Category: Corona Virus

A medical officer prepares to take samples from a visitor at a drive-throughtesting center atYeungnam University Medical Center.

By Dennis NormileMar. 17, 2020 , 8:00 AM

Europe is now the epicenter of the COVID-19 pandemic. Case counts and deaths are soaring in Italy, Spain, France, and Germany, and many countries have imposed lockdowns and closed borders. Meanwhile, the United States, hampered by a fiasco with delayed and faulty test kits, is just guessing at its COVID-19 burden, though experts believe it is on the same trajectory as countries in Europe.

Amid these dire trends, South Korea has emerged as a sign of hope and a model to emulate. The country of 50 million appears to have greatly slowed its epidemic; it reported only 74 new cases today, down from 909 at its peak on 29 February. And it has done so without locking down entire cities or taking some of the other authoritarian measures that helped China bring its epidemic under control. South Korea is a democratic republic, we feel a lockdown is not a reasonable choice, says Kim Woo-Joo, an infectious disease specialist at Korea University. South Koreas success may hold lessons for other countriesand also a warning: Even after driving case numbers down, the country is braced for a resurgence.

Behind its success so far has been the most expansive and well-organized testing program in the world, combined with extensive efforts to isolate infected people and trace and quarantine their contacts. South Korea has tested more than 270,000 people, which amounts to more than 5200 tests per million inhabitantsmore than any other country except tiny Bahrain, according to the Worldometer website. The United States has so far carried out 74 tests per 1 million inhabitants, data from the U.S. Centers for Disease Control and Prevention show.

South Koreas experience shows that diagnostic capacity at scale is key to epidemic control, says Raina MacIntyre, an emerging infectious disease scholar at the University of New South Wales, Sydney. Contact tracing is also very influential in epidemic control, as is case isolation, she says.

Yet whether the success will hold is unclear. New case numbers are declining largely because the herculean effort to investigate a massive cluster of more than 5000 cases60% of the nations totallinked to the Shincheonji Church of Jesus, a secretive, messianic megachurch, is winding down. But because of that effort, We have not looked hard in other parts of Korea, says Oh Myoung-Don, an infectious disease specialist at Seoul National University.

New clusters are now appearing. Since last week, authorities have reported 129 new infections, most linked to a Seoul call center. This could be the initiation of community spread, through Seoul and its surrounding Gyeonggi province, Kim says. The region is home to 23 million people.

South Korea learned the importance of preparedness the hard way. In 2015, a South Korean businessman came down with Middle East respiratory syndrome (MERS) after returning from a visit to three Middle Eastern countries. He was treated at three South Korean health facilities before he was diagnosed with MERS and isolated. By then, he had set off a chain of transmission that infected 186 and killed 36, including many patients hospitalized for other ailments, visitors, and hospital staff. Tracing, testing, and quarantining nearly 17,000 people quashed the outbreak after 2 months. The specter of a runaway epidemic alarmed the nation and dented the economy.

That experience showed that laboratory testing is essential to control an emerging infectious disease, Kim says. In addition, Oh says, The MERS experience certainly helped us to improve hospital infection prevention and control. So far, there are no reports of infections of COVID-19 among South Korean health care workers, he says.

Legislation enacted since then gave the government authority to collect mobile phone, credit card, and other data from those who test positive to reconstruct their recent whereabouts. That information, stripped of personal identifiers, is shared on social media apps that allow others to determine whether they may have crossed paths with an infected person.

After the novel coronavirus emerged in China, Korea Centers for Disease Control and Prevention (KCDC) raced to develop its tests and cooperated with diagnostic manufacturers to develop commercial test kits. The first test was approved on 7 February, when the country had just a few cases, and distributed to regional health centers. Just 11 days later, a 61-year-old woman, known as Case 31, tested positive. She had attended 9 and 16 February services at the Shincheonji megachurch in Daegu, about 240 kilometers southeast of Seoul, already feeling slightly ill. Upward of 500 attendees sit shoulder to shoulder on the floor of thechurch during 2-hour services, according to local news reports.

The country identified more than 2900 new cases just in the next 12 days, the vast majority Shincheonji members. On 29 February alone, KCDC reported more than 900 new cases, bringing the cumulative total to 3150 and making the outbreak the largest by far outside mainland China. The surge initially overwhelmed testing capabilities and KCDCs 130 disease detectives couldnt keep up, Kim says. Contact tracing efforts were concentrated on the Shincheonji cluster, in which 80% of those reporting respiratory symptoms proved positive, compared with only 10% in other clusters.

High-risk patients with underlying illnesses get priority for hospitalization, Chun says. Those with moderate symptoms are sent to repurposed corporate training facilities and spaces provided by public institutions, where they get basic medical support and observation. Those who recover and test negative twice are released. Close contacts and those with minimal symptoms whose family members are free of chronic diseases and who can measure their own temperatures are ordered to self-quarantine for 2 weeks. A local monitoring team calls twice daily to make sure the quarantined stay put and to ask about symptoms. Quarantine violators face up to 3 million won ($2500) fines. If a recent bill becomes law, the fine will go up to 10 million won and as much as a year in jail.

In spite of the efforts, the Daegu-Gyeongbuk region ran out of space for the seriously ill. Four people isolated at home, waiting for hospital beds, were rushed to emergency rooms when their conditions deteriorated, only to die there, according to local media.

Still, the numbers of new cases have dropped the past 2 weeks, aided by voluntary social distancing, both in the Daegu-Gyeongbuk region and nationwide. The government advised people to wear masks, wash their hands, avoid crowds and meetings, work remotely, and to join online religious services instead of going to churches. Those with fevers or respiratory illnesses are urged to stay home and watch their symptoms for 3 to 4 days. People were shocked by the Shincheonji cluster, Chun says, which boosted compliance. Less than 1 month after Case 31 emerged, The cluster is coming under control, Oh says.

