There was one new COVID-19 case reported today on the island of Maui, pushing Hawaiis COVID-19 case total to 652.

To date, 608 people (95.7%) have recovered including 110 in Maui County. There are currently 27 active cases in the state.

The breakdown by island includes the following:

The Hawaii State Department of Health reports that there were 608 individuals released from isolation; and 83 cases (13%) that have required hospitalization. A total of 591 patients (91%) were residents.

Maui Countys count increased by one from yesterday. Of the 120 cases in Maui County, at least 110 have been released from isolation, and 22 have required hospitalization.

To date, there have been 17 COVID-19 related deaths in Hawaii, including 11 on Oahu and 6 in Maui County. Lieutenant Governor Josh Green notes that Hawaii has the lowest mortality rate in the US at 1.2 deaths per 100,000.

*Positive cases include presumptive and confirmed cases, and Hawaii residents and non-residents; data are preliminary and subject to change. Note that CDC provides case counts according to states of residence.

Includes cases that meet isolation release criteria (Isolation should be maintained until at least 3 days (72 hours) after resolution of fever and myalgia without the use of antipyretics OR at least 10 days have passed since symptom onset, whichever is longer). (The cases that have died and one case that has left the jurisdiction have been removed from these counts).

One case is a Lnai resident whose exposure is on Maui Island and who will be remaining on Maui Island for the interim.

Maui County now has six COVID-19related deaths.

Maui Memorial Cluster: (Update 5.19.20)

The outbreak at Maui Memorial Medical Center in Kahului was considered closed as of May 19, 2020. The cluster of individuals linked to the Maui hospital outbreak totaled 52 including 38 health care workers and 14 patients who had tested positive, according to Maui Health. DOH officials say it appears the outbreak may have been driven by a single healthcare worker who was allowed to work while ill.

Other Highlights for Maui County:

Hawaii Governor David Ige on May 28 said that the 14-day travel quarantine will be extended for domestic and international travelers past June 30, but an official announcement will be made at a later date.Gov. Ige also mentioned that he and all four mayors have been working for the last three weeks to coordinate reopening of interisland travel and said they would make a decision within the next few days regarding plans on when to lift the interisland quarantine. In the meantime, Mayor Victorino has requested that the interisland travel quarantine be lifted on June 15.

An employee at the Maui Memorial Medical Center has been quarantined at home since the hospital learned of the individuals positive antibody detection on Friday, May 21. Asubsequent COVID swab test at the hospitals emergency department came back positive on Saturday, May 23. Hospital representatives say its too soon in the process to determine a source of the infection but have stated that the case is not related to the Maui Memorial Medical Center cluster of 52 individuals that was deemed closed on May 19.

Increased access to Haleakal National Park began on May 27. The public is now allowed in the Summit District from the park entrance to the summit at the 10,000 foot elevation between 9 a.m. and 5 p.m. Park entrance fees are temporarily waived. Sunrise and sunset viewing are not available at this time and the parks visitor center buildings, Kipahulu District, crater and backcountry areas remain closed. Commercial and special use permits also remain suspended.

Governor David Ige approved Maui Mayor Michael Victorinos request to reopen most businesses and services with modifications starting Monday, June 1, 2020. This includes clubhouses, dog parks, playgrounds and skate parks, all county parks and beach parks, select county pools, dine-in restaurant service, tattoo parlors, aestheticians, massage therapists and other personal services. Earlier openings included: hair and nail salons on May 25; and drive-in religious services on May 22; and certain retail shops at shopping malls in Maui Countyopened on May 11.

Governor David Ige signed his 8th supplementalemergency proclamation on May 18, effectively extending the eviction moratorium and extending the 14 day travel quarantine for both mainland and interisland travel through the end of June. The governor also unveiled his four step Roadmap to Recovery and Resilience Plan. He said the state is ready to move from Phase 1 of stabilization to Phase 2 of reopening and called the latest phase Act With Care.

The County of Maui started allowing passive recreation at beaches effective on Saturday, May 16. This is for a trial period only of two weeks (from May 16 to 30) and will be reassessed.

Also the 98th Maui Fair, which was scheduled to take place over four days in October, is cancelled for this year due to public health concerns. Organizers say the event was cancelled at the request of the County and will be held sometime next year.

On Tuesday, May 5, Governor David Ige unveiled details of his 7th Supplemental Proclamation, that allows for the next phase includes the reopening to include: non-food agriculture such as landscaping, floral and ornamental; astronomical observatories and support facilities; car washes; and pet grooming services. This also includes some retail operations.

On Monday, May 4, apatient on Maui who was diagnosed with COVID-19 over a month ago and had been on a ventilator, was greeted with a celebratory exit from hospital staff who lined the halls upon her departure.The single mom of three came into the Maui Memorial Medical Center 36 days prior and had a slow process to recovery, according to a hospital spokesperson. Also, Maui Health re-opened the Maui East unit as a medical surgical unit and it is no longer serving as a COVID-19 unit.

On Wednesday, April 29, Mayor Victorino identified a short list parks, golf courses andlocal businesses that quality for limited opening under the first phase of a reopening that began on May 1, 2020.

On Tuesday, April 28, local government leaders visited and toured the outside of Maui Memorial Medical Center in compliance with the hospitals COVID-19 no-visitor policy,and received an update from Maui Health on response efforts at the facility.

On Tuesday, April 28, officials confirmed thatan elderly Lnai womancontracted COVID-19 while she was hospitalized at the Maui Memorial Medical Center. The womaninitially tested negative for COVID-19, but a recent test came back positive. She will remain on Maui until she is healthy enough to return home to Lnai and she no longer poses a risk of transmitting the virus to others. The case is documented as a Maui Island case and there are still no confirmed positive cases on the island of Lnai.

Maui Health on Monday, April 27, confirmed that a Maui Medical Group hospitalist who provides care to patients at Maui Memorial Medical Center has tested positive for COVID-19. The provider was tested for COVID-19 two weeks prior by Maui Medical Group, was asymptomatic, and the results were negative. The provider then became symptomatic and self-quarantined at home. On Friday April 24, a repeat test was performed and on Sunday April 26, the results returned positive for COVID-19.

A joint statement was released on Wednesday evening, April 22, from Mayor Michael Victorino and Merrimans Kapalua restaurant confirming the location of the restaurant grouping from March, which consisted of three COVID-19 positive individuals and between 65 and 100 exposed contacts. Health officials say the grouping does not currently pose a significant risk to the community and refrained from labeling it a cluster.

Two individuals from the Ka Hale A Ke Ola Homeless Resource Center on Waiale Road in Wailuku on Maui were moved to a Department of Health quarantine facility after one of them tested positive for COVID-19. The other man who was awaiting test results has since received word that his test came back negative and he was released from quarantine. Monique Yamashita, Executive Director at the facility said 48 individuals including staff and guests were tested on April 24 during a mass testing event. She provided us with an update on May 1 saying all tests came back negative. Also the eight staff that had contact with the COVID-19 positive individual were back to work within a week after all tests came back negative. Yamashita said the facility is still being vigilant with the continued use of PPEs, washing hands and taking other precautions to protect staff and guests.

Update: (5.18.20) All Prior Cases of COVID-19 at Hale Makua are Now Negative: Two home health patients with Hale Makua Health Servicesand a nursing home resident from Hale Makua Kahuluiare now negative for COVID-19. The asymptomatic resident who had tested positive has sincereceived two consecutive test results showing they are negative for COVID-19. As for the home health cases, one client has been released from isolation andhad recovered in April;and the other client has recently received two negative COVID-19 tests so has been released from quarantine as well.

Maui Now learned that a mother who underwent a caesarean section delivery at the Maui Memorial Medical Center in April later tested positive for COVID-19. The source of infection at this time is unknown however, Maui Health noted that the hospital has never had an OB patient, provider or employee test positive for COVID-19. Employees in that department were tested in April, with all results returned as negative.

There was also a confirmed case of a physical therapy worker at the Kula Hospital who tested positive for COVID-19. A total of 16 individuals who received care were tested and so far, no positive cases have been reported as a result.

The Maui positive count included at least one resident of the rural community of Hna in East Maui and at leasttworesidents of Molokai.

See the article here:

One New COVID-19 Case on Maui Brings Hawaii Total to 652; 95.7% Recovered - Maui Now

Memorial Day weekend at Robert Moses State Park on Fire Island, N.Y. As the pandemic continues, Harvard's Dr. Ashish Jha says, mask wearing, social distancing and robust strategies of testing and contact tracing will be even more important. Jeenah Moon/Bloomberg via Getty Images hide caption

Memorial Day weekend at Robert Moses State Park on Fire Island, N.Y. As the pandemic continues, Harvard's Dr. Ashish Jha says, mask wearing, social distancing and robust strategies of testing and contact tracing will be even more important.

The bleak milestone the U.S. is about to hit 100,000 deaths from COVID-19 is far above the number of deaths seen from the pandemic in any other country.

So far, the impact of the coronavirus has been felt unevenly, striking certain cities and regions and particular segments of society much harder than others.

To get a sense of how that may change, and where in the course of the epidemic the U.S. is right now, NPR's Morning Edition host David Greene spoke Tuesday with Dr. Ashish Jha, director of the Harvard Global Health Institute and professor of health policy at the Harvard T.H. Chan School of Public Health.

Their conversation has been edited for length and clarity.

As you look at this number looming now, what are you reflecting on?

Well, a couple of things. First of all, it is a solemn moment to reflect on the idea that about 100,000 Americans have died mostly just in the last two months. The speed with which this has happened is really devastating. Of course, we've had very little opportunity to mourn all those losses because most of us have been shut down. And I've been thinking about where we go into the future and fall and reminding myself and others that we're early in this outbreak. We're not anywhere near done.

The U.S. ... has had more deaths than any country in the world. Do you think that the country is absorbing the significance of these numbers?

I think for a majority of Americans, this doesn't quite feel real because the deaths have been concentrated in [a] few places. Obviously, New York has been hit very hard, and some other places like Seattle, Chicago some of the big cities. And so people who don't live in those areas may not be absorbing it.

But the nature of this pandemic is that it starts and kind of accelerates in big cities, but then it moves out into the suburbs and into the rural areas. So, by the time we're done with this, I think every American will have felt it much more up close and personal. That's what I worry about that it shouldn't have to take that for people to really understand how tragic this is and how calamitous in many ways this is.

Q: We're coming out of Memorial Day weekend, and we saw many regulations relaxed in many parts of the country. As you were watching that, what are you predicting in terms of what we could see by the end of summer?

If you look at all of the models out there and most models have been relatively accurate a few of them have been too optimistic. But then, if you sort of look at the models of models the ones that really sort of combine it all and put it together and make projections the projections are that we're probably going to see 70,000 to 100,000 deaths between now and the end of the summer.

While the pace will slow down, because we are doing some amount of social distancing and testing is ramping up we're going to, unfortunately, see a lot more sickness and, unfortunately, a lot more deaths in the upcoming months.

Q: There's been talk of a seasonal aspect to this. Whatever happens over the summer, do we face even more deaths as we head later in the year?

Yes. I'm hoping that the models of the summer of an additional 70,000 to 100,000 deaths are too pessimistic. And they may be, because we may get a seasonal benefit because of the summer: People are outside more.

But the flip side of the seasonal benefit of the summer is what will almost surely be a pretty tough fall and winter with a surge of cases a wave that might be bigger than the wave we just went through. And we've got to prepare for that, because we can't be caught flat-footed the way we were this time around.

Q: What can we do to prepare? We're seeing so many states relax restrictions right now. Is it a matter of potentially putting those restrictions back in place where they need to be? Or are there other things we could be doing?

There are two things that I would say. First of all, people can't be locked down for the rest of this pandemic. I understand that people need to get out, and being outside is a good thing. But we have to maintain a certain amount of social distancing. I think mask wearing is really important.

The only other tool we have in our toolbox is a really robust testing, tracing, isolation program. You know, if you think about how it is that South Korea and Germany have been able to do much, much better? They have had a really aggressive testing, tracing, isolation program. We know that works. It allows us to kind of have more of our lives back without the number of deaths that we've suffered. So I really think that still remains and should remain one of our priority areas.

Q: The federal government's new strategic testing plan calls on states to take a lot of the responsibility for testing. ... Do you see that as the best approach?

