Category: Covid-19

With false information linking the coronavirus to 5G telecoms or Chinese labs being widely shared on social media, Ian Sample speaks to social psychologist Dr Daniel Jolley about why the pandemic is such fertile ground for conspiracy theories

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Covid-19: the psychology of conspiracy theories | Science - The Guardian

ST. LOUIS More than half ofGratiot County's knownCOVID-19 cases have been tied to a single home for the elderly, where 12 residents and three staff members have tested positive for the disease, according to a Tuesday news release from the local health department.

A resident ofRiverside Healthcare Center, a woman in her 70s, died from the disease on May 2,Leslie Kinnee, a health department spokeswoman said Tuesday.

The facility, located in St. Louis, Michigan north of Ithaca, offers nursing home, assisted living and independent living accommodations, according to its website. Its first positive COVID-19 case was reported April 25, Kinnee said.

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In all, 26Gratiot County residents have tested positive for the novel coronavirus and two have died, health officials reported.

Riverside Healthcare Center of St. Louishas canceled group activities and closed communal spaces. Residents who test positive for COVID-19must self-isolate in their rooms, according to the news release.

Employees who test positive are not allowed to return to work until all symptoms have improved and they've been released from monitoring by the Mid-Michigan District Health Department.Staff have access to "enhanced" personal protective equipment, including N95 masks and gowns, officials said.

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Riverside Healthcare Center took extensive measures to protect its residents and staff from COVID-19, but the virus still managed to infiltrate the building, Sarah Doak, community health and education division director for the MMDHD, said in statement.COVID-19 is very contagious and can spread easily among a vulnerable population, such as those residing in long-term care centers.

All staff and residents of the facility have been tested for COVID-19, temperatures are taken twice a day andnon-essential visitors are banned, according to the news release.

Angel: Journalists are on front lines of coronavirus pandemic, subscribe to show support

"Mid-Michigan District Health Department is in communication with our team on a daily basis and making every effort to rid Riverside of COVID-19," Al Raza, the facility's administrator, said in a statement. "The Riverside Healthcare Center team is deeply saddened by the loss of our resident and we will miss her dearly."

Across Michigan, at least43,950 people have tested positive for the disease and4,135 have died, according to data submitted Monday morning to the state health department.

Contact reporter Sarah Lehr at slehr@lsj.com. Follow her on Twitter @SarahGLehr.

Read or Share this story: https://www.lansingstatejournal.com/story/news/2020/05/05/more-than-half-gratiot-countys-covid-19-cases-one-nursing-home/3085793001/

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More than half of Gratiot County's COVID-19 cases tied to single nursing home - Lansing State Journal

Wondering when you can return to your normal activities after having COVID-19? It can be ... [+] complicated. (Photo: Getty)

You are not a Hot Pocket, at least in one way. When you get infected with the COVID-19 coronavirus, you cant just set a timer to then determine when exactly you will be ready. In this case, ready means fully recovered and ready to return to your normal activities, whatever normal activities happen to be these days with the pandemic.

As I have written previously for Forbes, COVID-19 can be a freaking confusing illness. Its still quite an enigma, wrapped with uncertainty, surrounded by some really bad bacon thats spoiled. There just havent been enough scientific studies to tell for sure how long you specifically may have symptoms and how long you specifically may be contagious when youve got a severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) infection. While some possible ranges have been identified, these durations do seem to vary quite a lot from person to person.

World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus had mentioned that recovery times tend to be about two weeks for those with mild disease and about three to six weeks for those with severe or critical disease. However, these seem to be only rough guidelines as studies have already shown a number of exceptions. For example, the symptoms of mild illness could easily extend into a third week, perhaps even longer.

Another issue is how much COVID-19 symptoms can fluctuate from day to day. Since your immune system has never seen this virus before, it can be like a guy on Tinder for the first time, just launching random things and seeing if anything will stick. You can feel better one day, only to feel worse the next, and vice-versa. Basically, your symptoms can hop around in type and severity, sort of like a really indecisive kangaroo that happens to be on Tinder for the first time.

This disease is a lot less predictable than the seasonal flu, which is more akin to momentarily hooking up with an ex whom you know is not right for you. You can do something to reduce the potential impact of flu (i.e., get vaccinated) and you know what to expect. By contrast, the trajectory for COVID-19 can be a lot less clear. Add this fact to the growing list of why COVID-19 is bleeping not the flu.

So if youve got relatively mild COVID-19, you may want to give yourself at least a two-to-three week window for recovery. At the same time, continue to closely monitor your symptoms and be ready to quickly seek medical attention if they do get much worse. Of course, having more severe disease extends your expected recovery time, perhaps into or beyond the three to six week range, perhaps even longer. Damage to your lungs or other organs could stretch out recovery much, much further, months further.

The timelines for recovery for those hospitalized for COVID-19 can be a lot longer. US Postal Worker ... [+] Robert Johnson, 40, is greeted by his relatives, wife Nicole, son Joseph and health care workers as he is released from Spaulding Hospital after spending more then 30 days in the ICU, many on a ventilator, after recovering from the COVID-19 virus in Cambridge, Massachusetts on May 4, 2020. (Photo by Joseph Prezioso / AFP) (Photo by JOSEPH PREZIOSO/AFP via Getty Images)

So how can you tell if youve recovered enough to return to your normal activities? Its not as if a microwave bell goes ding and someone sings, Hot Pocket, when you are ready. Instead, the timing of your return depends on how your illness progresses and what those normal activities happen to be. If normal means going back to Zoom meetings with just the top half of you dressed then the bar may not be super high. If it means doing something more strenuous or potentially interacting more directly with people as an essential worker, the bar should be higher.

The Centers for Disease Control and Prevention (CDC) offers guidelines on when health care professionals can return to work. They offer two possibilities for someone who has COVID-19 with symptoms: a test-based strategy and a symptom-based strategy.

The test-based strategy requires, guess what, access to testing. Otherwise it would have been called something else. In this strategy, you need to get to a point where you no longer have a fever without taking fever-reducing medications and have had improvement in your respiratory symptoms such as cough or shortness of breath. But thats not all. You also have to have negative results on a test that identifies the presence of SARS-CoV2 RNA test. This is the test where they stick a cotton swab way up your nose and another one to the back of your throat. Note that other more comfortable ways of testing are currently being developed and evaluated because no one really says, gee, what Id really like is a cotton swab to be stuck so far up my nose that it feels like my brain is being touched. As always, make sure that the test that you are getting is legit, one that has received authorization from the U.S. Food and Drug Administration (FDA). After all, surprise, surprise, there are people out there trying to scam you with bogus tests.

For this strategy, having one negative test is not enough to return to work. Thats because these tests can give you false negatives. Youve got to have at least two negative tests over a period of greater than 24 hours. This may sound straightforward, except for the swab up the nose deal. But for many, finding a way to get this test can be more difficult than finding flour in the supermarket these days. Plus, there can be delays in receiving test results. Being told two weeks later that you had a negative test may not really help your current decision of whether to return to work unless youve somehow mastered time travel.

If you dont have ready access to timely testing, the only other option offered by the CDC is the symptom-based strategy. Here you have to fulfill two criteria. One is that at least 10 days have passed since your symptoms first appeared. Ten days happens to be a little longer than the 9.5 days that was the median time from patients first having symptoms to finally testing negative for the virus RNA in a study published in theChinese Medical Journal.The other criterion is that at least 3 days (72 hours) have passed since recovery, defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath). Thus, dont rush back to work the very first day that you dont have any symptoms. That can be like going directly from sitting on the toilet to a full sprint without even pulling up your pants. Plus, as the saying goes, one can be an accident, two can be a coincidence, and three times is a pattern. Waiting can help make sure that youve finally, actually, really recovered.

Although the above recommendations are for health care professionals, they could potentially apply to you even if you arent in health care. The CDCs guidelines for Discontinuation of Isolation for Persons with COVID -19 Not in Healthcare Settings has similar specifications and timelines. Keep in mind, though, that these are minimal criteria, as evidenced by the fact that the words at least appear in each criterion. At least means at least and not that should be plenty. When your significant other says at least remember when my birthday is, simply writing an email that says Happy Birthday! See I remembered along with a thumbs up emoji is probably not enough. The response could be a not so nice emoji that involves another finger being raised. Similarly, if you can give yourself even more time to rest before returning to work, try to do so. Four days after your symptoms are completely gone is better than just three days. Five days is better four days. You can probably figure out what six days is.