Yet new clusters are emerging, and for 20% of confirmed cases, its unclear how they became infected, suggesting there is still undetected community spread. As long as this uncertainty remains, we cannot say that the outbreak has peaked, Chun says.

The government hopes to control new clusters in the same way it confronted the one in Shincheonji. The national testing capacity has reached a staggering 15,000 tests per day. There are 43 drive-through testing stations nationwide, a concept now copied in the United States, Canada, and the United Kingdom. In the first week of March, the Ministry of the Interior also rolled out a smartphone app that can track the quarantined and collect data on symptoms.

Chun Byung-Chul, an epidemiologist at Korea University, says scientists are eager to see more epidemiological data. We are literally stamping our feet, Chun says. KCDC releases the basic counts of patients, their age and gender, and how many are linked to clusters. That is not enough, Chun says. He and others would like to study detailed individual patient data, which would enable epidemiologists to model the outbreak and determine the number of new infections triggered by each case, also known as the basic reproductive number or R0; the time from infection to the onset of symptoms; and whether early diagnosis improved patients outcomes. (South Korea has had 75 deaths so far, an unusually low mortality rate, although the fact that Shincheonji church members are mostly young may have contributed.) Chun says a group of epidemiologists and scientists has proposed partnering with KCDC to gather and share such information, and we are waiting for their response.

Kim says medical doctors are also planning to share details of the clinical features of COVID-19 cases in the country in forthcoming publications. We hope our experience will help other countries control this COVID-19 outbreak.

With reporting by Ahn Mi-Young in Seoul.

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Coronavirus cases have dropped sharply in South Korea. What's the secret to its success? - Science Magazine

SINGAPORE Two hours. Thats all the time medical teams in Singapore are given to uncover the first details of how patients contracted the coronavirus and which people they might infect.

Did they travel abroad? Do they have a link to one of the five clusters of contagion identified across the city-state? Did they cough on someone in the street? Who are their friends and family, their drinking buddies and partners in prayer?

As Western nations struggle with the wildfire spread of the coronavirus, Singapores strategy, of moving rapidly to track down and test suspected cases, provides a model for keeping the epidemic at bay, even if it cant completely stamp out infections.

With detailed detective work, the governments contact tracers found, among others, a group of avid singers who warbled and expelled respiratory droplets together, spreading the virus to their families and then to a gym and a church forming the largest concentration of cases in Singapore.

We want to stay one or two steps ahead of the virus, said Vernon Lee, the director of the communicable diseases division at Singapores Ministry of Health. If you chase the virus, you will always be behind the curve.

Singapore, along with Taiwan and Hong Kong, offers successful approaches, at least so far, in battling a pandemic that has infected more than 182,000 people and killed at least 7,300 worldwide. Despite being hit months ago by the virus, these three Asian societies have recorded only a handful of deaths and relatively few cases, although they continue to face risks as people from emerging hot spots in the United States, Europe and elsewhere carry the virus with them.

Early intervention is key. So are painstaking tracking, enforced quarantines and meticulous social distancing all coordinated by a leadership willing to act fast and be transparent.

In Singapore, the details of where patients live, work and play are released quickly online, allowing others to protect themselves. Close contacts of patients are quarantined to limit the spread. The government further strengthened its borders this week to protect against a new wave of imported infections.

Some of these lessons are too late for the United States and Europe, where contagion is raging as some governments delay and debate their response.

And the vigilant monitoring systems in Singapore, Taiwan and Hong Kong were built over years, after their failures to stop another dangerous outbreak SARS 17 years ago. The United States disbanded its pandemic response unit in 2018.

There is also the question of how replicable this model from smaller Asian centers is in large Western countries where people might chafe at the harnessing of C.C.T.V. cameras or immigration records for the health of the nation. Disease control infringes on individual liberties, and places like Singapore, where chewing gum was once banned, are more willing to accept government orders.

Maybe its because of our Asian context, but our community is sort of primed for this, said Lalitha Kurupatham, the deputy director of the communicable diseases division in Singapore. We will keep fighting, because isolation and quarantine work.

Rich and orderly, Singapore has spent years building a public health system that includes designated clinics for epidemics and official messaging urging the public to wash their hands or sneeze into tissues during flu season. The Infectious Diseases Act gives the city-state wide latitude in prioritizing the common good over privacy concerns.

During peacetime, we plan for epidemics like this, Ms. Kurupatham said.

As the leader of Singapores contact tracing program, she has been working 16-hour days for two months, and her depiction of a war against disease is a function of its vulnerability to contagion. A tiny red dot on a world map, Singapore is a densely populated island where every flight is international.

In the early days of the outbreak, Singapore was highly susceptible to a large population of mainland Chinese people arriving during the Lunar New Year holiday.

The dozens of confirmed cases in Singapore in January reflect widespread and freely available testing. Many were mild cases that would otherwise have gone undiagnosed. Nevertheless Singapore was sprinting to stem the possibility of runaway local transmission.

Until Italy, Korea and Iran happened, Singapore was the worst outside China, said Linfa Wang, the director of the emerging infectious diseases program at the Duke-National University of Singapore Medical School. Why didnt we feel that way? Because the government is very transparent and because that number means we are so effective in tracing and isolating every case.

For all the panic erupting elsewhere, most Singaporeans do not wear masks out, because the government has told them its not needed for their safety. Most schools are still running, albeit with staggered lunchtimes to avoid big crowds. There is plenty of toilet paper.

As of Tuesday evening, Singapore had 266 confirmed cases. Only a fraction are mysteries, unlinked to recent foreign travel or previously identified local clusters, which include churches and a private dinner.

Nearly 115 patients have been discharged from the hospital. Singapore has recorded no deaths from the coronavirus.

