Category: Corona Virus

Chris Cuomo, the CNN anchor and younger brother of Gov. Andrew M. Cuomo of New York, has tested positive for the coronavirus, the network said on Tuesday.

Mr. Cuomo, 49, is feeling well, according to a memo distributed by CNN to staff members, and he plans to continue hosting his prime-time program from a studio in his home basement, where he is in quarantine.

A veteran news personality who joined CNN in 2013, Mr. Cuomo the youngest child of Mario M. Cuomo, the former New York governor is one of the most prominent members of the American media to learn he had the virus so far.

His program, Cuomo Prime Time, is a linchpin of CNNs coverage of the coronavirus pandemic, and he has conducted several remote interviews with his brother on the governors efforts to combat the outbreak in New York.

I have been exposed to people in recent days who have subsequently tested positive and I had fever, chills, and shortness of breath, Chris Cuomo said in a Twitter post on Tuesday, adding that he was hopeful he had not passed on the illness to his wife and children. He joked that the rest of the family seem pleased by his isolation in their basement, writing, We will all beat this by being smart and tough and united!

Governor Cuomo was in the midst of a nationally televised coronavirus briefing when news of his brothers diagnosis became public. The governor said that he had learned of Chris Cuomos illness on Tuesday morning, and that his brother is going to be fine.

Hes young, in good shape, strong not as strong as he thinks but he will be fine, the governor said, wryly. (The Cuomos often engage in on-air brotherly teasing.)

But Governor Cuomo continued at length about the more serious implications of his brothers diagnosis, including his relief that their 88-year-old mother, Matilda Cuomo, had not moved into Chris Cuomos home. The governor said he had told his brother that such a move would be a mistake."

You bring her to your house, you expose her to a lot of things, the governor said. She would have been doing what she wanted to do, he would have been doing what he wanted to do; it would have seemed great and harmless. But now we have a much different situation. Because if he was exposed, chances are she may very well have been exposed, and then we would be looking at a different situation than just my brother sitting in his basement for two weeks.

Andrew Cuomo is not known for public displays of sentiment. But his voice turned contemplative as he spoke about his sibling. Hes combative and hes argumentative and hes pushing people, but thats his job. Thats really not who he is, the governor said. Hes a sweet, beautiful guy, and hes my best friend.

Theres a lesson in this, the governor said. Hes an essential worker, a member of the press, so hes been out there. If you go out there, the chance that you get infected is very high.

Chris Cuomo is the third CNN employee in New York to receive a positive diagnosis. The network said he was last in the networks Manhattan offices on Friday.

Jonah Engel Bromwich contributed reporting.

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CNNs Chris Cuomo, Brother of Governor, Tests Positive for Coronavirus - The New York Times

Prime Minister Narendra Modi has ordered a lockdown of Indias 1.3 billion citizens to fight the spread of coronavirus, urging people to distance themselves socially and work from home.

But social distancing means hunger for many in India, with a work force heavily dependent on manual labor. It would be an unheard-of luxury for the ragpicker or street vendor who lives day to day.

About 80 percent of Indias 470 million workers are in the informal sector, lacking contracts and unprotected by labor laws. Many are manual laborers in the fields, factories and streets of India.

We asked people how they were making ends meet as the economy grinds to a halt with the coronavirus pandemic. India reported 1,024 cases and 27 dead as of Sunday. Here are some of their stories:

Ashu, 12 | ragpicker

Ashu and his two brothers spend their days at one of Delhis biggest dumps. They are ragpickers scavengers who hunt for scrap metal using a giant, rusted sieve to help them sort through the stinking refuse.

If Ashu works really hard, he can earn 53 cents a day. He and his brothers have been unable to go to the dump regularly since the lockdown was announced because if they are caught by the police, they will be beaten.

I miss my friends, he said, adding that he and four buddies would meet at the dumpsite every morning, work for a few hours and then play with whatever treasures they found broken toy cars, tattered dolls and ripped clothing.

I hear there is a virus from China going around, Ashu said. But Im more afraid of the police and not being able to eat.

When the money dries up, we will have to find a way to come back here again, he said.

Ramchandran Ravidas, 42 | bicycle rickshaw driver

On a Wednesday afternoon, normally peak rush hour in Delhi, Ramchandran Ravidas was bicycling around in big, lazy circles in the middle of a main thoroughfare, boredom, hunger and his empty pockets on his mind.

On a good day, if he has a lot of energy he can make up to 450 rupees, or $6, he said. He lives out of the garage he rents his bicycle rickshaw from and worries that he will be evicted soon; he has had no customers since the lockdown.

If you dont even have a house, how can you work from home? Mr. Ravidas said, worry lines furrowing his face. My home is my work. Today was the first time in my life I had to accept food from a charity.