Don't try to push yourself too hard such as resuming full exercise, the first few days back after ... [+] COVID-19. (Photo: Getty)

Also, ease yourself back into your daily routine. The first day back is probably not the time to resume power lifting. Instead, gradually test what you can handle and give yourself some slack. There have been reports of people not feeling quite right or having trouble thinking or sleeping for extended periods of time after the infection. In an article for NBC News, Erika Edwards described how some recovering patients were feeling a range of hard-to-pin-down symptoms, including a "weird forgetfulness," fear, and nervousness. Weird forgetfulness is not a great thing to have when you are on a Zoom business call and not wearing any pants.

In fact, consider consulting others like family, friends, or health care professionals when deciding whether and when to return to work and other daily routines. Note that this list didnt include random strangers on Facebook. The problem with not thinking straight is that you may not even realize that you are not thinking straight. So rely on trusted people to help steer you right.

Of course, not everyone has the luxury to take time to return to normal activities. Little kids dont tend to tell parents, I got this. You just rest there while I make everyone dinner, take out the trash, and finish caulking the ceiling. Also, your employer may have the sympathy and empathy of a toilet brush and push you to return to full working capacity immediately. Not everyone may really truly understand how new and how different this nasty COVID-19 coronavirus is. Once again, it is very different from the flu or anything that your immune system is used to seeing.

While you may know exactly what to expect when microwaving and eating a Hot Pocket, you dont quite know what you are getting with the COVID-19 coronavirus. You may want to keep reminding yourself and others that you are not a Hot Pocket. You are not a Hot Pocket.

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How Long Does It Take To Recover From COVID-19 Coronavirus And Return To Work? - Forbes

Physical and occupational therapists carry bags of personal protective equipment on their way to the room of a COVID-19 patient in a Stamford Hospital intensive care unit in Stamford, Conn., on April 24. This "prone team" turns over COVID-19 to help them breathe. John Moore/Getty Images hide caption

Physical and occupational therapists carry bags of personal protective equipment on their way to the room of a COVID-19 patient in a Stamford Hospital intensive care unit in Stamford, Conn., on April 24. This "prone team" turns over COVID-19 to help them breathe.

Intensive care teams inside hospitals are rapidly altering the way they care for patients with COVID-19.

The changes range from new protective gear to new treatment protocols aimed at preventing deadly blood clots.

"Things are moving so fast within this pandemic, it's hard to keep up" says Dr. Angela Hewlett, an infectious diseases physician at University of Nebraska Medical Center in Omaha and medical director of the Nebraska Biocontainment Unit. To stay current, she says, ICUs are updating their practices "on an hourly basis."

"We are learning at light speed about the disease," says Dr. Craig Coopersmith , interim director of the critical care center at Emory University. "Things that previously might have taken us years to learn, we're learning in a week or two. Things that might have taken us a month to learn beforehand, we're learning in a day or two."

The most obvious changes involve measures to protect ICU doctors, nurses and staff from the virus.

"There is a true and real probability of infection," says Dr. Tiffany Osborn a critical care specialist at Washington University School of Medicine and Barnes-Jewish Hospital in St. Louis. "You have to think about everything you touch as if it burned."

So ICUs are adapting measures used at special biocontainment units like the one at the University of Nebraska. These units were designed to care for patients affected by bioterrorism or infected with particularly hazardous communicable diseases like SARS and Ebola.

The Nebraska biocontainment unit "received several patients early on in the pandemic who were medically evacuated from the Diamond Princess cruise ship," Hewlett says. But it didn't have enough beds for the large numbers of local patients who began arriving at the University of Nebraska Medical Center.

So the nurses, respiratory therapists and physicians from the biocontainment team have "fanned out and are now working within those COVID units to make sure that all of our principles and protocols are followed there as well," Hewlett says.

Those protocols involve measures like monitoring ICU staff when they remove their protective gear to make sure the virus isn't transmitted, and placing infected patients in negative pressure rooms, which draw air inward, when possible to prevent the virus from escaping.

One of the riskiest ICU procedures is inserting a breathing tube in a COVID-19 patient's airway, which creates a direct path for virus to escape from a patient's lungs. "If you're intubating a patient, that's a much higher risk than, say, going in and doing routine patient care," Hewlett says.

So ICU teams are being advised to add several layers of protection beyond a surgical mask.

Extra personal protective equipment may include an N95 respirator, goggles, a full face shield, a head hood, an impermeable isolation gown and double gloves.

In many ICUs, teams are also placing a clear plastic box or sheet over the patient's head and upper body before inserting the tube. And as a final safety measure, the doctor may guide the tube using a video camera rather than looking directly down a patient's airway.

"It usually takes 30 minutes or so in order to get all of that equipment together, to get all of the right people there," says Dr. Kira Newman, a senior resident physician at UW Medical Center in Seattle. "and that would be a particularly fast intubation."

But most changes in the ICU are in response to an ongoing flood of new information about how COVID-19 affects the body.

There's a growing understanding, for example, that the infection can cause dangerous blood clots to form in many severely ill patients. These clots can kill if they block arteries supplying the lungs or brain. But they also can prevent blood from reaching the kidneys or even a patient's arms and legs.

Clots are a known risk for all ICU patients, Cooperman says, but the frequency and severity appears much greater with COVID-19. "So we're starting them on a higher level of medicine to prevent blood clots and if somebody actually develops blood clots, we have a plan B and a plan C and a plan D," he says.

ICU teams are also recalibrating their approach to ensuring that patients are getting enough oxygen. Early in the pandemic, the idea was to put patients on mechanical ventilator quickly to make sure their oxygen levels didn't fall too far.

But with experience, doctors have found that mechanical ventilators don't seem to work as well for COVID patients as they do for patients with other lung problems. They've also learned that that many COVID-19 patients remain lucid and relatively comfortable even when the oxygen levels in their blood are extremely low.

So many specialists are now recommending alternatives to mechanical ventilation, even for some of the sickest patients. "We're really trying now to not intubate," Osborn says.

Instead, ICU teams are relying on devices that deliver oxygen through the nasal passages, or through a mask that fits tightly over the face. And there's renewed interest in an old technique to help patients breathe. It's called proning.

"Instead of them being on their back, we're turning them on their front," Osborn says. The reason, she says is to open up a part of the lung that is collapsed when a patient is on their back.

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ICUs Transformed To Care For COVID-19 Patients : Shots - Health News - NPR

More than 260 COVID-19 patients in South Korea tested positive for the coronavirus after having recovered, raising alarm that the virus might be capable of "reactivating" or infecting people more than once. But infectious disease experts now say both are unlikely.

Rather, the method used to detect the coronavirus, called polymerase chain reaction (PCR), cannot distinguish between genetic material (RNA or DNA) from infectious virus and the "dead" virus fragments that can linger in the body long after a person recovers, Dr. Oh Myoung-don, a Seoul National University Hospital doctor, said at a news briefing Thursday (April 30), according to The Korea Herald.

These tests "are very simple," said Carol Shoshkes Reiss, a professor of Biology and Neural Science at New York University, who was not involved in the testing. "Although somebody can recover and no longer be infectious, they may still have these little fragments of [inactive] viral RNA which turn out positive on those tests."

Related: 13 coronavirus myths busted by science

That's because once the virus has been vanquished, there is "all this garbage of broken-down cells that needs to be cleaned up," Reiss told Live Science, referring to the cellular corpses that were killed by the virus. Within that garbage are the fragmented remains of now non-infectious viral particles.

To determine whether or not someone is harboring infectious virus or has been reinfected with the virus, a completely different type of test would be needed, one that is not typically performed, Reiss said. Instead of testing the virus as it is, lab technicians would have to culture it, or place that virus in a lab dish under ideal conditions and see if it was capable of growing.

Patients in South Korea who re-tested positive had very little to no ability to spread the virus, according to the Korea Centers for Disease Control and Prevention, the Korea Herald reported.

Reports of patients testing positive twice aren't limited to South Korea; they have also poured in from other countries, including China and Japan. But the general consensus in the scientific community with all the information available to date on the new coronavirus is that people aren't being reinfected, but rather falsely testing positive, Reiss said.

What's more, "the process in which COVID-19 produces a new virus takes place only in host cells and does not infiltrate the nucleus," or the very core of the cell, Oh said during the briefing, the Herald reported. Here's why: Some viruses, such as the human immunodeficiency virus (HIV) and the chickenpox virus, can integrate themselves into the host genome by making their way into the nucleus of human cells, where they can stay latent for years and then "reactivate." But the coronavirus is not one of those viruses and instead it stays outside of the host cell's nucleus, before quickly bursting out and infiltrating the next cell, Reiss said.

