Category: Covid-19

For the first time since the middle of March, Hawaii health authorities had no new COVID-19 infections to report.

The number of new infections has been declining in recent weeks, prompting more discussion about how to reopen the economy yet prepare for a possible comeback of the virus.

But state officials caution that the lack of new cases Friday is likely a lull.

As businesses reopen, as people become more active and travel more freely, we will inevitably see an increase in cases, said Dr. Sarah Park, the state epidemiologist.

The number of new COVID-19 cases daily is dwindling, but health officials believe that is temporary.

Cory Lum/Civil Beat

The cumulative case count on Hawaii island stands at 74, Oahus at 408, Kauais at 21, and Mauis at 116. Ten other residents have been diagnosed outside of Hawaii.

Peak infection rates were documented in late March and early April, and the last time DOH had no new cases to report was March 13.

However, state-verified cases come at a lag, since the virus has an incubation period that can last as many as 14 days, and officials begin case investigations once a test confirms diagnosis.

The number of cases statewide remains at 629.

The Department of Health also updated some of its data reporting this week.

In March, a spokesperson with the Hawaii COVID-19 Joint Information Center told Civil Beat the category of released from isolation was an indication of recovery. But on Thursday, the center indicated in a footnote that the number also included the 17 people who have died due to coronavirus related issues.

Anyone who tests positive for COVID-19 must isolate themselves.

To date, 566 people have been released from isolation according to DOH. One more person was added to that category on Friday, presumed to be another person in recovery because the death toll was unchanged.

As of Friday, to be released from isolation, a patient needs to be free of fever for three days or at least 10 days have passed since symptoms first occurred, whichever is longer. That period was recently extended by the federal Centers for Disease Control and Prevention from seven to 10 days after symptom onset.

The department also purged 1,010 duplicate tests in its testing count on Thursday.

There appears to have been a glitch in the ELR reporting, in that the system was over counting some tests over the past week. Staff have fixed the issue and adjusted the data, a press release stated.

Approximately 34,206 people have been tested for the COVID-19 disease as of Thursday.

The Harvard Global Health Institute has calculated the minimum number of tests that should be conducted in each state. Hawaii is among nine states that have exceeded those testing minimum estimates.

Some retailers on the Big Island and Kauai reopened Thursday. Maui has scheduled a partial reopening of businesses on Monday, and Oahus next phase of reopening is slated for May 15.

Restaurant operations continue to be limited to take-out and the tourism industry has tumbled.

Since the pandemic hit its shores, Hawaiis unemployment rate rose from 3% to 35%, making it the highest rate in the country.

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No New COVID-19 Cases Confirmed For The First Time In Nearly 2 Months - Honolulu Civil Beat

Construction at the COVID-19 field hospital at McCormick Place in Chicago on April 10. The city pared back plans for a 3,000-bed temporary hospital at the nation's largest convention center as infection numbers decreased. Nam Y. Huh/AP hide caption

Construction at the COVID-19 field hospital at McCormick Place in Chicago on April 10. The city pared back plans for a 3,000-bed temporary hospital at the nation's largest convention center as infection numbers decreased.

As hospitals were overrun by coronavirus patients in other parts of the world, the Army Corps of Engineers mobilized in the U.S., hiring private contractors to build emergency field hospitals around the country.

The endeavor cost more than $660 million, according to an NPR analysis of federal spending records.

But nearly four months into the pandemic, most of these facilities haven't treated a single patient.

Don't see the graphic above? Click here.

Public health experts said this episode exposes how ill-prepared the U.S. is for a pandemic. They praised the Army Corps for quickly providing thousands of extra beds, but experts said there wasn't enough planning to make sure these field hospitals could be put to use once they were finished.

"It's so painful because what it's showing is that the plans we have in place, they don't work," said Robyn Gershon, a professor at New York University's School of Global Public Health. "We have to go back to the drawing board and redo it."

But the nation's governors who requested the Army Corps projects and, in some cases, contributed state funding said they're relieved these facilities didn't get more use. They said early models predicted a catastrophic shortage of hospital beds, and no one knew for sure when or if stay-at-home orders would reduce the spread of the coronavirus.

"All those field hospitals and available beds sit empty today," Florida Gov. Ron DeSantis, a Republican, said last month. "And that's a very, very good thing."

