Category: Corona Virus

A CNN review of the latest airline-related data gives a clearer picture of how air travel has ground to a halt, a result of isolation measures around the country.

The latest announcement on Friday from American Airlines reflect the trends around the industry: Over the next two months, it expects to fly as little as 20% of its domestic schedule and between 10% and 20% of its international schedule.

Many of those planes have just a handful of passengers. American CEO Doug Parker said his planes are about 15% full. US airlines started the year filling about four of five available seats, but are now, on average, filling just one of every five seats, according to data from Airlines for America, an industry group.

The sliver of usual traffic that is now trickling through airport security checkpoints show how few people are packing their bags. The Transportation Security Administration on Thursday screened just 8% of the travelers that it did on the equivalent day in 2019 -- the first day since the coronavirus pandemic reached the US when that number has dropped below 10%.

As the number of travelers nationwide has dropped, TSA has cut back on the number of checkpoints it operates, particularly at medium- and large-sized airports, according to an aviation official familiar with the matter.

In some cases, the official said, the reductions have been linked to a reduced availability of officers to work. More than 60 TSA officers have tested positive for the coronavirus, according to agency data compiled by CNN. The union representing them said dozens more have needed to stay home due to the possibility of exposure.

The official noted that the drop in traffic means multiple security lanes are not needed and can be consolidated. The closures have also allowed the agency to space out the number of lanes that are operational.

The stark figures underscore why the nation's passenger and cargo airlines requested a $58 billion federal relief package, divided between grants to pay employees and loans for other expenses. Parker said his airline expects to receive "about $12 billion" of the package.

An additional $10 billion is for airports, and $3 billion is reserved for the companies whose employees stock and clean aircraft between flights.

Across the industry, airlines have slashed from their schedules. Two operators of regional jet service that work for American, Delta and United Airlines, are closing their doors because the cuts and passenger declines were too deep.

When Delta Air Lines unveiled one round of cuts, CEO Ed Bastian told employees in a memo obtained by CNN that "the speed of the demand falloff is unlike anything we've seen." Days later, the airline made even steeper cuts -- and is now flying only 30% of its usual schedule.

United says it is currently operating at only 68% of its schedule. Earlier this month, it cut its international schedule by 95%, then added a few flights back to its roster, adapting to the plight of Americans overseas who were "displaced and still need to get home."

Southwest is eliminating 1,500 of its 4,000 daily flights.

The schedule cuts have snowballed as the US and other governments rolled out travel restrictions. Some of the latest flight cancellations are linked to quarantine restrictions in Hawaii. The infrastructure around tourism and travel -- including conferences, hotels, sightseeing, cruises and restaurants -- have cut operations and staff.

Airlines are similarly closing lounges for premium travelers and cutting back on amenities for travelers, such as poured drinks on aircraft. Southwest, for example, is shifting to serve passengers only water in individual cans.

The schedule cuts mean the airlines need to operate far fewer planes. Delta has grounded 600 planes -- more than half its fleet. American says its grounded jets are congregating at airfields in Pittsburgh, Tulsa, Roswell, New Mexico, and Mobile, Alabama.

Airlines for America says about 1,200 planes in the US fleet of 6,215 have been grounded due to the coronavirus outbreak -- not including planes like the Boeing 737 MAX that were grounded a year ago, or are awaiting delivery.

Airlines rarely ground planes because it not only means no revenue, but losses. Planes in short-term storage require regular maintenance to remain ready to return into service.

Worldwide, nearly a third of the 17,750 passenger jets in operation are parked, according to the aviation data firm Cirium. That number is growing rapidly: It said 1,000 more planes were parked since its update a day earlier.

The airlines also need fewer pilots, flight attendants, and other employees. Hundreds of pilots at American Airlines have accepted early retirements. Delta announced Friday that more than 21,000 employees are taking unpaid leave. The memo to employees, obtained by CNN, described unpaid leave as "the most important way you can help the company over the next few months. We could use more volunteers."

One bright spot for airlines: The need for cargo shipping has grown. American Airlines recently flew its first cargo-only flight since 1984, laden with medical supplies, mail and packages people ordered from online retailers.

CNN's Chris Isidore and Joshua Replogle contributed to this report.

Read more:

Thousands of grounded planes. Nearly empty flights. How the coronavirus is affecting US airlines - CNN

Pennsylvania has scant reserves and likely cant rely on them to bridge the gap: The states rainy day account could fund government operations for only about 3 days, even after a large deposit last year. The decision to extend the deadline prioritizes public health at a time when Wolf is urging Pennsylvanians to stay at home to help prevent the spread of the virus, said Jeffrey Johnson, a state Department of Revenue spokesperson.

Read this article:

Delay of tax deadline due to the coronavirus will cause significant disruption to Pa.s budget process - The Philadelphia Inquirer

An organ transplant specialist has become the first working NHS surgeon to die from coronavirus.

Adil El Tayar, 63, died on Wednesday at West Middlesex university hospital in London, his family said.

