Category: Corona Virus

In an Instagram post on Tuesday, Rikaart said his symptoms started a few weeks ago with a slight cough and gradually got worse. He was then misdiagnosed with pneumonia.

"I just tested positive for coronavirus," he wrote, adding, "I am a pretty healthy 43-year-old who doesn't smoke, doesn't drink much, eats well and exercises regularly and this has been the hardest experience of my life."

He said while everyone in his house had a slight cough, they got better and he grew sicker.

"Two+ weeks ago, everyone in my house had a bit of a cough and my son came home from school with a high fever. Everyone recovered, but I deteriorated. I isolated from my family and have been in solo quarantine since Saturday the 14th. I had a fever for 11 days, difficulty breathing and was diagnosed with pneumonia."

He said he is finally starting to feel better.

"I'm confident that I have finally turned the proverbial corner and am fever free today for the first time since this all started. I was told to stay isolated for another 72 hours before I acclimate back into my family. So, nice try coronavirus, but I have another 4-5 decades worth of experiences to have with these guys. Furthermore, I want to thank you all for the well wishes and I hope you heed the warnings. Stay safe, stay healthy and stay inside."

Rikaart has appeared on the soap opera since 2003.

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'The Young and the Restless' star Greg Rikaart says he has coronavirus - CNN

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WHO: US could be the next epicenter of the global coronavirus pandemic - The Hill

Back when I was trying and failing to quit, I'd reach for any excuse to bail on my better self. A bad day. A text from my ex, or no text.

One day, a snowstorm walloped the city, shuttering my office, and I pulled on my rubber boots with a sigh as if to say, "I guess I'm drinking now."

I didn't want to be this person, passing out on the futon with the television flickering on her face, waking up to green empties mashed with cigarette butts, but I didn't know another way.

"Who cares?" I thought, as I trudged to the liquor store on sidewalks shoveled by strangers. "Why bother trying to change?" It felt that day, like many days, that the universe was conspiring to keep me good and drunk. I can't even imagine what I'd make of a shelter-in-place edict and booze on delivery.

"Who cares? Why bother?" is not just a drunk's dilemma, of course. As the planet throbs with uncertainty, as we disappear behind deadbolts with our curtains pulled shut, many of us will be called by the voice of romantic doom. Why bother getting out of bed? Who cares if I eat all the cupcakes? Why not watch Netflix all day?

Some of this is human and necessary, but too much is unhealthy and numbing -- and how we find that balance will be one of the many challenges of this moment.

We live in a culture that gives us so few tools to find peace in our minds and so many ways to escape it. Beer, wine, vodka it was the most reliable comfort I knew for a long time. But the more I reached for that fix, the more of a mess I became.

If you are trying and failing to quit drinking, I actually think this might be the perfect moment to get sober. The circumstances that force us to stare down our worst habits could also be the excuse we need to change.

I quit drinking nearly ten years ago, and the first months that followed were a bit like a self-quarantine. I bailed on social engagements and rarely went to bars or restaurants, where the free-flowing wine made my mouth water. I holed up inside my apartment listening to podcasts and reading books and occupying my hands with dorky crafting projects like latch-hooking a picture of a tabby. It's a bit eerie how much a society in lockdown resembles people in early sobriety -- without the devastating global consequences, of course.

I don't mean to make light of our dire moment; I only mean to point out these are the impossible circumstances under which I once wished I could give up booze. I wanted the rest of the world to disappear, to stop shoving easy happiness in my face. I could find temptation in any billboard or passing stranger. I got such a heart sink seeing a smiling couple sipping Chardonnay on the patio, or a glamorous friend hoisting her martini glass on Instagram.

For months, I felt like a woman living on the loneliest island.

The AA lifeline moves online

Recovery meetings can be a bridge back to human connection, but I struggled there too. I was allergic to Alcoholics Anonymous at first, with its corny slogans and awkward human blinking, and I used to fantasize that 12-step meetings would get canceled so I could stop feeling guilty for skipping them.

