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Coronavirus: the good, the bad, and the practical
 

by Pat McNees (updated 7-30-2020)

        Terminology: COVID-19, which stands for coronavirus disease 2019, is the name of the disease. The virus itself is called SARS-CoV-2, given by the International Committee on Taxonomy of Viruses. A new virus (a novel coronavirus) called SARS-CoV-2 caused a disease called COVID-19. Coronavirus is a family of viruses named for the spikes on their surfaces, which have a crown-like appearance.~ AP Stylebook Tips (Poynter)

 

Pandemic: The big picture
Covid-19 basic health info
(including good explanations of the science)
What to do or not do (and how not to do it)
Reliable sources of information
Testing: Finding the right test for the right reason
Contract tracing: How and why to do it quickly
Coronavirus numbers and maps
Who's counting, what are they counting, what are the numbers, and how reliable are they?
Combatting the misinformation epidemic/campaigns
Superspreaders and superspreading events


Social distancing, sheltering in place, and lockdown
Masks!
Vaccines, when?
Treatments, The truth about
What having Covid-19 feels like


Where in the world things went right
Politics, government, and the coronavirus
Trump's handling of the pandemic
Unusual problems and angles on the pandemic
Coronavirus and children (families)
Coronavirus and education
Reopening, safely or otherwise
End-of-life planning during COVID-19
COVID-19's economic impact
The latest conspiracy theories
Problems with personal protective equipment (PPE)
(and talking to coronavirus skeptics)
A salute to medical workers and others who help
Where things went wrong in the U.S.
Coronavirus plus protest spells trouble
Why Covid-19 is so dangerous
Who is harmed most by the coronavirus?
Death and the coronavirus
Remembering victims of the coronavirus
Life after the pandemic
Coronavirus humor and inspiration
Facts and tips that don't fit elsewhere
SARS, MERS, and other forms of coronavirus

See also
Covering the COVID-19 pandemic: Resources for journalists
Coronavirus: How to minimize your risk
Saying goodbye to the dead, during the pandemic
(changing our burial practices)
Recommended reading about pandemics
Lost to the coronavirus pandemic (Obits)
Keeping a diary or journal of the pandemic
COVID-19 fact checking and misinformation tracking (Writers and Editors site)
85+ things to do (listen, watch, read, share, do) during the pandemic

This website page started as a blog post--COVID-19: politics and the stock market vs. science and survival--which swelled to the point of feeling chaotic. This is an attempt to give it some shape as it keeps expanding.

 

Pandemic: The big picture


A Family Guide to Covid William A. Haseltine answers tough questions about Covid-19 honestly, with equal measures of clarity and compassion.
Understanding the US failure on coronavirus—an essay by Drew Altman (BMJ 2020;370:m3417) "The world has been staggered by the US’s disjointed response to covid-19, resulting in by far the highest case and death count globally. The die was cast by two fundamental policy decisions taken by the Trump administration" The federal government as back-up and a starkly partisan pandemic response--a patchwork of responses by state and local governments, divided sharply along partisan lines...."the disappointing US response to covid-19 has been because of a failure of policy and leadership, not healthcare, and largely owing to two fateful policy decisions. After first casting himself as a wartime president, in April President Trump made a fundamental policy shift that has shaped the US response to the pandemic ever since. He announced that states would have primary responsibility for containing the virus, with the federal government in a “back-up” role. The motivation for the policy shift was never clearly articulated. While consistent with conservative principles to let state and local governments customise solutions to local circumstances, it may also have been an effort, however futile in retrospect, to offload political accountability for a growing pandemic with the presidential election looming.
      "This variation had significant public health consequences. Some states opened up their economies earlier than others—and, in general, the states that opened up their economies earlier suffered larger outbreaks. This led directly to the second fateful policy decision shaping the US response: the Trump administration’s decision to push for an opening up of the economy before the virus was contained—and the fracturing of the country along partisan lines in response."

       This is the result when you leave it to states to decide what to do on their own with the federal government as "back-up." Pacesetters, a muddled middle, and laggards, often in the South. The consequences this time may be tragic."
How the Pandemic Defeated America (Ed Yong, The Atlantic, 8-4-2020) "Since the pandemic began, I have spoken with more than 100 experts in a variety of fields. I’ve learned that almost everything that went wrong with America’s response to the pandemic was predictable and preventable. A sluggish response by a government denuded of expertise allowed the coronavirus to gain a foothold. Chronic underfunding of public health neutered the nation’s ability to prevent the pathogen’s spread. A bloated, inefficient health-care system left hospitals ill-prepared for the ensuing wave of sickness. Racist policies that have endured since the days of colonization and slavery left Indigenous and Black Americans especially vulnerable to COVID‑19. The decades-long process of shredding the nation’s social safety net forced millions of essential workers in low-paying jobs to risk their life for their livelihood. The same social-media platforms that sowed partisanship and misinformation during the 2014 Ebola outbreak in Africa and the 2016 U.S. election became vectors for conspiracy theories during the 2020 pandemic."  An important piece of which that's just the beginning.
Your ‘Surge Capacity’ Is Depleted — It’s Why You Feel Awful (Tara Haelle, Elemental/Medium, 8-17-2020) Surge capacity is a collection of adaptive systems — mental and physical — that humans draw on for short-term survival in acutely stressful situations, such as natural disasters. “How do you adjust to an ever-changing situation where the ‘new normal’ is indefinite uncertainty?” A winding, uncharted path to coping in a pandemic.
How Did I Catch the Coronavirus? (Carolyn Kormann, New Yorker, 8-7-2020) For the majority of the nearly five million COVID-19 cases across the United States, the point of infection is unknown. A good overview of how the virus may spread, about new symptoms like Covid toes, about how contract tracing works, about why it's so much more prevalent in the U.S., about what we did and are doing wrong and need to do. "Part of what went wrong is that many states ignored guidelines on how to reopen—including reports by the American Enterprise Institute, the National Governors Association, and even the White House’s health experts—which, by April, all converged on a few recommendations: only reopen once cases have been going down over a period of fourteen days and once the local health agencies have established a strong public-health infrastructure, with testing and contact-tracing teams in place. Also, go very slowly."
By Nearly a 2-1 Margin, Parents Prefer to Wait to Open Schools to Minimize COVID Risk, with Parents of Color Especially Worried Either Way (Kaiser Family Foundation, 7-23-2020) Majorities across parties want Congress to prioritize funding for COVID Testing, Tracing, and PPE. With President Trump calling for schools to reopen and threatening to withhold federal funds from schools that don’t do so, there is a big partisan divide – with 87% of Democrats and 59% of independents preferring schools open later while 60% of Republicans prefer that schools open sooner.
Inside Trump’s Failure: The Rush to Abandon Leadership Role on the Virus (Michael D. Shear, Noah Weiland, Eric Lipton, Maggie Haberman and David E. Sanger, NY Times, 7-18-2020) "The roots of the nation’s current inability to control the pandemic can be traced to mid-April, when the White House embraced overly rosy projections to proclaim victory and move on.... Their ultimate goal was to shift responsibility for leading the fight against the pandemic from the White House to the states. They referred to this as 'state authority handoff,' and it was at the heart of what would become at once a catastrophic policy blunder and an attempt to escape blame for a crisis that had engulfed the country — perhaps one of the greatest failures of presidential leadership in generations." Definitely read this one.
Amy Maxmen Unveils Scientific Roadblocks Amid the COVID-19 Pandemic (Katherine J. Wu, The Open Notebook, 6-2-2020) Maxmen documents the process and progress and setbacks of science. And, with both Ebola and COVID-19, the places where science and society intersect. Or, as Katherine Wu writes, where biology and medicine "collide with politics, economics, and social justice."
Fauci calls coronavirus his 'worst nightmare' as infectious disease expert (Caitlin Oprysko, Politico. 6-9-2020) Fauci explained that he’d long feared the emergence of a brand new, respiratory-borne viral illness with both a significant degree of transmissibility and mortality. “We’ve had outbreaks that have had one or two or three of those three or four characteristics but never all four,” he said. Coronavirus, he noted, checked all of those boxes, and had “indeed turned out to be my worst nightmare....In a period of four months, it has devastated the world.”
How America's Hospitals Survived the First Wave of the Coronavirus (Charles Ornstein, ProPublica, 6-15-2020) ProPublica deputy managing editor Charles Ornstein wanted to know why experts were wrong when they said U.S. hospitals would be overwhelmed by COVID-19 patients. Here’s what he learned, including what hospitals can do before the next wave.All told, more than 30,000 New York state residents have died of COVID-19. It’s a toll worse than any scourge in recent memory and way worse than the flu, but, overall, the health care system didn’t run out of beds.... Early data from the U.S. Centers for Disease Control and Prevention suggested that for every person who died of COVID-19, more than 11 would be hospitalized. But that ratio was far too high and decreased markedly over time...As temporary hospitals began to come online, stay-at-home orders started producing results, with fewer positive cases and fewer hospitalizations. Ends with important lessons learned (and what to prepare for on the next round).
The pandemic shows the urgency of reforming care for the elderly (The Economist, 7-25-2020) Most people should be helped at home as they age. "In the future, many experts argue, the vast majority of old people should be looked after at home for as long as possible. In all but the most severe cases this is cheaper. It is also what most old people want. Putting them in big institutions is the opposite of what they say they value most: autonomy and independence. And for those who still need it, residential care should be transformed."
What Do Countries With the Best Coronavirus Responses Have in Common? Women Leaders (Avivah Wittenberg-Cox, Forbes, 4-13-2020) Many political organizations and companies are still working to get women to behave more like men if they want to lead or succeed. Yet the national leaders of Denmark, Iceland, Finland, Germany, New Zealand, Norway, and Taiwan are case study sightings of the seven leadership traits men may want to learn from women.
America Should Prepare for a Double Pandemic (Ed Yong, The Atlantic, 7-15-2020) Certain traits increase a pathogen’s pandemic potential. Those that spread via bodily fluids (Ebola), contaminated food and water (norovirus), or insect bites (Zika) are slower to spread around the world. By contrast, respiratory viruses like flu, which spread through coughs, sneezes, and exhalations, could conceivably travel fast enough to overlap with COVID-19.
The Looming Bank Collapse (Frank Partnoy, The Atlantic, June-July 2020) After months of living with the coronavirus pandemic, American citizens are well aware of the toll it has taken on the economy: broken supply chains, record unemployment, failing small businesses. Banks learned few lessons from the 2008 crash and the one that may be coming could be worse. Listen to him discuss the problem on radio., along with Rep. Katie Porter, Democratic representative from California: Coronavirus Economy: Are Big Banks On The Verge Of Financial Crisis? (On Point, WBUR and NPR, 7-9-2020) Could the U.S. be on the verge of a financial crash?
Grim Reapers: How Trump and Xi set the stage for the coronavirus pandemic (Laurie Garrett, New Republic, 4-2-2020) The "2020 pandemic is, at its root, the story of two deeply flawed leaders, Xi Jinping and Donald Trump, who for too long minimized the coronavirus threat—and who, because of the enormous, largely unaccountable power they wield, must share responsibility for its global scale. At key moments when their mutual transparency and collaboration might have spared the world a catastrophic pandemic, the world’s two most powerful men fought a war of words over trade policies, and charged each other with responsibility for the spread of the disease." Analysis of what they both did wrong.

What being on a ventilator looks like (Richard Logan). Look at these photos, read the sidebar on what happens when you are put on one, and then think again whether going out to dinner is worth the risk. (H/T Steve Taravella)
The U.S. Was On Track to Build Cheap, Easy-To-Use Ventilators Years Ago. Then a Big Device-Maker Got in the Way. (KHN Morning Briefing, 3-30-2020) Summaries of health policy coverage from major news organizations (with links to stories).Public health experts have long known that a ventilator shortage is a vulnerability in the system. The government tried to rectify the problem, but efforts stalled. The New York Times takes a deep-dive into what went wrong. Meanwhile, manufacturers across the country say they lack federal guidance on where to ship new products.

Bill Gates Warned Us About Pandemics Multiple Times (YouTube) "If anything kills over 10 million people in the next few decades, it's most likely to be a highly infectious virus, rather than a war....all of the supply chains would break down. There would be a lot of panic. Many of our systems would be overloaded." Why didn't we listen? See also The next outbreak? We're not ready (Bill Gates TED Talk, 2015) In 2014, the world avoided a global outbreak of Ebola, thanks to thousands of selfless health workers—plus, frankly, some very good luck. In hindsight, we know what we should have done better.
Pandemics That Changed History (History.com timeline, 4-1-2020) As human civilizations rose, these diseases struck them down.
The Official Coronavirus Numbers Are Wrong, and Everyone Knows It (Alexis C. Madrigal, The Atlantic, 3-4-2020) Because the U.S. data on coronavirus infections are so deeply flawed, the quantification of the outbreak obscures more than it illuminates. Preparing for a sizable outbreak seemed absurd when there were fewer than 20 cases on American soil. Now we know that the disease was already spreading and that it was the U.S. response that was stalled. The reality gap between American numbers and American cases is wide.
A national COVID-19 surveillance system: Achieving containment (Mark McClellan, Scott Gottlieb, Farzad Mostashari,Caitlin Rivers, and Lauren Silvis, Duke-Margolis Center for Health Policy, American Enterprise Institute, 4-7-2020) You can download the report. (See JAMA review/summary. "On state and local levels, every region of the country should aim for key outbreak surveillance and response capabilities: a test-and-trace infrastructure, real-time syndromic surveillance, serologic testing for markers of infection, and rapid response in the form of isolation, contact tracing, and quarantine."

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It Wasn’t Just Trump Who Got It Wrong (Zeynep Tufekci, The Atlantic, 3-24-2020) As it turns out, the reality-based, science-friendly communities and information sources many of us depend on also largely failed. We had time to prepare for this pandemic at the state, local, and household level, even if the government was terribly lagging, but we squandered it because of widespread asystemic thinking: the inability to think about complex systems and their dynamics. Widespread asystemic thinking may have cost America the entire month of February, and much of what we'd normally consider credible media were part of that failure.
How to Talk to Coronavirus Skeptics (Isaac Chotiner, New Yorker, 3-23-2020) A science historian discusses the Trump Administration's response to the pandemic and strategies for convincing doubters that the threat of the coronavirus is real. All of the major areas where we see resistance to scientific findings in contemporary life fall into the category of implicatory denial--that is, "we reject scientific findings because we don’t like their implications." See also Chotiner's piece Jeffrey Sachs on the Catastrophic American Response to the Coronavirus (New Yorker, 4-21-2020) The economist Jeffrey Sachs says that President Trump is the “worst political leader” he has seen in his forty years of working with governments around the world. Trump's disastrous response to Covid-19 demands investigation.
The Long Game of Coronavirus Research (Jerome Groopman, New Yorker, 7-23-2020) "Modern medical research is inherently collaborative, but the constellation of efforts now under way around the world is unprecedented in scale and scope. That diffusion heightens the value of places like NEIDL, which acts as a hub of knowledge. Many facilities fulfill a few of the functions that NEIDL does, but few gather so many disciplines and approaches under one roof, and fewer still also make it part of their missions to proactively pursue collaborations with surrounding institutions. This is no accident but, rather, a testimony to the value of long-range thinking, even at those moments of crisis when speed is on everyone’s mind."
100 Days That Changed the World (Michael Safi, The Guardian, 4-8-2020)
The Coronavirus Spurs a Movement of People Reclaiming Vacant Homes (Dana Goodyear, New Yorker, 3-28-2020)
'All of This Panic Could Have Been Prevented': Author Max Brooks On COVID-19 (Terry Gross, Fresh Air, NPR, 3-24-2020) Apocalyptic novelist Max Brooks is something of an expert on planning for pandemics and other disasters. His books include World War Z, Germ Warfare (YouTube, a graphic history), and Devolution. “President Trump was slow to acknowledge the virus as a real threat. And thus far, the president has resisted using the Defense Production Act to force private companies to manufacture masks, gloves and other essential supplies in the fight against the coronavirus. Many government task forces that plan for disasters have yet to be activated in this crisis."
Inside America’s 2-Decade Failure to Prepare for Coronavirus (Dan Diamond, Politico, 4-11-2020) Top officials from three administrations describe how crucial lessons were learned and lost, programs launched and canceled, and budgets funded and defunded.
How the Pandemic Will End (Ed Yong, The Atlantic, 3-18-2020) The U.S. may end up with the worst COVID-19 outbreak in the industrialized world. This is how it’s going to play out. See also his article The Next Plague Is Coming. Is America Ready? (Atlantic, July 2018—notice the date!) The epidemics of the early 21st century revealed a world unprepared, even as the risks continue to multiply. Much worse is coming.
Our Pandemic Summer (Ed Yong, The Atlantic, 4-14-2020) Three takeaways: 1. This virus isn’t going away anytime soon. 2. Even when the U.S. reopens, the fight won’t be over. 3. Steel yourself psychologically. Here’s how the nation must prepare itself.
Are Hospitals Near Me Ready for Coronavirus? Here Are Nine Different Scenarios. (Annie Waldman, Al Shaw, Ash Ngu, and Sean Campbell, ProPublica, 3-17-2020) In most scenarios, “vast communities in America are not prepared to take care of the COVID-19 patients showing up,” said Dr. Ashish Jha, director of the Harvard Global Health Institute, who led a team of researchers that developed the analysis.
The U.S. was beset by denial and dysfunction as the coronavirus raged (Yasmeen Abutaleb, Josh Dawsey, Ellen Nakashima and Greg Miller, Washington Post, 4-4-2020) From the Oval Office to the CDC, political and institutional failures cascaded through the system and opportunities to mitigate the pandemic were lost.
We Can Eliminate Covid-19 If We Want To (Andy Slavitt, Medium, 6-26-2020) We are always four to six weeks from being able to do what countries around the world have done.
How has the coronavirus pandemic affected global poverty? (Siobhán O'Grady, Wash Post, 7-3-2020) "The novel coronavirus pandemic has wreaked havoc on the global economy, upending entire industries and leaving scores of people around the world without work, child care and — in many places — enough food on their tables. The economic upheaval has exposed and intensified deep-seated inequity, thrusting many of the world’s most vulnerable people into more precarious situations and pushing others into poverty."

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The Intolerable Fragility of American Hospitals (Libby Watson, New Republic, 4-30-2020) The coronavirus pandemic has exposed the frail and unequal nature of our public health system. It doesn’t have to be this way.
What the Coronavirus Crisis Reveals About American Medicine (Siddhartha Mukherjee, New Yorker, 4-27-2020) "...it was known that SARS and MERS were deadly coronaviruses with animal reservoirs that could hop to humans. ...Why wasn’t our research investment remotely commensurate with our threat assessments?...No set of reforms will deal with every problem, such as a President who, bickering with scientists, equivocated and delayed what could have been a lifesaving, economy-protecting, coördinated response. Given the resolve and the resources, however, much is within our grasp: a supply chain with adequate, accordioning capacity; a C.D.C. that can launch pandemic surveillance within days, not months; research priorities that don’t erase recent history; an F.D.A. that serves as a checkpoint but not as a roadblock; a digital system of medical records that provides an aperture to real-time, practice-guiding information....

     "Some of medicine’s frailties are new; some are of long standing. But what the pandemic has exposed—call the experience a stress test, a biopsy, or a full-body CT scan—is painfully clear. Medicine needs to do more than recover; it needs to get better."

      "Competitive-bidding programs drove margins down so low that more than forty per cent of such companies—responsible for the supply of portable oxygen tanks and concentrators—went out of business." Not to mention the problem of health-care coverage that leaves millions of Americans uninsured.
The Pandemic Will Cleave America in Two (Joe Pinsker, The Atlantic, 4-10-2020) Some will emerge from this crisis disrupted and shaken, but ultimately stable. Others will come out of it with much more lasting scars. The answers to each of these two questions—whether someone still has a job, and whether they can do it safely—strongly predict how any given American household is faring right now. (Plus, whether they have any savings.)
What We Can Learn From 1918 Influenza Diaries (Meilan Solly, Smithsonian Magazine, 4-13-2020) These letters and journals offer insights on how to record one’s thoughts amid a pandemic. Though much has changed since 1918, the sentiments shared in writings from this earlier pandemic are likely to resonate with modern readers.
Comparing the Influenza Epidemic of 1918 to the Coronavirus (New Yorker Video, released 3-25-2020) John Barry, an expert on the earlier pandemic, speaks with David Remnick about the parallels between 1918 and 2020.
One Parallel for the Coronavirus Crisis? The Great Depression (Livia Gershon, JSTOR Daily, 5-20-2020) “The idea that the federal government would be providing emergency relief and emergency work was extraordinary,” one sociologist said. “And people liked it.”
10 Positive Updates on the COVID-19 Outbreaks From Around the World (McKinley Corbley, Good News Network, 3-17-2020) 1) US Researchers Deliver First COVID-19 Vaccine to Volunteers in Experimental Test Program. 2) Distilleries Across the United States Are Making Their Own Hand Sanitizers to Give Away for Free. 3) Air Pollution Plummets in Cities With High Rates of Quarantine. And so on.
I’m a Critical Care Doctor. I’m Tired, I’m Mourning, I’m Bracing for More. (Daniela J. Lamas, NY Times, 6-16-2020) Waiting for the second wave. We’re keeping empty units available. The virus is still here.

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Superspreaders and Superspreading Events


How the Sturgis Motorcycle Rally may have spread coronavirus across the Upper Midwest (Brittany Shammas and Lena H. Sun, Washington Post, 10-17-2020) Within weeks of the gathering that drew nearly half a million bikers, the Dakotas, along with Wyoming, Minnesota and Montana, were leading the nation in new coronavirus infections per capita. "More than 330 coronavirus cases and one death were directly linked to the rally as of mid-September, according to a Washington Post survey of health departments in 23 states that provided information. But experts say that tally represents just the tip of the iceberg, since contact tracing often doesn’t capture the source of an infection, and asymptomatic spread goes unnoticed....South Dakota, imposed no restrictions — in this case allowing the largest gathering of people in the United States and perhaps anywhere in the world amid the pandemic and creating huge vulnerabilities as tens of thousands of attendees traveled back home to every state in the nation."
One Meeting in Boston Seeded Tens of Thousands of Infections, Study Finds (Carl Zimmer, NY Times, 8-26-2020) On Feb. 26, 175 executives at the biotech company Biogen gathered at a Boston hotel for the first night of a conference. At the time, the coronavirus seemed a faraway problem, limited mostly to China. But the virus was right there at the conference, spreading from person to person.
How a Premier U.S. Drug Company Became a Virus 'Super Spreader' (Farah Stockman and Kim Barker, NY Times, 4-12-2020) Biogen employees unwittingly spread the coronavirus from Massachusetts to Indiana, Tennessee and North Carolina. In hindsight, many people have criticized Biogen's decision to continue with its leadership meeting in late February, which was attended by vice presidents from European countries already hit by the virus. Others in the industry fault Biogen for being too tight-lipped about the outbreak.
How 'Superspreading' Events Drive Most COVID-19 Spread (Christie Aschwanden, Scientific American, 6-23-2020) As few as 10 percent of infected people may drive a whopping 80 percent of cases in specific types of situations.
Coronavirus: What makes a gathering a ‘superspreader’ event? (Holly Honderich, BBC News, 7-4-2020) What is a superspreader? At a superspreading event, the number of cases transmitted will be disproportionately high and the risk of these superspreading events may balloon in the presence of superspreading people, who pass on their infection more widely either by being in contact with more people or emitting more of the virus. The risk is greater when there are any of the following in combination: being indoors, crowded, in closed spaces, without any sort of personal protective equipment like masks (as you would be if eating or drinking). When you sing, similar to when you speak loudly or shout, you expel respiratory droplets from your mouth and nose, and as singers rehearse and socialize those droplets hover in the air. "When the index case is someone central to the gathering, someone familiar with the guests - like the host of a party, as was the case at the Barbosa birthday - that added intimacy and contact may contribute to extra infections."
Most People With Coronavirus Won't Spread It. Why Do a Few Infect Many? (Carl Zimmer, NY Times, 6-30-2020) Growing evidence shows most infected people aren't spreading the virus. But whether you become a superspreader probably depends more on circumstance than biology.
Hugs, handshakes, and few masks: A Rose Garden Supreme Court announcement packed with Covid-19 red flags (Andrew Joseph, STAT, 10-3-2020) The event in the Rose Garden where President Trump announced the nomination of Amy Coney Barrett to the Supreme Court, as videos and photos of it make clear, violated many of the recommendations that everyone else has been told to adopt this year. More than 150 people, most maskless, sat crowded in together and glad-handing. Some of them traveled there from other places and would return back to their communities.The White House had been testing staff and visitors for Covid-19, but experts note that no test is perfect. The rapid tests the White House uses are more likely to return a false negative than other, lab-based tests, and they aren't cleared by regulators for screening people who don't have symptoms. Five to six days later several attendees (including President Trump and his wife Melania were diagnosed with Covid-19 — a time frame that fits with how long it takes for the virus to build up enough in someone's system to the point that it can cause symptoms and be detected by tests. "In a way, experts said, the fact that a president who has dismissed the seriousness of the pandemic and mocked certain precautions contracted the coronavirus felt like it was his administration's laxness catching up to him."
Epidemiology and transmission dynamics of COVID-19 in two Indian states (Ramanan Laxminarayan et all, Science, 9-29-2020)
Superspreading Database Now Has 1500+ Entries (9-23-2020) From all continents, including Antarctica. See article about database (Koen Swinkels, Medium, 6-12-2020) and links to blog, etc., about superspreader project and blog posts and bubble map with timeline. Click around and find much data, around the world.
Why the Coronavirus Is More Likely to 'Superspread' Than the Flu (Katherine J. Wu, NY Times, 8-7-2020) Most people won't spread the virus widely. The few who do are probably in the wrong place at the wrong time in their infection, new models suggest.
Largest COVID-19 contact tracing study to date finds children key to spread, evidence of superspreaders (Princeton)
23 bus passengers contracted coronavirus from 1 infected person. No one was wearing a mask. (Hilary Brueck, Business Insider, 9-1-2020) A new study shows how one superspreader's coronavirus infection spread to 23 others in less than 2 hours, when they piled on to a bus together, without masks, to get to an outdoor worship event at a Buddhist temple. Six feet of distance isn't always enough to prevent you from getting sick, especially in poorly ventilated indoor spots. "I would hope that the air circulation in US buses would be better," one infectious disease expert said. Very few people sitting near the windows on that sunny, crisp day (when temperatures fluctuated from the mid-30s to 50 degrees Fahrenheit) got sick.

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Unusual features of the pandemic


First presumed U.S. case of coronavirus reinfection reported in Nevada (Antonia Noori Farzan, Rick Noack, Abigail Hauslohner, Lateshia Beachum, Derek Hawkins, Hannah Denham, Miriam Berger, Hannah Knowles and Meryl Kornfield, Washington Post, 8-28-2020) A 25-year-old Reno man is the first reported coronavirus patient to be reinfected in the United States, scientists say. Unlike the world’s first presumed case of reinfection in Hong Kong, this patient developed more severe symptoms when he got sick in late May after a mild case in April, according to the newly released study, which has not yet been peer-reviewed.
Another COVID Mystery: Patients Survive Ventilator, But Linger in a Coma (Martha Bebinger, WBUR and KHN, 8-18-2020) Doctors across the U.S. and in other countries have noted a troubling phenomenon associated with some COVID cases: Even after extubation, some patients remain unconscious for days, weeks or longer. There’s no official term for the problem, but it’s being called a “prolonged” or “persistent” coma or unresponsiveness.
COVID-19: Using Telehealth to Reduce Your Risk (Compassion and Choices) An excellent overview, both of telemedicine and of anticipating final needs.
‘COVID toes,’ other rashes latest possible rare virus signs (Lauran Neergaard, AP News, 5-17-2020)
Mild COVID, Lingering Heart Effects for ICU Doc (Kristina Fiore, MedPage Today, 8-12-2020) Despite a mild case, it took months for Janet Shapiro, MD, to fully recover heart function. Two German studies published in the same journal found evidence of long-lasting cardiac effects, even in patients who never developed overt cardiac disease during their infection.
Heart Damage in COVID-19 Patients Puzzles Doctors (Markian Hawryluk, Kaiser Health News and Scientific American, 4-6-2020) Up to one in five hospitalized patients have signs of heart injury. Cardiologists are trying to learn whether the virus attacks the organ
4 unusual things we've learned about the coronavirus since the start of the pandemic (Sanjaya Senanayake, The Conversation and Medical XPress, 6-30-2020)
Isolation, Disruption and Confusion: Coping With Dementia During a Pandemic (Heidi de Marco, KHN, 8-18-2020)
One College’s Pop-Up COVID Test: Stop and ‘Smell the Roses’ (Or the Coffee) (Ann Bauer, KHN, 8-[24-2020) Forget those thermometers. Researchers, finding a surer link between the loss of the sense of smell and a coronavirus infection, suggest the symptom may be an easy and less expensive method for screening.
Restaurants Are Transforming into Grocery Stores to Survive the Pandemic (Jodi Helmer, Civil Eats, 4-22-2020) Selling sought-after eggs, flour, and toilet paper directly to consumers has provided an ‘emergency transfusion’ for restaurants. “We knew that people were having trouble finding things at the stores,” Heard recalls. “We thought it could help the neighborhood—and it’s possibly the only reason we’re staying afloat.”
The pandemic is giving people vivid, unusual dreams. Here’s why. (Rebecca Renner, National Geographic, 4-15-2020) Researchers explain why withdrawal from our usual environments—due to social distancing—has left dreamers with a dearth of “inspiration.”
Coronavirus pandemic makes for unusual times at 60-year-old Heth’s Hardware Hank & Rental (Steve Cahalan, La Crosse Tribune, 4-26-2020)

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What to do or not do (disinfecting, among other things)
(and how or how not to do it)

Matt Pearce (a Los Angeles Times reporter) tweeted: "I imagine all the closures and cancellations give people a sense of ominousness. But it's really an amazing act of social solidarity: We're sacrificing so we can give nurses, doctors and hospitals a fighting chance. Start from there and hopefully we can figure out the rest."
Advance directives, health care proxies, and medical orders for life-sustaining treatment A separate section on this website covers what you need to do to express your wishes about how you want to be cared for (what you want and don't want done). See also Paperwork for expressing your end-of-life and emergency-care preferences (U.S.) If your heart stops, do you want us to run in and do chest compressions and to pump on your chest an inch to two inches, to get your heart going and pumping, knowing that we could break ribs and that we might have to put in a chest tube after because of pneumothorax. Do you want to have a breathing machine? Do you want a feeding tube if you’re unable to eat normally? Do you want us to be giving medications? Etc., with links to explanations. .
Can Air-Conditioning Spread the Virus? (Paging Dr. Hamblin, The Atlantic, 6-24-2020) The exact risk is unknown, but it’s a good moment to make sure ventilation systems are working well.
Fauci Blames Virus Surge On U.S. Not Shutting Down Completely (Reuters, 7-13-2020) Top infectious disease expert Anthony Fauci on Monday ascribed the surge in U.S. coronavirus cases to the country’s failure to shut down completely, then a rush to reopen too soon, and urged a commitment to guidelines to snuff out the disease. He stressed basic protections including physical distancing, wearing masks, avoiding crowds and washing hands.
Hygiene Theater Is a Huge Waste of Time (Derek Thompson, The Atlantic, 7-27-2020) People are power scrubbing their way to a false sense of security, which can ironically lead to more infections. Many bars, indoor restaurants, and gyms, where patrons are huffing and puffing one another’s stale air, shouldn’t be open at all. They should be shut down and bailed out by the government until the pandemic is under control. No amount of soap and bleach changes this calculation.
Answers to frequently asked questions about COVID-19 (Harvard Health Publishing) Including What are the symptoms? What should I do if I feel sick? If a loved one gets it, how do I care for them? How do I keep from getting it?
Extra precautions needed to protect older adults (CDC)
How Fauci, 5 other health specialists deal with covid-19 risks in their everyday lives (Marlene Cimons, WaPo, 7-2-2020) Masks, yes, except at home, or when eating, and outdoors in some situations. Eat in restaurants, no; takeout, yes. Let the mail sit before opening it. Etc.
I Survived COVID-19. How Can I Give Back? (Michele Turk, Next Avenue, 6-17-2020) After being rejected as a volunteer, she learned the value of her plasma.

Disinfecting surfaces:
---The Most Effective Ways to Kill Coronavirus in Your Home (Robert Preidt, HealthDay reporter on WebMD, 3-18-2020) "An important general rule is that you shouldn't immediately wipe a cleaning solution off as soon as you've applied it to a surface. Let it sit there long enough to kill viruses first," Donald Schaffner said in a university news release. "Natural chemicals such as vinegar and tea tree oil are not recommended for fighting coronaviruses."
---6 Steps for Safe & Effective Disinfectant Use (PDF, poster, coronavirus.gov). In case you can't download the PDF:
Step 1: Check that your product is EPA-approved. Find the EPA registration number on the product. Then, check to see if it is on List N, EPA’s list of approved disinfectants: epa.gov/listnepa.gov/ListN
Step 2: Read the directions. Follow the product’s directions. Check “use sites” and “surface types” to see where you can use the product. Read the “precautionary statements.”
Step 3: Pre-clean the surface. Make sure to wash the surface with soap and water if the directions mention pre-cleaning or if the surface is visibly dirty.
Step 4: Follow the contact time. You can find the contact time in the directions. The surface should remain wet the whole time to ensure the product is effective.
Step 5: Wear gloves and wash your hands. For disposable gloves, discard them after each cleaning. For reusable gloves, dedicate a pair to disinfecting COVID-19. Wash your hands after removing the gloves.
Step 6: Lock it up. Keep lids tightly closed and store out of reach of children.

---"The U.S. Centers for Disease Control and Prevention (CDC) recommends daily disinfection of often-touched surfaces such as tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets and sinks, as well as the use of detergent or soap and water on dirty surfaces prior to disinfection.
---CDC: Unexpired household bleach will be effective against coronaviruses when properly diluted. Prepare a bleach solution by mixing 5 tablespoons (1/3 cup) bleach per gallon of water.
---WebMD: You can dilute alcohol with water or aloe vera to make hand sanitizer) but be sure to keep an alcohol concentration of around 70% to kill coronaviruses. Pure (96%) alcohol evaporates too quickly for such use.
--- Cleaning And Disinfecting Your Home (CDC, 2019)
--- Make CDC-Approved Disinfecting Wipes (DIY, 4-7-2020) 4 teaspoons bleach per quart of water
--- DIY Homemade Disinfectant Wipes (Clorox wipes) (MamaInTheKitchen)
--- DIY Disinfectant Wipes (Mitisha P's version, also made with Clorox)
--- KILL COVID - DIY Disinfectant Wipes made with with Bleach or Alcohol (Clueless Mama DIY)
--- How to Make Disinfectant Spray at Home Using CDC and WHO Methods (NOTaboutaMEn)
Running Essential Errands (CDC) Grocery Shopping, Take-Out, Banking, Getting Gas, and Doctor Visits. To protect yourself when getting your prescriptions:
---Call in prescription orders ahead of time. (Or ask if they can mail your order--special dispensation during the pandemic.)
---Use drive-thru windows, curbside services, mail-order, or other delivery services.
---Try to make one trip, picking up all medicine at the same time. During this time, you may also want to contact your Medicare prescription drug plan to see if they've temporarily waived certain requirements to help prevent the spread of COVID-19 — like waiving prescription refill limits or relaxing restrictions on home or mail delivery of prescription drugs.
Sanitizing Amazon boxes, taking Uber and getting food properly during the coronavirus pandemic (Kim Komando, USA Today, 4-3-2020)
Safety Advice If You Must Visit the Grocery Store (Sumathi Reddy, Wall Street Journal, 4-3-2020) Deliveries are safer during the coronavirus pandemic, but sometimes a store visit is unavoidable. Here are the precautions to take.
When and how to use masks (WHO, Advice for the public)
'Under No Circumstance': Lysol Maker, Officials Reject Trump's Disinfectant Idea (Colin Dwyer, NPR, 4-24-2020) After hearing about research reflecting the disinfectant capabilities of ultraviolet light on surfaces, Trump mused that scientists might try to find a way to place strong disinfectants directly inside the body to treat a patient's infection.