The doctor, who had worked around the world, spent his final days volunteering on the frontlines against the outbreak in an A&E department in the Midlands.

He wanted to be deployed where he would be most useful in the crisis, his cousin, British-Sudanese journalist Zeinab Badawi, said in a moving tribute on BBC Radio 4.

It had taken just 12 days for Adil to go from a seemingly fit and capable doctor working in a busy hospital to lying in a hospital morgue.

Tayar started self-isolating at home after developing symptoms about two weeks ago, but was taken to hospital and placed on a ventilator after his condition worsened.

Four days later medics told his family that his lungs had come under attack from the virus and he could no longer breathe unaided.

Until I had learned of Adils death I had been fairly phlegmatic about the pandemic, Badawi said. But there is nothing like a death in the family to bring home the realities of what we are facing.

Badawi learned of her cousins death on Thursday, three minutes before she joined millions across the UK in applauding NHS workers.

She said: Clapping along with my neighbours engendered in me a feeling of unity that we are all in this together and that we sink or swim together.

Perhaps this transformation will be permanent. I hope it will be.

Former colleague Abbas Ghaznafar, a renal transplant surgeon at St Georges University in Tooting, described Tayar as a noble human being who was a hard-working, dedicated surgeon.

Dr Hisam El Khidir, another of the surgeons cousins, told the BBC that he suspected Tayar had caught the virus while working on frontlines.

The British ambassador to Sudan Irfan Siddiq tweeted: Saddened to hear of Sudanese doctor Adel Altayars death in the UK from Covid-19.

Health workers around the world have shown extraordinary courage. We cannot thank them enough. In this fight we must listen to their advice.

Tayar leaves behind a wife and four children, two of whom also work as doctors in the NHS.

El Khidir told the BBC: Adil was someone who was central to our family, who was well respected by so many people.

Since his death on Wednesday, I have had hundreds of text messages from his colleagues and friends. He will be sorely missed.

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First working NHS surgeon dies from coronavirus - The Guardian

The coronavirus pandemic, which has escalated dramatically in the last month, has upended most of American life and the polling industry is no exception. Social distancing requirements have closed most offices and the exponential growth of cases has meant that a poll can be outdated even just a few days after it's conducted due to the rapid shifts in public opinion.

Polling is conducted in numerous ways and with an almost infinite number of methodological choices to be made. Surveys can be conducted by phone with live people asking questions, online, by mail, in person, by phone with automated callers and many other options in between, each presenting their own pros and cons in the pandemic.

And now public opinion firms are combating issues such as conducting polls without a room full of people at call centers, an influx of interest in pandemic data and a news cycle that won't stay still long enough to field a poll.

But with rapidly changing data comes new innovations and strategic changes to the polling industry. In an effort to gauge public opinion, many call centers are working from home, while pollsters who are methodologically diverse are relying more and more on online polling to properly represent the nation, trying to keep their finger on the ever-moving pulse.

How to have a call center at home

"Our work from home infrastructure has been in place for more than a decade, thankfully. We had it all set up," she said. "So, with the recent coronavirus development, we've been transitioning as many of our interviewers as possible using that technology. If we had to build this infrastructure on the spot, I think it would've been difficult to do."

Without that infrastructure in place, companies may have been scrambling to properly equip the thousands of call center employees before sending them off, but Herrmann reports they've been prepared.

"A few years ago, we moved our phone operations to where people are able to work remotely and essentially use a virtual console to do dialing from their homes. So, we're able to have some consistency and some continuity in our phone operations," Jackson said.

Ipsos conducts polling in multiple ways: over the phone, their online panel, mail, face to face and more. Jackson said the company is "methodologically agnostic" despite being known for their Ipsos KnowledgePanel.

It's important that Ipsos' and other pollsters remain relatively consistent with their methodology since many surveys have a trend line dating far back in history, and a change from live phone to online could make surveys not directly comparable.

Those guidelines vary country to country, but in the US, Jackson said Ipsos is pivoting slightly by relying more heavily on their online panel. Herrmann reports SSRS hasn't changed their methods significantly, but is ensuring all employees are safe.

Increased response rates

Jackson told CNN that, anecdotally, he's seen an increase in the people responding to surveys.

"We've definitely seen a real spike in demand, especially for our online platform," he said. "We've been talking internally, and we think we've done -- across the entire company, around the world -- around over a million interviews over the past couple of weeks. People who are stuck at home have nothing else to do but answer surveys, right?"

While there aren't any hard figures on response rates over the past few weeks, all pollsters mentioned some preliminary numbers that showed a boost in phone responses, online responses, people ready to discuss the issue.

Herrmann noted how interested Americans are in discussing the constantly changing issue, saying, "People have been really engaged about speaking to us on these salient topics and current events we're asking about, particularly coronavirus, due to the obvious impact it's having on everyone's lives right now."

How quickly the data is changing

Pollsters already struggle to keep up with the news. Polls with a short fielding period take around three days, depending on what questions the pollsters are asking, and pollsters often run the risk of having their poll completely irrelevant by the time the data is released.