I think this is a real missed opportunity and very unfortunate in many ways, because while states have a critical role to play, testing capacity and testing supply chains are national and international.

We don't want 50 states competing. We want a federal strategy that helps states. And I'm worried that we're just not getting that from the federal government.

Read this article:

Nearing 100000 COVID-19 Deaths, U.S. Is Still 'Early In This Outbreak' - NPR

If youre sick and dont have supplies, see if a friend can pick them up for you, or if a grocery store or bodega will deliver. (Tip well!) Either way, avoid contact: Whether its a friend or a delivery person, have the bag left outside your door, and dont open the door until the delivery person is gone.

Over-the-counter drugs may not be enough. In particular, the coughing and nausea caused by Covid-19 can be severe enough to warrant prescription medication.

For my husband and me, benzonatate (for the cough) and promethazine (for the nausea) were lifesavers. Some colleagues were prescribed codeine-based cough medicine or Zofran. If you feel you might need them, ask your doctor about medications sooner rather than later. Dont wait until youre doubled over coughing or cant keep anything down.

If you dont have a primary care doctor, some urgent care clinics offer virtual appointments, and some pharmacies offer prescription delivery.

Dry air can exacerbate some symptoms such as coughing and chest tightness. If you have a humidifier, use it. If not, a hot shower works.

Several readers reported that they felt better when they lay on their stomach. A woman in Britain whose partner was sick for several weeks told me that a particular breathing exercise helped him:

You take a deep breath, hold it for 5 seconds and release. Do that 5 times, then on the 6th time on the release, cough hard. Do that cycle twice, then lie on your front and take slightly deeper breaths for 10 minutes. Try to do it a couple of times a day.

In some cases, your doctor may also prescribe an albuterol inhaler to reduce your cough and ease your breathing.

As soon as you get sick, start a detailed log. Every time you take your temperature do it several times a day, at consistent times log it. Every time you take a pill, log it. Every time you eat or drink, log it. If one symptom resolves or a new one develops, log it.

Continue reading here:

How to Recover From Covid-19 at Home - The New York Times

President Alvarado,

Prime Minister Mottley,

Excellencies, dear colleagues and friends,

Since the beginning of the pandemic, science has been at the heart of WHOs efforts to suppress transmission and save lives.

Science is moving with incredible speed. Almost every day there is more news about research into vaccines, diagnostics and therapeutics.

But will all people benefit from these tools? Or will they become another reason people are left behind? These are the two most important questions.

A month ago, WHO and partners launched the ACT Accelerator, to speed up the development, production and equitable distribution of vaccines, diagnostics and therapeutics for COVID-19.

Today we are joining 35 countries and numerous partners to launch the COVID-19 Technology Access Pool, or C-TAP.

C-TAP was first proposed by His Excellency President Carlos Alvarado of Costa Rica, and Id like to thank His Excellency the President for his leadership and solidarity.

C-TAP is a sister initiative of the ACT Accelerator and offers concrete actions to achieve the objective of the ACT Accelerator, which is equitable access.

C-TAP has five priorities:

First, public disclosure of gene sequencing research;

Second, public disclosure of all clinical trial results;

Third, encouraging governments and research funders to include clauses in contracts with pharmaceutical companies about equitable distribution and publication of trial data;

Fourth, licensing treatments and vaccines to large and small producers;

And fifth, promoting open innovation models and technology transfer that increase local manufacturing and supply capacity.

Through C-TAP, we are inviting companies or governments that develop an effective therapeutic to contribute the patent to the Medicines Patent Pool, which would then sub-license the patent to generic manufacturers.

C-TAP is voluntary, and builds on the success of the Medicines Patent Pool in expanding access to treatments for HIV and hepatitis C.

WHO recognizes the important role that patents play in fuelling innovation.

But this is a time when people must take priority.

Tools to prevent, detect and treat COVID-19 are global public goods that must be accessible by all people.

Science is giving us solutions, but to make those solutions work for everyone, we need solidarity.

COVID-19 has highlighted the inequalities of our world. But its also offering us an opportunity to bridge those inequalities and build a fairer world a world in which health is not a privilege for the few, but a common good.

Now it gives me enormous pleasure to introduce His Excellency Carlos Alvarado, the President of Costa Rica.

Muchas gracias, Presidente Alvarado, mi hermano. Mucho gusto por su liderazgo.

Thank you. Muchas gracias.

Link:

WHO Director-General's opening remarks at the media briefing on COVID-19 - 29 May 2020 - World Health Organization

President Trump said Friday the U.S. would halt its funding of the World Health Organization and pull out of the agency, accusing it of protecting China as the coronavirus pandemic took off. The move has alarmed health experts, who say the decision will undermine efforts to improve the health of people around the world.

In an address in the Rose Garden, Trump said the WHO had not made reforms that he said would have helped the global health agency stop the coronavirus from spreading around the world.

We will be today terminating our relationship with the World Health Organization and redirecting those funds to other worldwide and deserving urgent global public health needs, Trump said. The world needs answers from China on the virus.

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Its not immediately clear whether the president can fully withdraw U.S. funding for the WHO without an act of Congress, which typically controls all federal government spending. Democratic lawmakers have argued that doing so would be illegal, and House Speaker Nancy Pelosi threatened last month that such a move would be swiftly challenged.

The United States has provided roughly 15% of the WHOs total funding over its current two-year budget period. A WHO spokesperson declined to comment Friday.

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Trumps announcement came the same day that the U.S. mission in Geneva met with Tedros Adhanom Ghebreyesus, the WHO director-general, about the countrys demands for WHO improvements. A source familiar with the meeting described it as constructive.

Some congressional Republicans have echoed Trumps attacks on the agency, but in a statement Friday, Sen. Lamar Alexander, the chair of the Senates health committee, said he disagreed with Trump.

Certainly there needs to be a good, hard look at mistakes the World Health Organization might have made in connection with coronavirus, but the time to do that is after the crisis has been dealt with, not in the middle of it, said Alexander (R-Tenn.). Withdrawing U.S. membership could, among other things, interfere with clinical trials that are essential to the development of vaccines, which citizens of the United States as well as others in the world need. And withdrawing could make it harder to work with other countries to stop viruses before they get to the United States.

Lawrence Gostin, the faculty director at Georgetowns ONeill Institute for National and Global Health Law, called Trumps decision a dangerous move.

Its making an earth-shattering decision in the middle of the greatest health crisis weve experienced literally out of pique and whim, without any deliberative process, Gostin said.

The WHO has repeatedly said it was committed to a review of its response, but after the pandemic had ebbed. Last month, Robert Redfield, the director of the Centers for Disease Control and Prevention, also said the postmortem on the pandemic should wait until the emergency was over.

But as the Trump administrations response to pandemic has come under greater scrutiny, with testing problems and a lack of coordination in deploying necessary supplies, Trump has sought to cast further blame on China and the WHO for failing to snuff out the spread when the virus was centered in China. During his remarks, Trump alleged, without evidence, that China pressured WHO to mislead the world about the virus.

The world is now suffering as a result of the malfeasance of the Chinese government, Trump said. Chinas coverup of the Wuhan virus allowed the disease to spread all over the world, instigating a global pandemic that has cost more than 100,000 American lives, and over a million lives worldwide. (That last claim is not true; globally, there have been about 360,000 confirmed deaths from Covid-19, the disease caused by the coronavirus.)

Trumps phrasing highlights the buildup of China-U.S. tensions amid the pandemic. After a Chinese government spokesman suggested, without evidence, that the U.S. Army first brought the novel coronavirus to Hubei province, Trump retaliated by using the terms Wuhan virus and Chinese virus words widely condemned as racist, and which coincided with a rash of racist incidents targeting Asian Americans.

Experts say that if the U.S. leaves the WHO, the influence of China will only grow.

Global health was our bipartisan moral leadership that had been preserved through this administration, said Amanda Glassman, executive vice president of the Center for Global Development. And right now that falls apart. Its really to me tragic that this one space that was really about our moral leadership and our convictions and soft power that were now going to let that go in the midst of a pandemic.

Glassman said there are thousands of U.S. employees at the WHO and its regional body for the Americas, and that the U.S. is home to 82 WHO collaborating centers.

When Trump earlier this month threatened to yank U.S. funding in a letter, Tedros would only say during a media briefing that the agency was reviewing it. But he and other officials stressed that the agency had a small budget about $2.3 billion every year relative to the impact the agency had and what it was expected to do.

Mike Ryan, head of the WHOs emergencies program, said the U.S. funding provided the largest proportion of that programs budget. In addition to the pandemic, the program also works to combat HIV, tuberculosis, polio, and other diseases.

So my concerns today are both for our program and working on how we improve our funding base for WHOs core budget, Ryan said. Replacing those life-saving funds for front-line health services to some of the most difficult places in the world well obviously have to work with other partners to ensure those funds can still flow. So this is going to have major implications for delivering essential health services to some of the most vulnerable people in the world and we trust that other donors will if necessary step in to fill that gap.

This story has been updated with reaction to the presidents announcement.

Lev Facher contributed reporting.

Read the rest here:

Trump: US will terminate relationship with WHO amid Covid-19 pandemic - STAT

The coronavirus has killed so many people in Iran that the country has resorted to mass burials, but in neighboring Iraq, the body count is fewer than 100.

The Dominican Republic has reported nearly 7,600 cases of the virus. Just across the border, Haiti has recorded about 85.

In Indonesia, thousands are believed to have died of the coronavirus. In nearby Malaysia, a strict lockdown has kept fatalities to about 100.

The coronavirus has touched almost every country on earth, but its impact has seemed capricious. Global metropolises like New York, Paris and London have been devastated, while teeming cities like Bangkok, Baghdad, New Delhi and Lagos have, so far, largely been spared.

The question of why the virus has overwhelmed some places and left others relatively untouched is a puzzle that has spawned numerous theories and speculations but no definitive answers. That knowledge could have profound implications for how countries respond to the virus, for determining who is at risk and for knowing when its safe to go out again.

There are already hundreds of studies underway around the world looking into how demographics, pre-existing conditions and genetics might affect the wide variation in impact.

Doctors in Saudi Arabia are studying whether genetic differences may help explain varying levels of severity in Covid-19 cases among Saudi Arabs, while scientists in Brazil are looking into the relationship between genetics and Covid-19 complications. Teams in multiple countries are studying if common hypertension medications might worsen the diseases severity and whether a particular tuberculosis vaccine might do the opposite.

Many developing nations with hot climates and young populations have escaped the worst, suggesting that temperature and demographics could be factors. But countries like Peru, Indonesia and Brazil, tropical countries in the throes of growing epidemics, throw cold water on that idea.

Draconian social-distancing and early lockdown measures have clearly been effective, but Myanmar and Cambodia did neither and have reported few cases.

One theory that is unproven but impossible to refute: maybe the virus just hasnt gotten to those countries yet. Russia and Turkey appeared to be fine until, suddenly, they were not.

Time may still prove the greatest equalizer: The Spanish flu that broke out in the United States in 1918 seemed to die down during the summer only to come roaring back with a deadlier strain in the fall, and a third wave the following year. It eventually reached far-flung places like islands in Alaska and the South Pacific and infected a third of the worlds population.

We are really early in this disease, said Dr. Ashish Jha, the director of the Harvard Global Health Research Institute. If this were a baseball game, it would be the second inning and theres no reason to think that by the ninth inning the rest of the world that looks now like it hasnt been affected wont become like other places.

Doctors who study infectious diseases around the world say they do not have enough data yet to get a full epidemiological picture, and that gaps in information in many countries make it dangerous to draw conclusions. Testing is woeful in many places, leading to vast underestimates of the viruss progress, and deaths are almost certainly undercounted.

Still, the broad patterns are clear. Even in places with abysmal record-keeping and broken health systems, mass burials or hospitals turning away sick people by the thousands would be hard to miss, and a number of places are just not seeing them at least not yet.

Interviews with more than two dozen infectious disease experts, health officials, epidemiologists and academics around the globe suggest four main factors that could help explain where the virus thrives and where it doesnt: demographics, culture, environment and the speed of government responses.

Each possible explanation comes with considerable caveats and confounding counter-evidence. If an aging population is the most vulnerable, for instance, Japan should be at the top of the list. It is far from it. Nonetheless these are the factors that experts find the most persuasive.