        As many experts have stated since horrified expressions crossed faces all over the country, THIS IS A HORRIBLE, DEADLY IDEA. Reported Domenico Montanaro of NPR on 4-25: ’"With the president facing criticism for seemingly thinking out loud behind the lectern at these briefings, floating untested ideas, Friday’s session was cut short to just over 20 minutes. Axios reported that the president may reduce the length of them or not appear daily....advisers to the president, in and out of the White House, reportedly think these briefings are hurting his image." Indeed.
Myth Busters (World Health Organizations) Things that are not true about covid 19.
Stories of Hope (The Obama Foundation) Tell us about the stories—big and small—that are lifting your spirits.
COVID-19 - Some Drug-Related Issues (The Medical Letter)
COVID-19 Loan and Relief Resources for Small Businesses (Gusto editors) Click on "COVID-19 Relief Resources for Small Businesses" to get updated spreadsheet.
Trump's mismanagement helped fuel coronavirus crisis (Dan Diamond, Politico, 3-7-2020) Current and former administration officials blame the president for creating a no-bad-news atmosphere that stifled attempts to combat the outbreak. Fortunately, we're learning to listen to Dr. Fauci instead of Trump.
Not His First Epidemic: Dr. Anthony Fauci Sticks to the Facts (Denise Grady, NY Times, 3-9-2020) Dr. Anthony Fauci, the nation’s leading expert on infectious diseases, is widely respected for his ability to explain science without talking down to his audience and to correct the president. See also “I Have No Ideology. My Ideology Is Health”: Dr. Anthony Fauci on the Tactics of Dealing With the Novel Coronavirus—And Trump (Gabriel Sherman, Vanity Fair, 3-31-2020) “We are by no means out of the woods,” Fauci says. But his insistence on facts, and science, may be finally changing the trajectory of the pandemic.
The Use of Bleach (Hong Kong health department during SARS crisis). Bleach is a good disinfectant but it's dangerous if misused. Follow instructions!
Interim Guidance for Responding to COVID-19 among People Experiencing Unsheltered Homelessness Key actions that local and state health departments, homelessness service systems, housing authorities, emergency planners, healthcare facilities, and homeless outreach services can take to protect people experiencing homelessness from the spread of COVID-19.
Whether planned surgery should proceed (Centers for Medicare & Medicaid Services). Determining essential vs. elective surgery. "At all times, the supply of personal protective equipment (PPE), hospital and intensive care unit beds, and ventilators should be considered, even in areas that are not currently dealing with COVID-19 infections."
Does Everyone Over 60 Need to Take the Same Coronavirus Precautions? (Judith Graham, KHN, 3-24-2020) If you’re going to the store, consider wearing cloth gloves, because viruses don’t survive as well on soft surfaces. Try not to handle your smartphone when you’re out of the house. “A phone is a hard plastic surface that can easily get contaminated,” she said. Are you frail? Answer these questions:

F: Are you consistently fatigued?

R, for resilience: Can you climb a flight of stairs?

A, for aerobic: Can you walk a block?

I, for illnesses: If you’ve got five or more, that’s bad.

L, for loss of weight: That’s not good.”

If you answer yes to three or more of those questions, you should be “really careful and self-isolate,” Morley said. ...even healthy people are becoming sick.
Life on Lockdown in China (Peter Hessler, Letter from Chengdu, New Yorker, 3-30-2020) Forty-five days of avoiding the coronavirus. 'There seems to be a brief window—perhaps two or three days—when people are infectious but not yet showing symptoms. Gabriel Leung, the dean of medicine at the University of Hong Kong, told me that he believes between twenty and forty per cent of infections come from people who don’t yet seem sick. “They could be spreading it through droplets, say during eating or speaking,” he said. “These droplets could contaminate surfaces, and this is how it spreads.”' [Not touching your face is the critical preventive step--that plus washing your hands when you've touched possibly contaminated surfaces.]
U.S. Health Workers Responding to Coronavirus Lacked Training and Protective Gear, Whistle-Blower Says (Emily Cochrane, Noah Weiland and Margot Sanger-Katz, NY Times, 2-27-2020) Team members were not properly trained, lacked necessary gear and moved freely around and off military bases where Americans were quarantined, a whistleblower complains.
How prepared are you for disaster? Sites geared to helping you prepare for hurricanes, earthquakes, tornadoes, floods and flash floods, and to increase child and campus security. Many of the steps are helpful in a pandemic.
Help fight Medicare fraud (Medicare.gov) Guard your Medicare card like it’s a credit card.
Why Texas is so far behind other states on virus response(Politico, 3-18-2020) Texas leaders have been reluctant to set restrictions conservative voters might consider draconian and business leaders oppose. They’ve also opposed steps to expand health insurance coverage. The state, which didn’t expand Medicaid, has the highest uninsured rate in the country, meaning millions of people don’t have doctors to call if they show symptoms.
The Coronavirus Outbreak: What You Need to Know (Next Avenue) Many practical articles, including COVID-19 Health Rationing: What You Need to Know (Jan Gurley, 7-14-2020) What it means when a state institutes Crisis Standards of Care, as Arizona has. "While hearing your loved one discussed in terms of their “organs” may feel abstract and impersonal, it is important to remember that an organ system approach is our best measure for avoiding discrimination and avoiding making value-based judgments about who gets care."
What am I supposed to do about my fundraising event: Event planning and COVID-19: (Vimeo video, Laura Pierce of Washington Nonprofit and Rebecca Zanatta of Ostara Group, a nonprofit consulting group) Cancel? or something else?
Worries about medical bills and lost pay may hamper coronavirus efforts in the United States (Amy Goldstein, Washington Post, 3-2-2020) The race to curb the spread of the new coronavirus could be thwarted by Americans fearful of big medical bills if they get tested, low-income workers who lose pay if they take time off when sick, and similar dilemmas that leave the United States more vulnerable to the epidemic than countries with universal health coverage and sturdier safety nets. As the test for the virus becomes more widely available, health-care experts predict that some people with flu-like illnesses — or those who may have been exposed — will avoid finding out whether they have been infected because they are uninsured or have health plans that saddle them with much of the cost of their care.
These Common Household Products Can Destroy the Novel Coronavirus (Consumer Reports) On surfaces, that is, and why you need to clean using the right stuff. Soap and water is right up there with disinfectants.
Tipsheet for Journalists: Covering the Coronavirus Epidemic Effectively without Spreading Misinformation (Laura Helmuth, TheOpenNotebook, 3-2-2020) See tip sheets for journalists below.
Avoid cruise ships, says State Department (Noah Weiland and Maggie Haberman, NY Times, 3-9-2020) “Absolutely don’t get on a cruise ship,” says Dr. Anthony Fauci, who has overseen epidemics for decades at NIH/NIAID.
Coronavirus: Fake health advice you should ignore (BBC News, 3-8-2020) Drinking water every 15 minutes (and eating garlic) cannot kill the virus. You should remain well-hydrated, however.
I.O.C.’s Reassurance About the Tokyo Olympics Rankles Some Athletes (NY Times, 3-18-2020) Some athletes on a conference call about whether to cancel the Summer Olympics in Tokyo in July were left dumbfounded when an athlete representative from Europe made a comment playing down the severity of the virus and blaming the news media for hyping its risks. The I.O.C. is insisting the games will go on; the athletes are worried about the health risk. (In late March the games were postponed a year.)
What you need to know about the coronavirus (Washington Post, 3-3-2020)
Online training as a weapon to fight the new coronavirus (World Health Organization, 2-7-2020) This free learning resource is available to anyone interested in novel coronavirus on WHO’s open learning platform for emergencies, OpenWHO.org.
Here Is What a WHO Global Health Emergency Means (Washington Post) While the recommendations aren’t enforceable, there’s considerable pressure for countries to abide by the WHO’s advisories.
You’re Likely to Get the Coronavirus (James Hamblin, The Atlantic, 2-24-2020) Most cases are not life-threatening, which is also what makes the virus a historic challenge to contain. (WHO)
Basic protective measures against the new coronavirus (ANSInet, 2-29-2020)
Growing Concerns of Coronavirus Should Spur Plans – Not Panic – in The Workplace (Julie Appleby, Kaiser Health News, 2-28-2020)
World experts and funders set priorities for COVID-19 research (WHO, 2-12-2020)

 

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Covid-19, Basic Health and Welfare Info


Asked and answered: What readers want to know about coronavirus (Washinhttps://www.youtube.com/watch?v=35Wt7Ncmgecgton Post info page, renewed regularly) Well-organized Q&A.
• Science journalist Carl Zimmer's excellent answers to questions that need answering. New York Times science journalist Carl Zimmer talks with ScienceWritersNYC (SWINY) co-chair about President Trump’s diagnosis of COVID-19, his treatment regimen and prognosis, what superspreader events are, and more (including which federal agencies Trump is stocking with climate deniers). The skinny from someone who knows more than most of us. Lots more SWINY video-recordings of excellent science conversations.
•  COVID-19′s silent spread: Princeton researchers explore how symptomless transmission helps pathogens thrive (Catherine Zandonella, Princeton, 9-30-2020) COVID-19′s rapid spread throughout the world has been fueled in part by the virus’ ability to be transmitted by people who are not showing symptoms of infection.
Seniors With COVID-19 Show Unusual Symptoms, Doctors Say (Judith Graham, KHN, 4-24-2020) 'COVID-19 is typically signaled by three symptoms: a fever, an insistent cough and shortness of breath. But older adults — the age group most at risk of severe complications or death from this condition ― may have none of these characteristics.
Instead, seniors may seem “off” — not acting like themselves ― early on after being infected by the coronavirus. They may sleep more than usual or stop eating. They may seem unusually apathetic or confused, losing orientation to their surroundings. They may become dizzy and fall. Sometimes, seniors stop speaking or simply collapse.
Why Some People Get Sicker Than Others (James Hamblin, The Atlantic, 4-21-2020) An important article about how the disease works (so far as we know) COVID-19 is proving to be a disease of the immune system. This could, in theory, be controlled. “There’s a big difference in how people handle this virus,” says Robert Murphy, a professor of medicine and the director of the Center for Global Communicable Diseases at Northwestern University. “It’s very unusual. None of this variability really fits with any other diseases we’re used to dealing with.” This degree of uncertainty has less to do with the virus itself than how our bodies respond to it.... Understanding exactly how and why some people get so sick while others feel almost nothing will be the key to treatment.... Ultimately, people who are unable to take time off of work when sick—or who don’t have a comfortable and quiet home, or who lack access to good food and clean air—are likely to bear the burden of severe disease.”
Long-Haulers Are Redefining COVID-19 (Ed Yong, The Atlantic, 8-19-2020) Without understanding the lingering illness that some patients experience, we can’t understand the pandemic. A follow-up story to COVID-19 Can Last for Several Months (Ed Yong, The Atlantic, 6-2020) This story contains links to many other basic explanations and stories.
Massive genetic study shows coronavirus mutating and potentially evolving amid rapid U.S. spread (Chris Mooney , Joel Achenbach and Joe Fox, Washington Post, 9-23-2020) This is a single study, and “you don’t want to over-interpret what this means.”
First presumed U.S. case of coronavirus reinfection reported in Nevada (Antonia Noori Farzan, Rick Noack, Abigail Hauslohner, Lateshia Beachum, Derek Hawkins, Hannah Denham, Miriam Berger, Hannah Knowles and Meryl Kornfield, Washington Post, 8-28-2020) A 25-year-old Reno man is the first reported coronavirus patient to be reinfected in the United States, scientists say. Unlike the world’s first presumed case of reinfection in Hong Kong, this patient developed more severe symptoms when he got sick in late May after a mild case in April, according to the newly released study, which has not yet been peer-reviewed
How COVID-19 Spreads (CDC) Please note a correction: Virus ‘does not spread easily’ from contaminated surfaces or animals, revised CDC website states (Ben Guarino and Joel Achenbach, Washington Post, 5-21-2020) "The coronavirus primarily spreads from person to person and not easily from a contaminated surface.... Touching contaminated objects or surfaces does not appear to be a significant mode of transmission.... An individual does not need to feel sick or show symptoms to spread the submicroscopic virus. Close contact means within about six feet, the distance at which a sneeze flings heavy droplets." See also "Tests to Detect Coronavirus on Surfaces Show Mixed Results” (Lina Zeldovich, Undark Magazine, 5-11-2020) Labs and companies are already distributing the tests, which vary drastically in price and potential performance.
WHO Warns Young People Are Emerging as Main Spreaders of the Coronavirus (William Wan and Moriah Balingit, WaPo, 8-18-2020) The World Health Organization warned Tuesday that young people are becoming the primary drivers of the spread of the novel coronavirus in many countries — a worrisome trend experts fear may grow in the United States as many colleges and schools begin to reopen. Many nations in Asia, which had previously pushed infections to enviably low rates, have experienced surges in recent weeks at the same time that the age of those infected skewed younger.
Immunology Is Where Intuition Goes to Die (Ed Yong, The Atlantic, 8-5-2020) Which is too bad because we really need to understand how the immune system reacts to the coronavirus. An immune response doesn’t necessarily provide immunity in the colloquial sense. It all depends on how effective, numerous, and durable those antibodies and cells are.
A Viral Epidemic Splintering Into Deadly Pieces (Donald G. McNeil Jr., NY Times, 7-29-2020) As infections mount across the country, it is dawning on Americans that the epidemic is now unstoppable, and that no corner of the nation will be left untouched. The spread of the virus is now influenced as much by human behavior as it is by the pathogen itself. Not only are American cities in the South and West facing deadly outbreaks like those that struck Northeastern cities in the spring, but rural areas are being hurt, too. In every region, people of color will continue to suffer disproportionately, experts said.
      "The virus is extremely transmissible, through not just coughed droplets but also a fine aerosol mist that is expelled when people talk loudly, laugh or sing and that can linger in indoor air. As a result, masks are far more effective than scientists once believed.
       "Virus carriers with mild or no symptoms can be infectious, and there may be 10 times as many people spreading the illness as have tested positive for it.
       "The infection may start in the lungs, but it is very different from influenza, a respiratory virus. In severely ill patients, the coronavirus may attach to receptors inside the veins and arteries, and move on to attack the kidneys, the heart, the gut and even the brain, choking off these organs with hundreds of tiny blood clots."
What is a coronavirus (animated video, Alex Rosenthal and Pall Thordarson, TED-Ed) A brief, clear, animated visual explanation. Watch or read transcript. These TED-Ed explanations are good for all ages!  Epidemics often occur when a virus jumps from animals to humans. This is true of the RNA viruses that caused the Ebola, Zika, and SARS epidemics, and the COVID-19 pandemic. Coronaviruses have a few key differences from most RNA viruses. They're some of the largest,  meaning they have the most genes. That creates more opportunity for harmful mutations. 
---Which is better: Soap or hand sanitizer? (Alex Rosenthal and Pall Thordarson, TED-Ed Talk)
---How does the immune system work? (Emma Bryce, TED-Ed Talk)
For Kids: How to Keep Covid Away (FREE, online) "This visual [online] story was created for kids to better understand the 2019 novel coronavirus and the COVID-19 illness it causes. Written by Signe Elisabeth Aasberg, PhD, illustrated by Elfy Chiang, presented by Lifeology, reviewed by our children."
• Free download: A Family Guide to Covid: Questions & Answers for Parents, Grandparents & Children by William A. Haseltine. Which I learned of through the Washington Post: An e-book for families provides answers to important questions about COVID-19 (Erin Blakemore, 7-20-2020)
Germs: Understand and protect against bacteria, viruses and infection (Mayo Clinic) Learn how germs (bacteria, viruses, fungi, protozoans, and helminths) work and what you can do to protect yourself.
COVID-19 Coronavirus Tracker (Kaiser Family Foundation, drawn from the Johns Hopkins University (JHU) Coronavirus Resource Center’s COVID-19 Map and the World Health Organization’s (WHO) Coronavirus Disease (COVID-2019) situation reports.)
State Data and Policy Actions to Address Coronavirus (KFF)
How to protect yourself and others (CDC)
What to Do If You Are Sick (CDC)

How long do coronavirus droplets last? The virus droplets last 3 hours in the air. If they land on a surface, they last hours or days, how long depending on type of surface. (This is why you want to sanitize surfaces, or wait before touching them.)

How Long Does the Coronavirus Live on Various Types of Surfaces?

(WebMD, downloadable, printable chart, which gives examples in each category):

    Metal, ceramics (5 days)

    Glass, paper (newspapers, magazines) (up to 5 days)

    Wood (4 days) Plastics, stainless steel (2 to 3 days)

    Cardboard (1 day)

    Aluminum (2 to 3 hours)

    Copper (4 hours)

But see above: Virus 'does not spread easily' from contaminated surfaces or animals, revised CDC website states. "It doesn't seem to spread through food, and has not been found in water."

 • Glossary for Coronavirus (COVID-19) Outbreak. R0 is pronounced "R naught."
CDC Coronavirus (COVID-19) Website (Centers for Disease Control) How to protect yourself. What to do if you're sick. Self-check your symptoms. Should you get tested? What to do at home and when going out to stay safe.
Coronavirus disease (COVID-19): WHO advice for the public (World Health Organization)
You’re Showering Too Much (James Hamblin, The Atlantic, 7-2020) Wash your hands, but lay off the other parts. At the very least, we’re starting to learn not to touch our face. Our mites are probably grateful.


Answers to frequently asked questions (Coronavirus Resource Center, Harvard)
Why Some People Get Sicker Than Others (James Hamblin, The Atlantic, 7-2020) COVID-19 is proving to be a disease of the immune system. This could, in theory, be controlled. "Once the virus has spread widely within our body, our own immune system becomes the thing that more urgently threatens to kill us. That response cannot be fully controlled. But it can be modulated and improved."
Safer Sex and Covid-19 (NYC Health)
211 Call this number if If you need assistance finding food, paying housing bills, or other local essential services.
Find Help (Aunt Bertha) Find food assistance, help paying bills, and other free or reduced cost programs, including new programs for the COVID-19 pandemic.
Protect yourself financially from the impact of coronavirus (Consumer Financial Protection Bureau)
IRS: Get Your Stimulus Payment
Covid-19 resources (Free Speech Coalition, from which I have lifted liberally here)

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End-of-life planning during COVID-19


My End-of-Life Decisions: An Advance Planning Guide and Toolkit (Compassioon and Choices)


COVID-19 End -of-Life Planning Kit (Compassion and Choices)
---Understanding Your Choices What do I need to think about if I were to become seriously ill with COVID-19? What do I need to know about different treatment options?
---Using Telehealth to Reduce Your Risk
---Advance Care Planning What should I be telling my loved ones now, when I am well? What are the steps to take to create a plan?
---COVID-19 Advanced Directive Addendum: Documenting Your Preferences Attach this form to your advance directive and date and sign.
---Dying in the Age of the Pandemic Unfortunately, many patients who contract coronavirus are likely to die in a hospital isolated from their loved ones. This page provides some tips for creating greater connection, and having a more compassionate death in the age of COVID-19.

#1: Avoiding the hospital.

Saying goodbye--when you are sick and when you are well.

Memorializing Your Loved One
---COVID-19: Impact on Underserved Communities "If all Americans had died of COVID-19 at the same rate as White Americans, at least 10,500 Black Americans, 1,400 Latino Americans and 300 Asian Americans would still be alive." ~ APM Research Lab, May 2020
---Juego de Herramientas del COVID-19 (COVID-19 Toolkit in Spanish)

 

H/T to Rosalind Kipping for alerting me to these valuable Compassion and Choices resources.

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Coronavirus, children, and families

Managing life in isolation

 

FREE READING MATERIAL FOR CHILDREN:
Why We Stay Home: Suzie Learns About Coronavirus (CIDD) Download this free children's book written by two medical students aiming to target medical info to children of color.
Free children's eBooks about Coronavirus/COVID-19 (New York City School Library System) To access the book, click on the cover of the book.

 

ARTICLES ABOUT COVID-19 AND CHILDREN (FAMILIES)
At Least 97,000 Children Tested Positive for Coronavirus in Last 2 Weeks of July (Cory Turner, Morning Edition, NPR, 8-11-2020) Children are not immune to this disease. Since the beginning of the pandemic, at least 340,000 children have tested positive for the coronavirus, representing roughly 9% of U.S. cases to date. Where the virus is still spreading widely, reopening schools may not be safe.
Behind the White House Effort to Pressure the C.D.C. on School Openings ( Mark Mazzetti, Noah Weiland and Sharon LaFraniere, NY Times, 9-28-2020) Documents and interviews show how senior officials sought to play down the risks of sending children back to the classroom, alarming public health experts. See also CDC director takes aim at Trump's Covid adviser: 'Everything he says is false' ( Tom McCarthy and Joan E Greve, The Guaridian, 9-28-2020) Robert Redfield overheard criticizing taskforce’s Scott Atlas Anthony Fauci concerned at ‘incorrect’ information from Atlas.
Why children avoid the worst coronavirus complications might lie in their arteries (David Cyranoski, Nature, 6-11-2020) Evidence is mounting that healthy blood vessels protect children from serious effects of COVID-19, such as stroke.
Why I Decided to ‘Pod Up’ — And How it’s Saving Me (Abigail Rasminsky, What’s Up Moms, 7-3-2020) “When close family friends approached us about forming a pod with them and another family — what would essentially be an extension of the closed family unit — we said we’d consider it.... We have had to relinquish some control in exchange for what we consider a huge gain: community, friendship, shared meals, and some relief from overwhelming childcare duties.... This situation is absolutely unsustainable without a support system in place, without friends and laughter and people to lean on and other kids for your kids.” See also her story So Together Yet So Alone: My Strange & Complicated Pandemic Loneliness (What' Up Moms). "I have neither social connection nor alone time."
Supporting Children’s Development During the Pandemic (Isaac Chotiner, New Yorker, 7-16-2020)
Kids are having pandemic dreams too (Rebecca Renner, National Geographic, 5-11-2020) Here’s what they might mean—and how parents can deal.
Why I Decided to ‘Pod Up’ — And How it’s Saving Me (Abigail Rasminsky, What’s Up Moms, 7-3-2020) “When close family friends approached us about forming a pod with them and another family — what would essentially be an extension of the closed family unit — we said we’d consider it.... We have had to relinquish some control in exchange for what we consider a huge gain: community, friendship, shared meals, and some relief from overwhelming childcare duties.... This situation is absolutely unsustainable without a support system in place, without friends and laughter and people to lean on and other kids for your kids.” Scroll down for more stories about podding up.
Birdwatching for Fun and Profit (Cameron Walker, Last Word on Nothing,5-25-2020) On bird watching with children, and re-evaluating old board games.
Coronavirus in Babies and Kids (Aaron Milstone, pediatrician at the Johns Hopkins Children’s Center)
How likely are kids to get Covid-19? Scientists see a ‘huge puzzle’ without easy answers (Helen Branswell, STAT, 6-18-2020) If we’re lucky, and the hints in the data hold true, a normalizing of children’s lives — and the lives of their parents — could be safely achieved. If we’re not lucky, and the hints were false harbingers, more disruption likely lies ahead. “The good thing about school opening is that it’s a point change that’s big,” said Lipsitch. “So if there’s an effect, it will be a little bit delayed — but it’s not fuzzy and it’s not subtle.”
How a Game With My Daughter Helped Us Cope With Quarantine and the Past (Amy Herzog, The New York Times Magazine, 5-20-2020) Playing hours of pretend with my 5-year-old showed me how coronavirus was re-activating old medical traumas in our family. One of several articles about children and quarantine, all in one long section.
It won't be easy: Back to school and daycare (Barbara Kaiser and Judy Sklar Rasminsky, Healthing, 7-4-2020)
The pandemic is undersocializing our kids (Anna Sharratt, Healthing, 7-7-2020) 'We are seeing more anxiety, as children don’t know what to talk about when they interact with a peer': psychologist. We've gone from overscheduled to undersocialized.
Tips for social distancing with older children (Commercial Free Childhood) Our experts' advice on social distancing with children 6-12. See also Managing social distancing with young children
Inflammatory Syndrome and COVID-19: What Do Parents Need to Know? (Erin Digitale, Stanford Children's Health, 5-14-2020) The immune-overresponse called multisystem inflammatory syndrome in children (MIS-C) is very rare, but parents should know what to watch for: persistent fever, a rash or changes in skin color, red eyes or conjunctivitis, abdominal pain, and swollen lymph nodes. “The key is to identify this early so the child can receive appropriate treatments to help with the body’s inflammatory response.” said Roshni Mathew, MD. Kids admitted to the hospital would be carefully monitored for complications such as cardiac problems. Children with MIS-C don’t always show respiratory symptoms of COVID-19.
Advice for parents who are feeling isolated: ‘Ask for what you need, give what you can’ (Pooja Makhijani, Washington Post, 3-31-2020) Parents and experts alike reiterated that being attentive and proactive, and communicating about our feelings, can mitigate some of the emotional turbulence we are feeling and also strengthen our ability to build or maintain strong social bonds.

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Coronavirus, education, and school reopenings

(parents suddenly home-schooling, open schools or not?,  etc.)

 


Data on schools reopening lag the actual reopening of schools (COVID-19 Data Dispatch) Reported COVID-19 cases in K-12 schools, compiled by Alisha Morris and other volunteers.
NEA School and Campus COVID-19 Reporting Site The site Alisha Morris and the NEA started, when there was no consistency in reporting nationally.
COVID-19: Reported Cases in U.S. Schools
Tracking Coronavirus Cases at U.S. Colleges and Universities (New York Times)
My covid symptoms were so severe I had to work from home. My school fired me. It was as devastating as the disease itself. (Jennifer Mazzotta-Perretti, WaPo, 9-9-2020)
Poetry in the time of coronavirus (Anndee Hochman, Broad Street Review, 3-17-2020) "Here’s what happened in my 2nd-grade classroom as COVID-19 became a pandemic." A lovely, real piece that brings classroom, kids, and teacher to life in those final days before schools closed and learning went online.  
By Nearly a 2-1 Margin, Parents Prefer to Wait to Open Schools to Minimize COVID Risk, with Parents of Color Especially Worried Either Way (Kaiser Family Foundation, 7-23-2020) Majorities across parties want Congress to prioritize funding for COVID testing, tracing, and PPE. With President Trump calling for schools to reopen and threatening to withhold federal funds from schools that don’t do so, there is a big partisan divide – with 87% of Democrats and 59% of independents preferring schools open later while 60% of Republicans prefer that schools open sooner.
I'm finishing my senior year of college from my parents' kitchen (Callie Patteson, Today, 4-2-2020) After my college moved classes online for the rest of the semester, I'm living with my parents again as I work to graduate.
Providing Resources during COVID-19 (Coalition for Responsible Home Education)
Parents are opting to home school their children because of COVID-19, but experts say it might not be for everyone (Safia Samee Ali, NBC News, 7-5-2020) "Kids need a safe space to feel comfortable learning, and what was being described to me by the school is not good enough for my kids," one parent said. Public schools have started to reveal what a return to classrooms may look like amid the pandemic, but many parents have pre-emptively opted not to return and are planning to home-school instead, a decision experts say is a huge undertaking that parents should be well prepared for.
What Homeschooling During COVID-19 Taught Me About My College Teaching (Bonni Stachowiak, EdSurge, 5-18-2020) "...when the pandemic struck, the current events were able to flow much more regularly into our class discussions. I modified the final assignment to be a manifesto. The ways in which students synthesized their learning was phenomenal. Many of them mentioned feeling equipped to continue learning about what they had discovered in the class much more than in other courses they have taken."
How schools across the globe are reopening amid the coronavirus pandemic (Michael Burke And Yuxuan Xie, EdSource, 6-30-2020) Some schools in rural parts of America have also reopened with new restrictions.
The Dos and Don’ts of ‘Quarantine Pods’ (Melinda Wenner Moyer, NY Times, 6-9-2020)One idea that some families are considering — and that infectious disease epidemiologists think might be a smart way to balance mental health needs with physical safety — is to create quarantine “pods” or “bubbles,” in which two or three families agree to socialize with one another but no one else. It might be awkward, difficult and even risky. But joining a social bubble might just save your sanity.
For parents who can afford it, a solution for fall: Bring the teachers to them (Laura Meckler and Hannah Natanson, Wash Post, 7-17-2020) "Fed up with remote education, parents who can pay have a new plan for fall: import teachers to their homes. In some cases, families are teaming up to form “pandemic pods,” where clusters of students receive professional instruction for several hours each day. It’s a 2020 version of the one-room schoolhouse, privately funded."
Amid Coronavirus, Parents ‘Pod Up’ to Form At-Home Schools (Anne Marie Chaker, Wall Street Journal, 7-21-2020) Wary of sending their children back into classrooms, some families are joining into pods to teach kids; other parents look online to replace or supplement in-person instruction.
CDC expects 2020 outbreak of rare, life-threatening condition affecting children (Jessie Hellmann, The Hill, 8-4-2020) The Centers for Disease Control and Prevention (CDC) warned parents and doctors Tuesday that it expects another outbreak this year of a rare but life-threatening condition that mostly affects children. Outbreaks of acute flaccid myelitis (AFM), a serious neurologic condition that can cause paralysis, typically peak every two years between August and November. The last peak occurred in 2018, when 238 cases were reported to the CDC.

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What patients with (or recovering from) COVID-19 experience


This Is What a Coronavirus Infection Feels Like (Rachel Nania, AARP, 6-11-2020) CDC expands list of COVID-19 symptoms and emergency warning signs.
Voices from the Pandemic (Washington Post, 2020) A collection of accounts from people who have been sharing their personal stories about covid-19.
What it feels like to survive COVID-19’s dreaded “cytokine storm” (Keith A. Spencer, Salon, 4-5-2020) "The primary symptoms I had are quite typical for those who find themselves truly afflicted with the illness: high fever, a dry cough and pain in my throat. Not a classic pharyngitis, rather a sort of aching pain which was intermittent. Subsequently, the fevers really took off and averaged 102.5 over the following days. Headaches, nausea, severe muscle and bone pain, change of bowel habits and a loss of taste and smell all evolved." A doctor and coronavirus patient in recovery describes his experience surviving COVID-19's worst side effects.
Coronavirus destroys lungs. But doctors are finding its damage in kidneys, hearts and elsewhere. (Lenny Bernstein, Carolyn Y. Johnson, Sarah Kaplan and Laurie McGinley, WaPo, 4-1-2020)
Another Presenting Sign of COVID-19 (Diana Swift, MedPage Today, 8-27-2020) Findings support adding to the list of GI manifestations of the disease, researchers say. COVID-19 patients can present with acute pancreatitis, often of idiopathic origin, and Black and Hispanic patients with pancreatitis were more likely than others to have the infection, according to a retrospective study in a New York health system.
COVID-19 Can Last for Several Months (Ed Yong, The Atlantic, 6-4-2020) The disease’s “long-haulers” have endured relentless waves of debilitating symptoms—and disbelief from doctors and friends.
California GOP Consultant Rues ‘Big Mistake’ That Led to Family’s COVID Infections (Samantha Young, KHN, 8-3-2020) Costigan, who worked as deputy chief of staff for Republican Gov. Arnold Schwarzenegger, is taking to social media and his 4,400 Twitter followers warning them not to do what his family did: They gathered with family members in Georgia and didn't wear masks. Now seven of the 10 family members who attended that backyard gathering are sick.
Why Some People Get Sicker Than Others (James Hamblin, The Atlantic, 4-21-2020) COVID-19 is proving to be a disease of the immune system. This could, in theory, be controlled. "COVID-19 is, in many ways, proving to be a disease of uncertainty. According to a new study from Italy, some 43 percent of people with the virus have no symptoms. Among those who do develop symptoms, it is common to feel sick in uncomfortable but familiar ways—congestion, fever, aches, and general malaise. Many people start to feel a little bit better. Then, for many, comes a dramatic tipping point. “Some people really fall off the cliff, and we don’t have good predictors of who it’s going to happen to,” Stephen Thomas, the chair of infectious diseases at Upstate University Hospital, told me. Those people will become short of breath, their heart racing and mind detached from reality. They experience organ failure and spend weeks in the ICU, if they survive at all."
I Survived COVID-19: A New Yorker's Story (Terri Marshall, AARP, 6-22-2020) First came the fatigue and fever, then the fear and anxiety.
Doctors Race For Answers As Kids Fight Rare Inflammatory Syndrome Tied to Coronavirus (Peter Breslow and Lulu Garcia-Navarro, NPR, WAMU, 6-7-2020) "The first sign that something was wrong came with stomach pains. It was April 30, and 9-year-old Kyree McBride wasn't feeling well. Soon, young McBride was battling a 102-degree fever....In a telemedicine call with McBride's doctor a few days later, Hairston was told to hang tight. Then the stomach pains came back, stronger this time. Then vomiting. Later, Kyree's skin began to develop a reddish hue. Then red eye.  And it mirrored what staff had been seeing in dozens of young patients who since the start of the pandemic have been diagnosed with a condition known as Multisystem-Inflammatory Syndrome in Children, or MIS-C. Listen to the 2-part story: "What Happens When Your Kid Develops MIS-C, A Rare COVID-19 Complication" and "D.C. Hospital Trying To Understand Rare COVID-19 Complications In Children."
Being on a Ventilator Was the Worst Experience of My Life, So Please Avoid Getting COVID-19 and Needing One (Kelly Boyd, Creaky Joints, Living With Arthritis, 4-2-2020) ‘Even though I was only on the ventilator for a couple days, it seemed like a lifetime. The memory is still vivid more than five years later.’ As a patient with severe rheumatoid arthritis, she knows how urgently people should avoid the risk of having to go on a ventilator.
COVID-19 Can Last for Several Months (Ed Yong, The Atlantic, 6-4-2020) 'The disease’s “long-haulers” have endured relentless waves of debilitating symptoms—and disbelief from doctors and friends.... Most have never been admitted to an ICU or gone on a ventilator, so their cases technically count as “mild.” But their lives have nonetheless been flattened by relentless and rolling waves of symptoms that make it hard to concentrate, exercise, or perform simple physical tasks. Most are young. Most were previously fit and healthy. “It is mild relative to dying in a hospital, but this virus has ruined my life,” LeClerc said. “Even reading a book is challenging and exhausting.”
Insane after coronavirus? Essayist Patricia Lockwood writes (London Review of Books) that “the most stubborn fact” of her recovery from coronavirus “seemed to be that I had forgotten how to read.” A full complement of symptoms.
A Medical Worker Describes Terrifying Lung Failure From COVID-19 — Even in His Young Patients (Lizzie Presser, ProPublica, 3-21-2020) “It first struck me how different it was when I saw my first coronavirus patient go bad. I was like, Holy shit, this is not the flu. Watching this relatively young guy, gasping for air, pink frothy secretions coming out of his tube.”
How does the coronavirus cause COVID toes or loss of smell?(Ramon Padilla, and Adrianna Rodriguez, USA Today) Illustrated. The CDC has officially listed nine symptoms of the illness caused by the new coronavirus: cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, sore throat and new loss of taste or smell. The CDC says these symptoms may appear two to 14 days after exposure to the virus. However, the unofficial list of symptoms continues to grow.They vary from patient to patient and can range from an acute skin rash to a severe inflammatory reaction. Some doctors have reported gastrointestinal issues such as nausea, vomiting and diarrhea. Other symptoms turning up: strokes, 'COVID toes,' rashes & other skin manifestations.
Startling Number Of Young People Without Any COVID Symptoms Seek Care For Strokes (KHN Morning Briefing, 5-15-2020) The trend of young people getting strokes from the virus is just one of the baffling aspects of the disease that doctors are trying to understand. See Coronavirus May Pose a New Risk to Younger Patients: Strokes (Roni Caryn Rabin, NY times, 5-14-2020) Doctors have reported a flurry of cases in Covid-19 patients — including a healthy 27-year-old emergency medical technician in Queens. After a month in the hospital, he is learning to walk again.
Voices from the Pandemic A collection of accounts from people who have been sharing their personal stories about covid-19. As told to Eli Saslow (Washington Post oral history collection)
---‘How long can a heart last like this?’ (5-9-2020) Darlene Krawetz, on what life becomes when covid-19 won’t go away. After weeks with coronavirus, a sick woman wonders when it will end.
A Medical Worker Describes Terrifying Lung Failure From COVID-19 — Even in His Young Patients (Lizzie Presser, ProPublica, 3-21-2020) “It first struck me how different it was when I saw my first coronavirus patient go bad. I was like, Holy shit, this is not the flu. Watching this relatively young guy, gasping for air, pink frothy secretions coming out of his tube.” Read what acute respiratory distress syndrome, ARDS, looks like and you’ll be more likely to social distance. "This is knocking out what should be perfectly fit, healthy people." 
‘I apologize to God for feeling this way.’ (5-2-2020) Gloria Jackson, on being 75, alone, and thought of as expendable.
Mysterious Heart Damage, Not Just Lung Troubles, Befalling COVID-19 Patients (Markian Hawryluk, KHN, 4-6-2020) Most of the attention in the COVID-19 pandemic has been on how the virus affects the lungs. But evidence shows that up to 1 in 5 infected patients have signs of heart damage and many are dying due to heart problems.
The Infection That’s Silently Killing Coronavirus Patients (Richard Levitan, Opinion piece, NY Times, 4-20-2020) A major reason this pandemic is straining our health system is the alarming severity of lung injury patients have when they arrive in emergency rooms. Covid-19 overwhelmingly kills through the lungs. And because so many patients are not going to the hospital until their pneumonia is already well advanced, many wind up on ventilators, causing shortages of the machines. And once on ventilators, many die. There is a way we could identify more patients who have Covid pneumonia sooner and treat them more effectively — and it would not require waiting for a coronavirus test at a hospital or doctor’s office. It requires detecting silent hypoxia early through a common medical device that can be purchased without a prescription at most pharmacies: a pulse oximeter. [The top-rated pulse oximeter monitors are sold out on Amazon, but that's what you want.] All persons with cough, fatigue and fevers should also have pulse oximeter monitoring even if they have not had virus testing, or even if their swab test was negative, because those tests are only about 70 percent accurate. A vast majority of Americans who have been exposed to the virus don’t know it.
Doing Time (Jill Siebers, Pulse, Voices from the Heart of Medicine, 5-5-2020) COVID-19 Confinement, Day Four. James has what is likely a moderate case--cough, no interest in food, a profound need for sleep. Still, it is shocking when a six-foot three-inch, 225-pound man goes down.
How COVID Killed My Colleague-Patient (Suraj Saggar, MedPage Today, 8-7-2020) He was watching soccer, then days later he was dead.
Covid-19 sickens seniors differently. Here’s why. (John W. Rowe, Washington Post, 6-29-2020) "Many older covid-19 patients did not present the “classic” symptoms so common in younger patients — fever, cough and shortness of breath. Seniors who came to hospitals or called their physicians were typically asked whether they had those symptoms and often replied that they did not. But many did complain of delirium, fainting or gastrointestinal symptoms. Because they did not have the symptoms that were required to be eligible for coronavirus testing, their infections often went undetected..." Info about seniors' higher risk factors.