Michigan Gov. Gretchen Whitmer, a Democrat, said: "These 1,000-bed alternate care sites are not necessary; they're not filled. Thank God."

Senior military leaders also said the effort was a success even if the beds sit empty. Gen. John Hyten, vice chairman of the Joint Chiefs of Staff, was asked at a news conference if it bothered him to see the field hospitals go unused.

"For gosh sakes, no," Hyten said. "If you see beds full, that means the local capacity of the local hospitals to handle this [has] been overwhelmed. And now we're into an emergency situation."

The Army Corps started building more than 30 field hospitals, retrofitting convention centers and erecting climate-controlled tents, in mid-March. Agency officials pushed to get these facilities done fast limiting the bidding process and often negotiating directly with contractors they knew could deliver on time.

"I tell our guys, you have three weeks," Lt. Gen. Todd Semonite, commander of the Army Corps of Engineers, said at a Pentagon news briefing in March. "You get as much as you can [get] done in three weeks. And then the mission is complete. We have a narrow window of opportunity. If we don't leverage that window of opportunity, we're gonna miss it."

At Chicago's McCormick Place, workers scrambled in April to transform the convention center into a massive temporary hospital with 3,000 beds more than the biggest hospital in Illinois.

"This was an empty convention hall," Illinois Gov. J.B. Pritzker said during a news conference while flanked by construction workers in hard hats and bright yellow vests. "Monumental, round-the-clock dedication is what got this done before we need it, preparing for saving lives in the event that things become as bad as some have predicted."

But just as construction got underway, states were issuing stay-at-home orders. And the spread of the coronavirus eventually began to slow.

Work on the field hospitals continued, though some projects were scaled back including McCormick Place. The field hospital opened with one-third of the beds originally planned, and it closed its doors a few weeks later after treating fewer than 40 patients.

The same story is playing out across the country. In fact, most Army Corps field hospitals haven't seen a single patient.

In many parts of the U.S., hospitals were able to expand their capacity to keep up with the surge of coronavirus patients. But in New York, hospitals were overwhelmed, and local officials pleaded with the public to save hospital beds for people who needed them most.

"The mantra was, 'Don't come to the hospital, don't go to the doctor, stay home, stay home till your lips turn blue,' " said Gershon of NYU's School of Global Public Health. "Well, we now know that was a crazy set of advice."

Gershon said she worries that a lot of people followed that advice and that some may have died because of it including a cousin of hers on Long Island. He stayed at home as he got sicker, Gershon said, and later died on a ventilator in the hospital.

Contractors built two field hospitals on Long Island, on the campuses of the State University of New York at Stony Brook and SUNY Old Westbury, at a total cost of more than $270 million.

The Army Corps limited the competition in awarding the projects to speed the process, which usually takes six to nine months, according to agency documents. Officials noted they were able to complete the contract award for the Stony Brook project in a "little more than three days."

"This time savings was critical in order for construction to begin as quickly as possible, supporting the unusual and compelling nature of the urgency of this procurement and the national emergency," the document said.

The two Long Island field hospitals were completed in late April. They never opened to the public and didn't treat any patients.

"That's outrageous," Gershon said. "That's completely crazy. I hope they didn't take them down."

The temporary hospitals in New York haven't been taken down. They're on hold in case they need to be reopened in the future, according to a state health department spokesman.

New York has "so far avoided the worst-case scenario we were preparing for," the spokesman said in a statement. "There has been a reduced need for hospital beds, and as of now we are not moving forward on purchasing supplies and equipment or securing staff for these sites."

Even in New York City, where the Army Corps field hospital did treat COVID-19 patients, it never reached full capacity.

"There are a lot of losers in it and not a lot of winners," said Dario Gonzalez, an emergency doctor with the New York City Fire Department who helped lead the medical response at the temporary hospital at the Javits Center in Manhattan.

"It was very disappointing," Gonzalez said. "Everybody was here, ready to work, ready to get patients in."

Medical supplies are viewed inside the Javits Center in March in New York City. The Javits field hospital treated about 1,100 patients while it was open for three weeks. Bryan R. Smith/AFP via Getty Images hide caption

Medical supplies are viewed inside the Javits Center in March in New York City. The Javits field hospital treated about 1,100 patients while it was open for three weeks.

The plan was for the Javits Center to take patients from overwhelmed hospitals in the city. But in practice it wasn't that easy. Some hospitals complained that the intake process was too complicated. And they sent few patients to Javits even as they resorted to treating patients in the hallways.