He said, for him, it was a race between whether the virus or hunger got to him first.

Im not worried about corona; if corona comes to get me, at least this life of misery will be over, Mr. Ravidas said, breaking into a grin as he roared with laughter.

Baudghiri, 60 | sadhu (religious ascetic)

Walking barefoot along Delhis deserted streets, his saffron-colored clothing stained and tattered, Baudghiri said he had not eaten in two days. A sadhu, or religious ascetic, he makes about $1.50 every day by offering prayers to people on the street.

Mr. Baudghiri, who goes by just one name, had never gone hungry a day in his life, he said, and had always found a meal in Hindu temples or gurdwaras, Sikh places of worship. But they have closed since the lockdown started last week.

While he agreed with the prime ministers decision to try to prevent the viruss spread by limiting peoples movement, he was frustrated with the governments lack of planning for the destitute like him.

I do not have a house to practice social distancing in, he said. I go from place to place, temple to temple, to eat. But the entire city is closed.

In all his decades of walking across India, Mr. Baudghiri said he had never seen India so paralyzed.

In every crisis, the gurdwaras, the temples were all open, he said. We were still able to feed ourselves and find shelter. Ive never seen this panic in my entire life.

Raj Kumari | street sweeper

Sweeping leaves and trash off a deserted street and dumping them into her rusted wheelbarrow, Raj Kumari said the silence of the normal cacophony of Delhi was glorious, but eerie.

She used to sweep Delhis streets with her husband, but he died eight years ago. She is now the sole breadwinner for her six children, after her eldest son was laid off from his tech job this past week because of the lockdown.

Its just me and the sewer cleaners out here now, she said.

The lockdown has affected public transportation, and she now walks two hours just to get to work.

This is what I have to do for money, for life, she said. Even if the streets are empty, I have to come out. I dont have the pleasure of staying at home, this is my duty.

The government has never provided Ms. Kumari, who does not know her exact age, with gloves or masks for her job. But one of her daughters forbade her from working without protective gear during the pandemic and gave her a mask that her school had donated to students to protect against Delhis infamous pollution.

Im not afraid of corona, Ms. Kumari said. Why would anyone fear death when it is time for God to take you?

Mohan Singh, 18 | fruit seller

Every morning, Mohan Singh and his father pile their carts with fruit and wheel their loads to work, on a busy neighborhood street corner. Although their jobs are deemed necessary and permissible during the lockdown, they say customers are too afraid to come to their carts. By midmorning, they had served one customer between them.

If we are afraid of this disease, we will die in our homes, Mr. Singh said, adding that he and his father provide for their entire family of six.

Mr. Singh said he was worried that the government was going to help big businesses and that small businesses like his would be overlooked. Although the government announced a $22 billion relief package to support the millions left unemployed because of the crisis, some say people in the informal work force, like Mr. Singh, will have trouble getting help.

They need to help people like us, he said. There are more people working on the streets than Indias biggest companies. If we close, no one can eat.

Arjun Chauhan, 18 | water deliverer

Many Indian homes lack running water or water safe enough to drink, making Arjun Chauhans job a necessity during the lockdown. He zipped across Delhis streets on his moped bike, stacked high with leaking water bottles.

If we stay at home, my family goes hungry and India goes thirsty, Mr. Chauhan said, adding that his parents and five siblings rely on his wages.

Since the lockdown, Mr. Chauhan has seen his daily earnings of about $8 cut in half. He said he had been unable to reach all his customers because the police had prevented him from deliveries and even beat him for being on the streets although under the lockdown rules, deliveries of necessary items like medicine and water are supposed to be allowed.

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For Indias Laborers, Coronavirus Lockdown Is an Order to Starve - The New York Times