In time I came to see that a 12-step program gave me what I badly needed not only community and accountability but a way to address the problems underneath my chronic drinking. AA doesn't work for everyone, but it worked for me, and over the years I've been grateful for wisdom I never saw out there in the endless scroll of quick fixes and entertainment on demand. "One day at a time" is a corny slogan, it's true. It will also save you a world of pain.

I didn't understand when I first quit how few coping strategies I had, how much I had outsourced to the stress management system of "one more round." I had an overthinker's disdain for prayer and meditation and exercise, until I started seeing how useful they could be for lowering stress and anxiety, focusing the mind, finding calm in my own body -- so many of the things I was drinking for in the first place.

AA taught me that status, riches, intelligence and beauty are not barriers against the random lashes of fate. Alcoholism, like a virus, can strike anyone at any level of society. I consider it one of the profound gifts of my life that I've been able to sit in those hard metal chairs and discover how much of my heart might be shared with a total stranger.

Honestly, this is how I would have preferred my meetings in the beginning. I wanted to participate, but I wanted to stay safe in my home at the same time. And for better or worse, technology lets us do that.

I haven't been surprised to find other kinds of support groups popping up online, too. Happy hours, of course, but also meditation groups, parenting groups, single-person groups, writing groups and reading groups -- people linked by common interests and seeking new ways to connect. One aspect of AA meetings I've always appreciated is that you have to stay quiet when someone else is sharing, no matter how much you disagree or want to interrupt. You'd be amazed what you can learn when you're forced to listen to another human. So much better than the "everyone yell at once" rules of engagement on social media.

Each day at 5 p.m., I log on to Zoom to find 20 faces staring back at me. I'm becoming familiar with the rattle of their ceiling fans, the buttons of the couch where they sit, the titles on their bookshelves. It's a new way to have recovery meetings, but it's not that different. People talk about the pain of having a family but also having no family. They talk about the stress of their job but also having no job. The world is in crisis and the same as it ever was. People are struggling. We need each other.

Combating loneliness, together

Alcoholism is an affliction of loneliness. Whatever else chronic drinking might be a disease, a rut, a genetic inheritance, a behavioral disorder, a deficiency of dopamine or some neurotransmitter (and we can argue about this over Zoom some other time) it feeds on solitude and despair, and we have plenty on tap these days.

But as many have pointed out, this could also be a moment when we return to humble pleasures and simpler connections. I love hearing the stories of families playing board games, of old-fashioned telephone conversations, of neighbors greeting each other from 6 feet away, sometimes for the first time.

And in the end, that's the answer to the questions, "Who cares? Why bother?" Because we need each other in this battle. Nobody could blame a person for cratering to self-pity and fear, but others might be inspired by your example if you rose up instead.

In those long and agonized months when I was trying and failing to quit drinking, I was haunted by a sense that I was not who I wanted to be. I wasn't really thinking about anyone else, and I wouldn't for a while. I could rationalize continuing to drink. I could keep making excuses. But in the deepest part of me I knew it was time, and that was a feeling I never could outrun.

Yes, a global catastrophe is the perfect excuse to stay good and drunk. It is also the perfect chance to finally become the person you want to be.

Sarah Hepola is the bestselling author of "Blackout" and currently working on her second memoir.

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For those struggling to stay sober, coronavirus shutdowns offer hope as well as temptation - CNN

A doctor in Germany prepares a swab to test for coronavirus infection.

By Robert F. ServiceMar. 22, 2020 , 12:15 PM

As the United States races to ramp up testing for the pandemic coronavirus using technology based on the tried-and-true polymerase chain reaction (PCR), alternative approaches are beginning to roll out that could make it easier and quicker for people to learn whether they have been infected. Some methods modify the standard PCR test, which amplifies tiny bits of genetic material to enable detection, whereasothers sequence the virus directly or use the genome editor CRISPR.