"This means it does not cause chronic infection or recurrence," Oh said. In other words, it's highly unlikely that the coronavirus would reactivate in the body soon after infection, Reiss said.

But reinfection at some point is a theoretical possibility. "We don't know what's going to happen a year from now, nobody has that kind of crystal ball," Reiss said.

Reassuringly, the virus is currently undergoing very small genetic changes that are "too tiny" to evade the immune systems of people who have already been infected. The genetic changes would have to be substantial enough that a person's existing antibodies to SARS-CoV-2 would no longer work against a new strain. So far, that seems unlikely.

"If this virus remains as it is [with] really tiny changes then it's highly unlikely" that a person would be reinfected next year, Reiss added.

In the best-case scenario, which Reiss thinks is likely, the virus will behave like the virus that causes chickenpox, "imprinting" on the host immune memory. Then, even if antibody levels drop over time, people will retain a population of memory cells that can rapidly boost production of more antibodies if they are exposed to the virus again, Reiss said. Of course, this is still an "assumption," and it will be some time before we can fully understand the strength of the army the immune system creates against this virus and whether that army's protection is long-lasting.

Editor's Note: This article was updated on May 2 to clarify the names of those quoted.

Originally published on Live Science.

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Recovered patients who tested positive for COVID-19 likely not reinfected - Livescience.com

Separate studies in Israel and the Netherlands claim to have created antibodies that can block the coronavirus infection, a potential future treatment touted as a game-changer until a vaccine becomes available.

A Dutch-led team of scientists said they had managed to halt infection in a lab setting. At the same time, the Israeli defence minister announced a state-run research centre had developed an antibody that he claimed could neutralise [the coronavirus] inside carriers bodies. The Guardian understands the antibody has not yet been trialled on humans, however.

Both efforts, which are in their initial stages, hope to eventually treat or prevent the development of the Covid-19 respiratory disease caused by coronavirus and stall the spread of the pandemic.

Such a neutralising antibody has potential to alter the course of infection in the infected host, support virus clearance or protect an uninfected individual that is exposed to the virus, said Berend-Jan Bosch from Utrecht University in the Netherlands.

The research, published in the Nature Communications journal on Monday, looked at antibodies developed to combat the 2002-04 Sars outbreak, also caused by a coronavirus. It said it identified one antibody that was also effective against the current virus, officially called Sars-CoV-2.

Scientists at Utrecht University, Erasmus Medical Center and the global biopharmaceutical company, Harbour BioMed (HBM), described it as an initial step towards developing a fully human antibody to treat or prevent Covid-19.

This is groundbreaking research, said Jingsong Wang, the CEO of HBM. But he added: Much more work is needed to assess whether this antibody can protect or reduce the severity of disease in humans.

The study was welcomed with cautious optimism by several experts.

Jane Osbourn, the chair of the UK BioIndustry Association (BIA) who received an OBE last year for her antibody research, said the study could be a valuable part of the future arsenal of options for development.

Contact tracing is one of the most basic planks of public health responses to a pandemiclike the coronavirus. It means literally tracking down anyone that somebody with an infection may have had contact with in the days before they became ill. It was and always will be central to the fight against Ebola, for instance. In west Africa in 2014/15, there were large teams of people who would trace relatives and knock on the doors of neighbours and friends to find anyone who might have become infected by touching the sick person.

Most people who get Covid-19 will be infected by their friends, neighbours, family or work colleagues, so they will be first on the list. It is not likely anyone will get infected by someone they do not know, passing on the street.

It is still assumed there has to be reasonable exposure originally experts said people would need to be together for 15 minutes, less than 2 metres apart. So a contact tracer will want to know who the person testing positive met and talked to over the two or three days before they developed symptoms and went into isolation.

South Korea has large teams of contact tracers and notably chased down all the contacts of a religious group, many of whose members fell ill. That outbreak was efficiently stamped out by contact tracing and quarantine.

Singapore and Hong Kong have also espoused testing and contact tracing and so has Germany. All those countries have had relatively low death rates so far. TheWorld Health Organizationsays it should be the backbone of the response in every country.

Sarah BoseleyHealth editor

James Gill, honorary clinical lecturer at Warwick Medical School, said it revealed a potential game-changing discovery with regard to Covid-19. However, he warned it was still too early to declare victory.

Simply because we have found an antibody which neutralises a virus in a group of cells in a lab Petri dish doesnt mean that we can expect the same response in patients, nor expect to see a positive change in a patients clinical condition, he said. But this is certainly a very promising discovery, coming from a robust scientific approach, and should be viewed as a reason for optimism.

In Israel, the defence minister, Naftali Bennett, claimed researchers had made a significant breakthrough.

The state-run Israel Institute for Biological Research (IIBR) had created antibodies that could defeat the coronavirus inside humans, he said in a statement.

Researchers were already moving to patent the antibodies, and the IIBR was looking to mass-produce it, the statement said.

The defence ministry later said in a separate statement that scientists that the IIBR believed the normal process of tests and regulatory approvals could be shortened to several months.

Both the Israeli and Dutch studies use monoclonal antibodies, which are lab-created proteins that resemble naturally occurring antibodies that make up the immune system. Antibodies work by binding with the virus, identifying it to be destroyed.

Roughly 100 other research groups around the world are also pursuing vaccines, which would provide immunity from infection.

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Israel and Netherlands studies claim progress in Covid-19 antibody trials - The Guardian

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Levi Sucre Romero remembers hearing the news back in January about a novel coronavirus infecting people in China. I honestly didnt believe it would make it this far, he said. I felt like it was really far away.

A member and leader of the Bribri, one of Costa Ricas largest indigenous groups, Romero lives in Talamanca, a remote, mountainous region in the south of the country full of meandering rivers, dense jungle canopies and a near-constant drizzle of warm rain. Though the thatched-roof wooden homes of Talamanca Bribri, the groups territory, are far removed from the countrys popular tourist hubs, Romero soon realised that it was only a matter of time until the virus reached them.

Romero also realised something else: the virus, he believes, was unleashed by human greed and ill treatment of the planet. Were unbalancing the habitat of species, were cutting down trees, were planting monocultures, were filling the world with cities and asphalt and were using too many chemicals, Romero said. Its a cocktail of bad practices.

Like Sars and Mers, two other recent, deadly coronaviruses, Covid-19 is a zoonotic disease that came from an animal. Evidence points to its likely origin in a bat, followed by a potential crossover into an intermediary species possibly a pangolin before transmission into humans at a wet market in Wuhan, China. While Covid-19s exact origins have yet to be pinpointed, overwhelming research shows that deforestation and commercial wildlife trade heighten the risk of zoonotic diseases that can potentially cause pandemics. And according to Romero, both are human activities that entail the destruction of nature.

My people have cultural knowledge that says when Sib, our God, created Earth, he locked up some bad spirits, Romero said. These spirits come out when were not respecting nature and living together.

Romero coordinates the Mesoamerican Alliance of People and Forests, one of the most important land-rights platforms for indigenous communities in Central America and Mexico, which represents more than 50,000 people who live in the most densely forested lands in the region. He knows for a fact that there is another, more sustainable and respectful way to live in relation to the Earth because the Bribri and many other indigenous groups around the world practice it.

I do not believe this will be the last pandemic of this type

For years, Romero and other indigenous leaders have been urging the rest of the world to adopt a more indigenous-inspired way of coexisting with nature, including leaving habitats intact, harvesting plants and animals at sustainable levels and acknowledging and respecting the connection between human and planetary health. Now, they are reiterating that message in light of the coronavirus.

At a March panel sponsored by the global journalism initiative Covering Climate Now in New York City, held days before the city shut down and later became the global epicentre of the worldwide pandemic, Romero and other indigenous leaders from Brazil and Indonesia emphasised the role that traditional knowledge, practices and land stewardship can play in protecting the planet. These protections, they said, extend not just to lessening climate change and biodiversity loss, but to reducing the risk of future pandemics.

We are convinced that this pandemic is the result of a wrong use of natural resources and a wrong way of living together with these resources, Romero said. I do not believe this will be the last pandemic of this type.

A wealth of research supports the link between novel disease emergence and environmental destruction. Many viruses naturally occur in animal species, and deforestation increases the odds of people coming into contact with an animal carrying a virus that is new to humanity, potentially resulting in a spill-over event. A 2017 Nature Communications paper revealed that emerging zoonotic disease risk is highest in tropical forests that are experiencing land-use changes, including from logging, mining, dam building and road development. As the authors report, such activities carry an intrinsic risk of disease emergence because they disrupt ecological dynamics and increase contact between humans, livestock and wildlife.

