficult and time-consuming, opponents say.

Each member state has launched its own interventions, and if we aggregate those, were talking about rather big figures, said Paolo Gentiloni, the European commissioner for the economy and a former Italian prime minister, who supports the idea of joint bonds. But we are a union, 19 member states who have a common currency.

It is crucial to have a common fund to face the crisis, and help the recovery, he added. How can you have a common fund? Only by issuing bonds, obviously.

Key to this is a question that has been nagging for nearly two decades: How can 19 of the now 27 European Union countries share a currency, the euro, and not use some, even limited, common debt to weather crises?

And the coronavirus counts as a crisis by any measure. The currency unions third- and fourth-largest economies, Italy and Spain, seem set to shrink by more than 10 percent, while the largest, Germany, could also shrink by 10 percent, unleashing a domino effect. By comparison, the euro area shrank by 4.5 percent in the post-financial crisis recession in 2009.

The stimulus that will be needed because of the damage caused by the epidemic is being estimated at more than 2 trillion, or $2.18 trillion. At stake wont be just the survival and recovery of each individual economy, but potentially the survival of the euro.

Eurobonds are the solution, a serious and efficient response, adapted to the emergency we are living, said Prime Minister Giuseppe Conte of Italy in an impassioned address to the nation on Monday.

Prime Minister Pedro Snchez of Spain, where the death toll has approached 14,000, has called for a new Marshall Aid plan for the reconstruction of Europe.

Without solidarity there can be no cohesion, without cohesion there will be disaffection and the credibility of the European project will be severely damaged, he warned.

Europes de facto top leader, Chancellor Angela Merkel of Germany, this week called the coronavirus outbreak and its aftermath the greatest test for the European Union since its inception.

Germany will only do well in the long run if Europe is doing well, Ms. Merkel told reporters at a news conference. The answer to current events, she said, was more Europe, a stronger Europe and a well-functioning Europe in all its parts, meaning in all its member states.

But Ms. Merkel stopped short of backing joint debt.

For Ms. Merkel, loans with few strings attached and German subsidies for unemployment benefits elsewhere in Europe were already quite brave measures, and as far as she was prepared to go.

She and other northern European leaders have signed off on waiving rules that normally punish European countries for running high deficits.

They have also implicitly backed a decision by the European Central Bank to launch a new bond-buying program that will see it swoop up the debt of eurozone countries, buying time for leaders to work out their next moves.

Joint debt has been a foundational step in the creation of federal states, most notably of the United States in the late 18th century,

In Europe in the age of coronavirus, it has been elevated to an existential question for the future of the bloc.

Why? Because these bonds imply a clear and explicit sharing of the cost incurred to fight the Covid-19 crisis, as a symbol of European solidarity, says Silvia Merler, head of research at the Algebris Policy Forum, the research branch of an investment fund based in Milan.

But they are by no means the only tools on the table, she added.

One key obstacle to joint debt is the scar tissue from the eurozone debt crisis of last decade, in which the bloc paid hundreds of billion of euros to Greece and another four countries, demanding in exchange some of the harshest austerity measures in modern history, to ensure no nation sought such bailouts opportunistically in future.

The wounds of that crisis are still deep, as is the feeling in Italy and Greece that the European Union was also not there to help much with the migration crisis that peaked in 2015-2016.

Mr. Gentiloni and others are keen to stress that, despite a fleeting resemblance, this time is different.

I think it is a completely different crisis, Mr. Gentiloni said. In itself this crisis is an equalizer, it is affecting at different speed and intensity more or less all of Europe, all countries, it is not concentrated like the financial and migration crises were.

And the debate over how to respond is more mature too, experts noted, pointing to the fact that even conservative German economists were no longer talking about solidarity as if it meant charity, as they had in the past.

When the Greek crisis started back at the end of 2009, the question of European solidarity was much more controversial, Ms. Merler said. Back then, policymakers could not even agree among themselves on whether it was legal for euro area countries to help financially a member in distress.

As the debate over assuming joint debt goes on, the European approach in the meantime to fighting the coronavirus will look similar to how Europe tends to respond to crises: a patchwork of imperfect measures.

Theyll build substandard instruments that are not good enough, but do the job at first, and they will keep kicking the can down the road, said Shahin Valle, a French economist who is a senior fellow at the German Council of Foreign Relations, and previously served as a senior adviser to the European Council during the eurozone crisis.

It wont be a make-or-break moment like some predict, Mr. Valle said. Instead well just continue to hobble along on our crutches.

Katrin Bennhold contributed reporting from Berlin, Emma Bubola from Rome and Raphael Minder from Madrid.

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As Europe Confronts the Coronavirus, What Shape Will Solidarity Take? - The New York Times

BERLIN Austria is allowing small shops to resume business after Easter. Denmark is reopening nurseries and primary schools. The Czech Republic is planning to lift a travel ban.

Gingerly, and with plenty of caveats, some corners of Europe are tiptoeing toward a loosening of the strict lockdown measures that have been in place for close to a month to slow the spread of the coronavirus, idling economies and leaving citizens in an uneasy limbo of social isolation.

But even as the number of new infections appears to be plateauing in several European countries, the message from leaders is clear: The next phase is not a return to normality. It is learning how to live with the pandemic possibly for quite a long time.

Wearing a face mask and speaking behind plexiglass, Chancellor Sebastian Kurz of Austria illustrated what that new normal might look like when he announced a step-by-step resurrection of the economy this week. We are not out of the woods, he said.

Prime Minister Mette Frederiksen of Denmark was more explicit: Its like walking a tightrope, she said. If we stand still, we may fall. If we go too fast, it may soon go wrong. We dont know when well be on firm ground again.

This weeks announcements came as China lifted its lockdown of the city of Wuhan on Wednesday, a powerful symbolic victory for the country and for a world battling a virus that first emerged there.

European governments are eager to give their citizens a sense of hope and to reboot economic activity, too. But overshadowing that desire is the real risk of unleashing a second wave of mass infections and deaths.