Faster and cheaper tests are coming, says Evan Jones, CEO of OpGen, a rapid diagnostics company. However, he adds, developing new kinds of tests is going to take time. Some of the new tests are coming online now, but others will likely take months to validate and ready for widespread distribution.

Testing, testing, testing has been the mantra repeated again and again by World Health OrganizationDirector-General Tedros Adhanom Ghebreyesus. Diagnostic assays that identify active infections in people are vitally important for public health efforts, not just for individuals health concerns. Widespread diagnostic testing, along with isolation of the infected, contact tracing, and quarantining of those contacts, seems to have been key in South Koreas work to suppress virus spread.

In the United States, the slow rollout of coronavirus PCR tests has been widely attributed to a combination of stringent rules aimed at ensuring their reliability and a complex web of companies and health care systems responsible for developing, carrying out, and paying for tests. The Trump administration says testing is accelerating. On 16 March, at a White House press conference, U.S. Health and Human Services Assistant Secretary for Health Brett Giroir saidthe country would be able to process 1 million tests by the end of the week, and 2 million the following week. But the actual numbers arent close to that yet. According to data compiled by the COVID Tracking Project, a nonprofit collaboration of public health officials and journalists counting tests given in the United States, 191,541 PCR diagnostics have been performed as of 22 March, with 24,345 of them positive for the virus.

On 29 February, the U.S. Food and Drug Administration (FDA) posted new rules to allow for emergency use authorizations of coronavirus tests beyond the ones being made and distributed by the U.S.Centers for Disease Control and Prevention. Academic virology labs, public health departments, and companies sprang to work creating their own PCR tests. Today, some four dozen organizations have received FDA approval for their tests. Among the largest are diagnostic companies, such as Roche Molecular Systems, which received FDAs green light for its test this week. It will initially supply some 400,000 tests per week in the United States and 3 million globally, according to Alexandra Valsamakis, the companys chief medical officer. Other large companies have recently gained approval for their tests as well, including Thermo Fisher Scientific and Abbott Laboratories.

University virology labs have also leaped into the breach to help diagnose cases in their vicinity. This past week, for example, doctors at the University of Pittsburgh Medical Center (UPMC) began to use a homemade PCR test to check for infection in Allegheny county. For now, its number of tests remains small, about 100 per week. We definitely wished we had started it sooner, says Alan Wells, who heads UPMCs clinical laboratories.

PCR is the most commonly used test for diagnosing coronavirus because its highly accurate. (SeeHow does the most common coronavirus test work?) But other problems limit it. Its not getting the turnaround we need, says Steven Wolinsky, an infectious diseases physician at Northwestern University. Each test takes about 4 hours once a sample reaches a centralized testing lab, with the time split between sample preparation and the actual PCR test. With transport and queues, getting a result can take 2 to 4 days. In that time, infected people may spread the virus to many others.

Another new dimension is now being added to the coronavirus diagnostic landscape: home tests, which involve mailing a sample taken at home to a lab. Tomorrow, for example, Everlywell expects to begin toshipkits to homes and retail pharmacies. These tests will start with screening questions, either online or at a retailer, to determine whether a person is likely to have been exposed to the virus. If they are, they can receive a nasopharyngeal sampling kit by mail or can buy one from a local retailer. A person will be given detailed instructions to administer their own swab, insert it into a protective vial, and overnight mail it to one of dozens of diagnostic labs (which partnered with Everlywell and already have FDA approval) for PCR analysis.

Frank Ong, Everlywells chief medical and scientific officer, says the company expects to quickly ramp up from offering thousands of such tests per day to tens of thousands. Although each test will still likely require a 4-day wait for results, Ong says, this home sampling strategy carries major benefits: It will protect health care workers from exposure to potential infection and free up their time. We need to make sure we give them the bandwidth to take care of patients, Ong says. Other companies, including Nurx and Carbon Health, say theyre now shipping limited supplies of their own home sampling kits.