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Social distancing, sheltering in place, and lockdown


How to Form a Pandemic Pod (Jeremy Adam Smith, William Winters, Greater Good Magazine, 7-15-2020) Here are some questions to ask as you expand your circle of care and cooperation during COVID-19.
Six feet may not be enough to protect against coronavirus, experts warn (Ben Guarino, Washington Post, 8-27-2020) Keeping safe from Covid-19 transmission is more complicated than just staying six feet away. Factors such as crowd density, ventilation, face masks and whether people are silent, speaking, shouting or singing should all be considered in assessing distance. For the full story, see Two metres or one: what is the evidence for physical distancing in covid-19? (Nicholas R Jones et al, British Medical Journal, 8-25-2020) Rigid safe distancing rules are an oversimplification based on outdated science and experiences of past viruses, argue Nicholas R Jones and colleagues. Physical distancing is an important part of measures to control covid-19, but exactly how far away and for how long contact is safe in different contexts is unclear. Distribution of viral particles is affected by numerous factors, including air flow. Evidence suggests SARS-CoV-2 may travel more than 2 meters through activities such as coughing and shouting. Rules on distancing should reflect the multiple factors that affect risk, including ventilation, occupancy, and exposure time. See chart that indicates relative differences in risk in different settings based on ventilation, the number of people, the length of time, the presence of face coverings, and whether people are speaking or shouting/singing.
Herd Immunity Is Not a Strategy (James Hamblin, The Atlantic, 9-2-2020) What the term actually means, and what it doesn’t. The title is a contradiction in terms, in that herd immunity is the absence of a strategy. "It involves a calculation of the percentage of people in a population who would need to achieve immunity in order to prevent an outbreak. The same concept offers little such guidance during an ongoing pandemic without a vaccine. If it were a military strategy, it would mean letting the enemy tear through you until they stop because there’s no one left to attack."
Amid Confusion About Reopening, An Expert Explains How to Assess COVID-19 Risk (Terry Gross interviews epidemiologist Michael Osterholm, founder and director of the Center for Infectious Disease Research and Policy at the University of Minnesota, Fresh Air, 6-17-2020) 41-minute listen with transcript of interview highlights.
New Trump pandemic adviser pushes controversial ‘herd immunity’ strategy, worrying public health officials (Yasmeen Abutaleb and Josh Dawsey, WaPo, 8-29-2020) Trump’s new medical adviser Scott Atlas is urging the White House to embrace Sweden's controversial “herd immunity” strategy to combat the pandemic, which would entail allowing the coronavirus to spread through most of the population to quickly build resistance to the virus, while taking steps to protect those in nursing homes and other vulnerable populations.He advises lifting restrictions so healthy people can build immunity to the disease rather than limiting social and business interactions to prevent the virus from spreading. Sweden’s approach has gained support among some conservatives who argue that social distancing restrictions are crushing the economy and infringing on people’s liberties. But Sweden’s handling of the pandemic has been heavily criticized by public health officials and infectious-disease experts as reckless — Sweden's infection and death rates are among the world’s highest. It also hasn’t escaped the deep economic problems resulting from the pandemic.
Dear Diary: This Is My Life in Quarantine (Morgan Ome, The Atlantic, 8-6-2020) Sensing that they’re living through a historic moment, many people are journaling to create a keepsake of life during the pandemic. “This is a pivotal moment in history,” Whitlock told me. “We’re in it right now. We have an opportunity to chronicle it.” Referring not only to the pandemic, but also to the Black Lives Matter protests, accelerating global warming, and the upcoming presidential election.
Health Experts Link Rise In Arizona COVID Cases to End of Stay-At-Home Order (Will Stone, KHN/NPR, 6-16-2020) With new daily coronavirus cases rising in at least two dozen states, an explosion of new infections in Arizona is stretching some hospitals and alarming public health experts who link the surge in cases to the state’s lifting of a stay-at-home order a month ago. Arizona has emerged as one of the country’s newest coronavirus hot spots, with the weekly average of daily cases more than doubling from two weeks ago.
For Abused Women, a Pandemic Lockdown Holds Dangers of Its Own (Alisha Haridasani Gupta and Aviva Stahl, NY Times and the Fuller Project, 3-24-2020) As millions across the U.S. stay home to help flatten the curve, domestic violence organizations and support systems are scrambling to adapt to the rapidly shifting landscape.
---The Anti-Violence Project offers a 24-hour English/Spanish hotline for L.G.B.T.Q.+ experiencing abuse or hate-based violence: call 212-714-1141.
---The National Domestic Violence Hotline is available around the clock and in more than 200 languages: call 1-800-799-SAFE or chat with their advocates here or text LOVEIS to 22522.
Measuring the Strictness of Your Lockdown: A University Boils It Down to One Number (Jason Douglas, WSJ, 5-23-2020) Researchers at Oxford University use 17 variables to develop a ‘stringency index’
We Need to Talk About Ventilation (Zeynep Tufekci, The Atlantic, 7-30-2020) How is it that six months into a respiratory pandemic, we are still doing so little to mitigate airborne transmission? Jose-Luiz Jimenez, an air-quality professor at the University of Colorado, told me that some air conditioners can increase the chances of spreading infection in a household. Open some windows to get fresh air.
Recordings and streams of classical performances have exploded in popularity in the time of social distancing. (Barbara Jepson, Wall Street Journal, 5-19-2020) Recordings and streams of classical performances have exploded in popularity in the time of social distancing.
Once The Pandemic Is Over, Can We Keep The World This Accessible? (Hilary Sutton, HuffPost, 4-30-2020) "So when this surreal nightmare of social distancing is over ― and thankfully, it will end ― can we remember the folks who are now feeling included for the first time? Can we make special live events streamable for a discounted rate? Can we remember to flip on our webcams at meetings, hop onto Facebook Live and give people the opportunity to experience events like we all can right now? Let’s use this moment to recognize how remarkably accessible our world can really be."
Oxford COVID-19 Government Response Tracker (OxCGRT) systematically collects information on several different common policy responses that governments have taken to respond to the pandemic on 17 indicators such as school closures and travel restrictions. It now has data from more than 160 countries. The data is also used to inform a ‘Lockdown rollback checklist’ which looks at how closely countries meet four of the six World Health Organisation recommendations for relaxing ‘lockdown’. See also Oxford COVID-19 Government Response Tracker (further ways of tracking data).
Under Lockdown in Italy’s Coronavirus-Quarantine Zone (Kenneth Rosen, New Yorker, 2-27-2020) A beautiful account of the grandfather in the house boldly breaking quarantine as he visits his way through a north Italian town, clearly determined not to follow the damned rules. See also In Italy, Our Lockdown Continues (Elyse Resnick, The Lilith Blog, 3-27-2020) What it's like when lockdown is seriously enforced.
Packed Bars Serve Up New Rounds of COVID Contagion (Jordan Rau and Elizabeth Lawrence, KHN and HuffPost, 6-25-2020) As states ease their lockdowns, bars are emerging as fertile breeding grounds for the coronavirus. They create a risky cocktail of tight quarters, young adults unbowed by the fear of illness and, in some instances, proprietors who don’t enforce crowd limits and social distancing rules. Officials in Texas and Florida have already announced they are closing bars in those states to help contain the spread of the coronavirus.
I Can’t Stop Thinking About Patient One (Rachel Donadio,The Atlantic, 4-16-2020) Italy shows us that controlling the pandemic will require reshaping family life in much of the world. "In Germany, some health experts have suggested that children not see their grandparents until well into the fall, or even after Christmas. In Britain, where the government has told citizens to save lives by staying home, a cabinet minister was criticized for visiting his own parents."
Domestic Violence Calls Mount as Restrictions Linger: ‘No One Can Leave’ (Julie Bosman, NY Times, 5-15-2020) The coronavirus has created new tensions. Staying at home has worsened abusive situations. Shelters worry about the spread of the virus. Safety supports aren't accessible. Callers to a hotline in Chicago have asked for help on how to keep their partners calm, how to secretly save money, how to develop code words with children that will tell them they need to call 911.
When You’re Pregnant During a Pandemic ( Sophia Jones, The Atlantic, 3-21-2020) I’m a war correspondent, but nothing prepared me for navigating the joys and fears of pregnancy under lockdown.
A Guide to Staying Safe as States Reopen (Joe Pinsker, The Atlantic, 5-7-2020) Can I eat at a restaurant? Can I go shopping? Can I hug my friends again? Experts weigh in. See The Atlantic's podcast Social Distance.
The Four Possible Timelines for Life Returning to Normal (Joe Pinsker, The Atlantic, 3-26-2020) The coronavirus outbreak may last for a year or two, but some elements of pre-pandemic life will likely be won back in the meantime.
How a superspreader at choir practice sickened 52 people with COVID-19 (Laura Geggel, Live Science, 5-14-2020) and Business InsiderThe virus spread to 87% of attendees at the session, which the CDC said "underscores the importance of physical distancing." The CDC said the choir meeting "provided several opportunities" for the virus to spread, "including members sitting close to one another, sharing snacks, and stacking chairs at the end of the practice." Officials said the group was able to stop the virus spreading further by self-isolating even before public health bodies were told of the outbreak. It also said that "The act of singing, itself, might have contributed to transmission through emission of aerosols, which is affected by loudness of vocalization."
I Miss My Grandchildren (Robin Marantz Henig, The Atlantic, 5-28-2020) The pandemic isn’t clarifying what’s important; it’s ripping it away.
How a Game With My Daughter Helped Us Cope With Quarantine and the Past (Amy Herzog, The New York Times Magazine, 5-20-2020) Playing hours of pretend with my 5-year-old showed me how coronavirus was re-activating old medical traumas in our family. One of several articles about children and quarantine, including (all in one long section)
--- "Insanity Can Keep You Sane" (by Molly Young). If you can’t live normally, why not find little harebrained ways to warp reality?
--- "The Comfort of Common Creatures" (by Helen Macdonald) Watching birds is a way of mobilizing attention, to turn it into a means of imaginative escape.
--- ‘‘Someone in Georgia Is Having a Bad Hair Day’’ (by Kara Walker) Conté crayon and graphite on paper (in progress), 2020
--- Finding Belonging in Exile (by Thomas Chatterton Williams) I didn’t feel Parisian until I escaped Paris.
--- Turning The Camera From War to Family (by Paolo Pellegrin)“We’re very fortunate to all be here together.”
--- Something Happens When You Fall (by Hisham Matar) Two artworks that ask the question: What world will we find on the other side of this?
--- When the World Unravels, Braid Your Own Hair (by Jazmine Hughes) I’ve worn my hair in the same exact style for six years. Learning to style it myself has brought some comfort of normalcy.
--- You Can Be Homesick at Home (By Mark O'Connell) The lockdown revealed an uncanny and alienating version of my surroundings.
--- You’re Never Alone in a Dusty Apartment (by Jamie Lauren Keiles) Your dust is you, and the life outside your window, and the life of every tenant before you. Gross — but who right now can turn down company?
--- The Truth About Cocoons What (by Sam Anderson) What caterpillars really go through in there has applications for our moment. Again, you can find those stories here.
How to beat loneliness during a pandemic? LGBTQ elders lend their wisdom (Rebecca Renner, Science, 6-17-2020) Loneliness, psychologically speaking, is different from mere solitude. LGBTQ seniors are more than twice as likely to live alone, but many have created strong communities to replace the family support they have lost.
Why some people can't resist crowds despite the pandemic (Rebecca Renner, National Geographic, 6-24-2020) Blame evolution for our compulsion to socialize even with the risk of COVID-19.
I used to shut my windows to New York’s noise. Now I long for a honking horn. (Candy Schulman, WashPost, 4-9-2020) It was the city that never sleeps. Now, in this strange covid-19 silence, it’s just me.
Why more men should see walking as a perfect form of exercise (Andrew Reiner, WashPost, 4-12-2020) Research has shown that walking can be a perfect whole-body exercise, a lower-impact workout with far fewer hazards. It can be done anywhere, anytime and with no expenditure of money.
How Coronavirus Is Changing the Dating Game for the Better (Helen Fisher, NY Times, 5-7-2020) Video chats are in. Small talk is out. You don’t have to fret about who picks up the check. And maybe the biggest plus: You’re forced to take things slow. See also Fisher's Cupid in Quarantine: What Brain Science Can Teach Us About Love (4-13-2020) A global tragedy has forced us into full-time togetherness. Here’s how couples can rekindle romantic love and grow together rather than apart. Fisher is author of Anatomy of Love: A Natural History of Mating, Marriage, and Why We Stray . Watch her TED Talk: Why we love, why we cheat.
Tips for social distancing with older children (Commercial Free Childhood) Our experts' advice on social distancing with children 6-12. See also Managing social distancing with young children
Unmute (Amy Cowan, MD, Pulse, 4-15-2020) 'He's already three sentences into his monologue, not pausing for breath as he mansplains the state of the world--telling me, his physician daughter, about COVID-19 and how we should wear masks "like the Orientals do." ...When we last talked, three weeks ago, he told me that COVID-19 was all a hoax.'
'I thought this was a hoax': Patient in 30s dies after attending 'COVID party' (Gerald Tracy, News4, San Antonio, WOAI/KABB, 7-10-2020) A patient in their 30s died from the coronavirus after attending what's being called a "COVID party," according to Dr. Jane Appleby, chief medical officer of Methodist Healthcare. "This is a party held by somebody diagnosed by the COVID virus and the thought is to see if the virus is real and to see if anyone gets infected," Dr. Appleby said. "Just before the patient died, they looked at their nurse and said 'I think I made a mistake, I thought this was a hoax, but it's not,'" Appleby said. She wants everyone, especially those in the younger demographic, to realize they are not invincible.
Why Fox News and Republicans are promoting a social distancing backlash (Paul Waldman, WaPo, 4-16-2020) Key excerpt: "Many of his voters have chosen to ignore his actual agenda, so intoxicated are they with the idea of giving a giant middle finger to the forces they thought were holding them down." (H/T Sam Greengard)
Life on Lockdown in China (Peter Hessler, Letter from Chengdu, New Yorker, 3-30-2020) Forty-five days of avoiding the coronavirus.
‘It’s Not Over Until It’s Over’: 5 Things to Know About Hitting the COVID-19 Peak (Phil Galewitz, KHN, 4-17-2020) It's hard to see the peak. The peak does not mean the pandemic is nearly over. What comes next depends on readiness. You're going to need masks a long time. Without a vaccine, people's risk doesn't change. See also Despite Trump's Optimism, There's Still a Long Road to Reopening (NPR, 4-17-2020) "Despite Trump's boasts, testing is still not widespread in the U.S. Not everyone who wants a test can get one. Only people with symptoms are getting them — and not all of them are — and asymptomatic people are able to spread the disease. That means no one really knows just how widespread the virus is. And without a vaccine or known treatment, there's the risk of more outbreaks." The main reason for stay-at-home orders is to prevent overwhelming hospitals, and people in rural areas would be particularly endangered because of fewer nearby hospitals.
Lockdowns Could Be the ‘Biggest Conservation Action’ in a Century (Ben Goldfarb, The Atlantic, 7-6-2020) Acknowledging the virus's silver linings—the cleaner air, the forestalled carbon emissions—can feel ghoulish. But one unintended consequence of lockdowns: Roadkill dropped dramatically.
18 family members diagnosed with coronavirus after surprise party in Texas (Scott Stump,Today, 6-25-2020) After a surprise birthday party, the coronavirus spread through a large Texas family infecting 18 people.
The Streets of New Orleans Under Quarantine (New Yorker video, released 5-6-2020) Scenes from a week of weirdness under lockdown, as residents of New Orleans practice social distancing to avoid spreading the coronavirus.
Quarantine Fatigue Is Real (Julia Marcus, The Atlantic, 5-11-2020) Instead of an all-or-nothing approach to risk prevention, Americans need a manual on how to have a life in a pandemic. For example, casual interaction in outdoor settings seems to be much lower risk than prolonged and close contact in enclosed and crowded settings.
Early Data Shows Black People Are Being Disproportionally Arrested for Social Distancing Violations (Joshua Kaplan and Benjamin Hardy, ProPublica, Crowds of mostly white protesters have defied Ohio’s stay-at-home order without arrest, while in several of the state’s biggest jurisdictions, police departments have primarily arrested black people for violating the order. In Columbus, Toledo, and Cincinnati, ProPublica found, black people were at least four times as likely to be charged with violating the stay-at-home order as white people.
Not again: China imposes NEW coronavirus lockdown—fears grow for devastating second wave despite the ruling Chinese Communist Party's attempts to claim the country is winning the battle against the disease. (Ciaran McGrath, Express, 4-19-2020)

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The link between coronavirus and protest

The nexus between coronavirus and protests: The virus ‘was the kindling, and the police brutality lit the fire.’ (Marc Fisher, Peter Jamison and Ava Wallace, Washington Post, 6-7-2020) The Smiths had talked and talked about the virus; they knew joining the protests against police brutality meant a higher risk of being infected. They took the risk to give their 10-year-old son a chance at a future in which he is not “walking around with the spirit of fear,” Shae said. They took the risk because after dealing with the pandemic “we still have to do whatever it takes.”
One city, two crises (Roman Stubbs, Jesse Dougherty, and Ava Wallace, WaPo, 6-7-2020) The coronavirus exposed Louisville’s racial divide. Two police killings revealed its depth. 'What Christopher 2X saw in Jefferson Square Park, on the sixth day of protests here, were white and black hands locked in prayer, hundreds listening in the shadow of city hall, all while a man pleaded for justice through a microphone. But one person was missing. “Some people protest. Some people post. Some people donate. Some people pray. There’s no WRONG way to support but NOT supporting at all IS wrong.”'
A Delicate Balance: Weighing Protest Against the Risks of the Coronavirus (Amy Harmon and Rick Rojas, NY Times, 6-7-2020) As the protests against police brutality continue, public officials are warily watching for signs that mass demonstrations are leading to virus outbreaks. None of the plans for how the nation might safely emerge from the coronavirus lockdown involved thousands of Americans standing shoulder to shoulder in the streets of major cities or coughing uncontrollably when the authorities used tear gas to disperse them. No one planned on protesters being herded into crowded prison buses or left in crowded cells. Before the eruption of outrage over the killing of George Floyd in police custody in Minneapolis, debates about reopening centered on whether states had adequate systems in place to detect and treat cases of the coronavirus, which has killed more than 110,000 people in the United States since the beginning of the year.
Amid reopenings and street protests, coronavirus transmission remains high in much of the U.S. (Joel Achenbach and Chelsea Janes, WaPo, 6-5-2020) "Data compiled by The Washington Post shows that 23 states, as well as the District of Columbia and Puerto Rico, have seen an increase in the rolling seven-day average of coronavirus cases compared with the previous week. Most have registered an increase of 10 percent or more. Now public health officials across the nation are warily eyeing caseloads and hospitalizations to see if there is a spike in infections resulting from mass protests against racism and police violence."

Protests Complicate Mayors’ Efforts to Combat Coronavirus (Thomas M. Burton, Wall Street Journal, 6-7-2020) Cities, filling a gap left by federal government, work on testing and tracing. "The sudden outbreak of large protests sparked by the killing of George Floyd on May 25 at the hands of Minneapolis police came at the same time mayors across the country were working to implement more aggressive testing and tracking programs to combat the coronavirus pandemic, complicating their efforts. Public-health doctors say the federal government hasn’t played a leading role in urging broader testing, so mayors and local officials are increasingly thrust into the breach. Scores of them are guided by leading university institutes and public-health experts."
George Floyd Protests Add New Front Line for Coronavirus Doctors (Emma Goldberg, NY Times, 6-7-2020)"Outside medical centers across the country, doctors and other health care workers have been stopping work in recent days for 8 minutes and 46 seconds to join in protesting the death of George Floyd, who was pinned down by a police officer in Minneapolis for that amount of time before his death. For doctors in New York who have strained to meet the challenges of coronavirus care for months, participating in the demonstrations has been especially poignant. Workers at a number of the hospitals hit hard by Covid-19 including Bellevue, Downstate, Lincoln, Mount Sinai and Montefiore have held events displaying their support for the protests this week.
     Dr. Oluyemi Omotoso, an emergency medicine resident at Lincoln Medical Center in the Bronx, said he could not bring himself to watch the George Floyd video after all the Covid-19 deaths he had witnessed, especially among black patients. “Seeing clips of it is traumatizing because in the last three months on the front line I kept seeing patients saying they couldn’t breathe,” Dr. Omotoso said. “I remember one shift where five people were intubated and five people died.”

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Masks should be mandatory

 

"The fragility of folks who won't wear a mask is truly breathtaking. I lived for four years inside two internment camps, and I heard less bitching and whining there than I do today." '~George Takei

 

"The biggest mistake we made is telling Americans that wearing masks is to protect other people." Atul Gawande on Twitter: @Atul_Gawande "The recipe is clear: We need #MandatoryMasks. We need #MoreTesting with clear messaging that everyone with even the slightest COVID19 symptom or with close contact with a known caseneeds to get tested and self-isolate. And we need #MoreTracing of cases to find those contacts."
(PPE means "personal protective equipment")
THE most important tool in public health is communication. Clear, consistent messaging from the top supporting mask wearing, testing, and health officials is how you stop this virus. When the President and Governors communicate the opposite, it is guaranteed to increase the harm.


Wearing masks might help you avoid major illness even if you get coronavirus, experts say (Rong-Gong Lin II, WaPo, 7-28-2020) Skeptics ask: If masks can’t fully protect me against covid-19, what is the point of wearing them? Scientists argue that masks can help reduce the severity of the disease caused by coronavirus even if you get infected. Breathing in a small amount of virus may lead to no disease or a more mild infection. But inhaling a huge volume of virus particles can result in serious disease or death. Masking can protect you from more severe disease.

     There’s mounting evidence that silent spreaders are responsible for the majority of transmission of the coronavirus, making universal masking essential to slow the spread of the highly contagious virus. With the coronavirus, even among people who do end up becoming visibly sick, peak infectiousness can occur before they show symptoms. Significant amounts of virus can start coming out of people’s noses and mouths even when they feel well. Read what studies show.
COMIC: You're Wearing It Wrong! A Face Mask Safety Refresher (Connie Hanzhang Jin, NPR, 10-10-2020) Seeing is believing?
23 bus passengers contracted coronavirus from 1 infected person. No one was wearing a mask. (Hilary Brueck, Business Insider, 9-1-2020) "A new study shows how one superspreader's coronavirus infection spread to 23 others in less than 2 hours, when they piled on to a bus together, without masks, to get to an outdoor worship event at a Buddhist temple. When 67 Buddhist passengers and their driver boarded a bus in Ningbo, China, on January 19, 2020, it's likely that only one person among them was incubating the coronavirus. None knew or expected they'd get ill that day, so no one was wearing a mask. Days later, a total of 24 passengers from that bus were ill. It's another clear warning that being inside poorly-ventilated spaces with the coronavirus, even at a "safe" distance of 6 feet away from seemingly healthy people harboring the virus, is a bad idea, especially when no one is wearing a mask.
      "The superspreader went on to develop worrying symptoms just hours after returning home from the bus rides, with a cough, chills, and aches and pains. (Those critical hours right before a person starts feeling sick are often when people are most contagious with the coronavirus.)
      "None of the 60 individuals on the second bus got sick. It made for a near-perfect experiment to show how the virus spread, likely with the help of the bus's air recirculation system, blowing the infected person's virus around to others for a total of 100 minutes.
      "Airborne transmission is important," Renyi Zhang, a professor of atmospheric sciences and chemistry at Texas A&M, who studies the impact of aerosols on human health, told Insider, after taking a glance at the study. "Social distancing alone doesn't work."

      A similar study of people who had lunch at a restaurant with another presymptomatic, infected person in Guangzhou, China in late January also showed how the restaurant's ventilation system likely blew the virus around.
Researchers created a test to determine which masks are the least effective (Alaa Elassar, CNN, 8-8-2020) Researchers tested 14 commonly available masks including a professionally fitted N95 mask, usually reserved for health care workers. First the test was performed with a speaker talking without wearing a mask. Then they did it again while a speaker was wearing a mask. Each mask was tested 10 times. (The visuals here make things clear.) The most effective mask was the fitted N95. Three-layer surgical masks and cotton masks, which many people have been making at home, also performed well. Bandanas and fleece masks performed poorly.

How the Navajo Nation slowed one of the worst Covid-19 outbreaks in the US ( Lois Parshley, Vox, 7-29-2020) “We had a fast increase in cases ... but wearing masks has flattened our numbers.”
Health Care Masks: Types, Definitions, Classifications and Approved Models (AHRMM)
• Some definitions:

Respirator Rating Letter Class

N - Not oil resistant
R - Resistant to oil
P - Oil Proof    (these are for working in dust-filled environments)

Respirator Rating Number Class

95 - Removes 95% of all particles that are at least 0.3 microns in diameter
99 - Removes 99% of particles that are at least 0.3 microns in diameter
100 - Removes 99.97% of all particles that are 0.3 microns in diameter or larger. HE or HEPA quality filter.

 

So:

---N95 – Filters at least 95% of airborne particles. Not resistant to oil.

---Surgical N95 – A NIOSH-approved N95 respirator that has also been cleared by the Food and Drug Administration (FDA) as a surgical mask.

---N99 – Filters at least 99% of airborne particles.

The higher the letter rating and number rating, the more likely breathing fatigue will increase.

        What is NIOSH approval? NIOSH approval is issued only to a specific and complete respirator assembly after the respirator has been evaluated in the laboratory and found to comply with all of the requirements of Title 42, Code of Federal Regulations , Part 84, and after the manufacturer's quality plan is determined to be satisfactory.

CDC's New Guidelines for Mask Effectiveness (worked out by a team of researchers at Stanford and the World Health Organization).
The Maskification of America happened quickly, but not for everybody (Dave Lieber, Dallas News, 5-7-2020) "We’re proud people. We don’t like being told what to do. And yes, this is inconvenient, uncomfortable and dehumanizing. But consider the alternative."
The Dudes Who Won’t Wear Masks (Julia Marcus, The Atlantic, 6-23-2020) Face coverings are a powerful tool, but health authorities can’t simply ignore the reasons some people refuse to use them. As one research team noted, men are especially likely to opt out of wearing masks, believing them to be “shameful,” “a sign of weakness,” and “not cool”—even though men are at higher risk than women of dying from coronavirus infection.
Colleagues feared U.S. Rep. Louie Gohmert would catch COVID-19. Sure enough, he did. (Abby Livingston, Texas Tribune, 7-29-2020) Gohmert's colleagues were afraid the mask-avoiding congressman from Northeast Texas might get infected with the coronavirus. On Wednesday, their fears came true. For months, members and staffers on the Hill watched with simmering fury as Gohmert and a handful of other Republican lawmakers made their rounds each day without masks.
COVID-Positive Doc: 'I Didn't Wear a Mask and I Regret It' (Kristina Fiore, Medpage Today, 7-21-2020) Outdoor gathering leads to COVID spread among family members. Eight of the 11 people who went to the lakehouse have tested positive for COVID-19. "We did not mask while visiting with family because we let our guard down and thought we were safe."
Fact check: Masks are effective against COVID-19; OSHA doesn't say they offer no protection (Anna Staver, USA Today, 6-27-2020) The claim: Cloth masks will dangerously reduce oxygen levels, and masks don't work. Fact check: Ear loop masks – even homemade cloth masks – offer protection against COVID-19. Fact check: No, N95 filters are not too large to stop COVID-19 particles. The Centers for Disease Control and Prevention asks the general public to wear cloth masks, not "use a face mask meant for a health care worker.”
Study Ranks the Best and Worst Materials for Face Masks (Rachel Nania, AARP, 8-12-2020) Some coverings work better than others when it comes to blocking virus spray.
Nano air masks For when you want to limit how much the mask touches your face. "PURE-MSK marries world class nanofiber technology with American manufacturing and thoughtful design to create the only mask comfortable enough to wear all day long....article penetration and inhalation/exhalation resistance was tested by an independent lab to meet the test method acceptance criteria for NIOSH N95 prequalification. PURE-MSK is not NIOSH approved."
Is a Bandanna a Mask? (James Hamblin, Paging Dr. Hamblin, The Atlantic, 7-22-2020) The value of face coverings varies wildly. Much of it comes down to how we use and maintain them. "If you waited a week to reuse a mask, I see no reason that you shouldn’t feel certain it was free of the virus. Bacteria and fungi can grow on all sorts of mediums, but viruses need a host. Without one, their days are numbered....Have several masks, made to fit well around your nose and mouth. Make them as heavily layered as you can tolerate. After wearing them for a day or so, or in a high-contact scenario, let them sit for a few days in a sunny, out-of-the-way place. Between the effects of time and light, there should be little need for running a washing machine or going through the hassle of hand-washing your masks...." But read the article, for details about why which masks work best.
Simple DIY masks could help flatten the curve. We should all wear them when out in public. (Jeremy Howard, Washington Post, 3-28-2020) When historians tally up the many missteps policymakers have made in response to the coronavirus pandemic, the senseless and unscientific push for the general public to avoid wearing masks should be near the top. The evidence not only fails to support the push, it also contradicts it. Masks effective at "flattening the curve" can be made at home with nothing more than a T-shirt and a pair of scissors. See CDC on use of face coverings (how-to, illustrated)
How NOT to Wear a Mask (Tara Parker-Pope, NYTimes, 4-8-2020) Wearing a face mask takes some getting used to. To get the most benefit, you need to avoid these common mistakes.
Some Experts Say Face Shields Better Than Masks for Coronavirus Protection (Renée Bacher and Christina Ianzito, AARP, 6-15-2020) The advantages of wearing a clear plastic face covering, and how to make your own in minutes.
How to sew your own fabric mask (Washington Post, 4-5-2020) Download the sewing pattern to print at home here.
Nearly 600 — And Counting — US Health Workers Have Died Of COVID-19 (Christina Jewett and Melissa Bailey and Danielle Renwick, The Guardian, 6-6-2020) "Occupational safety experts raised alarms about CDC guidance permitting workers treating COVID patients to wear surgical masks ― which are far less protective than N95 masks."
How to Choose and Wear a Mask During the Coronavirus Pandemic (Catherine Roberts, Consumer Reports,4-24-2020)Science hasn’t yet revealed all the answers to what makes a good reusable mask. Here’s what we know, and what to do. Illustrated.
Instructions on how to make a hand-sewn mask (PDF, Johns Hopkins Medicine)
Why Face Masks Are Crucial Now in the Battle Against COVID-19 (Bob Curley, Healthline, 4-6-2020) “We now know from recent studies that a significant portion of individuals with coronavirus lack symptoms (“asymptomatic”) and that even those who eventually develop symptoms (“pre-symptomatic”) can transmit the virus to others before showing symptoms,” according to the CDC. “This means that the virus can spread between people interacting in close proximity — for example, speaking, coughing, or sneezing — even if those people are not exhibiting symptoms....In light of this new evidence, CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies) especially in areas of significant community-based transmission.”
It feels weird to wear a mask in public. But it could help save my husband’s life. (Jen Reeder, Colorado Sun, 4-16-2020) We need other people to care enough to keep us safe.
Unmasking Uncertainty Claire Merchlinsky, Columbia Journalism Review, Summer 2020) First they said "don't wear masks" (to keep the supply line to medical workers steady) . Then they said "everyone should wear masks when around other people." "The usual shortcuts to writing authoritative-sounding articles were not available on this story. People picked up on that, filling the air of uncertainty with political conviction. Conservatives adopted masks as symbols of fearmongering government overreach; liberals counter-adopted them as icons of Enlightenment values. Political reporters lapped it up, mindful that the pandemic had arrived in an election year. President Trump played the lightning rod; he declined repeatedly to wear a mask, even after the White House made them mandatory in the West Wing."
•Who should wear masks and why? CDC and the Surgeon General initially discouraged the use of face masks, because there was a critical shortage and they were needed more urgently by medical personnel -- and we're in need of the medical personnel. The use of facemasks is crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility) to prevent their catching the virus.  As production of facemasks ramps up and there is no shortage, whenever you go out you should use a facemask (especially if you show symptoms of COVID-19) to help prevent the spread of the disease to others. If nothing else, facemasks keep YOU from touching your own mouth and nose. Read Guidance against wearing masks for the coronavirus is wrong – you should cover your face (Boston Globe) Blocking access to your nose, throat, and eyes will prevent infection from the coronavirus, flu, and any other several other respiratory viruses, which is why medical workers must wear them. We should all wear masks — store-bought or homemade — whenever we're out in public.
What’s the Deal With Shifting Guidance on Masks During the Coronavirus Pandemic? (Craig F. Walker, Boston Globe, 5-27-2020) Guidance on masks has shifted during the COVID-19 pandemic, with experts initially saying they were largely unnecessary before reversing course and advising people to don face coverings whenever they can’t practice social distancing. So what changed? An entry on the CDC website suggests the recommendation on masks evolved as researchers learned more about the potential for asymptomatic coronavirus carriers to unknowingly spread the disease to others.
Everyone Thinks They’re Right About Masks (Ed Yong, The Atlantic, 4-1-2020) How the coronavirus travels through the air has become one of the most divisive debates in this pandemic. When masks were in short supply, mask-wearing among the public was discouraged because the masks were needed by health care professionals. “You’re not wearing them to stop yourself getting infected, but to stop someone else getting infected.” This might be especially important for SARS-CoV-2, which can spread without immediately causing symptoms. If people are infectious before they fall sick, then everyone should wear face masks “when going out in public, in one additional societal effort to slow the spread of the virus down,” says Thomas Inglesby of the John Hopkins Center for Health Security.
The best way to clean your face mask (National Geographic) The virus can remain infectious for several hours, potentially up to a few days, on various surfaces, including masks--whether you’re wearing a disposable surgical mask or a cloth bandana. Here’s how to clean masks and gloves, when to dispose of them, and why you ultimately shouldn’t fear harboring the coronavirus on the rest of your clothes. CDC advises a cloth covering for anyone venturing into a crowded public place. The masks and gloves themselves collect viruses if they’re not cleaned or changed frequently, and they may then contaminate your hands or things that you later touch without protection.
Face Mask Type Matters When Sterilizing, Study Finds (Jennifer Garcia. Medscape, 6-16-2020)
Different types of face mask to use during the COVID-19 pandemic (Medical News Today)
Republicans push back on Trump's mask rhetoric. ‘Wearing A Face Covering Is Not About Politics’ (KHN Morning Briefing) See, for example, ‘There’s no stigma attached to wearing a mask’: McConnell makes plea in favor of face masks (Caitlin Oprysko, Politico, 5-27-2020) and Trump’s Mockery of Wearing Masks Divides Republicans (Michael Scherer, Wash Post, 5-26-2020) A growing chorus of Republicans are pushing back against President Trump’s suggestion that wearing cloth masks to prevent the spread of the novel coronavirus is a sign of personal weakness or political correctness. They include governors seeking to prevent a rebound in coronavirus cases and federal lawmakers who face tough reelection fights this fall, as national polling shows lopsided support for wearing masks in public.
Without a Strong Partner in Washington, Charlie Baker and His Fellow Governors Are on their Own (Anthony Brooks, WBUR, 4-8-2020) It's a race to prepare a medical system before it is overwhelmed by the epidemic. A big part has been Governor Baker's effort to secure equipment for doctors, nurses and other medical workers in Massachusetts. The federal government hasn't made it easy. At one point, the state had ordered 3 million N-95 masks — but the feds stepped in and impounded the shipment in New York.
How Mask Mandates Were Beaten Down in Rural Oklahoma (Victor Luckerson, New Yorker, 5-27-2020) In Oklahoma, where the state government is currently implementing one of the country's fastest reopening plans, local leaders have found themselves caught between state politics, economic imperatives, and a clear scientific consensus.
The Secret, Absurd World of Coronavirus Mask Traders and Middlemen Trying to Get Rich Off Government Money (J. David McSwane, ProPublica, 6-1-2020) The federal government and states have fueled an unregulated, chaotic market for masks ruled by oddballs, ganjapreneurs and a shadowy network of investors.
Is It Time That We All Start Wearing Masks? (Amy L. Baxter, Medscape,4-1-2020)

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Testing: Choosing the right test for the right reason

See also Contact tracing.