Many countries that have escaped mass epidemics have relatively younger populations.

Young people are more likely to contract mild or asymptomatic cases that are less transmissible to others, said Robert Bollinger, a professor of infectious diseases at the Johns Hopkins School of Medicine. And they are less likely to have certain health problems that can make Covid-19, the disease caused by the coronavirus, particularly deadly, according to the World Health Organization.

Africa with about 45,000 reported cases, a tiny fraction of its 1.3 billion people is the worlds youngest continent, with more than 60 percent of its population under age 25. In Thailand and Najaf, Iraq, local health officials found that the 20-to-29 age group had the highest rate of infection but often showed few symptoms.

By contrast, the national median age in Italy, one of the hardest hit countries, is more than 45. The average age of those who died of Covid-19 there was around 80.

Younger people tend to have stronger immune systems, which can result in milder symptoms, said Josip Car, an expert in population and global health at Nanyang Technological University in Singapore.

In Singapore and Saudi Arabia, for instance, most of the infections are among foreign migrant workers, many of them living in cramped dormitories. However, many of those workers are young and fit, and have not required hospitalization.

Along with youth, relative good health can lessen the impact of the virus among those who are infected, while certain pre-existing conditions notably hypertension, diabetes and obesity can worsen the severity, researchers in the United States say.

There are notable exceptions to the demographic theory. Japan, with the worlds oldest average population, has recorded fewer than 520 deaths, although its caseload has risen with increased testing.

The Guayas region of Ecuador, the epicenter of an outbreak that may have claimed up to 7,000 lives, is one of the youngest in the country, with only 11 percent of its residents over 60 years old.

And Dr. Jha of Harvard warns that some young people who are not showing symptoms are also highly contagious for reasons that are not well understood.

Cultural factors, like the social distancing that is built into certain societies, may give some countries more protection, epidemiologists said.

In Thailand and India, where virus numbers are relatively low, people greet each other at a distance, with palms joined together as in prayer. In Japan and South Korea, people bow, and long before the coronavirus arrived, they tended to wear face masks when feeling unwell.

In much of the developing world, the custom of caring for the elderly at home leads to fewer nursing homes, which have been tinder for tragic outbreaks in the West.

However, there are notable exceptions to the cultural distancing theory. In many parts of the Middle East, such as Iraq and the Persian Gulf countries, men often embrace or shake hands on meeting, yet most are not getting sick.

What might be called national distancing has also proven advantageous. Countries that are relatively isolated have reaped health benefits from their seclusion.

Far-flung nations, such as some in the South Pacific and parts of sub-Saharan Africa, have not been as inundated with visitors bringing the virus with them. Health experts in Africa cite limited travel from abroad as perhaps the main reason for the continents relatively low infection rate.

Countries that are less accessible for political reasons, like Venezuela, or because of conflict, like Syria and Libya, have also been somewhat shielded by the lack of travelers, as have countries like Lebanon and Iraq, which have endured widespread protests in recent months.

The lack of public transportation in developing countries may have also reduced the spread of the virus there.

The geography of the outbreak which spread rapidly during the winter in temperate zone countries like Italy and the United States and was virtually unseen in warmer countries such as Chad or Guyana seemed to suggest that the virus did not take well to heat. Other coronaviruses, such as ones that cause the common cold, are less contagious in warmer, moist climates.

But researchers say the idea that hot weather alone can repel the virus is wishful thinking.

Some of the worst outbreaks in the developing world have been in places like the Amazonas region of Brazil, as tropical a place as any.

The best guess is that summer conditions will help but are unlikely by themselves to lead to significant slowing of growth or to a decline in cases, said Marc Lipsitch, the director of the Center for Communicable Disease Dynamics at Harvard University.

The virus that causes Covid-19 appears to be so contagious as to mitigate any beneficial effect of heat and humidity, said Dr. Raul Rabadan, a computational biologist at Columbia University.

But other aspects of warm climates, like people spending more time outside, could help.

People living indoors within enclosed environments may promote virus recirculation, increasing the chance of contracting the disease, said Mr. Car of Nanyang Technological University.

The ultraviolet rays of direct sunlight inhibit the growth of this coronavirus, according to a study by ecological modelers at the University of Connecticut. So surfaces in sunny places may be less likely to remain contaminated, but transmission usually occurs through contact with an infected person, not by touching a surface.

No scientist has proposed that beaming light inside an infected person, as President Trump suggested, would be an effective cure. And tropical conditions may have even lulled some people into a false sense of security.

People were saying Its hot here, nothing will happen to me, said Dr. Domnica Cevallos, a medical investigator in Ecuador. Some were even going out on purpose to sunbathe, thinking it would protect them from infection.

Countries that locked down early, like Vietnam and Greece, have been able to avoid out-of-control contagions, evidence of the power of strict social distancing and quarantines to contain the virus.

In Africa, countries with bitter experience with killers like H.I.V., drug-resistant tuberculosis and Ebola knew the drill and reacted quickly.

Airport staff from Sierra Leone to Uganda were taking temperatures (since found to be a less effective measure) and contact details and wearing masks long before their counterparts in the United States and Europe took such precautions.

Senegal and Rwanda closed their borders and announced curfews when they still had very few cases. Health ministries began contact tracing early.

All this happened in a region where health ministries had come to rely on money, personnel and supplies from foreign donors, many of which had to turn their attention to outbreaks in their own countries, said Catherine Kyobutungi, executive director of the African Population and Health Research Center.

Countries wake up one day and theyre like, OK, the weight of the country rests on our shoulders, so we need to step up, she said. And they have. Some of the responses have been beautiful to behold, honestly.

Sierra Leone repurposed disease-tracking protocols that had been established in the wake of the Ebola outbreak in 2014, in which almost 4,000 people died there. The government set up emergency operations centers in every district and recruited 14,000 community health workers, 1,500 of whom are being trained as contact tracers, even though Sierra Leone has only about 155 confirmed cases.

It is not clear, however, who will pay for their salaries or for expenses like motorcycles and raincoats to keep them operating during the coming wet season.

Uganda, which also suffered during the Ebola contagion, quickly quarantined travelers from Dubai after the first case of coronavirus arrived from there. Authorities also tracked down about 800 others who had traveled from Dubai in previous weeks.

The Ugandan health authorities are also testing around 1,000 truck drivers a day. But many of those who test positive have come from Tanzania and Kenya, countries that are not monitoring as aggressively, leading to worries that the virus will keep penetrating porous borders.

Lockdowns, with bans on religious conclaves and spectator sporting events, clearly work, the World Health Organization says. More than a month after closing national borders, schools and most businesses, countries from Thailand to Jordan have seen new infections drop.

In the Middle East, the widespread shuttering of mosques, shrines and churches happened relatively early and probably helped stem the spread in many countries.

A notable exception was Iran, which did not close some of its largest shrines until March 18, a full month after it registered its first case in the pilgrimage city of Qum. The epidemic spread quickly from there, killing thousands in the country and spreading the virus across borders as pilgrims returned home.

As effective as lockdowns are, in countries lacking a strong social safety net and those where most people work in the informal economy, orders closing businesses and requiring people to shelter in place will be difficult to maintain for long. When people are forced to choose between social distancing and feeding their families, they are choosing the latter.

Counter-intuitively, some countries where authorities reacted late and with spotty enforcement of lockdowns appear to have been spared. Cambodia and Laos both had brief spates of infections when few social distancing measures were in place but neither has recorded a new case in about three weeks.

Lebanon, whose Muslim and Christian citizens often go on pilgrimages respectively to Iran and Italy, places rife with the virus, should have had high numbers of infections. It has not.

We just didnt see what we were expecting, said Dr. Roy Nasnas, an infectious disease consultant at the University Hospital Geitaoui in Beirut. We dont know why.

Finally, most experts agree that there may be no single reason for some countries to be hit and others missed. The answer is likely to be some combination of the above factors, as well as one other mentioned by researchers: sheer luck.

Countries with the same culture and climate could have vastly different outcomes if one infected person attends a crowded social occasion, turning it into what researchers call a super-spreader event.

That happened when a passenger infected 634 people on the Diamond Princess cruise ship off the coast of Japan, when an infected guest attended a large funeral in Albany, Ga., and when a 61-year-old woman went to church in Daegu, South Korea, spreading the disease to hundreds of congregants and then to thousands of other Koreans.

Because an infected person may not experience symptoms for a week or more, if at all, the disease spreads under the radar, exponentially and seemingly at random. Had the woman in Daegu stayed home that Sunday in February, the outbreak in South Korea might have been less than half of what it is.

Some countries that should have been inundated are not, leaving researchers scratching their heads.

Thailand reported the first confirmed case of coronavirus outside of China in mid-January, from a traveler from Wuhan, the Chinese city where the pandemic is thought to have begun. In those critical weeks, Thailand continued to welcome an influx of Chinese visitors. For some reason, these tourists did not set off exponential local transmission.

And when countries do all the wrong things and still end up seemingly not as battered by the virus as one would expect, go figure.

In Indonesia, we have a health minister who believes you can pray away Covid, and we have too little testing, said Dr. Pandu Riono, an infectious disease specialist at the University of Indonesia. But we are lucky we have so many islands in our country that limit travel and maybe infection.

Theres nothing else were doing right, he added.

Original post:

The Covid-19 Riddle: Why Does the Virus Wallop Some Places and Spare Others? - The New York Times

SARS-CoV-2, the virus that causes Covid-19. (Port City Daily photo illustration/Courtesy CDC)

WILMINGTON The last two weeks saw some light at the end of the tunnel, with some local restrictions lifted and hope for a phased state-wide reopening. Still, tensions continue to mount over how and when to fully reopen businesses and public spaces.

What follows is a snapshot that, at least for the time being, covers some of the major moving parts of the Covid-19 situation: the states new metrics for reopening, restrictions and resistance to those restrictions, and what the future beyond reopening in the next months might hold.

If youre looking for resources, you can find some useful ones here:Covid-19 resource roundup: Wilmington-area small businesses, childcare, health, info [Free read]. If youre looking for whats still open, you can find a directory of local businesseshere.

Of course, its hard to recap the whole week, so you can find all of Port City Dailysfree reporting on Covid-19 here.We also encourage you to send comments, questions, and concerns to info@portcitydaily.com.

Late last month, Governor Roy Cooper announced the state was looking at a three-phase reopening plan, beginning as soon as May 8 (when the current stay-at-home order expires). The plan looks to four variables to decide when to move ahead into each new phase: (1) number of Covid-like cases, (2) positive laboratory tests, (3) percentage of total tests that come back positive, and (4) hospitalization.

Take a deep dive into the place with our podcast, here.

Its important to note that these variable go beyond just the number of new cases. While some news outlets continue to announce daily increases, at least some of those dramatic efforts to ramp up testing meaning those with minor symptoms, not just serious respiratory issues, are getting counted now. As Dr. Mandy Cohen, secretary of the North Carolina Department of Health and Human Services, put it, the more you test, the more cases youll find.

So where are things right now? Unfortunately, several of the metrics continue to trend slightly upward, including the number of hospitalizations (at any given time) in the graph above.

Below, graphics based on data from NCDHHS on Covid-like cases, testing, and positive tests.

Cases with symptoms similar to Covid-19 Mild COVID-19 illness presents with symptoms similar to influenza-like illness, so surveillance systems that have historically been used during influenza seasons are being used to track trends of mild COVID-19 illness and allow for comparison with prior influenza seasons. It also includes influenza, allowing the state to determine the level of Covid-19 cases above and beyond typical levels of flu cases, according to NCDHHS.

Laboratory-confirmed cases Unfortunately, it doesnt yet look like the case numbers are leveling off, let alone decreasing. However, thats not the whole story (see percentage of tests, below).

Percentage of tests that come back positive Because of increased testing supplies and aggressive efforts to implement those tests, a wider portion of the population is being tested. That means, to some extent, increased numbers of cases arent necessarily new cases as much as they are previously undocumented ones. In other words, its just a better picture of whats out there.

To that end, the percentage of tests that come back positive rather than just the total number of positives is the more important data figure. And, in that department, the percentage of positive cases do appear to be leveling and even decreasing.