Upwards of 30 polls have been released on coronavirus since February, included a huge number this week alone. Many are repeat polls, trying to get a proper trendline to show how quickly concerns around coronavirus have surged.

Companies like Abt Associates -- another major survey outlet contracted by private and public sectors alike, including the CDC -- are seeing how far and wide the data can reach.

"Not only do we need to maintain continuity for our current data collection, analytic, and systems support efforts, but we also have to continue providing urgent support to agencies attempting to understand the wide-ranging impacts of the COVID-19 pandemic on public health, homelessness, the education of our children, food security and the like, in addition to efforts to track the prevalence of the virus itself," writes Link.

Survey demand and employee safety

But increased response rates and a salient topic doesn't always mean easy going for the pollsters. Media attention spikes around coverage of emerging infectious diseases and pollsters are feeling the heat of a busy news cycle.

Herrmann told CNN that SSRS can anticipate this, but still says they're working long hours.

"Once you do polling, you're pretty accustomed to working quickly. Our teams are used to it. But it has been changing so quickly in this case," she said.

Herrmann specifically discussed concern for her employees at SSRS. After lamenting how much she misses the office -- they usually conduct their own daily poll around the coffee machine for questions like "favorite candy type" -- she said she's had to be assertive, making sure they aren't biting off more than they can chew and are keeping their own well-being at the forefront.

"But in terms of what has changed, it's mostly been from a personnel perspective, making sure we're doing things in the best interest of our staff. You have to be forceful about it and we're trying to keep everyone safe."

Jackson said he's been working long days but wants to get his data out there before it goes bad, since the dialogue has changed so quickly.

"It's a terrifying, yet fascinating time to be doing public opinion research," he said.

Read this article:

How coronavirus is impacting public opinion research - CNN

Editor's note: If you'd like an email notice whenever we publish Ross Ramsey's column, click here.

Only three COVID-19 cases have been confirmed in the 22 counties in state Rep. Drew Springers North Texas House district, and he said Thursday that a lot of people are just coming to the realization about why we need social distancing.

There were more people on the road in Gainesville and Muenster yesterday than in New York City, he said.

My constituents would have argued [earlier] that were drastically overreacting, Springer said. I think as they have started hearing more, theyre coming around. ... Im waiting to see whether the cases here, and the names of people who get sick, will change peoples opinions.

Pandemic is a word for a disease that is no longer local, that has taken on worldwide scope.

But the responses to the new coronavirus pandemic in Texas and elsewhere are distinctly local and vary deeply from the mostly voluntary shelter-in-place orders in effect in the states most populated cities and counties to the wait-and-see positions of governments and businesses elsewhere.

Those local differences help explain why statewide officials like Gov. Greg Abbott have been so reluctant to issue statewide stay-at-home orders. Metropolitan areas are aggressively putting social distancing rules in place, while less populated parts of Texas are more reticent.

Reports of COVID-19 cases might not be as prevalent outside of the metropolitan areas, and official actions have been slower and less restrictive.

In Midland, many residents have continued their normal routines, shopping in grocery stores and at busy retail locations. The city hasnt issued restrictive orders but has been talking about it. Theres a striking parallel between the places restricting social gathering and the political map, but thats not what some politicians see.

I dont know if its a red versus blue thing; its a human nature thing, said Jack Ladd Jr., a member of the Midland City Council. A lot of people want to see something like this before they react.

That visibility is increasing as cases pop up in Midland. And the county recorded its first death attributed to COVID-19, the disease caused by the new coronavirus, this week, which has prompted more discussion from public leaders.

At the same time Abbott was issuing his first set of emergency orders, Anderson County in East Texas was doing the same, barring gatherings of 10 people or more and asking people to limit their interactions.

County Judge Robert Johnston said the reaction has been pretty positive overall. He said some churches have pushed back, noting many of them dont have the kind of internet access that would allow online services to replace in-person congregation.

The order has limited gatherings but hasnt kept people inside, Johnston said. No, I dont think theyre staying at home. They are eating at home, still running errands, but there are fewer people out.

So far, the county hasnt reported any confirmed cases of COVID-19, either from its general population or from any of its five state prisons.

The county has no plans to impose a shelter-in-place order, he said, but suggested it might not be necessary. People know if were going to get a hand on this, were going to have to stay home.

Lubbock stopped short of telling residents to stay at home, but it did put restrictions in place. Lubbocks emergency order, Mayor Dan Pope said, is like the stay-at-home orders elsewhere, without the panic in it.

You know West Texas, he said. We have a little more common sense ... and a healthy sense of skepticism.

I would say people are in two camps those who have bought in and understand and are really staying home, and another group thats harder to reach, he said.

He said Lubbocks two hospitals are well situated at the moment they can open another 40 ICU beds if needed and added that we dont have any stress on our health care system at this time. As of Thursday, the city had a drive-through testing center, and he said it plans to have a total of four by Monday. Lubbock County had 19 confirmed cases of COVID-19 on Thursday, he said.