 

"Testing is the only way to know whether a person is potentially contagious and in need of isolation."

~ Atul Gawande


We Can Solve the Coronavirus-Test Mess Now—If We Want To (Atul Gawande, New Yorker, 9-2-2020) The key to taming the pandemic will be both a new commitment to “assurance testing” and a new vision of what public health really means. "The lunacy of our testing system is the lunacy of our health system in microcosm.... We are now paying the price of our long, uniquely American resistance to making sure that everyone has proper health-care coverage, and to building an adequate public-health infrastructure. We have not fully grappled with the difficulties we’re up against. But, if we do, we have a chance to fix the problem before the worst of flu season hits."
The Plan That Could Give Us Our Lives Back (Robinson Meyer and Alexis C. Madrigal, The Atlantic, 8-14-2020) The U.S. has never had enough coronavirus tests. Now a group of epidemiologists, economists, and dreamers is plotting a new strategy to defeat the virus, even before a vaccine is found. "We have been covering coronavirus testing since March. For most of that time, the story has been one of failure after failure. But in the past few weeks, something has changed. After months without federal leadership, a loose confederation of scientists, economists, doctors, financiers, philanthropists, and public-health officials has assembled to fill in that gap. They have reexamined every piece of the testing system and developed a new set of tactics to address the months-long testing shortage. Mina’s plan is the most aggressive of these ideas; other groups—such as the new nonprofit Testing for America, founded by private-sector experts who helped the White House in the spring—have advanced their own plans. Taken together, they compose a box of tools that could allow the country to fix its ramshackle house." Listen to Madrigal explain Mina's proposal on Terry Gross's Fresh Air radio program (8-27-2020)
The White House relied on a rapid test, but used it in a way it was not intended. (Apoorva Mandavilli, NY Times,10-2-2020) For months, the White House’s strategy for keeping President Trump and his inner circle safe has been to screen all White House visitors with a rapid test. But one product they use, Abbott’s ID Now, was never intended for that purpose and is known to deliver incorrect results, particularly if administered when a person is pre-symptomatic. See also The White House Bet on Abbott’s Rapid Tests. It Didn’t Work Out. (Katherine J. Wu, NY Times, 10-6-2020) Federal officials relied too heavily on the tests, then took the results for granted, experts say.
Where are the rapid testing data? (Betsy Ladyzhets, COVID-19 Data Dispatch, 10-11-2020) Explains the issues that occur when rapid tests are either not reported or are lumped in with other test types in public COVID-19 data. Simplified data lag in an increasingly complicated testing landscape.
White House Completely Misused Rapid COVID-19 Tests to Avoid Face Masks (Daniel Politi, Slate, 10-3-2020)
11 things to know about COVID-19 testing (Cynthia DeMarco interviews Dr. Micah M Bhatti of M.D. Anderson Center, 5-21-2020) "It’s important to obtain the best possible specimens, so COVID-19 nasal swab testing that includes nucleic acid testing, which is what we do for our patients here at MD Anderson, remains the best option. After all, what’s the point of doing a test, if you can’t get an accurate answer?" A useful set of Q&As.
My Mother Died of the Coronavirus. It’s Time She Was Counted. (Elisabeth Rosenthal, KHN, 5-27-2020) And we are fooling ourselves: Not having an accurate, standard, honest, nationwide way to tally COVID cases will only add to the current tragedy. First of all, states, agencies and workplaces are all counting differently, sometimes bending, I suspect, to political convenience. For states, avoiding robust testing and reporting is a good way to make sure new cases decrease for 14 days (a CDC recommendation for reopening). But it deprives those same states of crucial information for rational decisions. For assisted living facilities, nursing homes and other businesses, there is pressure not to know. Who wants to be known as a place where 20%, 30% or 50% of the residents or workers have gotten COVID-19?
#MoreTesting
Coronavirus Testing Basics (FDA) Two kinds of tests are available for COVID-19: viral tests and antibody tests. A viral test tells you if you have a current infection. An antibody test tells you if you had a previous infection.
      The swab test. Until recently, most tests for COVID-19 required a clinician to insert a long swab into the nose and sometimes down to the throat. In mid-April, the FDA granted emergency approval for a saliva-based test.
      The saliva test is easier to perform — spitting into a cup versus submitting to a swab — and more comfortable. Because a person can independently spit into a cup, the saliva test does not require interaction with a healthcare worker. This cuts down on the need for masks, gowns, gloves, and other protective equipment, which has been in short supply.
      Both the saliva and swab tests work by detecting genetic material from the coronavirus. Both tests are very specific, meaning that a positive test almost always means that the person is infected with the virus. However, both tests can be negative, even if a person is proven later to be infected (known as a false negative). This is especially true for people who carry the virus but have no symptoms.
What to Know About COVID-19 Tests, From PCR to Antigen to Antibody (Jamie Ducharme, Time, 8-20-2020) The majority of COVID-19 testing happening in the U.S. right now uses polymerase chain reaction (PCR) technology. These tests detect disease by looking for traces of the virus’ genetic material on a sample most often collected via a nose or throat swab. The U.S. Centers for Disease Control and Prevention (CDC) considers PCR tests the “gold standard” of COVID-19 testing, but, like all tests, they’re not perfect. False negatives seem to be much more common than false positives. Also described: saliva tests, antigen tests, antibody tests (which wlook for SARS-CoV-2-specific antibodies to see if you’ve previously had coronavirus).
COVID-19 diagnostic testing (Mayo Clinic's equally clear explanations of the basics of testing)
• ***America’s failures to test, trace, and isolate, explained (Dylan Scott, Vox, 7-29-2020) Why is the US so bad at tracing Covid-19 contacts? Three words explain why many developed countries have contained their coronavirus outbreaks more successfully than the United States: test, trace, and isolate. The federal government’s attitude toward contact tracing has been, at best, indifference and, at worst, active resistance. The Trump White House has reportedly tried to block any new funding for testing and contact tracing in the latest Covid-19 relief legislation, though that was overruled by Congress. And making matters worse, public health officials told me test results have been taking a week or longer to come back from the lab, severely limiting their usefulness in heading off new outbreaks.
For COVID Tests, the Question of Who Pays Comes Down to Interpretation (Julie Appleby, KHN, 7-20-2020) Early on in the coronavirus pandemic — when scarce COVID testing was limited to those with serious symptoms or serious exposure — the government and insurers vowed that tests would be dispensed for free to ensure that those in need had ready access. Now, those promises are being rolled back in ways that are creating turmoil for consumers, even as testing has become more plentiful and more people are being advised to get tested.
Tests to Detect Coronavirus on Surfaces Show Mixed Results (Lina Zeldovich Undark, 5-11-2020) Labs and companies are already distributing the tests, which vary drastically in price and potential performance.
Nursing homes get more financial help, must test more often (Liz Seegert, Covering Health, AHCJ, 7-27-2020) U.S. nursing homes that participate in Medicare and Medicaid will be getting a $5 billion infusion of "provider relief funds" from the Department of Health and Human Services, in funds meant to help with testing, purchasing personal protective equipment and hiring additional staff.
CRISPR Comes to COVID: A Pandemic Pivot and the Push for a Simple Coronavirus Test (Carey Goldberg, WBUR, CommonHealth, 7-10-2020) "So rarely in science do you get to work on something with such an immediate need." See also New CRISPR-based test for Covid-19 could be a simple, cheap at-home diagnostic, scientists say (Sharon Begley, STAT, 5-5-2020) And see Scientists tap CRISPR’s search-and-detect skills to create a rapid Covid-19 test (Erin Brodwin, STAT, 4-16-2020)
How Jared Kushner’s Secret Testing Plan “Went Poof Into Thin Air” (Katherine Eban, Vanity Fair, July 2020) This spring, a team working under the president's son-in-law produced a plan for an aggressive, coordinated national COVID-19 response that could have brought the pandemic under control. So why did the White House spike it in favor of a shambolic 50-state response?

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‘How Could the CDC Make That Mistake?’ (Alexis C. Madrigal and Robinson Meyer, The Atlantic, 5-21-2020) The government’s disease-fighting agency is conflating viral and antibody tests, compromising a few crucial metrics that governors depend on to reopen their economies. Pennsylvania, Georgia, Texas, and other states are doing the same. The two tests reveal different information and are used for different reasons. As they state in another article, combining results from viral and antibody tests in the same statistic threatens to confound America’s understanding of the pandemic.
As COVID Testing Soars, Wait Times for Results Jump to a Week — Or More (Phil Galewitz, KHN, 7-9-2020) While hospital patients can get the findings back within a day, people getting tested at urgent care centers, community health centers, pharmacies and government-run drive-thru or walk-up sites are often waiting a week or more. That means they don't have the information they need to know what actions to take.
A national COVID-19 surveillance system: Achieving containment (Mark McClellan, Scott Gottlieb, Farzad Mostashari,Caitlin Rivers, and Lauren Silvis, Duke-Margolis Center for Health Policy, American Enterprise Institute, 4-7-2020) You can download the report. (See JAMA review/summary. "On state and local levels, every region of the country should aim for key outbreak surveillance and response capabilities: a test-and-trace infrastructure, real-time syndromic surveillance, serologic testing for markers of infection, and rapid response in the form of isolation, contact tracing, and quarantine."
68% Have Antibodies in This Clinic. Can a Neighborhood Beat a Next Wave? (Joseph Goldstein, NY Times, 7-9-2020) Data from those tested at a storefront medical office in Queens is leading to a deeper understanding of the outbreak’s scope in New York.
NIH Is Testing People for Covid-19 Antibodies—and Looking for Volunteers (Kristen Hinman, Washingtonian, 4-13-2020) You can enroll in the serological study from home. They'll mail you a blood-test kit.
What a Negative COVID-19 Test Really Means (Sarah Zhang, The Atlantic, 6-21-2020) "Understanding false negatives from COVID-19 tests is especially important because people who do not yet know that they’re sick play a major role in the spread of COVID-19." Presymptomatic transmission keeps the pandemic going. The timing of the test matters. "As soon as the coronavirus finds its way into a new host, it hijacks cells to copy itself. The amount of virus builds over this time, peaking at or right before symptom onset, which can take two to 14 days but usually takes an average of five or six. Accordingly, public-health authorities have advised getting tested about four days after exposure."
False Negative Tests for SARS-CoV-2 Infection — Challenges and Implications Steven Woloshin, et al., New England Journal of Medicine, 6-5-2020) "A false positive result erroneously labels a person infected, with consequences including unnecessary quarantine and contact tracing. False negative results are more consequential, because infected persons — who might be asymptomatic — may not be isolated and can infect others."
Discussing the Need for Reliable Antibody Testing for COVID-19 (Dr. Francis Collins, NIH Director's blog, 6-4-2020) A useful Q&A with Dr. Norman “Ned” Sharpless, Director of NIH’s National Cancer Institute (NCI) and an expert on antibody testing for COVID-19.
Dr. Sanjay Gupta takes coronavirus antibody test(CNN, 4-21-2020) He walks us through his coronavirus antibody test and highlights key details regarding this type of testing. See also WebMD's explanation: Antibody Testing for COVID-19. Elsewhere Dr. Gupta explained on CNN the difference between three types of Covid-19 test and says "so far the tests we have are giving a lot of false positives.":
---PCR diagnostic test confirms if person is positive or negative for the virus. (PCR stands for polymerise chain reaction.)

---Serology test detects antibodies which mean person has been infected
---Antigen test detects viral proteins typically made for flu & strep screenings. With a throat swab you can get quick results (though less expensive, these results are less reliable and may need to be confirmed with genetic tests). See a fuller description of these three types of test here: Different paths to the same destination: screening for Covid-19 (Chloe Kent, Medical Device Network, 4-3-2020)
Let’s Get Real About Coronavirus Tests (Michael T. Osterholm and Mark Olshaker, Opinion, NY Times, 4-28-2020) There aren’t enough. Many are shoddy. Most aren’t even designed to tell us what we really want to know.
The 4 Key Reasons the U.S. Is So Behind on Coronavirus Testing (Olga Khazan, The Atlantic, 3-13-2020) Bureaucracy, equipment shortages, an unwillingness to share, and failed leadership doomed the American response to COVID-19.

(1) Red Tape. Dozens of labs in the U.S. were eager to make tests and willing to test patients, but they were hamstrung by emergency use authorization (EUA) regulations for most of February, even as the virus crept silently across the nation.

(2) Hard-to-get virus samples.Miller said it would help if researchers, governments, and companies firmed up pathogen-sharing contracts in advance of an outbreak.

(3) “We don’t have a nationalized health-care system where you put the same equipment in all the hospitals,” Wu says. “We have all these independent hospital systems with their own equipment in their own labs.” Even though some hospitals actually have the new, functional CDC tests, the extraction machines and reagents that are used to perform them are in short supply.

(4) Leadership and coordination problems. For months, President Trump made light of the coronavirus. “Much of what he’s said publicly about the virus has been wrong, a consequence of downplaying any troubles on his watch.” Trump put Mike Pence, who has no public health experience, in charge, late, and there was infighting between and little coordination among departments.

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Why a Negative Test Doesn’t Guarantee You Don’t Have the Coronavirus (Clayton Dalton, New Yorker, 9-16-2020) We want coronavirus tests to give us the all-clear. But, in medicine, test results are clues, not answers—and no test is perfect. (A long read.)
Why even a super-accurate Covid-19 test can fail (Umair Irfan, Vox, 5-1-2020) Public health officials know that some infected people can spread the virus without showing symptoms, sometimes for weeks. That makes testing to identify and isolate the infected the most important way to slow the spread of the virus. But the shortage of tests means officials don’t yet know how many are still out there, or how many have already recovered. It also turns out that the tests are not always that great. Both the genetic tests for Covid-19 (that look for active infections) and the serological antibody tests (that can identify past infections) have had issues with accuracy. The prevalence of the disease influences the chances of a correct test result. Many researchers agree that the United States needs to be testing millions of people per day, yet the country is struggling to test more than 200,000 in a day. And since a test is just a snapshot in time, many people, particularly in high-risk jobs, will have to be tested over and over.
Essential Worker Shoulders $1,840 Pandemic Debt Due to COVID Cost Loophole (Sarah Varney, 'Bill of the Month,' KHN, 6-30-2020) Carmen Quintero had symptoms of COVID-19, couldn’t get tested and ended up with a huge bill. She also was told to self-isolate and assume she had the coronavirus — which is hard when you live with elders. She works at a distribution warehouse and has an Anthem Blue Cross health insurance plan through her job with a $3,500 annual deductible. Her primary care doctor directed her to the nearest emergency room for testing because the practice had no coronavirus tests. She was evaluated in the emergency room for symptoms consistent with COVID-19: a wracking cough and difficulty breathing. Congress had passed the CARES Act just the week before, with its headlines saying coronavirus testing would be free. That legislation was riddled with loopholes.She ended up $1,845 in debt. At this point in the pandemic, tests are more widely available and federal law is very clearly on your side: You should not be charged any cost sharing for a coronavirus test. Any test you get at an emergency room could come at a high price. Ask if there are any other testing sites available.
Let’s Get Real About Coronavirus Tests (Michael T. Osterholm and Mark Olshaker, Opinion, NY Times, 4-28-2020) There aren’t enough. Many are shoddy. Most aren’t even designed to tell us what we really want to know.
Study Raises Questions About False Negatives From Quick COVID-19 Test (Rob Stein, Morning Edition, NPR, 4-21-2020)
What coronavirus antibody tests tell us — and what they don’t (Erin Garcia de Jesus, Science News, 4-28-2020) Widespread testing could reveal who has had COVID-19, but not whether they’ll get it again. "Knowing how many people have already been exposed to the virus is also a step toward understanding when the pandemic might end (SN: 3/24/20). High numbers of immune people can protect the population as a whole from outbreaks, creating what's called herd immunity. Researchers estimate that around one-third to two-thirds of a population would need to be infected with SARS-CoV-2 to reach herd immunity." 
The False Hope of Antibody Tests (Sarah Zhang, The Atlantic, 4-28-2020) The immunity tests were supposed to be a “game changer,” but they are instead revealing that the majority of Americans are still vulnerable to COVID-19 infection.
Can Antibody Tests Help End the Coronavirus Pandemic? (Apoorva Mandavilli, NY Times, 4-26-2020) The tests are not reliable enough to guide policy on lockdowns and reopenings, experts said. But they can help model the spread of the virus.
What Covid-19 antibody tests say — and don’t say — about immunity (Brian Resnick, Vox, 4-28-2020) A positive antibody test doesn’t yet mean you’re immune to Covid-19.
What Antibody Studies Can Tell You — and More Importantly, What They Can’t (Caroline Chen, ProPublica, 4-28-2020)
Congress Said COVID-19 Tests Should Be Free — But Who’s Paying? (Blake Farmer, Nashville Public Radio and KHN, 5-22-2020)
Lessons on Coronavirus Testing From the Adult Film Industry (Michelle C. Hollow, New York Times, 6-18-2020) An industry that survived the AIDS crisis could be a model for others looking to build confidence, experts say. Maitland Ward performs in adult films that rely on a health screening system that some experts say could be a model for a coronavirus screening database. The adult film industry uses a nationwide program called PASS, for Performer Availability Screening Services, that requires performers to be tested every 14 days for H.I.V. and other sexually transmitted infections in order to be cleared for work. If a worker tests positive, he’s treated, and his partners are traced.
Coronavirus Testing Used by the White House Could Miss Infections (Katie Thomas, NY Times, 5-13-2020) A rapid coronavirus test used by the White House to screen its staff could miss infections up to 48 percent of the time, according to a study by researchers at N.Y.U. Langone Health. A study found that the Abbott ID Now machine was less accurate when it processed short, dry swabs. The study, which has not yet been peer reviewed, evaluated the accuracy of the test, Abbott ID Now, a machine about the size of a toaster oven that can yield results in five to 13 minutes. The product, which was given emergency authorization by the Food and Drug Administration in late March, has been enthusiastically promoted by President Trump — it was even used as a prop during at least one news conference. Mr. Trump has said the tests are “highly accurate.”

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Records show snags in Oregon's search for COVID-19 test supplies (Nick Budnick, Portland Tribune, 4-29-2020) 'Swab shortages and a federal 'runaround' have curbed state efforts to boost coronavirus testing. President Donald Trump unveiled rapid coronavirus-testing machines to great fanfare, saying the devices manufactured by Abbott Laboratories would create "a whole new ballgame" in fighting the disease. The federal government sent 15 of the Abbott machines to Oregon in early April— with no supplies to operate them. The machines require a special Abbott-made test-kit to operate. Allen likened the federal government's sending of the 15 Abbott machines to "giving us a printer with no ink." State officials reached out to Abbott, which said Oregon could only order from the federal government. State officials ordered 5,000 more test kits from the federal government. When the shipment arrived however, it fell short — 4,996 test kits short.'
What Antibody Studies Can Tell You — and More Importantly, What They Can’t (Caroline Chen, ProPublica, 4-28-2020) Coronavirus antibody studies and what they allegedly show have triggered fierce debates, further confusing public understanding. Chen explains the basics. Antibody studies can be used to answer more questions than you might think. Setting up a sero-survey correctly means you need to test a random population — easier said than done. Test accuracy can skew results in some pretty surprising ways (true positive, false positive, and true negative, explained). Antibody tests aren’t ready to be used to issue “immunity passports.”
Tip sheet can aid your reporting on COVID-19 serology/antibody testing (Tara Haelle, Covering Health, AHCJ, 5-5-2020)  For AHCJ members only. Worth joining, if you're a journalist.
Developing a national strategy for serology (antibody testing) in the United States (Johns Hopkins Center for Health Security)
Important information on the use of serological (antibody) tests for COVID-19 — letter to health care providers (US FDA)
Emergency Use Authorizations (FDA) (scroll down for testing kits, both PCR and serology)
Emergency Use Authorizations (FDA) Scroll down for testing kits, both PCR and serology.
FDA pushed through scores of inaccurate antibody tests without agency review. (Zachary Brennan and David Lim, Politico, 4-27-2020) Some are giving too many false positive results, which could mislead some people into thinking they have already been infected.
Seniors With COVID-19 Show Unusual Symptoms, Doctors Say (Judith Graham, KHN, 4-24-2020) "COVID-19 is typically signaled by three symptoms: a fever, an insistent cough and shortness of breath. But older adults — the age group most at risk of severe complications or death from this condition ― Instead, seniors may seem “off” — not acting like themselves ― early on after being infected by the coronavirus. They may sleep more than usual or stop eating. They may seem unusually apathetic or confused, losing orientation to their surroundings. They may become dizzy and fall. Sometimes, seniors stop speaking or simply collapse."
1 In 5 New Yorkers May Have Had Covid-19, Antibody Tests Suggest (Goodman and Rothfeld, NY Times, 4-23-2020) One of every five New York City residents tested positive for antibodies to the coronavirus, according to preliminary results described by Gov. Andrew M. Cuomo on Thursday that suggested that the virus had spread far more widely than known (and the death rate may therefore be lower than previously thought). Accurate antibody testing is a critical tool to determine if the pandemic has slowed enough to begin restarting the economy. A top health official in New York City cautioned that the tests being used were not a reliable indicator of immunity.
COVID Tests Are Free, Except When They’re Not (Carmen Heredia Rodriguez, KHN, 4-29-2020) Her doctor worried she had COVID-19 but couldn’t test her for it until she ruled out other things. That test cost a bundle. (Scroll down to The Takeaway for practical advice.)
•  The Strongest Evidence Yet That America Is Botching Coronavirus Testing (Robinson MeyerAlexis C. Madrigal, The Atlantic, 3-6-2020) “I don’t know what went wrong,” a former CDC chief told The Atlantic.
A New Statistic Reveals Why America’s COVID-19 Numbers Are Flat (Robinson Meyer and Alexis C. Madrigal,The Atlantic, 4-17-2020) "At least 630,000 people nationwide now have test-confirmed cases of COVID-19, according to The Atlantic’s COVID Tracking Project, a state-by-state tally conducted by more than 100 volunteers and experts. But an overwhelming body of evidence shows that this is an undercount...".(We don't know our prevalence rate because we haven't tested enough.) "The U.S. still lags far behind other countries in the course of fighting its outbreak. South Korea — which discovered its first coronavirus case on the same day as the U.S. — has tested more than half a million people, or about 1 percent of its population, and discovered about 10,500 cases. The U.S. has now tested 3.2 million people, which is also about 1 percent of its population, but it has found more than 630,000 cases. So while the U.S. has a 20 percent positivity rate, South Korea’s is only about 2 percent — a full order of magnitude smaller....Each of those uncounted cases is a small tragedy and a microcosm of all the ways the U.S. testing infrastructure is still failing."
COVID Tests Are Free, Except When They’re Not (Carmen Heredia Rodriguez, KHN, 4-29-2020) Her doctor worried she had COVID-19 but couldn’t test her for it until she ruled out other viral possibilities. That test cost a bundle. The guidelines state that insurers are required to cover the cost of an appointment without cost sharing only if the doctor orders or administers a COVID-19 test. “They’re getting a battery of other tests,” said Corlette. “But because there’s not enough [COVID-19] tests, they can’t get this protection.”... If an insurer does not cover the total amount charged by a provider, the patient may get balance-billed, or slapped with a surprise charge.Consumers may find protection from these bills through a requirement attached to federal relief funding for medical providers. Health care facilities that receive any of the $100 billion from the CARES Act Provider Relief Fund are not allowed to balance-bill patients for COVID-19 treatment. (Somewhat complicated. Read the article!)
Chicago Plans for a Slow Recovery from the Coronavirus (Peter Slevin, New Yorker, 4-22-2020) Chicago Mayor Lori Lightfoot has spoken of her frustration with the White House’s response to the coronavirus and believes Chicago is “not testing nearly enough people.”

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Testing Falls Woefully Short as Trump Seeks an End to Stay-at-Home Orders (Abby Goodnough, Katie Thomas and Sheila Kaplan, NY Times, 4-15-2020) Flawed tests, scarce supplies and limited access to screening have hurt the U.S.’s ability to monitor Covid-19, governors and health officials warn. Most of the country is not conducting nearly enough testing to track the path and penetration of the coronavirus in a way that would allow Americans to safely return to work, public health officials and political leaders say. So far there is not enough national capacity for either diagnostic or antibody testing. Testing is critical for detecting and stamping out smaller outbreaks before they get big. Many say the biggest challenge is getting not the diagnostic tests themselves but the supplies to process them, including chemical reagents, swabs and pipettes. One expert said 'confusion over which laboratories were accepting tests, and “convoluted” systems connecting providers to labs, meant his facilities were running about 200 to 300 tests per day when they could handle 1,000.'

Thousands of coronavirus tests are going unused in US labs (Amy Maxmen, Nature, 4-9-2020) Experts say the lack of a national strategy is largely to blame. "A Nature investigation of several university labs certified to test for the virus finds that they have been held up by regulatory, logistic and administrative obstacles, and stymied by the fragmented US health-care system. Even as testing backlogs mounted for hospitals in California, for example, clinics were turning away offers of testing from certified academic labs because they didn’t use compatible health-record software, or didn’t have existing contracts with the hospital." (Worth a read.)
Local officials on watch for unauthorized COVID-19 test sites (Cheryl Clark, Covering Health, AHCJ, 4-16-2020) Cities, counties and states around the country are probably on heightened alert for unauthorized pop-up COVID-19 testing operations after San Diego County took steps to shut down one such clinic Wednesday, lest a bogus test give someone a false result and jeopardize public health.
Despite Promises, Testing Delays Leave Americans ‘Flying Blind’ (Sheila Kaplan and Katie Thomas, NY Times, 4-6-2020) Testing availability remains a signature failure of the battle against the coronavirus in the United States, despite President Trump’s boast last week that he got a rapid test and results within minutes. On a per capita basis, the United States had tested far fewer people than several other countries. Even as new and faster tests become available, lengthy delays to obtain results continue and test materials are running low, compounding the crises hospitals are facing. Demand for testing has overwhelmed many labs and testing sites and swabs and chemicals needed to run the tests are in short supply in many of the nation’s hot zones. Excellent overview of where things stand from many viewpoints.
Most Americans are not willing or able to use an app tracking coronavirus infections. That’s a problem for Big Tech’s plan to slow the pandemic. (Craig Timberg, WashPost, 4-29-2020) 1 in 6 Americans do not have smartphones, which would be necessary for running any apps produced by the initiative. Rates of smartphone ownership are much lower among seniors, who are particularly vulnerable to the ravages of covid-19, with just over half of those aged 65 or older saying that they have a smartphone (53 percent). Rates are even lower for those 75 and older. Among the 82 percent of Americans who do have smartphones, willingness to use an infection-tracing app is split evenly, with 50 percent saying they definitely or probably would use such an app and an equal percentage saying they probably or definitely would not. [Is this next point weird?:] Willingness runs highest among Democrats and people reporting they are worried about a covid-19 infection making them seriously ill. Resistance is higher among Republicans and people reporting a lower level of personal worry about getting the virus.
‘We're behind the curve’: U.S. hospitals confront the challenges of large-scale coronavirus testing (Jon Cohen, Science, 3-11-2020) “The reality is most people will not be able to get a test this week, and most people will not be able to get a test next week,” says physician and epidemiologist Michael Mina, who helps run the diagnostic lab at Brigham and Women’s Hospital in Boston and has been critical of the Trump administration in blistering tweets. Mina "also anticipates that there will be—or may already be—a shortage of reagents needed to run the test kits."
The Dangerous Delays in U.S. Coronavirus Testing Haven’t Stopped (Robinson MeyerAlexis C. Madrigal, The Atlantic, 3-9-2020)
Reviewing Public Health Record of Coronavirus Commander Mike Pence (KHN, 2-28-2020) KHN Midwest editor and correspondent Laura Ungar appeared on “CNN Newsroom with Brooke Baldwin” to discuss Vice President Mike Pence’s appointment to lead the nation’s response to the novel coronavirus in light of how he handled a 2015 HIV outbreak when he was governor of Indiana. Prevention and quick evidence-based action are the most important steps to take in these health crises and Pence took neither in 2015.
Key Missteps at the CDC Have Set Back Its Ability to Detect the Potential Spread of Coronavirus (Caroline Chen, Marshall Allen, Lexi Churchill and Isaac Arnsdorf, ProPublica, 2-28-2020) The CDC designed a flawed test for COVID-19, then took weeks to figure out a fix so state and local labs could use it. New York still doesn’t trust the test’s accuracy.
Drive through testing begins at Edinburgh hospital (BBC News, 2-28-2020)
New California Coronavirus Case Reveals Problems with U.S. Testing Protocols (Anna Maria Barry-Jester and Rachel Bluth, KHN, 2-27-2020)

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Estimates fall short of the F.D.A.’s pledge for 1 million coronavirus tests. Health care supply companies and public health officials have cast doubt on the federal U.S. government’s assurances of greatly ramped-up testing for the virus, as complaints continue that the need for testing remains far greater than the capacity. Some companies developing tests say their products are still weeks away from approval. See also What went wrong with the coronavirus tests in the U.S. (Carolyn Y. Johnson and Laurie McGinley, WaPo, 3-7-2020)
‘It’s Just Everywhere Already’: How Delays in Testing Set Back the U.S. Coronavirus Response (Sheri Fink and Mike Baker, NY Times, 3-10-2020).
The Strongest Evidence Yet That America Is Botching Coronavirus Testing (Robinson Meyer and Alexis C. Madrigal, The Atlantic, 3-6-2020) "The haphazard debut of the tests—and the ensuing absence of widespread data about the epidemic—has hamstrung doctors, politicians, and public-health officials as they try to act prudently during the most important week for the epidemic in the United States so far....the capacity to test for the coronavirus varies dramatically—and sometimes dangerously—from state to state." 
COVID-19: Who's at fault when a negative test is false? Maybe nobody. (MadelineMitchell, Cincinnati Enquirer, 5-5-2020) A negative result does not rule out COVID-19.  False negatives are more possible with less sensitive tests because patients without symptoms, or with mild symptoms, often have low viral loads that may evade detection by standard tests.
Coronavirus: How CDC Lab Contamination, and a Failure to Cooperate Globally, Led to Catastrophe (Anita Bartholomew, Forbes, 4-19-2020)

      “You cannot fight a fire blindfolded. And we cannot stop this pandemic if we don’t know who is infected. We have a simple message for all countries: test, test, test.” 
The Doctor Who Helped Defeat Smallpox Explains What's Coming (Steven Levy, Wired, 3-19-2020) Epidemiologist Larry Brilliant, who warned of pandemic in 2006, says we can beat the novel coronavirus—but first, we need lots more testing. Brilliant is chairman of the board of Ending Pandemics.
Talking Can Generate Coronavirus Droplets That Linger Up to 14 Minutes (Knvul Sheikh, NY Times, 5-14-2020) A new study shows how respiratory droplets produced during normal conversation may be just as important in transmitting disease, especially indoors.
How To Know If You Can Trust That Headline-Grabbing COVID-19 Study (Rachel Fairbank, Lifehacker, 4-29-2020) Fairbank lays out significant issues with antibody testing.

What's important about contact tracing

#MoreTracing


What are contact tracers? And how many each state needs to safely reopen (Betsy Ladyzhets, Stacker, 5-20-2020)
The Most American COVID-19 Failure Yet (Olga Khazan, The Atlantic, 8-31-2020) Contact tracing works almost everywhere else. Why not here? Contact tracers are not to blame. Tracers tend to be relatively low-paid, civic-minded workers who make calls relentlessly in an attempt to rescue the nation from a ruthless pandemic. But they’re struggling for three main reasons: too many cases to track, testing that takes too long, and too much insufficient trust in goverment "to give up their contacts or follow quarantine orders."
Contact tracing, CDC politics, and more (Betsy Ladyzhets, COVID-19 Data Dispatch, 10-18-2020) What states are ready to test and trace today? (See graphic.) Data available for all states.
Contact tracing workforce estimators (George Washington University)
Tracking Coronavirus Exposure: How Contact Tracing Works (Grace Tatter and Meghna Chakrabarti, On Point, WBUR, 4-29-2020) Contact tracing. It's infectious disease detective work. We learn all about the techniques and technology used to track down people who've been exposed to the coronavirus. Excellent links to more key articles on the topic.
Combatting fraud There’s no question, contact tracing plays a vital role in helping to stop the spread of COVID-19. But scammers, pretending to be contact tracers and taking advantage of how the process works. Here are five ways you can tell the difference between a real contact tracer and a scammer. According to the FTC, contract tracers will never:
     Ask for money or payment of any kind.
     Ask for your bank account or credit card number.
     Ask for your Social Security number.
     Ask for your immigration status.
     Ask you to click on a link in a text or email.
What to Know About Becoming a Contact Tracer (Eve Glicksman, Next Avenue, 6-12-2020) The qualifications, pay, training and how to get hired. One independent recruiter is the nonprofit Contrace Public Health Corps, "working to deploy an army of 100,000 qualified contact tracer applicants."
Party Guests Wouldn’t Talk After 9 Tested Positive. Then Subpoenas Came. (Ed Shanahan, NY Times, 7-1-2020) Rushing to contain a coronavirus cluster tied to a big party in a New York City suburb, officials turned to an unusual legal strategy.
Coronavirus: NHS contact tracing app to target 80% of smartphone users (Leo Kelion, BBC, 4-16-2020) "A contact-tracing app could help stop the coronavirus pandemic, but 80% of current smartphone owners would need to use it, say experts advising the NHS."
As States Reopen, Do They Have The Workforce They Need To Stop Coronavirus Outbreaks? (Selena Simmons-Duffin, Morning Edition, 6-18-2020) An NPR survey of state health departments shows that the national coronavirus contact tracing workforce has tripled in the past six weeks, from 11,142 workers to 37,110. Yet given their current case counts, only seven states and the District of Columbia are staffed to the level that public health researchers say is needed to contain outbreaks. Contact tracers are public health workers who reach out to each new positive coronavirus case, track down their contacts, and connect both the sick person and those who were exposed with the services they need to be able to safely isolate themselves. This is an essential part of stamping out emerging outbreaks.
States Nearly Doubled Plans For Contact Tracers Since NPR Surveyed Them 10 Days Ago (Shots, NPR, 4-28-2020) The idea behind this public health strategy is simple: Keep the virus in check by having teams of public health workers — epidemiologists, nurses, trained citizens — identify each new positive case, track down their contacts and help both the sick person and those who were exposed isolate themselves. An influential group of former government officials released a letter last week calling for a contact tracing workforce of 180,000 around the country. Other estimates of how many contact tracers are needed range from 100,000 to 300,000.
We need tech and government help with contact tracing. That doesn’t have to mean Big Brother." (Danielle Allen, WaPo, 4-3-2020) We need to get to work on two phases. First, restarting our economy will require millions of tests a day. As others have argued, we will comfortably be able to ease the current social distancing once four things are in place: a sustained reduction in cases for at least 14 days, hospitals’ capacity to manage all cases needing treatment, the capacity to test at the levels described above, and the capacity to supply personal protective equipment at scale, including for universal mask-wearing. Then we hit the second phase. Once social distancing ends, the goal of the testing regimen would shift to identifying those who should be in individual quarantine. This must be done carefully. Here's how.
Clever Cryptography Could Protect Privacy in Covid-19 Contact-Tracing Apps (Andy Greenberg, Wired, 4-8-2020) Researchers are racing to achieve the benefits of location-tracking without the surveillance.
We Can’t Reopen the Country Without Better Contact Tracing (Jane C. Hu, Slate, 4-17-2020) Here’s what that entails. Some countries, like Singapore and Korea, have rolled out apps that track users’ locations and ping them if they’ve recently crossed paths with someone who has tested positive for COVID-19.
Virus hunters rely on faxes, paper records as more states reopen (Darius Tahir, Politico, 5-11-2020) Congress approved more than $500 million for health data in last month's relief package, but disease trackers say they're using paper reports and outdated spreadsheets for contact tracing and determining how many people were potentially exposed to the virus.