How soon is too soon to allow the resumption of some activities and which activities is the overriding question.

While the number of deaths from the disease continues to accelerate in the United States, it has begun stabilizing in parts of Europe and even declined in hard-hit countries like Italy. But the number of new daily infections in major countries like Germany, France and Britain, the three largest on the continent, may peak only after Easter.

Austria, Denmark and the Czech Republic, the three countries that have begun planning an exit from the lockdowns, are all smaller nations that moved early to shut down public life and perhaps as a result have been spared the worst of the fallout from the pandemic.

Many other countries are reluctant to announce a concrete timetable. The European Commission abandoned plans to present a road map for ending restrictions this week after several capitals insisted that such a move would send a dangerous message at a time when they are still asking millions of people to stay at home.

On Wednesday, the World Health Organizations director for Europe, Hans Kluge, warned that despite seeing positive signs, it was too early to roll back containment measures.

Now is not the time to relax measures, he told a news conference. It is the time to once again double and triple our collective efforts to drive toward suppression with the whole support of society.

Instead of searching for a return of normality, many experts warn that living with the virus may be the new normal, at least for months to come. The only time the world could hope to return to anything resembling pre-coronavirus normality was after a vaccine had been found, they said.

This wont go away until we have an effective vaccine, hopefully in 12 months time, said Walter Schachermayer, a professor of mathematics at the University of Vienna who was consulted by Mr. Kurzs team on their exit timetable.

The idea that immunity would rise fast enough in any country to allow social distancing measures to be abandoned before then without paying for it with an exorbitant death toll and overwhelming hospitals was a total illusion, Professor Schachermayer said. There is the constant risk of a second wave.

After the Spanish flu first emerged in 1918, he noted, a second wave killed millions a year. There are already signs of a second wave now building in some East Asian countries that recently ramped up business.

That is why, even as Chancellor Kurzs government announced its tentative opening, it made clear that the situation needed to be constantly monitored and reserved the right to impose restrictions quickly again.

We will very closely monitor the number of new infections and will immediately pull the emergency brake if need be, he said.

That monitoring will require a high volume of testing, Professor Schachermayer said. Its hard to get it right, because everything comes with a delay of two weeks because of the viruss incubation period, he said.

Even so, European leaders and their populations worry that the consequences of not allowing a broader resumption of economic activities could be devastating, too.

As the strain on hospitals intensive care units eases, the conversation has begun shifting from the immediate goal of saving lives to the longer-term goal of saving livelihoods.

Even in Italy, officials have begun talking about phase two of the national shutdown starting next month.

This is an extraordinary result, the countrys health minister, Roberto Speranza, said on Italian television on Tuesday evening after the latest statistics showed that the rate of contagion had decreased from one person infecting around three people to one person infecting only one.

The measures have worked, and we can finally start planning the future, he said.

In Spain, Prime Minister Pedro Sanchez said a ban on all nonessential work might be lifted after Easter, even as he extended the lockdown in his country until April 26. When we have the curve under control, we will shift toward a new normality and toward the reconstruction of our economy, Mr. Sanchez said.

What exactly that new normal will look like is unclear, though it is likely to involve mandatory masks in enclosed public spaces and smartphone apps tracking contact with people who are potentially infected. Going back to work and traveling might be contingent on test results, and potentially the presence of antibodies that might provide a measure of immunity.

Early versions of this new reality will soon be rehearsed in Austria, Denmark and the Czech Republic, all of which moved quickly in response to the pandemic.

It paid off. When Austria went into lockdown in mid-March, the number of infections was doubling every three days. Now, with new infections receding every day over the past week, that period has slowed to two and a half weeks.

Austria acted quicker and more decisively than other countries, Mr. Kurz told The New York Times in emailed comments. We have managed to prevent the worst. This also enables us to get quicker out of the crisis again.

Small shops, hardware stores and garden centers will be allowed to reopen on April 14, followed by other businesses at the end of the month. Restaurants and services that involve close human contact, like gyms and hairdressers, might not get the green light until mid-May or June.

The gradual acceleration of economic activity is accompanied by strict new rules requiring people to cover their nose and mouth in shops and on public transport and many more months of strict social distancing. Overseas travel is off the cards for now, and most schools might remain closed until the fall. In Denmark, day care centers and primary schools are scheduled to reopen on April 15, though that is subject to the number of infections stabilizing.

Every incremental loosening can be reversed at any point.

Denmark has seen daily deaths gradually decline from a peak a week ago. But restaurants and borders will remain closed for now. The government has also banned large gatherings through August.

Meanwhile, the Czech Republic extended a state of emergency until the end of April even as Prime Minister Andrej Babis announced a loosening of travel restrictions from Thursday. Borders will remain closed to foreigners, but Czechs who need to go abroad will be authorized to do so. Small shops are allowed to reopen on Thursday.

We are now able to manage the pandemic relatively well, the Czech health minister, Adam Vojtech, told a recent news conference. Its not the pandemic that is managing us.

If shutting down economies was hard, reopening them will be even harder, officials warn.

The fact that the countries now pioneering the reboot in Europe have chosen such different paths highlights the absence of any clear road map.

We are in uncharted territory, said Prof. Elisabeth Puchhammer-Stckl, the head of virology at the Medical University of Vienna. We have to figure this out as we go along.

Only one thing is certain, said Professor Puchhammer-Stckl, who is a member of the coronavirus task force advising Austrias health minister.

We are still living in a pandemic, she said. This virus is not going anywhere.

Reporting was contributed by Christopher F. Schuetze from Berlin, Hana de Goeij from Prague, Martin Selsoe Sorensen from Copenhagen, and Jason Horowitz from Rome.

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Some of Europe, Walking a Tightrope, Will Loosen Coronavirus Restrictions - The New York Times

Doctors see patients at a New Delhi hospital on 18 March. India recommends hydroxychloroquine for health care workers at risk of COVID-19.