Its a stochastic process, said Erin Mordecai, a biologist at Stanford University. Its driven by chance encounters between particular people and particular animals, and what pathogens theyre carrying at that time.

Deforestation can also spread existing diseases. In October, Mordecai and co-author Andrew MacDonald reported in the Proceedings of the National Academy of Sciences that an increase in deforestation in Brazil tends to increase the rate of malaria transmission, with about six-and-a-half new cases occurring per square kilometre of cut-down forest. The reason, they believe, is that cutting trees creates more forest edge the favourite breeding habitat for Brazils malaria-transmitting mosquitoes. Development in frontier regions also brings more people closer to the forest and draws pioneers in from other parts of the country who have never been exposed to malaria and thus have no resistance.

Deforestation tends to lead to these opportunities in which species that dont normally come into contact are coming into contact

While every disease is different, the general pattern, Mordecai told me, is that deforestation disrupts ecosystems and creates edge habitats hovering between domesticated and wild, in which the human and natural world overlap. Deforestation tends to lead to these opportunities in which species that dont normally come into contact are coming into contact, she said. That creates opportunities for pathogens to spill over.

Studies reveal that the both legal and illegal commercial wildlife trade also increase the risk of new diseases emerging by subjecting wild animals to stressful, unhygienic conditions. Still-living species are often mixed together, allowing them to exchange viruses. Trade also often takes place in urban centres, where many people may come into contact with the animals and with each other further encouraging a new diseases spread.

The wildlife trade itself is also linked to deforestation. Hunters and poachers tend to access wilderness areas through roads. As formerly remote areas are opened up by new transportation corridors, wildlife trade tends to follow.

Medical experts and conservationists have been warning of the health risks posed by both deforestation and wildlife trade for decades, but to no avail. In 2003, for example, China briefly banned wildlife trade in response to Sars, but business resumed within a year and has only grown since.

As land stewards, many indigenous groups help to guard against these threats. By protecting indigenous landscapes, youre protecting not only those people and their way of life, but also preventing really rapid transformation of landscapes, Mordecai said. That rapid transformation has huge-scale cultural and environmental consequences, but also disease-transmission consequences.

How travellers can help protect indigenous land

Indigenous tourism directly engages indigenous people to let them share their culture and land on their own terms. According to the United Nations World Tourism Organization, indigenous tourism can spur cultural interaction and revival, bolster employment, alleviate poverty, curb rural flight migration, empower women and youth, encourage product diversification, and nurture a sense of pride among indigenous people.

To ensure that your travel will directly benefit the people whose culture and land you experience, the World Indigenous Tourism Alliance recommends booking indigenous-owned-and-operated tours. Fortunately, indigenous-led travel experiences have recently surged in places like Australia, Canada and the US. In the last few years, the Bribri launched Costa Ricas first indigenous-operated tour agency, which teaches visitors about the groups worldview and spiritual connection to the land, with all funds going back to the community.

A large number of indigenous groups live in tropical forests precisely the landscapes with the highest risk for new disease emergence, and also the places facing the highest rates of deforestation. Tropical deforestation is accelerating and accounts for about 90% of total deforestation worldwide. A 2020 study reported that at least 36% of the worlds remaining intact forests half of which are located in the tropics fall within indigenous lands.

Of course, indigenous people are extremely diverse. Some live in cities, others in forests; some extract resources for profit, others use nature only for subsistence. In general, though, indigenous groups are much more effective at protecting the forest and environment on their lands than most other users, said Mary Menton, a research fellow in environmental justice at the University of Sussex. In certain parts of Brazil, for example, indigenous protection is visible in satellite images from space.

You can see exactly where the lines of indigenous territories are, Menton said. Deforestation eats into forests around where indigenous areas are, and those areas really act as an effective barrier for expansion.

Indigenous peoples lands, by and large, tend to be much better protected than other areas of the forest

This is also supported by scientific evidence. A 2012 study comparing 40 protected areas and 33 community-managed forests revealed that the community-managed areas suffered less deforestation. If we look across the tropics, indigenous peoples lands, by and large, tend to be much better protected than other areas of the forest, even comparing community and indigenous lands to protected areas, Menton said.

Practically speaking, this is partly because indigenous people tend to live on large areas of land with relatively small populations. But even groups that live in smaller tracts of forest in north-east Brazil, for example, live more sustainably than much of the rest of humanity. Its not just that they have lots of forest, its the way they treat and see the forest, and interact with it, Menton said.

Many groups have been living in forested areas for generations and view the landscape as part of their community. Some also believe that their ancestors are part of the forest. Protecting nature, therefore, isnt just about ecology and biodiversity, Menton says, but also about preserving lives, history and culture.

You may also be interested in: The ancient guardians of the Earth A 60,000-year-old cure for depression The New Zealand river that became a legal person

Indigenous people accomplish this through a variety of means that largely boil down to having a respect and awareness of the effect they have on the forest, Menton said. The Bribri, for example, divide their land into family and community areas, each of which have internal rules designed to promote sustainability. For example, members of the community can cut as many leaves as they want from local suita palms used to make everything from houses to brooms so long as they leave at least five leaves on each harvested plant so it can produce more leaves.

We need to rethink the model of development thats based on accumulating wealth while destroying resources

Many indigenous people also do not treat the forest as a means or impediment to getting rich. Romero, for his part, thinks that hyper-globalisation and consumerism are at the heart of many of the worlds ills. We need to rethink the model of development thats based on accumulating wealth while destroying resources, Romero said. I see an economic model that is predatory to resources and to nature, that causes a lack of balance in the world.

However, profit-driven companies, governments and individuals often view indigenous people as standing in the way of economic growth. Around the world, indigenous land rights are under attack by agriculture, mining and other extractive industries. Between 2002 and 2017, Menton found that more than 1,500 environmental defenders were murdered in 50 countries, and that indigenous peoples died in higher numbers than any other group on the list. In 2015 and 2016, for example, indigenous people represented 40% of all murdered environmental defenders. A report published in April 2020 by the Pastoral Land Commission, a non-profit organisation in Brazil, likewise revealed that one-third of all families who faced land conflicts in rural Brazil in 2019 were indigenous.

Menton adds that indigenous people face additional threats because of racism and perceptions that theyre second-class citizens. Often, this is a problem promoted from the top down. Brazils president, Jair Bolsonaro, recently said, for example, that Indians are evolving to become increasingly human, like us. Indigenous people, in other words, are facing threats both in terms of actual physical conflicts over land, but also cultural threats and attacks over their right to exist, Menton said.

Attacks on indigenous rights are not just attacks on individual cultures, Romero says, but on the health of the planet as a whole. When we have rights over our forests and our lands, that means survival for us, for our families, he said. But it also means we have a better probability of avoiding pandemics.

The Bribri, like much of the world, are now on lockdown. The rhythm of our lives has been cut short, he said. Visits with elders are no longer permitted, sales of produce to the national market have dropped by around 90%, and the groups cultural and ecological tourism efforts including guided trips to mountains and rivers, traditional food tours and home stays on family ranches have stopped as well. I could go on and on. Theres a lot of impacts, Romero said.

Once the world does emerge from Covid-19, Romero hopes that there will be a silver lining to all of the suffering, loss and hardship that it has caused. He hopes that people will be more receptive to the knowledge that he and other indigenous leaders have to offer, and that humanity will begin to re-evaluate its relationship with nature.

I think we have a long way to go, but after the coronavirus, I have faith that this will open up some space with governments, Romero said. After this pandemic, governments should listen more.

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The Food and Drug Administration has authorized a new coronavirus antibody test, making it the first to receive independent validation from the federal government.

According to federal officials, the test can tell if people have been infected with the virus and recovered from it.

The FDA, Centers for Disease Control and Prevention, and the National Institutes of Health evaluated its effectiveness.

Other tests are currently available, but public health officials say they are not accurate.

Many experts believe accurate antibody testing is the key to fighting the pandemic.

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1st COVID-19 Antibody Test Receives Approval of FDA - 9&10 News

The statewide cumulative case count reached 621 on Monday, with the addition of one new infection confirmed by the Department of Health on Hawaii island.

Statewide, four new recoveries were reported. A total of 548 people have recovered enough to be released from isolation about 88% of those diagnosed to date.

Hawaii Countys cumulative infection count reached 75 on Monday, but 63 of the people with confirmed infections are now in recovery. One person is hospitalized on the Big Island, and 63 people have recovered to date, according to the health department.