This week, New Hanover County allowed its restrictions (which went beyond Governor Coopers executive orders) to lapse, leaving it up to beach towns and Wilmington whether or not to keep stricter rules.

Beach towns including Wrightsville Beach and Carolina Beach have opened access points and allowed limited activities, mostly mobile exercise (i.e. running is ok, yoga is not) and requiring social distancing. While the mayors of those towns have said relaxed rules could be put back in place, theres also hope for additional restrictions to be lifted. (For example, on Friday, Carolina Beach announced it would allow fishing from the public beach strand starting Monday).

Its worth noting that some of the moves including the selective reopening of fishing piers in Wrightsville Beach and Kure Beach seem to pose some serious state constitutional issues.

Wilmington continued its State of Emergency (and will formally approve it on Tuesday), maintaining six of the nine additional restrictions initially imposed by the county in April. These include the closure of short-term rentals, motels, and hotels (except were in accordance with government efforts to provide emergency lodging and resource management). It also includes keeping public playgrounds and sports facilities (except golf, tennis, and pickleball) closed.

The updated state of emergency does allow for take-out food from restaurants, relaxing the curbside-only policy put in place in March.

Additionally, auto sales are allowed after considerable back-and-forth between the local dealers (backed by the statewide dealership lobby) and local leaders.

Much of the states plan for reopening is based on the best and latest data available but theres a great deal of uncertainty. It remains unclear what the diseases actual mortality rate is, how widespread it actually is right now, and perhaps most importantly whether or not those who get the disease develop lasting immunity (or any immunity at all).

Immunity is a spectrum, after all. With some viruses like Chickenpox humans develop lifelong immunity. With others like HIV theres nearly no protection at all. It remains unclear where SARS-CoV-2 lies on the spectrum (for a good overview,check out Scientific Americans article on the issue).

This uncertainty has led to speculation about whether there will be a second wave of Covid-19 in the fall of 2020. And, while recent polling by Meredith College indicated that three out of four North Carolinians supported Governor Coopers restrictions, its worth considering how many would be willing to go through another round of lock-downs and closures after just a few months.

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Covid-19 recap: Benchmarks, restrictions, and round two? - Port City Daily

Amid Ongoing COVID-19 Pandemic, Governor Cuomo Announces Results of Completed Antibody Testing Study of 15,000 People Showing 12.3 Percent of Population Has COVID-19 Antibodies | Governor Andrew M. Cuomo Skip to main content

State Will Distribute Over7 Million More Cloth Masks to Vulnerable New Yorkers and Frontline Workers Across the State

State is Distributing $25 Million to Food Banks Across the State Through the Nourish New York Initiative

Confirms 4,663 Additional Coronavirus Cases in New York State - Bringing Statewide Total to 312,977; New Cases in 44 Counties

Amid the ongoing COVID-19 pandemic, Governor Andrew M. Cuomo today announced the results of the state's completed antibody testing study, showing 12.3 percent of the population have COVID-19 antibodies. The survey developed a baseline infection rate by testing 15,000 peopleat grocery stores and community centers across the state over the past two weeks.Of those tested, 11.5% of women tested positive and 13.1% of men tested positive. A regional breakdown of the results is below:

Region

Percent Positive

Capital District

2.2%

Central NY

1.9%

Finger Lakes

2.6%

Hudson Valley(Without Westchester/Rockland)

3%

Long Island

11.4%

Mohawk Valley

2.7%

North Country

1.2%

NYC

19.9%

Southern Tier

2.4%

Westchester/Rockland

13.8%

Western NY

6%

Audio Photos

The Governor also announced that the state will distribute over seven million more cloth masks to vulnerable New Yorkers and essential workers across the state. The masks will be distributed as follows:

While we're in uncharted waters it doesn't mean we proceed blindly, and the results of the 15,000 people tested in our antibody survey program - thelargest survey in the nation - will inform our strategy moving forward

The Governor also announced the state is distributing $25 million to food banks across the state through the Nourish New York Initiative. The Nourish New York initiative, announced earlier this week by Governor Cuomo, is working to quickly reroute NewYork's surplus agricultural products to the populations who need them most through New York's network of food banks. Funding will be distributed as follows:

"While we're in uncharted waters it doesn't mean we proceed blindly, and the results of the 15,000 people tested in our antibody survey program - thelargest survey in the nation - will inform our strategy moving forward,"Governor Cuomo said."We're also going to undertake a full survey of antibody testing for transit workers, who have been on the front lines of this crisis. We've said thank you to our essential workers thousands of times but actions speak louder than words, and we want them to know that we're doing everything we can do to keep them safe."

Finally, the Governor confirmed 4,663 additional cases of novel coronavirus, bringing the statewide total to 312,977 confirmed cases in New York State. Of the 312,977 total individuals who tested positive for the virus, the geographic breakdown is as follows:

County

Total Positive

New Positive

Albany

1,238

34

Allegany

35

0

Broome

305

6

Cattaraugus

50

1

Cayuga

51

0

Chautauqua

35

0

Chemung

124

1

Chenango

99

0

Clinton

62

1

Columbia

205

3

Cortland

28

0

Delaware

61

0

Dutchess

3,049

47

Erie

3,598

117

Essex

28

0

Franklin

15

0

Fulton

79

4

Genesee

155

1

Greene

142

3

Hamilton

See the original post:

Amid Ongoing COVID-19 Pandemic, Governor Cuomo Announces Results of Completed Antibody Testing Study of 15000 People Showing 12.3 Percent of...

The Livingston County Department of Health reported five new positive cases of COVID-19 in Livingston County this morning.

The total number of positive cases the county has had is 80, with 34 of those cases active as of Saturday, according to the countys COVID-19 data tracking map.

The newest cases include a male in his 40s living in Mount Morris, a male in his 20s who resides in Mount Morris, a female in her 50s who resides in Geneseo, a male in his 70s who resides in Conesus, and a male infant living in North Dansville.

The individuals and any associated household members are now in the county Department of Health quarantine process, according to Jennifer Rodriguez, the countys public health director.

The county Department of Health has begun outreach to identify close contacts and potential exposure areas per prescribed New York State regulations, Rodriguez said.

The county has reported 33 new cases of COVID-19 in the past 13 days. The last day without a new case reported was April 18.

Rodriguez attributed the succession of positive cases to the increased testing the county has been able to conduct. More than 1,100 Livingston County residents have been tested for COVID-19, including nearly 50 on Friday. The results include 1,078 negative test results, and 80 positive tests.

COVID-19 testing is available for Livingston County residents at curbside testing locations in Dansville and Geneseo. The tests are to confirm the presence of the COVID-19 virus and are not an antibody test, which is a blood test that looks for antibodies that are created in your body after you have had COVID-19.

Individuals seeking a test will need to first call their primary care physician to get a requisition for a test. Individuals who do not have a healthcare provider, should call the Livingston County Department of Health at (585) 243-7270 to see if they meet the COVID-19 testing criteria.

Testing includes those with COVID-19 symptoms such as fever, cough or trouble breathing. Testing has also been expanded to include those who are considered essential healthcare workers and those without a fever, but having other respiratory ailments, or those who are vulnerable due to underlying health conditions.

COVID-19 testing in Livingston County has also been prioritized for individuals with or without symptoms who are employed as health care workers, first responders, or in any position within a nursing home, long-term care facility, or other congregate care setting.

Confirmed cases in Livingston County include 25 in Avon, including 13 at the Avon Nursing Home; 11 in Geneseo, 10 in Mount Morris, six in Nunda, five each in Caledonia, Livonia, North Dansville and York, four in Lima, three in Conesus, and one in Springwater.

The county has reported that 41 patients have recovered from the virus. These include eight each in Geneseo and Avon, five each in Mount Morris and Nunda, four in Livonia, three in North Dansville and York, two in Conesus, and one each in Caledonia, Lima and Springwater, according to the countys COVID-19 data tracking map.

The county has reported five deaths attributed to COVID-19.

The county updates its COVID-19 tracking map daily. To view it, click here.

If you have a fever, cough or trouble breathing, call your health care provider for an assessment of your symptoms.

If you feel as though you may have had exposure to COVID-19, call the county Department of Health at (585) 243-7270.

For general information on COVID-19 or to learn how to volunteer, call 1-877-280-6775.

Livingston County Mental Health has created a help line for community members who need someone to talk to during these stressful times. This is a free and confidential service. Call (585) 243-7251 Monday through Friday from 9 a.m. to 5 p.m.

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Livingston County COVID-19 cases at 80 with 5 new cases confirmed Saturday - The Livingston County News

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Gov. JB Pritzker says during a news conference Saturday in Chicago that the increased number of cases of COVID-19 in Illinois is directly a result of increased testing.

SPRINGFIELD Illinois COVID-19 confirmed case count grew by nearly 2,500 again Saturday as a sustained increase in testing continues to drive the number upward.

It really is a function of doing more testing, Gov. JB Pritzker said of the increased positive case count at his daily briefing on the virus Saturday.

There are now 58,505 confirmed cases in Illinois in 97 counties, including 2,559 deaths.

But the state reported another 15,208 test results, meaning about 16 percent of those resulted in positive cases. That number has gone down in recent weeks from a consistent appearance in the 20s to more frequently appearing in the teens. They had spiked, however, in the two days prior to Saturday.

There have been just less than 300,000 tests conducted in Illinois since the outbreak began, and the state has tested more than 10,000 residents daily for more than a week.

We're doing more and more testing, that is a very good thing, Pritzker said. It's a very good sign, because more testing leads us to be able to keep more people at home who may have come in contact with those people so that we can have fewer infections across the state rather than more.

There were also 105 more deaths related to the virus reported in the past 24 hours, and 4,717 COVID-19 patients were still hospitalized as of midnight Friday, according to Illinois Department of Public Health Director Dr. Ngozi Ezike. There were 1,250 COVID-19 patients in intensive care beds and 789 on ventilators as of midnight as well, according to IDPH.

More here:

Increased testing continues to push COVID-19 count higher - The Southern

In 2010, the moral philosopher Kwame Anthony Appiah made a list of practices that he believed people in the distant future will condemn our generation of humanity for, much as people in the 21st century almost universally condemn slavery or the denial of womens suffrage.

His four candidates were the American prison system, which cages about 2.3 million Americans at any given time; the exploitation of animals in factory farms; the abandonment of Americas elderly (and the elderly of many rich countries) in nursing homes; and environmental degradation.

My friend Avi Zenilman, a journalist turned nurse, sent me Appiahs piece a few weeks into the coronavirus pandemic, when Appiahs list started to read like a premonition. Excluding the environment climate change specifically, which has gotten a temporary respite as we do much less carbon emitting under quarantine Appiahs list doubles as a rundown of the most prominent and brutal vectors of Covid-19 in the US.

Coronavirus outbreaks have been reported at carceral facilities across the country, including pretrial detention centers like Rikers Island where most inmates have not yet been convicted of the offense with which theyre charged; one prison in Ohio reported that 78 percent of inmates tested positive. More humane states are releasing prisoners simply to avoid a medical catastrophe that feels inevitable if they stay caged.

The Tyson, Smithfield, and JBS meat production companies have shut down pork plants that collectively produce 15 percent of Americas pork due to coronavirus spread. Tysons CEO took out a full-page newspaper ad warning that the nations food supply is breaking down. Thats a ludicrous exaggeration (experts say the US isnt about to run out of food), but it is true that the factory farming industry is particularly vulnerable to Covid-19 and poses a pandemic risk generally.

Nursing homes for both older people and those with disabilities are likewise seeing widespread coronavirus outbreaks. The Washington Post analyzed news reports and state data releases and found that almost 1 in 10 nursing homes in the US have reported coronavirus cases. The Kaiser Family Foundation estimates that in the 23 states for which data exists, 27 percent of deaths from Covid-19 have occurred in nursing homes. In several states, like Massachusetts and Pennsylvania, most deaths have occurred in nursing homes.

Its not a coincidence that Covid-19 is foregrounding these institutions. This crisis has cast a spotlight on inequalities that have plagued American life for decades, and it is forcing us to look seriously at how we relate to one another. Social distancing has a way of clarifying social reality, and Americas social reality is one of haves and have-nots.