Health care workers around the world are asking for help. What do you want? PPE. When do you need it? Now. Theyre in desperate need of more PPE, also known as personal protective equipment. Stocks of the critical gear are disappearing during the coronavirus pandemic. Doctors say they are rationing gloves, reusing masks and raiding hardware stores. The C.D.C. has even said that scarves or bandannas can be used as protection as a last resort. Ive met the doctors, and talked with them every day. I think theres an interesting challenge here in that, currently, theres such a need that if they had anything, they would deploy it. The cries for help are mobilizing a wide range of innovators, some of them even joining forces through online messaging platforms like Slack. These are engineers, doctors and even high school students from around the world. They come from all walks of life, but say their goal is the same. Its amazing because no ones asking which country are you from? Theyre just like, how can I help? What do you need? Theyre pitching in by crowdsourcing designs for masks, face shields and even ventilators that could be reproduced around the world. This is Nick Moser. Hes an active player in one of the maker groups. His day job is at a design studio. Now, hes designing replicable face masks. Were focused on three products: a face shield, a cloth mask and an alternative to N95-rated respirators. The face shield is the first line of defense for medical workers. It protects against droplets. If a patient coughs, itll hit the face shield rather than them. Some designs are produced using 3-D printers or laser cutters. There you go. Then, the prototypes are field-tested by health care workers. Even some university labs are experimenting with DIY techniques. A group at Georgia Tech is working with open-source designs from the internet to develop products. My lab works in the area of frugal science, and we build low-cost tools for resource-limited areas. And now, weve realized that I dont have to go that far. Its in our backyard, right? We need it now. So this is a plastic sheet I have not too different from what you would get out from a 2-liter Coke or a soda bottle. I actually bought this from an art store. Its just sheets of PET, so we can cut these out. We are calling this an origami face shield, and its the Level 1 protection. This is one idea. There are multiple different prototypes. This headband can be reused, and a doctor or nurse could just basically tear this off and basically snap another one on. Were hearing that, in some cases, that they go through close to 2,000 of these a day. Because the need is growing so rapidly, the makers are also thinking about how to increase their production. So how do we get from this one that someone made at home on a laser cutter or a 3-D printer, and then get it in the hands of thousands of doctors and front-line workers? Theyre working with mass manufacturers that can take their tested designs, and replicate them at a larger scale. Weve been on the phone talking to a number of suppliers, material suppliers. So I think one of the neat things that weve done is not only the design, proving that you can make it rapidly, but then also trying to secure the entire supply chains. This is Dr. Susan Gunn, whose hospital system in New Orleans has even started its own initiative to 3-D print equipment. So it starts with an idea. We put the idea into place. And then we make sure that its professional-grade first. Infection control is looking at it, and were making sure that were using the correct materials that would be approved by the C.D.C. and the World Health Organization. Dr. Gunn says the gear is a safe alternative for those who might otherwise face a shortage. Were creating face shields and were creating these different PPEs, and were putting them in the hands where people felt like they needed them. Another critical piece of equipment is the N95 mask, and the supply is dwindling fast. Nick and his team are designing a robust alternative for this mask that can hold any filter material, and be mass produced. It is easily printable. This one is used in medical situations where theres an actively infectious patient. So nursing homes or obviously I.C.U. units would be the target to receive these. These are really hard objects to manufacture because youre going to give it to a nurse, and then I want to be really confident that it will not let a virus through, right? This equipment is not approved by federal agencies, but the designers are testing their respirator prototypes for safety. That was basically the first, almost the first question that was asked. Can we do anything thats actually going to be safe and helpful? Some makers are pursuing even more ambitious projects. An engineer named Stephen Robinson in New Haven, Conn., is working on designing ventilators to help patients breathe. Countries are facing a dire shortage of the lifesaving machines. Right now, these DIY ventilators are still prototypes. So really, this should be thought of as the seed of an idea that could potentially be grown with, and absolutely requiring, the medical and the tech communities. But they could become key if critical supplies run out. Were in very uncertain times, and I see explorations and projects as kind of an insurance policy that could potentially be leaned on if there was extreme circumstances. Health care workers are hopeful that these efforts could prevent an even worse outcome. We dont want anybody lets be clear to use a bandanna to protect themselves. I hope it never gets to the point where we have to wear a bandanna. And I dont think, with this initiative that we will get there. For innovators like Saad, the challenge is personal. I just cant stop. I have to do stuff. And then Im currently at a hospital. Thats why I have this uplifting little flower portrait. Were expecting a baby boy, and what do we tell him when he grows up about what we did when society needed us?

Excerpt from:

D.I.Y. Coronavirus Solutions Are Gaining Steam - The New York Times

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Testing is the biggest problem that were facing, Peter Slavin, president of Massachusetts General Hospital, said recently in a roundtable on Covid-19 at Harvard Medical School. While South Korea had tested about 4,000 people per million of its population at the time, the United States had just run five tests per million despite the fact that they both reported their first cases at essentially the same time (on January 21 and 20). The discrepancy was surprising because the genome of the virus had been available since January and scientists had figured out the diagnostics shortly thereafter, using proven molecular methods first discovered in the 1970s.

The value of a test comes from its so-called specificity and sensitivity: Infected patients should be correctly identified as infected, patients who dont carry the virus should be diagnosed as such, and people that unknowingly had the infection should be tested for immunity. This helps us understand who is infected, where the infection occurred, and how the virus was transmitted.

Testing is also needed to address the uncertainty in making decisions about patient treatment, resource allocation, policy, and so much more. Answers to questions such as When should we relax social distancing measures and for whom? or How many ventilators are needed in hospitals? are vital to our economic recovery and public health outcomes and cannot be answered without reliable test data. To find answers requires organizations in which testing is embraced (in action and orientation) by every employee, from top to bottom. Test early and often needs to be an organizations ethos.