The Big Island has documented 75 COVID-19 infections to date.

Flickr: Matt McGee

Kauai Countys cumulative case count has remained at 21 for a couple of weeks. Only one case is still actively monitored by DOH and the person is hospitalized. The 20 others have recovered.

Oahus cumulative case count remained at 400, including 374 recoveries documented by the health department. Fifty-three people have required hospitalization on Oahu to date, and another 11 people have died.

Maui Countys cumulative case count remained at 116 on Monday, including one Lanai resident who was exposed on Maui and has not returned to Lanai since.

On Sunday, Mauis sixth death related to the coronavirus was confirmed. The woman who died was older than 60 and had been hospitalized for other medical issues since February at Maui Memorial Medical Center. Her COVID-19 infection occurred in mid-April. The hospital is the site of a cluster of cases affecting both staff and patients.

The state health departments epidemiologists have found that most cases confirmed in April were community-related, and new infections have dwindled.

Department of Health

Across the islands, 73 people have been hospitalized to date, including some Hawaii residents hospitalized out of state. Patients who do not require hospitalization recuperate at home in isolation and only qualify to be released when at least 14 days of quarantine have passed and their symptoms have subsided.

The state has registered 17 deaths in relation to COVID-19 since March.

Hawaii is still under a stay-at-home order through the end of May but some restrictions have been lifted.

Those who are not under mandatory quarantine are allowed to exercise on beaches and at some public parks if they abide by six-foot social distancing guidelines. Florists are back open for business. Gov. David Ige said Monday that other kinds of low-contact retail operations will soon be given approval to reopen.

Honolulu Mayor Kirk Caldwell isallowing people to exercisein parks, although he doesnt want them to congregate, play team sports or use any playground equipment.The city alsoopened its botanical gardens.

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1 New COVID-19 Case Confirmed On The Big Island - Honolulu Civil Beat

When the Krewe of Zulu parade rolled out onto Jackson Avenue to kick off Mardi Gras festivities on Feb. 25, the party started for black New Orleans. Tens of thousands of people lined the four-and-a-half-mile route, reveling in the animated succession of jazz musicians, high-stepping marching bands from historically black colleges and universities and loose-limbed dancers dressed in Zulu costumes, complete with grass skirts and blackface makeup, an homage to the Zulu people of South Africa and, for some, a satirical spit in the eye to the past, when Mardi Gras was put on by clubs of white men who barred black people from taking part.

Though some black critics have chided the Zulus for continuing to black up, their costumes and traditions are a way of reclaiming and redeploying the most toxic stereotypes of black Americans. Founded in 1909, the Zulu Social Aid and Pleasure Club is a brotherhood of some 800 men, nearly all of them black, known for community service, civic pride, black excellence and that Mardi Gras parade. And so on that late February day, as people stood shoulder to shoulder and several feet deep, hoping to catch a painted coconut, the throw that is the Zulu parades signature and coveted prize, no one had any idea that this joyous gathering would turn out to be a coronavirus hothouse.

For the Zulu club, the Carnival season involves a series of meticulously planned and eagerly awaited ceremonies, balls and festivals, almost every day in January and February. The Zulu Ball, one of the groups three grand-scale, marquee events, fell on Friday, Feb. 21, this year. Some 20,000 people, floor-length ball gowns and tuxedos required, packed into the New Orleans Ernest N. Morial Convention Center one of the few venues large enough to hold the crowd that came to eat and drink and dance and witness the crowning of the Zulu King and Queen of Mardi Gras. At the parade, the king, elected by club members, wears a golden crown and an elaborate festoon of feathers. He rides on a float, waving a glittery scepter at the crowd, flanked by two hand-painted leopards rearing up on their hind legs.

As Mardi Gras festivities began, bringing over a million visitors from around the world streaming into the warm, welcoming city to celebrate face to face and elbow to elbow with local residents in a progression of street parties and parades, dozens of coronavirus cases had already been documented in China, which reported its first death on Jan. 11. On Jan. 20, the first known case was confirmed in the United States: a Washington State resident who had recently returned from Wuhan, China. Behind the scenes, Louisiana health administrators had begun discussing the growing situation, seeing it as low-risk, according to emails obtained by Columbia Universitys Brown Institute for Media Innovation.

On Feb. 5, four days after Surgeon General Jerome Adams tweeted, Roses are red/Violets are blue/Risk is low for #coronavirus/But high for the flu, New Orleans officials held a multiagency coronavirus planning meeting. The same day, a statement posted on the citys website read: Our publichealth and health caresystems are ready for Mardi Gras,and the coronavirus poses a verylow risk to the Carnival celebrations. At the time, just 12 cases had been reported in the United States and none in Louisiana.

On Sunday, Feb. 23, two days after the Zulu Ball, President Trump set the tone for the country, the state of Louisiana and the city of New Orleans when he said at a news conference: We have it very much under control in the country. On Monday, Feb. 24, when an estimated 200,000 people spent the day at Lundi Gras, sponsored by the Zulu club, enjoying a smorgasbord of New Orleans food and music on three stages at Woldenberg Park along the Mississippi River, he reiterated on Twitter that the disease was under control. According to an internal memo, however, Trump had already been warned by his own trade adviser about the potential of half a million deaths and an economic hemorrhage of trillions of dollars as a result of the pandemic. According to reports, his health and human services director had alerted him twice about the possibility of a pandemic; the president accused him of being alarmist.

The day after Lundi Gras, the Zulu club member Cornell Charles everybody called him Dickey, a childhood nickname rose early and put on a honey yellow jacket, part of the groups signature uniform. As part of the Zulu Krewe parade organizing committee, he spent the next 10 hours fussing over the logistics of the exuberant, chaotic parade. Larry A. Hammond, 70, a former Zulu king and a club member, waved to the crowd from one of the many floats. On that same day, officials from the C.D.C. issued a far bleaker warning than any before about the spread of the virus in the United States, recommending social-distancing measures. Yet the president himself was still playing down the risk; that same day, while traveling in India, Trump said, We have very few people with it. The people who did have it, he said, are getting better, theyre all getting better. The following day, he reassured the country that the number of confirmed cases within a couple of days is going to be down close to zero.

Mayor LaToya Cantrell of New Orleans stood on St. Charles Avenue during the Feb. 25 parade next to Jay H. Banks, chairman of the Zulu clubs board, raising a glass and joyfully shouting, Hail Zulu! as the king passed by on his float. She would later defend not canceling the festivities. When its not taken seriously at the federal level, its very difficult to transcend down to the local level in making these decisions, Cantrell told CNN on March 26.

On March 9, the same day Louisiana reported its first presumptive case of Covid-19, Trump compared the virus to the flu on Twitter, and also tweeted: The Fake News Media and their partner, the Democrat Party, is doing everything within its semi-considerable power (it used to be greater!) to inflame the CoronaVirus situation, far beyond what the facts would warrant.

Banks, a city councilman who first became involved with the Zulu club as a boy, remembers the rush of panic he felt on March 16, when he saw a Facebook post about the first of his Zulu brothers to get sick, Dickey Charles, who was just 51. Written by the chaplain of the Zulu club, Jefferson Reese Sr., it read, Zulu Brother Cornell Dickey Charles is very ill and in need of prayer. Amen followed by three brown praying-hands emojis. When I saw the post, I thought, Oh, man, Banks says. I knew we were going to have a problem. Eight weeks after Mardi Gras, at least 30 members of the club had been found to have Covid-19. Eight would be dead.

Banks, who believes he knows at least 16 people who have died of the disease, says if he and the Zulu leadership had had the slightest clue that the pandemic was a direct danger, they would have canceled their events. The president was saying that this was not a big deal, and nobody in the federal government raised a red flag, Banks says. Gov. John Bel Edwards of Louisiana could have canceled the parade. But like Mayor Cantrell, he said he had little useful guidance from Washington. There was not one person at the state or its federal government, not at the C.D.C. or otherwise, who recommended canceling any event, not just Mardi Gras, but I dont think anywhere across the country, he told Face the Nation on March 29.

Zulu is 800 men, predominantly black, Banks says. Like all black communities, we have a large contingent of people who have pre-existing conditions. Our members come from all walks of life, and many of them dont have jobs with sick days and dont have the luxury of working at home. When you add these factors to a disease that capitalizes on these kind of circumstances, you get a perfect storm.

