Category: Corona Virus

President Trump takes questions from reporters Monday. Joining him at the press briefing on coronavirus are Vice President Pence; Attorney General William Barr; Dr. Deborah Birx, White House coronavirus response coordinator; and Navy Rear Adm. John Polowczyk, who leads FEMA's task force on the supply chain. Alex Brandon/AP hide caption

President Trump takes questions from reporters Monday. Joining him at the press briefing on coronavirus are Vice President Pence; Attorney General William Barr; Dr. Deborah Birx, White House coronavirus response coordinator; and Navy Rear Adm. John Polowczyk, who leads FEMA's task force on the supply chain.

At a time when the nation is desperate for authoritative information about the coronavirus pandemic, the country's foremost agency for fighting infectious disease outbreaks has gone conspicuously silent.

"I want to assure Americans that we have a team of public health experts," President Trump said at Tuesday evening's coronavirus task force briefing a bit of reassurance that probably would not have been necessary if that briefing had included anyone from the Centers for Disease Control and Prevention.

The CDC normally takes the lead in outbreaks, ranging from the 2009 flu pandemic to Ebola to the lung injuries caused by vaping. Its recent absence from the national stage has led to fears that the agency's objective, science-based approach is being ignored, especially as Trump signals that he hopes to relax restrictions on social gatherings by Easter to help revive the economy.

That idea has horrified public health experts outside of the government, who say that the virus is spreading rapidly and that social distancing measures still need time to work.

"This has never happened before. In the nearly 75 years that the CDC has existed, in every single infectious disease outbreak the country has dealt with, the CDC has been central. It's been at the decision table, and it's been at the podium," says former CDC director Tom Frieden, who is now president and CEO of the global health initiative Resolve to Save Lives.

"I feel less safe because it's not clear that the CDC's expertise is feeding into the decisions that are being made, and these are life and death decisions," says Frieden. "We are less safe because the CDC doesn't have the voice and the role it needs to have."

The CDC is normally a credible, reliable source of infectious disease knowledge, led by physicians, scientists and epidemiologists capable of fielding detailed questions about what is scientifically known and what is not.

In past health emergencies, the agency has not only provided specific numbers and data about the changing status of an epidemic, but also offered informed commentary on the likely course of an outbreak and the best known strategies for mitigation and containment. The agency is usually in close contact with state public health agencies, and has an overview on what is happening across the entire country.

Though represented behind the scenes on the White House's coronavirus task force, the CDC hasn't held its own press briefing for reporters in two weeks. Those briefings had been happening frequently as the novel coronavirus outbreak began, but stopped abruptly early this month. The last one was held on March 9. An inquiry from NPR to the CDC about why the agency's briefings stopped and whether they would resume went unanswered.

Meanwhile, various members of the White House task force have taken over the job of informing the public. Much time is spent in briefings on economic or political considerations like legislation or the performance of the stock market, with questions often being answered by the president or Vice President Mike Pence.

Asked, for example, why Easter was targeted as a possible timeline for lifting social distancing measures, the president replied, "I just thought it was a beautiful time. It would be a beautiful time, a beautiful timeline. It's a great day."

A follow-up question asked whether the time was based on any data, and the president again said that he thought it would be a beautiful timeline.

"I am concerned that I haven't seen CDC as a participant in the briefings in days, and that CDC does not seem to be speaking otherwise directly to the public, which is really a break with how they have communicated about past epidemics in the United States," says Tom Inglesby, director of the Johns Hopkins Center for Health Security.

"We're in the middle of the most serious epidemic that this country has experienced probably in 100 years, and CDC is the organization that studies and prepares for and responds to epidemics, and is known throughout the world for that expertise," says Inglesby. "To me, it seems like they should be a central participant in all communications with the public."

At the White House briefings, science and public health questions often get addressed by Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, or the coronavirus response coordinator, Ambassador Deborah Birx.

The two, both doctors, seem to walk a tightrope of trying not to annoy the president while deftly attempting to temper some of his more optimistic assertions, like the potential of the drug chloroquine to treat COVID-19.

Fauci's absence on Monday led to speculation that his willingness to contradict the president had led to his banishment. But on Tuesday, Fauci spoke during the White House briefing, and received praise from Trump.

Inglesby says of the doctor: "Dr. Fauci is a national treasure and is extraordinary. But he has many, many things to explain and be responsible for, including the entire development process for vaccines and medicines and the research agenda."

It is CDC officials who actually have the mission of preparing the nation to control epidemics, he says, "so they should be there with Dr. Fauci."

"Dr. Fauci is one of the world's greatest researchers. He has a fantastic career; he is a wonderful human being. He is able to navigate very complex scientific and political issues extremely well," agrees Frieden. "But CDC is the country's public health agency. Fighting this pandemic without CDC central to that fight is like fighting it with one hand tied behind your back."

Dr. Anthony Fauci (left), director of the National Institute of Allergy and Infectious Diseases, confers with Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, at a congressional hearing on March 11. Patrick Semansky/AP hide caption

Dr. Anthony Fauci (left), director of the National Institute of Allergy and Infectious Diseases, confers with Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, at a congressional hearing on March 11.

Top officials who could be communicating with the public more regularly include CDC Director Robert Redfield; CDC principal deputy director, Anne Schuchat; and Nancy Messonnier, who is director of the CDC's National Center for Immunization and Respiratory Diseases.

"Those are the most important people to have out there because of the positions they hold, what they represent, the fact that many of them are physicians, and all of them have expertise in public health and particularly in infectious disease," says Bill Pierce of APCO Worldwide, who served as spokesperson for the Department of Health and Human Services under President George W. Bush.

"I think we need to hear from them more consistently," says Pierce. "Clearly, we have heard a lot from Tony Fauci. But I think we need to hear from more of them. And I think there needs to be more than just the briefing at the White House. That's important, but also I think the agencies themselves can do briefings."

Messonnier is scheduled to speak at a teleconference on Thursday but it's one organized by the State Department, aimed largely at foreign media, to discuss how the CDC is coordinating with other countries.

Some question whether Redfield is up to the task of serving as a strong public communicator, noting that his recent testimony before lawmakers about the coronavirus outbreak did not inspire confidence.