If I were more religious, I would say this feels like a biblical plague, a force beyond our control identifying our worst societal sins to get us to finally pay attention. But that would be incorrect, because in many ways the spread of this virus is within our control. That the coronavirus has ripped through the US via these vectors only underscores how complicit Americans have been in making ourselves more vulnerable to this disease.

What factory farms, prisons, and nursing homes have in common is that theyre warehousing efforts. They all involve placing people or animals into confined facilities where most of society doesnt have to think too hard about them anymore. They are institutions optimized for neglect.

Few people would likely be able to eat a Chicken McNugget if each order came with a photo of the tortured chickens who were killed to fulfill that order; but because that torture takes place behind closed doors, confined to a few big facilities in rural areas and staffed by invisible low-wage workers, people are free to forget about the actual chickens and the working conditions there and eat their nuggets in peace. Its no fluke that ag gag laws banning the dissemination of information about factory farms are one of the industrys main lobbying priorities. Big corporations know perfectly well what would happen if people actually paid attention.

Prisons enable governments to take people that civilian society doesnt want to deal with anymore and stash them out of sight so that average citizens can forget about them. That enables truly horrendous conditions. Groups of prisoners in Washington, DC, and Texas are so desperate that theyve sued for access to soap, cleaning supplies, and toilet paper amid the pandemic. On at least one unit, a closet full of cleaning supplies and clean rags is present, but residents are told they will be punished if they attempt to access or use those supplies to clean the unit, their own cells, or their hands and bodies, the DC lawsuit alleges.

These conditions are hardly new a one-ply-per day rationing of toilet paper and a ban on showering more than once a week were among the policies at Attica state prison in New York that sparked the 1971 prisoner takeover there. But this neglect is increasingly deadly in a pandemic.

Nursing homes are not necessarily an injustice, and there are plenty of valid reasons for families to place relatives there, or for residents to ask to be placed in homes. My family is no exception. But the same mechanisms through which nursing homes ease pressure on family caregivers make them places where widespread neglect is possible. Richard Mollot, an advocate for long-term care patients, notes that about one-third of Medicare beneficiaries admitted to nursing homes reported suffering some kind of harm within two weeks of entering the home.

These are the short-term residents for whom homes are paid the most and who are typically most able to articulate their concerns if something is wrong, Mollot writes. Where does that leave a majority of residents who are there long-term, most of whom are older, frail and cognitively impaired?

Warehousing leaves its victims vulnerable to Covid-19 through at least two mechanisms. First, it forces affected individuals into close proximity with one other including those maintaining the warehouse, like factory farm staff or prison guards or nursing home attendants. Its difficult to socially distance under those conditions.

But the second mechanism is subtler and arguably just as important. Warehousing fosters social inequality, and we know that social inequality kills.

Pandemics are times of scarcity. Tests are scarce, doctors and nurses are scarce, masks and gloves are scarce. And scarce goods tend to be distributed according to existing social inequalities, because those inequalities reflect varying levels of respect paid to various groups by governments, businesses, and other social decision-makers.

So it is with coronavirus. Its fairly well-known at this point that Covid-19 has disproportionately affected black Americans. Recent data from the Centers for Disease Control and Prevention suggests that out of Covid-19 patients for whom race is known, 30 percent are African American, more than double African Americans share of the overall population.

Unauthorized immigrants in detention, or working close-proximity jobs at farms and as delivery staff, or just existing in the US without access to most of the social safety net, are uniquely vulnerable too, and not just in the US but in many rich countries. Many report fear of seeking out health care because of the risk that their status will be uncovered.

We see the same inequalities with factory farms, nursing homes, and prisons. Incarcerated people, especially ones locked up for violent offenses, have long suffered from politicians, and the publics, conviction that their past deeds make them undeserving of help. Thats especially true now, with grave consequences for both them and their guards.

Nursing home patients are victims not just of density but of a broader societal disregard toward older people and those with disabilities. Texas Lt. Gov. Dan Patrick famously suggested that Americans 70-plus should be willing to die to get the economy back running again.

Meanwhile, the Covid-19 outbreaks at factory farms arent among their animals but among their staffers and the staffers at meatpacking facilities, who are disproportionately black, Latino, and/or immigrants. Warehousing hurts the people enlisted to do the warehousing, too. (And, it should be noted, even though the coronavirus didnt originate in a factory farm, factory farms are a pretty big pandemic risk if not this pandemic, it may well be the next one.)

None of this is an accident. Social inequality, as the political theorist Judith Shklar taught us, fosters cruelty. In unequal societies, where one group of individuals is privileged in power above others, that power differential creates the social estrangement necessary for the powerful to treat the less powerful with cruelty.

But social equality can remedy social cruelty. If such social distances create the climate for cruelty, then a greater equality might be a remedy, she wrote. Even Machiavelli had known that one cannot rule ones equals with cruelty, but only ones inferior subjects.

Covid-19 is not simply a natural disaster. It is a brutal reminder of the consequences of inequality Shklar identified. And it is a reminder that things can be different. The US can shrink its prisons. It can create housing laws, social supports, and other structures that enable older people to live with their families whenever possible. It can abolish factory farming, for both the animals and the workers sakes.

Pandemics are social phenomena, and addressing pandemics requires attacking social inequalities head-on.

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Covid-19 in prisons and meatpacking plants shed a light on Americas moral failures - Vox.com

HARRISONBURG, Va. -- Harrisonburg partnered with the Virginia Department of Health and Sentara Healthcare to bring free COVID-19 testing to two diverse neighborhoods in the city.

100 tests total, administered on a first-come-first-served basis, was given at testing sites in the Mosby Court and Harris Gardens neighborhoods of the city.

To receive a test, Vice-Mayor Sal Romero said people needed to have at least one COVID-19 symptom, like cough, fever, shortness of breath, or diarrhea.

Tests were only given to one person per household.

Romero said they hope to bring more testing centers to locations across the city in the upcoming weeks.

"We're working very hard to ensure that we bring additional tests because we know that there are more people in our city who do lack the access to the tests, so we want to make sure that it's available to more people across the city," Romero said.

He said they not only brought coronavirus tests, but also educational materials about what COVID-19 is, what to do if you're sick, and prevention.

Go here to read the rest:

COVID-19 tests offered to diverse neighborhoods in Harrisonburg - WHSV

A COVID-19 antibody testing center is seen at Steve's 9th Street Market in Brooklyn on April 25. Here's a quick guide to sorting out the pluses and minuses to each type of test. Michael Nagle/Xinhua News Agency/Getty Images hide caption

A COVID-19 antibody testing center is seen at Steve's 9th Street Market in Brooklyn on April 25. Here's a quick guide to sorting out the pluses and minuses to each type of test.

Testing for the coronavirus has been very much in the news. The first and most urgent focus is on increasing access to tests to diagnose people with current infections. But now other tests are appearing as well. Antibody tests, which can identify people with signs of past infection, are starting to be available. And a third type of test is on the way.

Here's a quick guide to sorting out the pluses and minuses to each type of test.

What it does: Doctors use this test to diagnose people who are currently sick with COVID-19. This is the one we've been hearing so much about.

How it works: This test uses a sample of mucus typically taken from a person's nose or throat. The test may also work on saliva that's under investigation. It looks for the genetic material of the coronavirus. The test uses a technology called PCR (polymerase chain reaction), which greatly amplifies the viral genetic material if it is present. That material is detectable when a person is actively infected.

How accurate is it: Generally speaking, these are the most reliable tests. However, a few days may pass before the virus starts replicating in the throat and nose, so the test won't identify someone who has recently been infected. And swabs can sometimes fail to pick up signs of active infection.

How quick is it: These samples are generally sent to centralized labs for analysis, so it can take several days to get results back. Wait times were longer earlier in the pandemic because of a testing backlog. There are also two rapid PCR tests, which can be run on specialized equipment already widely distributed throughout the U.S. The speediest one, by Abbott Laboratories, can provide a result in 13 minutes, but one study suggests this test can miss more than 10% of cases.

What it does: Antibody tests identify people who have previously been infected with the coronavirus. They do not show whether a person is currently infected. This is primarily a good way to track the spread of the coronavirus through a population.

How it works: This is a blood test. It looks for antibodies to the coronavirus. Your body produces antibodies in response to an infectious agent such as a virus. These antibodies generally arise after four days to more than a week after infection, so they are not used to diagnose current disease.

How accurate is it: There are more than 120 antibody tests on the market. The Food and Drug Administration has allowed them to be marketed without FDA authorization, and quality is a great concern. A few tests have voluntarily submitted to extra FDA approval. Other tests are being validated by individual medical labs or university researchers.

In general, these tests aren't reliable enough for individuals to act based on the results. And researchers say, even if you were certain you had antibodies to the coronavirus, it's still unknown if that protects you from getting sick again. Still, these tests can provide good information about rates of infection in a community, where errors in an individual result have less impact.

How quick is it: These tests generally produce results in a few minutes, based on a drop of blood taken from the finger. Some research labs use a more sophisticated antibody test, called an Elisa (Enzyme-linked immunoassay) that are more accurate but are not as widely available.

What it does: This test identifies people who are currently infected with the coronavirus. It may be used as a quick test to detect active infections. Initially it will not be used to diagnose disease, but it may be used to screen people to identify those who need a more definitive test.

How it works: Antigen tests can identify virus in nose and throat secretions. It does this by looking for proteins on the surface of the virus (as opposed to the diagnostic test, which looks for genetic material that is carried inside the virus). This is the same technology used in your doctor's office for rapid strep testing.

How accurate is it: These tests are not yet on the market, so there is currently no information about their accuracy. Researchers do not expect it to be as accurate as the PCR diagnostic test, but it is possible they could be used to screen patients for infection. Dr. Jordan Laser, a lab director at Northwell Health, notes antigen testing is used for rapid strep tests, which are reliable, and rapid flu tests, which are not.

How quick is it: These tests should provide results in just a few minutes. As a result, they could be used to screen people in hospitals, certain workplaces, or in other instances where it's important to find out quickly whether someone is currently at risk of spreading the disease. But unless these tests are proven to be highly accurate, physicians would still need to follow up a positive result with a PCR test to make a medical diagnosis.

You can contact NPR science correspondent Richard Harris at rharris@npr.org.

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Antibody, Antigen And PCR Tests For COVID-19: Know The Differences : Shots - Health News - NPR

A woman has had to bury her daughter and husband within days of each other after both died from coronavirus.

Tributes were paid to former police officer and Red Cross director David Whincup, 79, and his daughter Joanne Rennison, 52, who both passed away after contracting the disease.

MP David Davis described Whincup, from Cottingham in east Yorkshire, as an utterly decent man. David was the kindest, most thoughtful and utterly decent man I have ever had the privilege to meet. He had a fantastic commitment to selfless public service. We shall all miss him greatly, he added.

Whincup, who lived with his wife, Margaret, their daughter Joanne and granddaughter Alice, said his greatest achievement was his family. He worked as a director for the Red Cross and prior to that he was a Humberside police officer for more than 30 years.

His charity work raised thousands of pounds for causes in Hull and East Yorkshire and he supported many other charities as a founder member of Haltemprice Lions club in 1973, serving as president four times and as secretary.

Rennison also became a Red Cross fundraising manager. Diagnosed with multiple sclerosis when she was 30, her family said the MS Society was always a focus in her fundraising efforts.

Tributes have also been paid to 25-year-old Nasro Ade a beautiful spirit. Her devastated family told how they had to say their final goodbyes on a video call as she lay in a hospital bed.

Ade, originally from Somalia, had kidney failure and died within 11 days of being diagnosed with the virus at St Georges hospital in Tooting, south London, last month.

Her sister Fartuun Ade, 23, said the family were unable to visit her before she passed away, and had to say their goodbyes via FaceTime.

Its been so difficult for family not to be with her and tell her how much we love her. Its been so hard to take in. But all this love we have been receiving from people all around the world, who were touched by Nasros story. It has brought comfort to our family, said Fartuun.

She added: Theres probably thousands of millions of families around the world experiencing the same thing. I pray for everyone, for their health, for their life. Nasro was a blessing to us and to so many she touched.

For one family there was relief after a 16-year-old girl managed to recover from the disease waking from a coma on her birthday.

Marisa Bappoo spent 21 days in Southampton childrens hospitals intensive care unit, much of the time on a ventilator, when she woke to find nurses had put up birthday banners, cards and pictures of her family.