Springers House District 68, which stretches from north of Dallas-Fort Worth across North Texas and into the Panhandle, is seeing a new kind of visitor he attributes to the pandemic: shoppers.

The odd stuff here is really the foot traffic, he said.

One meat market sold out in a matter of hours this week. Some of the stores are limiting sales, he said, to allow locals a chance to buy groceries and supplies before out-of-towners scoop them up.

He said the county clerks in Cooke and Montague counties have seen a rush of lovebirds from the D-FW area, where the courthouses are closed, seeking marriage certificates. The clerk has to actually see both people to issue a license, he said. Some of them dont want to wait.

Read more:

Coronavirus and local control in Texas - The Texas Tribune

If the rate of growth in coronavirus cases in the New York metro area continues, it will suffer a more severe outbreak than those experienced in Wuhan, China, or the Lombardy region of Italy.

There is no guarantee, of course, that current trends will continue. What has happened to this point cant be used to predict what will happen next. It is possible that social distancing will soon slow or arrest the growth of cases.

But what can be said is that the New York metro area has had less success in flattening the curve, at this point in its outbreak, than Wuhan or the Lombardy region did at the same point in theirs. And some other American metropolitan areas appear to be on a similar path.

Here are four ways to measure the size of the outbreak across the countrys metro areas.

The New York City area has more known cases per capita than any other metro area in the United States.

Figures as of March 26; includes micropolitan statistical areas

Pros of this measure Focuses on communities where the disease is prevalent.

Cons Varying testing rates make comparisons difficult. Not all confirmed cases are active.

In the early stages of an outbreak, the population size doesnt matter one infected person will probably infect a few people, whether that person lives in a metropolitan area of 100,000 or one of 10 million. But as an epidemic progresses, the number of cases per capita can provide a good measure of the prevalence of coronavirus in a community. Per capita measurements also give a sense of how strained a communitys health care system has become, since larger places tend to have more medical resources.

To make useful per capita comparisons, weve focused on metropolitan areas instead of countries or cities or U.S. states. Thats because metropolitan areas roughly correspond with the regions where the virus might spread quickly among families, co-workers or commuters. The New York City metropolitan area includes nearby cities and suburbs in Westchester, Long Island, and northern New Jersey, as well as sprawling, outlying areas that stretch even farther from the city.

As of March 26

Our tables include numbers from Lombardy and Wuhan to provide a benchmark for metro areas in the United States. The comparisons are illustrative, but not exact. Those outbreaks have been going on longer, which means their case numbers are spread over more time. In most of the U.S., cases are from only the last month.

The number of confirmed cases is an imperfect measure of what we really care about: the prevalence of the virus in the population, and therefore if it is early in the epidemic how many people are sick or may be contagious. The limited availability of testing in some places means that many people with coronavirus wont be counted among the confirmed cases. And the varying rates of testing across states and countries make it hard to compare the number of confirmed cases in different regions.

Deaths per capita are currently higher in the New York City area than in most other places.

As of March 26; includes only metro areas with three deaths or more.

Pros of this measure Coronavirus deaths are much more likely to be accurately counted than total cases.

Cons Death rates depend on the underlying health and age of various communities. They also lag infections by several weeks, so they dont tell us whats happening now.

Examining deaths can allow for a more direct comparison between communities, since it avoids many of the problems with variable testing. Testing differences matter less in measuring deaths because in most places with established outbreaks in the United States, the sickest patients are getting tested. (That may be less true in other parts of the world: Patients who die outside hospitals in Britain and Italy have, in some cases, been omitted from official data.)

But measuring only deaths has drawbacks, too. We know that the death rate from coronavirus differs depending on the age and health of the populations affected and the availability of medical resources, like ventilators. That means that per capita rates may look high in places where the virus has infiltrated nursing homes, for example, even if it has not spread widely through the rest of the community.

Because patients who die of Covid-19 tend to be sick for weeks first, counting deaths may also understate the current size of the outbreak in a given place if it is growing quickly.

As of March 26; includes only metro areas with three deaths or more.

The number of cases in the New York area is still growing quickly.

To assess the possible future of the outbreak, its helpful to look not just at the number of cases but also at how quickly they are increasing. The accompanying chart shows the growth rate of cumulative cases over time, averaged over the previous week.

Pros of this measure Growth rates help us judge whether the epidemic is getting better or worse in a given place right now.

Cons The timing of different outbreaks can make comparisons difficult. Case data quality varies a lot by place.

Here, we can see whether the trajectory of a local epidemic is getting better or worse. A growth rate of 40 percent on this chart means the cumulative number of cases is growing by 40 percent every day. A rate of 100 percent would mean that the number of cases was doubling daily.

Public health officials have been talking about the value of social distancing measures as a way to flatten the curve of the epidemic. Such a flattening would mean that the rates in this chart are falling, eventually to zero. New Yorks current growth rate is just over 30 percent, suggesting that its curve remains quite steep, and that the disease is continuing to spread rapidly throughout the region.