By Kai KupferschmidtApr. 7, 2020 , 3:50 PM

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

When malaria researcher Nicholas White saw coronavirus infections picking up around the world 2 months ago, he immediately thought of the impact they could have on poorer countries. In fragile health care systems, if you start knocking out a few nurses and doctors, the whole thing can collapse, says White, who is based at Mahidol University in Bangkok. So we realized that the priority would be to protect them.

White and his colleagues at the Mahidol Oxford Tropical Medicine Research Unit wondered whether widely available drugs could help. They have designed atrialin which 40,000 doctors and nurses in Asia, Africa, and Europe will prophylactically receive chloroquine or hydroxychloroquine, two old drugs against malaria. White hopes the trial will start this month, but its launch has been incredibly difficult because of bureaucratic processes, he says

The international study is one of several in preparation or underway that seek to use drugs for what is called pre-exposure prophylaxis (PrEP), a strategy already widely used against HIV. The Bill & Melinda Gates Foundation is funding plans for another huge study that will test the same two drugs in Africa, North America, and Europe. Separate studies of the same drugs are planned or underway in the United States, Australia, Canada, Spain, and Mexico. Researchers are also considering other potential preventives, including nitazoxanide, a drug used to treat parasitic infections, and the antibody-laden serum from people who have recovered from an infection.

If there was a drug that could prevent infections and that health care workers could take, that would be an enormous public health benefit, says Jeremy Farrar, head of the Wellcome Trust, which is funding Whites effort.

PrEP studies of the malaria drugs could also be the best way to settle the heated debateinflamed by U.S. President Donald Trumps advocacyover whether they are a promising treatment for COVID-19, says virologist Matthew Frieman of the University of Maryland School of Medicine. The weak and equivocal studies so far were mainly done in seriously ill patients. To show an effect you really have to treat early, Frieman says. I dont know any drug that works better late in infection. Giving a drug before exposure is as early as it gets.

White adds that chloroquine and hydroxychloroquine are good choices to test because they are widely availablea major consideration given the huge number of people who might be eligible for any drug that proves its worth. The attraction of these drugs is that they are potentially readily deployable and we know an awful lot about them.

In Whites proposed trial, health care workers in Asia will be randomized to take chloroquine or a placebo for 3 months, while hydroxychloroquine will be used in Africa and Europe. Participants have to take their temperature twice a day and report it, along with any symptoms, through an app or a website. The researchers will compare the number of symptomatic and asymptomatic infections in both groups, as well as the severity and duration of illness in those who become infected.

Meanwhile, a trial of a related approach called postexposure prophylaxis (PEP) started in Barcelona, Spain, in mid-March. The idea behind that study, born before Spains COVID-19 epidemic exploded, is that a short course of a drug might prevent disease or lessen its impact in health care workers, nursing home residents, and household contacts of COVID-19 patients who have already been exposed to the virus. We said, we need something stronger than nonpharmacological interventions like isolation and quarantine, says Oriol Mitj of the Germans Trias I Pujol University Hospital, who leads the study.

In the Spanish trial, people with symptoms who test positive for COVID-19 are treated with the HIV combination drug darunavir/cobicistat plus hydroxychloroquine. Anyone known to have spent more than 15 minutes with them in the previous 5 days is treated with hydroxychloroquine for 4 days. Patients in a control group and their contacts receive no drugthere was no time to prepare an appropriate placebo, Mitj says.

The researchers plan to compare how many new symptomatic infections occur in the two groups after 14 days. More than 1000 contacts have been included already; the first result from that subset should be available around 15 April, Mitj says. Similar studies are underway in Minnesota, Washington, and New York.

Experience with HIV has shown that PrEP and PEP can work to reduce infections. But before large-scale studies in HIV began, scientists had an amazing amount of data from a monkey model and epidemiology studies suggesting the strategies would work, says Steven Deeks, an HIV researcher at the University of California, San Francisco (UCSF). Im not sure any of that applies to whats happening now.

Potential side effects of chloroquine and hydroxychloroquine, including heart arrhythmia, are another concern. The risks that might be acceptable in someone with disease may be much less acceptable when you are treating someone who doesnt have it, says Annie Luetkemeyer, an infectious disease physician at UCSF. And youre very unlikely to be monitoring them in the same way.

Some countries arent waiting for the new trials. India, for instance, has already recommended hydroxychloroquine for health care workers caring for suspected or confirmed COVID-19 cases as well as patients household contacts; Bangladesh has a similar policy. (White says he had to exclude both countries from the international study as a result.) There is no basis for recommending wide use of the drug, many scientists say. The idea that it is better than nothing is not true, White says. It could be worse than nothing.

Thats not just because of the potential side effects. People who think they are protected may also become less cautious and run a greater risk of infection. And broad use of the drugs will make them harder to obtain for other conditions. In addition to curing malaria, chloroquine and hydroxychloroquine are mainstays for patients with lupus and rheumatoid arthritis, Luetkemeyer says. We better be really sure that these drugs are working before we start impacting that drug supply.

Because the demand could be so big, there has been some debate among researchers about which dose to test. White has decided to go with the highest possible dose, to maximize the chance of getting a positive result. But the Gates-funded study plan calls for evaluating medium and low doses as well. If one of those shows an effect, more patients could benefit if supplies are low.

Even if chloroquine works, it is unlikely to confer 100% protectionand a low level of protection may not make the risk of side effects worthwhile. If you were a health care worker and I said, Heres a medicine which you have to take every day and it reduces your risk of getting COVID-19 by 20%, would you take it? White asks. Below that, people probably wouldnt bother, he says.

White hopes to start the international trial on 22 April in the United Kingdom, but he is still navigating the myriad rules, regulations, and sequential hurdles that govern the conduct of clinical trials. No one is acting with ill intent, he adds, but he thinks the emergency warrants faster action. Is it really ethical to take 3 weeks to review an application for a medicine that has been available for 70 years?