When rumors of a mysterious respiratory virus began circulating in China at the beginning of the year, Singapore moved quickly. It was one of the first countries to ban all travelers from mainland China, starting in late January. Thermal scanners measured the temperatures of all who came into the country.

In a nation of 5.7 million residents, Singapore rapidly developed the capacity to test more than 2,000 people a day for the coronavirus. In Washington State, one of the hardest hit places in the United States, public labs are aiming to process 400 samples a day.

Testing is free in Singapore, as is medical treatment for all locals. Singapore has 140 contact tracers outlining each patients case history, along with the police and security services doing the shoe-leather work.

After weeks of investigation and the use of a new antibody test that can detect people who have recovered, health officials were able to tie two church clusters of 33 people to a Lunar New Year dinner attended by members of both congregations. The people who transmitted the disease between the two churches had never shown serious symptoms.

Close contacts of patients are put into mandatory quarantine to stop further contagion. Nearly 5,000 have been isolated. Those who dodge quarantine orders can face criminal charges.

All pneumonia patients in Singapore are tested for coronavirus. So are people who are seriously ill. Positive cases have been identified at the airport, at government clinics and, most frequently, through contact tracing.

Singapores epidemic regimen was shaped by the 2003 SARS outbreak, when 33 people died out of 238 confirmed cases. As in Hong Kong, medical workers were among the casualties in Singapore.

Hong Kongs heavy death toll from SARS, nearly 300 people, has spurred residents in the semiautonomous Chinese territory to exercise vestigial muscles of disease prevention this time around, even as the local authorities initially dithered on whether to close the border with mainland China. Nearly everyone, it seemed, began squirting hand sanitizer. Malls and offices set up thermal scanners.

The most important thing is that Hong Kong people have deep memories of the SARS outbreak, said Kwok Ka-ki, a lawmaker in Hong Kong who is also a doctor. Every citizen did their part, including wearing masks and washing their hands and taking necessary precautions, such as avoiding crowded places and gatherings.

The Hong Kong government eventually caught up to the publics caution. Borders were tightened. Civil servants were ordered to work from home, prompting more companies to follow suit. Schools were closed in January, until at least the end of April.

Taiwan acted even faster. Like Hong Kong and Singapore, Taiwan was linked by direct flights to Wuhan, the Chinese city where the virus is believed to have originated. Taiwans national health command center, which was set up after SARS killed 37 people, began ordering screenings of passengers from Wuhan in late December even before Beijing admitted that the coronavirus was spreading between humans.

Having learned our lesson before from SARS, as soon as the outbreak began, we adopted a whole-of-government approach, said Joseph Wu, Taiwans foreign minister.

By the end of January, Taiwan had suspended flights from China, despite the World Health Organizations advising against it. The government also embraced big data, integrating its national health insurance database with its immigration and customs information to trace potential cases, said Jason Wang, the director of the Center for Policy, Outcomes and Prevention at Stanford University. When coronavirus cases were discovered on the Diamond Princess cruise ship after a stop in Taiwan, text messages were sent to every mobile phone on the island, listing each restaurant, tourist site and destination that the ships passengers had visited during their shore leave.

As of Tuesday, Taiwan had recorded 77 cases of the coronavirus, although critics worry that testing is not widespread enough. Students returned to school in late February.

With new waves of the virus surging across the world, public health officials in the three locales are gearing up for a longer fight.

On Tuesday, the government of Hong Kong, where only 157 cases have been confirmed, announced a mandatory 14-day quarantine for all travelers from abroad beginning later this week.

Taiwan will require self-quarantine for arrivals from 20 countries and three American states.

Prime Minister Lee Hsien Loong of Singapore warned last week that the countrys caseload would increase sharply. Singapore announced 23 new coronavirus patients on Tuesday, the highest single-day tally, with 17 imported cases.

The city-state has restricted its borders further. Arrivals from Southeast Asia and parts of Europe must now undergo a 14-day self-quarantine.

The world is only as good as the weakest link, said Dr. Lee, the head of Singapores communicable diseases division. Diseases do not respect borders.

Chris Horton contributed reporting from Taipei, Taiwan, and Elaine Yu from Hong Kong.

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Tracking the Coronavirus: How Crowded Asian Cities Tackled an Epidemic - The New York Times

Working at a breakneck pace, a team of hundreds of scientists has identified 50 drugs that may be effective treatments for people infected with the coronavirus.

Many scientists are seeking drugs that attack the virus itself. But the Quantitative Biosciences Institute Coronavirus Research Group, based at the University of California, San Francisco, is testing an unusual new approach.

The researchers are looking for drugs that shield proteins in our own cells that the coronavirus depends on to thrive and reproduce.

Many of the candidate drugs are already approved to treat diseases, such as cancer, that would seem to have nothing to do with Covid-19, the illness caused by the coronavirus.

Scientists at Mount Sinai Hospital in New York and at the Pasteur Institute in Paris have already begun to test the drugs against the coronavirus growing in their labs. The far-flung research group is preparing to release its findings at the end of the week.

There is no antiviral drug proven to be effective against the virus. When people get infected, the best that doctors can offer is supportive care the patient is getting enough oxygen, managing fever and using a ventilator to push air into the lungs, if needed to give the immune system time to fight the infection.

If the research effort succeeds, it will be a significant scientific achievement: an antiviral identified in just months to treat a virus that no one knew existed until January.

Im really impressed at the speed and the scale at which theyre moving, said John Young, the global head of infectious diseases at Roche Pharma Research and Early Development, which is collaborating on some of the work.

We think this approach has real potential, he said.

Some researchers at the Q.B.I. began studying the coronavirus in January. But last month, the threat became more imminent: A woman in California was found to be infected although she had not recently traveled outside the country.

That finding suggested that the virus was already circulating in the community.