During the three weeks it was open, the Javits field hospital treated about 1,100 patients. Gonzales said it could have handled a lot more.

"We all could have done a much better job," Gonzalez says. "And we've got to really get it together to get that right the next time."

Officials in other states such as Illinois and Michigan also said field hospitals can be quickly reopened if there's an increase in coronavirus cases.

"We really wanted to make sure that we were maintaining some of the physical infrastructure that has been built there. So that should we need it, it doesn't take us a long time to potentially turn that back on," said Allison Arwady, the public health commissioner in Chicago.

She said officials there are keeping a close eye on the number of COVID-19 patients in local hospitals.

"We watch it really closely every day," Arwady said. "And certainly if we start to see any direction that things are not going the right way, we stand ready in case that needs to be reassessed."

National Desk Senior Producer Walter Watson and intern Brooklyn Riepma contributed to this report.

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U.S. Field Hospitals Stand Down, Most Without Treating Any COVID-19 Patients - NPR

"I'm not new to this game, I'm true to the game," the blues singer told CNN. "I've been doing it for a long time. You really have a lot of ups and downs in this crazy situation."

Cohen is part of a community of musicians trying to keep the blues alive in a landscape where live music is on hold and the artists dedicated to the genre are particularly vulnerable to Covid-19.

"It shut a lot of us down," Cohen said. "The ones that were doing the clubs, they don't have the clubs [to perform in] anymore. They don't have the regular gigs anymore. They don't have anything."

Musician and singer Sam Frazier, Jr. recently rose to the top of the kidney transplant list, but he is now unsure when he might receive one because of the pandemic.

He told CNN he's working hard to protect himself and stay healthy, but misses performing -- even locally in Alabama where he lives.

"I'm an entertainer," he said. "I'm a singer. I play the harmonica, guitar and I can play the [bass] drum using my feet. I sing blues and I sing country. That's what I do."

Already in a crisis situation

The group helps book members for performances and also provides financial assistance to artists.

Timothy Duffy, founder and executive director of the foundation, told CNN that many of the artists they assist are most susceptible to falling critically ill were they to contract Covid-19.

"Almost all our partners are elderly, so that makes them extremely vulnerable to the virus," Duffy said. "The majority, over 80% of the artists we work with, are African Americans over the age of 55."

Duffy said most of them were already making do with annual incomes of less than $18,000 a year. Any work they used to get from playing bars and restaurants is now gone.

"They're already in a crisis situation," said Duffy, whose organization gave out 85 grants to struggling artists in April and helped set up grocery and medicine deliveries for some. "They're already marginalized, so our staff has a dedicated social worker that is working to ensure that our artists are safe and informed."

Still singing

Cohen said she appreciates the help as she waits things out in the new normal and finds strength in what she's already overcome.

"I lost everything in Katrina," said Cohen, who added she relies on the power of positive thinking and consuming inspirational content. "I haven't lost everything because of this pandemic."

She definitely hasn't lost her ability to entertain.

Lately she takes her audio equipment to a nursing home where her brother resides. With current health precautions preventing her from entering, Cohen performs for residents from the parking lot.

"I wanted to make sure that my brother got some entertainment," she said. "They said the only way that we could see them is to go to their windows outside and you know, wave to them and talk to them through the windows with the windows closed. But they can still hear you."

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Covid-19 taking toll on blues community - CNN

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There are big changes coming to the future of work.

Heres what you need to know - and how it will affect you.

With 62% of employed Americans working from home due to the COVID-19 pandemic, what is the future of work? For the past few months, youve worked at home, done countless Zoom calls, juggled home schooling, and have tried to maintain composure in the face of uncertainty. How will your job change in the future? Some changes may be temporary until there is a Coronavirus vaccine, while other changes may become permanent. Here are some ways that your job may change due to COVID-19:

This wont apply to every job, but it turns out many people can actually work from home productively. Plus, the majority of employed Americans who have been working from home would prefer to continue a work-from-home policy. According to Gallup, approximately 60% of Americans workers prefer to work remotely as much as possible, even when public health restrictions are lifted. If more employees work from home, there is increasing potential to disrupt the commercial real estate market. As more employees work from home, there is less overall need to own or rent office space. Watch for the impact on supply and demand in commercial real estate.