Most PCR tests for the new virus are being done with big, expensive automated machines that do many tests at once. Major hospitals or diagnostic facilities have them, but another option beginning to roll out now is smaller, less expensive devices that also do nucleic acid amplification. These could be used by smaller hospitals and even individual doctors offices.

On Friday, for example, Cepheid, which sells small PCR systems for rapidly detecting influenza viruses, tuberculosis bacteria, and other microbes, received FDA emergency use approval for a severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) test cartridge that slots into the companys GenXpert system, a device the size of espresso machine that can produce a diagnostic result in as little as 45 minutes. Cepheid officials say that 23,000 such systems are in place worldwide, with 5000 in the United States. On 19 March, GenMark received FDA emergency use approval for its own coronavirus tests, which run on similar-sizemachines that use a proprietary electrochemical approach to detect target genetic material in less than 2 hours. Other companies rushing to deliver point-of-care diagnostic machines include Mesa Biotech, HiberGene, Mobidiag, and QuantuMDx.

So, too, are companies such as Oxford Nanopore and Fulgent Genetics, which instead of using PCR directly sequence any genetic material in a sample and then look for matches to, say, the new coronavirus. This high-speed gene sequencing approach could help characterize the coronavirusgenome to better understand how the virus is evolving, but it could alsobe a diagnostic in certain situations, such as remote sites without access to PCR. Oxford Nanopores handheld devices have been used in Ebola outbreaks, and the company sent many to China early in the pandemic.

The fastest way to test for the coronavirus may ultimately be offered by companies using the CRISPR genome editor, better known for adding or deleting DNA in cells. Two U.S. companies, Mammoth Biosciences and Sherlock Biosciences, say they have created CRISPR-based tests and are in the process of validating them with patient samples before seeking emergency use approval by FDA. The technique starts with a patient sample, extracts viral RNA, and uses a fast nucleic acid amplification test called loop-mediated amplification to make just enough RNA for the test to detect. Researchers then add two components of a CRISPR genome editor, a protein called CAS12 that cuts DNA or RNA and a guide RNA that slots into CAS12 and helps it search out a sequence corresponding to a piece of the coronavirus genome. If CAS12 and its guide find a match in the RNA, CAS12 binds to that matched RNA, which activates CAS12 to cut it and go on to cut any other short RNA or DNA strands in the vicinity, including copies of a strand designed to liberate color-changing molecules when CAS12 cuts them free. The upshot can be a simple color change on a test strip.

The technique excels at hunting for small snippets of genetic material, says Jennifer Doudna, a biochemist at the University of California (UC), Berkeley, a CRISPR pioneer, who is chair of Mammoth Biosciencess science advisory board.

In a preprint posted 10 March on medRxiv, researchers at Mammoth Biosciences and UCSan Franciscoreport that tests on clinical samples produced results with accuracy rates comparable to PCR in just 30 minutes. It uses a simple paperlike strip with a colored line that appears with a positive result. The company is discussing with partners manufacturing test kits that would allow rapid and cheap diagnosis of SARS-CoV-2 infection at home without requiring medical know-how, says Trevor Martin, Mammoths CEO.

It may take months to finalize the test and get regulatory approval for it, so it likely wont be ready in the crucial weeks ahead. But it could be ready if the spread of the coronavirus continues. Some predict the virus will also recede but then have a resurgence of infections in the fall. Getting results wouldnt require PCR machines operated by trained technicians, Martin says. It would be a game changer for our response to emerging diseases, Martin says.

Even as companies and academic labs are scaling up their PCR-based diagnostic efforts, hospitals and testing sites around the country report that they are facing a more immediate crunch: Many are running out of chemicals and other materials that enable the tests, such as the swabs to collect samples from patients and the reagents needed by PCR. Benjamin Pinsky, a Stanford University pathologist who developed a PCR-based diagnostic test in use in Northern California, says his lab is facing rolling shortages of different supplies, most notably the kits used to extract RNA from viral samples, before it can be loaded into PCR machines.