"He did a terrible job in front of Congress. If that's any indication of the way he would communicate, we probably don't want to see him," says Paul Argenti, professor of corporate communication at the Tuck School of Business at Dartmouth.

In a crisis, says Argenti, there ideally needs to be one voice delivering one consistent message, much as Gov. Andrew Cuomo has been doing in New York.

And if multiple officials are addressing the public, they shouldn't be sending mixed messages, Argenti adds.

"They don't have to be maniacally consistent, but they have to actually make sense when put together. They cannot be contradictory," he says. "And what we are seeing right now are contradictory messages."

In difficult times, Argenti says, people are desperate for the voice of a leader.

"And so I do think it is a good idea for President Trump to continue to try to get this right," he says. "But boy, it would be good if he conferred with his health experts to make sure that that message is both correct and consistent."

Originally posted here:

Where's The CDC Gone, As The Leader Of Coronavirus Policy And Communication? : Shots - Health News - NPR

When Californias governor ordered his state shut down to contain the spread of the coronavirus pandemic this month, semiconductor equipment manufacturer Lam Research shut down its Silicon Valley factories and complied.

In Oregon, though, Lam has kept its massive Tualatin plant running and ordered employees to keep reporting for work. The decision confounds Lam technician Michael Borek, who said theres no way he and his colleagues can do their jobs and remain six feet apart, as Oregon Gov. Kate Brown mandated in Mondays stay-home order.

Technicians work in teams around hazardous chemicals and electricity, he said, a basic safety measure to prevent a potentially serious accident. By continuing to work in close quarters, though, Borek said he fears efforts to contain the coronavirus will come to naught and that it could spread widely throughout the factory, and the community.

Lam said it has been four weeks since Borek has been on site and that the company has made significant changes in that time designed to ensure the six-foot separation and has added protective equipment and gear in situations where its not possible to keep workers that far apart.

Lam said its products represent critical infrastructure. The company said it has taken additional steps to keep workers safe by sanitizing their work areas, keeping people apart in the cafeteria and monitoring their temperatures when they come in for work.

My concern is theyre not going to catch something, its going to spread to a lot of people, lots of people are going to get sick, said Borek, 29. I just dont feel safe.

Several dozen workers across a variety of industries reported similar concerns to The Oregonian/OregonLive in the time since Brown issued her Monday order. They complain its inherently impossible to do their jobs and maintain the six-foot buffer from their colleagues that health authorities recommend.

Unlike governors in other states, Brown gave Oregon businesses enormous latitude to decide for themselves whether to close during her indefinite stay-home order. She said some businesses, among them shopping malls, theaters, spas and barbers, must close because their are inherently unable to operate without putting people at risk of spreading the virus.

Many other businesses could remain open but Brown called on those employers to take personal responsibility in ensuring worker safety by keeping employees at least six feet apart.

If they cannot, Brown said, Then those businesses should shut down.

The governor has no firm enforcement mechanism to make sure they are complying, though, or to make businesses close if they dont follow her orders. At various times this past week Brown has designated three different state agencies as responsible for taking complaints about workplace violations.

The confused message concerns workers who fear exposing themselves to the virus, or worry crowded workplaces will thwart efforts to contain the outbreak. The state, meanwhile, says it is fielding many hundreds of complaints daily about alleged social distancing violations. (Oregon is taking complaints here but has yet to conduct any inspections or issue any citations.)

Workers in factories, grocery stores, warehouses, delivery services, restaurants, a flight-training school even the states own Employment Department call center all have said they feel uncomfortable continuing to work during the outbreak. But the employees said they cant afford to quit or take vacation time without knowing how long the outbreak will last.

Most of my coworkers currently believe that we have to choose between showing up or not getting paid unless we have accrued sick time or vacation time, said one Precision Castparts employee, who asked not to be named discussing his employer. There are also fears of retaliation if we do choose to take a leave of absence in order to self-quarantine.

Photos shot at job sites this week and shared with The Oregonian/OregonLive show many apparent violations:

Intel and Precision Castparts couldnt be immediately reached for comment Thursday. Both companies have acknowledged positive coronavirus tests at their Oregon sites in the past week, and both companies have said they are taking steps to ensure their workers remain safe.

Construction has been allowed to proceed in the state of Oregon, as it supports so many other essential businesses such as healthcare and public services, J.E. Dunn vice president Emily Gallagher wrote in an email Thursday. She said Oregons order allows the company to support its contractors and employees with jobs that support their families.

However, we know that there will inevitably be a period of transition as individual behavior is modified and jobsite culture and methods are adjusted, Gallagher wrote. Workers have been doing things a certain way for decades, and changing behavior, although critical, will take some effort.

J.E. Dunn has assigned two people at each jobsite to enforce social distancing, she said, and taken other steps to ensure workers remain safe.

We are committed to being as proactive as we can based on a new normal one that changes daily, Gallagher said.

Washington Gov. Jay Inslee issued a stay-at-home order Monday, shortly after Brown issued hers in Oregon. He followed up Wednesday with a new, more specific directive that Commercial and residential construction is not authorized under the proclamation because construction is not considered to be an essential activity.

Manufacturing and construction are two of Oregons most vital industries and shutting them down would be a severe blow to the states economy, which is already staggering during the coronavirus outbreak. Economists say Oregon faces a severe recession.

While Brown specifically exempted construction and manufacturing from her stay-home order, she said such employers must still take steps to protect their workers. On Tuesday, before Inslee acted, Brown said she didnt see a need to shut down Oregon construction.

The six feet of distancing, telecommuting, that probably doesnt work on a construction site, Brown said. But they also have equipment, from masks and helmets, that should provide a layer of protective gear.

Violators of Browns stay-home order are subject to a misdemeanor citation that could include a $1,250 fine, 30 days in jail or both. But the governor has said repeatedly she doesnt want to use law enforcement to enforce her rules.

I cant have police in every single law office or every single business office around the state of Oregon, Brown said this week. I am asking people to take personal responsibility and act with consideration for your employees and for your customers.

Big Oregon employers that continue requiring workers to report to the job include all the states major grocery chains, many restaurant kitchens that offer takeout or delivery service, construction contractors, and manufacturers large and small among them Intel, Precision Castparts and Boeing.

Boeing shut down its Washington factories on Monday. Like Lam Research, though, it kept its Oregon factories operating.