On April 6, Louisiana became one of the first states to release Covid-19 data by race: While making up 33 percent of the population, African-Americans accounted for 70 percent of the dead at that point. Around the same time, other cities and states began to release racial data in the absence of even a whisper from the federal government where health data of all kinds is routinely categorized by race. Areas with large populations of black people were revealed to have disproportionate, devastating death rates. In Michigan, black people make up 14 percent of the population but 40 percent of the deaths. (All data was current as of press time.) In Wisconsin, black people are 7 percent of the population but 33 percent of the deaths. In Mississippi, black people are 38 percent of the population but 61 percent of the deaths. In Milwaukee, black people are 39 percent of the population but 71 percent of the deaths. In Chicago, black people are 30 percent of the population but 56 percent of the deaths. In New York, which has the countrys highest numbers of confirmed cases and deaths, black people are twice as likely to die as white people. In Orleans Parish, black people make up 60 percent of the population but 70 percent of the dead. Data from the Louisiana Department of Health shows that neighborhoods in the parish with large numbers of black residents have been hit hardest.

The coronavirus pandemic has stripped bare the racial divide in the health of our nation. A complex and longstanding constellation of factors explains these higher death rates. On April 8, a C.D.C. study suggested that about 90 percent of the most serious Covid-19 cases involve underlying health conditions hypertension and cardiovascular disease, obesity, diabetes, chronic lung disease that are more common and more deadly in black Americans and strike at younger ages. According to the C.D.C., the rate of diabetes is 66 percent higher in black Americans than in white Americans; the rate of hypertension is 49 percent higher. The average black life expectancy, from birth, is about 3.5 years lower than white life expectancy. In fact, the health outcomes of black Americans are by several measures on par with those of people in poorer countries with much less sophisticated medical systems and technology. And though these health disparities are certainly worsened by poverty, they are not erased by increased income and education. The elevated rates of these serious illnesses have weaponized the coronavirus to catastrophic effect in black America.

Earl Benjamin-Robinson is deputy director of the Louisiana Department of Healths Office of Community Partnerships and Health Equity, created in 2019 to identify and target health disparities in vulnerable populations. When we first started hearing about Covid in China, he says, and learned that those who got severely ill and who subsequently died dealt with underlying conditions like hypertension, diabetes, lung disease and so on, I became concerned and kept in the forefront knowing that African-Americans in the U.S. and in our state are overrepresented when it comes to those conditions. Benjamin-Robinson, who lives in New Orleans, says he also had begun hearing rumors in the local community and on social media that black people were immune to the coronavirus, supposedly because melanin protected against it. These false theories became so rampant that on March 17, the day after the actor Idris Elba announced that he had tested positive for the disease, he posted a Twitter live video to denounce the rumors. There are so many stupid, ridiculous conspiracy theories about black people not being able to get it, he said. Thats dumb, stupid.

As public-health officials, we knew about the clear, distinct racial health disparities, as it relates to chronic illnesses in our state, in the early months, Benjamin-Robinson says. But in the absence of racial data and with no real sense of urgency coming from the federal government, we werent able to put a plan in action to create targeted messaging and get information directly to African-Americans. After the release of racial data for Louisiana in early April, Benjamin-Robinsons office helped develop public-health promotional materials about Covid-19 specifically for black Louisianans, which were distributed via email and social media.

On March 27, Senators Kamala Harris of California, Elizabeth Warren of Massachusetts and Cory Booker of New Jersey, and Representatives Ayanna Pressley of Massachusetts and Robin Kelly of Illinois, all Democrats, sent a letter to Alex Azar, secretary of the Department of Health and Human Services, urging the agency to reveal racial data on testing and treatment for the virus. Although Covid-19 does not discriminate along racial or ethnic lines, existing racial disparities and inequities in health outcomes and health care access may mean that the nations response to preventing and mitigating its harms will not be felt equally in every community, the lawmakers wrote. Lack of information will exacerbate existing health disparities and result in the loss of lives in vulnerable communities.

On April 3, the American Medical Association, the professional organization that represents some 250,000 physicians, residents and medical students, also implored the Department of Health and Human Services to release coronavirus data by race. It is well documented that social and health inequities are longstanding and systemic disturbances to the wellness of marginalized, minoritized and medically underserved communities, read its letter, co-signed by organizations including the American Academy of Pediatrics, the American Academy of Family Physicians and the National Medical Association. While Covid-19 has not created the circumstances that have brought about health inequities, it has and will continue to severely exacerbate existing and alarming social inequities along racial and ethnic lines.

Amid this pressure from lawmakers, physicians, scientists and advocacy groups to release national Covid-19 statistics by race, on Wednesday, April 8, the C.D.C. put out a limited data set of 1,482 coronavirus patients hospitalized in 14 states. It indicated that despite making up 18 percent of those studied, black people accounted for a third of all severe cases.

At the daily White House press briefing the day before, President Trump, apparently aware of the C.D.C. numbers that were about to be released, asked Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, who has served under six American presidents and is the most visible member of the White House coronavirus-response team, to address Covid-19 among black Americans. Dr. Fauci highlighted the underlying health conditions that are more common among black Americans and that raise the risk of death from Covid-19. Were very concerned about that, he said. Its very sad. Theres nothing we can do about it right now, except to try and give them the best possible care to avoid those complications.

Trump then referred to the racial statistics as very nasty numbers. Terrible numbers. As the news conference went on, the president expressed confusion about the disproportionate rates of infection. Why is it that the African-American community is so much, you know, numerous times more than everybody else? he asked.

Fifty years after the legislative and societal advances of the civil rights movement, America remains deeply segregated. Black people are more likely than white people to live in communities with high rates of poverty, where physical and social structures are crumbling, where opportunity is low and unemployment high. Even educated, affluent black people live in poorer neighborhoods, on average, than white people with working-class incomes.

The conditions in the social and physical environment where people live, work, attend school, play and pray have an outsize influence on health outcomes. Those in the public-health field call these conditions social determinants of health. Living in safe communities with adequate education and health care services, outdoor space, clean air and water, public transportation and affordable healthful food all contribute to lower rates of disease and longer, healthier lives. Living where the streets are unsafe and the air and water are polluted, where adequate health care facilities and outdoor space are lacking and where a dearth of healthful and affordable food creates a desert all leads to poorer health outcomes.

As scientists and policymakers have known since the 1980s, black and poor communities shoulder a disproportionate burden of the nations pollution. Covid-19 typically attacks the lungs and is especially dangerous to those with existing respiratory conditions, and a paper released on April 5 by researchers at the Harvard T.H. Chan School of Public Health found that a majority of the conditions that increase the risk of death from Covid-19 are also affected by long-term exposure to air pollution. After analyzing over 3,000 U.S. counties, the researchers concluded that even a small increase in exposure to fine particulate matter tiny particles in the air leads to a significant increase in the Covid-19 death rate. Less than two weeks after the report was released, the Trump administration declined to impose stricter controls on the lung-corroding industrial matter that the Harvard researchers underlined as hazardous.

New Orleans is at the southeastern end of what has been called Cancer Alley, the 85-mile stretch of the Mississippi known for its concentration of polluting petrochemical manufacturers. As soon as I heard about Covid, I started getting nervous about the relationship between PM 2.5 and this virus, says Beverly Wright, the founder and executive director of the Deep South Center for Environmental Justice in New Orleans. PM 2.5 refers to the width of the airborne particles: 2.5 micrometers or less, a small fraction of the width of a human hair. We have long known that emissions coming from these facilities are very dangerous to the health of people who live nearby, and it is black people who live the closest. So Im getting tired of being told our Covid death rates are only because were obese or have diabetes or are eating badly, without any regard to the systematic harm pollution has caused us.

The accumulated effects of environmental inequality are compounded by the physiological ramifications of an atmosphere of bias and discrimination, which have been documented to lead to higher rates of poor health outcomes for black Americans. Dr. Arline Geronimus, a professor at the University of Michigan School of Public Health, termed this phenomenon weathering. The landmark research she and her colleagues published in 2006 pointed to early health deterioration, caused by stress that required high-effort coping, evident across multiple biological systems even when adjusted for poverty. The authors concluded that the lived experience of being black exacted a physical price on the bodies of African-Americans. Dr. Camara Phyllis Jones, a physician and epidemiologist and a former president of the American Public Health Association, describes this effect as accelerated aging. We have evidence that the wear and tear of racism, the stress of it, is responsible for the differences in health outcomes in the black population compared to the white population, Dr. Jones says. In a 2019 study comparing 71 individuals, 48 of them black, a team of U.C.L.A. scientists found evidence that racist experiences may lead to increased inflammation in black Americans, heightening the risk of serious illness including heart disease. In the study, published in the journal Psychoneuroendocrinology, the scientists compared participants with similar socioeconomic backgrounds to rule out poverty as a determining factor in the changes in inflammation.