This has been a big challenge, Pinsky says. Weve had to be very nimble in dealing with this, constantly switching suppliers or even chemical procedures, which must be validated before they can be used on patient samples. His team has even sent pleas over Twitter to the Stanford community and regional biotech companies calling for donations of reagent assemblies, such as kits from Zymo and Qiagen. And even though donations have been pouring in, supplies are still running short, Pinsky says.

Reagent companies are trying to respond. For example, Qiagen, a major supplier of RNA extraction kits, announced Tuesday that its employees are working around the clock to increase production from 1.5 million kits per month to 6.5 million per month by the end of April and further increases later.

Pinsky, for one, says hes ready for companies to take over coronavirus testing entirely from academics such as himself. Im hopeful these companies will be able to provide the testing they have promised, Pinsky says. That remains to be seen.

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The standard coronavirus test, if available, works wellbut can new diagnostics help in this pandemic? - Science Magazine

Dr. Scott Isaacs has worked as an endocrinologist for more than two decades, focused on the medical needs of adults with diabetes in the Atlanta area. He never expected to be serving on the front lines of a pandemic.

For weeks, his phone has been ringing off the hook. His diabetes patients, a high-risk group for coronavirus infection, want to know: How can they get tested? How can they stockpile extra medication? And can he write to their employers to recommend they work from home?

Last week, Dr. Isaacs saw a patient with Type 1 diabetes, a nurse who is 10 weeks pregnant. She asked him how long she should stay home from work to avoid possible exposure, and he had to respond honestly: I really dont have an answer to that.

Dr. Isaacs is used to relying on his medical expertise, but the coronavirus has suddenly put him in new territory, an experience shared by many medical specialists who may serve as the primary physicians of patients with particular medical needs. Physicians across every field who are trained to care for very specific medical problems are confronting a surge of patient questions and scrambling to keep up with rapid changes in case numbers and advisories from governments and health agencies.

Were hearing a lot of anxieties from specialists who dont know what the right thing to do is for their patients, said Dr. Megan Ranney, an emergency physician in Rhode Island. Dermatologists, ophthalmologists, were even hearing from dentists.

Dr. Sandra Weber, president of the American Association of Clinical Endocrinologists, said the coronavirus outbreak had made it immediately clear how much Americans rely on medical specialists.

It has exposed that not every person has a primary care provider, she said, referring to people who may not regularly see an internist or family doctor.

Their first calls to the medical system could be to a specialist theyve been seeing for a particular health problem. Specialists in heart medicine, lung care and obstetrics have training that is highly pertinent to treating the effects of the coronavirus. But specialists in other fields are hearing queries they may not be used to answering.

Endocrinologists like Dr. Weber are helping their patients coordinate extra supplies of medication, in case they need to self-isolate. And psychiatrists, especially on campuses, are facing a barrage of questions on an array of topics, like potential virus exposure and the sudden upending of work and academic schedules.

For Dr. Gauri Khurana, a psychiatrist who works predominantly with college students, the coronavirus questions began as a trickle from patients with family in China. In recent weeks, its become a flood of anxious phone calls from young people wondering about how theyll complete graduation requirements or whether they might be infected.

I dont think a lot of them have primary care doctors and at this point everyone is terrified, wondering whats going to happen, she said. I have patients that want to drop out of school, move to Canada. Theyre grateful for any advice, especially coming from a doctor because theres so much misinformation.

So Dr. Khurana, reading news articles nonstop to educate herself on the virus, has done her best to counsel her patients on practical steps to prevent exposure: using credit cards instead of cash, wearing gloves when going outside and carrying personal items in sandwich bags. I wish I had taken sandwich bags to work and given everyone a sandwich bag, she said.

For specialists who treat high-risk demographics, the best medical advice for the coronavirus outbreak can feel contradictory: To stay safe, try to avoid the doctors office. Both the Surgeon General and the American College of Surgeons have advised that hospitals cancel elective procedures in the coming weeks, and some states have ordered postponements.