If more employees work from home, employers may increase monitoring of their employees. That means your productivity could be measured and tracked, even if youre working outside a traditional office environment. Many companies already do this, but now it would take place in your home. For example, your employer could track your keystrokes on your computer to analyze your productivity, or understand how often you are away from your computer. While there are evident privacy concerns, this is not a spy novel. Companies argue that responsible monitoring is necessary to ensure productivity.

The entire world wont work from home. Offices will still exist. However, they may look different. Big trading floors or other open floor plans may be replaced in some cases by cubicles or other partitions for health reasons. How will social distancing be maintained at work? These may be temporary changes until theres a Coronavirus vaccine, or employers may find that this new normal layout may continue so long as it doesnt hinder productivity, jeopardize health or adversely affect employee morale.

What will happen to all those standing-room-only, in-person meetings in conference rooms? Video conference calls have become more popular than ever during the COVID-19 pandemic. This could continue even after a Coronavirus vaccine. If you work in any sales-oriented job, in-person contact may be essential to your business. However, from a public health perspective, frequent business travel may be replaced by more video conference calls. It may not happen in every industry, but companies will want to protect employees and clients alike in a post-COVID world. This doesnt mean business travel is going away (its not), but companies may limit travel. This has direct implications for the airline and hospitality industries, at least in the short-term.

5. Happiness at work matters

Your happiness at work matters. There are many lessons from the COVID-19 pandemic. As more than 30 million people have lost their job due to COVID-19, many people will start to think critically about their job, where they work, their health and other financial realities in the wake of Coronavirus. As more people work from home, your work life and personal life will become more connected. This has important implications for your happiness. No longer can you think of your work life and personal life as separate. Your happiness at home and at work both need to be present. If youre happy at home and miserable at work, that formula wont work. One silver lining is this may be your wake-up call to go find more meaningful work in which you feel more inspired and can create impact.

Business will go on. Life will continue. It just may look different than before. Will all these changes happen at once? Maybe. It depends on your employer, industry, job type and other financial and non-financial factors. Will these changes become permanent? Its too soon to tell. Employers may test the waters, monitor the public health situation and collect employee feedback. One thing is certain in this uncertain time: changes to the future of work are coming.

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How COVID-19 Will Change The Future Of Work - Forbes

Good morning, good afternoon and good evening.

Exactly 40 years ago today, on the 8th of May 1980, the World Health Assembly officially declared that the world and all its peoples have won freedom from smallpox.

Smallpox is the first and, to date, the only human disease to be eradicated globally.

Until it was wiped out, smallpox had plagued humanity for at least 3000 years, killing 300 million people in the 20th century alone.

Its eradication stands as the greatest public health triumph in history.

As the world confronts the COVID-19 pandemic, humanitys victory over smallpox is a reminder of what is possible when nations come together to fight a common health threat.

Many of the basic public health tools that were used successfully then are the same tools that have been used to respond to Ebola, and to COVID-19: disease surveillance, case finding, contact tracing, and mass communication campaigns to inform affected populations.

The smallpox eradication campaign had one crucial tool that we dont have for COVID-19 yet: a vaccine; in fact, the worlds first vaccine.

As you know, WHO is now working with many partners to accelerate the development of a vaccine for COVID-19, which will be an essential tool for controlling transmission of the virus.

But although a vaccine was crucial for ending smallpox, it was not enough on its own.

After all, the vaccine was first developed by Edward Jenner in 1796. It took another 184 years for smallpox to be eradicated.

The decisive factor in the victory over smallpox was global solidarity.

At the height of the Cold War, the Soviet Union and the United States of America joined forces to conquer a common enemy.

They recognized that viruses do not respect nations or ideologies.

That same solidarity, built on national unity, is needed now more than ever to defeat COVID-19.

Stories like the eradication of smallpox have incredible power to inspire.

But there are many more untold stories about health around the world.

Next Tuesday, the 12th of May, WHO will announce the five winners of our inaugural Health for All Film Festival.

The winning films were chosen by a distinguished panel of jurors from almost 1300 entries from 110 countries.

The short-listed films can be seen on WHOs YouTube channel, and we invite everyone to join us on our social media channels next Tuesday, for the announcement of the winners.

===

Yesterday, I announced the resources WHO estimates it needs to deliver our updated Strategic Preparedness and Response Plan for COVID-19.