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Trials of drugs to prevent coronavirus infection begin in health care workers - Science Magazine

On April 3, Iraqi volunteers in full hazmat gear prayed over the coffin of a 50-year-old who died of COVID-19. She was buried at a cemetery specifically opened for such deaths, some 12 miles from the holy city of Najaf. Haidar Hamdani/AFP via Getty Images hide caption

On April 3, Iraqi volunteers in full hazmat gear prayed over the coffin of a 50-year-old who died of COVID-19. She was buried at a cemetery specifically opened for such deaths, some 12 miles from the holy city of Najaf.

For centuries, Hindus gathered to burn corpses on funeral pyres along the Ganges River. Jews received condolences at home during a seven-day mourning period. Muslims huddled together to wash the corpses of loved ones in Iraq and across the Arab world.

But global burial rituals are being dramatically changed by the coronavirus pandemic.

The World Health Organization in its March 24 guidance on burials of COVID-19 victims says dead bodies are generally not infectious. But its recommendations that relatives not touch or kiss the body and government rules on social distancing to prevent the spread of disease have upended important funeral and death rituals in virtually all of the world's faiths.

Just as the United States now restricts gatherings for funerals, so do countries and religious authorities around the world.

Here, some of NPR's foreign correspondents share details of how COVID-19 has changed traditions in the countries they cover.

Iraq: Days of delays for some burials

In Iraq, relatives participate in washing the bodies of their loved ones and preparing them for burial. The dead are buried the same day wherever possible. For both Muslims and Christians, deaths are normally followed by three days of condolences held in large tents or mosques or church halls. With the family surrounded by relatives, friends and neighbors, outpourings of grief are expected and often encouraged.

But with the pandemic, such public gatherings of grief are no longer allowed.

"It took eight days to get the body of my father from the morgue," says Abdul-Hadi Majeed, whose father died of COVID-19 in a Baghdad hospital in March. "It was very difficult arranging the burial."

Majeed, a soldier, says his father's body was among a group of bodies the government intended to bury in a field near Baghdad, outside the city. But tribal leaders refused to allow the bodies to be buried there, mistakenly fearing they could spread disease.

So paramilitary forces in hazmat suits took over the process and conducted the burials according to Islamic rites at a sprawling cemetery in the holy city Najaf, south of Baghdad, in a special section of COVID-19 victims.

India: Empty banks on the Ganges, a controversial call for cremation

In India, where the government has reported 124 COVID-19 deaths (as of April 6), new guidelines for disposal of dead bodies were issued on March 15. Funerals are now limited to 20 or fewer attendees. Gone are the big, public funeral processions that are a key part of mourning for adherents of many faiths across South Asia.

In the Hindu holy city of Varanasi, on the banks of the Ganges River, a lone Hindu priest now recites a truncated daily prayer as a symbolic gesture to the Hindu goddess Ganga, whom faithful believe embodies the river. Thousands of people including tourists used to gather here for sunrise and sunset ceremonies honoring the river goddess. Typically lined with funeral pyres giant piles of wood set alight to burn corpses the riverbanks are now largely empty because of a nationwide lockdown.

Many of India's majority Hindus believe that being cremated next to the Ganges, or having ashes submerged in its waters, ensures salvation. But with limited public transportation and travel curtailed under lockdown, families are unable to transport the bodies or ashes of their loved ones to the river, and there are reports of ashes piling up in crematoriums because families can't come to pick up the ashes.

A major association of Hindu priests is asking mourners to postpone travel to the northern Indian city of Haridwar, another popular pilgrimage site on the Ganges River, citing a shortage of priests to perform rituals again, because of the lockdown.

"After the waiver of the [lockdown] restrictions, one can come to Haridwar for ritual ash immersion," Pradeep Jha, president of the association, called Ganga Sabha, was quoted as saying. "Our [priests] will duly perform the rituals for peace and salvation to the deceased souls."

The Indian central government's new guidelines also prohibit bathing or embalming the corpse of a COVID-19 victim and ban relatives from kissing or hugging the body to avoid any risk of transmitting the virus. The rules are carefully worded, without mentioning any specific religion. But body-washing is typically practiced by Muslims, who number at least 180 million in India, and have faced religious discrimination and attacks in the past.

In the commercial capital Mumbai, municipal authorities announced last month that all COVID-19 bodies must be cremated. The order said the city's burial grounds were in densely-populated areas, which might pose a risk of contamination.

While cremation is most commonly practiced by India's Hindu majority, it is strictly forbidden in Islam.

After a Muslim politician intervened, the order was withdrawn within hours. Muslims can continue to bury their dead, with the order rescinded.

There is one burial tradition in India that doesn't involve crowds, and is thus still allowed: Sky burials. Practiced by Parsis, Zoroastrians and some Tibetan Buddhists, adherents place dead bodies on a high platform or mountaintop, and allow vultures to dispose of the remains.

Pakistan, Turkey and Ireland: Grieving at a distance

In neighboring Pakistan, the most populous province, Punjab, issued guidelines requiring those performing the ritual Islamic washing of bodies to wear appropriate protective gear. A prominent clerical council also called on Pakistani Muslims to practice social distancing as they undertake traditional communal prayers to honor the dead.

It was not immediately clear how widely that is being respected, but one video shared from a remote Pakistani province showed a handful of worshippers standing carefully apart as they prayed for a COVID-19 victim about to be buried.

In Turkey, close farewells have been replaced by distance burials. Only those physically involved in the burial are allowed at the pre-burial body washing ritual normally attended by close family members, and only the closest relatives can attend the burial, with the imam praying from a safe distance away, speaking through a mask. Authorities have forbidden mourners from approaching the coffin for a last look or word.

In Ireland, people are determined to pay their condolences despite new rules. Last week, when an elderly resident died in a village in county Kerry, Catholic parishioners lined a more than mile-long road to the local cemetery socially distanced at several feet from one another in a tribute that was filmed and shared widely on social media.