I got to the lab and said weve got to drop everything else, recalled Nevan Krogan, director of the Quantitative Biosciences Institute. Everybody has got to work around the clock on this.

Dr. Krogan and his colleagues set about finding proteins in our cells that the coronavirus uses to grow. Normally, such a project might take two years. But the working group, which includes 22 laboratories, completed it in a few weeks.

You have 30 scientists on a Zoom call its the most exhausting, amazing thing, Dr. Krogan said, referring to a teleconferencing service.

Viruses reproduce by injecting their genes inside a human cell. The cells own gene-reading machinery then manufactures viral proteins, which latch onto cellular proteins to create new viruses. They eventually escape the cell and infect others.

In 2011, Dr. Krogan and his colleagues developed a way to find all the human proteins that viruses use to manipulate our cells a map, as Dr. Krogan calls it. They created their first map for H.I.V.

That virus has 18 genes, each of which encodes a protein. The scientists eventually found that H.I.V. interacts, in one way or another, with 435 proteins in a human cell.

Dr. Krogan and his colleagues went on to make similar maps for viruses such as Ebola and dengue. Each pathogen hijacks its host cell by manipulating a different combination of proteins. Once scientists have a map, they can use it to search for new treatments.

In February, the research group synthesized genes from the coronavirus and injected them into cells. They uncovered over 400 human proteins that the virus seems to rely on.

The flulike symptoms observed in infected people are the result of the coronavirus attacking cells in the respiratory tract. The new map shows that the viruss proteins travel throughout the human cell, engaging even with proteins that do not seem to have anything to do with making new viruses.

One of the viral proteins, for example, latches onto BRD2, a human protein that tends to our DNA, switching genes on and off. Experts on proteins are now using the map to figure out why the coronavirus needs these molecules.

Kevan Shokat, a chemist at U.C.S.F., is poring through 20,000 drugs approved by the Food and Drug Administration for signs that they may interact with the proteins on the map created by Dr. Krogans lab.

Dr. Shokat and his colleagues have found 50 promising candidates. The protein BRD2, for example, can be targeted by a drug called JQ1. Researchers originally discovered JQ1 as a potential treatment for several types of cancer.

On Thursday, Dr. Shokat and his colleagues filled a box with the first 10 drugs on the list and shipped them overnight to New York to be tested against the living coronavirus.

The drugs arrived at the lab of Adolfo Garcia-Sastre, director of the Global Health and Emerging Pathogens Institute at Mount Sinai Hospital. Dr. Garcia-Sastre recently began growing the coronavirus in monkey cells.

Over the weekend, the team at the institute began treating infected cells with the drugs to see if any stop the viruses. We have started experiments, but it will take us a week to get the first data here, Dr. Garcia-Sastre said on Tuesday.

The researchers in San Francisco also sent the batch of drugs to the Pasteur Institute in Paris, where investigators also have begun testing them against coronaviruses.

If promising drugs are found, investigators plan to try them in an animal infected with the coronavirus perhaps ferrets, because theyre known to get SARS, an illness closely related to Covid-19.

Even if some of these drugs are effective treatments, scientists will still need to make sure they are safe for treating Covid-19. It may turn out, for example, that the dose needed to clear the virus from the body might also lead to dangerous side effects.

In February, a team of researchers found that remdesivir could eliminate the coronavirus from infected cells. Since then, five clinical trials have begun to see if the drug will be safe and effective against Covid-19 in people.

Other researchers have taken startling new approaches. On Saturday, Stanford University researchers reported using the gene-editing technology Crispr to destroy coronavirus genes in infected cells.

As the Bay Area went into lockdown on Monday, Dr. Krogan and his colleagues were finishing their map. They are now preparing a report to post online by the end of the week, while also submitting it to a journal for publication.

Their paper will include a list of drugs that the researchers consider prime candidates to treat people ill with the coronavirus.

Whoever is capable of trying them, please try them, Dr. Krogan said.

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Coronavirus Treatment: Hundreds of Scientists Scramble to Find One - The New York Times

This is my career this is not my side job, she said. If I only have experience in restaurants, how do I branch out?

Across the East River in Queens, Quy Tran, a 55-year-old waiter and delivery man for a Vietnamese restaurant in Jackson Heights, said he had two or three weeks of cash in the bank. I feel nervous, scared, he said, not about the sickness but about money.

And in a restaurant on Columbus Avenue, as the owners sat around a table trying to figure out how to convert to takeout and delivery, a dishwasher swept the floor nearby. He said he still owed $5,000 to the person who helped him cross the border from Mexico last year.

Im not scared to come into work, the dishwasher said. I need the job.

At Bar Tabac, a longtime bistro in Carroll Gardens, Brooklyn, Roman Kologov, a waiter, set up water glasses on empty tables as if in a trance. Basically serve whoever wants to still eat, he said when asked about the last day before closing. Would you want to eat out?

Its a question that could linger beyond the shutdown. Once the crisis passes, chefs and restaurateurs do not expect business to immediately return. After what might be months of time away, diners might be initially wary of public gatherings or might still be out of the habit of dining out.

Everyone is going to have to make an effort, Mr. Ripert, the co-owner of Le Bernadin, said. We are going to see some drastic changes in the restaurant industry. Whatever was yesterday will be difficult to recreate.

Mr. Boulud agreed. We are going to work on zero margins for a long time, Im sure, he said. We need to be able to make the guests feel more comfortable to go out.

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New Yorks Nightlife Shuttered to Curb Coronavirus - The New York Times

The fight against Covid-19 is a full-on war. China seems to have won the first battle. Hong Kong, Taiwan, Singapore and Japan have also chalked up visible successes in mitigating the outbreak, no doubt owing to their experiences in dealing with the 2003 Sars epidemic. Europe and the US, on the other hand, are only just awakening from their illusions of invulnerability. As a result, the epidemic is now raging across the west.