The updated plan estimates that WHO requires US$1.7 billion to respond to COVID-19, across the three levels of the organization, between now and the end of 2020.

This estimate includes the funds that WHO has already received to date, leaving WHOs COVID-19 response with a funding gap of US$1.3 billion for 2020.

To be clear, this estimate only covers WHOs needs, not the entire global need.

WHO is deeply grateful to the countries and donors who responded to WHOs initial Strategic Preparedness and Response Plan, and to the hundreds of thousands of individuals, corporations and foundations who have contributed to the COVID-19 Solidarity Response Fund we thank you so much for your commitment and support.

Our updated strategic plan takes into account the lessons we have learned so far, strengthening WHOs role in global and regional coordination.

It is built on five strategic objectives:

First, to mobilize all sectors and communities;

Second, to control sporadic cases and clusters by rapidly finding and isolating all cases;

Third, to suppress community transmission through infection prevention and control and physical distancing;

Fourth, to reduce mortality through appropriate care;

And fifth, to develop safe and effective vaccines and therapeutics.

To support these objectives, WHO will continue to provide technical, operational and logistics support to countries, and we will continue to update and adapt our guidance according to local needs.

In certain fragile settings and countries with weaker health systems, WHO will continue its operational work as a provider of essential health services.

===

As we reflect today on the eradication of smallpox, were reminded of what is possible when nations come together to confront a common foe, to confront a common enemy.

The legacy of smallpox was not only the eradication of one disease; it was the demonstration that when the world unites, anything is possible. If there is a will, there is a way.

It gave us the confidence to pursue the eradication of other diseases like polio and Guinea worm.

Like smallpox, COVID-19 is a defining challenge for public health.

Like smallpox, its a test of global solidarity.

Like smallpox, COVID-19 is giving us an opportunity not only to fight a single disease, but to change the trajectory of global health, and to build a healthier, safer, fairer world for everyone to achieve universal health coverage, to achieve our dream from the establishment of WHO in the 1940s: Health for All.

Thank you.

Before we move on to questions, Id like to mention one small way we are commemorating the eradication of smallpox.

When WHOs smallpox eradication campaign was launched in 1967, one of the ways countries raised awareness about smallpox was through postage stamps when social media like Twitter and Facebook was not even on the horizon.

To commemorate the 40th Anniversary of smallpox eradication, the United Nations Postal Administration and WHO are releasing a commemorative postage stamp to recognize global solidarity in fighting smallpox.

I especially want to thank my friend Mr Atul Khare, United Nations Under-Secretary-General for Operational Support, for making this commemorative stamp possible.

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WHO Director-General's opening remarks at the media briefing on COVID-19 - 8 May 2020 - World Health Organization

Chinese researchers who tested the sperm of men infected with Covid-19 found a minority had the new coronavirus in their semen. According to the researchers, this opened up a small chance the disease could be sexually transmitted, though this claim has been questioned by other academics in the wake of the findings being published.

Such commentators have noted that while viral genome may be found in body secretions, it must be new and active to be infectious. It is unclear from the Chinese study whether the researches found old traces, or active new virus.

The study by doctors at Chinas Shangqiu municipal hospital of 38 men hospitalised with the disease found that six of them(16%), tested positive for Sars-CoV-2 in their semen.

The researchers said that while the findings were preliminary, and based on only a small number of infected men, more research is needed to see whether sexual transmission might play a role in the Covid-19 pandemic.

Further studies are required with respect to the detailed information about virus shedding, survival time and concentration in semen, the team wrote in a study published in the Journal of the American Medical Association.

If it could be proved that Sars-CoV-2 can be transmitted sexually ... [that] might be a critical part of the prevention, they said, especially considering the fact that Sars-CoV-2 was detected in the semen of recovering patients.

Independent experts said the findings were interesting but should be viewed with caution and in the context of other small studies that have not found the new coronavirus in sperm.

A previous small study of 12 Covid-19 patients in China in February and March found that all of them tested negative for Sars-CoV-2 in semen samples.

Allan Pacey, a professor of andrology at Sheffield University in the UK, said the studies should not be seen as conclusive, as there were some technical difficulties in testing semen for viruses. He said the presence of Sars-CoV-2 in sperm did not show whether it is active and capable of causing infection.

However, we should not be surprised if the virus which causes Covid-19 is found in the semen of some men, since this has been shown with many other viruses such as Ebola and Zika, he said.