France and Brazil: No more than 10 funeral guests

Members of the Charitable Brotherhood of Saint-Eloi de Bethune, which first formed during the plague 800 years ago, carry an urn to a family tomb at the cemetery in Bethune, France. The photo was taken on March 18. Pascal Rossignol/Reuters hide caption

Many countries are limiting the number of mourners allowed to attend funerals. In both Brazil and France, authorities urge people to limit funerals to ten attendees. In Brazil, they also specify that mourners must remain about six feet apart a stark contrast from traditional funeral gatherings there, which often last all day and are attended by hundreds of people.

Israel: Goodbyes behind glass, virtual shiva

Some Israeli hospitals, like the Sheba Medical Center, place the body of a person who died of coronavirus in a glass booth. That way, families who weren't able to be with a dying relative can say a last goodbye. Courtesy of Sheba Medical Center hide caption

Some Israeli hospitals, like the Sheba Medical Center, place the body of a person who died of coronavirus in a glass booth. That way, families who weren't able to be with a dying relative can say a last goodbye.

Some Israeli hospitals have offered alternatives to families blocked from coronavirus wards to bid goodbye to a dying loved one. Sheba Medical Center built a glass booth in which to place the body so families may get a last glimpse. Families stand on the other side of a wall and peer through a window to see the deceased.

Burial officials restrict funerals to 20 guests and forbid the custom of passing around a shovel for attendees to scoop dirt into the grave so participants don't touch the same shovel. At some funerals, participants insist on keeping the tradition to honor the dead by scooping up dirt with their bare hands. Coronavirus victims' bodies are wrapped in two plastic body bags to protect those who handle the body, since coffins are not typically used in Jewish burials in Israel and bodies are lowered directly into the grave, wrapped in shrouds.

Israelis may no longer host guests for the shiva, the weeklong mourning gathering for family, friends and well-wishers. The bereaved must grieve at home alone. Some host shiva gatherings by video conference, but many Orthodox Jews must give up reciting the special mourner's prayer, the kaddish, because it requires the physical presence of a quorum of ten. More liberal rabbis have permitted a virtual quorum to gather through video conference for the mourner's prayer.

Some coronavirus victims in parts of Europe have been flown to Israel for burial, following a Jewish custom to be buried in the Holy Land. But not U.S. Jews, an Israeli burial official told NPR. United Airlines, servicing the only remaining direct U.S.-Israel flights, has suspended international funeral shipments, a service airlines provide to transfer the deceased to their desired final resting place. A leading Orthodox rabbi in New York has permitted temporary burial in the U.S. until casket shipments are renewed and the bodies can be exhumed and reburied in the Holy Land.

China: Reserving time slots to pick up ashes

In the city of Wuhan, the epicenter of the virus in China, families under lockdown hadn't been able to pick up the cremated ashes of their loved ones for the last two months, until about late March in the run up to Tomb Sweeping holiday. That traditional Chinese festival, which pays respect to ancestors, was observed this year on April 4.

To prevent large crowds from forming, authorities in Wuhan require families to reserve a time slot to pick up their loved ones' ashes and bury them, while accompanied by a neighborhood official.

Philippines: Cremation within 12 hours, with some exceptions

On April 3, funeral workers in protective suits unloaded the body of a person presumed to have died of the coronavirus, to be cremated at a public cemetery in Manila. Ezra Acayan/Getty Images hide caption

In the Philippines, a government edict has decreed that the remains of a COVID-19 victim should be cremated within 12 hours, with an exception if a religion forbids cremation. If the deceased is a Muslim, for example, the body of the deceased should be placed in a sealed bag and buried in the nearest Muslim cemetery according to Muslim rites, also within 12 hours.

The speedy burials are a disrupting departure from traditional Christian burials in the Philippines, a predominantly Catholic country where the "lamay" or wake can last three to seven days.

NPR international correspondents Diaa Hadid, Emily Feng, Peter Kenyon, Julie McCarthy, Philip Reeves and Eleanor Beardsley contributed to this report from Islamabad, Wuhan, Istanbul, the U.S., Rio de Janeiro and Paris, respectively. NPR producer Sushmita Pathak contributed from Mumbai, and NPR producers Awadh al-Taee and Ahmed Qusay contributed from Baghdad.

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The Coronavirus Is Changing How The World Buries And Mourns Its Loved Ones : Goats and Soda - NPR

In an alternative universe, a new virus emerges in China. The country quickly identifies the pathogen, closes its borders, launches an unprecedented campaign to eradicate the virus, and manages to ensure that very few cases leave the country. The other countries that do report cases such as South Korea, Taiwan, Hong Kong and Singapore rapidly identify those who are infected, trace the people they have contacted, isolate the carriers of the virus and contain its spread. Through this three-pronged strategy test, trace, isolate eradication is successful. Humanity is saved.

In reality, Sars-CoV-2, the novel coronavirus, escaped the public health interventions of the Chinese government and spread across the world. As other governments fumbled in their early responses, the virus silently rippled through communities, infecting many people and hospitalising and killing some. The virus is remarkably dangerous it spreads as easily as a cold or flu, even via individuals who dont have any visible symptoms, and the latest data shows that roughly 5% of people who become infected will require hospitalisation. Among them, 30% will be admitted to ICU. An estimated 0.6-1.4% of those who contract the virus will die.

The world now has more than 1 million confirmed cases of coronavirus. The United States, which has more than 400,000 cases and approaching 13,000 deaths, has overtaken China, where there have been roughly 82,000 cases and 3,000 deaths. Half of all confirmed cases are now in Europe. Low- and middle-income countries are just a few weeks behind. While nations such as Senegal, Liberia and Nigeria have shown themselves aggressively ready to meet this challenge, their governments are constrained by a lack of resources, healthcare and testing capacity. Others, such as Brazil, India and Mexico, seem in denial of what is to come.