In some other metro areas, like Baton Rouge, La., the growth rate is high, but the number of cases is still low. That means the community may still have time to flatten its curve before the outbreak becomes widespread. But communities with a lot of cases and a high growth rate are on track to have a serious problem. A high growth rate on top of a large number of cases means that a still larger number of people are on track to become ill or die.

Case numbers in the New York area are also growing quickly given the size of its outbreak.

Pros of this measure Helps distinguish between places where cases are growing fast with few cases and places where cases are numerous and still growing fast.

Cons Hard to read. Relies on case data.

The chart above shows the growth rate by the number of cases in a given place. This measurement shows whether a community has succeeded in slowing the rate of growth before there are many cases. In other words, it shows whether a community is succeeding at flattening the curve.

By this measure, the situation in the New York area does not appear promising. The rate of increase in cases is far higher for the number of cases than it was in Wuhan or Lombardy, once they had reached similar numbers of cases. Other metropolitan areas, like Detroit and New Orleans, stand out as places where a coronavirus outbreak might escalate quickly without preventive measures. The Seattle and San Francisco areas, in contrast, seem to have made serious progress in flattening the curve.

The chart also helps avoid the illusion of success created by a slow, initial rate of growth. Many charts depict the growth of cases over time, and it can be easy to assume that the communities that get an outbreak quickly, and therefore appear above the pack on the chart, are faring the worst. But a community that experiences a high rate of growth with a large number of cases is in serious trouble, regardless of whether the outbreak occurs 10 or 100 days after it had its first cases.

See more here:

Some U.S. Cities Could Have Coronavirus Outbreaks Worse Than Wuhan's - The New York Times

Google has banned the Infowars Android app from the Google Play store, the company confirmed to Wired on Friday. Google also confirmed the apps removal to The Verge, and we couldnt find the Infowars app in a search on the Play Store this evening.

The app was apparently removed because of a video posted by radio host and conspiracy theorist Alex Jones that, according to Wired, disputed the need for social distancing, shelter in place, and quarantine efforts meant to slow the spread of the novel coronavirus. Before it was removed, the app had more than 100,000 downloads, Wired reports.

Now more than ever, combating misinformation on the Play Store is a top priority for the team, a Google spokesperson said in a statement given to The Verge. When we find apps that violate Play policy by distributing misleading or harmful information, we remove them from the store. Infowars was not immediately available for comment.

Last week, Alex Jones was ordered by New York Attorney General Letitia James to stop selling Infowars products that were marketed as a treatment or cure for the coronavirus. [Alex Jones] latest mistruths are incredibly dangerous and pose a serious threat to the public health of New Yorkers and individuals across the nation, James said in a statement.

Tech companies have also publicly committed to cracking down on coronavirus misinformation. Google has an SOS Alert in place for searches for COVID-19, the disease caused by the novel coronavirus, that points to resources from the CDC and local governments at the top of search results. And a group of companies that includes Facebook, Google, LinkedIn, Microsoft, Reddit, Twitter, and YouTube said theyre jointly combating fraud and misinformation about the virus in a statement issued on March 16th.

Apple permanently banned the Infowars app from the App Store in September 2018, citing App Store guidelines that forbid content thats offensive, insensitive, upsetting, intended to disgust, or in exceptionally poor taste.

Read the rest here:

Google has banned the Infowars Android app over false coronavirus claims - The Verge

Dr. Deborah Birx, who coordinates the White House Coronavirus Task Force, criticized a test "where 50% or 47% are false positives" at a briefing on March 17. Kevin Dietsch/UPI/Bloomberg via Getty Images hide caption

Dr. Deborah Birx, who coordinates the White House Coronavirus Task Force, criticized a test "where 50% or 47% are false positives" at a briefing on March 17.

When asked why the United States didn't import coronavirus tests when the Centers for Disease Control and Prevention ran into difficulty developing its own, government officials have frequently questioned the quality of the foreign-made alternatives.

But NPR has learned that the key study they point to was retracted just days after it was published online in early March.

Top officials in the Trump administration have alluded to this study, including Dr. Deborah Birx, who coordinates the White House coronavirus task force. "It doesn't help to put out a test where 50% or 47% are false positives," she said at a White House briefing on March 17, explaining why health officials didn't accept tests from other countries.

Food and Drug Commissioner Stephen Hahn cited the figure as well during an interview on Morning Edition on Friday.

"It's really important to understand, getting an accurate and reliable test on the market's important," he told host David Greene. "Our team can provide you with an abstract that was recently published in the literature about a test that was performed in another country that demonstrated a 47% false positive rate. Now, think about that, David. What that means is that if you had a positive test, it was pretty close to a flip of a coin as to whether it was real or not."

We followed up and got the abstract, which is a summary of the scientific paper.