The hardest-hit western country so far is Italy, which has particularly strong economic ties to China. Northern Italy is the new Wuhan (the Chinese megacity where the coronavirus first emerged). With its health system overwhelmed, the Italian government has slammed on the brakes, shutting down the retail economy and quarantining the entire country. All shops except pharmacies and grocery stores are closed. People have been instructed to stay at home and may enter public places only for necessary shopping or commuting to work. Many public and private debt obligations (such as housing rents and interest payments) have been suspended. Italy is attempting to slow down the economic clock until the coronavirus dies out.

Meanwhile, although Germany has had very few coronavirus deaths so far, the number of infections is now skyrocketing as quickly as anywhere else. In response to the crisis, the German government has introduced a short-time work allowance and granted generous credit assistance, guarantees or tax deferrals for distressed companies. Public events across the country have been cancelledand schoolchildren have been told to stay at home. And Austria, for its part, has long since closed its border with Italy. Austrian schools, universities and most shops have also been closed. Initially, France pursued a more relaxed approach, but it has now also shuttered its schools, restaurants and shops, as has Spain. Denmark, Poland and the Czech Republic have closed their borders with Germany.

The US president, Donald Trump, has declared a national state of emergency. Congress has approved an $8.3bn (6.7bn) emergency programme to fund efforts to contain the epidemic. Even larger sums are awaiting passage through the Senate. The federal government has also barred foreign travellers, first from China and Iran, and now from Europe.

Globally, not all responses to the crisis have been well targeted, and others have not been strong enough. Most worryingly, some governments have convinced themselves that they can merely slow down the spread of the virus, rather than taking the steps needed to halt it entirely. The predictable overcrowding of hospitals in many heavily affected areas has already exposed the folly of such complacency.

On the economic front, a severe recession can no longer be avoided, and some economists are already calling for governments to introduce measures to shore up aggregate demand. But that recommendation is inadequate, given that the global economy is suffering from an unprecedented supply shock. People are not at work because they are sick or quarantined. In such a situation, demand stimulus will merely boost inflation, potentially leading to stagflation (weak or falling GDP growth alongside rising prices), as happened during the 1970s oil crisis, when another important production input was in short supply.

Worse, measures targeting the demand side could even be counterproductive, because they would encourage interpersonal contact, thus undermining the effort to limit transmission of the virus. What good would it do to give Italians money for shopping trips, when the government closes the shops and forces everyone to stay at home?

The same arguments apply to liquidity support. The world is already awash in liquidity, with nominal interest rates close to or below zero nearly everywhere. More interest-rate cuts into deep-red territory might help stock markets, but they also could trigger a run on cash.

The brutal decline in economic activities that epidemiologists say is required make crashing stock markets inevitable, given that central banks policy of excessively cheap money and pooled liabilities caused an unsustainable bubble. Because they used up their ammunition at inopportune moments, central banks bear responsibility for the bubble that has now burst.

What is really needed are fiscal measures to save companies and banks from bankruptcy, so that they can recover quickly once the pandemic is over. Policymakers should be considering various forms of tax relief and public guarantees to help firms borrow if necessary. But the most promising option is a short-time work allowance. This approach, which has been tried and tested in Germany, compensates for the underemployment of the workforce through the same channels that are already used for unemployment insurance. Better yet, it costs hardly anything, because it prevents the losses that would follow from increased real unemployment. All countries should be replicating this part of Germanys policy to prevent job losses.

But, most important, all governments need to follow China in taking direct action against Covid-19. Nobody on the frontlines should be constrained by a lack of funds. Hospital intensive-care units must be expanded; temporary hospitals must be built; and respirators, protective gear and masks must be mass-produced and made available to all who need them. Beyond that, public health authorities must be given the resources and funds they need to disinfect factories and other public spaces. Hygiene is the order of the day. Large-scale testing of the population is particularly important. The identification of each case can save multiple lives. Surrendering to the pandemic simply is not an option.

Hans-Werner Sinn is professor of economics at Munich University. He was president of the Ifo Institute for Economic Research and serves on the German economy ministrys dvisory ouncil.

Project Syndicate

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How best to fight the economic impact of the coronavirus pandemic - The Guardian

Nearly everyone in the US will be affected in some way by the COVID-19 pandemic, the illness caused by the novel coronavirus by stress and anxiety, event closures, or the illness itself. Theres cause for concern: the disease can be deadly, and the outbreak in the US is likely to continue to get worse.

Theres still a lot that scientists and doctors dont know about the new coronavirus and the illness it causes. With three months of data, though, it appears that around 80 percent of people who are infected have a mild or moderate illness, around 15 percent have severe disease (which requires hospitalization), and around 5 percent are critical (and go into respiratory or organ failure). Around 3 percent of people with confirmed cases of the infection in China died, according to the World Health Organization (WHO).

Different groups of people, though, are more likely to fall into the severe or critical categories than others:

The elderly: People who are over the age of 60 are at a higher risk of developing a severe case of COVID-19, according to data collected by the WHO. The highest death rate is in people above the age of 80. Around 15 percent of people in that age group died from the disease in one set of Chinese patients. The Centers for Disease Control and Prevention (CDC) recommends that people who are older stay away from crowds and avoid nonessential travel.

Children: Children, on the other hand, dont appear to get as sick. Very few develop the disease in the first place, and if they do, only a small group develop severe or critical disease. No young children have died from the virus in China.

Researchers are still trying to figure out why thats the case. It may be that childrens lungs are less susceptible to infection or that their immune systems are stronger. Children might carry the virus around, though, and pass it between each other and then to their parents and caregivers. Thats why kids should still wash their hands as much as adults. Its also one of the reasons why areas where the virus is spreading are closing down schools.