We still dont know what percentage of the worlds population has already been exposed to the virus. Without a reliable antibody test that can identify whether someone has had the virus and are likely to be immune, its unclear how many people are carrying the virus but not showing symptoms. The role of children in transmission is also unclear; children are neither immune nor seem to be heavily affected.

So, what now? Based on what Ive learned from published modelling and other countries responses to the virus, there are four possible scenarios for how this might end. One is that governments come together to agree a plan of eradication dependent on a rapid and cheap point-of-care diagnostic. All countries would simultaneously close their borders for an agreed amount of time and mount an aggressive campaign to identify carriers of the virus and prevent transmission.

This approach seems unlikely; the virus has spread aggressively, and some countries have been reticent to cooperate with one another. But it could become more realistic for three reasons: antiviral therapies used to prevent or treat symptoms of Covid-19 may be poor; a vaccine may take decades to produce; and immunity may only be short-term, resulting in multiple waves of infection, even within the same individuals. New Zealand is currently attempting a version of this approach; the country has closed its borders, enforced a lockdown and is rolling out community testing to eradicate the virus.

A second scenario, which seems moderately more likely, is that early vaccine trials are promising. While waiting for the vaccine, countries would try to delay the spread of the virus over the next 12-18 months through intermittent lockdowns. Health authorities would need to anticipate, three weeks in advance, whether there are enough beds, ventilators and staffing to treat those infected. On this basis, governments could decide whether to relax or increase quarantine measures.

But this scenario is far from ideal. Healthcare systems would still be strained, and the economic and social costs of lockdown are high. Repeated lockdowns could lead to mass unemployment, an increase in child poverty and widespread social unrest. In poorer countries, more people could die from the lockdown than from the virus itself: of malnutrition, vaccine-preventable diseases or dehydration from limited access to clean water.

A third and even likelier scenario is that countries follow South Koreas example while they wait for a vaccine: increase testing to identify all carriers of the virus, trace the people they have contacted, and quarantine them for up to three weeks. This would involve large-scale planning, the swift development of a contact-tracing app, and thousands of volunteers to help with swabbing, processing results and monitoring quarantine. More relaxed physical distancing measures could be enforced to prevent the spread of the virus and ease the pressure on healthcare systems.

In the absence of a viable vaccine for the foreseeable future, a final scenario could involve managing Covid-19 by treating its symptoms rather than its cause. Health workers could administer antiviral therapies that prevent patients from deteriorating to the point where they needed intensive care, or preventing them from dying when they reach a critical phase. An even better solution would be using prophylactic therapy to prevent the onset of Covid-19, in combination with rapid diagnostic testing to identify those who have been infected. In countries with the resources, this could be sustainable but for poorer countries this approach would be difficult, if not impossible.

There is no easy solution. The months ahead will involve a fragile balancing act between the interests of public health, society and the economy, with governments more reliant on each other than ever before. While half the battle will be in developing the tools to treat the virus a vaccine, antiviral therapies and rapid diagnostic testing the other half will be manufacturing enough doses, distributing these in a fair and equitable manner, and ensuring they reach individuals across the world.

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The coronavirus crisis could end in one of these four ways - The Guardian

Coronavirus Live Updates: Trump Threatens to Cut Funding for World Health Organization  The New York Times

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Coronavirus Live Updates: Trump Threatens to Cut Funding for World Health Organization - The New York Times

Based in Las Vegas, Three Square Food Bank previously distributed food through 180 pantries across Clark County. Since the outbreak and the sudden closing of nearly all of the citys gambling and tourism attractions the organization has restructured, with 10 pantries and 21 new drive-through distribution sites.

Larry Scott, Three Squares chief operating officer, said that the group had expected 200 to 250 cars a day at each drive-through. Theyre getting up to 500 to 600 cars instead, with lines up to four miles long. Every day, we distribute everything that we bring to a site, Mr. Scott said.

An initial glut of high-quality food from shuttered casinos is basically gone, Mr. Scott said. Now his food bank is burning through an extra $300,000 to $400,000 a week in cash to buy food.

He said that he saw no relief in sight. What we do today has to be repeated again tomorrow, and the next day, and the next day, Mr. Scott said. Hungry people are hungry each and every day.

Ericka Smrcka, an official at Food Bank for the Heartland in Nebraska, went to a recent mobile food distribution at a middle school in neighboring Council Bluffs, Iowa. She and a colleague arrived nearly an hour before it was scheduled to start to find the streets jammed in every direction and the police directing traffic.

We were overwhelmed with tears, Ms. Smrcka said. Oh, my gosh. Everywhere we looked, there were just cars.

The delivery truck had enough boxes of food produce, bread and milk for 200 vehicles. Some 400 showed up. Ms. Smrcka recalled feeling apprehensive at the prospect of walking car to car with nothing more than a flier describing alternative resources, thinking she might get yelled at.

But thats not what happened. After sitting in their car for an hour and not receiving any food, they still said thank you, she said, recalling in particular a father who had left work early and picked up his three daughters, and who departed empty-handed.

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Food Banks Are Overrun, as Coronavirus Surges Demand - The New York Times

SAN FRANCISCO Jack Dorsey, the chief executive of Twitter and Square, said on Tuesday that he planned to donate $1 billion, or just under a third of his total wealth, to relief programs related to the coronavirus, in one of the more significant efforts by a tech billionaire to fight the pandemic.

Mr. Dorsey said he would put 28 percent of his wealth, in the form of shares in his mobile payments company Square, into a limited liability company that he had created, called Start Small. Start Small would make grants to beneficiaries, he said, with the expenditures to be recorded in a publicly accessible Google document.

Why now? The needs are increasingly urgent, and I want to see the impact in my lifetime, Mr. Dorsey said in a series of tweets announcing his plans. I hope this inspires others to do something similar.

Mr. Dorsey, 43, joins a growing list of celebrities, world leaders and technologists who are earmarking some portion of their wealth to fighting the spread of the coronavirus and its effects.