Lam, which has had as many as 3,000 people working at its Tualatin campus in recent years, said Thursday that The health and safety of our employees remains our highest priority.

To protect our workforce, we have implemented robust workplace protections including enhanced and frequent disinfecting, social distancing controls, and active temperature monitoring, Lam said. We continue to monitor the situation closely to ensure we have the highest health and safety protocols.

A memo that Lam issued to workers late Wednesday, obtained by The Oregonian/OregonLive, appeared to acknowledge the hazards and the need for a fix.

We have too many people in the cleanroom and not enough controls for keeping physical distance between employees, the memo read. The note from a supervisor instructed employees to take the day off while supervisors and managers work on social distancing control.

Lam declined to discuss the memo. The company reiterated it has already taken steps to provide safety equipment and spacing within its factory.

The coronavirus has already arrived at many of Oregons largest workplaces. Precision Castparts acknowledged an infected worker last week and Intel said this week a contractor helping build its multibillion-dollar factory expansion in Hillsboro has been infected.

RVP Construction in Ontario shut down Monday after Brown issued her order. The small kitchen remodeler said it learned the next day that one of its employees had tested positive for the coronavirus and now has had seven employees and the family member of one worker become sick.

RVP didnt say whether any of those others have been tested for the virus, but did say in a statement Thursday that All are recovering at home and seem to be over the worst of it.

While highly contagious, the coronavirus presents little risk for most people the vast majority of those infected recover, and many have mild or no symptoms.

The potential consequences of infection, though, are high. Estimates vary widely about the fatality rate but scientists believe COVID-19, the disease caused by the coronavirus, to be significantly more deadly than the flu. It appears especially dangerous for older people and those with underlying health conditions.

Thats why Oregon and many other states have instructed people to stay home during the outbreak. Government officials hope that if they can slow the spread of the virus that will reduce the strain on hospitals and give testing and treatment regimens a chance to catch up.

Oregon has had 317 people test positive for the virus and 11 deaths attributed to COVID-19. The outbreak is much more severe elsewhere, with cases overwhelming hospitals in New York City, Italy and Spain.

Pressed this week for details about how Oregons stay-home order applies, Brown insisted repeatedly she has been very clear that people should stay home and businesses should not operate if they cannot ensure workers safety.

The governors message has been muddled, though, on how workers should respond if they see workplace violations. Her office initially directed workplace complaints to Oregons Occupational Safety & Health division (OSHA), but on Tuesday the governor said concerns should go to the Oregon Employment Department. On Wednesday, the governor said workers should direct concerns to the states Bureau of Labor & Industries.

On Thursday, shortly after this article posted, the governors office said complaints and coronavirus safety violations should go only to Oregon OSHA, not to the other state agencies.

OSHA said it is taking hundreds of complaints per day, but said it has yet to perform any inspections or write any citations.

The governor ordered restaurants and bars to close last week, but allowed them to continue offering delivery and takeout meals. Andy Ricker, owner of Portlands renowned chain of Pok Pok restaurants, opted Wednesday to close his businesses altogether. His decision followed the death of a fellow chef, Floyd Cardoz, and Ricker said he wished he had acted sooner.

Keeping our kitchens open is a microcosm of the tension between the economy and public health that is playing out on the world stage. The fact is, we all need to stay at home to stop the spread of Covid-19, all of us, now, Ricker wrote in a letter to employees.

Pok Pok is a restaurant, not a hospital, not a fire station, not a police station, not a vital food delivery service, He wrote. Though it is nice to have a familiar food available during this time of isolation people do not need fish sauce wings to survive.

This article has been updated with additional comment from Lam Research.

-- Mike Rogoway | mrogoway@oregonian.com | twitter: @rogoway |

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Continued here:

Oregon employers operating during coronavirus outbreak fuel workers anxiety and confusion - OregonLive

Reporting was contributed by David E. Sanger, Maggie Haberman, Zolan Kanno-Youngs, Emma Goldberg, Stephanie Saul, Michael Cooper, Alan Blinder, Karen Zraick, Annie Karni, Jonah Engel Bromwich, Jennifer Steinhauer, Sheri Fink, Raphael Minder, Ben Hubbard, Hannah Beech, Mujib Mashal, Thomas Gibbons-Neff, Helene Cooper, Eric Schmitt, Najim Rahim, Caitlin Dickerson, Katy Reckdahl, Hana de Goeil, Campbell Robertson, Richard Fausset, Patricia Mazzei, Kirk Johnson, Julie Bosman, Nicholas Bogel-Burroughs, Marc Santora, Megan Specia, Julie Hirschfeld Davis, Iliana Magra, Elisabetta Povoledo, Abdi Latif Dahir, Daniel Victor, Emily Cochrane, Nicholas Fandos, Michael Corkery, Sapna Maheshwari, Mariel Padilla, Christine Hauser, Fatima Faizi, David Zucchino, Alex Marshall, Vivian Wang, Yiwei Wang and Pam Belluck.

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U.S. Now Leads the World in Confirmed Cases - The New York Times

Now that many parts of the US have shut down temporarily to combat the coronavirus, our greatest enemy is our own impatience.

The measures taken in California last week and 15 other states since then hurt. They kill off businesses that were critical to the livelihoods of millions of people. They throw millions of Americans out of work and off their health insurance.

And for the next two weeks, it wont even be clear if theyre doing anything.

We have sacrificed so much already, but it feels like nothing is working. Thats because it takes weeks to see results. We must stay committed and trust that the social distancing we are enduring now will save thousands of lives, Dr. Caitlin Rivers at the Johns Hopkins Center for Health Security wrote Monday.

Heres why it will take so long for our sacrifices to have visible effects. The thing were trying to reduce new coronavirus infections is invisible at first. It takes between 2 and 14 days for a newly infected person to start showing symptoms. After symptoms begin to show, it can take more than a week for them to be eligible for testing (many people are not eligible at all). And then, thanks to backlogs in testing availability, it can take days for them to learn they tested positive.

As a result, every positive test today reflects infections that occurred, on average, a few weeks ago. And it will be a few weeks from now before we see new case numbers start to fall if our lockdown measures today are successful.

In other words, once you shut down your city to fight the virus, you should actually expect things to get worse before they get better. And because of that, theres a very real risk that that will discourage us and prompt us to give up. We shouldnt.