People with chronic conditions: People who have underlying health conditions like high blood pressure, kidney disease, cancer, or diabetes are also more likely to get very sick or die from COVID-19. Around 9 percent of people with diabetes who contracted the virus died, for example, as did around 8 percent of people with high blood pressure. The CDC also recommends that people in this group avoid crowds, stick close to home, and stock up on medication for their condition if theyre able to.

Everyone else: Most people who are young or healthy and who contract the virus dont get severely ill. But if you have the virus, even if you dont get that sick, you might come into contact with people who are more at risk and pass the virus to them. Thats why its so important to stay home if youre not feeling well. Minimizing the number of people each sick person infects is low-tech, but its the best way to slow the spread of a disease like COVID-19. Its the goal of policies like school closures and event cancellations and why people who might have been exposed to the illness are asked to isolate themselves.

Not everyone can work from home, stop taking public transportation, or skip large gatherings, though. If you can do those things even though they may seem silly and even if there have not been many cases identified in your area you can help blunt the impact of the pandemic.

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Heres whos most at risk from the novel coronavirus - The Verge

[Want to get New York Today by email? Heres the sign-up.]

Its Monday. Because of the coronavirus outbreak, officials are urging a reduction in gatherings. As such, we are temporarily suspending our event listings.

Weather: Bright in the morning, then building clouds; high in the mid-40s.

Alternate-side parking: In effect until April 9 (Holy Thursday).

New York Citys public schools will begin shutting down this week, Governor Cuomo announced yesterday afternoon, in an effort to slow the spread of the coronavirus. Hours later, Mayor de Blasio announced that he would soon order all bars and restaurants to close, limiting them to takeout and delivery.

Mr. de Blasio said that the schools would be closed today for all students and staff, but that teachers would be asked to report to work later in the week for training on remote learning. By March 23, the city will move to remote learning, and the school system will be closed except for several dozen buildings that will be used as learning centers to support the children of essential city workers like health care employees.

Schools will be closed until at least April 20, but could stay closed for longer, Mr. de Blasio said.

City school buildings will remain open this week for children to pick up food, and then the city will find alternative sites for students who need food to receive it. Students who do not have computers at home will be lent laptops, and the city will work on helping students who do not have internet access get online.

[Read more on the decision to close the citys schools, and find the latest coverage on nytimes.com.]

Around 10 p.m., Mr. de Blasio issued a statement saying that he was closing restaurants and bars, effective Tuesday at 9 a.m. He said his executive order would limit restaurants, bars and cafes to takeout and delivery. Nightclubs, movie theaters, small theater houses and concert venues must all close.

This is not a decision I make lightly, he said. These places are part of the heart and soul of our city. They are part of what it means to be a New Yorker. But our city is facing an unprecedented threat, and we must respond with a wartime mentality.

[Everything is a black hole: Mounting dread in the age of coronavirus.]

Mr. Cuomo called yesterday for private businesses to voluntarily close and have their employees work from home. And Mr. de Blasio ordered hospitals in the city to cancel all elective surgery, postponed an election for the Queens borough president and closed city senior centers.

The states presidential primary election could be moved from April 28 to June 23, the date of another scheduled statewide vote, officials said yesterday.

State courts will postpone many criminal cases indefinitely and stop performing all but the most essential functions to help stop the spread of the coronavirus, officials said.

In addition, all eviction proceedings and pending eviction orders have been suspended statewide until further notice.

New York State had 732 confirmed coronavirus cases officials said. The largest concentration of cases was in New York City, where 329 people had tested positive. Of the six deaths in the state from the virus, five were in the city.

College in the Coronavirus Era: Wistful Goodbyes and a Sense of Loss

Stirring Sermons About Coronavirus, in Empty Cathedrals

Two Boys Jumped Into the Hudson River. They Havent Been Seen Since.

At the Library, Last Call for Beauty and Books

Want more news? Check out our full coverage.

The Mini Crossword: Here is todays puzzle.

Orders to marijuana delivery services have reportedly seen a sharp increase since the coronavirus outbreak. [Complex]

Amazon is buying the former Lord & Taylor flagship building in Midtown for $1.15 billion. [The Street]

A Brooklyn man was reunited with two police officers who saved his life as an infant nearly 30 years ago. [New York Post]

The Timess Rebecca Halleck writes:

In the 17th century, Brooklyn was Breuckelen. Harlem was Haarlem. And Wall Street was an actual wall to keep the English from marching south on the Dutch colony of New Netherland.

Before the Treaty of Westminster in 1674, Britain and the Netherlands had spent two decades locked in a global game of capture the colony. As part of the pacts terms, the Dutch surrendered Manhattan to the English and in exchange legitimized their control of several islands and other territories around the world, including the sugar-rich Suriname.

Several readers recently asked The Times what inspired the Dutch to trade Manhattan for Suriname and if there were remnants of Dutch history remaining in New York City today. Their questions are part of a project from The Times that invites readers to join in our reporting process.

Though it may seem like there was a simple swap of land, that would be an oversimplification, according to Charles Gehring, the director of the New Netherland Research Center in Albany.

The English had controlled Manhattan for nine years, and mostly left alone a Dutch settlement on the southern tip of the island, before the summer of 1673. Then, 600 Dutch marines sailed into New York Harbor, emboldening Dutch settlers to take up arms against English troops.

The Dutch emerged victorious, renaming the whole island New Netherland. They signed it away 14 months later.

The Dutch probably saw the writing on the wall, Mr. Gehring said. They were basically surrounded by the English colonies in the North and the tobacco farms in the South.

But there were also economic factors at play: The supply of beaver fur that initially brought the Dutch to the Hudson Valley was dwindling, while the demand for sugar, a crop grown in tropical climates like Surinames, had skyrocketed.