If testing is so valuable, why wasnt the United States prepared to deploy tests quickly, even before Covid-19 hit the country? In recent weeks, the American media has focused on the Centers for Disease Control and Preventions (CDC) flawed test kits, the reluctance of the Food and Drug Administration (FDA) to approve new tests, manufacturing problems, government red tape, and President Trumps conflicting or even false statements about the availability of and need for tests.

I have studied and written about testing for more than two decades and can tell you that the central reason is often culture. For virtually all organizations not just those in health care having a testing strategy and building a culture to execute it are crucial when dealing with a crisis. Time and again, I have seen how as organizations try to scale testing capacity, they often find that the obstacles are not technology, but shared behaviors, beliefs, and values. Testing early and often is often viewed as wasteful in the eyes of organizations that emphasize efficiency and predictability. Thats until, of course, the opportunity cost of not testing becomes blatantly obviousand precious time and lives have been lost.

To reduce uncertainty, organizations need to make testing an integral part of what they do even when budgets are tight. A good test will show what does and does not work and improve decision-making, whether its about the design of a product, the implementation of a new policy, or how to treat patients.

But here is the dilemma: Despite being awash in information coming from every direction, todays decision-makers operate in an uncertain world where they lack the right data to inform strategic and tactical decisions. Consequently, for better or worse, their actions tend to rely on experience, intuition, and beliefs. But this all too often doesnt work.

What does work is creating an environment where employee curiosity is nurtured, data trumps opinions, and leaders embrace a new model of managing. Although my research has identified more cultural elements, I believe that the three below are especially important during the Covid-19 crisis.

Cultivate curiosity. Testing will surprise people, by definition: We test to figure out what we dont know! Everyone in an organization, from the leadership on down, needs to value such surprises, despite the difficulty of assigning a dollar figure to them and the impossibility of predicting when and how often theyll occur. Curious people thrive when they feel safe in their workplace and are not blamed for discovering inconvenient truths. When firms adopt this mindset, curiosity will prevail, and people will see wrong predictions not as costly mistakes but as opportunities for learning.

In test cultures, employees are undaunted by the possibility that they are wrong. The people who thrive here are curious, open-minded, eager to learn and figure things out, and OK with being proven wrong, a senior manager who oversees all testing at Booking.com, the worlds largest online accommodations platform, told me. The firms recruiters look for such people, and to make sure that theyre empowered to follow their instincts, the company puts new hires through a rigorous onboarding process, which includes training on its online test platform, and then gives them access to all testing tools.

Insist that data trumps opinions. The test results must prevail with few exceptions when they clash with strong opinions, no matter whose opinions they are. This must be the attitude of leaders, but its rare among most organizations for an understandable reason: human nature. We tend to happily accept good results that confirm our biases but challenge and thoroughly investigate bad results that go against our assumptions. Unless this simple fact is recognized, leaders will never appreciate the true value of early tests and prioritize them. Surprises from such tests are especially desirable when few commitments have been made and organizations have time to react.

Getting the top ranks to abide by this rule isnt easy. (As the American writer Upton Sinclair once quipped, It is difficult to get a man to understand something when his salary depends upon his not understanding it.) But its vital that they do: Nothing stalls the mobilization of testing resources faster than a so-called HiPPO highest-paid persons opinion. (Or in the case of whats been going on in the United States, I might say: The highest political persons opinion.) Note that Im not saying that all decisions can or should be based on tests alone. Some things are very hard, if not impossible, to conduct tests on for example, strategic calls on whether to acquire a company. But if everything that can be tested is tested, it will fuel healthy management debates and become instrumental to decision-making under uncertainty.

Embrace a different leadership model.If most decisions follow tests, is there anything left for senior leaders to do, beyond developing an organizations strategic direction and tackling big decisions such as which acquisitions to make? Of course in particular, the following:

Set a grand challenge. Employees need to see how large-scale testing supports an overall strategic goal. The grand challenge needs to be broken down into testable hypotheses and key performance metrics. Only then can organizations get aligned and work toward a common objective, such as X tests by date Y.

Put in place systems, resources, and organizational designs that allow for large-scale testing. Scientific testing requires infrastructure: instrumentation, data pipelines, scientists, people, and materials if tests are physical. Reliable tests may be available, but to scale things up, senior leaders must tightly integrate the testing capability into an organizations processes. Doing so requires striking the right balance between centralization and decentralization. It also requires a sense of urgency: leaders need to resist the so-called Not Invented Here Syndrome the unwillingness to accept outside solutions that work.