Oprah Winfrey has donated more than $10 million of her personal wealth to Covid-19 relief efforts, while other Hollywood personalities including Justin Timberlake, Dolly Parton and Rihanna have also made contributions. Last week, the Amazon chief executive, Jeff Bezos, said he would donate $100 million to American food banks through a nonprofit, Feeding America. And Mark Zuckerberg, chief executive of Facebook, has also organized relief campaigns through Facebook and his own philanthropic organization, the Chan Zuckerberg Initiative.

Even so, Mr. Dorseys contribution stands out for the sum he is putting in and for how much of his net worth that represents.

Square declined a request for an interview with Mr. Dorsey. Twitter declined to comment.

In creating a limited liability company, Mr. Dorsey is following a model that Mr. Zuckerberg has used. In 2015, when Mr. Zuckerberg and his wife, Priscilla Chan, set up the Chan Zuckerberg Initiative, it was organized as an L.L.C., holding much of their wealth to fund charitable causes.

At the time, critics said the vehicle was a self-serving maneuver that allowed Mr. Zuckerberg to engage in private lobbying, for-profit investment and political donations. Mr. Zuckerberg pushed back, saying a limited liability company gave him and his wife more control over how their resources would be put to use.

Mr. Dorsey, who has been criticized in the past for his lack of transparency around philanthropic efforts, said he was creating an L.L.C. for flexibility and pledged to use the Google document to update the public on its latest grants, stock transfers and sales.

He said the first $100,000 donation would be to Americas Food Fund, a high-profile effort committed to feeding the hungry. It was started in a GoFundMe page last week by Leonardo DiCaprio, Laurene Powell Jobs and Apple.

After the most pressing matters of the pandemic are resolved, Mr. Dorsey said, he plans to shift the aim of Start Small to supporting initiatives around universal basic income, under which Americans would get a base level of regular income from the federal government, and womens health and education efforts.

Universal basic income has been a pet issue for some Silicon Valley progressives, made more popular in recent months by the now-ended presidential candidacy of Andrew Yang, a Democrat who ran partly on the idea.

Life is too short, so lets do everything we can today to help people now, Mr. Dorsey tweeted, followed by an emoji of a peace sign hand gesture.

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Jack Dorsey Vows to Donate $1 Billion to Fight the Coronavirus - The New York Times

LONDON Prime Minister Boris Johnson was moved into intensive care on Monday, a worrisome turn in his 10-day battle with the coronavirus and the starkest evidence yet of how the virus has threatened the British political establishment and thrown its new government into upheaval.

The government said the decision was a precaution and that he had been in good spirits earlier in the day. But with Mr. Johnsons aides releasing few details about his condition, the nation kept a tense vigil on Monday night, hoping for the best and experiencing, together, the frightening mysteries of this disease.

In a sign of how grave the situation had become, Downing Street said in a statement on Monday that Mr. Johnson had asked the foreign secretary, Dominic Raab, to deputize for him where necessary. The pound fell against the dollar after investors reacted to the news.

After noting earlier in the day that the prime minister was still getting official papers, Mr. Johnsons aides said he had been moved to the intensive care unit in case he needed a ventilator to help his recovery. Not every patient in critical care is ventilated, medical experts said, but many are or are at least given oxygen. The prime minister remains conscious, officials said.

For Mr. Johnson, 55, it was an especially cruel reversal. Just four months ago, he engineered the greatest Conservative Party victory since Margaret Thatcher in 1987, delivered his promise to take Britain out of the European Union, and set in motion an ambitious economic program to transform his divided country.

Now, Mr. Johnson, a political phenomenon whose career has always had a quicksilver quality, finds himself in a debilitating battle after contracting a virus he initially viewed with characteristic nonchalance.

For Britain, which had so recently emerged from three and a half years of paralysis and polarization over Brexit, Mr. Johnsons illness plunges the country back into the uncertainty Britons thought they had left behind.

When the prime minister announced on March 27 that he had tested positive for the virus, he insisted he would remain firmly in charge of the governments response to the virus, chairing the daily crisis meetings by video while self-isolating.

It had been an occasionally shaky performance until then: The government initially debated how aggressively it would try to curb the spread of the pathogen. That contributed to an inadequate, poorly organized testing program, and reinforced Mr. Johnsons reluctance to impose a strict lockdown on his country.

In recent weeks, Mr. Johnson had seemed more in command. Britain has pledged to test 100,000 people a day by the end of this month. And the prime minister has become an ardent, if relentlessly cheerful, advocate of social distancing.

Even after Mr. Johnson had isolated himself in his apartment next door to 10 Downing Street he released a shaky, handheld video on Friday, in which he warned people not to crowd parks during a sunny spring weekend.

Mr. Johnsons aides predicted he would emerge from isolation that day. But he said he was running a temperature and suffering a cough. Two days later, he was admitted to St Thomas Hospital in central London, still suffering from those symptoms.

On Monday, Downing Street said in a statement, Over the course of this afternoon, the condition of the Prime Minister has worsened and, on the advice of his medical team, he has been moved to the Intensive Care Unit at the hospital.

Mr. Johnsons hospitalization coincided with a call by Queen Elizabeth II for Britons to face the pandemic with the stoicism and self-discipline they showed during World War II. Her rare televised address reassured many, but barely an hour later, they were jolted by news of Mr. Johnsons deteriorating condition.

On Monday, the government tried to put a good face on the situation. Mr. Raab told a news conference that Mr. Johnson was in good spirits after a comfortable night in the hospital, a short distance from Downing Street. He said Mr. Johnson remained in charge of the government and was working from his hospital bed.

But Mr. Raab, who chaired the daily coronavirus meeting on Monday morning, admitted he had not spoken to the prime minister since Saturday. The paucity of details on the prime ministers condition or any sign of ongoing communication between him and Mr. Raab deepened the unease.