Dr. Rajeev Jain, a gastroenterologist in Dallas, sees a large number of patients with autoimmune disorders like Crohns. To help minimize their risk of coronavirus exposure, he has canceled appointments that arent immediately necessary on a normal Monday and Tuesday he would see 30 patients, and this week hell see six.

Much of his time is now spent fielding calls from patients who wonder if they should stop taking their immunosuppressive medications in order to minimize risk of serious infection. Following a joint advisory from American gastroenterological associations, Dr. Jain has told patients to continue their course of normal treatment.

He worries that if his patients stop taking medications, they could contract other illnesses and be hospitalized. Thats where a large reservoir of Covid-19 is at the moment, he said. Thats the last thing I want to do.

As physicians brace for what they realize will be an increasingly challenging period, representatives of medical associations say they are moving quickly to develop and distribute resources to support their members. Patrice Harris, president of the American Medical Association, said the association had developed a Covid-19 online resource center and physicians guide. She added that the association was aware of and working to address shortages in protective equipment for physicians, like N-95 respirators.

As fears about the virus spread in local communities, physicians are also facing unanticipated stress. Dr. Isaacs said his clinic had been robbed four times of masks, sanitizing wipes and hand soap. Dr. Supriya Mahajan, a neurologist at a private practice in Ohio, said that shes had to confront the financial losses of converting most in-person appointments to telemedicine because her partner in the practice is her father, whose age makes him at high-risk for severe Covid-19.

And some specialists wonder whether, in the weeks to come, they might be called in to assist with front-line care. Dr. Jain works at a Dallas hospital that treated Ebola patients in 2014 and recalls when I.C.U. doctors were put in quarantine.

We dont know if in two weeks there will be a surge and well be pulled in to take care of patients in the E.R., he said. The system is already starting to get overwhelmed.

Dr. Jains days are now filled with all sorts of new precautions: designating clothing just for work, removing his scrubs before coming home, hand sanitizing more often than he already did. Its an adjustment, he said, to his routine life as a gastrointestinal specialist.

But foremost on his mind is the health of his patients.

Im reminded that this is why I got into medicine in the first place, Dr. Jain said. I need to step up now and do what I can to help.

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These Doctors Have Specialties. Fighting Coronavirus Wasnt One of Them. - The New York Times

Taking large doses of single vitamins and minerals also carries risks. Excessive levels of zinc, for example, can disrupt the bodys uptake of copper, increasing the likelihood of anemia. Vitamin D is not metabolized efficiently without an adequate level of magnesium, and in high doses it can be toxic.

Vitamins and herbal supplements can also interact with prescription medications, dampening their effectiveness or, in the case of blood thinners, for example, raising concentrations to dangerously high levels.

There are times when taking a supplement can be very useful, such as during pregnancy or to address a clear nutrient deficiency. But for healthy adults who are worried about the coronavirus, eating a nutritious diet and getting proper sleep and exercise are the best ways to strengthen your immune system, said Linda Van Horn, chief of nutrition in the department of preventive medicine at the Northwestern University Feinberg School of Medicine.

Whole foods like fruits, vegetables, fish, poultry, nuts, legumes and milk contain a wide range of vitamins, minerals and phytochemicals including zinc and vitamin D that work in synergy to protect your health.

This is an ideal time to look at what youre eating, said Dr. Van Horn. We all know that grocery stores have been experiencing some limitations. But for the most part people are still able to find fresh produce and other healthy foods.

Ms. Koff, the dietitian in Ohio, said she tells people it is fine to take a multivitamin to address any gaps in their nutrition. But she encourages people to focus on their diet, stress levels and sleep and warns them not to overload their systems with large doses of supplements.

This is the time to start implementing behaviors that support your health, not going and taking high amounts of things that are incorrectly listed as immune boosters, she said.