She said: Mum and dad say the nurses were always holding my hand and stroking my head. They gave me massages and plaited my hair. I came round still attached to the ventilator.

I was frightened, but one of the nurses was there holding my hand to reassure me. I was amazed when I saw the happy birthday banner. Later they gave me loads of presents as if I was their daughter. Its something I will never forget.

Bappoo is among just a small number of children to have fallen seriously ill with the virus. Her father, Roshan, 48, a graphic designer from Basingstoke, said: Wed all been suffering from the virus and were recovering, but Marisa didnt.

She became very poorly. It was shocking to see her struggling to breathe. They were going to start to bring her round when she woke up by herself on her 16th birthday. We were elated. It was the best birthday present.

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Man and his daughter die of Covid-19 within days of each other - The Guardian

Congress has opened a probe into Carnival Corporation, the operator of the Princess Cruises line of cruise ships, over its handling of COVID-19 outbreaks, according to a report from Bloomberg. Officials are now requesting Carnival turn over documents and communications about its coronavirus response and its plans for future improvement.

The investigation, led by the US House Committee on Transportation and Infrastructure, is specifically looking into how much Carnival executives were aware of the severity of the coronavirus outbreaks on its cruise ships and the lack of action it took during active cruises after being informed of the risks. More than 1,500 confirmed COVID-19 cases can be traced back to the company's cruise ships, and dozens of Carnival customers and crew members have since died from the virus.

The probe cites a damning Bloomberg feature story from writers Austin Carr and Chris Palmeri from last month that delves intricately into how Florida-based Carnival handled news of the COVID-19 outbreaks aboard nine of its ships. The story itself, which everyone should go read, is astonishing, featuring illuminating interviews with crew members and passengers and a lengthy sit-down with Carnival CEO Arnold Donald. It paints the picture of a company that, even in early March as the threat of the novel coronavirus become abundantly clear worldwide, did not take action fast enough to order its passengers into self-isolation and dock its cruise ships. Instead, many ships decided to let customers remain in extremely close contact with one another in swimming pools and in dining areas featuring buffets.

We would hope that the reality of the COVID-19 pandemic will place a renewed emphasis on public health and passenger safety, but frankly that has not been seen up to this point, wrote House member Peter DeFazio (D-OR) in the letter sent to Carnival announcing the investigation. It seems as though Carnival Corporation and its portfolio of nine cruise lines, which represents 109 cruise ships, is still trying to sell this cruise line fantasy and ignoring the public health threat.

Bloomberg reports that many of the customers who received refunds from Carnival were given the option to receive the credit for a future cruise, and Carnival in some cases sweetened the deal by giving out free vouchers as well. While the company suspended its cruises starting in March, some passengers and crew remain stuck on ships around the world. Our goal is the same as the committees goal, Carnival said in a statement to Bloomberg, to protect the health, safety and well-being of our guests and crew, along with compliance and environmental protection.

In addition to the House probe, Australian police last month launched a criminal investigation into how Carnival handled the docking of one of its Princess ships, the Ruby Princess, in Sydney on March 19th. The investigation is looking into whether Carnival officials misled Australian authorities about the COVID-19 outbreak aboard the ship, as Carnival customers at the time made up nearly one-third of all Australian deaths from the virus.

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Congress is investigating cruise ship company Carnival over COVID-19 outbreaks - The Verge

Tracing infection from mobility data

What sort of measures are required to contain the spread of severe acute respiratory syndromecoronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19)? The rich data from the Open COVID-19 Data Working Group include the dates when people first reported symptoms, not just a positive test date. Using these data and real-time travel data from the internet services company Baidu, Kraemer et al. found that mobility statistics offered a precise record of the spread of SARS-CoV-2 among the cities of China at the start of 2020. The frequency of introductions from Wuhan were predictive of the size of the epidemic sparked in other provinces. However, once the virus had escaped Wuhan, strict local control measures such as social isolation and hygiene, rather than long-distance travel restrictions, played the largest part in controlling SARS-CoV-2 spread.

Science, this issue p. 493

The ongoing coronavirus disease 2019 (COVID-19) outbreak expanded rapidly throughout China. Major behavioral, clinical, and state interventions were undertaken to mitigate the epidemic and prevent the persistence of the virus in human populations in China and worldwide. It remains unclear how these unprecedented interventions, including travel restrictions, affected COVID-19 spread in China. We used real-time mobility data from Wuhan and detailed case data including travel history to elucidate the role of case importation in transmission in cities across China and to ascertain the impact of control measures. Early on, the spatial distribution of COVID-19 cases in China was explained well by human mobility data. After the implementation of control measures, this correlation dropped and growth rates became negative in most locations, although shifts in the demographics of reported cases were still indicative of local chains of transmission outside of Wuhan. This study shows that the drastic control measures implemented in China substantially mitigated the spread of COVID-19.

The outbreak of coronavirus disease 2019 (COVID-19) spread rapidly from its origin in Wuhan, Hubei Province, China (1). A range of interventions were implemented after the detection in late December 2019 of a cluster of pneumonia cases of unknown etiology and identification of the causative virus, severe acute respiratory syndromecoronavirus 2 (SARS-CoV-2), in early January 2020 (2). Interventions include improved rates of diagnostic testing; clinical management; rapid isolation of suspected cases, confirmed cases, and contacts; and, most notably, restrictions on mobility (hereafter called cordon sanitaire) imposed on Wuhan city on 23 January 2020. Travel restrictions were subsequently imposed on 14 other cities across Hubei Province, and partial movement restrictions were enacted in many cities across China. Initial analysis suggests that the Wuhan cordon sanitaire resulted in an average 3-day delay of COVID-19 spread to other cities (3), but the full extent of the effect of the mobility restrictions and other types of interventions on transmission has not been examined quantitatively (46). Questions remain over how these interventions affected the spread of SARS-CoV-2 to locations outside of Wuhan. Here, we used real-time mobility data, crowdsourced line list data of cases with reported travel history, and timelines of reporting changes to identify early shifts in the epidemiological dynamics of the COVID-19 epidemic in China, from an epidemic driven by frequent importations to local transmission.

As of 1 March 2020, 79,986 cases of COVID-19 were confirmed in China (Fig. 1A) (7). Reports of cases in China were mostly restricted to Hubei until 23 January 2020 (81% of all cases), after which most provinces reported rapid increases in cases (Fig. 1A). We built a line list dataset from reported cases in China with information on travel history and demographic characteristics (8). We note that the majority of early cases (before 23 January 2020; see the materials and methods) reported outside of Wuhan had known travel history to Wuhan (57%) and were distributed across China (Fig. 1B), highlighting the importance of Wuhan as a major source of early cases. However, initial testing was focused mainly on travelers from Wuhan, potentially biasing estimates of travel-related infections upward (see the materials and methods). Among cases known to have traveled from Wuhan before 23 January 2020, the time from symptom onset to confirmation was 6.5 days (SD = 4.2 days; fig. S2), providing opportunity for onward transmission at the destination. More active surveillance reduced this interval to 4.8 days (SD = 3.03 days; fig. S2) for those who traveled after 23 January 2020.

(A) Epidemic curve of the COVID-19 outbreak in provinces in China. Bars indicate key dates: implementation of the cordon sanitaire of Wuhan (gray) and the end of the first incubation period after the travel restrictions (red). The black line represents the closure of the Wuhan seafood market on 1 January 2020. The width of each horizontal tube represents the number of reported cases in that province. (B) Map of COVID-19 confirmed cases (n = 554) that had reported travel history from Wuhan before travel restrictions were implemented on 23 January 2020. Colors of the lines indicate date of travel relative to the date of travel restrictions.

To identify accurately a time frame for evaluating early shifts in SARS-CoV-2 transmission in China, we first estimated from case data the average incubation period of COVID-19 infection [i.e., the duration between time of infection and symptom onset (9, 10)]. Because infection events are typically not observed directly, we estimated the incubation period from the span of exposure during which infection likely occurred. Using detailed information on 38 cases for whom both the dates of entry to and exit from Wuhan were known, we estimated the mean incubation period to be 5.1 days (SD = 3.0 days; fig. S1), similar to previous estimates from other data (11, 12). In subsequent analyses, we added an upper estimate of one incubation period (mean + 1 SD = 8 days) to the date of Wuhan shutdown to delineate the date before which cases recorded in other provinces might represent infections acquired in Hubei (i.e., 1 February 2020; Fig. 1A).

To understand whether the volume of travel within China could predict the epidemic outside of Wuhan, we analyzed real-time human mobility data from Baidu Inc., together with epidemiological data from each province (see the materials and methods). We investigated spatiotemporal disease spread to elucidate the relative contribution of Wuhan to transmission elsewhere and to evaluate how the cordon sanitaire may have affected it.

Among cases reported outside of Hubei province in our dataset, we observed 515 cases with known travel history to Wuhan and a symptom onset date before 31 January 2020, compared with only 39 cases after 31 January 2020, illustrating the effect of travel restrictions (Figs. 1B and 2A and fig. S3). We confirmed the expected decline of importation with real-time human mobility data from Baidu Inc. Movements of individuals out of Wuhan increased in the days before the Lunar New Year and the establishment of the cordon sanitaire, before rapidly decreasing to almost no movement (Fig. 2, A and B). The travel ban appears to have prevented travel into and out of Wuhan around the time of the Lunar New Year celebration (Fig. 2A) and likely reduced further dissemination of SARS-CoV-2 from Wuhan.

(A) Human mobility data extracted in real time from Baidu Inc. Travel restrictions from Wuhan and large-scale control measures started on 23 January 2020. Gray and red lines represent fluxes of human movements for 2019 and 2020, respectively. (B) Relative movements from Wuhan to other provinces in China. (C) Timeline of the correlation between daily incidence in Wuhan and incidence in all other provinces, weighted by human mobility.

To test the contribution of the epidemic in Wuhan to seeding epidemics elsewhere in China, we built a nave COVID-19 generalized linear model [GLM (13)] of daily case counts (see the materials and methods). We estimated the epidemic doubling time outside of Hubei to be 4.0 days (range across provinces, 3.6 to 5.0 days) and estimated the epidemic doubling time within Hubei to be 7.2 days, consistent with previous reports (5, 12, 14, 15). Our model predicted daily case counts across all provinces with relatively high accuracy (as measured with a pseudo-R2 from a negative binomial GLM) throughout early February 2020 and when accounting for human mobility (Fig. 2C and tables S1 and S2), consistent with an exploratory analysis (6).

We found that the magnitude of the early epidemic (total number of cases until 10 February 2020) outside of Wuhan was very well predicted by the volume of human movement out of Wuhan alone (R2 = 0.89 from a log-linear regression using cumulative cases; fig. S8). Therefore, cases exported from Wuhan before the cordon sanitaire appear to have contributed to initiating local chains of transmission, both in neighboring provinces (e.g., Henan) and in more distant provinces (e.g., Guangdong and Zhejiang) (Figs. 1A and 2B). Further, the frequency of introductions from Wuhan were also predictive of the size of the early epidemic in other provinces (controlling for population size) and thus the probability of large outbreaks (fig. S8).

After 1 February 2020 (corresponding to one mean + one SD incubation period after the cordon sanitaire and other interventions were implemented), the correlation of daily case counts and human mobility from Wuhan decreased (Fig. 2C), indicating that variability among locations in daily case counts was better explained by factors unrelated to human mobility, such as local public health response. This suggests that whereas travel restrictions may have reduced the flow of case importations from Wuhan, other local mitigation strategies aimed at halting local transmission increased in importance later.

We also estimated the growth rates of the epidemic in all other provinces (see the materials and methods). We found that all provinces outside of Hubei experienced faster growth rates between 9 January and 22 January 2020 (Fig. 3, A and B, and fig. S4b), which was the time before travel restrictions and substantial control measures were implemented (Fig. 3C and fig. S6); this was also apparent from the case counts by province (fig. S6). In the same period, variation in the growth rates is almost entirely explained by human movements from Wuhan (Fig. 3C and fig. S9), consistent with the theory of infectious disease spread in highly coupled metapopulations (16, 17). After the implementation of drastic control measures across the country, growth rates became negative (Fig. 3B), indicating that transmission was successfully mitigated. The correlation of growth rates and human mobility from Wuhan became negative; that is, provinces with larger mobility from Wuhan before the cordon sanitaire (but also larger number of cases overall) had more rapidly declining growth rates of daily case counts. This could be due partly to travel restrictions but also to the fact that control measures may have been more drastic in locations with larger outbreaks driven by local transmission (for more details, see Current role of imported cases in Chinese provinces section).