The abstract is in English, though the paper itself is in Chinese, and describes a test developed in China. That provenance in itself is notable, because the factoid about flawed tests has come up in response to questions about why the administration didn't ask to import tests the World Health Organization distributes, when it became evident the CDC was struggling to scale up its own test.

The WHO has relied heavily on a test produced in Germany not China.

The figure 47% does indeed appear in the abstract of the Chinese paper, but it doesn't refer to the overall quality of this viral test. Instead, it refers to one particular slice of the population: people who have no symptoms of COVID-19 but have had close contact with those who had been diagnosed with the disease.

The abstract concludes that close contacts are often labeled as being infected when they apparently are not. The abstract makes no mention of the overall performance of the test.

When we tried to retrieve the actual paper from the Chinese journal, we got a dead link. A graduate student at Stanford University School of Medicine who is fluent in Chinese volunteered to help us track down the paper.

In a phone call with the journal Chinese Journal of Epidemiology, sponsored by the Chinese Medical Association, she learned that the paper had been accepted after peer-review and published online on March 5, but it was retracted within a few days. A representative from the journal told the graduate student there was a problem with the paper but did not know the details.

However, during the brief period the paper was available from the Chinese journal, it was indexed by the U.S. National Library of Medicine's PubMed service, which posted the English-language abstract. It is not marked retracted, though the link to the underlying paper leads to an error message.

The senior author of the study, Prof. Guihua Zhuang, who is the dean of the school of public health at Xi'an Jiaotong University, informed the graduate student via email that there was some issue with the paper and confirmed it had been retracted. The professor did not explain the problem, but said it was a sensitive matter.

Without access to the paper, nobody can assess the value of the work or determine whether it suffers from a scientific flaw. It's also unknown if the paper was retracted for political reasons. That's a possibility, though it was retracted well before U.S. officials started citing it in public in a way that disparaged the Chinese coronavirus test.

Whatever the case, the expectation in science is that conclusions in papers that have been retracted should not be relied upon.

"Scientists shouldn't be depending on the results of as scientific paper when the authors are saying through the retraction that they do not have confidence in the results," says Dr. Steven Goodman, professor of epidemiology and population health at Stanford.

NPR asked FDA Commissioner Hahn for a comment. His press office pointed to the abstract that is still posted on PubMed, but did not say whether anyone at FDA had read the full paper during the few days it was considered a legitimate entry in the scientific literature.

You can reach NPR Science Correspondent Richard Harris at rharris@npr.org.

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Coronavirus Testing And A Retracted Study : Shots - Health News - NPR

PARIS One of the worlds best health care systems is facing its severest test ever, and whether it succeeds will say much about the ultimate adequacy of a well-funded, well-equipped and broadly accessible national treatment plan.

If Frances experiment in confining its citizens less rigorous than the Chinese, more precocious than the Italian, far more organized than the American yields the hoped-for flattening of the curve, it would be vindication not just for the underlying system, but for a Western democracys organized effort to combat the coronavirus. The verdict is still weeks away.

President Emmanuel Macron has told the French, over and over, that the country is at war. On the surface, it is going into battle well prepared.

France spends more on health than most of its developed-world peers, offers world-beating access to doctors at less cost, and encourages all its citizens, through universal government-funded coverage, to keep track of their conditions. It has twice the number of intensive care beds that Italy has.

Mr. Macron has not been shy about touting the virtues of that system, especially in comparison with the United States.

What this pandemic is showing, right now, is that free health care, without regard to income, career, or profession, our welfare state, these are not costs or burdens, but precious assets when fate strikes, Mr. Macron said in a televised address to the country two weeks ago.

What the pandemic shows is that there are goods and services which must be protected from the laws of the market, he added.

But with coronavirus cases doubling every four days, even Frances relatively luxurious system is creaking and straining. A week into Frances total lockdown little stirs on the echoing streets of Paris and the normally traffic-bound Place de la Concorde is now an empty windswept plaza there are no signs of a letup in the intensity of the epidemic.

For France, this is a crash test of our system, said Franois Bricaire, an infectious disease specialist at the National Academy of Medicine. It is small comfort to the French that the coronavirus numbers in their country are well below those in Italy and Spain, for the moment. By Thursday, 1,696 had died in the hospitals in Italy, deaths were at 6,077 more than 3,000 were in critical condition, and there were more than 29,000 known infections.

Our centralized system is perhaps better adapted than the Italian to an epidemic, Mr. Bricaire said, adding, The decisions made in Paris are immediately circulated around the country.

But the authorities may be significantly underestimating the number of dead in France.

The hospital deaths represent only a small portion of the mortality, the French national health director Jrme Salomon told journalists Tuesday night. In particular, more and more deaths in nursing homes, not counted so far in the official tallies, are coming to light, particularly in eastern France 16 in Haute-Marne, seven in Haute-Savoie, 20 in Vosges.

Another 16 died in a Paris nursing home, according to French news reports.

The epidemic was worsening rapidly, Mr. Salomon said Tuesday night, calling it intense and severe.