Lets say we lock down a city to prevent the further spread of the coronavirus, and the lockdown works very well, as the one in Wuhan seems to have. Where previously the average infected person spread the disease to 2-3 other people, after the lockdown in Wuhan it is estimated that each infected person only spread the disease to .32 people.

If we accomplished the same thing, the number of new infections would start declining right away. But heres the thing: The number of new positive tests? It would keep growing.

Heres why: Symptoms of the coronavirus typically take some time to start showing after infection. The average incubation period is 5-6 days but may range from 2-14 days, according to the Center for Disease Control and Prevention. So keep that in mind when thinking about people who are starting to develop symptoms now those were people who were exposed to coronavirus about a week ago, in some cases even longer.

Now, most people cannot get a test as soon as they start to show symptoms. In some parts of the country, in fact, its impossible to get a test until you are hospitalized, unless you are a health care worker, or are otherwise considered high risk.

The coronavirus has a long course of illness people are usually sick for a while before they get sick enough to need hospitalization. In one study from China, the average time from symptom onset to hospitalization was nine days, and in another study, difficulty breathing usually surfaced 5-13 days after symptoms started.

That means that, in the parts of the US where most patients arent tested for the coronavirus until they are hospitalized, a patient may be tested 14 days after they were infected five days for the average patient to show symptoms and nine days after that to end up in the hospital.

Finally, tests dont always get results right away. There are some testing sites that advertise same-day turnaround, but other labs are backlogged, and in many parts of the country results take longer. Rand Pauls positive test for coronavirus reportedly took six days to come back.

Add it all up, and it will take at least two weeks, likely longer, for a coronavirus infection to be reported in official statistics.

That means that it will look for weeks like the measures were taking now like self-quarantines, school closures, and social distancing are not working, even if they are. And if theyre not actually working? Same thing we wont know for at least a couple of weeks.

On January 23, China locked down the city of Wuhan amid a growing epidemic. On that date, the country had 830 cases. Much of the rest of Hubei province locked down later that week, and then restrictions were imposed on the whole country.

For the next few weeks, things got worse. By February 13, the country had 63,851 cases most of them in Wuhans Hubei province. But things were starting to turn around. That day, China reported 5,090 new cases more than on any previous day (except the day of a one-time change in the types of cases reported). On February 14, however, officials reported 2,641 new cases. On the 15th, 2,008. New case numbers kept declining from there; China now reports no new local transmission cases (though they could be either missing some or hiding some, experts dont think theyre hiding a full-blown epidemic.)

Take a look at that gap again: The peak of new cases came fully three weeks after the lockdown started. In Italy, its starting to look like the same dynamic is at work.

These big social distancing measures take time to work, Johns Hopkins Center for Health Security director Tom Inglesby tweeted Monday. The impact of big interventions in Wuhan China took about 3 wks to start to reverse things. And then everyday after the situation got better.

Should the US expect the same thing?

Not necessarily. Some things are definitely different. The US implemented social distancing measures more gradually than Wuhan, which escalated quickly from few restrictions to a full lockdown. No place in the US is employing measures as strict as Wuhans. China separated symptomatic people from their families, and locked people in their houses. Enforcement of stay-at-home orders has, so far, been lax in the US.

But if our measures suffice to reduce transmission so that each new patient infects less than one person, it wouldnt be surprising if the overall trajectory of the disease in a city like New York looks somewhat like Chinas, with cases peaking three weeks after the measures went into place. That would put us into early April.

In other parts of the country, where those measures havent yet been put into place, the peak is even farther off.

We know when this started. We can get a good estimate on when it will end, former FDA Commissioner Scott Gottlieb argued Tuesday, projecting a peak in New York in 2-3 weeks.

Its difficult to be patient and wait for that. The costs of social distancing measures upended routines, shuttered stores, and restaurants, lost jobs, vulnerable people put at risk are apparent already, while the benefits arent. Social distancing measures save lives, but the lives they save are a month away while the lives they throw into turmoil are visible right now.

Unsurprisingly, there is overwhelming pressure to identify results from these measures right now. And preliminary data that looks good is not hard to find. Articles have proliferated comparing states that implemented social distancing to states that didnt, or declaring that early data shows Californias stay-at-home order is working.

Its tempting to draw those conclusions. But its really too early to say any of those things with certainty. The numbers published today reflect measures taken in the last week of February before awareness of the virus in the US was widespread through the first week of March. They dont reflect the effects of the lockdowns or even the school closures. The states that are doing well cannot credit their success to measures theyve taken in the last few weeks, and the states that have imposed such measures shouldnt expect results yet.

Whats important to remember is that if the numbers suddenly get worse in a state that recently implemented stay-at-home measures, it wont prove that stay-at-home doesnt work. The confirmed cases we are seeing today are largely people infected a few weeks ago, and the data on how well our current measures are working wont be available for a while.

For a while it will feel like nothing is working but it takes time, Rivers wrote Monday.

When things are changing as rapidly as they are with this crisis and when families are struggling with lost jobs, wiped retirement accounts, sick loved ones, and closed schools the few weeks well need to wait before case numbers hopefully start declining feel like an eternity. But the best thing we can do is help our cities develop a plan for the next stage of virus response, support essential workers, stay home, and wait.

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Lockdowns work against coronavirus. But they take a few weeks to show theyre working. - Vox.com

An assistant nursing manager at a New York City hospital, who told his family he believed he had contracted the coronavirus after being exposed at work, died Tuesday evening, his sister told NBC News.

The death of Kious Jordan Kelly, 48, was confirmed by Mount Sinai Hospital. It comes amid an escalating crisis in New York in which hospitals are faced with surging numbers of coronavirus patients and shortages of crucial medical equipment and protective gear for staffers.

Kelly suffered from severe asthma, said his sister, Marya Sherron, but she questioned whether his death could have been prevented and expressed alarm over the reports of inadequate protection for health care workers.

"There's only going to be more," Sherron said. "He's not the only one with asthma. He's not the only one with conditions who is going to work every day helping and fighting for people."

Full coverage of the coronavirus outbreak

Mount Sinai Hospital did not respond to specific questions about how Kelly was exposed to the virus, but it insisted that it has provided workers with the necessary protective equipment.