Read more:

Supplements for Coronavirus Probably Wont Help, and May Harm - The New York Times

Each days delay in stopping human contact, experts said, creates more hot spots, none of which can be identified until about a week later, when the people infected there start falling ill.

To stop the explosion, municipal activity must be curtailed. Still, some Americans must stay on the job: doctors, nurses, ambulance drivers; police officers and firefighters; the technicians who maintain the electrical grid and gas and phone lines.

The delivery of food and medicine must continue, so that people pinned in their homes suffer nothing worse than boredom. Those essential workers may eventually need permits, and a process for issuing them, if the police are needed to enforce stay-at-home orders, as they have been in China and Italy.

People in lockdown adapt. In Wuhan, apartment complexes submit group orders for food, medicine, diapers and other essentials. Shipments are assembled at grocery warehouses or government pantries and dropped off. In Italy, trapped neighbors serenade one another.

Its an intimidating picture. But the weaker the freeze, the more people die in overburdened hospitals and the longer it ultimately takes for the economy to restart.

South Korea avoided locking down any city, but only by moving early and with extraordinary speed. In January, the country had four companies making tests, and as of March 9 had tested 210,000 citizens the equivalent of testing 2.3 million Americans.

As of the same date, fewer than 9,000 Americans had been tested.

Everyone who is infected in South Korea goes into isolation in government shelters, and phones and credit card data are used to trace their prior movements and find their contacts. Where they walked before they fell ill is broadcast to the cellphones of everyone who was nearby.

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Coronavirus Can Be Stopped Only by Harsh Steps, Experts Say - The New York Times

Maybe it was that one store where you shopped while on vacation a few years ago, or perhaps that online service that you used just last week, but its all the same message: Businesses have flooded everyone on their email lists with coronavirus updates, tips on staying healthy and words of encouragement much to peoples dismay.

Thanks to the Insta ad that lured me into buying a pair of everyday/gym-to-office/rugged/softest/all-weather/spill-proof/hidden pocket pants for sending me 6 emails to let me know how their company is dealing with #coronavirus, one user said on Twitter.

Is anyone else now only realizing how many company email subscriptions theyre part of? Thanks, company I booked a gig ticket through five years ago, Im glad youre also disinfecting your offices #coronavirus, said another.

The email deluge, which quickly became a running joke online, raises questions about marketing practices as nonessential businesses closed shops and storefronts amid the spread of the coronavirus.

The basic element of crisis communication is that you should say something, said Hilary Fussell Sisco, an associate professor and chair of strategic communication at Quinnipiac University in Hamden, Conn.

The emails can be an effective strategy, she said, but it depends on the person receiving them someone who last ate at a restaurant in 2007 might dismiss its message, but a person who orders delivery twice a week will be looking for that information.

Theres also a reputational side to it, Dr. Fussell Sisco said.

Its not just that I dont want to order anything from you right now, or youre going to be closed, she said, adding, Are you somebody that I want to buy from again, once all this is over, because of what your practices were?

Some messages have included details from companies on how theyre weathering the pandemic and whether they will continue paying or providing benefits for their workers business decisions that some consumers value more than a good sale.

Unless your company is emailing me to tell me how youre paying your employees and contractors during this time, one user wrote on Twitter, I do not care for your coronavirus marketing email one bit.

Michael Wentz, the director of digital marketing at Adelphi University in Garden City, N.Y., said companies that were sending out emails with facts about the pandemic, as well as their responses to it, were demonstrating great social responsibility.

That, he said, gives consumers a better understanding or appreciation for that company because they felt the need, even though theyre not obligated to and its not in their purview to be giving me that information.

But the message can be easily muddied, so businesses need to make sure their emails are cohesive and stick to one message, Mr. Wentz said. In other words, avoid dropping updates about your staff in the same email in which you send out a coupon code.

David Hagenbuch, a professor of marketing at Messiah College in Mechanicsburg, Pa., said companies needed to do some soul-searching before hitting the send button.