(A) Daily counts of cases in China. (B) Time series of province-level growth rates of the COVID-19 epidemic in China. Estimates of the growth rate were obtained by performing a time-series analysis using a mixed-effects model of lagged, log linear daily case counts in each province (see the materials and methods). Above the red line are positive growth rates and below are negative rates. Blue indicates dates before the implementation of the cordon sanitaire and green after. (C) Relationship between growth rate and human mobility at different times of the epidemic. Blue indicates before the implementation of the cordon sanitaire and green after.

The travel ban coincided with increased testing capacity across provinces in China. Therefore, an alternative hypothesis is that the observed epidemiological patterns outside of Wuhan were the result of increased testing capacity. We tested this hypothesis by including differences in testing capacity before and after the rollout of large-scale testing in China on 20 January 2020 [the date that COVID-19 became a class B notifiable disease (18, 19)] and determined the impact of this binary variable on the predictability of daily cases (see the materials and methods). We plotted the relative improvement in the prediction of our model (on the basis of normalized residual error) of (i) a model that includes daily mobility from Wuhan and (ii) a model that includes testing availability (for more details, see the materials and methods). Overall, the inclusion of mobility data from Wuhan produced an improvement in the models prediction [delta-Bayesian information criterion > 250 (20)] over a nave model that considers only autochthonous transmission with a doubling time of 2 to 8 days (Fig. 3B). Of the 27 provinces in China reporting cases through 6 February 2020, we found that the largest improvements in prediction for 12 provinces could be achieved using mobility only (fig. S5). In 10 provinces, both testing and mobility improved the models prediction, and in only one province (Hunan) was testing the most important factor improving model prediction (fig. S5). We conclude that laboratory testing during the early phase of the epidemic was critical; however, mobility out of Wuhan remained the main driver of spread before the cordon sanitaire. Large-scale molecular and serological data will be important to investigate further the exact magnitude of the impact of human mobility compared with other factors.

Because case counts outside of Wuhan have decreased (Fig. 3B), we can further investigate the current contribution of imported cases to local epidemics outside of Wuhan by investigating case characteristics. Age and sex distributions can reflect heterogeneities in the risk of infection within affected populations. To investigate meaningful shifts in the epidemiology of the COVID-19 outbreak through time, we examined age and sex data for cases from different periods of the outbreak and from individuals with and without travel from Wuhan. However, details of travel history exist for only a fraction of confirmed cases, and this information was particularly scant for some provinces (e.g., Zhejiang and Guangdong). Therefore, we grouped confirmed cases into four categories: (I) early cases (i.e., reported before 1 February 2020) with travel history, (II) early cases without travel history, (III) later cases (i.e., reported between 1 February and 10 February 2020) with travel history, and (IV) later cases without travel history.

Using crowdsourced case data, we found that cases with travel history (categories I and III) had similar median ages and sex ratios in both the early and later phases of the outbreak (age 41 versus 42 years; 50% interquartile interval: 32.75 versus 30.75 and 54.25 versus 53.5 years, respectively; P value > 0.1, 1.47 versus 1.45 males per female, respectively; Fig. 4D and fig. S7). Early cases with no information on travel history (category II) had a median age and sex ratio similar to those with known travel history (age 42 years; 50% interquartile interval: 30.5 to 49.5, P value > 0.1; 1.80 males per female; Fig. 4D). However, the sex ratio of later cases without reported travel history (category IV) shifted to ~1:1 (57 male versus 62 female, 2 test, P value < 0.01), as expected under a null hypothesis of equal transmission risk [Fig. 4, A, B, and D; see also (21, 22) and the materials and methods], and the median age in this group increased to 46 (50% interquartile interval: 34.25 to 58, t test: P value < 0.01; Fig. 4, A to C, and fig. S7). We hypothesize that many of the cases with no known travel history in the early phase were indeed travelers who contributed to disseminating SARS-CoV-2 outside of Wuhan. The shift toward more equal sex ratios and older ages in nontravelers after 31 January 2020 confirms the finding that epidemics outside of Wuhan were then driven by local transmission dynamics. The case definition changed to include cases without travel history to Wuhan after 23 January 2020 (see the materials and methods).

(A) Age and sex distributions of confirmed cases with known travel history to Wuhan. (B) Age and sex distributions of confirmed cases that had no travel history to Wuhan. (C) Median age for cases reported early (before 1 February) and those reported later (between 1 and 10 February). Full distributions are shown in fig. S7. (D) Change through time in the sex ratio of (i) all reported cases in China with no reported travel history, (ii) cases reported in Beijing without travel history, and (iii) cases known to have traveled from Wuhan.

Containment of respiratory infections is particularly difficult if they are characterized by relatively mild symptoms or transmission before the onset of symptoms (23, 24). Intensive control measures, including travel restrictions, have been implemented to limit the spread of COVID-19 in China. Here, we show that travel restrictions are particularly useful in the early stage of an outbreak when it is confined to a certain area that acts as a major source. However, travel restrictions may be less effective once the outbreak is more widespread. The combination of interventions implemented in China was clearly successful in mitigating spread and reducing local transmission of COVID-19, although in this work it was not possible to definitively determine the impact of each intervention. Much further work is required to determine how to balance optimally the expected positive effect on public health with the negative impact on freedom of movement, the economy, and society at large.

T. J. Hastie, D. Pregibon, Generalized linear models in Statistical Models in S, J. M. Chambers, T. J. Hastie, Eds. (Wadsworth & Brooks/Cole, 1992), pp. 195246.

M. J. Keeling, O. N. Bjrnstad, B. T. Grenfell, Metapopulation dynamics of infectious diseases in Ecology, Genetics and Evolution of Metapopulations, I. Hanski, O. E. Gaggiotti, Eds. (Elsevier, 2004), pp. 415445.

J. H. McDonald, Handbook of Biological Statistics (Sparky House, ed. 3, 2014).

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The effect of human mobility and control measures on the COVID-19 epidemic in China - Science Magazine

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

Models predicting the potential spread of the COVID-19 pandemic have become a fixture of American life. Yet each model tells a different story about the devastation to come, making it hard to know which one is right. But COVID-19 models arent made to be unquestioned oracles. Theyre not trying to tell us one precise future, but rather the range of possibilities given the facts on the ground.

One of their more sober tasks is predicting the number of Americans who will die due to COVID-19. FiveThirtyEight with the help of the Reich Lab at the University of Massachusetts Amherst has assembled six models published by infectious disease researchers to illustrate possible trajectories of the pandemics death toll. In doing so, we hope to make them more accessible, as well as highlight how the assumptions underlying the models can lead to vastly different estimates. Here are the models U.S. fatality projections for the coming weeks.

See forecasts from

TodayMay 1April 21April 14April 7

Forecasts like these are useful because they help us understand the most likely outcomes as well as best- and worst-case possibilities and they can help policymakers make decisions that can lead us closer to those best-case outcomes.

And looking at multiple models is better than looking at just one because it's difficult to know which model will match reality the closest. Even when models disagree, understanding why they are different can give us valuable insight.

Each model makes different assumptions about properties of the novel coronavirus, such as how infectious it is and the rate at which people die once infected. They also use different types of math behind the scenes to make their projections. And perhaps most importantly, they make different assumptions about the amount of contact we should expect between people in the near future.

Understanding the underlying assumptions that each model is currently using can help us understand why some forecasts are more optimistic or pessimistic than others.

Below are individual forecasts for all 50 states and the District of Columbia.

See forecasts from

Forecasts from

TodayMay 1April 21April 14April 7

Scroll to a state

AllAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

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AllColumbia Univ.IHMELos AlamosMITNortheastern Univ.Univ. of Texas

288deathsas ofMay 2

9deaths

330deaths

72deaths

2,180deaths

832deaths

2,436deaths

168deaths

240deaths

1,364deaths

1,177deaths

16deaths

64deaths

2,559deaths

1,115deaths

175deaths

142deaths

248deaths

1,993deaths

56deaths

1,251deaths

3,846deaths

4,021deaths

394deaths

291deaths

376deaths

16deaths

73deaths

255deaths

84deaths

7,742deaths

138deaths

24,198deaths

431deaths

24deaths

1,022deaths

238deaths

109deaths

2,695deaths

296deaths

267deaths

21deaths

209deaths

863deaths

49deaths

51deaths

617deaths

830deaths

48deaths

334deaths

7deaths

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Where The Latest COVID-19 Models Think We're Headed And Why They Disagree - FiveThirtyEight

Britains once bustling high streets are now eerily quiet, with all non-essential shops closed and thousands of staff furloughed. Many may never reopen as the lockdown accelerates shifts to online shopping, while others will have to find ways to adapt to a radically different retail world of long-term social distancing rules and nervous customers afraid of catching the virus.

The British Independent Retailers Association warned last week that one fifth of their members might close for good if footfall is low. Yet some of the big non-food retailers such as Homebase and B&Q are starting to reopen stores, and the British Retail Consortium has issued guidance on how non-essential shops could trade while keeping customers and staff safe.

The Observer spoke to five shop owners on one British high street to find out how they are faring and what the future holds for their businesses.

Hairdresser Anne Murray misses her regulars and the small intimacies that are shared during haircuts at her usually busy salon on Wares High Street. People really open up to you, she says from her home in the Hertfordshire commuter-belt town. Were like secondary counsellors.

Her salon, Mint, has been closed since the lockdown was announced at the end of March. She has been able to furlough the other hairdresser she employs and is planning to use a 10,000 cash grant to pay her bills. But she worries she might be one of the last shops to reopen as hairdressers will struggle to comply with social distancing rules, which are likely to stay in place until at least the end of the year. When you cut someones hair, you are rarely face to face, she says. But the physical proximity makes it hard. It is impossible to stay two metres away.

Murray, 37, would consider wearing PPE if it was made available to shop workers. I would definitely do that in order to protect other people and myself, she adds. But hairdressing is quite a personal service and so it would be very odd.

However, an extended closure could potentially put the salon at risk. I cant think of many businesses that could survive for that long unless they are online, she says. It makes me feel sad and anxious. In my household, it is a major source of income. My salon brings in more than my husbands business.

She sometimes walks down the High Street during her exercise and wonders how it will look after the coronavirus crisis is over: Its eerie and so quiet. I go past the other shops and cant help thinking which ones will and wont survive.

Al Bramley is getting ready for the phone to start ringing with takeaway orders in the Mexican restaurant he launched with his business partner, Brett Cahill-Moreno, in September.

People tend to do their own stuff at the start of the week and then treat themselves at weekend. Theres a lot of Zoom parties and quizzes and they tend to buy takeaways for those occasions, he says taking a quick break, while two chefs prep food in the kitchen.

Before the lockdown, the restaurant was packed with diners. Now the tables and chairs are stacked up against the walls. Bramley, 50, and Cahill-Moreno, 47, closed completely for two weeks, with all 10 staff furloughed. But last month they brought back two chefs and two front-of-house staff to provide takeaway meals. Weve had to adapt and change the way we do things, says Bramley.

Last weekend, they had 140 orders and they are hoping to expand beyond Ware. They have even launched an app to speed up ordering: It went live last week and weve had 650 downloads already.

However, their turnover has halved and they will only be able to keep going if they can secure a long-term rent reduction. We are going to have to renegotiate our rent with our landlord, Bramley says. I havent had that conversation yet, but its coming.

Bramley has been thinking hard about how he could lay out the tables in the restaurant to keep diners and staff two metres apart. We could do about 25 covers inside. And if the sun is shining, we could do another 30 covers outside, he says. With the takeaway market and a rent reduction, we could just about survive.

The tiny Book Nook on Wares High Street had not even been open a year before it was forced to shut. The owner Julia Chesterman, 49, had to mark the anniversary with a cup of tea and slice of cake in an empty shop. I sat down with the bookshop cat and I had a tear in my eye, she says. In a year we have become a little community hub and achieved so much.