"This crisis is straining the resources of all New York area hospitals and while we do and have had enough protective equipment for our staff, we will all need more in the weeks ahead," a spokesperson said. "This crisis is only growing and it's essential that we not only have all the right equipment but that we come together to help and support one another."

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In an earlier statement, the hospital described Kelly as "a compassionate colleague, friend and selfless caregiver."

"Today, we lost another hero," the statement added.

A colleague confirmed that Kelly had been working directly with coronavirus patients at the Mount Sinai West medical center.

"He was moving them, transporting them, going into their rooms," said the colleague, who asked to remain anonymous for fear of jeopardizing the person's job. "He used to do whatever he needed to do to decongest the emergency department or help the nurses out so patients wouldn't sit in the hallway exposing others."

"He paid the ultimate price for working too hard and caring too much," the colleague added.

Kelly was born in Chicago and grew up in Lansing, Michigan, his sister said. He was valedictorian of his high school and worked as a dancer for many years before becoming a nurse.

"He was born with a hole in his lung, and my mom talked about how she was told he wasn't going to live and he healed," Sherron said. "He wasn't supposed to be able to do a lot of things physically that he did, and we were always in awe. "

Download the NBC News app for full coverage and alerts about the coronavirus outbreak

The last time Sherron heard from her older brother was via text message. He got in touch on March 18, Sherron said, telling her that he had been moved to the intensive care unit at the main Mount Sinai Hospital and that he couldn't talk because he was on a ventilator. He sent her a photo and told her he would be OK and not to worry the rest of the family. Six days later, he was dead.

"He was the best. He was just the most giving, selfless person," Sherron said. "He would always find a way to make you smile."

Joseph Fuoco, the son of a former patient, described Kelly as an angel in a post on Mount Sinai's website, where he recounted how Kelly took care of his dying mother.

"He showed my mom and us empathy and compassion that helped us get through the weekend and what was to come," Fuoco said. "He went above and beyond and is an asset to the hospital."

Kelly's family, like the loved ones of any coronavirus patient, were barred from visiting him in the hospital because of the risk of transmission.

His sister said she's still wrestling with the fact that her younger brother died alone.

"I want his unit, the hospital and health care providers to get the protective gear they need," Sherron said.

CORRECTION (March 26, 2020, 6:35 p.m. ET): An earlier version of this article identified the nurse who died as James Kious Kelly. Kelly's sister said James was his middle name at birth but that he had legally changed his name to Kious Jordan Kelly. The article also misspelled the sister's first name. She is Marya Sherron, not Mayra.

Emmanuelle Saliba is a reporter with the NBC News Investigative Unit, specializing in visual verification and open-source investigations.

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'There's only going to be more': NYC nurse dies after contracting coronavirus - NBCNews.com

President Trump, in saying that he wanted to reopen the economy by Easter, has argued that an economic downturn would be more deadly than the coronavirus.

What Was Said

You have suicides over things like this when you have terrible economies. You have death. Probably and I mean definitely would be in far greater numbers than the numbers that were talking about with regard to the virus. at a news conference on Monday

Youre going to lose more people by putting a country into a massive recession or depression. during a virtual town hall on Fox News on Tuesday

This lacks evidence. Though the question of the overall impact of recessions on mortality remains unsettled, experts disputed Mr. Trumps claim that an economic downturn would be more deadly than a pandemic. (The White House did not respond when asked for the source of the presidents conjecture.)

All these effects of economic expansions or recessions on mortality that can be seen, e.g., during the Great Depression or the Great Recession, are tiny if compared with the mortality effects of a pandemic, said Dr. Jos A. Tapia, a professor of public health and economics at Drexel University who has written several studies on the topic.

It is difficult to disaggregate the impact of an economic downturn on health and mortality from other factors. Those who become unemployed do tend to have higher levels of depression and bad health. But for the general population, studies have found that death rates from other causes cardiovascular disease, respiratory diseases, and traffic and industrial injuries were either unchanged or actually decreased.

For example, a 2012 study found that suicides did increase during the Depression of the 1930s, but the death rate for car accidents decreased and no significant effects were observed for 30 other causes of death in the United States. A 2009 study found that mortality actually decreased across almost all ages during the Depression. Researchers last year also found that mortality rates overall declined from 2005 to 2010, a period that covered the deep recession that ran from late 2007 through mid-2009.

In comparison, projections from the Centers for Disease Control and Prevention estimated that deaths from the coronavirus in the United States could range from 200,000 to 1.7 million.

Mr. Trump is right to be concerned about the trend of increased suicides during recessions, said Aaron Reeves, a professor and sociologist at Oxford University and the lead author of a 2012 study that estimated an excess of 4,750 suicides in the United States after 2007, coinciding with the recession. But in a scenario in which workplaces and businesses reopen and social distancing is more limited but people continue to wash their hands, Mr. Reeves said, my sense is that this virus would almost certainly kill more people under those conditions than suicides would.

Moreover, it is not inevitable that a recession would lead to excess suicides. In countries and American states with adequate social programs in place, the impact of economic downturns can be reduced.

There are some choices that governments have about how you potentially offset the consequences of recessions that may come, Mr. Reeves said, pointing to the $2 trillion economic package passed by the Senate. Trump could put in place more to protect those people if hes worried about suicides.

Experts also warned that the argument about whether to stave off a recession or contain the coronavirus was a somewhat false choice. If efforts to mitigate the coronavirus abate and cases and deaths spiral out of control, the economy would also be affected by self-imposed lockdowns.

The mental health effects of high levels of unemployment during a recession, too, would have its parallels if the United States suffered colossal loss of lives. That would bring about communal bereavement, where there is widespread distress and feelings of loss even among those who do not know the deceased, and its associated health risks, said Ralph Catalano, a professor of public health at the University of California at Berkeley.

Id rather contain the epidemic first and then take my chances with the recession, Mr. Catalano said. Humans control recessions; mindless nature controls epidemics. Its just bad medicine to mix epidemiology and economics right now.

Curious about the accuracy of a claim? Email factcheck@nytimes.com.

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Trumps Baseless Claim That a Recession Would Be Deadlier Than the Coronavirus - The New York Times

Dont rush to the emergency room.