The societal discrimination that harms the bodies of those on the receiving end is also present in the health care system itself. In 2003, the National Academy of Sciences documented the effects of bias in the medical system in a report that laid out the facts in damning detail. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care examined 480 previous studies and found that in every medical intervention, black people and other people of color received poorer-quality care than white people, even when income and insurance were equal. This unequal treatment in the health care system persists today in numerous studies showing that black patients receive inadequate pain management for a variety of illnesses, surgeries and other medical procedures, both in the emergency room and in other settings, compared with people of other races. New York Citys health department is among a number of health departments and medical facilities around the country that have acknowledged the problem by mandating anti-racism training for their employees. During the current pandemic, health care providers are putting themselves in the line of fire to save lives, but they are working within a flawed system. Research on implicit bias shows its more likely to operate when people are working under time pressure, explains Dr. David Williams, chairman of the department of social and behavioral sciences at Harvards T.H. Chan School. Dr. Williams suggests that this kind of pressure could be worsened by long shifts, fatigue, the need to make quick judgments and even a shortage of protective gear and ventilators. All of those are factors that are more likely to make health care providers go into autopilot, he says. And when they do, they are more likely to rely on the shorthand social categorization to navigate their decisions. So I worry about what it means in terms of the life-or-death decisions in the context of coronavirus.

Dr. Clyde W. Yancy, chief of cardiology in the department of medicine at Northwesterns Feinberg School of Medicine, has studied racial health inequities for most of his career. As a black man and a native of the Baton Rouge area who grew up during segregation, he also understands them on a personal level. These disparities are real, they are deep and they are exacting a terrible price, says Dr. Yancy, who wrote an article pulling together research about the connection between black Americans and Covid-19, published online in The Journal of the American Medical Association on April 15. If there ever was a moment to have a rallying cry, to have a call to action, to have a wake-up call, there should be a moment of epiphany right now. And that epiphany should be: This is not the way a civil society allows its population to exist.

About 10 days after the end of Mardi Gras, Dickey Charles told his wife, Nicole, that he wasnt feeling well. Charles, a courier for GE Healthcare, rose most days around 2 a.m. to work an early route driving a van to deliver medical supplies to hospitals and clinics. His second shift, as a supervisor at the New Orleans Recreation Development Commission and the baseball, football and girls basketball coach at Lusher Charter School, left him little time for rest. Adding the annual whirlwind of Zulu Carnival activities was taxing for Charles, though he rarely let on. He was an easygoing, humble mountain of a man and father of two grown daughters. At six feet and 260 pounds, he carried his weight well. But he also had a number of health conditions: hypertension, diabetes and kidney disease. His wife, who worked as a medical administrator, kept a watchful eye on him but also says he tried to take good care of himself. He had been fighting those things for 20 years, says Nicole Charles, who added that her husband took three different blood-pressure medications, two kinds of insulin and another medication for his kidneys. He was very good with taking his medications. I didnt have to fight him, never had to fuss.

Burnell Scales Sr., Nicoles father, who goes by Slim, knew something was wrong on Sunday, March 8, when he showed up at the Charleses home in Uptown Carrollton, expecting to see his son-in-law stirring a giant pot of gumbo or red beans or heaping shrimp, crawfish and crabs onto plates for the procession of friends, family and Zulu members who came by every week after church for an open-door hangout and to watch Saints games during football season. I came in thinking hed be handing me a plate of something he was cooking up, but he wasnt in the kitchen like usual, says Scales, who joined the Zulus decades ago and introduced his son-in-law to the group in 2004. He was in bed. Thats when I started to worry a little.

On March 12, it was clear to Nicole that Charles still didnt feel well. His fever had been up and down, spiking close to 102. She stayed close to him, administering fluids and Tylenol, assuming he had the flu. That day, after it proved difficult to get a fast appointment with his primary-care doctor, she insisted that he go to urgent care, where he was tested for the flu. When the test was negative, he was sent home with no mention of Covid-19.

Nicoles anxiety rose the following day when he completely lost his appetite. My husband is a big man, and food was definitely something he loved, she says. She also worried that he needed to eat something because he couldnt take medications to control his blood pressure, diabetes and kidney problems on an empty stomach. Even if he was sick, he would still eat, but I couldnt even get him to eat soup.

That Friday, Nicole says, she told him, Baby, were going to the hospital. Of course, that was an argument, she says, because hes a man. They agreed to go the next day. I said to him, Youre going, because you dont have a choice.

The next day, Saturday, March 14, her husband told her he felt weaker, and Nicole took him to the emergency room. Security was high at the hospital as the growing coronavirus cases had begun to grip the city: That day, the Louisiana Department of Health reported 77 cases of the virus, 53 of them in Orleans Parish, and the first death. It was like Fort Knox, Nicole recalls. They directed me to one area so I could register him and took him off to another where I couldnt go. And of course you had to put on a mask; they gave everybody one.

In the E.R., Charles was again tested for the flu, and again the test was negative. But Nicole says no one suggested a Covid-19 test at that time. By that evening, Charles was lying in a hospital bed, attached to IV fluids. It just all happened so fast, says Nicole, her voice catching. It was like zero to 100.

In the late 19th century, W.E.B. Du Bois, the eminent black sociologist and author, conducted research to better understand the diseases that contributed to high rates of mortality in black communities. Du Bois and his team did extensive shoe-leather fieldwork that he would turn into his 1899 opus, The Philadelphia Negro, canvassing neighborhoods and interviewing residents in 2,500 households. He also used census data to document the distribution of health status. Unlike most experts at the time, who blamed racial inferiority and genetic flaws for health inequities, Du Bois highlighted the social conditions they studiously ignored. In a later work, The Health and Physique of the Negro American, Du Bois wrote: With the improved sanitary condition, improved education and better economic opportunities, the mortality of the race may and probably will steadily decrease until it becomes normal. Du Bois was unsparing on the lack of empathy for the health and well-being of black Americans, who were still reeling and recovering from 250 years of enslavement and struggling through the reactionary years of Jim Crow. The most difficult social problem in the matter of Negro health is the peculiar attitude of the nation toward the well-being of the race, Du Bois wrote in The Philadelphia Negro. There were, he continued, few other cases in the history of civilized peoples where human suffering has been viewed with such peculiar indifference.

This peculiar indifference was infamously sanctioned by the federal government between 1932 and 1972, when the United States Public Health Service conducted a study on hundreds of black day laborers and sharecroppers in Alabama. The Tuskegee Study of Untreated Syphilis in the Negro Male examined the progression of untreated syphilis, under the assumption that the infection manifested differently in black people. The subjects were told they would receive treatment for what was described as bad blood, but they never did. Instead, they were poked and prodded while the illness was allowed to progress. Once the men died, doctors autopsied their bodies to compile data on the ravages of the disease. The effects of the Tuskegee syphilis study still reverberate in the form of distrust and sometimes avoidance of the health care system among black Americans. In our current moment, this medical distrust has shown up in the form of those conspiracy theories and low-information rumors about Covid-19 akin to the false theories and rumors that were also prevalent during the AIDS era that Dr. Benjamin-Robinson of the Louisiana Department of Health warned against and Idris Elba tried to dispel.

In 1985, nearly a century after Du Bois made his observations about racial health disparities, the U.S. Department of Health and Human Services released the Report of the Secretarys Task Force on Black and Minority Health, better known as the Heckler Report. This 239-page study marked the first time the federal government had comprehensively examined the health status of black people and other people of color and elevated the issue of health inequality into the national arena. Named for Secretary Margaret Heckler of H.H.S., the report estimated more than 18,000 excess deaths each year among black people because of heart disease and stroke, compared with the number of deaths that would occur if their health were on par with that of non-Hispanic white people. It also cited 8,100 excess deaths from cancer, 6,200 from infant mortality and 1,850 from diabetes. Heckler called this shameful inequality an affront both to our ideals and to the ongoing genius of American medicine.

But the Heckler Report recommended no new government funding to address the crisis. Instead, the report essentially advised black Americans to save themselves by improving their health through education, self-help and self-care. Dr. Edith Irby Jones, president of the National Medical Association, a black medical society, was one of many critics of the reports emphasis on merely health education and lifestyle changes. If black people would only behave, their health problems would be solved, she wrote in 1986 in the associations journal. The insidious conclusion was that black people, individually and collectively, were poor, irresponsible, careless, uneducated and making thoughtless choices that led to the health crisis in the first place. There was and remains little focus on the societal conditions that erode the health of black Americans, and little mention of discrimination and bias either inside or outside the health care system.