     Public health technology was in crisis even before the pandemic, but the novel coronavirus has significantly elevated concern. “Outdated digital infrastructure means that services don’t scale, so rapid relief is unavailable to large numbers in times of crisis,” four congressmen wrote in a “dear colleague” message seeking upgrades in state and local IT. “It means that government employees are unable to work remotely, putting them and their communities at risk. And it means that these systems are under increasing threat from malicious cyber actors looking to take advantage of the crisis.”

     The congressmen recommend the bill should: maximize flexibility for systems that can receive funding; require states to submit modernization plans based on risk assessments that ensure access for local governments; and focus on long-term projects with some funds for immediate equipment and license needs.
How Contact Tracing Can Help Stop COVID-19 (Healthline) As U.S. states begin reopening, health experts are calling for massive investment in contact tracing — identifying and notifying people who have come into close contact with someone who has tested positive for the new coronavirus. Many states also don’t yet have the resources needed to make contact tracing work effectively. We may need many more contact tracers to control the COVID-19 outbreak.
Contact tracing starts with a person testing positive for SARS-CoV-2, the virus that causes COVID-19. It can also be done for suspected cases, as when someone shows symptoms of COVID-19, such as cough or shortness of breath. A trained public health worker interviews that person to help them recall all the people they’ve had close contact with while they were infectious.
States Nearly Doubled Plans for Contact Tracers Since NPR Surveyed Them 10 Days Ago (Selena Simmons-Duffin, Morning Edition, NPR, 5-7-2020) An influential group of former government officials released a letter last week calling for a contact tracing workforce of 180,000 around the country. Other estimates of how many contact tracers are needed range from 100,000 to 300,000. See NPR's chart for how many contract tracers your state has.
When I call you, it means you’ve been exposed to the coronavirus (Jackie Munn, Opinion, Washington Post, 5-24-2020) Contact tracing is laborious and stressful — and essential to reopening safely.
Does Covid-19 Contact Tracing Pose a Privacy Risk? Your Questions, Answered (Andy Greenberg, Security, Wired, 4-17-2020) "When Google and Apple announced last week that the two companies are building changes into Android and iOS to enable Bluetooth-based Covid-19 contact tracing, they touched off an immediate firestorm of criticisms. The notion of a Silicon Valley scheme to monitor yet another metric of our lives raised immediate questions about the system's practicality and its privacy. Now it's time to seek answers."
A National Plan to Enable Comprehensive COVID-19 Case Finding and Contact Tracing in the US (PDF, Johns Hopkins Center for Health Security)
Contact Tracing : Part of a Multipronged Approach to Fight the COVID-19 Pandemic (CDC, Covid-19)
Contact tracing must balance privacy and public health (David Blumenthal and Richard Blumenthal, STAT News, 5-15-2020) In the digital age, contact tracing comes with a modern twist: the ability to use smartphones and devices to do the work of walking back through weeks of our lives to find out where we have been, who we have been with, and how widely we may have spread a virus....[But] it’s important to acknowledge that contact tracing of any stripe is intrusive. Professional contact tracers will sit with an individual to review his or her social media, text messages, credit card statements, public transportation records, and more to find anyone they could have exposed. Those contacts receive unexpected calls from strangers asking them to potentially upend their lives for weeks to self-isolate or get tested for potential exposure to an infectious disease."
Feds Make $631 Million Available to States to Pay for Coronavirus Testing, Contact Tracing (William Wan, WashPost,4-23-2020) CDC announced that it is sending $631 million to state and local health departments to increase their capacity to do contact tracing and testing for the novel coronavirus — a fraction of what many officials say they need to safely restart their economies.
The Callousness of India’s COVID-19 Response (Vidya Krishnan, The Atlantic,3-27-2020) The government is showing how not to handle a pandemic. The government is offering little in the way of a safety net. The lockdown may help “flatten the curve” and buy the authorities some time, but that means little if they do not take advantage by aggressively testing, isolating confirmed cases, and performing contact tracing. Absent these measures, the lockdown will merely create concentrated pockets of outbreaks that will then expand rapidly once the restrictions are eventually lifted.
Small Towns Won’t Know They’re Infected Until It’s Too Late (Mark Bowden, The Atlantic, 5-27-2020) The demise of local news is a pandemic emergency. Local news has largely disappeared—the phenomenon of news deserts is by now well known....The crucial virus data is hyper-local. We all know that these numbers are imprecise. Most people have not been tested. Some of those who have been tested were tested for active infections and others for antibodies that signal old infections—numbers that have been combined, for no good reason. Some of the jump might simply be because more tests are being administered.

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What's important about contact tracing

#MoreTracing


Tracking Coronavirus Exposure: How Contact Tracing Works (Grace Tatter and Meghna Chakrabarti, On Point, WBUR, 4-29-2020) Contact tracing. It's infectious disease detective work. We learn all about the techniques and technology used to track down people who've been exposed to the coronavirus. Excellent links to more key articles on the topic.
Combatting fraud There’s no question, contact tracing plays a vital role in helping to stop the spread of COVID-19. But scammers, pretending to be contact tracers and taking advantage of how the process works. Here are five ways you can tell the difference between a real contact tracer and a scammer. According to the FTC, contract tracers will never:
     Ask for money or payment of any kind.
     Ask for your bank account or credit card number.
     Ask for your Social Security number.
     Ask for your immigration status.
     Ask you to click on a link in a text or email.
What to Know About Becoming a Contact Tracer (Eve Glicksman, Next Avenue, 6-12-2020) The qualifications, pay, training and how to get hired. One independent recruiter is the nonprofit Contrace Public Health Corps, "working to deploy an army of 100,000 qualified contact tracer applicants."
CDC infographic on contact tracing (CDC) Severe symptoms include trouble breathing, persistent pain or pressure in the chest, confusion, inability to wake or stay awake, or bluish lips or face.If you have been diagnosed with COVID-19, a public health worker will call you to check on your health. They will ask you who you’ve been in contact with and where you spent time while you were sick and may have spread COVID-19 to others.
Party Guests Wouldn’t Talk After 9 Tested Positive. Then Subpoenas Came. (Ed Shanahan, NY Times, 7-1-2020) Rushing to contain a coronavirus cluster tied to a big party in a New York City suburb, officials turned to an unusual legal strategy.
Coronavirus: NHS contact tracing app to target 80% of smartphone users (Leo Kelion, BBC, 4-16-2020) "A contact-tracing app could help stop the coronavirus pandemic, but 80% of current smartphone owners would need to use it, say experts advising the NHS."
As States Reopen, Do They Have The Workforce They Need To Stop Coronavirus Outbreaks? (Selena Simmons-Duffin, Morning Edition, 6-18-2020) An NPR survey of state health departments shows that the national coronavirus contact tracing workforce has tripled in the past six weeks, from 11,142 workers to 37,110. Yet given their current case counts, only seven states and the District of Columbia are staffed to the level that public health researchers say is needed to contain outbreaks. Contact tracers are public health workers who reach out to each new positive coronavirus case, track down their contacts, and connect both the sick person and those who were exposed with the services they need to be able to safely isolate themselves. This is an essential part of stamping out emerging outbreaks.
States Nearly Doubled Plans For Contact Tracers Since NPR Surveyed Them 10 Days Ago (Shots, NPR, 4-28-2020) The idea behind this public health strategy is simple: Keep the virus in check by having teams of public health workers — epidemiologists, nurses, trained citizens — identify each new positive case, track down their contacts and help both the sick person and those who were exposed isolate themselves. An influential group of former government officials released a letter last week calling for a contact tracing workforce of 180,000 around the country. Other estimates of how many contact tracers are needed range from 100,000 to 300,000.
We need tech and government help with contact tracing. That doesn’t have to mean Big Brother." (Danielle Allen, WaPo, 4-3-2020) We need to get to work on two phases. First, restarting our economy will require millions of tests a day. As others have argued, we will comfortably be able to ease the current social distancing once four things are in place: a sustained reduction in cases for at least 14 days, hospitals’ capacity to manage all cases needing treatment, the capacity to test at the levels described above, and the capacity to supply personal protective equipment at scale, including for universal mask-wearing. Then we hit the second phase. Once social distancing ends, the goal of the testing regimen would shift to identifying those who should be in individual quarantine. This must be done carefully. Here's how.
Clever Cryptography Could Protect Privacy in Covid-19 Contact-Tracing Apps (Andy Greenberg, Wired, 4-8-2020) Researchers are racing to achieve the benefits of location-tracking without the surveillance.
We Can’t Reopen the Country Without Better Contact Tracing (Jane C. Hu, Slate, 4-17-2020) Here’s what that entails. Some countries, like Singapore and Korea, have rolled out apps that track users’ locations and ping them if they’ve recently crossed paths with someone who has tested positive for COVID-19.
Virus hunters rely on faxes, paper records as more states reopen (Darius Tahir, Politico, 5-11-2020) Congress approved more than $500 million for health data in last month's relief package, but disease trackers say they're using paper reports and outdated spreadsheets for contact tracing and determining how many people were potentially exposed to the virus.

     Public health technology was in crisis even before the pandemic, but the novel coronavirus has significantly elevated concern. “Outdated digital infrastructure means that services don’t scale, so rapid relief is unavailable to large numbers in times of crisis,” four congressmen wrote in a “dear colleague” message seeking upgrades in state and local IT. “It means that government employees are unable to work remotely, putting them and their communities at risk. And it means that these systems are under increasing threat from malicious cyber actors looking to take advantage of the crisis.”

     The congressmen recommend the bill should: maximize flexibility for systems that can receive funding; require states to submit modernization plans based on risk assessments that ensure access for local governments; and focus on long-term projects with some funds for immediate equipment and license needs.
How Contact Tracing Can Help Stop COVID-19 (Healthline) As U.S. states begin reopening, health experts are calling for massive investment in contact tracing — identifying and notifying people who have come into close contact with someone who has tested positive for the new coronavirus. Many states also don’t yet have the resources needed to make contact tracing work effectively. We may need many more contact tracers to control the COVID-19 outbreak.
Contact tracing starts with a person testing positive for SARS-CoV-2, the virus that causes COVID-19. It can also be done for suspected cases, as when someone shows symptoms of COVID-19, such as cough or shortness of breath. A trained public health worker interviews that person to help them recall all the people they’ve had close contact with while they were infectious.
States Nearly Doubled Plans for Contact Tracers Since NPR Surveyed Them 10 Days Ago (Selena Simmons-Duffin, Morning Edition, NPR, 5-7-2020) An influential group of former government officials released a letter last week calling for a contact tracing workforce of 180,000 around the country. Other estimates of how many contact tracers are needed range from 100,000 to 300,000. See NPR's chart for how many contract tracers your state has.
When I call you, it means you’ve been exposed to the coronavirus (Jackie Munn, Opinion, Washington Post, 5-24-2020) Contact tracing is laborious and stressful — and essential to reopening safely.
Does Covid-19 Contact Tracing Pose a Privacy Risk? Your Questions, Answered (Andy Greenberg, Security, Wired, 4-17-2020) "When Google and Apple announced last week that the two companies are building changes into Android and iOS to enable Bluetooth-based Covid-19 contact tracing, they touched off an immediate firestorm of criticisms. The notion of a Silicon Valley scheme to monitor yet another metric of our lives raised immediate questions about the system's practicality and its privacy. Now it's time to seek answers."
A National Plan to Enable Comprehensive COVID-19 Case Finding and Contact Tracing in the US (PDF, Johns Hopkins Center for Health Security)
Contact Tracing : Part of a Multipronged Approach to Fight the COVID-19 Pandemic (CDC, Covid-19)
Contact tracing must balance privacy and public health (David Blumenthal and Richard Blumenthal, STAT News, 5-15-2020) In the digital age, contact tracing comes with a modern twist: the ability to use smartphones and devices to do the work of walking back through weeks of our lives to find out where we have been, who we have been with, and how widely we may have spread a virus....[But] it’s important to acknowledge that contact tracing of any stripe is intrusive. Professional contact tracers will sit with an individual to review his or her social media, text messages, credit card statements, public transportation records, and more to find anyone they could have exposed. Those contacts receive unexpected calls from strangers asking them to potentially upend their lives for weeks to self-isolate or get tested for potential exposure to an infectious disease."
Feds Make $631 Million Available to States to Pay for Coronavirus Testing, Contact Tracing (William Wan, WashPost,4-23-2020) CDC announced that it is sending $631 million to state and local health departments to increase their capacity to do contact tracing and testing for the novel coronavirus — a fraction of what many officials say they need to safely restart their economies.
The Callousness of India’s COVID-19 Response (Vidya Krishnan, The Atlantic,3-27-2020) The government is showing how not to handle a pandemic. The government is offering little in the way of a safety net. The lockdown may help “flatten the curve” and buy the authorities some time, but that means little if they do not take advantage by aggressively testing, isolating confirmed cases, and performing contact tracing. Absent these measures, the lockdown will merely create concentrated pockets of outbreaks that will then expand rapidly once the restrictions are eventually lifted.
Small Towns Won’t Know They’re Infected Until It’s Too Late (Mark Bowden, The Atlantic, 5-27-2020) The demise of local news is a pandemic emergency. Local news has largely disappeared—the phenomenon of news deserts is by now well known....The crucial virus data is hyper-local. We all know that these numbers are imprecise. Most people have not been tested. Some of those who have been tested were tested for active infections and others for antibodies that signal old infections—numbers that have been combined, for no good reason. Some of the jump might simply be because more tests are being administered.

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Reopening schools and the economy, safely or otherwise


The challenge of finding data on COVID-19 testing and school openings (Bara Vaida, Covering Health, AHCJ, 8-31-2020)There is no federal standardized dataset on COVID-19, testing and school reopenings, making it challenging for journalists to report a national perspective of the pandemic. Filling in the void are efforts created by journalists, such as the COVID-19 Tracking Project . Other sources include nonprofit organizations like the Kaiser Family Foundation and academic groups that include the Johns Hopkins Coronavirus Research Center.
How We Reopen Safely Tracking states as they make progress towards a new normal
Reopening Safely in the Time of COVID-19: Guidance for Deciding Whether to Reopen and Legal Implications of Reopening (American Bar Association)
What Do College Students Think of Their Schools’ Reopening Plans? (Masha Gessen, New Yorker, 7-11-2020) "If colleges asked, they would probably find that many of their students are learning actively right now in similar ways, suggesting that an off-campus learning pod or smaller team might undertake a program of self-organized study in which the college plays a supporting role."
School reopening is a disaster in the making (Cathy O’Neil, Bloomberg, 8-18-2020) "It’s pretty easy to imagine what a responsible plan to reopen schools might look like. Districts would find out what all the people involved — the educators, the parents, the students — considered prudent. They would attempt in-person teaching only where the pandemic was more or less under control. They would take consistent safety measures, closely track infections and pull back if things didn’t go well. I know a lot of educators. These are professionals, utterly dedicated to their students. Judging from our conversations — and given the lack of good data, there’s not much else to go on — the U.S. is in no way going about this responsibly, and the consequences will be disastrous."
Community transmission rate key to K-12 school reopening (Bara Vaida, Covering Health, AHCJ, 8-3-2020)
Failing Schools: The Woeful Inadequacy of School-Reopening Plans (Amy Davidson Sorkin, New Yorker, 8-9-2020) We wasted the summer, while President Trump sowed distrust and promoted heedlessness. What’s left now is to see what can be salvaged.
Fauci: Here's How Schools Can Safely Reopen — Areas with high case loads 'have a choice. You can either close the bars or close the schools' (Kristina Fiore, Enterprise & Investigative Reporting, MedPage Today, 8-13-2020) 'The nation's goal should be getting children back to school, but there's a "big 'however' there," says NIAID director Anthony Fauci, MD. “The primary consideration should always be the safety, health, and welfare of the children and teachers, and the families of both of those groups," Fauci said. The country's heterogeneity as the reason for confusion about school reopenings. Public health officials have designated zones as either red, yellow, or green to aid determinations about allowing students back into classrooms.
      'Green zones have a test positivity rate lower than 5% and fewer than 10 cases per 100,000 residents; yellow zones have a 5% to 10% test positivity rate and 10 to 100 cases per 100,000; while red zones are above a 10% test positivity rate with more than 100 cases per 100,000. "If you are a red state and you want to get your schools open, you can ask yourself the question -- you have a choice. You can either close the bars or close the schools," Fauci said. "If you want to have people congregating in bars, it's likely you're going to stay red. If you do something about that, it's very likely you'll transition to yellow or green." '
3 lessons from how schools responded to the 1918 pandemic worth heeding today (Mary Battenfeld, The Conversation, 6-16-2020) She sees three main lessons today’s educators and policymakers can draw from how schools and communities responded to the 1918 flu pandemic: Invest in school nurses. Partner with other authorities. Tie education to other priorities (such as school lunches, child labor laws, and “large, clean, airy school buildings” with outdoor spaces.
We Need to Talk About Ventilation (Zeynep Tufekci The Atlantic, 7-30-2020) How is it that six months into a respiratory pandemic, we are still doing so little to mitigate airborne transmission?
See How All 50 States Are Reopening (and Closing Again) (Jasmine C. Lee, Sarah Mervosh, Yuriria Avila, Barbara Harvey and Alex Leeds Matthews, NY Times) Map and graphics showing what's happening in which states.
Most States That Are Reopening Fail to Meet White House Guidelines (Keith Collins and Lauren Leatherby, NY Times, 5-7-2020)
How Did I Catch the Coronavirus? (Carolyn Kormann, New Yorker, 8-7-2020) For the majority of the nearly five million COVID-19 cases across the United States, the point of infection is unknown. A good overview of how the virus may spread, about new symptoms like Covid toes, about how contract tracing works, about why it's so much more prevalent in the U.S., about what we did and are doing wrong and need to do. "Part of what went wrong is that many states ignored guidelines on how to reopen—including reports by the American Enterprise Institute, the National Governors Association, and even the White House’s health experts—which, by April, all converged on a few recommendations: only reopen once cases have been going down over a period of fourteen days and once the local health agencies have established a strong public-health infrastructure, with testing and contact-tracing teams in place. Also, go very slowly."
The Coronavirus in America; The Year Ahead ( Donald G. McNeil Jr., NY Times, 4-18-2020) There will be no quick return to our previous lives, according to nearly two dozen experts. But there is hope for managing the scourge now and in the long term. Without a vaccine, the virus is expected to circulate for years, and the death tally will rise over time.“We need to reopen the faucet gradually, not allow the floodgates to reopen."
As the U.S. weighs school reopenings, a study finds that older children spread the virus comparably to adults. (NY Times, 7-18-2020) Children younger than 10 transmit to others much less often, the study found, although the risk is not zero. A study in South Korea showed that "older children transmit the virus at least as well as adults do.... A panel from the prestigious National Academies of Science, Engineering and Medicine recommended reopening schools wherever possible for disabled children and for those in elementary schools, because those groups have the most trouble learning online."
Amid Confusion About Reopening, An Expert Explains How To Assess COVID-19 Risk (Terry Gross interviews epidemiologist Michael Osterholm, founder and director of the Center for Infectious Disease Research and Policy at the University of Minnesota, Fresh Air, 6-17-2020) 41-minute listen with transcript of interview highlights. Face masks and physical distancing remain the best practices in terms of curbing the spread of the coronavirus. But "distancing" is just physical; it shouldn't mean cutting off all social contact. Expect a second wave. "But this virus is not going to slow down transmission overall. It may come and go, but it will keep transmitting until we get at least 60 or 70% of the population infected and hopefully develop immunity."  Look at history. Influenza epidemics lasted for years, not months.
The Young Cut Loose in Myrtle Beach. The Virus Followed Them Home. (Hailey Fuchs, NY Times, 7-1-2020) A popular spring break and summertime destination on the South Carolina coast is linked to clusters of coronavirus cases among teenagers and young adults in several states.
Reopening Guidance for Cleaning and Disinfecting Public Spaces, Workplaces, Businesses, Schools, and Homes (CDC)
Airlines Want Flyers to Feel Safe, But Grab Bag of COVID Policies Adds Turbulence (Victoria Knight, KHN, 6-25-2020) As consumers consider traveling again, they discover the public health guidelines in place for flying often are a messy patchwork of precautions that lack the teeth to protect passengers. More often, the priority is on selling tickets. And, so far, federal agencies have been loath to establish and enforce specific safety standards.
Europe prepares to reopen to foreign travelers, but Americans don’t even figure into the discussion (Michael Birnbaum and Quentin Ariès, WaPo, 6-26-2020) With the coronavirus still raging in the United States, the possibility of allowing American tourists hasn't even figured into the discussion, according to six diplomats familiar with the talks. China is among the 15 countries set to make the cut, despite E.U. skepticism about how transparent it has been about its outbreak. The decision underscores the perception here that the United States has failed in its coronavirus response. European leaders and health experts have watched with unease as many American states insist on reopening, even as infections spike in many parts of the country.
TSA head orders new virus safety measures after meeting whistleblower (Ian Duncan, Washington Post,7-8-2020) The new measures require officers to wear eye protection when they are in close contact with travelers and aren’t protected by a plastic screen, the attorney said. Officers must also change their gloves or sanitize them after patting down passengers, handling identification documents or checking in luggage.
TSA implements changes amid pandemic following whistleblower complaint (Gregory Wallace and Pete Muntean, CNN, 7-9-2020) The Transportation Security Administration has implemented a number of procedure changes to better protect employees and passengers against the coronavirus following a recent whistleblower complaint that raised concerns about how the agency was responding to the pandemic. The changes require TSA officers to clean their gloves -- or change to a new pair of gloves -- between interactions with passengers, such as a pat down or ID check. More than 1,000 TSA employees have tested positive for the coronavirus, according to agency data released Thursday, which includes just more than 900 front-line TSA officers who screen passengers at airports around the country. And six TSA employees have died due to the virus, according to the agency.
National coronavirus response: A road map to reopening (Scott Gottlieb, Caitlin Rivers, Mark McClellan, Lauren Silvis, and Crystal Watson, American Enterprise Institute, 3-29-2020) Directions for adapting our public-health approach away from sweeping mitigation strategies as we limit the epidemic spread of COVID-19, such that we can transition to new tools and approaches to prevent further spread of the disease.
Our Minds Aren’t Equipped for This Kind of Reopening (Tess Wilkinson-Ryan, The Atlantic, 7-6-2020) As states ease restrictions on businesses, individuals face a psychological morass. “Individuals are being asked to decide for themselves what chances they should take, but a century of research on human cognition shows that people are bad at assessing risk in complex situations,” the psychology professor Tess Wilkinson-Ryan explains.
A Guide to Coronavirus and the Food World(Eater.com, 3-13-2020) Links to many, many articles on how the food world is coping. As Restaurants Go, So Goes Everything Else. What Restaurants Need Right Now to Actually Survive. The Effects on Delivery, Groceries, and More. The Livelihoods of Food-Service Workers Are Completely Uncertain.
The Costs of Safely Reopening a High-End Restaurant (John M. Glionna, Postcard from Wine Counry, KHN, 6-18-2020) Like countless other restaurateurs across California and the nation, Alex and Charity Prestifilippo have been caught in a precarious health-and-safety limbo. Beginning in March, the COVID-19 pandemic shuttered their popular Gourmet Italia restaurant in Temecula, a wine-growing community of 115,000 southeast of Los Angeles. Dozens of employees were laid off; food stocks quickly became outdated. They began bleeding cash — about $20,000 every day in lost business, rent and sundry other payments...The Centers for Disease Control and Prevention’s guidelines [on reopening] were confusing enough for the general public. For restaurants trying to keep loyal patrons safe, the lack of clarity was maddening.
How to Reopen America Safely (Marty Makary, Opinion, NY Times, 5-14-2020) Months ago, I called for a long lockdown. Now we must minimize collateral damage. Doctors in China believe universal masking is one of the main reasons they have stemmed the spread of the virus.
How restaurants are responding to challenge of reopening safely (Video, Today, 5-28-2020) Restaurants focus on distance and hygiene.
The CEO’s guide to safely reopening the workplace (Ajay Agrawal, Joshua Gans, Avi Goldfarb, and Mara Lederman, MIT Technology Review, 5-28-2020) Until there’s a treatment or vaccine for covid-19, public health will depend heavily on decisions by business leaders. Technology and systematic thinking can help. First, information-based solutions involve predicting who is infectious and who is immune and then using this information to decide who gets to enter the workplace. Second—since these predictions will inevitably be imperfect—are always-on solutions: technologies and processes that limit the spread of the virus when infectious people do enter. Lockdown is the most extreme always-on solution; reopening requires more nuanced ones.
5 Tips for Safely Reopening Your Office (Joseph Grenny, Harvard Business Review, 5-20-2020)
Reopening Safely: Helpful Tips for Community Leaders and Small Business Owners (Matthew Wagner, Main Street America, 4-30-2020) One tip sheet for community leaders and one for small business owners.
Cruise Ships on Land’: As Las Vegas Reopens, a Huge Test for Casinos (Jo Becker, NY Times, 6-8-2020) If one of the trickiest aspects of containing the pandemic is figuring out when and where people contract the virus and then quickly tracing their contacts, then there is perhaps no place in the nation where that is as tricky a task as in Las Vegas, where last year guests outnumbered residents by 20 to 1. While the contact-tracing challenges faced by Las Vegas are extreme, they highlight larger systemic problems in monitoring the coronavirus across the country.
The False Hope of Antibody Tests (Sarah Zhang, The Atlantic, 4-28-2020) The immunity tests were supposed to be a “game changer,” but they are instead revealing that the majority of Americans are still vulnerable to COVID-19 infection. ‘The pandemic may be global but, as Yonatan Grad, an immunologist at Harvard University, told me, “it is made up of hyperlocal epidemics that are differentially impacting communities.” If neighboring cities, states, or countries are at very different points in their outbreak trajectory, it could create difficult questions about when and how to reopen.’
What’s the Risk of Catching Coronavirus From a Surface? (YouTube video, Tara Parker-Pope, NY Times, 5-28-2020) Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen.

From Camping to Dining Out: Here's How Experts Rate the Risks of 14 Summer Activities (Allison Aubrey, Laurel Wamsley, and Carmel Wroth, Shots, Morning Edition, NPR, 5-23-2020) The relative level of risk calculated for various activities: a BYOB backyard gathering with one other household, eating indoors at a restaurant, attending a religious service indoors, an outdoor celebration such as a wedding with more than 10 guests, using a public restroom, letting a friend use your bathroom, going to a vacation house with another family, staying at a hotel, getting a haircut, going shopping at a mall, going to a nightclub, going camping, and exercising outdoors.
8 ways to go out and stay safe during the coronavirus pandemic (German Lopez, Vox, 5-22-2020) People are starting to leave their homes again. Here’s how to do that and stay as safe as possible. Part of The Vox guide to navigating the coronavirus crisis.
Sweden’s Coronavirus Strategy Will Soon Be the World’s (Nils Karlson, Charlotta Stern, and Daniel B. Klein, Foreign Affairs, 5-12-2020) Herd Immunity Is the Only Realistic Option—the Question Is How to Get There Safely. Rather than declare a lockdown or a state of emergency, Sweden asked its citizens to practice social distancing on a mostly voluntary basis. Swedish authorities have not officially declared a goal of reaching herd immunity, which most scientists believe is achieved when more than 60 percent of the population has had the virus. But augmenting immunity is no doubt part of the government’s broader strategy—or at least a likely consequence of keeping schools, restaurants, and most businesses open. When much of the world experiences a deadly second wave, Sweden will have the worst of the pandemic behind it. Lockdowns are simply not sustainable for the amount of time that it will likely take to develop a vaccine. See also Coronavirus: Has Sweden got its science right? (Maddy Savage, BBC News, 4-25-2020) and A Virtual Conversation with Malin Attefall, science journalist at Sweden's Public TV (ScienceWritersNYC, YouTube video, 1 hour, 5-13-2020) David Levine, host, as Attefall discusses how Sweden is responding to coronavirus, common misconceptions about Sweden’s approach, and differences in everyday life compared to the lockdown in other countries.

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Ending lockdown, town by town? state by state?


Dr. Anthony Fauci, Sen. Rand Paul spar over safety and death rates among children with coronavirus (William Feuer @WillFOIA and Christina Wilkie, CNBC, 5-12-2020)
Coronavirus Advice From Abroad: 7 Lessons America’s Governors Should Not Ignore as They Reopen Their Economies (Stephen Engelberg, Caroline Chen and Sebastian Rotella, ProPublica, 4-18-2020). Advice on restarting the economy. They spoke to frontline experts from around the globe and have compiled a list of recommendations for reopening U.S. states. Their consensus? It’s tough to find policies that simultaneously save lives and livelihoods. Essential reading.
Thousands from coronavirus hot spots flocked to Maryland and Virginia as parts of the states reopened (Katherine Shaver, Washington Post, 5-20-2020) By reopening some parts of states considered at lower risk ahead of coronavirus hot spots, Zhang said, “It actively encour­ages people to travel from high-risk areas to these otherwise safer, more rural areas without many cases. That’s certainly not a good trend.” Traveling generally increases personal interactions, making it easier to transmit the virus. It also makes contact tracing more difficult, they say, because people who later discover they’re infected are less likely to know with whom they interacted.
Executive Orders, by State (COVID-19 Resources for State Leaders, The Council of State Governments) You can view executive orders by state or by classification.
The Risks - Know Them - Avoid Them (Erin Bromage, Comparative Immunologist and Professor of Biology (specializing in Immunology) at the University of Massachusetts Dartmouth) "The only reason the total USA new case numbers look flat right now is because the New York City epidemic was so large and now it is being contained." So throughout most of the country we are going to add fuel to the viral fire by reopening. He details how much virus is released into the environment every time someone breathes, sneezes, coughs, spends time in a bathroom, etc. This is also why it is critical for people who are symptomatic to stay home. "Your sneezes and your coughs expel so much virus that you can infect a whole room of people."
The success of Gov. Abbott’s plan to reopen the Texas economy rests with what we do in our cities and counties (Editorial, Dallas Morning News, 4-23-2020) "The decision to shut down the Texas economy was a tough call. Getting back to business safely is becoming an equally difficult decision. On Tuesday, Colleyville Mayor Richard Newton announced plans to relax stay-at-home orders and Dallas County Commissioners voted to extend Dallas County’s stay-at-home order until May 15, both acting before the expiration of the governor’s statewide shelter in place order at the end of April. It is essential that state and local officials work together and that timetables for reopening the Texas economy not devolve into a clash over local and state control. By law, Abbott has the legal last word over cities and counties, and he plans soon to issue a new executive order to reopen the economy and replace his statewide order to shelter in place with a phased-in process.
‘Is this another death I’ll have to pronounce?’ (4-25-2020) Michael Fowler, Dougherty County coroner, on the reopening of Georgia. 'I’m always driving, going back-and-forth between nursing homes, the hospital, and the morgue. All these roads should be empty if you ask me. But now I see people out running errands, rushing back into their lives, and it’s like: “Why? What reason could possibly be good enough?” Sometimes, I think about stopping and showing them one of the empty body bags I have in the trunk. “You might end up here. Is that worth it for a haircut or a hamburger?”'
Lockdown. A poem by Brother Richard (Irish Central, 3-23-2020)

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What patients with covid-19 experience

Including the immune-overresponse called
multisystem inflammatory syndrome in children (MIS-C)


What it feels like to survive COVID-19’s dreaded “cytokine storm” (Keith A. Spencer, Salon, 4-5-2020) "The primary symptoms I had are quite typical for those who find themselves truly afflicted with the illness: high fever, a dry cough and pain in my throat. Not a classic pharyngitis, rather a sort of aching pain which was intermittent. Subsequently, the fevers really took off and averaged 102.5 over the following days. Headaches, nausea, severe muscle and bone pain, change of bowel habits and a loss of taste and smell all evolved." A doctor and coronavirus patient in recovery describes his experience surviving COVID-19's worst side effects.
Mysterious Heart Damage, Not Just Lung Troubles, Befalling COVID-19 Patients (Markian Hawryluk, KHN, 4-6-2020) Most of the attention in the COVID-19 pandemic has been on how the virus affects the lungs. But evidence shows that up to 1 in 5 infected patients have signs of heart damage and many are dying due to heart problems.
The Infection That’s Silently Killing Coronavirus Patients (Richard Levitan, Opinion piece, NY Times, 4-20-2020) A major reason this pandemic is straining our health system is the alarming severity of lung injury patients have when they arrive in emergency rooms. Covid-19 overwhelmingly kills through the lungs. And because so many patients are not going to the hospital until their pneumonia is already well advanced, many wind up on ventilators, causing shortages of the machines. And once on ventilators, many die. There is a way we could identify more patients who have Covid pneumonia sooner and treat them more effectively — and it would not require waiting for a coronavirus test at a hospital or doctor’s office. It requires detecting silent hypoxia early through a common medical device that can be purchased without a prescription at most pharmacies: a pulse oximeter. [The top-rated pulse oximeter monitors are sold out on Amazon, but that's what you want.] All persons with cough, fatigue and fevers should also have pulse oximeter monitoring even if they have not had virus testing, or even if their swab test was negative, because those tests are only about 70 percent accurate. A vast majority of Americans who have been exposed to the virus don’t know it.
Voices from the Pandemic A collection of accounts from people who have been sharing their personal stories about covid-19. As told to Eli Saslow (Washington Post oral history collection)
---‘How long can a heart last like this?’ (5-9-2020) Darlene Krawetz, on what life becomes when covid-19 won’t go away. After weeks with coronavirus, a sick woman wonders when it will end.
‘I apologize to God for feeling this way.’ (5-2-2020) Gloria Jackson, on being 75, alone, and thought of as expendable.
A Medical Worker Describes Terrifying Lung Failure From COVID-19 — Even in His Young Patients (Lizzie Presser, ProPublica, 3-21-2020) “It first struck me how different it was when I saw my first coronavirus patient go bad. I was like, Holy shit, this is not the flu. Watching this relatively young guy, gasping for air, pink frothy secretions coming out of his tube....This is knocking out what should be perfectly fit, healthy people."
Inflammatory Syndrome and COVID-19: What Do Parents Need to Know? (Erin Digitale, Stanford Children's Health, 5-14-2020) The immune-overresponse called multisystem inflammatory syndrome in children (MIS-C) is very rare, but parents should know what to watch for: persistent fever, a rash or changes in skin color, red eyes or conjunctivitis, abdominal pain, and swollen lymph nodes. “The key is to identify this early so the child can receive appropriate treatments to help with the body’s inflammatory response.” said Roshni Mathew, MD. Kids admitted to the hospital wouldbe carefully monitored for complications such as cardiac problems. Children with MIS-C don’t always show respiratory symptoms of COVID-19.
Why does COVID-19 appear to cause inflammatory response in some children? (Judy Woodruff, William Brangham, and Jane Newburger, PBS NewsHour, 5-15-2020) In more than 100 cases in New York and 60-plus across Europe, young people have developed an inflammatory response similar to what's known as Kawasaki disease. It's led to concerns that we still don't fully understand the full impact that COVID is having on children and teens. In young people exposed to the virus, "it's manifested by either an extreme inflammatory response and by at least one organ, often two or more, that are not functioning properly because of the inflammatory milieu. It's less about the virus and much more related to the body's immune response to having been exposed to the virus. Newburger: "So if a child has fever and seems inflamed, with a rash, red eyes, red lips, any signs of what we call Kawasaki disease, and if they have G.I. symptoms as well, which seem to be very, very common, diarrhea, vomiting, abdominal pain, they should be in contact with their primary caregiver or their pediatrician.
"If the child really seems sick, in a sense — the way that a parent's sixth sense tells you, and they don't seem responsive or their color doesn't seem right, then they should go to a hospital, if they're worried."
Rare, COVID-Related Inflammatory Disease Affecting Children (Beata Mostafavi, Health Lab, U of Michigan, 5-14-2020) Cases of what’s being called pediatric multi-system inflammatory syndrome (MIS-C) have been reported in parts of the U.S. and Europe, with some children experiencing organ failure. At least three deaths have been reported in New York. The novel coronavirus still affects a very small number of children, but new reports describe serious symptoms in some pediatric cases in parts of the U.S. and Europe. Experts suspect that in children with PMIS, the virus may trigger the immune system to overreact and cause widespread inflammation throughout the body.
      Symptoms include a high fever that lasts four or more days, a rash, very red eyes, abdominal pain and skin peeling on hands or feet. The condition resembles a rare childhood illness called Kawasaki disease, which has similar signs and symptoms and can lead to enlargement of blood vessels that in severe forms may cause heart damage.
Two more NY children dead of coronavirus-related disease (Sara Dorn, New York Post, 5-9-2020) This “truly disturbing” coronavirus-linked inflammatory syndrome mirrors Kawasaki disease, Gov. Andrew Cuomo announced. The illness, which experts have said appears to originate from the novel coronavirus, has infected at least 73 children statewide. Similar to toxic-shock syndrome, Kawasaki disease causes an inflammation of blood vessels in infants, toddlers and elementary school-aged kids, potentially leading to heart disease and death.
Doing Time (Jill Siebers, Pulse, Voices from the Heart of Medicine, 5-5-2020) COVID-19 Confinement, Day Four. James has what is likely a moderate case--cough, no interest in food, a profound need for sleep. Still, it is shocking when a six-foot three-inch, 225-pound man goes down.