Emergency room waiting rooms are packed with very sick people and overworked staff and doctors. Its not a place you want to be, and if you show up unnecessarily, youre taking care away from people who really need it. Before going to the E.R., stop and ask yourself, Would I go to the E.R. for these symptoms (a cough or fever) under normal circumstances? In most cases, the answer is probably no. Coughs, fevers, sore throats and runny noses have rarely been an emergency in the past, and those symptoms, even if due to the coronavirus, wont be an emergency in most cases. Call your doctor.

Patients at high-risk should check in with their doctors as soon as they have symptoms. A doctor who knows your situation can help you navigate the system and advise you on how and when to seek treatment. High-risk patients include the elderly as well as people with asthma or lung disease, or a history of pneumonia, heart disease, kidney disease, diabetes, a compromised immune system due to illness or a drug therapy, or a person who has recently been treated for cancer.

The Centers for Disease Control and Prevention said the following symptoms should prompt you to seek emergency treatment.

Difficulty breathing

Persistent pain or pressure in the chest

Confusion or inability to arouse

Bluish lips or face

Any other symptom that is severe or concerning

Many people who have the coronavirus will not stay in a hospital and will be isolated at home. If you have all of the symptoms of the virus but havent been tested, you should assume you have it and still take precautions.

Caring for someone with mild to moderate symptoms of the coronavirus is similar to caring for someone with the flu. Give them supportive care, fluids, soups and Tylenol, and have them take their temperature regularly. If a person is so sick or weak that he or she cant eat, drink or go to the bathroom, call a doctor. The World Health Organization has guidelines on home care for patients with suspected or confirmed cases of the coronavirus.

Yes! The patient should be confined to a separate room with no or minimal contact with the rest of the household (including pets), and should use a separate bathroom if possible. Most of the time, a sick person will feel miserable, but he or she can pick up food trays left at the door and sanitize a shared bathroom after using it. (This may not be the case with young children.) If you have masks at home, both patient and caregiver should wear them when in contact with each other.

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What to Do if You or a Loved One Might Have the Coronavirus - The New York Times

Thousands of miles away in Berlin, German scientist Olfert Landt was already on alert. For 30 years, he had worked on diagnosing emerging diseases, including Severe acute respiratory syndrome (SARS). He wanted to make a test kit to help doctors diagnose the disease -- and he wanted to do it fast.

Virologists usually wait until the genetic material of a new virus is sequenced to start working on a test. This time, Landt and his 30-strong company TIB Molbiol got started early. By January 9 they had designed their first test kit using SARS and other known coronaviruses as references. Along with scientists from a local university hospital, he designed three kits, meaning once the sequence was published, they could pick the one that worked best.

On January 11, Landt sent his kit to Taiwan's Centers for Disease Control and diagnostic company Roche in Hong Kong. He didn't know for certain that it would work, and he hadn't even prepared instructions.

Over the weekend, he worked up a manual and emailed it over. "We said, listen, you have six tubes without any instructions," he recalls. "Give them to the test laboratory, you can test patients with this."

Landt estimates he has manufactured four million tests by the end of February, and another 1.5 million each week since then. Each kit -- which includes 100 tests -- has sold for at least 160 euro ($173) each to clients in Saudi Arabia, South Africa, Australia, Europe, with his two adult children helping label and pack the kits. His wife, who has worked for the company for 15 years, is also involved.

"I'm not working for money. I take the money, yes, it's fair, we do good work," he said. "But in the end, we don't need money."

But nearly three months after Landt first noticed reports of a mysterious disease, countries around the world are still struggling to test for Covid-19, the infectious disease caused by a new novel coronavirus. Some tests are inaccurate, others took a long time to create, and now testing companies are warning they are running dangerously low on materials.

That raises an important question: if a test can be developed so quickly, why are some countries still struggling?

In Hong Kong, virologist Leo Poon was also watching the developments unfold in January.

Like Landt, he had worked on emerging diseases for years. In 2003, it was his team of scientists at Hong Kong University (HKU) who identified that SARS, which had emerged the year before in mainland China, was a coronavirus.

"Because we have gone through all these events in the past, we know how important it is to have a working diagnostic test," he said. "That's why we basically tried to get the work done as soon as possible."

But unlike Landt, Poon waited for the sequence.

All forms of life have a type of molecule that carries their genetic instructions. In humans, and most life forms, that's DNA -- the genetic material that tells us to grow two legs and walk upright. Instead of DNA, many viruses -- including hepatitis, Ebola, and rabies -- have RNA, or ribonucleic acid, which, like DNA, is a nucleic acid that carries genetic information.

Once Zhang shared the sequence, Poon's team started work.

First, they looked at the RNA of the new coronavirus, and decided their test would target parts of the code that were similar to the RNA of the SARS coronavirus -- parts that would be less likely to mutate, as they were essential to the virus.

Next, they designed the test.

The standard way to detect a virus is using a technique called polymerase chain reaction (PCR). Invented in the 1980s, PCR is used for a range of things, from identifying the DNA of a suspect at a crime scene, to testing whether a crop of fruit is infected with a virus.

PCR tests are made up of ingredients called reagents, which include primers and probes.

Before running a PCR test, the RNA in a virus has to be turned into a DNA copy. Then, the primers look for the target regions within a gene. If they find the gene targets, then these regions are copied over and over, explained Maureen Ferran, an associate professor of biology at Rochester Institute of Technology.

Each time a copy is made of the DNA, light will be emitted. If there's a lot of light, that indicates the presence of the genetic material that identifies the virus -- meaning that a person has tested positive for the virus.

Most kits have at least two genetic targets, to improve the reliability of the result.

2019

December 31: Cases of pneumonia detected in Wuhan, China,are first reported to the WHO.

2020

January 5: China announces that the unknown pneumonia cases in Wuhan are not SARS or MERS.

January 7: Chinese authorities confirm that they have identified the virus as a novel coronavirus, initially named2019-nCoVby the WHO.

January 11: The sequenced genome is posted on open-source site virological.org. The Wuhan Municipal Health Commission announces the first death caused by the coronavirus. Berlin scientist Olfert Landt and his team send their test kit to Hong Kong and Taiwan.

January 12: Chinese authorities share the sequence on January 12.

January 16: Hong Kong University scientists submit their kit to the World Health Organization.

January 17: A top health official says the US Centers for Disease Control and Prevention has made its own test, without using the protocols published by the WHO.