Chesterman initially tried delivering books but it wasnt practical. I was taking telephone orders and leaving books on peoples doorsteps but to be honest I wasnt getting enough orders, she says. In the end she closed completely and furloughed herself.

Even though the shop is quite narrow, Chesterman is confident she could reopen safely. She would probably only need to limit the number of customers on a Saturday morning, when lots of people come in for tea and cake. We never really get overwhelmed, she adds.

Chesterman, who used to work for the library service, is not especially worried about reduced footfall. Bookselling can be quite challenging, she says. Im not in this business to make a massive profit. I just want to do something that I love and be part of the community.

The last time estate agent Jake Shropshire, 49, was in Wares branch of Jonathan Hunt was in March. I was able to rescue my telephone and computer, he says.

Since then the usual buying and selling of property has almost ground to a halt. Theres been no property viewings, he says. It has all stopped.

Shropshire is trying to keep existing house sales on track. We are nursing along sales as best we can, but 60% of the lawyers we deal with have been furloughed so there are challenges.

There are buyers stuck in property chains containing vulnerable individuals. We have one where a person is shielding so everyone else in that chain will have to wait, says Shropshire.

A few are moving, however. He is giving the keys to the buyers of a derelict Grade II-listed house this weekend. There is no crossover of people. There is no danger of contamination, he says. Im just going to leave the keys on their doorstep, ring the bell and run off.

While he can ride out rest of the lockdown, Shropshire has some concerns about reopening. Staff will need to be paid but it will take a while for new houses to be marketed and sold. Our income is not instantaneous. Its going to be three months at best before any money comes in, he says. Thats going to be the tough part.

Cathy Emmerson, 53, decided to close her card shop the day before Boris Johnson announced a national lockdown. We closed at the end of Mothers Day, she says. Ive got four members of staff and I didnt feel comfortable asking them to come to work.

It might be difficult to maintain social distancing when the shop eventually reopens as it is not much bigger than a living room. We deal with people directly. The elderly like us to read cards to them. Staff need to move around the shop too, she says.

Nonetheless, she is confident she will find a way to comply. If we have to put up a sign saying two customers only we will, she says. Its a card and greetings shop. It only gets busy on Saturday and around occasions.

She worries more about the market for party products. Im hoping people will want balloons to party but how much socialising will we be allowed to do? Some of our business came from people going out for meals and having drinks at parties. But the greetings card side will definitely remain because people like to send a card.

Read more:

After Covid-19: How will a socially distanced high street actually work? - The Guardian

As more people around the world are infected with Covid-19, were learning that the novel coronavirus can not only cause severe respiratory illness, but also can attack just about every major organ system in the body. And lately doctors have been sounding the alarm about a disturbing new outcome: blood clots and strokes, which are striking even healthy young people with no known risk factors and sometimes no other symptom of the virus.

An April 28 report in the New England Journal of Medicine details the cases of five people, ages 33 to 49, in New York City who had strokes and subsequently tested positive for Covid-19. All of them had large-vessel strokes outside of the hospital before experiencing other severe symptoms of the virus; one of them has since died.

It was very surprising to see the increase in this large-vessel stroke in young people, Thomas Oxley, a neurosurgeon at Mount Sinai in New York and a coauthor of the new report, tells Vox. As he explains, The bigger the vessel, the bigger the stroke.

Its the biggest story emerging about Covid-19, he adds. The rate of large-vessel stroke victims under 50 they saw was seven times higher than before the pandemic.

Blood clots are also causing other unexpected problems for Covid-19 patients. For example, Broadway actor Nick Cordero, who has been hospitalized since March with severe Covid-19, had his right leg amputated earlier this month after doctors were unable to control clotting there.

And many patients are developing small clots in their lungs, reducing the amount of oxygen they can move into their bodies. For others, their blood is clogging dialysis machines (which has been a problem due to the amount of kidney failure this illness is also causing).

Im a hematologist, and this is unprecedented, says Jeffrey Laurence of Weill Cornell Medical College, who has been in the field for three decades. This is not like a disease weve seen before.

Nearly every patient he has seen for blood disorders in the past month and a half has had Covid-19. Ive never had so many consults in my life. These people are clotting, and we cant shut it off.

Doctors and researchers are racing to figure out why this is happening, and how they might be able to best use existing therapies, such as blood thinners, to mitigate it in patients. The clots and strokes also add to the list of potential symptoms some people with Covid-19 might experience early on and gives another possible reason that the number of coronavirus-related deaths around the country is looking far larger than those officially being counted in hospitals.

When we get injured, we depend on our bloods ability to clot to stop the flow of blood. Clotting is a complex process that involves small cell fragments called platelets congregating and changing shape, proteins that help even more cells bind together, and the secretion of substances called blood clotting factors. If any of these processes go off course, people can experience excessive bleeding, which can be life-threatening.

On the other end of the spectrum, sometimes clots form inside blood vessels (more rarely, in arteries) without an injury. These can cause serious harm and sometimes death. There are many risk factors for developing internal blood clots, including smoking, obesity, heart disease, and others. And, now, it looks like Covid-19 is a risk factor as well.

Some clots remain in the place where they form and are known as thrombosis. This can cause severe pain and swelling. These clots can also travel to or form in a major organ, where they can do even more serious damage.

For example, a clot in the leg can travel up to the lungs, cutting off blood flow and causing a pulmonary embolism (which can lead to death or permanent lung damage). A clot can also flow to the heart, triggering a heart attack. And one in or near the head can block blood flow in part of the brain, bringing on a stroke.

Small early studies and case reports about the link between the novel coronavirus and blood clots are now pouring in. For example, one team in the Netherlands followed 184 severe Covid-19 patients who were receiving treatment in three different intensive care units. They found that 31 percent of these people had some sort of blood clotting issue, a percentage they call remarkably high.

Other data is emerging with similar implications. In patients with severe disease, various forms of blood clots are estimated to occur in 15-35 percent of patients, Behnood Bikdeli, a cardiology fellow at Columbia University Medical Center, tells Vox. And these clots, especially the small ones, could impact the illness severity and involvement of many of the organs, he says. (He and an international team of dozens of researchers published an April review of clotting issues in the Journal of the American College of Cardiology.)

Laurence has been studying small blood clots in HIV/AIDS patients for decades. In March, a dermatologist sent him a photo of surprising skin lesions on a young man who was severely ill with Covid-19. Laurence was stunned. Its a picture of microvascular clotting, where you can see exactly where the vessels have clotted, he says. He started wondering if something similar might be happening in the lungs.

Just hours later, another doctor called, giving him access to an autopsy of a different Covid-19 patient. Not only did this individual have small clots in the skin but also in his lungs. (Laurence and his colleagues published descriptions of these and three other cases of severe clotting in an April Translational Research paper.)

The presence of small clots in the lungs is disturbing, but it also might help to explain a puzzling trend medical staff have noticed in some Covid-19 patients. When people develop more advanced illness, their lungs can become stiff, making breathing on their own very difficult. This leads to a drop in blood oxygen if they are not on mechanical ventilation.

But health care workers have seen many patients with low oxygen levels but who still have fairly flexible lungs, Laurence explains. This points to the presence of microvessel clots [in the lungs] shutting off the ability of people to bring oxygen into their blood, he says. (He also noted that sustained time on a ventilator can, itself, increase lung stiffness, which could have been throwing off clinicians who were seeing that as an outcome of the illness, and perhaps along the way missing signs that something else was going on.)

Laurence also describes the multitude of people sick with Covid-19 whose blood clots are plugging up the dialysis machines in their wards. Beyond that, he says, even as the nurses are drawing their blood, its clotting in the tubes, and theyre on full doses of Heparin and other blood-thinning medications. Everyone is seeing a similar kind of thing, he says.

These observations also bear out in autopsies.

A team of Chinese researchers that looked at 183 people hospitalized with Covid-19 pneumonia in Wuhan, China, found evidence of clotting in 71 percent of those who died but less than 1 percent of those who didnt. (Notably, this paper was published early in the pandemic, in February.)

The prevalence of blood clots also raises the question of whether some stroke or heart attack home deaths in recent months were actually linked to Covid-19. Its yet another possible way Covid-19 fatalities might be being undercounted. Many people who have already died are not currently tested for Covid-19 (often in the interest of preserving tests for those who are still alive). But more widespread posthumous testing could help clarify the full impact of this disease.

Scientists still dont understand exactly what is triggering this excessive blood clotting. (Some viruses, such as the Ebola virus, cause extreme bleeding, but others, such as HIV, can trigger small clots.) And its not yet clear if these changes in the blood are from the virus itself or the bodys immune response to the infection.

One of the hypotheses has to do with how the virus gains entry to our cells. Researchers have found that this coronavirus manages to sneak into our cells via a specific type of receptor known as ACE2. These are prominently found in the lungs, which might explain why so much of the viruss damage has been centered there. But ACE2 receptors are also very common along the walls of blood vessels throughout the body, Oxley explains. So its possible that its presence there is spurring additional inflammation of the vessels, prompting the formation of blood clots.

Laurence also points to this inflammatory problem. It is this insidious feedback loop of inflammation, he says. And once its going, he says, you cant intervene in that system effectively.

To be sure, sustained immobility, such as in a hospital bed, can increase the risk for blood clots, but the rates currently being reported in Covid-19 patients is way above what would normally be expected, Laurence notes.

With the new evidence about this viruss potential effect on the blood, doctors at many major medical facilities have begun administering low doses of preventative blood thinners to Covid-19 patients.

Its a tricky move, though, because too much blood thinner can cause a patient to bleed internally and possibly die. To gauge the best doses, many physicians are going off of a patients D-dimer levels, which is a biomarker for the presence of blood clots. New clinical trials have quickly spun up (including a multi-state one in the US to test one type of powerful blood thinners, known as tPA (tissue plasminogen activator) in Covid-19 patients, as STAT News reports). And Bikdeli and others have formed an international collective to provide interim consensus-based guidance, he says. What is needed most is high-quality data.

But these preventive treatments wont help those whove had strokes or other major blood-clot complications before receiving medical care. And that number, though still small, is real, as the five young stroke victims from New York City show.

The New England Journal of Medicine report included all stroke patients under 50 at the Mount Sinai health system in New York City during a two-week period in late March and early April. That this rate was nearly seven times the number of stroke patients in that age group during any average two-week period over the previous year indicates a very strong correlation between Covid-19 even mild and asymptomatic cases and the potential for major blood-clotting.

These patients were at home with mild or no symptoms who suddenly developed signs of stroke, Oxley says.

Some of these young patients had also been reluctant to seek medical attention even after fairly severe stroke symptoms. And it wasnt unreasonable for them not to be on the lookout for such a major neurological issue. These are people among the least likely statistically to have a stroke, J Mocco, a Mount Sinai neurosurgeon and coauthor of the report, told the Washington Post.

For example, the youngest, a 33-year-old woman, developed slurred speech and felt weak and numb on her left side for 28 hours before seeking help. She (as well as one other stroke patient in the study) was concerned about going to a hospital during the pandemic, the authors noted even though she had had a cough, headache, and chills for a week.

She is one of the lucky ones. She is the only one who has been able to start speaking again. After 10 days in the hospital to treat her blood clotting, she was discharged to a rehabilitation center.

There is also a question of how long the danger of Covid-19-related clotting lasts. Laurence notes that a lot of our cases, they went through their cough and fever, then all of a sudden, theres a stroke or a blood clot in their legs. For other patients, after having recovered from their primary Covid-19 symptoms, their difficulty of breathing came back, signaling that they have a pulmonary embolism in their lungs, he says. So people have to be vigilant to look for possible signs even after they feel like they have passed the worst of their illness.

Additionally, people at high risk for thrombotic events need to be vigilant, keep good hydration, and keep being active, especially during the period of social distancing and lockdown, Bikdeli says. This group includes people with a family history of blood clots or strokes, obesity, some cancer treatments and surgeries, pregnancy, some birth control methods, and others.

But major strokes can be treatable, Oxley notes. Its just a question of timing. For best results treatment must begin within six hours of stroke. As he told the Washington Post, the message we are trying to get out is if you have symptoms of stroke, you need to call the ambulance.

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Continued here:

Stroke and coronavirus: Blood clotting is a new Covid-19 mystery - Vox.com