Centuries later, here are four places you can see traces of New Netherland:

The Lovelace Tavern on Pearl Street: It was accidentally discovered by excavators searching for Stadt Huys, New Netherlands City Hall, which was built in 1641.

The Schenck Houses at the Brooklyn Museum: The older of the pair was built by Jan Martense Schenck around 1675, and it survived in its original location for 275 years before being disassembled and reconstructed inside the museum in 1952.

Wyckoff House in Brooklyn: The one-room house was constructed in 1652 and is thought to be the oldest building in the city. It has a packed-dirt floor and was the home of Pieter and Grietje Claesen and their 11 children.

The Dyckman farmhouse: The house was built in 1784, after the original farmstead was destroyed during the Revolutionary War. The site was once the centerpiece of a farm covering 250 acres of Upper Manhattan.

Its Monday know your history.

Dear Diary:

I was on my way to meet some friends for lunch. I was wearing my green dress with white polka dots. A young woman stopped me as I left the subway station.

That is a great dress, she said.

I was out to dinner one night at a local restaurant. I was wearing the polka dot dress again. When the waitress brought the check, there was a note at the bottom.

Best dress of the day, it said.

Another time, two men complimented me on my polka dots as I was leaving church one Sunday.

I bought a new red dress with white polka dots. I was wearing it one night while waiting for the light to change on West End Avenue. A car that was turning slowed down, and the window rolled down.

Love the dress, the woman who was driving shouted as she passed by.

That was when I realized that polka dots rule.

Catherine Henihan

New York Today is published weekdays around 6 a.m. Sign up here to get it by email. You can also find it at nytoday.com.

Were experimenting with the format of New York Today. What would you like to see more (or less) of? Post a comment or email us: nytoday@nytimes.com.

See more here:

Closing Down the Schools Over Coronavirus - The New York Times

Since inflation is a composite indicator of many prices, the few items that are going up because of supply bottlenecks and rising demand (including medical supplies and food, because of stockpiling) are not sufficiently significant to push up the overall inflation numbers, which will remain subdued. We could be heading for deflation, but if the government gives working people a tax cut and provides transfers to those losing their gig and other incomes, as it should do, that would sustain demand.

Justin Le, Mountain View, Calif.: How will this affect Generations Y and Z? Millennials are scarred by years of economic downturn, job insecurity and financial instability. Were just now recovering from losing money and opportunity as a result of the Great Recession. My fear is that this coming recession will cause permanent damage to our finances and spending power. And that Generation Z will suffer, as younger millennials did, with high student-loan balances while they enter a hostile and competitive job market.

I.G.: You are right to be concerned about this. The elderly are becoming a larger share of the population and the vote. The median age in the country is rising about two years every decade, because of increasing life expectancy and falling fertility. Given the rising costs of retirement and health care, this causes growing strains on family, state and other budgets. There will be less money to transfer to children, and as life expectancy increases, children will be older and older before they inherit anything from their parents, if indeed they are lucky enough to have parents who have sufficient wealth and savings. Economic crises exacerbate these tendencies, as do pandemics.

Lincoln Shlensky, Victoria, British Columbia: Is this epidemic a product of our times in some unique way, or is it just that the botched response to it is characteristic of the new political landscape you mention in your piece?

I.G.: The pandemic is a product of our times in the speed and intensity of its rapid spread. The super spreaders of the good aspects of globalization, such as major airports, which facilitate business and leisure travel, are also the super spreaders of the bads, like disease. The rapid growth of cities and rising incomes in many places is also relatively recent, so more people live in concentrated centers close to major hubs.

There have been pandemics before, and the Spanish flu of 1918 is estimated to have infected around a third of the worlds population and led to the death of more than 50 million people. This time is different in terms of how quickly and how far the pandemic can spread quickly. This is a feature of the growing complexity and interdependence of the world, but it also reflects the failure of politics to understand how the systems have developed and how to respond. The failure of politicians to understand and act on this, even after the financial crisis of 2008 and the growing evidence of climate change and other risks, is what worries me most, as I discuss in my books The Butterfly Defect, which looks at systemic risk, and Age of Discovery, which compares current challenges with previous ones.

Thomas Marini, Aptos, Calif.: I was mesmerized by a Times animated graphic of airline flights over a map of China. As the effects of the virus on air travel kicked in, the red swarm of flights dwindled into a scattering of individual red airplanes. It occurred to me that the coronavirus pandemic could inadvertently have a large impact on carbon emissions. Does the coronavirus, with its collateral damage to the world economy and corresponding reduction in worldwide carbon emissions, give us a model for the kind of tremendous dislocation and change that will be necessary to save us from climate catastrophe?

Original post:

The U.S. Economy Cant Withstand the Coronavirus by Itself - The New York Times

Coronavirus testing data has been spotty and not easily available, especially in the United States. Based on official government sources, heres how testing efforts in the United States compare with those in Italy and South Korea.

Delays in testing in the United States have set back the nations response to the pandemic, even though its first case was discovered around the same time that South Koreas was. But part of the problem in the United States has also been gaps created by the way the state and federal agencies report the data.

An internet community effort, called the COVID Tracking Project, is attempting to provide a fuller picture of testing in the United States. According to the tracker which collects information directly from state health departments, local news reports and live news conferences at least 41,000 people have been tested in the United States, much higher than official C.D.C. figures.

It has been difficult to track reliable testing data in the United States for a number of reasons. Data from the Centers for Disease Control, which lags several days, reports the number of specimens tested, not the number of people multiple specimens can be tested from each person. And some states report only positive results, not negative ones, making it hard to know the total number tested.

The COVID Tracking Projects data, however, lays bare just how behind the United States has been in responding to the pandemic, which by Monday night had sickened more than 178,000 people worldwide, according to official accounts.