Be a role model. Leaders have to live by the same rules as everyone else and subject their opinions, ideas, and decisions to tests. You cant have an ego, thinking that you always know best, Booking.coms former CEO told me. If I, as the CEO, say to someone, This is what I want you to do because I think that its good for our business, employees would literally look at me and say, OK, thats fine, we are going to test it and see if you are right. Bosses ought to display intellectual humility and be unafraid to admit, I dont know. They should heed the advice of Francis Bacon, the father of the scientific method: If a man will begin with certainties, he shall end in doubts; but if he will be content to begin with doubts, he shall end in certainties.

Most of all, leaders need to understand that words can affect behavior. If test evidence isnt explicitly valued or invited because they may interfere with public relations or other goals, progress will be impeded. The conclusion of Richard Feynman, the famous physicist who participated in the investigation of the 1986 Challenger space shuttle accident, ring especially true during these difficult times: reality must take precedence over public relations, for nature cannot be fooled.

See more here:

Why Is the US Behind on Coronavirus Testing? - Harvard Business Review

The Department of Health and Human Services did not immediately respond to a request for comment.

The law permits federal agencies to skip an often bureaucratic procurement process that can take months and force companies to come to the table to sign a contract. Given the speed of the crisis, Joshua Gotbaum, a former assistant secretary of defense for economic security, said the government did not have the luxury of normal bidding and contracting.

Under the process of business as usual, theyre not even going to award contracts until this month or April, then there will be a protest, he said. Under the Defense Production Act, they could have sat down with people in February and finalized a contract.

Previous administrations have also been hesitant to invoke the law for nonmilitary matters.

If the federal government used the law to make itself the priority, other clients that had worked through the companys procurement process could have their orders delayed, though under the law, the vendor is protected from lawsuits.

My general experience is when youre in the midst of a national crisis, contractors generally speaking want to help, said Ernest B. Abbott, who was the general counsel of FEMA during the Clinton administration. They want to participate. They want to be able to keep their people employed to build whats needed for the nation.

But Mr. Hall, who in the months after Mr. Trump took office assisted Customs and Border Protection in using the law to secure body armor from Armor Express, a Michigan-based company, said such caution had allowed understanding of the laws powers to atrophy.

You have people on the civil side saying, What is this thing? I might get in trouble using it, Mr. Hall said.

While FEMA and Health and Human Services have discussed the law in training situations, Mr. Hall said he often had to press his superiors to prepare for its use in the event of a national emergency, such as a pandemic.

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Defense Production Act Has Been Used Routinely, but Not With Coronavirus - The New York Times

"We are not at war. Sailors do not need to die. If we do not act now, we are failing to properly take care of our most trusted asset our Sailors," Capt. Brett Crozier wrote in a memo to the Navy's Pacific Fleet, three US defense officials have confirmed to CNN.

"The spread of the disease is ongoing and accelerating," he added.

"Decisive action is required. Removing the majority of personnel from a deployed US nuclear aircraft carrier and isolating them for two weeks may seem like an extraordinary measure," he wrote in the memo. "This is a necessary risk. It will enable the carrier and air wing to get back underway as quickly as possible while ensuring the health and safety of our Sailors. Keeping over 4,000 young men and women on board the TR is an unnecessary risk and breaks faith with those Sailors entrusted to our care."

The commander of US Pacific Fleet declined to say how many sailors aboard the nuclear-powered aircraft carrier had tested positive for the coronavirus, but said that no one had been hospitalized.

"What I will tell you is I have no sailors hospitalized, I have no sailors on ventilators, I have no sailors in critical condition, no sailors in an ICU status on the Theodore Roosevelt," Adm. John Aquilino told reporters.

Asked about Crozier's letter, Aquilino said, "We're welcoming feedback. ... We want to make sure we understand exactly what the leader on the ground needs."

"We are on the same sheet of music and I am really trying to make it happen more quickly but there are some constraints we are operating around," Aquilino said, saying that the ship's captain wanted to see a faster pace than what was currently taking place.

One issue delaying the process is the lack of capacity to house, isolate and quarantine sailors in Guam where the ship is currently in port, something the admiral said the Navy was working to mitigate.

Asked about the letter, Secretary of Defense Mark Esper told CBS Tuesday, "Well, I have not had a chance to read that letter, read it in detail. Again I'm going to rely on the Navy chain of command to go out there to assess the situation and make sure they provide the captain and the crew all the support they need to get the sailors healthy and the ship back at sea."

"The commanding officer of the Theodore Roosevelt alerted leadership in the Pacific Fleet on Sunday evening of continuing challenges in isolating the virus," a US Navy official told CNN.

"The ship's commanding officer advocated for housing more members of the crew in facilities that allow for better isolation," the official added.

A second Navy official said that the number of coronavirus cases on board the aircraft carrier had surpassed 70 as of Tuesday morning, added that the Navy expected that figure to increase.