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The race for effective COVID-19 vaccines

What to watch for, what to ask

 

Health care makes money from sick care.

Nobody makes money from prevention so there is little incentive to focus on it.

 

Vaccine nationalism (FDA): It's take care of yourself first (as w/ oxygen in a plane)

 

COVID-19 Vaccine & Therapeutics Tracker (BioRender)
Covid-19 Treatment and Vaccine Tracker (Milken Institute) A list of all treatments and vaccines currently in development.
These are the top coronavirus vaccines to watch This Washington Post page/chart shows how many of the 200 experimental vaccines WaPo is tracking are at various stages of development: Phase 1 (testing for safety), Phase 2 (testing against a higher-risk group), Phase 3 (tested in thousands of people to check their effectiveness and safety) and Approved (none, determined to provide benefits that outweigh known and potential risks).
Here come the tortoises: In the race for a Covid-19 vaccine, slow starters could still win out (Helen Branswell, STAT, 9-24-2020) 'Corporate giants Sanofi and Merck, which got a relatively late start in developing Covid-19 vaccines, may seem far behind the frontrunners. But experts say they also have such deep experience developing and testing vaccine candidates, and producing vaccine at commercial scale, that both could well close the gap considerably in the months ahead. Each is developing two vaccines, in partnership with others.
How to Tell a Political Stunt From a Real Vaccine (Caroline Chen, Isaac Arnsdorf and Ryan Gabrielson, ProPublica, 9-26-2020) There is a small chance that Pfizer’s vaccine trial will yield results by Nov. 3. But it could still take weeks for FDA review. Here’s everything that has to happen and how to tell a political stunt from a real vaccine.
Who Decides When Vaccine Studies Are Done? Internal Documents Show Fauci Plays a Key Role. (Isaac Arnsdorf, Caroline Chen and Ryan Gabrielson, ProPublica,10-16-2020) Dr. Anthony Fauci will see data from government-funded vaccine trials before the FDA does. One caveat: Pfizer’s study, which is ahead of the others, isn’t included in his purview.
It’s Okay to Have Questions About a Covid-19 Vaccine. Here’s What to Ask. (Tara Haelle, “Six Months In" series, Elemental, 9-17-2020) The approval process, interpreting clinical trial results, and how to be confident in your choice to get the vaccine. See also What to look for in COVID-19 vaccine trials (Tara Haelle, Covering Health, AHCJ, 10-5-2020)
You don't need an ad com to tell u what to look for in a vaccine trial. Here is all you need (a brief thread of tweets from Vinay Prasad, M.D., a hematologist-oncologist and associate professor of medicine at the University of California, SF)
The top coronavirus vaccines to watch (Aaron Steckelberg, Carolyn Y. Johnson, Gabriel Florit and Chris Alcantara, Washington Post) Where the various vaccines are in the race to finish development and testing and gain approval.
Coronavirus Vaccine Updates (Derek Lowe, In the Pipeline, Science Magazine)
A Vaccine Reality Check (Sarah Zhang, The Atlantic, 7-24-2020) The good news is that experts think there will be a COVID-19 vaccine. The virus that causes COVID-19 does not seem to be an outlier like HIV. But biologically, a vaccine against the COVID-19 virus is unlikely to offer complete protection. Logistically, manufacturers will have to make hundreds of millions of doses while relying, perhaps, on technology never before used in vaccines and competing for basic supplies such as glass vials. The Centers for Disease Control and Prevention, which has led vaccine distribution efforts in the past, has been strikingly absent in discussions so far—a worrying sign that the leadership failures that have characterized the American pandemic could also hamper this process. To complicate it all, 20 percent of Americans already say they will refuse to get a COVID-19 vaccine, and with another 31 percent unsure, reaching herd immunity could be that much more difficult.
An unchartered situation for all of us’: From shipping containers to security concerns, a Covid-19 vaccine supply chain takes shape (Ed Silverman @Pharmalot, STAT+, 9-8-2020) Requres subscription.
Pharmacies, Not the Military, Will Handle COVID-19 Vaccinations (Drew Altman, KFF, 8-31-2020) President Trump has conjured up the image of a top general and the military delivering the coronavirus vaccine drawing on their vast logistical experience. It’s much more likely to be at your local Walgreens or CVS pharmacy.
Health Officials Worry Nation’s Not Ready for COVID-19 Vaccine (Liz Szabo, KHN and AP, 9-2-2020) As the nation awaits a vaccine to end the pandemic, local health departments say they lack the staff, money, tools ― and a unified plan ― to distribute, administer and track millions of vaccines, most of which will require two doses. Dozens of doctors, nurses and health officials interviewed by KHN and The Associated Press expressed their concern and frustration over federal shortcomings.
First Covid-19 vaccine trial moving at a good clip, but officials still "very concerned" (Elizabeth Cohen, CNN, 8-19-2020) The first coronavirus vaccine trial in the US is moving along at a good clip, but needs more minorities to enroll if it is to succeed, officials tell CNN. While Black people and Latinos account for more than 50% of Covid-19 cases nationwide, so far they make up only about 15% of participants in the nation's first large-scale clinical trial to test out a coronavirus vaccine, according to data obtained by CNN from a government official. Moderna is on track to finish enrolling its 30,000 participants by mid to late September. But if they can't increase the number of minorities, the panel of experts overseeing the trial could tell Moderna they need to take the time to recruit more participants from minority groups. That could potentially delay a vaccine from getting to the marketplace.
Will Covid-19 vaccines be safe for children and pregnant women? The data, so far, are lacking (Helen Branswell, STAT, 8-19-2020) As potential Covid-19 vaccines speed their way through development, manufacturers and U.S. regulators have largely delayed testing in children and women who are pregnant, raising the possibility that experts will lack critical safety and efficacy data in those populations when there’s a pressing need to inoculate them. Vaccines are always tested first in healthy adults, a population that is most likely to provide a clear picture of whether a vaccine triggers protection. It’s also a population deemed to be at lowest risk should there be side effects from an experimental vaccine.
I’d Need Evidence Before I’d Get a Covid-19 Vaccine. It Doesn’t Exist Yet. (Natalie Dean, NY Times, 8-3-2020) Coronavirus vaccines are rapidly advancing through the development pipeline. But the concept of developing a vaccine at “warp speed” makes many people uncomfortable....What we have right now is a collection of animal data, immune response data and safety data based on early trials and from similar vaccines for other diseases. The evidence that would convince me to get a Covid-19 vaccine, or to recommend that my loved ones get vaccinated, does not yet exist. That data can be generated by the large trials that are just beginning, known as Phase III or efficacy trials. Some have argued that we already have enough safety and immune response data to start vaccinating people now. But this would be a big mistake.
"It is possible that some Covid-19 vaccines may not prevent infection entirely, but they could still prepare a person’s immune system so that, if infected, they would experience milder symptoms, or even none at all. That’s similar to the flu vaccine: It’s not perfect, but we advise people to get it because it reduces intensive care admissions and deaths." Worth a read.


How Big Pharma Left the World Vulnerable to Coronavirus (Paul Constant, Civic Skunk Works, 8-12-2020) The free market cares about profits—not your health.At the time of the SARS and MERS coronavirus outbreaks of 2002 and 2012, the media reported on Big Pharma’s intense quest for a vaccine. But Amin explains that those searches “weren’t sustained in terms of investment” because there was no immediate profit motive to keep shareholders happy. At the time of the SARS and MERS coronavirus outbreaks of 2002 and 2012, the media reported on Big Pharma’s intense quest for a vaccine. But Amin explains that those searches “weren’t sustained in terms of investment” because there was no immediate profit motive to keep shareholders happy. “SARS and MERS and COVID are very, very similar,” Amin explains, “so a sustained investment in both treating coronaviruses and finding a vaccination for them over the last 10 years would have certainly given the world a head start on this problem. But because the free market didn’t get an immediate return on its investment, Big Pharma gave up the hunt....Thankfully, this problem would be relatively easy to fix if the public demands it. I-MAK offers a suite of policy solutions to dial down the profit motive for Big Pharma and increase the benefits for the public good — everything from detangling the convoluted over-patenting process to relaxing the vice grip that pharmaceutical companies can claim over broad swaths of research areas."
Can old vaccines from science’s medicine cabinet ward off coronavirus? (Carolyn Y. Johnson and Steven Mufson, WaPo, 6-11-2020) Researchers think tuberculosis and polio vaccines could rev up the body’s innate immune system against a new pathogen
A Virtual Conversation with Dr. Paul Offit, Children's Hospital of Philadelphia (YouTube Video, SciWritersNYC, 8-21-2020) Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, talks with David Levine about the hype around current vaccines in clinical trials and what is needed to have a safe and effective vaccine for the public.
Volunteering for a COVID-19 Vaccine Trial: What to Know (Arlene Weintraub, Next Avenue, 7-27-2020) Who's a candidate, what's involved and what are the possible side effects.
How a secretive Pentagon agency seeded the ground for a rapid coronavirus cure (Paul Sonne, Washington Post, 7-30-2020) The goal of the Defense Advanced Research Projects Agency (DARPA), established years before the current pandemic, was to find a way to produce antibodies for any virus in the world within 60 days of collecting a blood sample from a survivor. “We have been thinking about and preparing for this for a long time, and it’s almost a bit surreal,” said Amy Jenkins, manager of DARPA’s antibody program, which is known as the Pandemic Prevention Platform, or P3. DARPA has "quietly been seeding the ground for the United States to produce a rapid cure for a pathogen like covid-19 for years." More than a decade ago DARPA began trying to find "super-fast ways to protect American troops if they were to confront a deadly new virus in the field. If it weren’t for DARPA’s investments over the past decade and earlier, largely outside the glare of Washington’s partisan politics, the American race toward a vaccine and antibody therapy to stop the coronavirus most likely wouldn’t be moving as quickly as it is today....By 2010, scientists had tested the idea using DNA with mixed results. Wattendorf wanted to try its single-stranded sibling RNA. If successful, RNA could be used to develop both vaccines and antibodies, shortening development timelines from years to days before clinical trials, he thought....At the time, many considered it a fool’s errand."
Russia’s approval of virus vaccine greeted with some alarm (Vladimir Isachenkov and Daria Litvinova, AP News, 8-11-2020) Russia on Tuesday became the first country to clear a coronavirus vaccine and declare it ready for use, despite international skepticism. President Vladimir Putin said that one of his daughters has already been inoculated. Putin emphasized that the vaccine underwent the necessary tests and has proven efficient, offering a lasting immunity from the coronavirus. However, scientists at home and abroad have been sounding the alarm that the rush to start using the vaccine before Phase 3 trials — which normally last for months and involve thousands of people — could backfire.
•  ‘This Is All Beyond Stupid.’ Experts Worry About Russia’s Rushed Vaccine (Carl Zimmer, NY Times, 8-11-2020) Vaccines are among the safest medical products in the world — but only because of the intense rigor of the clinical trials that test their safety and effectiveness.
The Covid-19 Vaccine-Development Multiverse (Penny M. Heaton, New England Journal of Medicine, 7-14-2020) Jackson et al. now report in the Journal preliminary findings from a phase 1 trial to evaluate the safety and immunogenicity of an mRNA SARS-CoV-2 vaccine.
Whipping Up a Vaccine Is Way Tougher Than It Sounds — Especially If You’re Short on Glass Vials ProPublica dives deep into the complications of creating a coronavirus vaccine with the quickest turnaround ever attempted. Meanwhile, drugmakers have a shortage of containers to put it in.
Proceed with caution in covering the road to a COVID-19 vaccine(Bara Vaida, Covering Health, AHCJ, 6-5-2020) More than 120 COVID-19 vaccine candidates are being tested worldwide, the speed of the research into potential vaccines has created a kind of horse-race narrative in the media, and the public may not understand that the end of the race could end up being multiple years away and even end with no vaccine. Excellent report and links for AHCJ members. Membership is not costly.
Fauci Optimistic About COVID-19 Vaccines, Though Immunity Unknowns Complicate Development Liz Szabo, Kaiser Health News and Scientific American, 7-31-2020) Teams are starting to test vaccines using messenger RNA or chimpanzee cold viruses to inoculate humans. Will their benefits last?
Vaccine Testing and the Approval Process (CDC)
Will Vaccine Trials Reflect America’s Diversity? (JoNel Aleccia, The Color of America's Diversity, KHN, 7-27-2020) Black and Latino people have been three times as likely as white people to become infected with COVID-19 and twice as likely to die. Asian Americans appear to account for fewer cases but have higher rates of death. Eight out of 10 COVID deaths reported in the U.S. have been of people ages 65 and older. And the Centers for Disease Control and Prevention warns that chronic kidney disease is among the top risk factors for serious infection. But the pressure to produce an effective vaccine quickly during a pandemic could sideline efforts to ensure diversity in its testing and administration.
Can a Vaccine for Covid-19 Be Developed in Record Time? (New York Times, 6-9-2020) A discussion moderated by Siddhartha Mukherjee.
How A COVID-19 Vaccine Could Cost Americans Dearly (Elisabeth Rosenthal, Analysis, NY Times, 7-8-2020) The United States is the only developed nation unable to balance cost, efficacy and social good in setting prices. In setting prices, drugmakers rarely acknowledge the considerable federal funding and research that have helped develop their products; they have not offered taxpayer-investors financial payback. The panels that recommend approval of new drugs generally have no idea how they will be priced. There is no simple, direct mechanism for regulators or legislators to control pricing. Investors already smell big money for a COVID-19 vaccine.
Profits and Pride at Stake, the Race for a Vaccine Intensifies (David E. Sanger, David D. Kirkpatrick, Carl Zimmer, Katie Thomas and Sui-Lee Wee, NY Times, 5-2-2020) "Governments, companies and academic labs are accelerating their efforts amid geopolitical crosscurrents, questions about safety and the challenges of producing enough doses for billions of people. Seven of the roughly 90 projects being pursued by governments, pharmaceutical makers, biotech innovators and academic laboratories have reached the stage of clinical trials....But the whole enterprise remains dogged by uncertainty about whether any coronavirus vaccine will prove effective, how fast it could be made available to millions or billions of people and whether the rush — compressing a process that can take 10 years into 10 months — will sacrifice safety."
U.S. Will Pay $1.6 Billion to Novavax for Coronavirus Vaccine (Katie Thomas, Katie Thomas, 7-7-2020) The Maryland-based company, which has never brought a product to market before, just made the biggest deal to date with the Trump administration’s Operation Warp Speed. With this deal, the federal government has now invested nearly $4 billion in companies pursuing vaccines, but has provided little information about how Operation Warp Speed is spending money, which agencies the funding is coming from or how decisions are being made.
What you need to know about the COVID-19 vaccine (Bill Gates, GatesNotes, 4-30-2020) The world is creating this vaccine on a historically fast timeline. There are over 100 different coronavirus vaccine candidates in the works. These candidates take a variety of approaches to protecting the body against COVID-19.We need to manufacture and distribute at least 7 billion doses of the vaccine.
Why a vaccine may not be enough to end the pandemic (Umair Irfan, Vox, 6-3-2020) We need to plan for many different Covid-19 vaccine scenarios. These four factors will influence the outcome.
Efficacy: Will the vaccine grant lifelong immunity, or will immunity weaken in a few years?
Timing: How soon until scientists find a vaccine that works?
Distribution: Will countries compete or collaborate on a global vaccination campaign?
Public health responses: Can we keep up pandemic control measures until, and after, a vaccine arrives?
A top virologist believes the coronavirus vaccines won't be ready for distribution until 2021 — here's why (Guido Vanham and Peter Vanham, Business Insider, 4-18-2020) The phases of vaccine testing, explained. Most of the current candidates are still in the non-human development and testing phase. In the end, SARS-CoV2 vaccines will not be realistically available for another 12-18 months. And even then, we must be lucky every step of the way. A vaccine must be rigorously tested before it is released to the public. "Before we have effective treatment or vaccine, we will have to behave similarly to South Korea, Singapore or Hong Kong, with widespread access to testing, contact tracing and isolation, quarantining people in cases of potential contact."
President Trump on Vaccines: From Skeptic to Cheerleader (Jan Hoffman, NY Times, 3-9-2020) He once blamed vaccines for autism. Now he’s demanding the quick development of one for the coronavirus, but shows limited understanding of the science.
The COVID-19 vaccine development landscape (Tung Thanh Le, Zacharias Andreadakis,Arun Kumar, Raúl Gómez Román, Stig Tollefsen, Melanie Saville & Stephen Mayhew, Nature Magazine, 4-9-2020) Overview as of early April.
The Danger of Rushing Through Clinical Trials in the Pandemic (Isaac Chotiner, New Yorker, 5-14-2020) An epidemiologist discusses what makes a good trial and why a pandemic is not the time to speed up the drug-approval process.
How profit makes the fight for a coronavirus vaccine harder (Stephen Buranyi, The Guardian, 3-4-2020) The near-total lack of interest from markets means there’s precious little foundation for scientists to build on.
Warning: early vaccine trial results don’t always stand test of time (Gary Schwitzer, Health News Review, 5-19-2020) Not good enough: "The vaccine "appears to be safe." Strengths and weaknesses of various news accounts, including Fox News. Good for explaining what to look for in a news account of developing science. Recommended reading: Vaccine experts say Moderna didn’t produce data critical to assessing Covid-19 vaccine (Helen Branwell, STAT News, 5-19-2020) and Moderna’s claim of favorable results in its vaccine trial is an example of ‘publication by press release’(William Haseltine, Opinion, WashPost, 5-19-2020) See also How Upbeat Vaccine News Fueled a Stock Surge, and an Uproar< (Katie Thomas and Denise Grady, Wash Post, 5-23-2020) Dr. Fauci said the big question remained: Will the vaccine work? “When you’re developing a vaccine,” he said, “nothing is guaranteed.”

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Vaccines and treatments

STAT Drugs & Vaccines Tracker (tracking selected vaccines)
Covid-19 Information Portal (BioCentury, slow loading).
Despite pronouncements, no quick turnaround likely for COVID-19 treatments, vaccines (Bara Vaida, Covering Health, Association of Health Care Journalists, 3-20-2020) While there are more than 85 trials for vaccines and treatments underway for COVID-19, scientists don't expect them to be available to the public soon, despite what some headlines suggest.

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The search for anti-viral treatments


Understanding the COVID-19 plasma treatment debate (Bara Vaida, Covering Health, AHCJ, 8-26-2020) "By forcing the Food and Drug Administration on Aug. 23 to approve blood plasma as a COVID-19 treatment under an emergency use authorization (EUA), President Trump again inserted politics into scientific research ― a situation that may create even more uncertainty about plasma as a potential treatment. Plasma ― the part of blood that contains antibodies and proteins ― is still under investigation for this use, and those leading randomized clinical trials now fear they may have difficulty recruiting new patients due to the controversy."
Dozens of U.S. Hospitals Poised to Defy Trump FDA’s Directive on COVID Plasma (JoNel Aleccia, KHN, 9-3-2020) The FDA, under pressure from the Trump administration, has authorized broader use of convalescent plasma for emergency treatment in COVID patients. But several major hospitals are resisting, saying they’ll opt instead to dedicate their resources to a gold-standard clinical trial that could help settle the science for good.
COVID-19: Understanding Your Options (Compassion and Choices) Understanding the facts can help you make decisions about how to plan for the type of care you want in the event you contract the virus. Who is most affected by the coronavirus? What are the symptoms of COVID-19? What do I need to think about if I were to become seriously ill with COVID-19? (Determine your goals of care. Contact your healthcare team now to talk about your options, described). What do I need to know about different treatment options? (Non-Invasive Respiratory Care, Intubation with Ventilation, Cardiopulmonary Resuscitation or CPR, Comfort-Focused Treatment).
How a Potential Treatment for the Coronavirus Turned Up in a Scientist’s Freezer (Paul Tullis, New Yorker, 7-20-2020) A deep dive into research to address past coronaviruses and what arose from SARS and MERS labs. "Freezing the antibodies that neutralized SARS was a bet that had paid off."
After saving his own life with a repurposed drug, a professor reviews every drug being tried against Covid-19. Here's what he's found (Ryan Prior, CNN, 6-27-2020)...He spends most of the next 14 hours leading dozens of fellow researchers and volunteers in a systematic review of all the drugs that physicians and researchers have used so far to treat Covid-19....The goal of the CORONA database isn't to find a wonder drug per se, but to help design better clinical trials that can establish a real cause-and-effect relationship between a drug agent and an individual's survival.
Treatments Considered for COVID-19 (The Medical Letter on Drugs and Therapeutics)

 

Dexamethasone
Coronavirus breakthrough: dexamethasone is first drug shown to save lives (Heidi Ledford, Nature, 6-16-2020) In a large trial, a cheap and widely available steroid cut deaths by one-third among patients critically ill with COVID-19.
Common Steroid Found to Reduce Mortality Rate in Severe COVID Patients In Study Hailed As ‘Tremendous’ (KHN Morning Briefing, 6-17-2020) The "significant" results from the Oxford University research shows that dexamethasone reduces mortality in severely ill patients. Some scientists remain cautious though, wanting to see the actual data. "We've been burned before," Dr. Kathryn Hibbert, director of the medical intensive care unit at Harvard’s Massachusetts General Hospital, tells Reuters. The drug, dexamethasone, is widely available and is used to treat conditions including rheumatoid arthritis, asthma, and some cancers. (Links to several articles.)
RECOVERY: Steroid Benefit in Severe COVID-19 Holds Up (Molly Walker, MedPage Today, 7-17-2020) Sickest patients helped the most, drug already added to NIH guidelines.  

Remdesivir
Chasing the Elusive Dream of a COVID Cure (Liz Szabo, KHN, 5-15-2020) Although scientists and stock markets have celebrated the approval for emergency use of remdesivir to treat COVID-19, a cure for the disease that has killed nearly 260,000 people remains a long way off — and might never arrive. Researchers have already announced that they will combine remdesivir with an anti-inflammatory drug, baricitinib — now used to treat rheumatoid arthritis — in the hope of improving results.
But COVID-19 is an elusive enemy. Doctors treating COVID patients say they’re fighting a war on multiple fronts, battling a virus that batters organs throughout the body, causes killer blood clots and prompts an immune system overreaction called a “cytokine storm.”
Most of Feds' Remdesivir to Be Distributed by End of Month (Jillian Mock, Medscape, 6-16-2020)
What the public didn’t hear about the NIH remdesivir trial (Gary Schwitzer, Health News Review, 4-30-2020) It reduced recovery time by 4 days but didn't reduce fatality. As Fauci stated, "it is very important proof of concept.” The mortality rate “trended” towards being better but “has not yet reached statistical significance.”
Fauci’s announcement of remdesivir trial findings leaves out crucial detail (Tara Haelle, Covering Health, AHCJ, 5-1-2020)  It doesn't reduce the number of deaths.
The COVID-19 research news rollercoaster is running again: STAT News + Gilead’s remdesivir (Gary Schwitzer, Health News Review, 4-29-2020) Don't mistake publicity for journalism.

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Hydroxychloroquine

"An inaccurate statement that President Trump made during a March 19 news briefing - that the malaria drug hydroxychloroquine had been approved as a COVID-19 treatment - demonstrates how skeptical journalists should remain when covering the unfolding story about treatments and preventative measures."

        ~Bara Vaida, Covering Health, AHCJ


Drugs such as hydroxychloroquine, with well-documented adverse effects, subject patients to these risks without proof of clinical benefit. (See FDA warning.


What does the FDA’s hydroxychloroquine decision mean for Covid-19 patients or politicians? And 4 other burning questions (Nicholas Florko, STAT, 6-16-2020)
Matthew Herper @matthewherper, STAT, 6-3-2020)

How false hope spread about hydroxychloroquine to treat covid-19 — and the consequences that followed (Elyse Samuels and Meg Kelly, Washington Post, 4-13-2020)
Malaria Drug Promoted by Trump Did Not Prevent Covid Infections, Study Finds (Denise Grady, NY Times, 6-3-2020) The first carefully controlled trial of hydroxychloroquine given to people exposed to the coronavirus did not show any benefit.
What does the FDA’s hydroxychloroquine decision mean for Covid-19 patients or politicians? And 4 other burning questions (Nicholas Florko, STAT, 6-16-2020) The FDA warned that the drug is “unlikely to be effective in treating Covid-19,” and highlighted “serious side effects,” but the decision could have a lasting impact on public confidence in the agency and its independence. 
Frequently Asked Questions on the Emergency Use Authorization (EUA) for Chloroquine Phosphate and Hydroxychloroquine Sulfate for Certain Hospitalized COVID-19 Patients (FDA) Specifically, FDA has determined that CQ and HCQ are unlikely to be effective in treating COVID-19 for the authorized uses in the EUA. Additionally, in light of ongoing serious cardiac adverse events and other serious side effects, the known and potential benefits of CQ and HCQ no longer outweigh the known and potential risks for the authorized use.
Trump, Fauci differ on possible ‘game-changer’ coronavirus drug (Bob Frederick, New York Post, 3-20-2020)
The RECOVERY Trial Reports on Hydroxychloroquine (6-5-2020) The RECOVERY trial is a large effort in the UK to evaluate several potential therapies, and today its organizers announced results from an evaluation of the hydroxychloroquine treatment arm: "We have concluded that there is no beneficial effect of hydroxychloroquine in patients hospitalised with Covid-19."
As Trump touts an unproven coronavirus treatment, supplies evaporate for patients who need those drugs (Christopher Rowland, Washington Post, 3-23-2020) Chloroquine and hydroxychloroquine are in high demand, even though they have not yet been verified as an effective treatment for the coronavirus.The sudden shortages of the two drugs could come at a serious cost for lupus and rheumatoid arthritis patients who depend on them to alleviate symptoms of inflammation, including preventing organ damage in lupus patients. See also
Trump’s Inaccurate Claims on Hydroxychloroquine (Linda Qiu, FactCheck, WashPost, 5-21-2020) The president falsely described scientific research around the malaria drug, falsely denied the existence of a federal warning against it and argued, with no evidence, that large numbers of health care workers were taking it.
Hydroxychloroquine for COVID-19: Cure-All or Flim-Flam?(Anita Bartholomew, Forbes, 4-8-2020) Hydroxychloroquine (brand name Plaquenil) is an anti-malarial drug being used experimentally to treat COVID-19 patients. Hydroxychloroquine and an earlier variant, chloroquine, appear to hold promise, though not nearly as much as some overheated rhetoric suggests, nor as little as the opposite side insists. Hydroxychloroquine kills viruses, including SARS-CoV-2 in the test tube, but the anti-malarials are almost certainly not preventives. 'With hydroxychloroquine, the most likely benefit comes from the drug’s ability to tamp down inflammation. This is how it’s used to treat lupus, rheumatoid arthritis, and other auto-immune disease symptoms. A misfiring, hyper-active immune system appears to be behind some of the worst coronavirus respiratory symptoms, too. The lungs become disastrously inflamed as the body attempts to expel the virus. If the inflammation becomes pronounced enough, it’s the immune response itself, rather than the virus, that can land someone on a ventilator in the ICU, and sometimes result in death....This means that, for those with or at risk of severe COVID-19 lung complications, hydroxychloroquine might be a good, potentially lifesaving treatment....Although there has been much hand-wringing about politicians and certain media touting an “unproven drug” like hydroxychloroquine, it cannot be stressed enough: There are no proven treatments for COVID-19.'
What if hydroxychloroquine doesn’t work? What if it does? Right now, we don’t know (Matthew Herper, STAT News, 3-27-2020) An old malaria medicine, hydroxychloroquine, has gone viral on the internet. But is it really an antiviral drug? The drug stops the virus from infecting cells in the dish, but in humans...?
Much-Hyped Malaria Drug Linked To Higher Rates of Death in VA Study (KHN Morning Briefing, 4-22-2020) Links to several articles about hydroxychloroquine.
Amid Hydroxychloroquine Uproar, Real Studies of Drug Are Suffering (Sheryl Gay Stolberg, NY Times, 5-19-2020)

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Clinical Trials
Lost opportunities from FDA, NIH inaction when sponsors fail to report clinical trial results (Christopher Morten, Peter G. Lurie, and Charles Seife, STAT, 4-13-2020) The federal government provides a handy resource for navigating disputes about clinical trials: ClinicalTrials.gov, where drug makers and other sponsors of clinical trials must report their results. But that decision-making machinery can be thrown off when trial sponsors don’t have to share the results of all of their trials. STAT News identified a loophole letting trial sponsors do just that and sued the federal government to close it, but that will prove a hollow victory unless the FDA and NIH step up enforcement of an important law, and soon. Without enforcement, Americans are at greater risk of wasting money on useless medical products and being injured by unsafe ones.

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    • Why Covid-19 is so dangerous


The Infection That’s Silently Killing Coronavirus Patients (Dr. Richard Levitan, NY Times, 4-20-2020) During 10 days of treating Covid pneumonia at Bellevue Hospital, this ER doctor found that elderly patients who had passed out for unknown reasons and a number of diabetic patients were found to have Covid pneumonia, even though they did not report any sensation of breathing problems, even though their chest X-rays showed diffuse pneumonia and their oxygen was below normal. "As the inflammation from Covid pneumonia starts, it causes the air sacs to collapse, and oxygen levels fall. Yet the lungs initially remain “compliant,” not yet stiff or heavy with fluid. This means patients can still expel carbon dioxide — and without a buildup of carbon dioxide, patients do not feel short of breath. Patients compensate for the low oxygen in their blood by breathing faster and deeper... injuring their own lungs by breathing harder and harder.
      This silent hypoxia (the body being deprived of oxygen) can be detected early through a common medical device that can be purchased without a prescription at most pharmacies: a pulse oximeter. [By the end of the day this article came out, many leading suppliers of the best of these were sold out.]

How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes (Meredith Wadman, Jennifer Couzin-Frankel, Jocelyn Kaiser, Catherine Matacic, Science Magazine, 4-17-2020) Despite the more than 1000 papers now spilling into journals and onto preprint servers every week, a clear picture is elusive, as the virus acts like no pathogen humanity has ever seen. 'Some clinicians suspect the driving force in many gravely ill patients’ downhill trajectories is a disastrous overreaction of the immune system known as a “cytokine storm,” which other viral infections are known to trigger. Cytokines are chemical signaling molecules that guide a healthy immune response; but in a cytokine storm, levels of certain cytokines soar far beyond what’s needed, and immune cells start to attack healthy tissues. Blood vessels leak, blood pressure drops, clots form, and catastrophic organ failure can ensue.'
     Meanwhile, other scientists are zeroing in on an entirely different organ system that they say is driving some patients’ rapid deterioration: the heart and blood vessels..."The more we look, the more likely it becomes that blood clots are a major player in the disease severity and mortality from COVID-19," says Behnood Bikdeli, Columbia University Irving Medical Center. Scientists are struggling to understand exactly what causes the cardiovascular damage.
    For some, “The lung is the primary battle zone. But a fraction of the virus possibly attacks the kidney. And as on the real battlefield, if two places are being attacked at the same time, each place gets worse,” says Hongbo Jia.

     Another striking set of symptoms in COVID-19 patients centers on the brain and central nervous system. ' Some people with COVID-19 briefly lose consciousness. Others have strokes. Many report losing their sense of smell. And Frontera and others wonder whether in some cases, infection depresses the brain stem reflex that senses oxygen starvation. This is another explanation for anecdotal observations that some patients aren’t gasping for air, despite dangerously low blood oxygen levels.'
Chasing the Elusive Dream of a COVID Cure (Liz Szabo, KHN, 5-15-2020) Although scientists and stock markets have celebrated the approval for emergency use of remdesivir to treat COVID-19, a cure for the disease that has killed nearly 260,000 people remains a long way off — and might never arrive. Researchers have already announced that they will combine remdesivir with an anti-inflammatory drug, baricitinib — now used to treat rheumatoid arthritis — in the hope of improving results. But COVID-19 is an elusive enemy. Doctors treating COVID patients say they’re fighting a war on multiple fronts, battling a virus that batters organs throughout the body, causes killer blood clots and prompts an immune system overreaction called a “cytokine storm.”

Young and middle-aged people, barely sick with covid-19, are dying from strokes (Ariana Eunjung Cha, WashPost, 4-24-2020) Doctors sound alarm about patients in their 30s and 40s left debilitated or dead. Some didn’t even know they were infected. Once thought to be a pathogen that primarily attacks the lungs, it has turned out to be a much more formidable foe — impacting nearly every major organ system in the body. See also Large Vessel Strokes in Younger Patients Tied to COVID-19 (Judy George, MedPage Today, 4-28-2020) Five patients ages 33 to 49 presented to Mount Sinai Health System from March 23 to April 7, all tested positive for SARS-CoV-2, and all developed acute ischemic large-vessel stroke.

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Who and what are harmed most by Covid19?