Surgeon General Jerome Adams echoed this trope when he recently implied that individual behavior was leading to higher deaths from Covid-19 among African-Americans. At a White House press briefing on Friday, April 10, he told communities of color to step up and help stop the spread so that we can protect those who are most vulnerable. Adams, who is black and has spoken openly of his own struggles with high blood pressure, asthma and pre-diabetes, nonetheless added that African-Americans and Latinos should avoid alcohol, tobacco and drugs. He went on: We need you to do this, if not for yourself, then for your abuela. Do it for your granddaddy. Do it for your big mama. Do it for your pop-pop.

Dr. Williams of Harvard cautions against such suggestions. Its important to recognize and to acknowledge that the higher death rates of African-Americans from the coronavirus are not linked to the individual decisions black people have made or their communities have made, he says. We are looking at societal policies, driven by institutional racism, that are producing the results that they were intended to produce.

Many of the same experts who had pushed to release coronavirus data by race also worried that racial disparities in infections, hospitalizations and deaths would be used against black people. And like clockwork, after cities with sizable populations of black people began to report large numbers of Covid-19 infections at the beginning of April and statistics showed disproportionate death rates for African-Americans, a counternarrative began to arise: The national, state and municipal shutdowns were too draconian; the coronavirus pandemic was not as much of a threat at least, not to all Americans as had been argued. A smattering of demonstrations broke out the week of April 13, as protesters gathered in a handful of states to push back against stay-at-home orders.

President Trump fanned the extremist flames on April 17 in a series of tweets that encouraged his supporters to flout state policies put in place to keep residents safe during the pandemic. LIBERATE MINNESOTA! Trump wrote. LIBERATE MICHIGAN! LIBERATE VIRGINIA, and save your great 2nd Amendment. It is under siege! The next day in Austin, Tex., at a You Cant Close America rally, hundreds of demonstrators, nearly all white, defied social-distancing guidelines by gathering on the steps of the Capitol. The protesters many without masks but outfitted with Trump hats and flags shouted Let us work and Fire Fauci. A woman wearing a Keep America Great cap waved a sign reading, My Life, My Death, My Choice, Personal Responsibility, and another protester held a hand-drawn poster that read, My Life! Not Yours!

Dr. Jones notes that even before the coronavirus struck, the country had veered toward an ominous distrust of legitimate science that spread down from the White House and into the streets. But the pandemic has intensified the peril of such thinking. These protesters dont understand that nobody is immune to this infectious disease that doesnt respect state borders, city borders, neighborhood borders, she says. We are not the land of the free and the home of the brave individually, but their individual actions have profound impacts on the collective. Were in a dangerous situation by letting ideology take priority over the health interest and well-being of the nation.

On Sunday, March 15, the day after he was admitted to the hospital, Dickey Charless oxygen levels had become unstable, with his fever spiking and breaking. Late that evening, a chest X-ray showed potential signs of pneumonia. Nicole, who had been sleeping on a pullout chair next to her husband in his room, said one of the doctors told her it was time for an honest conversation. They said, Your husband is much sicker than he looks,. she remembers. .His lungs will not be functioning much longer. We need to vent him. That day, her husband was finally tested for Covid-19.

Nicole was able to stay with Charles for the next three days, locked to his side. Attached to the ventilator, unable to speak, he looked surprisingly peaceful to her, even vital. She kept up a vigil of prayer, whispering I love you over and over. She streamed gospel music on Pandora on her phone, taking comfort in the song The Blood Still Works. Its still healing, she sang to him. There is power in the blood of Jesus, the blood still works. She had Charless phone with her and did her best to field an avalanche of calls from worried family members and Zulu brothers. I told them, Please keep him in prayer,. she says.

On Wednesday, March 18, while Nicole was in the midst of praying, Charles opened his eyes. I said to him: Baby, you opened your eyes for me! I love you so much,. she recalls. That was the last time I saw my husband with his eyes open. The next day, Nicole says, hospital administrators told her she could no longer visit her husband because of a shortage of personal protective equipment. Louisianas caseload had increased to 392 cases from 280 the day before. At a news conference, Governor Edwards announced that the states health care system could be overwhelmed in seven to 10 days on its current trajectory.

Five days later, on Tuesday, March 24, a team of hospital medical providers called Nicole. Charless blood pressure had dropped, and his kidneys had failed. They told her that he wasnt going to make it. They asked if she would like to see him in person or use FaceTime. She wanted to see him and asked if his two daughters could come too. The hospital ran through a series of questions to assess the daughters own exposure to the coronavirus, and then administrators allowed Bethaney, 24; LeTreion, 32; and Nicole to come to his room. Wearing gowns, gloves and masks, they prayed over his body and said goodbye. At 1:30, when Charles took his last breath, Nicole, his wife of nearly 30 years, was by his side. I told God, I love him; Im leaving him in your hands,. she says. I said, Please let him rest, let him go in peace.'

The following day, as Nicole was subsumed by staggering grief, she received a call that Charless Covid-19 test had come back positive. Since his death, she and LeTreion have tested negative for the virus. Bethaney and Nicoles father, Burnell Scales, have tested positive; Bethaney has remained asymptomatic, while Scales had mild symptoms and has since recovered.

The afternoon Charles died, Jay Banks was crushed to learn that two other friends had died as well. The same day, at a White House briefing, President Trump stated, There is tremendous hope as we look forward and we begin to see the light at the end of the tunnel. At a Fox News town hall, he said: I would love to have the country opened up and just raring to go by Easter. Since then, Reese, the Zulu clubs chaplain, has posted a heart-wrenching scroll of deaths on his Facebook page: the Zulu warriors who have received, he wrote, their wings. On March 26, Earl Henry Jr., 63, died. He was a Zulu member for nearly half his life. Three days later, Terry Sharpe Sr., 49, died. He drove a truck for a living and was a loyal member of Pilgrim Baptist Church. On March 31, Larry A. Hammond died. A retired postal worker, he was a member of the Omega Psi Phi fraternity and a veteran of the Air Force; he died in the local V.A. hospital. On the day of his death, Mayor Cantrell tweeted that he had been a vital part of our citys rebirth after Katrina, and a culture bearer in the truest sense. She included a picture of them smiling together. Hammond was wearing his Zulu jacket.

The Zulu Social Aid and Pleasure Club had its origins at the intersection of discrimination and death. After Emancipation, formerly enslaved Africans often could not afford to bury their dead. So they pooled their money by forming social-aid clubs to provide dignified, respectful funerals. But the coronavirus has broken the Zulu clubs 111-year tradition of sending off passing members with respect and grace. On April 3, fewer than a dozen people came to Zion Travelers First Baptist Church to say goodbye to Dickey Charles. They sat scattered throughout the pews in the chapel in observance of the guidelines Mayor Cantrell put into place on March 16 prohibiting gatherings of more than a few people. Nicole and her family managed to live-stream the service, and another 600 people watched from home. Elroy A. James, an assistant attorney general for Louisiana and the president of the Zulu club, tuned in, saddened that the organization wasnt able to celebrate its fallen brother in style. He deserved a second-line funeral, James says, referring to the New Orleans tradition of commemorating life with a spirited procession of pageantry, jazz and dance. Man, it would have been great.

As a boy and later a student at Southern University and the Tulane University School of Medicine, Dr. Clyde W. Yancy, the cardiologist at Northwestern, remembers being fascinated with the decorated coconuts, the sought-after prize of the Krewe of Zulu parade. Everybody, including me, wanted a gold Zulu coconut, he says. There was no status, no privilege, we were all just standing on the sidewalk, hoping we got lucky enough to catch the gold coconut.

He says this precious memory has been marred by the racial health disparities he has spent much of his career studying, the disparities that have come to define the American outbreak of Covid-19 and the harm this lethal combination has inflicted on the Zulu club. These men were doing something as seemingly harmless as socializing, as networking, and just because of that moment of fellowship to celebrate their heritage, theyre now dead? he says. That just made me pause. It makes you understand the pain, the hurt of this gap in health care outcomes as a function of race that have been with us for decades. Covid-19 has basically taken off the Band-Aid that was covering the wound, pointed out how deep it is and left us no other choice but to finally say: We get it, we see it.

The rest is here:

A Terrible Price: The Deadly Racial Disparities of Covid-19 in America - The New York Times