Mr. Johnson wrote from the hospital on Twitter that he had undergone some routine tests because he was still experiencing symptoms. He also thanked health workers for taking care of him.

In a Twitter post, Andrew Neil, one of the countrys most prominent interviewers, asked why Mr. Johnson had not spoken to his stand-in, Mr. Raab, since Saturday. Something not right here, Mr. Neil added.

In Britain, patients who experience symptoms of the virus are being encouraged to stay at home if possible, a policy that suggested Mr. Johnsons condition at least crossed some threshold of seriousness to warrant hospital admission at a time when the health service is stretched.

British politicians from across the political spectrum offered their best wishes, as did the French president, Emmanuel Macron, who said he hoped Mr. Johnson would make a swift recovery. Buckingham Palace said Downing Street had informed the queen of Mr. Johnsons condition.

Lindsay Hoyle, the Speaker of the House of Commons, said in a statement, This is terrible news. I know the thoughts and prayers of everyone across the House are with the Prime Minister and his family right now.

On Monday, at his daily briefing, President Trump wished Mr. Johnson well. Americans are all praying for him, he said. Hes been a really good friend. The president suggested that American pharmaceutical companies could aid the prime minister by supplying therapeutic drugs, although there are not yet any proven treatments. He also said he and other senior officials would take more tests for the virus in light of Mr. Johnsons ordeal.

Mr. Trump has had an affinity for Mr. Johnson, whom he views as a like-minded populist. While the two leaders have similarities including their initially skeptical view of the threat posed by the virus they are quite different. Mr. Johnson, for example, has described his approach to the virus as guided by science. In news conferences, he has typically deferred to his scientific and medical advisers unlike Mr. Trump, who has constantly promoted an unproven anti-malaria drug as a potential treatment, going well beyond the advice of doctors and public health experts.

The prime minister first experienced the symptoms of the virus on March 26, was tested that day and received a positive result around midnight, going into self-isolation in Downing Street, but chairing meetings by videolink.

Even people with mild infections can have pneumonia, which is detected with CT scans. Sometimes the illness turns more severe in the second week the stage where Mr. Johnson is now with increased breathing difficulty and worsening pneumonia. Blood tests may detect greatly elevated levels of inflammation, a sign that the immune system may be overreacting to the infection. Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, has warned about some patients taking such a sudden turn for the worse after a week.

Until just weeks ago, Mr. Johnson had taken a more lax approach to the virus than had other many European leaders. At a news conference in early March, he described visiting a hospital where he said there were coronavirus patients.

I shook hands with everybody, youll be pleased to know, he said, and I continue to shake hands.

Later, the prime minister hesitated to force pubs and restaurants to close, even as he asked people to stop packing them, and he left schools open after France and Germany closed theirs.

The prime minister is not thought to have any pre-existing medical conditions though he has admitted to struggling with his weight, particularly during a period when he served as foreign secretary and traveled extensively.

In 2018, he wrote in an article that he had cut out some high-calorie foods because he had reached about 230 pounds. For Mr. Johnsons height 5 feet 9 inches that weight would medically be defined as obese, and obesity increases the risk of a more severe illness in patients with the coronavirus.

Several other key figures in the government have self-isolated after suffering symptoms of the coronavirus, including the health secretary, Matthew Hancock, and the chief medical officer, Chris Whitty, both of whom have now returned to work.

Prince Charles, the queens eldest son and heir, suffered mild symptoms and quarantined himself at his residence in Scotland. He emerged from isolation last week to dedicate, via video, a field hospital in London.

Mr. Johnsons 32-year-old partner, Carrie Symonds, who is pregnant, disclosed on Saturday that she, too, had experienced symptoms.

On Monday, Mr. Raab said that it was too early to discuss an exit strategy from Britains lockdown, arguing that the focus should remain on social distancing measures designed to curb the spread of the virus.

According to statistics released on Monday, more than 51,000 people had tested positive for the virus in Britain and 5,373 people had died, though there was some cause for optimism from figures that showed the rate of hospital admissions slowing.

Denise Grady and Pam Belluck contributed reporting.

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With Coronavirus Symptoms, Boris Johnson Is Moved to Intensive Care in Hospital - The New York Times

Where is the UK compared with other EU countries?

A total of 7,097 deaths have been recorded in hospitals across the UK to date. Although this is lower than the death tolls in Italy, the US, Spain and France, the daily increase in the volume of fatalities now puts the UK on a par with rises seen in Italy and Spain.

The deadliest day reported in Italy was on 28 March with 971 deaths and in Spain on 3 April with 950 fatalities, according to the European Centre for Disease Prevention and Control. Death tolls in both countries now appear to have hit their peak on those dates, with lower numbers reported since.

But are the UKs figures accurate?

However, the figures we focus on dont tell us the full picture of how many deaths are actually happening. Guardian analysis showed that due to delays in reporting we cant accurately say how many deaths take place each day.

This means as previous days figures are continuously revised upwards, we dont have a true picture of where the country is on the curve at any current point in time. It also means, as the headline death toll increases, we wont know when we reach and pass the peak in real time. Similar issues are also faced in recording Covid-related deaths in other countries.

It also bears repeating that the true death toll is likely to be significantly higher once deaths in the community are factored in. In France more than 3,000 deaths have been recorded in care homes. The inclusion of deaths in the community caused its toll to increase sharply from 8,911 to 10,328 on 7 April a daily increase of 1,417.

According to figures for England, Wales and Scotland the number of fatalities where Covid-19 has been mentioned on the death certificate is much higher than the official number we focus on. Preliminary figures from the Office for National Statistics show Covid-19 registered deaths have been 70% higher than the reported headline figure in England and Wales. These figures are anticipated to be the gold standard in Covid-19 fatalities as more deaths are registered. The equivalent figure is 61% higher in Scotland.

If these figures were to be included in Wednesdays daily death toll, the UK would likely have already topped 1,000.

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UK's coronavirus death toll: how does it compare with Spain and Italy? - The Guardian