A Transit Worker’s Survival Story (Jennifer Gonnerman, New Yorker, 4-24-2020) Bus driver Terence Layne used the phrase “pandemic trauma.” He knew that he was suffering from it, too.... In early March, as COVID-19 began to seize the local media’s attention, the M.T.A. prohibited its employees from wearing masks....By March 8th, the M.T.A. had put out another memo, stating that employees could wear masks “if this makes them more comfortable during this time.” But masks were difficult to obtain, and the M.T.A. didn’t provide them....
Costco Is Thriving During The Coronavirus Pandemic. Its Workers Say They’ve Paid The Price. (Brianna Sacks and Ryan Mac, BuzzFeed News, 4-17-2020) Costco has long been beloved by employees, some of whom have worked there for decades. But the retailer’s decision-making during the coronavirus pandemic has tested their loyalty and compromised their health.
Staffing in nursing homes matters when combating COVID-19 ( Liz Seegert, Covering Health, AHCJ, 8-25-2020) "Why are some nursing homes doing so much better at containing the coronavirus among residents and staff than others? Testing, adequate protective gear and the ability to isolate infected residents are all important factors. Another key contributor is sufficient staffing, according to a recent research letter in JAMA."
Creating a path towards the "next normal" in senior living (International Council on Active Aging white paper) Download paper free, after signing in.
Low Pay, High Risk: Nursing Home Workers Confront Coronavirus Dilemma (video, Emma Cott, Ben Laffin and Elie Khadra, NY Times, 3-31-2020) “Who else is going to take care of them?” We spoke with nursing home workers about their fear of catching and spreading coronavirus. See also ‘Health Care Kamikazes’: How Spain’s Workers Are Battling Coronavirus, Unprotected (video, in Spanish)
Pandemic Upends the Lives of People With Disabilities — And of Their Caregivers (Bram Sable-Smith, Wisconsin Public Radio and KHN, 6-17-2020) For residents with disabilities who need caregivers in order to live and work independently, the pandemic is adding hurdles. These visiting aides take on demanding duties and are typically paid about $12 an hour in Wisconsin. Clients with disabilities and their caregivers must weigh how to keep each other safe during close interactions, especially as protective equipment remains scarce. Some caregivers have stuck around; others have quit. And many clients who lose their caregivers also lose independence.
The pandemic exposed a painful truth: America doesn’t care about old people (Nina A. Kohn, WaPo, 5-8-2020) We speak of the elderly as expendable, then fail to protect them.
Hundreds of nursing homes with cases of coronavirus have violated federal infection-control rules in recent years (Debbie Cenziper, Joel Jacobs and Shawn Mulcahy, Washington Post, 4-17-2020) Of about 650 homes with publicly reported coronavirus cases, 40 percent have been cited more than once with violations related to infection control, a Post analysis found.
The U.S. Is Repeating Its Deadliest Pandemic Mistake (Olga Khazan, The Atlantic, 7-6-2020) More than 40 percent of all coronavirus deaths in America have been in nursing homes. Nursing homes were already struggling with infection control before the pandemic hit. A shortage of personal protective equipment (PPE) and a lack of federal (and state) leadership have exacerbated the current crisis. Here’s how it got so bad, and why there might still be more to come as cases surge in the Sun Belt.
Flattening the Curve for Incarcerated Populations — Covid-19 in Jails and Prisons (Matthew J. Akiyama, Anne C. Spaulding, and Josiah D. Rich, New England Journal of Medicine, 4-2-2020) "[W]e believe that efforts to decarcerate, which are already under way in some jurisdictions, need to be scaled up; and associated reductions of incarcerated populations should be sustained."
A State-by-State Look at Coronavirus in Prisons (The Marshall Project) The Marshall Project is collecting data on COVID-19 infections in state and federal prisons.By June 9, at least 43,967 people in prison had tested positive for the illness, an 8 percent increase from the week before. Much of the remarkable growth in coronavirus cases has been due to some states—Michigan, Ohio, Tennessee, Texas among them—that began aggressively testing nearly everyone at prisons where people had become sick. This spate of testing would suggest that coronavirus had been circulating in prisons in much greater numbers than known in the early weeks of the pandemic, and that in the many states where tests had not been prevalent, far more people may have been carrying it than were initially reported.
Jarvis Masters Writes From Death Row in San Quentin as Covid-19 Spreads Unchecked (LitHub, 7-21-2020) "...today a memorandum was circulated that all phone privileges in the prison are to be taken away—not wanting any of us inside to communicate with our family, friends, or the media...The world gets to know only what the California Department of Corrections and Rehabilitation (CDCR) decides." See also Massive coronavirus outbreak strikes iconic Californian prison after it rejected expert aid (Noah Baker, Amy Maxmen & Benjamin Thompson, Nature, 7-10-2020) San Quentin prison faces the third-largest outbreak in the United States. Legal pressure builds as one in three inmates is infected.
COVID-19 Has Devastated the Black Community. Here’s Why and What Needs to Change. (Akilah Jefferson Shah, HuffPost, 6-3-2020) "My colleagues and I have many common experiences. We all attended top-tier medical schools and training programs, and have worked at prestigious institutions. But my Blackness still sets me apart. I live in a different America."
‘I Wasn’t Eating’: Senior Twin Sisters Battle Pandemic Anxiety Together (Cara Anthony, KHN, 4-16-2020) As a longtime advocate for residents of East St. Louis, Ethel Sylvester hopes more people will take time to listen to the needs of seniors long after the pandemic ends. “With all of this stuff going around, we old folk feel lost,” Sylvester said. “We don’t know where we are going and we don’t know what to do.”
Packed Bars Serve Up New Rounds of COVID Contagion (Jordan Rau and Elizabeth Lawrence, KHN and HuffPost, 6-25-2020) As states ease their lockdowns, bars are emerging as fertile breeding grounds for the coronavirus. They create a risky cocktail of tight quarters, young adults unbowed by the fear of illness and, in some instances, proprietors who don’t enforce crowd limits and social distancing rules. Officials in Texas and Florida have already announced they are closing bars in those states to help contain the spread of the coronavirus.
Coronavirus is harming the mental health of tens of millions of people in U.S., new poll finds (Joel Achenbach, Washington Post, 4-2-2020) Nearly half the people in the United States feel the coronavirus crisis is harming their mental health, according to a survey published Thursday that demonstrates how the covid-19 pandemic has escalated into a nationwide psychological trauma. The poll makes one thing clear: If you’re scared, anxious, depressed, struggling to sleep through the night, or just on edge, you’re not alone. Mental health experts suggest ways to cope with anxiety, stress and adjusting to how covid-19 is changing our lives. 

How does the coronavirus pandemic affect suicide rates? (Eileen Abbott, Changing America, The Hill) Some indicators suggest a rising call volume at crisis centers. Here are two of them:

---Disaster Distress Helpline 1-800-985-5990 www.samhsa.gov/find-help/disaster-distress-helpline (SAMHSA’s helpline provides 24/7, 365-day-a-year crisis counseling and support to people experiencing emotional distress related to natural or human-caused disasters.

---National Suicide Prevention Lifeline 1-800-273-8255
Why COVID-19 will end up harming the environment (Beth Gardiner, National Geographic, 6-18-2020) In China, Brazil, and the United States the pandemic has led to environmental rollbacks, enabling coal, logging, mining and fracking companies to operate with impunity. Even though the air has been cleaner as a result of the global lockdowns, a more polluted future has been brewing while we weren’t looking.
We’re flying less. And wild places that count on tourism dollars are starting to take notice. (Dimitri Selibas, Ensia, 7-1-2020) Between flight shaming and a global pandemic, destinations that depend on travelers to protect ecosystems are finding themselves with fewer resources to do so.
92 Years Old, Scared and Pleading to Come Home (Dan Barry, NY Times, 3-19-2020) A family grapples with a wrenching coronavirus question: Do we leave our father in the nursing home? See also Coronavirus-19 in Geriatrics and Long-Term Care by Joseph G. Ouslander (Wiley)
COVID-19 Presents Significant Risks for American Indian and Alaska Native People (Samantha Artiga and Kendal Orgera, KFF, 5-14-2020) AIAN people face disproportionate risks from the COVID-19 outbreak given significant underlying disparities in health, social, and economic factors. Addressing their needs as part of COVID-19 response efforts will be key for preventing further widening of these disparities. See also Doctors Without Borders dispatches team to the Navajo Nation (video and transcript, Christina Capatides, CBS News, 5-11-2020)
A Hospital’s Secret Coronavirus Policy Separated Native American Mothers From Their Newborns (Bryant Furlow, New Mexico In Depth, ProPublica, 6-13-2020) Gov. Michelle Lujan Grisham cited “significant, awful allegations” in a ProPublica and New Mexico In Depth story on a hospital where clinicians said pregnant Native women were singled out for COVID-19 testing and separated from newborns after delivery.
Under COVID Cloud, Prisons In Rural America Threaten To Choke Rural Hospitals (LJ Dawson, KHN, 5-14-2020)As the COVID-19 pandemic swept into Montana, it spread into the Marias Heritage Center assisted living facility, then flowed into the nearby 21-bed hospital. Toole County quickly became the state’s hot spot for COVID-19 deaths, with more than four times the infection rate of all other counties and the most recorded deaths in the state. Six of the state’s 16 COVID deaths through Tuesday have occurred here. Almost 70% of the nation’s more than 1,100 prisons are located outside of metropolitan areas...even a small number of serious cases in a small jail or prison could overwhelm limited resources."
COVID Runs Amok in 3 Detroit-Area Jails, Killing At Least 2 Doctors (Natalia Megas, The Guardian and KHN, 7-23-2020) This article on COVID outbreaks in Detroit-area jails notes that at least 100,000 people in U.S. jails and prisons have been infected so far, and almost 800 inmates and staffers have died. 'Crawford, the head of the deputies’ union, said that most of all he wanted to know the full picture. “All we want is transparency and truth. We want to know the truth because we can deal with the truth. Everyone needs to be transparent. And that’s not only Wayne County, everyone in government needs to tell everyone the truth. What are the real numbers? What are we really dealing with here?” '
“It Spreads Like Wildfire”: The Coronavirus Comes to New York’s Prisons (Daniel A. Gross, New Yorker, 3-24-2020) The U.S. as a whole may be able to flatten the curve of the outbreak through social distancing, but Gregg Gonsalves, the epidemiologist, expected to see in prisons, jails, and immigration detention centers a largely “uncontrolled, unflattened curve,” even if the incarcerated try to practice social distancing and have constant access to soap and hand sanitizer.
Are people of color hit harder by COVID-19 in your state or city? (Matthew Kauffman, Positive Deviance Data Project, Solutions Journalism Network, The Whole Story) The database is dynamic: Where it reports the data it simply links to each state or city's reporting page.
“Similar to Times of War”: The Staggering Toll of COVID-19 on Filipino Health Care Workers ( Nina Martin and Bernice Yeung, ProPublica, 5-3-2020) One of every four Filipinos in the New York-New Jersey area is employed in the health care industry. With at least 30 worker deaths and many more family members lost to the coronavirus, a community at the epicenter of the pandemic has been left reeling.
From Black Death to fatal flu, past pandemics show why people on the margins suffer most (Lizzie Wade, Science, 5-14-2020) ' “Bioarchaeology and other social sciences have repeatedly demonstrated that these kinds of crises play out along the preexisting fault lines of each society,” says Gwen Robbins Schug, a bioarchaeologist at Appalachian State University who studies health and inequality in ancient societies. The people at greatest risk were often those already marginalized—the poor and minorities who faced discrimination in ways that damaged their health or limited their access to medical care even in prepandemic times. In turn, the pandemics themselves affected societal inequality, by either undermining or reinforcing existing power structures.' An interesting chart shows this: "Before the 20th century, rising economic inequality in Italy was reversed only once: during and after the Black Death, according to tax records. Data from elsewhere in Europe suggest economic inequality dropped again after 1918, but the impact of that year’s influenza pandemic can’t be separated from that of two world wars."

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Communities of Color at Higher Risk for Health and Economic Challenges due to COVID-19 (Samantha Artiga, Rachel Garfield, and Kendal Orgera, KFF, 4-7-2020) People of color have higher rates of certain underlying health conditions than whites, are less likely to have access to adequate healthcare, and are more likely to live in circumstances that put them at increased risk of infection from coronavirus.
The First 100: COVID-19 Took Black Lives First. It Didn’t Have To. (Duaa Eldeib, Adriana Gallardo, Akilah Johnson, Annie Waldman, Nina Martin, Talia Buford and Tony Briscoe, ProPublica, 5-9-2020) In Chicago, 70 of the city’s 100 first recorded victims of COVID-19 were black. Their lives were rich, and their deaths cannot be dismissed as inevitable. Immediate factors could — and should — have been addressed.
'We're Like A Lifeline': Postal Workers Fight Fear To Work During Pandemic (Jey Born and Emma Bowman, Morning Edition, NPR, 5-15-2020) Craig Boddie and Evette Jourdain, both mail carriers in Palm Beach, Fla., spoke for a remote StoryCorps conversation last month about the job risks created by the coronavirus outbreak. They worry they will bring the virus home.
Hospitals Have Left Many COVID-19 Patients Who Don’t Speak English Alone, Confused and Without Proper Care (Joshua Kaplan, ProPublica, 3-31-2020) One medical worker told us: “It takes 10 minutes of sitting on the phone to get an interpreter, and that’s valuable time when you’re inundated. So this utilitarian calculus kicks in. And the patients that are most mainstream get the best care.”
Hospitals Tell Doctors They’ll Be Fired If They Speak Out About Lack of Gear (Olivia Carville, Emma Court, and Kristen V Brown. Bloomberg, 3-31-2020)
Early Data Shows African Americans Have Contracted and Died of Coronavirus at an Alarming Rate (Akilah Johnson and Talia Buford, ProPublica, 4-3-2020) No, the coronavirus is not an “equalizer.” Black people are being infected and dying at higher rates. Here’s what Milwaukee is doing about it — and why governments need to start releasing data on the race of COVID-19 patients. See also The Coronavirus’s Unique Threat to the South (Vann R. Newkirk II, The Atlantic, 4-2-2020) More young people in the South seem to be dying from COVID-19. Why? And see Virus Is Twice as Deadly for Black and Latino People Than Whites in N.Y.C. (Jeffery C. Mays and Andy Newman, NY Times, 4-8-2020) "The preliminary death rate for Hispanic people in the city is about 22 people per 100,000; the rate for black people is 20 per 100,000; the rate for white people is 10 per 100,000; and the rate for Asian people is 8 per 100,000. The rates are adjusted for the size and age of the population." And 100 to 200 people a day "are presumed to be virus victims but who are not tested and are left out of the virus death toll."
The Coronavirus’s Unique Threat to the South (Vann R. Newkirk II, The Atlantic, 4-2-2020) More young people in the South seem to be dying from COVID-19. Why? “Due to high rates of conditions like lung disease and heart disease and obesity, the people living in these states are at risk if they get the virus,” Neuman told me. These aren’t “people who are sick, but these are people who have underlying comorbidities that put them at higher risk of serious illness if they get infected." ... The South is the poorest region in the country. The poor, black, Latino, or rural residents who make up large shares of southern populations tend to lack access to high-quality doctors and care."
Los New Yorkers: Essential and Underprotected in the Pandemic’s Epicenter (Adriana Gallardo and Ariel Goodman, ProPublica, 5-2-2020) In a city besieged, undocumented New Yorkers have been left outside public measures to help those impacted by the spread of the coronavirus. Instead, they weigh impossible choices: medical help and exposure, safety or sustenance.
What Happened When Health Officials Wanted to Close a Meatpacking Plant, but the Governor Said No (Michael Grabell, ProPublica, 5-7-2020) New documents obtained by ProPublica show public health officials in Grand Island, Nebraska, wanted the JBS meatpacking plant closed. But Gov. Pete Ricketts said no. Since then, cases have skyrocketed.
Why Housing the Homeless in the Age of Covid-19 Is Essential (Anita Bartholomew, Forbes, 4-3-2020) The country can’t afford to allow large swathes of the population to go unhoused and exposed. It endangers everyone.

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who

Where in the world things went right


A German Exception? Why the Country’s Coronavirus Death Rate Is Low (Katrin Bennhold, NY Times, 4-4-2020) The pandemic has hit Germany hard, with more than 100,000 people infected. But the percentage of fatal cases has been remarkably low compared to those in many neighboring countries. "Germany’s fatality rate stood at 1.6 percent, compared with 12 percent in Italy, around 10 percent in Spain, France and Britain, 4 percent in China and nearly 3 percent in the United States. Even South Korea, a model of flattening the curve, has a higher fatality rate, 1.8 percent....[One] explanation for the low fatality rate is that Germany has been testing far more people than most nations. That means it catches more people with few or no symptoms, increasing the number of known cases, but not the number of fatalities....But there are also significant medical factors that have kept the number of deaths in Germany relatively low, epidemiologists and virologists say, chief among them early and widespread testing and treatment, plenty of intensive care beds and a trusted government whose social distancing guidelines are widely observed."
How Munich Turned Its Coronavirus Outbreak Into a Scientific Study (Elisabeth Zerofsky, New Yorker, 7-19-2020) As Hoelscher had first noted, diagnostic testing alone would only provide a partial measurement. The only way to get an accurate measurement of the epidemic, he reasoned, was to implement wide-scale antibody testing. Within six hours, just before the lockdown was announced, he received a million euros from the government. Locally run antibody studies are being carried out across Germany in an orchestrated effort to construct an over-all picture of the disease’s penetration in the country.
The Need for Telehealth Has Never Been Greater (Sylvia Trujillo, Compassion & Choices, 8-26-2020) COVID-19 has catalyzed one of the biggest transformations of healthcare: the way doctors treat patients across the country.
How South Korea Flattened the Curve (Max Fisher and Choe Sang-Hun, NY Times, 3-23-2020) South Korea showed that it is possible to contain the coronavirus without shutting down the economy, but experts are unsure whether its lessons can work abroad.

Lesson 1: Intervene Fast, Before It’s a Crisis.

Lesson 2: Test Early, Often and Safely.

Lesson 3: Contact Tracing, Isolation and Surveillance.

Lesson 4: Enlist The Public’s Help.. See also What’s Behind South Korea’s COVID-19 Exceptionalism? (Derek Thompson, The Atlantic, 5-7-2020) Seven weeks ago, South Korea and the U.S. had the same number of virus deaths. Today, South Korea has fewer than 300, and the U.S. has more than 70,000. The country’s three-pronged strategy: Test, trace, isolate. But it may be too late for most countries to follow South Korea's model.
• "Nursing homes have been hit disproportionately hard by the pandemic—more than 40 percent of all coronavirus deaths in America have been in nursing homes—but this shouldn't have been inevitable, writes health writer Olga Khazan in The Atlantic. On the magazines Social Distance podcast, she gave a few examples of places that got it right: "In Hong Kong, there were no nursing-home deaths or cases … They had a really bad SARS outbreak in Hong Kong in 2003. That caused them to come up with this new plan for nursing homes in case of an outbreak like this. They stocked up on masks. They isolated nursing-home residents in special hospital wards instead of in the nursing homes. They had government-trained infectious-control officers stationed inside the nursing homes … The Maryland Baptist Aged Home did something similar and also prevented any coronavirus deaths."
New Zealand isn’t just flattening the curve. It’s squashing it. (Anna Fifield, MSN, 4-7-2020) Prime Minister Jacinda Ardern is adamant that New Zealand will complete four weeks of lockdown — two full 14-day incubation cycles — before letting up. It has been less than two weeks since New Zealand imposed a coronavirus lockdown so strict that swimming at the beach and hunting in bushland were banned. See also New Zealand’s Prime Minister May Be the Most Effective Leader on the Planet (Uri Friedman, The Atlantic, 4-19-2020) Her leadership style, focused on empathy, isn’t just resonating with her people; it’s putting the country on track for success against the coronavirus. “She doesn’t peddle in misinformation; she doesn’t blame-shift; she tries to manage everyone’s expectations at the same time [as] she offers reassuring notes.”
The Secret to Germany’s COVID-19 Success: Angela Merkel Is a Scientist(Saskia Miller, The Atlantic, 4-20-2020) The chancellor’s rigor in collating information, her honesty in stating what is not yet known, and her composure are paying off.
'Prayer Is Not Enough.' The Dalai Lama on Why We Need to Fight Coronavirus With Compassion (Dalai Lama, Time, 4-14-2020) "This crisis shows that we must all take responsibility where we can. We must combine the courage doctors and nurses are showing with empirical science to begin to turn this situation around and protect our future from more such threats."
Seattle’s Leaders Let Scientists Take the Lead. New York’s Did Not (Charles Duhigg, New Yorker, 4-26-2020) The initial coronavirus outbreaks on the East and West Coasts emerged at roughly the same time. But the danger was communicated very differently. More than fifteen thousand people in New York are believed to have died from COVID-19. Last week in Washington State, the estimate was fewer than seven hundred people....Said Sonja Rasmussen, a former CDC official, “It seems silly, but all these rules and SOHCOs and telling people again and again to wash their hands—they make a huge difference. That’s why we study it and teach it.” She continued, “It’s really easy, with the best of intentions, to say the wrong thing or send the wrong message. And then more people die.”
How Iceland Beat the Coronavirus (Elizabeth Kolbert, Letter from Reykjavík,New Yorker, 6-1-2020) By May 17th, Iceland had tested 15.5 per cent of its population for the virus. In the U.S., the figure was 3.4 per cent. By sequencing the virus from every person infected, researchers at deCODE could also make inferences about how it had spread. “One of the very interesting things is that, in all our data, there are only two examples where a child infected a parent,” Stefánsson told me. “But there are lots of examples where parents infected children.”...“So we started our preparations long before the first case tested positive here in Iceland. And it was very clear from the beginning that this was something that should be led by experts—by scientific and medical experts.” Jakobsdóttir praised the work of the contact-tracing team, which had compelled one of her three sons to go into quarantine.
Why Estonia Was Poised to Handle How a Pandemic Would Change Everything (Masha Gessen, New Yorker, 3-24-2020) The little start-up country that did better than the U.S.
'The impossible has already happened': what coronavirus can teach us about hope (Rebecca Solnit, a 'long read,' The Guardian, 4-7-2020) In the midst of fear and isolation, we are learning that profound, positive change is possible. Having lived through and written extensively about past disasters, Rebecca Solnit senses as well as anyone what comes next. We’re still in the middle of a global battle, but slowly talk of “after” will come, and we will need guidance from those who have endured similarly treacherous stretches. “It is too soon to know what will emerge from this emergency,” Solnit writes, “but not too soon to start looking for chances to help decide it.&rdquo
A German Exception? Why the Country’s Coronavirus Death Rate Is Low (Katrin Bennhold, NY Times, 4-4-2020) "The pandemic has hit Germany hard, with more than 92,000 people infected. But the percentage of fatal cases has been remarkably low compared to those in many neighboring countries...significant medical factors that have kept the number of deaths in Germany relatively low, epidemiologists and virologists say, chief among them early and widespread testing and treatment, plenty of intensive care beds and a trusted government whose social distancing guidelines are widely observed."
Desperate for Covid-19 answers, U.S. doctors turn to colleagues in China (Sharon Begley, STAT, 3-24-2020) Fed 'up with what they see as inadequate and confusing directives from public health authorities, many physicians are trying to get on-the-ground advice directly from colleagues in countries that were the first to be hit by the coronavirus pandemic.The U.S. Centers for Disease Control and Prevention originally told physicians, nurses, and others caring for Covid-19 patients to use N95 masks, for instance, but earlier this month changed that to ordinary surgical masks for most needs....

      Severe and critical cases in China get hospitalized, but at a dedicated facility, to reduce spread from Covid-19 patient to hospital worker to non-Covid-19 patient....The Hopkins teams was impressed with China’s scrupulous measures to minimize viral transmission, “especially among health care workers,” Auwaerter said. “Such measures have successfully slowed the epidemic in China.” In contrast, failing to do so has fueled the disastrous spread of Covid-19 in Italy, physicians at a hospital in the country’s hard-hit north warned over the weekend.'
'In The End, The Voters Responded': Surprising Takeaways From Wisconsin's Election (Miles Parks, Coronavirus Crisis series), 4-15-2020) "Unlike more than a dozen other states, Wisconsin plowed ahead with the April 7 election in the face of the coronavirus pandemic after the intervention of the state Supreme Court and the U.S. Supreme Court.... former Vice President Joe Biden won the state's Democratic presidential primary, and a judge backed by Democrats was elected to a 10-year term on the Wisconsin Supreme Court. That high-stakes judicial race was at the heart of the conflict around the election. Many liberals and election experts accused Republicans of trying to suppress turnout by holding the election during a public health crisis."
Why covid-19 seems to spread more slowly in Africa (The Economist, 5-16-2020) Transport links are worse.

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Where things went wrong in the U.S.

In nursing homes and elsewhere
"Having some states lock down and some states not
lock down is like having a peeing section in the swimming pool."
~ Seen on the internet

 

"The recipe is clear: We need #MandatoryMasks. We need #MoreTesting with clear messaging that everyone with even the slightest COVID19 symptom or with close contact with a known case needs to get tested and self-isolate. And we need #MoreTracing of cases to find those contacts."

THE most important tool in public health is communication. Clear, consistent messaging from the top supporting mask wearing, testing, and health officials is how you stop this virus. When the President and Governors communicate the opposite, it is guaranteed to increase the harm."
~Atul Gawande

How Big Pharma Left the World Vulnerable to Coronavirus (Paul Constant, Civic Skunk Works, 8-12-2020) The free market cares about profits—not your health.At the time of the SARS and MERS coronavirus outbreaks of 2002 and 2012, the media reported on Big Pharma’s intense quest for a vaccine. But Amin explains that those searches “weren’t sustained in terms of investment” because there was no immediate profit motive to keep shareholders happy. The United States devoted the second half of the 20th century to a great experiment: the goal was to see if the free market could handle healthcare more efficiently and affordably without government intervention. Coronavirus was the final exam, and now the experiment is over. The free market has failed miserably."
Europe prepares to reopen to foreign travelers, but Americans don’t even figure into the discussion (Michael Birnbaum and Quentin Ariès, WaPo, 6-26-2020) With the coronavirus still raging in the United States, the possibility of allowing American tourists hasn't even figured into the discussion, according to six diplomats familiar with the talks. China is among the 15 countries set to make the cut, despite E.U. skepticism about how transparent it has been about its outbreak. The decision underscores the perception here that the United States has failed in its coronavirus response. European leaders and health experts have watched with unease as many American states insist on reopening, even as infections spike in many parts of the country.
The pandemic exposed a painful truth: America doesn’t care about old people (Nina A. Kohn, WaPo, 5-8-2020) We speak of the elderly as expendable, then fail to protect them.
How the Coronavirus Became an American Catastrophe (Alexis C. Madrigal and Robinson Meyer, The Atlantic, 3-21-2020) Nearly every flaw in America’s response to the virus has one source: America did not test enough people for COVID-19. "esting should have told doctors how to triage patients and hospitals when to prepare their wards. It should have allowed governors to gauge the severity of a local outbreak and informed federal officials as they allocated scarce masks and ventilators. Testing should have answered the all-important question in any pandemic: How many people are sick right now? Had the nation known that, the systems that were put into place over years of pandemic planning could have powered on, protecting millions of Americans and containing the illness."
Biden Is Right. Pay for Home Health Workers Is Paltry. (Stephanie Stapleton, KHN, 7-28-2020) True: 'When it came to home health workers, Biden zeroed in on their paychecks. “They’re doing God’s work,” he said. “But home health workers aren’t paid much, they have few benefits. Forty percent are still on SNAP or Medicaid. So my plan is direct. It gives caregivers and early childhood educators a much-needed raise.
White House Left States On Their Own To Buy Ventilators. Inside Their Mad Scramble. (Rachana Pradhan, KHN, Daily Beast, 6-15-2020) The scramble to purchase thousands of ventilators as the pandemic worsened underscores the crisis triggered by the federal government’s lack of a coordinated response. Officials from Louisiana, Washington, Michigan and Minnesota said in interviews that they ordered millions of dollars’ worth of ventilators from private companies even as the Trump administration snapped up thousands of its own to replenish the Strategic National Stockpile.
Europe prepares to reopen to foreign travelers, but Americans don’t even figure into the discussion (Michael Birnbaum and Quentin Ariès, WaPo, 6-26-2020) With the coronavirus still raging in the United States, the possibility of allowing American tourists hasn't even figured into the discussion, according to six diplomats familiar with the talks. China is among the 15 countries set to make the cut, despite E.U. skepticism about how transparent it has been about its outbreak. The decision underscores the perception here that the United States has failed in its coronavirus response. European leaders and health experts have watched with unease as many American states insist on reopening, even as infections spike in many parts of the country. See also Abroad, Trump leaves the US isolated, ridiculed, and pitied (Steve Benen, MNS, NBC News, 6/3/2020)
How A COVID-19 Vaccine Could Cost Americans Dearly (Elisabeth Rosenthal, Analysis, NY Times, 7-8-2020) Investors already smell big money for a COVID-19 vaccine. The United States is the only developed nation unable to balance cost, efficacy and social good in setting prices. In setting prices, drugmakers rarely acknowledge the considerable federal funding and research that have helped develop their products; they have not offered taxpayer-investors financial payback. The panels that recommend approval of new drugs generally have no idea how they will be priced. There is no simple, direct mechanism for regulators or legislators to control pricing. “The idea that we would allow ourselves to be held hostage in an emergency is mind-boggling,” said David Mitchell, head of Patients for Affordable Drugs, an advocacy group. That’s why a bipartisan coalition in the House recently proposed two new bills to prevent “price gouging” for “taxpayer funded COVID-19 drugs” to ensure affordable pricing. Read this article and hold your elected representatives accountable.
Our Deadliest Pandemic Mistake (Olga Khazan joins James Hamblin and Katherine Wells on Social Distance, The Atlantic, 7-15-2020) How did it get so bad in nursing homes? What did China do right that we did not do in America? And how do we protect patients in them now? See her piece The U.S. Is Repeating Its Deadliest Pandemic Mistake More than 40 percent of all coronavirus deaths in America have been in nursing homes. Here’s how it got so bad, and why there might still be more to come as cases surge in the Sun Belt. In the U.S., "Nursing homes were ill-equipped, both literally and figuratively, to deal with the pandemic, and federal and state governments took a hands-off approach until it was too late. Nursing homes were already struggling with infection control before the pandemic hit. Many homes had “persistent problems and were cited across multiple years....Grabowski and other experts have also noted that nursing-home staffers tend to make little money, so many work multiple jobs. That creates an environment in which busy, undertrained personnel are shuffling quickly between patient rooms and nursing homes, taking the virus with them....asymptomatic staffers brought the virus into homes, Konetzka and other experts believe, and these workers weren’t being tested."
“Fire Through Dry Grass”: Andrew Cuomo Saw COVID-19’s Threat to Nursing Homes. Then He Risked Adding to It. (Joaquin Sapien and Joe Sexton, ProPublica, 6-16-2020) A nursing home in Troy, New York, followed the governor’s order to accept patients being treated for COVID-19. Six weeks later, 18 residents were dead of the disease. The risks to the home’s staff and other residents were obvious: The virus was ravaging nursing homes across the country. But the week before, New York Gov. Andrew Cuomo and his health commissioner, Howard Zucker, had all but made such discharges mandatory. Nurse Stephanie Gilmore was told not to share information that a resident had Covid 19 — the management didn’t want to provoke panic. Gilmore said she refused to go along and was later fired.
'The CDC Waited 'Its Entire Existence for This Moment.' What Went Wrong? (Eric Lipton, Abby Goodnough, Michael D. Shear, Megan Twohey, Apoorva Mandavilli, Sheri Fink and Mark Walker, New York Times, 6-3-2020) The technology was old, the data poor, the bureaucracy slow, the guidance confusing, the administration not in agreement. The coronavirus shook the world's premier health agency, creating a loss of confidence and hampering the U.S. response to the crisis. "The C.D.C., long considered the world’s premier health agency, made early testing mistakes that contributed to a cascade of problems that persist today as the country tries to reopen. It failed to provide timely counts of infections and deaths, hindered by aging technology and a fractured public health reporting system. And it hesitated in absorbing the lessons of other countries, including the perils of silent carriers spreading the infection."
One Hospital Was Besieged by the Virus. Nearby Was ‘Plenty of Space.’ (Jim Dwyer, NY Times, 5-14-2020) How The Chaos At Elmhurst Hospital Exposed Health Care’s Fiefdoms. Even as Elmhurst faced “apocalyptic” conditions, 3,500 beds were free in other New York hospitals, some no more than 20 minutes away. In late March, as the most dire public health crisis in a century swept across New York, sick people and those caring for them faced a hospital system that was less than the sum of its mighty parts. At Elmhurst Hospital in Queens, hundreds of Covid-19 patients arrived in need of more help than besieged medical workers could give. Patients were found dead in rooms. One medical resident described conditions as “apocalyptic.” Yet at the same time, 3,500 beds were free in other New York hospitals, some no more than 20 minutes from Elmhurst, according to state records. The city, which runs Elmhurst, had a fleet of 26 new ambulances available to transfer patients.
Medicaid Providers at the End of the Line for Federal Covid Funding (Julie Rovner, KHN, 5-18-2020) In March, Congress authorized $100 billion in funding for health care providers, the majority of which so far has gone to hospitals, doctors and other facilities that serve Medicare patients. That allocation, however, leaves out a large swath of the health system infrastructure that serves the low-income Medicaid population and children. State Medicaid directors say that without immediate funding, many of the health facilities that serve Medicaid patients could close permanently. Of special concern are children because Medicaid covers nearly 40% of them across the county. And with the economy in free fall, more people will qualify for Medicaid coverage in the coming weeks and months.
Coronavirus: How CDC Lab Contamination, and a Failure to Cooperate Globally, Led to Catastrophe (Anita Bartholomew, Forbes, 4-19-2020) "Failures happen. Contamination happens. But if one thing has stood in the way of saving the [U.S.] from the worst of the pandemic more than others, it might be the country’s own go-it-alone attitude.... If the world doesn’t come together on its response to the coronavirus, not only will global—and US—pain continue longer than it needs to, the world could miss the chance to eradicate this virus." [America had better stop seeing the rest of the world as markets, competitors, or obstacles and start being part of a global team.]

     Quoting WHO Director General Tedros Adhanom Ghebreyesus: “…the most effective way to prevent infections and save lives is breaking the chains of transmission. And to do that, you must test and isolate.

Docs show top WH officials buried CDC report (Jason Dearen, AP, 5-9-2020) The decision to shelve detailed advice from the nation’s top disease control experts for reopening communities during the coronavirus pandemic came from the highest levels of the White House, according to internal government emails obtained by The Associated Press. The document, titled “Guidance for Implementing the Opening Up America Again Framework,” was researched and written to help faith leaders, business owners, educators and state and local officials as they begin to reopen. It included detailed “decision trees,” or flow charts aimed at helping local leaders navigate the difficult decision of whether to reopen or remain closed.
How Profit and Incompetence Delayed N95 Masks While People Died at the VA (J. David McSwane, ProPublica, 5-1-2020) Federal agencies have hired contractors with no experience to find respirators and masks, fueling a black market filled with price gouging and multiple layers of profiteering brokers. One contractor called them “buccaneers and pirates.” Though several states have clear price gouging laws, those rules don’t apply to federal government purchases.
Small Towns Won’t Know They’re Infected Until It’s Too Late (Mark Bowden, The Atlantic, 5-27-2020) The demise of local news is a pandemic emergency.
How Mask Mandates Were Beaten Down in Rural Oklahoma (Victor Luckerson, New Yorker, 5-27-2020) In Oklahoma, where the state government is currently implementing one of the country's fastest reopening plans, local leaders have found themselves caught between state politics, economic imperatives, and a clear scientific consensus.
Nursing Homes Violated Basic Health Standards, Allowing the Coronavirus to Explode (Charles Ornstein and Topher Sanders, ProPublica, 4-24-2020) ProPublica's analysis of federal inspection reports found that nine nursing homes put residents in “immediate jeopardy,” including a case where a nursing assistant fed a resident after changing soiled briefs without washing hands.
Despite violation records, nursing homes seek liability waivers during pandemic (Joseph Burns and Liz Seegert, Covering Health, AHCJ, 5-29-2020) 'Despite a recent GAO report detailing persistent infection control violations at nursing homes throughout the United States, many states are waiving liability for these facilities during the COVID-19 pandemic. To date, at least 20 states have issued executive orders or enacted legislation temporarily absolving long-term care and assisted living facilities unless “gross negligence” or “willful misconduct” can be proven.'
In 18 States, Deaths in Long-Term Care Facilities Account for at Least Half of Their COVID-19 Deaths (Chart showing state stats, Kaiser Family Foundation, 5-18-2020)
Major nursing home chain violated federal standards meant to stop spread of disease even after start of covid-19, records show (Debbie Cenziper, Sidnee King, Shawn Mulcahy and Joel Jacobs, Washington Post, 5-16-2020) "Nursing homes operated by Life Care Centers of America, one of the largest chains in the industry, violated federal standards meant to stop the spread of infections and communicable diseases even after outbreaks and deaths from covid-19 began to sweep its facilities from the Pacific Northwest to New England, inspection reports show.
Since the outbreak in Kirkland, the privately owned company with more than 200 nursing homes has seen at least 2,000 cases and 250 deaths among residents and staff, according to a Post tally of state data and local media accounts. Five Life Care nursing homes have experienced outbreaks of 100 or more cases. More than 6,000 nursing homes have been assessed, with inspectors finding “sporadic noncompliance” involving hand-washing, the proper use of personal protective equipment and the separation of sick patients from healthy ones...."
Nursing Homes Fought Federal Emergency Plan Requirements for Years. Now, They’re Coronavirus Hot Spots. (Bryant Furlow, New Mexico In Depth, Carli Brosseau, The News & Observer and Isaac Arnsdorf, ProPublica, 5-29-2020)The long-term care industry resisted a federal mandate to plan for disasters including pandemics. About 43% of nursing homes have been caught violating the requirement, including facilities that have now had deadly COVID-19 outbreaks.
Nursing homes caring for mostly minorities are more than twice as likely to have COVID-19 outbreaks (Katie Camero, Miami Herald, 5-27-2020)
COVID-Plagued California Nursing Homes Often Had Problems in Past (Jordan Rau and Anna Almendrala, KHN, 5-4-2020) Michael Connors, an advocate with the California Advocates for Nursing Home Reform, said nursing homes with fewer staff members and poor compliance with infection control practices are ripe for the spread of the virus. “No place could be more dangerous to live right now,” Connors said. “It’s these characteristics that make nursing homes ground zero for COVID-19 outbreaks and deaths.”
The State Attorney General Is Scrutinizing This Assisted Living Facility Over Its Handling of COVID-19. Some Residents Are Suing It, Too. (Joaquin Sapien, ProPublica, 5-8-2020) Coronavirus was infecting residents and staff of a Queens adult home, who told ProPublica management had misled them about its spread. Now, the New York attorney general is examining what happened and several residents are suing.
Covid-19 experts lament dismissal of early warnings and disease’s impact on communities of color (Shraddha Chakradhar, STAT News, 5-13-2020) From testing failures to downplayed virus risks to the disproportionate effect on communities of color, two Covid-19 experts emphasized at a Tuesday forum what is now a familiar refrain: The U.S. response has been fundamentally flawed. “We had information and we discounted it,” said panelist David Williams, a professor of public health, African and African American studies, and sociology at Harvard. “We didn’t take it as seriously as we could have. I do think that we could have been in a better position than we currently are if we had acted promptly.” The U.S. is paying for these early missteps, reporter Helen Branswell said, and the ripple effects will be felt for quite some time. “People make mistakes, but the lack of swift action to make up for it and to find a plan B, I think, really, was a very bad mistake,” she said.
To Understand the Medical Supply Shortage, It Helps to Know How the U.S. Lost the Lithium Ion Battery to China (Lydia DePillis, ProPublica, 4-21-2020 The failed U.S. effort to dominate global production of the lithium ion battery — which is key to energy independence, automobile innovation and more — holds lessons for leaders grappling with the U.S.’s reliance on China for emergency medical supplies. “The government invests in basic research and leaves everything else to chance,” said Sridhar Kota, an engineering professor at the University of Michigan. “The free market has spoken for 30 years. It’s not working for us, because we are not leveraging our own investments, and lithium ion batteries are just one painful example of that.”
What Happened When Health Officials Wanted to Close a Meatpacking Plant, but the Governor Said No (Michael Grabell, ProPublica, 5-7-2020) New documents obtained by ProPublica show public health officials in Grand Island, Nebraska, wanted the JBS meatpacking plant closed. Although hundreds of workers from this plant have tested positive for COVID-19, Gov. Pete Ricketts blocked recommendations to close it. Since then, cases have skyrocketed.