February 11: The WHO names the coronavirus Covid-19.

Sources: CNN reporting, World Health Organization

All this is taking place on a tiny scale -- in test tubes, within a diagnostic machine. The diagnostic machine measures the level of light, and compares it with the positive control -- usually a sample of the virus. If the positive control doesn't test positive, then scientists will know that the test isn't working.

Developing a test is not difficult, according to Nathan Grubaugh, an assistant professor of epidemiology at Yale School of Medicine. The trick is making sure it doesn't pick up other viruses, too.

Within six days of getting the sequence, Poon had a working test.

Like Landt's kit, Poon's test can pick up SARS and Covid-19. Poon says that isn't an issue, as there isn't currently a SARS outbreak.

In the months since, Poon has sent tests for free to more than 40 countries all over the world, including Egypt and Cambodia. Each country only gets one kit, which costs between 4,000 to 5,000 Hong Kong dollars ($515 to $644) and can be used to test 100 samples. Some countries, like Nepal, have sent their samples to Hong Kong University to test. The idea is to "buy some time" for countries, so they have a test while mobilizing resources to create their own.

But while companies like TIB Molbiol are making money from their kits, Poon and his team have reallocated funding from other projects to their Covid-19 test kits, and are essentially working for free.

"We don't have money, we have zero resources," said Poon. "We are just distributing it from our good will."

"The (intellectual property) issue is not what we care about in this public health crisis," Poon said. "What drives us to do this work is to try to react to these emerging infections so we can save more lives."

In mid-January, in Gisborne, a sunny city on the coast of New Zealand, John Mackay got a request from the government's National Reference Laboratory -- he needed to buy materials to detect the coronavirus.

Mackay, the technical director of diagnostics lab Dnature, emailed Landt. "Olfret, if this is playing out like SARS, I'm guessing you have the kits sitting on the shelf ready to go immediately," he recalls writing that afternoon.

Within half an hour, there was a reply from Landt, despite it being early morning, Berlin time. "Yes, do you want some?"

"The guy is a complete workaholic," Mackay said of Landt. "He's a phenomenal guy."

It was a similar situation in Australia. Like New Zealand, they had no samples of the virus, so they referred to tests developed overseas, according to William Rawlinson, the director of Serology, Virology and OTDS Laboratories, which leads much of the testing in the Australian state of New South Wales. Even before Australia had its first case, it had kits.

Other countries decided to go it alone.

In the United States, there were also problems.

The agency announced on February 5 that it would begin shipping kits. Soon after, some labs reported that the tests were not working, meaning some had to be re-manufactured. It's not clear how the defect happened.

It's easy to see how Landt and Poon's early work helped other countries buy time and prepare for an outbreak. But neither Landt nor Poon have the capacity to make enough tests for the whole world.

And there are other also reasons why the world needs multiple test kits.

Another issue is that the virus could potentially mutate in such a way that one kit no longer works. If a test targets Covid-19's "N" gene, for instance, and the virus mutates so that gene no longer exists, then the kit will not pick up the virus.

Another consideration is that a test that works in one country might not work in another, said Rawlinson. If, hypothetically, the presence of dengue fever caused a test not to work, and a country had a large rate of dengue fever, then there might be a high rate of false negative, he said.

Having a range of tests also puts less pressure on one manufacturer or supply chain, as different suppliers may use different materials.

Ferran said testing could have changed the US's infection rate.

"If we had better testing early on, we could have really changed the rate of infection. But we can't go back," she said. "We just have to go forward and learn from this and have this not happen again."

Put bluntly, some countries have squandered the opportunity to prepare that Poon and Landt's early work gave them.

Both the United States and the United Kingdom have been criticized for being slow to test, and for not testing enough people.

That's in stark contrast with the approach of other countries.

"We're doing a lot of testing comparatively," he said. "We want to find the cases which is why we're testing where there's suspicion."

Poon says there are a number of reasons why some countries have been slow to test -- some are practical, others administrative.

Testing requires trained staff, the right equipment, and the right materials -- a lack of any of those could hold up testing.

In the US, there has been an additional bureaucratic hoop. In some countries, tests can be used almost immediately due to different rules around emerging diseases.

The FDA has now allowed companies to manufacture and ship tests before receiving permission.

Thanks to the loosened rules, private companies have been able to speed up their response. US company Quest Diagnostics, for instance, launched its new test on March 9 and expects to be able to perform 280,000 tests per week by the start of April.

To people like Landt, inaction from politicians is frustrating.

He recalls being at the opera at the start of February, when very few people had been infected in Munich, and approaching the German Minister of Health, who he saw there by chance. "You should tell the public this is a bad disease," he recalls telling him. "Don't tell them it's only something in China."

But the German government was slow to take vital action, such as reducing social contact. It now has more than 29,000 confirmed cases.

"The virus must travel," Landt said, explaining whether the virus kills the host, or the host's immune system kill the virus, either way, the virus will need to find another person to infect to stay alive. "If you reduce your contact to other people, the virus can no longer travel ... One infected will infect one or two other people, so it's like an atomic bomb, it's an exponential curve," he said.

"Only with testing we can identify people and isolate them to prevent the spread over to other people."

CNN's Yoko Wakatsuki and Rebecca Wright contributed additional reporting from Tokyo.

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A coronavirus test can be developed in 24 hours. So why are some countries still struggling to diagnose? - CNN

On Wednesday, Twitter briefly locked conservative site The Federalists account for suggesting people deliberately expose themselves to the novel coronavirus. The Federalist promoted the medically unsound idea of medical chickenpox parties to infect young, healthy people with the virus under controlled quarantine.

The tweet was removed for violating the social media platforms policies, and a Twitter spokesperson tells The Verge that the account was temporarily locked for violating the Twitter Rules regarding COVID-19.

Twitter bans coronavirus-related content that goes directly against guidance from authoritative sources of global and local public health information. That includes tweets promoting ineffective or counterproductive treatments, denying the effectiveness of measures like social distancing, or contradicting known public health facts.

The Federalist was tweeting an article where an Oregon physician urged readers to seriously consider a somewhat unconventional approach to the pandemic. But unconventional is a bit of a euphemism. The hospital system is overloaded even without deliberate infections, and unlike with chickenpox, we dont know how long COVID-19 immunity lasts. In other words, hosting a coronavirus chickenpox party is a very bad idea.