If a restaurant, for example, has very important health and safety reasons for sending the email then those motives are pretty legitimate, he said, warning that customers know when a company sends an email just for the sake of sending one.

Consumers are increasingly savvy, Professor Hagenbuch said. As we read these emails, we can tell pretty quickly if one is being sent with the former types of reasons in mind, our health and safety, versus ones that just come across as kind of disingenuous. Theyre just trying to roll with the tide.

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Coronavirus Has Opened the Corporate Email Floodgates - The New York Times

One reason for measured optimism is the prospect that antiviral medicines will beat the coronavirus; some are already in clinical trials. Scientists have hopes for remdesivir, originally developed for Ebola; chloroquine, an old anti-malaria drug; and some anti-H.I.V. and immune-boosting drugs. Many other drugs are also lined up for trials.

Even without proven treatment, the coronavirus may be less lethal than was originally feared, so long as health care systems are not overwhelmed. In South Korea and in China outside Hubei Province, about 0.8 percent of those known to be infected died, and the rate was 0.6 percent on a cruise ship.

Thats still roughly six times the rate of seasonal flu, about 0.1 percent, but Dr. John Ioannidis of Stanford University argues that the fatality rate may end up even lower. He warns that we are engaging in hugely disruptive interventions without firm evidence of the threat that the virus poses. Singapore has had more than 200 confirmed cases of the virus and not a single death.

About four out of five people known to have had the virus had only mild symptoms, and even among those older than 90 in Italy, 78 percent survived. Two-thirds of those who died in Italy had pre-existing medical conditions and were also elderly; Dr. David L. Katz, the former director of the Prevention Research Center at Yale University, notes that many might have died soon of other causes even if the coronavirus had not struck.

That said, a new C.D.C. study finds that of coronavirus cases in the United States requiring admission to the intensive care unit, nearly half involved patients under age 65; there is also concern about lasting lung damage among survivors.

Putting it all together, Dr. Tara C. Smith, an epidemiologist at Kent State University, said: Im not pessimistic. I think this can work. She thinks it will take eight weeks of social distancing to have a chance to slow the virus, and success will depend on people changing behaviors and on hospitals not being overrun. If warm weather helps, if we can get these drugs, if we can get companies to produce more ventilators, we have a window to tamp this down, Smith said.

So thats the best case, and its plausible. If you want to feel upbeat, stop reading here.

Now we get to the other end of the range of possibilities. Dr. Neil M. Ferguson, a British epidemiologist who is regarded as one of the best disease modelers in the world, produced a sophisticated model with a worst case of 2.2 million deaths in the United States.

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The Best-Case Outcome for the Coronavirus, and the Worst - The New York Times

MUSKEGON, Mich. Muskegon County has identified its first positive case of COVID-19 on Monday, March 23.

Public Health Muskegon County (PHMC) was able to identify the positive case through Michigan Department of Health and Human Services (MDHHS) testing.

Weve been anticipating and expecting the confirmation of COVID-19 in our community, said Kathy Moore, Muskegon County Health Officer. To slow the potential spread its critical for the public to comply with public health orders and practice common sense precautions.

The positive case is an adult female. PHMC officials are now working to find the people who have been in close contact with the woman.

No other details about the case were available as of Monday morning.

Those who are identified will be monitored for symptoms and be asked to self-quarantine.

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The uncertainty of the situation brings a great deal of anxiety to everyone, said Mark Eisenbarth, Muskegon County Administrator. We need your help in following the Executive Orders of Gov. Gretchen Whitmer in an effort to protect all the citizens of Muskegon County.

STATE RECOMMENDATIONS FOR COVID-19

Patients with confirmed infection have reportedly had mild to severe respiratory illness with symptoms of:

The best prevention for viruses, such as influenza, the common cold or COVID-19 is to:

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First case of coronavirus confirmed in Muskegon County - WZZM13.com