The outbreak seems to be escalating rapidly. A week ago the Pentagon confirmed three sailors on the Roosevelt had tested positive and that number had risen to 25 two days later. Since then the number of cases has almost tripled. On Monday, a US defense official told CNN that a second US aircraft carrier, the USS Ronald Reagan, is also facing a "handful" of positive cases.

Acting Navy Secretary Thomas Modly told CNN's John King Tuesday that he was aware of the letter and that the Navy was working to get the sailors off the ship.

"I heard about the letter from Capt. Crozier this morning, I know that our command organization has been aware or this for about 24 hours and we have been working actually the last seven days to move those sailors off the ship and get them into accommodations in Guam. The problem is that Guam doesn't have enough beds right now and were having to talk to the government there to see if we can get some hotel space, create tent-type facilities," Modly said.

"We don't disagree with the (Commanding Officer) on that ship and we're doing it in a very methodical way because it's not the same as a cruise ship, that ship has armaments on it, it has aircraft on it, we have to be able to fight fires if there are fires on board the ship, we have to run a nuclear power plant, so there's a lot of things that we have to do on that ship that make it a little bit different and unique but we're managing it and we're working through it," he added.

"We're very engaged in this, we're very concerned about it and we're taking all the appropriate steps," Modly said.

However, despite the large number of cases aboard, senior US military officials have insisted that the ship is capable of performing its missions.

"If that ship had to sail today for combat it's ready to sail right now if it was needed," Maj. Gen. Jeff Taliaferro, the vice director for operations for the Joint Staff, told reporters Monday.

"The appropriate measures are being taken for folks who have tested positive," he added.

The carrier is in port on a visit to Guam that the military has said was previously scheduled.

Crozier struck a more optimistic tone in a post on the ship's Facebook page on Monday, saying the "Sailors are in good spirits and are facing this new challenge with a level of professionalism that I have come to expect from such an amazing and resilient team."

CNN's Devan Cole and Michael Conte contributed to this report.

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Commander of aircraft carrier hit by coronavirus outbreak warns Navy 'decisive action' is needed - CNN

SEOUL, South Korea Shin Dong-yun, a scientist from the North Korean Institute of Virology, rushed to the northwestern border with China in early February. There, he conducted 300 tests, skipping meals to assess a stream of people so that the country is protected from the invasion of the novel coronavirus.

Stories like this, carried in the state-run newspaper Rodong Sinmun, focus attention on one of the stranger oddities surrounding the Covid-19 pandemic: How could North Korea claim to not have a single coronavirus case while countries around the world stagger under the exploding epidemic?

North Korea has taken some of the most drastic actions against the virus and did so sooner than most other nations. It sealed its borders in late January, shutting off business with neighboring China, which accounts for nine-tenths of its external trade. It clamped down on the smugglers who keep its thriving unofficial markets functioning. It quarantined all diplomats in Pyongyang for a month. The totalitarian states singular ability to control the movement of people also bolsters its disease-control efforts.

But decades of isolation and international sanctions have ravaged North Koreas public health system, raising concerns that it lacks the medical supplies to fight an outbreak, which many fear has already occurred.

You can see immediately whats going to happen if you get a surge of Covid-19 patients streaming in, said Dr. Kee B. Park, a lecturer at Harvard Medical School who has worked alongside North Korean doctors to help improve the countrys health system. It will overwhelm the system very quickly.

Many observers of North Korea doubt its claims of not having any coronavirus cases. But a lack of testing equipment may mean it literally has not detected a single case, Dr. Park said.

Its because they may have cases but they just dont know how to detect it, he said. So they can say, We have not confirmed it.

Some accuse North Korea of hiding an outbreak to preserve order.

Its a blatant lie when they say they have no cases, said Seo Jae-pyoung, secretary-general of the Seoul-based Association of North Korean Defectors, who said he heard from his North Korean contact that a family of three and an elderly couple died of the virus in the east coast city of Chongjin in mid-March. The last thing the North wants is a social chaos that may erupt when North Koreans realize that people are dying of an epidemic with no cure.

The Norths leader, Kim Jong-un, is clearly aware of the threat the virus poses to his countrys decrepit health system. Around when Washington announced on Feb. 13 that it would allow coronavirus-related humanitarian shipments, North Korea made a rare request for urgent help from relief groups, including diagnostic kits, according to people familiar with the matter.

In recent weeks, the Norths official media outlets have carried alarming reports detailing the coronaviruss toll around the world: a snowballing caseload in South Korea; bodies piling up in Italy; panicked citizens hoarding guns and ammunition in the United States.