The coronavirus pandemic has led to a global lockdown and thousands of deaths, as well as economic chaos. America has the third-highest number of confirmed cases, after China and Italy. Congress is attempting to mitigate the economic harm with a stimulus package.

President Donald Trump has chronically minimized the risk of coronavirus infection and made falsely rosy claims about new treatments and vaccines, recently alarming experts by suggesting social distancing restrictions end by Easter Sunday. Other Republicans have either downplayed the threat or argued that some Americans should accept a heightened risk of death to let the country leave lockdown. Social media platforms have to decide when these statements could have a negative effect on the larger pandemic response, sometimes drawing ire in the process.

Earlier this week, blogging platform Medium removed an article from technologist and former Mitt Romney campaign team member Aaron Ginn. Ginn claimed that the COVID-19 response was being driven by hysteria or a mob-like fear. A Medium spokesperson told The Verge that Ginns essay violated rules against controversial, suspect, and extreme content, which cover distorted or pseudoscientific arguments that could have serious social repercussions.

Every day, we are removing coronavirus-related posts that violate our rules, the spokesperson said.

Twitter also slapped a warning on the article when it was later reposted elsewhere, telling readers who clicked the link that it was potentially harmful or associated with a violation of Twitters Terms of Service.

Ginns Medium article didnt fit the stereotype of social media misinformation posts, which often incorporate alarmist exaggerations, blatantly made-up facts, or miracle cure scams. But critics like University of Washington biology professor Carl Bergstrom cited logical leaps that painted a misleading yet widely cited portrait of the pandemic. The Wall Street Journals editorial board, however, slammed Mediums decision and urged platforms not to require conformity with the judgment of expert institutions, even as many of those institutions themselves woefully misjudged the situation months or weeks ago.

Facebook also recently published guidance for COVID-19 hoaxes and misinformation, drawing a line around content that could contribute to imminent physical harm. That includes statements like saying that social distancing doesnt work something Facebook says it recently started taking down. It doesnt include more abstract claims like conspiracy theories about the origin of the virus, which arent considered immediately harmful, but can be de-ranked and flagged with a warning label, like other false information on the platform.

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Twitter locks The Federalists account over coronavirus chickenpox parties tweet - The Verge

Advanced computers have defeated chess masters and learned how to pick through mountains of data to recognize faces and voices. Now, a billionaire developer of software and artificial intelligence is teaming up with top universities and companies to see if A.I. can help curb the current and future pandemics.

Thomas M. Siebel, founder and chief executive of C3.ai, an artificial intelligence company in Redwood City, Calif., said the public-private consortium would spend $367 million in its initial five years, aiming its first awards at finding ways to slow the new coronavirus that is sweeping the globe.

I cannot imagine a more important use of A.I., Mr. Siebel said in an interview.

Known as the C3.ai Digital Transformation Institute, the new research consortium includes commitments from Princeton, Carnegie Mellon, the Massachusetts Institute of Technology, the University of California, the University of Illinois and the University of Chicago, as well as C3.ai and Microsoft. It seeks to put top scientists onto gargantuan social problems with the help of A.I. its first challenge being the pandemic.

The new institute will seek new ways of slowing the pathogens spread, speeding the development of medical treatments, designing and repurposing drugs, planning clinical trials, predicting the diseases evolution, judging the value of interventions, improving public health strategies and finding better ways in the future to fight infectious outbreaks.

Condoleezza Rice, a former U.S. secretary of state who serves on the C3.ai board and was recently named the next director of the Hoover Institution, a conservative think tank on the Stanford campus, called the initiative a unique opportunity to better manage these phenomena and avert the worst outcomes for humanity.

The new institute plans to award up to 26 grants annually, each featuring up to $500,000 in research funds in addition to computing resources. It requires the principal investigators to be located at the consortiums universities but allows partners and team members at other institutions. It wants coronavirus proposals to be submitted by May and plans to award its first grants in June. The research findings are to be made public.

The institutes co-directors are S. Shankar Sastry of the University of California, Berkeley, and Rayadurgam Srikant of the University of Illinois, Urbana-Champaign. The computing power is to come from C3.ai and Microsoft, as well as the Lawrence Berkeley National Laboratory at the University of California and the National Center for Supercomputing Applications at the University of Illinois. The schools run some of the worlds most advanced supercomputers.

Successful A.I. can be extremely hard to deliver, especially in thorny real-world problems such as self-driving cars. When asked if the institute was less a plan for practical results than a feel-good exercise, Mr. Siebel replied, The probability of something good not coming out of this is zero.

In recent decades, many rich Americans have sought to reinvent themselves as patrons of social progress through science research, in some cases outdoing what the federal government can achieve because its goals are often unadventurous and its budgets unpredictable.

Forbes puts Mr. Siebels current net worth at $3.6 billion. His First Virtual Group is a diversified holding company that includes philanthropic ventures.

Born in 1952, Mr. Siebel studied history and computer science at the University of Illinois and was an executive at Oracle before founding Siebel Systems in 1993. It pioneered customer service software and merged with Oracle in 2006. He founded what came to be named C3.ai in 2009.

The first part of the companys name, Mr. Siebel said in an email, stands for the convergence of three digital trends: big data, cloud computing and the internet of things, with A.I. amplifying their power. Last year, he laid out his thesis in a book Digital Transformation: Survive and Thrive in an Era of Mass Extinction. C3.ai works with clients on projects like ferreting out digital fraud and building smart cities.

In an interview, Eric Horvitz, the chief scientist of Microsoft and a medical doctor who serves on the spinoff institutes board, likened the push for coronavirus solutions to a compressed moon shot.

The power of the approach, he said, comes from bringing together key players and institutions. We forget who is where and ask what we can do as a team, Dr. Horvitz said.

Seeing artificial intelligence as a good thing perhaps a lifesaver is a sharp reversal from how it often gets held in dread. Critics have assailed A.I. as dangerously powerful, even threatening the enslavement of humanity to robots with superhuman powers.

In no way am I suggesting that A.I. is all sweetness and light, Mr. Siebel said. But the new institute, he added, is a place where it can be a force for good.

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A.I. Versus the Coronavirus - The New York Times