Overstretched hospitals in Alsace, the hardest-hit region by far, have had to send out patients by military planes to less affected regions, and even in a medicalized train. A conference of 2,000 evangelical Christians at Mulhouse in February, where an unknown but significant number of those there were infected, has had the effect of a coronavirus bomb, first on Alsace, and then on all of France, as the participants spread throughout the country.

Were at the limit of our capacities, Jean Sibilia, dean of the medical faculty at Strasbourg University, said. As long as were doubling cases every four days, you can just imagine the load, he said.

Hospitals in Alsace are so full the French Army has had to scramble to set up a field hospital.

What were living through here is completely exceptional, said Jean-Franois Cerfon, an emergency room doctor in the eastern town of Colmar. A massive influx of patients, over a short period, and theyre in for the long haul. Lets just hope that by July were out of this nightmare.

Now, amid the same bitter debates taking place in other countries opposition politicians are asking whether officials were prepared, why stocks of masks were not higher, and whether Mr. Macron moved fast enough the government is holding its breath about whether the robust French system can hold. The debates have been muted though, because public anxiety has so far outweighed the countrys strong attachment to individual liberties.

There are no guarantees. No system can hold indefinitely, said Philippe Juvin, head of the emergency room at Hpital Europen Georges-Pompidou in Paris. Theres always a moment when the wave is too big, he said.

Its going to be a test of organization, and a human test, he added, noting that the wave of patients arriving at hospitals in critical condition was growing. Will we have the capacity to hold up?

Weeks of protests by hospital personnel, before the crisis, over too-long hours and overstretched personnel underscored the health systems low morale.

Others are trying to put on a brave face. The teams are holding up well, said Martin Hirsch, the director of Paris hospitals. They have extraordinary capabilities.

Yet the capital is hovering near its critical-care bed limit of 1,200, and Mr. Hirsch told French news media on Wednesday that he could only see three days ahead.

Mr. Hirsch, a veteran health official, also has acknowledged the giant unknown. How can you talk about facing up to something that we have never even known before? he said in a telephone interview.

For weeks, France thought it could escape Italys fate even as it kept a wary eye on its neighbor. The initial measures were limited closing schools in the rural Paris exurbs and in the northwestern region of Brittany, where some cases had been noted, and banning gatherings of more than 1,000.

On March 6, with nine dead already, Mr. Macron went to the theater, partly to show the French that normal life could continue. But five days later, he closed the schools, and two days after that, bars, restaurants and nonessential businesses.

Still, he allowed the first round of Pariss mayoral election to go ahead on March 15. On that sunny Sunday, thousands of French crowded the citys parks and cafes.

Mr. Macron ordered them to remain in their homes the next day.

With this action, France put itself in a more favorable position than Italy. The confinement order began when just 148 were dead. The Italian government, by contrast, waited until the death toll was over 800 before ordering a national lockdown.

Sick patients who could have been saved were not, because the Italian health system was saturated, said William Dab, a former French national health director. He added, In France, we are still able to save patients who are in intensive care.

There has been resistance to the confinement in the immigrant suburbs, where restless residents are crammed into inhospitable tower blocks. Police officers have already handed out tens of thousands of fines.

The authorities say they have no choice but to continue. The stakes are too high.

The measures that have been adopted, they are our last chance to overcome this crisis democratically, Mr. Dab said. To show we can overcome this without authoritarianism, without dictatorship, that a democracy can overcome a crisis like this.

For me, he added, thats what this is all about.

Constant Mheut and Eva Mbengue contributed reporting from Paris.

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For France, Coronavirus Tests a Vaunted Health Care System - The New York Times

In the third week of February, as the COVID-19 epidemic was still flaring in China, I arrived in Kolkata, India. I woke up to a sweltering morningthe black kites outside my hotel room were circling upward, lifted by the warming currents of airand I went to visit a shrine to the goddess Shitala. Her name means the cool one; as the myth has it, she arose from the cold ashes of a sacrificial fire. The heat that she is supposed to diffuse is not just the fury of summer that hits the city in mid-June but also the inner heat of inflammation. She is meant to protect children from smallpox, heal the pain of those who contract it, and dampen the fury of a pox epidemic.

The shrine was a small structure within a temple a few blocks from Kolkata Medical College. Inside, there was a figurine of the goddess, sitting on a donkey and carrying her jar of cooling liquidthe way she has been depicted for a millennium. The temple was two hundred and fifty years old, the attendant informed me. That would date it to around the time when accounts first appeared of a mysterious sect of Brahmans wandering up and down the Gangetic plain to popularize the practice of tika, an early effort at inoculation. This involved taking matter from a smallpox patients pustulea snake pit of live virusand applying it to the pricked skin of an uninfected person, then covering the spot with a linen rag.

The Indian practitioners of tika had likely learned it from Arabic physicians, who had learned it from the Chinese. As early as 1100, medical healers in China had realized that those who survived smallpox did not catch the illness again (survivors of the disease were enlisted to take care of new victims), and inferred that the exposure of the body to an illness protected it from future instances of that illness. Chinese doctors would grind smallpox scabs into a powder and insufflate it into a childs nostril with a long silver pipe.