Sheena Lewis, a professor of reproductive medicine at Queens University Belfast, stressed that this was a very small study and said its findings were in keeping with other small studies showing low or no Sars-CoV-2 in tests of semen samples.

However, the long-term effects of Sars-CoV-2 on male reproduction are not yet known, she said.

This article was amended on 8 May 2020 to expand on the distinction between finding inert Covid-19 in semen, and finding active new Covid-19. A sub-heading mentioning the chance of sexual transmission was changed to attribute this claim to the authors of the study cited in the article.

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Covid-19 found in semen of infected men, say Chinese doctors - The Guardian

A man wearing a face mask travels on a ferry to cross the Yangtze River in Wuhan in April. Chinese officials are working to silence people suspected of challenging the narrative that authorities in Wuhan and Beijing acted swiftly and efficiently to contain the coronavirus outbreak. Hector Retamal/AFP via Getty Images hide caption

A man wearing a face mask travels on a ferry to cross the Yangtze River in Wuhan in April. Chinese officials are working to silence people suspected of challenging the narrative that authorities in Wuhan and Beijing acted swiftly and efficiently to contain the coronavirus outbreak.

China's leaders have declared the coronavirus outbreak largely under control within its borders. Now, the authorities are working to control the narrative of how the country contained the virus by questioning and even detaining people who might possess information that challenges the official line.

Those being questioned include Internet-savvy archivists; families and their legal counsel suing the state for damages from the coronavirus epidemic; and even lauded volunteers who staffed critical emergency services from the epicenter city of Wuhan.

In February, during the peak of the outbreak in Wuhan, where the virus is believed to have originated, thousands of volunteers delivered supplies to hospitals, drove medical workers around the city and staffed online mental health services.

But now public security agents are questioning these volunteers over suspicions they provided foreign organizations with documentation that has led to accusations that China intentionally covered up the full extent of its coronavirus epidemic, according to two people familiar with the matter. They requested anonymity because those questioned were told by security agents to keep the matter confidential.

Some of the volunteers questioned ran a telephone hotline that became a well-known resource offering both counseling services and help finding open hospital beds as Wuhan's health care system became overwhelmed with COVID-19 patients.

Hotline volunteers kept active counts of hospital beds and emergency cases of the coronavirus across Wuhan information that could be used for estimating fatalities.

"The police say they have been investigating whether different Chinese volunteer groups provided U.S. intelligence agencies with the real death number of COVID-19 in China," said a person familiar with the police questioning who declined to be named for fear of retribution.

Another Shanghai-based volunteer group said a prominent organizer of theirs had also been questioned by public security agents in connection with possibly leaking information to foreign agencies and was asked to provide a list of names of other volunteers. The group, which denies leaking any information, said the organizer refused to identify the volunteers.

Official messaging from China's Communist Party insists the authorities in Wuhan and Beijing acted swiftly and efficiently to implement lockdown measures and contain the outbreak.

This effort to silence those who might provide information contradicting the official Chinese narrative comes as U.S. intelligence officials have been warning the White House that China vastly undercounted its coronavirus death toll, according to various U.S. news reports. The stakes are high: Missouri and Mississippi are suing China over damages from the coronavirus pandemic, and U.S. citizens have filed several related class-action lawsuits alleging China covered up the scope of the initial outbreak in Wuhan.

"A whitewash"

China has strenuously denied the allegations. "The sole purpose for some U.S. politicians trying to fool others with their obvious lies is to shift the blame of their own incompetence," a foreign ministry spokesperson said last month. A day later, China's state broadcaster ran a segment on its widely watched evening news program that featured footage of U.S. Secretary of State Mike Pompeo with "liar" stamped in red letters across his visage, in response to unfounded allegations from Pompeo that the coronavirus was leaked from a Wuhan lab.

Current efforts to conceal unfavorable information contrast with Chinese leaders' transparency pledge following the 2003 SARS epidemic, which health officials initially tried to hide, according to Susan Shirk, an expert on Chinese politics at the University of California, San Diego.

That year, Shirk points out, Chinese leadership changed hands Hu Jintao and Wen Jiabao took over as president and premier and promised to do things differently. "It was the new broom sweeping out the old ways of doing things and made a point of creating a new image emphasizing transparency," Shirk said.