They contrast such reports with pictures of North Korean disease-control officials in full protective gear spraying disinfectant in buses, trams, playgrounds and hotel gyms in Pyongyang, the showcase capital city. Garment factories are shown making masks instead of clothes. There is a national drive to send eggs, meat and fish to those under quarantine.

By its own account, North Korea has quarantined 10,000 people. International disease-control officials have all been amazed how North Korea could have done it, the state-run Rodong newspaper said this month.

But video clips shot in Hyesan, a town on the Norths central border with China, in February and early March depict a far less flattering picture of the Norths disease-control efforts.

A red wooden marker on a sidewalk covered with a dirty slush of ice said disinfection station, according to a clip, which was smuggled to the Rev. Kim Seung-eun, a human rights activist in South Korea, and viewed by The New York Times. A lone official in a green plastic suit with a tank of disinfecting liquid on his back stood idly. A silver van raced through the town blaring the importance of wearing masks. In another clip, a sign saying Quarantined was stuck on the door of what looked like a tenement house where Reverend Kim said people with possible symptoms were kept.

Reverend Kim said one of his North Korean contacts had been unable to return home for a month after visiting another town because the government controlled internal movement. Such restrictions were needed for disease control because of North Koreas crowded public transportation network.

The countrys information blackout and the inability of outside health experts to get into the country leave the rest of the world largely in the dark about how North Korea is coping with the virus.

Last month, Daily NK, a Seoul-based website that hires anonymous informants inside the North, reported the deaths of 200 soldiers, as well as 23 others, who were suspected of contracting the coronavirus. But Kang Mi-jin, a North Korean defector-turned journalist in Seoul, said that no matter how hard they searched, her contacts in the North could not find a death officially ascribed to the coronavirus.

In the past, the country has hushed or played down epidemics, military rebellions, man-made disasters or anything else that could undermine the peoples faith in the government.

But this time, the Norths unusually aggressive moves, as well as its unique ability to detain people, may have prevented a devastating outbreak, said Jung Gwang-il, a North Korean defector who leads No Chain, a North Korean human rights activist group in Seoul. As soon as an outbreak was reported in China, North Korea rounded up all Chinese visitors in its northeastern town of Rason and quarantined them on an island for a month, Mr. Jung said.

Its safe to say that there are cases in North Korea, but I dont think the outbreak there is as large as the ones we have seen in South Korea, Italy and the U.S., said Ahn Kyung-su, the head of the Seoul-based Research Center of DPRK Health and Welfare, which monitors the Norths health system. North Koreans are trained to obey government orders in a shipshape way during crises. But there is the risk of the virus running out of control if it starts spreading among its malnourished people.

Mr. Ahn said testing kits from China were available in big cities like Pyongyang. Telltale evidence came when Kim Jong-un inspected a missile test this month and military officers surrounding him did not wear masks, which Mr. Ahn said would not have happened had they not tested negative.

But the coronavirus has put Mr. Kim between a rock and a hard place, analysts say.

On March 17, he broke ground on a modern Pyongyang General Hospital to be completed by October. But such projects in the North rely on mass mobilizations of soldiers who sleep and eat together for months at a stretch, and raise the risk of mass infections during an epidemic.

By this month, some help began reaching North Korea in its efforts to confront the virus. Russia donated 1,500 test kits. China is also believed to have sent diagnostic tools. The United Nations has begun waiving sanctions for aid groups like the Red Cross to ship testing machines and diagnostic kits, as well as ventilators and protective equipment. But the shipments have been slow.

Given the global shortage of supplies and items being available in different locations, we are still in the process of procuring the items, said Ellie Van Baaren, a Red Cross spokeswoman.

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North Korea Claims No Coronavirus Cases. Can It Be Trusted? - The New York Times

Consumer spending is 70 percent of GDP, said Torsten Slok, chief international economist at Deutsche Bank Securities. An important part of what drives your and my consumer spending is your wealth and whether you have a job.

The decline was not as bad as some economists were expecting consumers were surveyed between March 1 and March 18 but with more than 3 million people joining the unemployment ranks in just one week this month, that number is sure to drop much further.

The survey period is almost entirely before the shutdowns/mass layoffs began, said Megan Greene, an economist at Harvard Kennedy School. I would also expect the next set of consumer confidence numbers to be a whole lot worse.

Consumer confidence was consistently one of the bright spots in the U.S. economy under Trump before the pandemic hit; even when business investment shrank and the manufacturing entered a recession, healthy spending by Americans helped drive unemployment down to lows not seen since the 1960s.

That confidence could be difficult to recover, depending on the effectiveness of the relief measures pursued by Congress and the administration, economists say.