Vaccination with live virus was a tightrope walk: if the amount of viral inoculum in the powder was too great, the child would succumb to a full-fledged version of the diseasea disaster that occurred perhaps one in a hundred times. If all went well, the child would have a mild experience of the disease, and be immunized for life. By the seventeen-hundreds, the practice had spread throughout the Arab world. In the seventeen-sixties, women in Sudan practiced tishteree el jidderee (buying the pox): one mother haggling with another over how many of a sick childs ripe pustules she would buy for her own son or daughter. It was an exquisitely measured art: the most astute traditional healers recognized the lesions that were likely to yield just enough viral material, but not too much. The European name for the disease, variola, comes from the Latin for spotted or pimpled. The process of immunizing against the pox was called variolation.

Lady Mary Wortley Montagu, the wife of the British Ambassador to Constantinople, had herself been stricken by the disease, in 1715, leaving her perfect skin pitted with scars. Later, in the Turkish countryside, she witnessed the practice of variolation, and wrote to her friends in wonder, describing the work of one specialist: The old woman comes with a nut-shell full of the matter of the best sort of small-pox, and asks what vein you please to have opened, whereupon she puts into the vein as much matter as can lie upon the head of her needle. Patients retired to bed for a couple of days with a fever, and, Lady Montagu noted, emerged remarkably unscathed. They have very rarely above twenty or thirty in their faces, which never mark; and in eight days time they are as well as before their illness. She reported that thousands safely underwent the operation every year, and that the disease had largely been contained in the region. You may believe I am well satisfied of the safety of this experiment, she added, since I intend to try it on my dear little son. Her son never got the pox.

In the centuries since Lady Montagu marvelled at the efficacy of inoculation, weve made unimaginable discoveries in the biology and epidemiology of infectious disease, and yet the COVID-19 pandemic poses no shortage of puzzles. Why did it spread like wildfire in Italy, thousands of miles from its initial epicenter, in Wuhan, while India appears so far to have largely been spared? What animal species transmitted the original infection to humans?

But three questions deserve particular attention, because their answers could change the way we isolate, treat, and manage patients. First, what can we learn about the dose-response curve for the initial infectionthat is, can we quantify the increase in the risk of infection as people are exposed to higher doses of the virus? Second, is there a relationship between that initial dose of virus and the severity of the diseasethat is, does more exposure result in graver illness? And, third, are there quantitative measures of how the virus behaves in infected patients (e.g., the peak of your bodys viral load, the patterns of its rise and fall) that predict the severity of their illness and how infectious they are to others? So far, in the early phases of the COVID-19 pandemic, we have been measuring the spread of the virus across people. As the pace of the pandemic escalates, we also need to start measuring the virus within people.

Most epidemiologists, given the paucity of data, have been forced to model the spread of the new coronavirus as if it were a binary phenomenon: individuals are either exposed or unexposed, infected or uninfected, symptomatic patients or asymptomatic carriers. Recently, the Washington Post published a particularly striking online simulation, in which people in a city were depicted as dots moving freely in spaceuninfected ones in gray, infected ones in red (then shifting to pink, as immunity was acquired). Each time a red dot touched a gray dot, the infection was transmitted. With no intervention, the whole field of dots steadily turned from gray to red. Social distancing and isolation kept the dots from knocking into one another, and slowed the spread of red across the screen.

This was a birds-eye view of a virus radiating through a population, seen as an on-off phenomenon. The doctor and medical researcher in meas a graduate student, I was trained in viral immunologywanted to know what was going on within the dots. How much virus was in that red dot? How fast was it replicating in this dot? How was the exposurethe touch timerelated to the chance of transmission? How long did a red dot remain redthat is, how did an individuals infectiousness change over time? And what was the severity of disease in each case?

What weve learned about other virusesincluding the ones that cause AIDS, SARS, and smallpoxsuggests a more complex view of the disease, its rate of progression, and strategies for containment. In the nineteen-nineties, as researchers learned to measure how much H.I.V. was in a patients blood, a distinct pattern emerged. After an infection, the virus count in the blood would rise to a zenith, known as peak viremia, and patients with the highest peak viremia typically became sicker sooner; they were least able to resist the virus. Even more predictive than the peak viral load was the so-called set pointthe level at which someones virus count settled after its initial peak. It represented a dynamic equilibrium that was reached between the virus and its human host. People with a high set point tended to progress more rapidly to AIDS; people with a low set point frequently proved to be slow progressors. The viral loada continuum, not a binary valuehelped predict the nature, course, and transmissibility of the disease. To be sure, every virus has its own personality, and H.I.V. has traits that make viral load especially revealing: it causes a chronic infection, and one that specifically targets cells of the immune system. Yet similar patterns have been observed with other viruses.

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How Does the Coronavirus Behave Inside a Patient? - The New Yorker