But China's handling of the COVID-19 outbreak seems to revert to old ways. "[Chinese leaders] decided to not go with transparency but to go with a whitewash," Shirk says. "That's very different from SARS."

In several cases over the past month, China has outright detained those suspected of challenging the official version of how the outbreak was quickly brought to heel.

Eyes on GitHub

For the past three months, Beijing tech worker Chen Mei and more than a dozen other tech-savvy volunteers used GitHub, the open-source programming platform, to archive copies of nearly four dozen, often critical, journalistic reports and essays put together by Chinese writers, journalists, freelance bloggers and writers deleted by China's Internet censors.

Among the articles Chen and others archived was a widely read profile of Ai Fen, a Wuhan doctor who first forwarded a medical report in early January nearly three weeks before Chinese leader Xi Jinping warned the public about the epidemic to other doctors describing a mysterious SARS-like pneumonia arising in hospitals. GitHub, which is not blocked in China, is widely used by programmers and companies to collaborate on writing software.

Beijing tech worker Chen Mei and more than a dozen other tech-savvy volunteers used GitHub, the open-source programming platform, to archive copies of nearly four dozen, often critical, journalistic reports and essays put together by Chinese writers, journalists, freelance bloggers and writers deleted by China's Internet censors. Family of Chen Mei hide caption

Beijing tech worker Chen Mei and more than a dozen other tech-savvy volunteers used GitHub, the open-source programming platform, to archive copies of nearly four dozen, often critical, journalistic reports and essays put together by Chinese writers, journalists, freelance bloggers and writers deleted by China's Internet censors.

Then on April 19, Chen was suddenly detained, say three people close to him. Two friends Cai Wei, who helped update the GitHub archive, and Cai's girlfriend Xiaotang were also detained in Beijing on the same day as Chen for "picking quarrels and provoking trouble," according to a police notice seen by NPR. Lawyers for both Cai and Xiaotang say they have been unable to meet or communicate with their clients.

"Chen Mei used his personal ID on GitHub, so I sent him a message saying his ID was public and to be careful," said Lucy Qiu, a friend of Chen's. "That was our last contact."

NPR's calls to Beijing's Changping district police department, near where Chen lives, and calls and texts to the Chaoyang district police department, where the three are reportedly being held, were not answered.

Suing the city

Families demanding justice from the state have also been subject to sustained pressure from China's security apparatus.

"It is all part of social stability management," said a lawyer who has been providing legal aid to Wuhan residents. He requested anonymity because of the sensitivity of the topic. "They made a mistake, and they will not allow people to take them to court."

He is part of a group of about 20 lawyers who helped Wuhan residents seeking to sue the city and provincial government for allegedly mishandling the outbreak. They say that local officials failed to notify the public early enough about the virus' contagiousness and the extent of the outbreak in Wuhan.

In mid-April, several of the lawyers were called in by Chinese justice ministry officials and were told to stop their pro bono work. They were also asked to name the other lawyers in the group and plaintiffs. At least three plaintiffs have since dropped their cases after being coerced by police, according to those who were providing them legal assistance.

But a handful of Wuhan residents say they are pressing ahead with their lawsuits despite the danger in doing so. "What happened in Wuhan was a warning for the entire country. Leaders here created havoc for the entire country," one of the plaintiffs, whose mother died in February from the coronavirus, told NPR by phone. He vowed to continue with his lawsuit, saying it was his responsibility to push for an accurate accounting of human suffering during the lockdown.

Then he hung up abruptly, saying his phone was being monitored.

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China Says It Contained COVID-19. Now It Fights To Control The Story - NPR

Numerous reports of skin rashes in patients with COVID-19 are cropping up around the world.

The rashes can take many forms some appear as tiny red spots, while others appear as larger flat or raised lesions. Some have a hive-like appearance, while others look like frostbitten toes.

However, it's too early to say whether these rashes are indeed caused by the new coronavirus, or whether they are related to other factors. "That's really the million dollar question," said Dr. Kanade Shinkai, a professor of dermatology at the University of California, San Francisco, and editor-in-chief of the journal JAMA Dermatology.

"It's unclear whether the skin lesions we see in COVID are actually a direct manifestation of the virus" in the skin, or whether they are a "reaction pattern" due to a generally ramped-up immune system, Shinkai told Live Science.

Related: What are symptoms of the coronavirus?