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Coronavirus hits the economy where it hurts: Consumer confidence - POLITICO

Some senators had wanted to put a provision in the coronavirus bill to protect patients from surprise out-of-network billing either a broad clause or one specifically related to coronavirus care. Lobbyists for hospitals, physician staffing firms and air ambulances apparently helped ensure it stayed out of the final version. They played what a person familiar with the negotiations, who spoke on condition of anonymity, called the Covid card: How could you possibly ask us to deal with surprise billing when were trying to battle this pandemic?

Even without an E.R. visit, there are perilous billing risks. Not all hospitals and labs are capable of performing the test. And what if my in-network doctor sends my coronavirus test to an out-of-network lab? Before the pandemic, the Kaiser Health News-NPR Bill of the Month Project produced a feature about Alexa Kasdan, a New Yorker with a head cold, whose throat swab was sent to an out-of-network lab that billed more than $28,000 for testing.

Even patients who do not contract the coronavirus are at a higher risk of incurring a surprise medical bill during the current crisis, when an unrelated health emergency could land you in an unfamiliar, out-of-network hospital because your hospital is too full with Covid-19 patients.

The coronavirus bills passed so far and those on the table offer inadequate protection from a system primed to bill patients for all kinds of costs. The Families First Coronavirus Response Act, passed this month, says that the test and its related charges will be covered with no patient charge only to the extent that they are related to administering the test or evaluating whether a patient needs it.

That leaves hospital billers and coders wide berth. Mr. Cencini went to the E.R. to get a test, as he was instructed to do. When he called to protest his $1,622.52 for hospital charges (his insurers discounted rate from over $2,500 in the hospitals billed charges), a patient representative confirmed that the E.R. visit and other services performed would be eligible for cost-sharing (in his case, all of it, since hed not met his deductible).

This weekend he was notified that the physician charge from Emergency Care Services of New York was $1,166. Though covered by his insurance, he owes another $321 for that, bringing his out-of-pocket costs to nearly $2,000.

By the way, his test came back negative.

When he got off the phone with his insurer, his blood was at the boiling point, he told us. My retirement account is tanking and Im expected to pay for this?

The coronavirus aid package provides a stimulus payment of $1,200 per person for most adults. Thanks to the billing proclivities of the American health care system, that will not offset Mr. Cencinis medical bills.

Elisabeth Rosenthal, a former New York Times correspondent, is the editor in chief of Kaiser Health News, the author of An American Sickness: How Healthcare Became Big Business and How You Can Take It Back and a contributing Opinion writer. Emmarie Huetteman is a correspondent at Kaiser Health News.

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He Got Tested for Coronavirus. Then Came the Flood of Medical Bills. - The New York Times

So what has happened? Well, several different things. From the Wuhan outbreak through somewhere in mid-February, the responses to the coronavirus did seem to correspond very roughly to theories of conservative and liberal psychology. Along with infectious-disease specialists, the people who seemed most alarmed by the virus included the inhabitants of Weird Right-Wing Twitter (a collection of mordant, mostly anonymous accounts interested in civilizational decline), various Silicon Valley eccentrics, plus original-MAGA figures like Mike Cernovich and Steve Bannon. (The radio host Michael Savage, often considered the most extreme of the rights talkers, was also an early alarmist.)

Meanwhile, liberal officialdom and its media appendages were more likely to play down the threat, out of fear of giving aid and comfort to sinophobia or populism. This period was the high-water mark of its just the flu reassurances in liberal outlets, of pious critiques of Donald Trumps travel restrictions, of deceptive public-health propaganda about how masks dont work, of lectures from the head of the World Health Organization about how the greatest enemy we face is not the virus itself; its the stigma that turns us against each other.

But then, somewhere in February, the dynamic shifted. As the disease spread and the debate went mainstream, liberal opinion mostly abandoned its anti-quarantine posture and swung toward a reasonable panic, while conservative opinion divided, with a large portion of the right following the lead of Trump himself, who spent crucial weeks trying to wish the crisis away. Where figures like Bannon and Cernovich manifested a conservatism attuned to external perils, figures like Rush Limbaugh and Sean Hannity manifested a conservatism of tribal denial, owning the libs by minimizing the coronavirus threat.

Now we are in a third phase, where Trump is (more or less, depending on the day) on board with a robust response and most conservatives have joined most liberals in alarm. Polls show a minimal partisan divide in support for social distancing and lockdowns, and some of that minimal divide is explained by the fact that rural areas are thus far less likely to face outbreaks. (You dont need a complicated theory of the ideological mind to explain why New Yorkers are more freaked out than Nebraskans.)

But even now, there remains a current of conservative opinion that wants to believe that all of this is overblown, that the experts are wrong about the likely death toll, that Trump should reopen everything as soon as possible, that the liberal media just wants to crash the American economy to take his presidency down.

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The Coronavirus and the Conservative Mind - The New York Times