Recent data shows that about 125 people per million have been tested in the United States far fewer than most other countries where data is available.

Through intensive testing and monitoring, South Korea has managed to slow the growth of new cases. Health officials there tracked down people with symptoms and even set up drive-through testing, allowing at least 10,000 people to be tested per day. Government websites and mobile apps disclosed how many people had been tested and where.

Italy has also tested aggressively for the virus, which could help explain why its total confirmed cases are higher than every other country in Europe. Health officials in Lombardy Italys hardest-hit region initially carried out swab tests on those who were sick as well as those who came into contact with infected people, even if they had no symptoms.

Until now, testing in the United States has been done manually, with individual labs performing only 40 to 60 tests a day. Testing has ramped up in recent days on Monday, the COVID Tracking Projects count of reported tests rose by 13,000, suggesting a surge in the nations testing.

Also on Monday, federal officials said they were moving ahead with plans to set up more drive-through testing centers around the country and to speed the processing of tests by commercial labs. By the end of the week, officials said that 1.9 million tests should be available.

Read more from the original source:

U.S. Lags in Coronavirus Testing After Slow Response to Outbreak - The New York Times

A couple wear face masks as they visit Buckingham Palace in London on Saturday. After criticism for responding slowly, the United Kingdom has urged the public to avoid unnecessary contact. Frank Augstein/AP hide caption

A couple wear face masks as they visit Buckingham Palace in London on Saturday. After criticism for responding slowly, the United Kingdom has urged the public to avoid unnecessary contact.

Updated at 3:22 p.m. ET

The United Kingdom's government is urging the public to work from home and avoid pubs, restaurants and theaters to slow the spread of the coronavirus as the death toll hit 67, with 1,950 confirmed cases. But, unlike some other European countries, including Ireland, the U.K. will keep schools open for now.

In a news conference Monday, Prime Minister Boris Johnson told people to avoid unnecessary social contact and travel and to not visit nursing homes. He also suggested that by the weekend, he will call for those older 70 and those with the most serious health conditions to stay at home for 12 weeks.

"It now looks as though we are approaching the fast growth part of the upward curve, and without drastic action, cases could double every five or six days," Johnson said.

It now looks as though we are approaching the fast growth part of the upward curve, and without drastic action, cases could double every five or six days.

Boris Johnson, U.K. prime minister

Johnson said he was not shutting schools, in part because it would require parents, including National Health Service staff, to stay home. On Tuesday, the Foreign Office advised against nonessential international travel.

The government's strategy is to try to avoid a spike in cases that could easily inundate the NHS.

The coronavirus pandemic comes at a vulnerable time for the country's NHS. A decade of crippling funding cuts has left tens of thousands of vacancies and has led to record emergency room wait times. Doctors worry about whether the system can hold up.

"I see, when I do shifts on the front line, the real impacts of this shortfall in resources," says Rosena Allin-Khan, an emergency room doctor in south London as well as a member of Parliament in the main opposition Labour Party. "We don't have enough nurses; we have people waiting far too long for operations."

Allin-Khan says she thinks the country's health care system could be heading for a reckoning.

"I believe this outbreak is really going to expose the gaping chasms, not even just cracks, but the gaping chasms in the NHS," she says.

Patients are also concerned about the system's capacity. Monika Lakomy-Diep, an accountant in London, struggled last week to get a doctor to treat her daughter's allergies.

"The NHS is already stretched," she says, standing outside St. Thomas' Hospital across the River Thames from Big Ben. "Getting a simple GP appointment is a miracle."

The NHS is an institution in this country. The government created it in 1948, following the end of World War II, as part of a series of reforms to give people cradle-to-grave support. Funded by taxpayers, it provides everything from annual physicals to cancer surgery at no cost to users.

For most of its existence, the health system received annual funding increases of about 4% above the inflation rate. But after the global financial crisis, the U.K. government reduced those increases to about 1.5% annually over the past decade, says Siva Anandaciva, a chief analyst at the King's Fund, a health care think tank.

The U.K.'s Conservative prime minister said last week that he hopes to push the peak of COVID-19 cases into the late spring to avoid swamping the system.

"If we delay the peak even by a few weeks, then our NHS will be in a stronger state as the weather improves and fewer people suffer from normal respiratory diseases," Johnson said. "More beds are available, and we'll have more time for medical research."

Ron Daniels, an NHS critical care doctor, says that if the government's strategy works, the NHS will be able to cope. But if it doesn't, Daniels says, the U.K. could come to resemble parts of Italy, where more than 2,100 people have died.

"If we're unable to change public behavior and we see a rapid spread," Daniels says, "then the NHS is very quickly going to find itself overwhelmed, as has happened in Lombardy," a northwestern Italian region that has been devastated by COVID-19.

In Britain's House of Commons last week, Ed Davey, an acting leader of another opposition party, the Liberal Democrats, confronted Johnson over the lack of health care funding.

"Does the prime minister not agree that the three Conservative governments since 2015 should have fixed the roof when the sun was shining?" said Davey.

Johnson responded that his administration has been addressing the problem: "There are 8,700 more nurses this year than last year, and we are recruiting another 50,000 more," Johnson answered.

Last week, the U.K.'s new Treasury chief, Rishi Sunak, vowed in his budget speech to provide the NHS with whatever resources it needs to fight the coronavirus, including a portion of a $6 billion COVID-19 emergency fund.

It's tough for many Britons to watch the NHS struggle because they love it so much. Anandaciva, of The King's Fund, says the service regularly tops public opinion polls on what makes people proud to be British.

"Something that is comprehensive, universal and free at the point of use, as a social construct," Anandaciva says, "I think speaks to something in the British identity about a sense of fairness, our sense of everyone being in it together."

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U.K. Steps Up Coronavirus Prevention, But Its Hospitals Have Already Been Strained - NPR