It's also possible some rashes are due to complications from the disease, reactions to medications or even due to other viruses in patients with "co-infections," Shinkai and colleagues wrote in an editorial published April 30 in the journal JAMA Dermatology.

Social media posts and online forum discussions have called attention to these rashes, but "it is now time for rigorous science," the authors wrote. Work is needed to address many unanswered questions, such as how common the rashes are, and what they mean with regard to the patients' ultimate outcomes.

It's well known that some viral illnesses, such as chickenpox, measles and hand, foot and mouth disease, can cause rashes. But virus-related rashes are more typically seen in children, Shinkai said. "That's why it's much more striking" to see numerous reports of rashes in adult patients with COVID-19, she said.

Exactly how common the rashes are remains unclear. In one early study of more than 1,000 COVID-19 patients in China, published Feb. 28 in the New England Journal of Medicine, rashes were noted in only 0.2% of patients. However, in a more recent study of about 150 hospitalized COVID-19 patients in Italy, rashes were found in 20% of patients. The latter study, published March 26 in the Journal of the European Academy of Dermatology and Venereology, was conducted by dermatologists, who "are going to be able to detect more subtle skin changes" than doctors in other specialities, Shinkai said.

More studies are needed that follow patients over a period of time to get a better idea of the true prevalence of rashes tied to COVID-19, Shinkai said. Still, one challenge to this is that some patients may have mild or no other symptoms of disease, and may never be diagnosed with COVID-19, she said.

Distinct rashes can sometimes be a "telltale sign" of a particular infection. Whether this will be the case for COVID-19 patients remains to be seen, the JAMA editorial said.

So far, a variety of rashes have been noted in COVID-19 patients. A Spanish study published April 29 in the British Journal of Dermatology grouped coronavirus-related rashes into five categories: a "maculopapular" rash, or one that's characteristic of viral infections such as measles, with red bumps on reddish skin; a "urticaria" rash characteristic of hives; a 'livedo" rash with a lace-like or fishnet pattern; a "vesicular eruption" or blistering rash; and a frostbite-like rash on the toes, unofficially dubbed "covid toes."

In addition, one recent case report published April 30 in JAMA Dermatology described the case of a man in Spain who developed "petechiae," or tiny red dots on the skin; and a separate case report, also published in JAMA Dermatology, described a patient in France who developed larger lesions known as a "digitate papulosquamous eruption."

The timing of rash symptoms with COVID-19 also seems to vary widely in some cases, rashes precede symptoms such as fever; in other cases, rashes may appear a few days into the illness or not show up until late in the course of the infection.

Related: 13 coronavirus myths busted by science

Research is needed to comprehensively evaluate these rashes and when they occur, Shinkai said. Doctors will also need to examine tissue samples to determine if the virus that causes COVID-19, known as SARS-CoV-2, can be detected in the skin itself, which is the case for some viral illnesses that cause rashes, Shinkai said.

In addition, the significance of these rashes such as whether they are tied to better or worse outcomes for patients should also be studied, she said. For example, some patients with covid toes have been reported to have mild or asymptomatic cases of COVID-19, Live Science previously reported.

To help doctors learn more about COVID-19 and rashes, a task force with the American Academy of Dermatology has created an online COVID-19 dermatology registry, where health care providers can report skin findings linked to the disease, Live Science previously reported.

Originally published on Live Science.

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More than 'covid toes': Numerous reports of skin rashes tied to COVID-19 - Live Science

COVID-19 testing: Conflicting results as Brian Kelly gets another antibody test

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COVID-19 testing: TPGs Brian Kelly got a second coronavirus antibody test with very different results - The Points Guy

SIOUX FALLS, S.D. (KELO) COVID-19 cases in South Dakota continue to climb.

According to numbers released by the South Dakota Department of Health, there are now a total of 3,144 positive cases in the state. Thats up 239 over Thursday. There are 1,044 active cases (an increase of 198 over Thursday) and 2,069 recovered patients, which is up 41 from Thursday.

76 patients are in the hospital; overall, 247 people have had to be hospitalized.

Deaths from the virus are at 31, with no new deaths reported on Friday.

Fridays results are from 1,179 total tests.

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Your Guide To Coronavirus

KELOLAND News is covering the COVID-19 pandemic. This is your guide to everything you need to know to prepare. We also have the latest stories from across the globe feeding into this page.

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COVID-19 in South Dakota: Active cases up nearly 200 over Thursday - KELOLAND.com