• Personal historian Leah Abrahams writes: 'I don't see God coming to save us to end this plague. I believe in free will so it's more a question of—can we change our society? How can we reunite the incarcerated immigrant children, distributed haphazardly and without accountability around the country, with their parents—some separated for more than two years? How can we resurrect a society where real journalism is respected and news is not entertainment or propaganda? It all seems to come down to politics if we want to realize the values that many of us hold: feed the hungry; clothe the poor; justice and healthcare for all, and not just for those who can afford it. What can I personally do besides voting to change this society? To rescue democracy? And finally, who are these frightened people who work with and support the Administration day after day and can't admit that "the emperor has no clothes"? Don't they have a conscience, a moral compass? How do they sleep at night?'
Medical Staffing Companies Cut Doctors’ Pay While Spending Millions on Political Ads (Isaac Arnsdorf, ProPublica, 4-20-2020) While cutting benefits for emergency room doctors and other medical workers, TeamHealth and Envision have spent millions on ads meant to pressure politicians working on legislation to cap out-of-network costs for Americans.
Internal Emails Show How Chaos at the CDC Slowed the Early Response to Coronavirus (Caroline Chen, Marshall Allen and Lexi Churchill, ProPublica, 3-26-2020) The CDC fumbled its communication with public health officials and underestimated the threat of the coronavirus even as it gained a foothold in the United States, according to hundreds of pages of documents ProPublica obtained.
Who Should Get Bailed Out in the Coronavirus Economy? (John Cassidy, New Yorker, 4-23-2020) The pandemic has left small businesses and unemployed workers struggling. Yet there is no shortage of taxpayer money to help large corporations. Although the CARES Act provided for a system of oversight by an independent inspector general and two new committees, to be appointed by Congress, this system isn’t up and running.
The Secret to Germany’s COVID-19 Success: Angela Merkel Is a Scientist (Saskia Miller, The Atlantic, 4-20-2020) The chancellor’s rigor in collating information, her honesty in stating what is not yet known, and her composure are paying off.
'Prayer Is Not Enough.' The Dalai Lama on Why We Need to Fight Coronavirus With Compassion (Dalai Lama, Time, 4-14-2020) "This crisis shows that we must all take responsibility where we can. We must combine the courage doctors and nurses are showing with empirical science to begin to turn this situation around and protect our future from more such threats."
In Desperation, New York State Pays Up to 15 Times the Normal Prices for Medical Equipment (Lydia DePillis and Lisa Song, ProPublica, 4-2-2020) State data shows that New York is paying enormous markups for vital supplies, including almost $250,000 for an X-ray machine. Laws against price gouging usually apply to consumers, but not to government purchases. See also Taxpayers Paid Millions to Design a Low-Cost Ventilator for a Pandemic. Instead, the Company Is Selling Versions of It Overseas. (Patricia Callahan, Sebastian Rotella and Tim Golden, ProPublica, 3-30-2020) As coronavirus sweeps the globe, there is not a single Trilogy Evo Universal ventilator — developed with government funds — in the U.S. stockpile. Meanwhile, Royal Philips N.V. has sold higher-priced versions to clients around the world.
The 9/11 Era Is Over (Ben Rhodes, The Atlantic, 4-6-2020) "We need to change our attitude about government itself. The multidecade assault on the role of government in American life led to a Trump administration that disregards expertise and disdains career civil servants. The COVID-19 crisis has revealed that government is essential; that public service is valuable; that facts and science should guide decisions; and that competence matters more than Washington’s endless gamesmanship."
When science loses its voice (Cinnamon Janzer, CJR, 4-23-2020) "Concerns that CDC officials are being muzzled seem especially notable under an administration characterized by a brazen disregard for facts, science, and truth itself. (Throughout the pandemic, variations on the phrase “the CDC did not respond to a request for comment” have abounded.)...Scientists, the report argued, “need to have the freedom to speak candidly with journalists—and hence the public—about their work. For example, if scientists at the US Centers for Disease Control and Prevention have apprehensions about a new strain of influenza or a tuberculosis outbreak, the public needs to have confidence that these scientists are communicating openly with the press and that the CDC’s response is based on science.”

How Big Pharma Left the World Vulnerable to Coronavirus (Paul Constant, Civic Skin Works, 8-12-2020) The free market cares about profits—not your health. At the time of the SARS and MERS coronavirus outbreaks of 2002 and 2012, the media reported on Big Pharma’s intense quest for a vaccine. But Amin explains that those searches “weren’t sustained in terms of investment” because there was no immediate profit motive to keep shareholders happy. "SARS and MERS and COVID are very, very similar,” Amin explains, “so a sustained investment in both treating coronaviruses and finding a vaccination for them over the last 10 years would have certainly given the world a head start on this problem.” But because the free market didn’t get an immediate return on its investment, Big Pharma gave up the hunt.

'A Tragedy Is Unfolding': Inside New York's Virus Epicenter (Annie Correal and Andrew Jacobs, NY Times, 4-9-2020) In a city ravaged by an epidemic, few places have been as hard hit as central Queens.
Millions Stuck at Home With No Plumbing, Kitchen or Space to Stay Safe (Laura Ungar and Elizabeth Lucas, KHN, 5-12-2020) In nearly half a million American homes, washing hands to prevent COVID-19 isn’t as simple as soaping up and singing “Happy Birthday” twice while scrubbing. In many of those homes, people can’t even turn on a faucet. There’s no running water. In 470,000 dwellings in the United States — spread across every state and in most counties — inadequate plumbing is a problem, the starkest of several challenges that make it tougher for people to avoid infection.
How Climate Change Is Contributing to Skyrocketing Rates of Infectious Disease (Abrahm Lustgarten, ProPublica, 5-7-2020) A catastrophic loss in biodiversity, reckless destruction of wildland and warming temperatures have allowed disease to explode. Ignoring the connection between climate change and pandemics would be “dangerous delusion,” one scientist said.
$8,000 rentals. Private jets. How the super-rich escape the coronavirus (Kurtis Lee, Richard Read and Jaweed Kaleem, Los Angeles Times, 4-26-2020)
Millions of Americans Might Not Get Stimulus Checks. Some Might Be Tricked Into Paying TurboTax to Get Theirs. (Justin Elliott and Paul Kiel, ProPublica, 4-5-2020) Congress gave the IRS the job of sending out coronavirus rescue checks. But the underfunded agency is struggling, while for-profit companies like Intuit have started circling, hoping to convert Americans in need into paying customers.
Two coronavirus podcasts (are there more?):
---Six Feet Apart (COVID podcast with Alex Wagner)
---American Dissected: Coronavirus The Coronavirus is now a global pandemic. How did we get here? What went wrong? What do we do about it now? New episodes every Tuesday & Friday.

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Politics, government, and the coronavirus


The Militias Against Masks (Luke Mogelson, New Yorker, 8-24-2020) Groups protesting lockdown measures see the coronavirus pandemic as a pretext for tyranny—and as an opportunity for spreading rage.

•  Prescription Politics: Pharma is showering Congress with cash, even as drug makers race to fight the coronavirus (Lev Facher and Kaitlyn Bartley, STAT, 8-10-2020) "The world’s biggest drug makers and their trade groups have cut checks to 356 lawmakers ahead of this year’s election — more than two-thirds of the sitting members of Congress, according to a new STAT analysis. It’s a barrage of contributions that accounts for roughly $11 million in campaign giving, distributed via roughly 4,500 checks from the political action committees affiliated with the companies....Washington has responded with clear financial rewards for that work. Already, Congress has provided billions of additional dollars to federal health care agencies aimed at helping fund drug company research. A recent proposal from Senate Republicans would award BARDA, an agency largely tasked with funding drug companies’ Covid-19 efforts, an additional $20 billion — 14 times more money than it was allocated last year....The industry’s congressional spending is also an attempt to avert something of a political armageddon in 2020: If Democrats take control of the Senate and former vice president Joe Biden defeats President Trump, Congress would be poised to enact unprecedented reforms to the way Americans pay for prescription drugs — reforms that would likely slash drug industry revenues."
Florida’s Cautionary Tale: How Gutting and Muzzling Public Health Fueled COVID Fire (Laura Ungar and Jason Dearen, The Associated Press and Hannah Recht, KHN, 8-24-2020) Watch Florida Gutted Its Public Health System Ahead of Pandemic (KHN, 9-2-2020) KHN Midwest editor and correspondent Laura Ungar appeared on Spectrum News Bay News 9 to discuss her recent investigation with The Associated Press on how Florida slashed its local health departments — downsizing staffing from 12,422 full-time equivalent workers in 2010 to 9,125 in 2019 and cutting spending from $57 to $34 per resident over that period. The staffing and funding fell faster and further in the Sunshine State than the nation, leaving Florida especially unprepared for the worst health crisis in a century.
Hollowed-Out Public Health System Faces More Cuts Amid Virus (Lauren Weber, Laura Ungar, and Michelle R. Smith, The Associated Press, and Hannah Recht and Anna Maria Barry-Jester, KHN, 7-1-2020) "The U.S. public health system has been starved for decades and lacks the resources necessary to confront the worst health crisis in a century....when this outbreak arrived — and when, according to public health experts, the federal government bungled its response — hollowed-out state and local health departments were ill-equipped to step into the breach. Over time, their work had received so little support that they found themselves without direction, disrespected, ignored, even vilified. The desperate struggle against COVID-19 became increasingly politicized and grew more difficult."
Poll: Most Americans don't trust Trump on coronavirus. Republicans don't trust CDC or Fauci. (NBC News, late July 2020) A new poll shows a serious political divide driving public opinion. As Fauci warned that cases were beginning to climb in July, White House officials provided reporters with a list of times they said Fauci had made mistakes during the pandemic. The partisan divide continues when it comes to wearing masks outside the home. Trump endorsed wearing masks in July after several months of having waffled on the issue.
Litigating the Federal Government's Conduct in Portland Protests (Samantha Fry, Lawfare, 7-29-2020)
Underfunded and Under Threat (KHN and the AP) A series examining how the U.S. public health front lines have been left understaffed and ill-prepared to save us from the coronavirus pandemic. how decades of cuts to public health departments by federal, state and local governments has affected the system meant to protect the nation’s health. Among others linked to here, see How the Pandemic Further Politicized Public Health. KHN Midwest correspondent Lauren Weber joined Texas Public Radio’s David Martin Davies on “The Source” show to talk about the politicization of public health during the COVID pandemic. It's ridiculous that health care decisions and trends are shaped by whether a state is controlled by Republicans or Democrats. How could such a great country be so dumb?
America Didn’t Give Up on Covid-19. Republicans Did. (Paul Krugman, Opinion, NY Times, 6-25-2020) "After all, the Northeast, with its largely Democratic governors, has been appropriately cautious about reopening, and its numbers look like Europe’s. California and Washington are blue states that are seeing a rise in cases, but it’s from a relatively low base, and their Democratic governors are taking actions like requiring the use of face masks and seem ready to reverse their reopening. So the really bad news is coming from Republican-controlled states, especially Arizona, Florida and Texas, which rushed to reopen and, while some are now pausing, haven’t reversed course."
Coronavirus Coverage and the Silencing of Female Expertise (Teresa Carr, Undark, 6-22-2020) With male voices dominating the pandemic narrative, female scientists are lamenting the loss of diverse perspectives.
Short-term, limited-duration health plans assailed in Congressional Democrats’ report (Joseph Burns, Covering Health, AHCJ, 7-21-2020) "Short-term, limited-duration insurance plans threaten the health and financial well-being of American families, according to a recent staff report from Congressional Democrats on the Committee on Energy and Commerce (E&C). The report is a result of an investigation that staff conducted into nine health insurers, including UnitedHealth Group and Anthem, and five insurance company brokers that sell these plans for insurers. “These plans are simply a bad deal for consumers, and oftentimes leave patients who purchase them saddled with thousands of dollars in medical debt,” according to Shortchanged: How the Trump Administration’s Expansion of Junk Short-Term Health Insurance Plans Is Putting Americans at Risk. The committee’s investigation into how these plans operate outlines what the report calls “the deeply concerning industry practices” of STLDI plans and the insurance brokers who sell them.

        "Short-term limited duration insurance plans spend less than half of consumers' premiums on medical care, while insurance plans that comply with the rules of the Affordable Care Act spend 80 percent to 85 percent of premium income on medical care, according to a recent congressional staff report.
What Do Countries With the Best Coronavirus Responses Have in Common? Women Leaders (Avivah Wittenberg-Cox, Forbes, 4-13-2020) Many political organizations and companies are still working to get women to behave more like men if they want to lead or succeed. Yet the national leaders of Denmark, Iceland, Finland, Germany, New Zealand, Norway, and Taiwan are case study sightings of the seven leadership traits men may want to learn from women.
Nicaragua’s Ruling Sandinistas Fall Victim to Covid-19, Highlighting the Disease’s Spread (Frances Robles, NY Times, 7-18-2020) The haphazard, politicized response to the pandemic by the country’s leaders has put the government’s own officials and supporters at particular risk. "A string of recent deaths across Nicaragua — including mayors, judges, police officials, sports figures, university rectors and government bureaucrats — is pointing to the chilling reality that the coronavirus is devastating this Central American country, although the government is not publicly acknowledging it." See also
Resisting Lockdown, Nicaragua Becomes a Place of Midnight Burials ( Alfonso Flores Bermúdez and Frances Robles, NY Times, 5-31-2020) The country is one of the last to reject the strict measures introduced globally to curb the spread of the coronavirus. Families say they are paying the price. And see Latin America’s Outbreaks Now Rival Europe’s. But Its Options Are Worse. (Anatoly Kurmanaev, Manuela Andreoni, Letícia Casado and Mitra Taj, NY Times, 5-12-2020) Much of Latin America’s pain is unfolding far from global view, under governments that can’t — or won’t — offer a full tally of the dead. The increase in deaths offers the most complete picture of the pandemic’s toll, demographers say.
‘Deadly delay’ hampered nursing home virus response (Ricardo Alonso-Zaldivar, AP News, 7-1-2020) The Trump administration was slow to comprehend the scale of COVID-19′s impact on nursing homes and a disjointed federal response has only compounded the devastating toll, according to a report from Senate Democrats. Statistics reported by nursing homes to the federal government as of June 14 show nearly 30,800 residents have died, according to an AP analysis.
Florida Man Leads His State to the Morgue (Adam Weinstein, New Republic, 6-17-2020) Ron DeSantis is the latest in a long line of Republicans who made the state a plutocratic dystopia. Now he’s letting its residents die to save the plutocrats. 'Testing is finding more afflicted Floridians because there are more afflicted Floridians. “The fact that these are going up means there’s more community spread,” said Palm Beach County health director Alina Alonso. “The virus now has food out there. It has people that are out there without masks, without maintaining distancing. So it’s infecting more people.”' See also Nearly 35,000 coronavirus tests in Florida cannot be processed (Tampa Bay Times, 5-21-2020) The latest mishap came when more than 1,700 completed tests were damaged in transit. Additionally, AdventHealth announced that 33,000 of its tests in central and west Florida would either not be processed or were deemed unreliable because of an issue with a laboratory.
PEN America’s Guide on COVID-19 and Disinformation Some messages may have been intended to cause panic, but there’s also been earnest confusion (what we at PEN America define as misinformation, rather than disinformation). Steps totake to evaluate news stories that are blowing up your feed or finding their way into your messaging systems.
A plan to defeat coronavirus finally emerges, but it’s not from the White House (Lena H. Sun, William Wan and Yasmeen Abutaleb, Washington Post, 4-10-2020) Instead, a collection of governors, former government officials, disease specialists and nonprofits are pursuing a strategy that relies on the three pillars of disease control: Ramp up testing to identify people who are infected. Find everyone they interact with by deploying contact tracing on a scale America has never attempted before. And focus restrictions more narrowly on the infected and their contacts so the rest of society doesn’t have to stay in permanent lockdown.Administration officials, speaking on the condition of anonymity to describe internal deliberations, say the White House has made a deliberate political calculation that it will better serve Trump’s interest to put the onus on governors — rather than the federal government — to figure out how to move ahead.
A Trump Official Tried to Fast-Track Funding for His Friend’s Unproven COVID-19 'Treatment,' Whistleblower Says ( Lisa Song, ProPublica, 5-14-2020) Whistleblowing virologist Rick Bright says that his Trump-appointed boss tried to fast-track funding for a friend’s coronavirus treatment, and that he was reassigned for insisting that funding be reserved for “safe and scientifically vetted solutions."
Obama Says U.S. Lacks Leadership on Virus in Commencement Speeches (NY Times, 5-16-2020) The virus has “torn back the curtain on the idea that so many of the folks in charge know what they’re doing,” the former president said. “A lot of them aren’t even pretending to be in charge.” Transcript of Obama's speech.
Two Coasts. One Virus. How New York Suffered Nearly 10 Times the Number of Deaths as California. (Joe Sexton and Joaquin Sapien, ProPublica, 5-16-2020) California’s governor and San Francisco’s mayor worked together to act early in confronting the COVID threat. For Andrew Cuomo and Bill de Blasio, it was a different story, and 27,000 New Yorkers have died so far. In an interview, California Health and Human Services Secretary Dr. Mark Ghaly said it was critical to allow Northern California counties to rely on their own experts, act with a degree of autonomy and thus perhaps pave the way for the state to expand on what they had done. And three days after San Francisco and its neighboring counties were closed, Newsom, on March 19, imposed the same restrictions on the rest of California.
     New York Gov. Andrew Cuomo, however, reacted to de Blasio’s idea for closing down New York City with derision. It was dangerous, he said, and served only to scare people. Language mattered, Cuomo said, and “shelter-in-place” sounded like it was a response to a nuclear apocalypse. When de Blasio finally decided to close the city’s schools, it was Cuomo who rushed to make the public announcement, claiming it as his decision.“No city in the state can quarantine itself without state approval,” Cuomo said of de Blasio’s call for a shelter-in-place order. “I have no plan whatsoever to quarantine any city.”Cuomo’s conviction didn’t last. On March 22, he, too, shuttered his state. By then, New York faced a raging epidemic, with the number of confirmed cases at 15,000 doubling every three or four days.
• <Two decades of pandemic war games failed to account for Donald Trump (Amy Maxmen & Jeff Tollefson, Nature, 8-4-2020) The scenarios foresaw leaky travel bans, a scramble for vaccines and disputes between state and federal leaders, but none could anticipate the current levels of dysfunction in the United States.
Washington Post FactChecker: McConnell’s claim that Obama left behind no ‘game plan’ for the coronavirus outbreak (Glenn Kessler, WaPo, 5-14-2020) There is little continuity in the top levels of the U.S. government when one political party replaces the presidential administration led by another. The natural inclination is to ignore much of the work left behind by the previous folks — and to reinvent the wheel all over again. But former Obama administration officials cried foul after McConnell’s comments. “We literally left them a 69-page Pandemic Playbook.... that they ignored,” tweeted Ron Klain, the former “Ebola czar” in the Obama administration. See also Trump team failed to follow NSC’s pandemic playbook (Dan Diamond and Hahal Toosi, Politico, 3-25-2020) The 69-page document, finished in 2016, provided a step by step list of priorities – which were then ignored by the administration.
Amy Maxmen Unveils Scientific Roadblocks Amid the COVID-19 Pandemic (Katherine J. Wu, The Open Notebook, 6-2-2020) Maxmen documents the process and progress and setbacks of science. And, with both Ebola and COVID-19, the places where science and society intersect. Or, as Katherine Wu writes, where biology and medicine "collide with politics, economics, and social justice."
Trump Accuses Media and Democrats of Exaggerating Coronavirus Threat (Peter Baker and Annie Karni, NY Times, 2-28-2020) The accusations came as other elements of the federal government moved to head off a broader wave of infections like those in China.
As Washington stumbled, governors stepped to the forefront (Dan Balz, Washington Post, 5-3-2020) The history of the United States has generally been written with the states in a subordinate role or cast in a negative light — but no longer. The story of America’s confrontation with the coronavirus pandemic is one in which states and their governors have been dominant. As Washington has stumbled, governors of both parties have acted to fill the void. States have pleaded with Washington for help, and sometimes have gotten it. As often, however, the tensions and disagreements between state leaders and the federal government — especially with President Trump — have come to define the crisis.
      Over time, the federal government has regularly usurped the broad authority given to the states, often to wipe away problems or correct historical injustices.This spring, the balance of power has been flipped, with states forced to compensate for failings at the national level. Those federal deficiencies reflect an absence of readiness and sometimes a lack of interest and competence on the part of the Trump administration."
  Be Prepared but Don't Panic: Health Departments Respond to Coronavirus (Alan Greenblatt, Governing, 3-2-2020) State and local governments have adapted plans for other pandemics and are putting them into action. They're hoping for better coordination and more funding from the feds. Most medical dollars are devoted to individual treatment and care. Less than 3 percent of U.S. health-care spending is devoted to public health. Those dollars aren’t all distributed evenly. The American health system is highly fragmented. Not every community has the resources of a San Antonio or Seattle.
America’s far right is energised by covid-19 lockdowns (A political virus, The Economist, 5-17-2020) 'America’s far right is energised by covid-19 lockdowns. Extremists see the pandemic as the prelude to the apocalyptic “boogaloo” ...The spreading of conspiracy theories is central to the extreme right’s activities. Some claim the virus is a hoax. Others blame the Chinese, the Jews or even Bill Gates. Some claim that the federal government is using the virus as a pretext to confiscate weapons and enforce “medical martial law”. Extremists also spread more familiar conspiracy theories, decrying 5G networks and vaccinations, which help introduce the uninitiated to their ideology.'
Masks Become a Flash Point in the Virus Culture Wars (Rick Rojas, NY Times, 5-3-2020) As people resume going out in public in the middle of a pandemic, to wear or not to wear a face mask has become a personal statement and sometimes a political one.
‘Extraordinary change’: How coronavirus is rewiring the Republican and Democratic parties (David Siders, Politico, 3-23-2020) "Last week, Republicans joined Democrats — and in some cases got in front of them — in calling for direct payments to Americans to help cope with the economic fallout from the pandemic. The Trump administration, after laboring for years to repeal Obamacare, said it was considering creating a special enrollment period for the program due to the coronavirus. When Donald Trump himself suggested the government could take equity stakes in private companies that receive federal aid, it was a Democratic governor, Colorado’s Jared Polis, who accused the president of being a socialist....The pandemic could alter politics for a generation — or even longer." This is what happens when so many Americans live right on the edge of disaster.
Letters from an American (Heather Cox Richardson, 5-4-2020) "While there is a lot of talk about Trump wanting to reopen the states to repair the economy, it’s hard to see how that can happen if the pandemic continues unabated or even gets worse....But I wonder...if what is really driving this mad push, funded as we know it is by right-wing political groups, is a frantic determination to make sure the country does not turn again now, in the midst of this pandemic, to a government that regulates business and provides a basic social safety net, a government like the one we created during the Great Depression."

Why Trump's new CDC director is an abysmal choice (Laurie Garrett, CNN, 5-13-2020) Giving Dr. Robert Redfield the top job at CDC has ignited controversy because of his dubious qualifications for the job, his hardcore, right-wing credentials, and the over-the-top salary offer. Such a prominent job at such ridiculous pay—even a lowered sum—is another example of the Trump administration's willingness to place politics over sensible public policy. On the other hand, as Darius Tahir points out in Politico (How the CDC director became the MAGA whisperer on coronavirus), "Robert Redfield is becoming Trump's point man with a fervent crowd that has been deeply skeptical of the pandemic....Redfield may be filling the role of 'trusted communicator' for the conservative audience skeptical of mainstream media and the public health establishment, said MIT political scientist Adam Berinsky, who studies the sticking power of misinformation and tactics to counter it.... He’s becoming the point man for President Donald Trump with a fervent crowd that has been deeply skeptical of the coronavirus outbreak, believing it a hoax, a Chinese weapon or a Deep State plot to tank the economy and destroy the Trump presidency."
Trump Has Emergency Powers We Aren’t Allowed to Know About (Elizabeth Goitein and Andrew Boyle, Brennan Center for Justice, Opinion piece, NY Times, 4-10-2020) Given that they could make their first appearance in the coronavirus crisis, Congress should insist on having full access to them. Read follow-up warning/piece in Heather Cox Richardson's excellent newsletter Letters from an American (4-12-2020) -- by the author of To Make Men Free: A History of the Republican Party.
The Federalist as “Medical Journal” in the Time of the Coronavirus (Charles Bethea, New Yorker, 4-12-2020) The Federalist, a conservative online magazine not known for its medical coverage, has published pseudoscientific takes on COVID-19 by writers not known for their epidemiological expertise.
The American Exception (Zadie Smith, New Yorker, 4-10-2020) Death comes to all—but in America it has long been considered reasonable to offer the best chance of delay to the highest bidder.
White House: We’re Going to Have to Let Some People Die So the Stock Market Can Live (Bess Levin, Vanity Fair, 3-23-2020)
GOP Congressman: Lawmakers Must “Put On Our Big Boy and Big Girl Pants” and Let Americans Die (Bess Levin, Vanity Fair, 4-14-2020) Indiana congressman Trey Hollingsworth told a radio-show host that it’s Congress’s job to sit Americans down and explain to them that dying in a pandemic isn’t as bad as the havoc said pandemic is wreaking on the economy. "And while we would absolutely hate to draw some sort of distinction between the approach of the two political parties, it would appear that whereas Democrats are urging vigilance, science, and an emphasis on preserving human life, the general take of Republicans might be summed up as: Screw it, some people are going to have to take one for the team."<
Trump Moves to Replace Watchdog Who Reported Medical Shortages (Jason Slotkin, NPR, 5-2-2020)
Fully Armed Rally-Goers Enter Kentucky’s Capitol Building With Zero Resistance (Peter Wade, Rolling Stone, 2-1-2020) Follow-up story: Kentucky Reports Highest Coronavirus Infection Increase After a Week of Protests to Reopen State (Christina Zhao, Newsweek, 4-19-2020) .
The Quiet Hand of Conservative Groups in the Anti-Lockdown Protests (Kenneth P. Vogel, Jim Rutenberg and Lisa Lerer, NY Times, 4-21-2020) Groups in a loose coalition have tapped their networks to drive up turnout at recent rallies in state capitals and financed lawsuits, polling and research to combat the stay-at-home orders. Some key Republican leaders have embraced the types of restrictions being targeted, while powerful grass-roots mobilizing groups, including those spearheaded by the billionaire activist Charles Koch, have so far not embraced the protests.
Medical Expert Who Corrects Trump Is Now a Target of the Far Right (Davey Alba and Sheera Frenkel, NY Times, 3-28-2020) Dr. Anthony Fauci, the administration’s most outspoken advocate of emergency virus measures, faces a torrent of false claims that he is mobilizing to undermine the president. See also How Anthony Fauci Became America’s Doctor (Michael Specter, New Yorker, 4-10-2020) Fauci once explained 'that he has developed a method for dealing with political leaders in times of crisis: “I go to my favorite book of philosophy, ‘The Godfather,’ and say, ‘It’s nothing personal, it’s strictly business.’ ” He continued, “You just have a job to do. Even when somebody’s acting ridiculous, you can’t chide them for it. You’ve got to deal with them. Because if you don’t deal with them, then you’re out of the picture.” '
After Threats, Anthony Fauci to Receive Enhanced Personal Security (Katie Benner and Michael D. Shear, NY Times, 4-1-2020) Dr. Fauci has become a target of online conspiracy theorists after advocating social distancing rules
Trump Says U.S. Isn’t ‘Built to Be Shut Down’ Over Virus (Justin Sink, Bloomberg, 3-23-2020)
In Idaho, Far-Right Republicans Defy Coronavirus Health Restrictions (Kirk Siegler, NPR, 4-13-2020) "Quite frankly, I don't know why Idaho is falling in line with some of the most liberal governors across the nation," said Rep. Heather Scott, a state lawmaker from Blanchard, in northern Idaho. On her YouTube channel and in her regular newsletter to constituents, Scott called COVID-19 the virus that threatened to kill the Constitution. She also routinely casts doubt on the severity of the pandemic. "The lying, Trump-hating media who continues to push global and socialist agendas has told us that there is an emergency," Scott said in her YouTube video.
What Trump’s Twitter Feed Tells Him About the Coronavirus (Politico, 3-14-2020) The president follows 47 accounts on Twitter. Here are the five main things they’re saying about the pandemic. #1 This is China's fault. #2 Joe Biden would be worse. #3 Trump is doing a great job. #4 The media is fueling the panic. #5 But there's no reason to panic.
Trump says he would consider government equity stakes in companies seeking bailouts (Lauren Hirsch, CNBC, 3-17-2020) "An equity stake is unlikely to be the companies’ preferred form of relief. The move is often dilutive to shareholders and gives the government greater ability to oversee a company. General Motors gave a stake in its business to the U.S. government during the auto bailout in 2009. When it ultimately paid back the government, it had to wipe out shareholders in return."
Sen. Richard Burr Is Not Just a Friend to the Health Care Industry. He’s Also a Stockholder. (Robert Faturechi and Derek Willis, ProPublica, 4-27-2020) The Republican of North Carolina, who is under investigation for his stock trading, regularly flips health care stocks even as he pushes for legislation to help the industry. Then, same authors: On the Same Day Sen. Richard Burr Dumped Stock, So Did His Brother-in-Law. Then the Market Crashed. (5-6-2020) The brother-in-law, a Trump appointee, sold between $97,000 and $280,000 worth of stock. Burr is under federal investigation over whether he traded on non-public information gathered through his work in the Senate.
An Invitation to Corruption (Annie Lowrey, The Atlantic, 3-20-2020) "As long as lawmakers are allowed to trade individual stocks, disaster profiteering is always a risk." This week, ProPublica and the Daily Beast reported that members of Congress sold equities after receiving briefings on the dangers of the novel coronavirus. The sales came before a global financial panic slashed stock prices around the world, and before the American public was broadly cognizant of the scale and danger of the virus." See also Shareholder suit accuses Sen. Richard Burr of securities fraud (Matthew Choi, Politico, 3-23-2020) Sen. Richard Burr (R-N.C.) is being sued after selling shares in a hotel company (up to $1.7 million in stocks) while possessing confidential information about the potential impact of the coronavirus pandemic. And see Sen. Kelly Loeffler Dumped Millions in Stock After Coronavirus Briefing (Lachlan Markay, William Bredderman, and Sam Brodey, Daily Beast, 3-19-2020) The Senate’s newest member (R-GA) sold off seven figures’ worth of stock holdings in the days and weeks after a private, all-senators meeting on the novel coronavirus that subsequently hammered U.S. equities.

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Trump’s handling of the pandemic

"Patriotism means to stand by the country. It does not mean to stand by the President."

     ~ Theodore Roosevelt, 26th President of the United States.

 

"Never attribute to malice that which is adequately explained by stupidity." - Robert J. Hanlon

 

As the numbers escalate, going into the election Trump still downplays the seriousness of the pandemic, saying it's just that we're doing more testing--so let's do less of it!  Not so, and experts agree that the U.S numbers are so terrible because we lack national leadership on crucial measures.


How Trump let Covid-19 win (German Lopez, Vox, 9-22-2020) Trump’s magical thinking couldn’t beat the coronavirus. America is stuck with the consequences. Headers: The US wasn’t prepared for a pandemic — and Trump made it worse. As Covid-19 spread, Trump downplayed the threat. Months into the pandemic, Trump has continued to flail. The window to avert further catastrophe may be closing. Experts have urged the federal government to provide clear, consistent guidance and deploy stronger policies, encouraging people to take Covid-19 as a serious threat — now, not later.

     "The scientific consensus was initially against wearing masks, but even after experts shifted in favor of masks as the evidence of their effectiveness grew, Trump refused to wear a mask well into the summer and often cast doubt on the expert consensus. 

      "The Trump White House has undermined and muzzled public health authorities and stoked speculation about the unreliability of official statistics, including the death count.
       "States, lacking clear and consistent guidance from the federal government, relaxed their social distancing policies even though their outbreaks were not contained enough to reopen their economies according to the metrics laid out by experts.
       "Scientists are cautiously optimistic about a speedy timeline for developing a Covid-19 vaccine, but Trump's apparent attempts to influence the approval process could end up compromising people's willingness to take a vaccine."
How the Trump team has meddled in health officials’ coronavirus work (Aaron Blake, The Fix, Washington Post, 9-14-2020) "Generally speaking, whatever apolitical health officials recommend should be evaluated and incorporated — or not — into the plans of those elected or appointed by elected officials....The trend, though, seems to be toward influencing that advice as if it’s designed or just happens to undermine the eventual decisions of Trump. And in light of Trump’s tendency to downplay the entire situation, it’s wholly relevant that the recommendations of health officials are being disregarded, at best, and might have been changed, at worst." A summary of the worst cases of political meddling in medical reports.
CDC director concerned Atlas is sharing misleading information with Trump (Nick Valencia and Sam Fossum, CNN, 9-28-2020) US Centers for Disease Control and Prevention Director Dr. Robert Redfield is concerned that White House Coronavirus Task Force member Dr. Scott Atlas is providing President Trump with misleading information about Covid-19, a federal official told CNN. NBC said that Redfield, in a conversation with a colleague that took place on Friday, suggested Atlas is providing Trump with misleading data about the efficacy of masks, young people's susceptibility to the coronavirus and herd immunity. CNN has reported that Atlas -- a critic of severe lockdowns who was supported herd immunity strategies against the coronavirus -- has found himself at odds with other medical experts in his administration.
The Unraveling of America (Wade Davis, Rolling Stone, 8-6-2020) Anthropologist Wade Davis on how COVID-19 signals the end of the American era. "In a single season, civilization has been brought low by a microscopic parasite 10,000 times smaller than a grain of salt. COVID-19 attacks our physical bodies, but also the cultural foundations of our lives, the toolbox of community and connectivity that is for the human what claws and teeth represent to the tiger.... In a dark season of pestilence, COVID has reduced to tatters the illusion of American exceptionalism. At the height of the crisis, with more than 2,000 dying each day, Americans found themselves members of a failed state, ruled by a dysfunctional and incompetent government largely responsible for death rates that added a tragic coda to America’s claim to supremacy in the world."
Secret Service copes with coronavirus cases in aftermath of Trump appearances (Carol D. Leonnig, WaPo, 8-28-2020) When President Trump gave a speech to a group of sheriffs in Tampa, his decision to travel forced a large contingent of Secret Service agents to head to a state that was then battling one of the worst coronavirus surges in the nation. Dozens of Secret Service agents who worked to ensure the security of the president and Vice President Pence at public events have been sickened or sidelined because they were in direct contact with infected people. Trump has continued to hold large gatherings — most dramatically at the White House when he delivered his acceptance speech before a crowd of 1,500 people seated closely together on the South Lawn, with few masks in sight. The vast majority were not tested for the coronavirus ahead of time.
How Trump Is Helping Tycoons Exploit the Pandemic (Jane Meyer, New Yorker, 7-20-2020) The secretive titan behind one of America’s largest poultry companies, who is also one of the President’s top donors, is ruthlessly leveraging the coronavirus crisis—and his vast fortune—to strip workers of protections.
Inside Trump’s pressure campaign on federal scientists over a covid-19 treatment (Laurie McGinley, Yasmeen Abutaleb, Josh Dawsey and Carolyn Y. Johnson, WaPo, 8-30-2020) Trump accused the “deep state” [regular employees] at the Food and Drug Administration of trying to sandbag his election prospects by slowing progress on coronavirus treatments and vaccines until after Nov. 3. At a news conference on the eve of the Republican National Convention, Trump lauded an emergency authorization for convalescent plasma as a “very historic breakthrough.” He said that 35 of 100 people with covid-19 “would have been saved because of the administration of plasma”— a gross overstatement denounced by scientists and public health experts. The misrepresentations became a stunning debacle for the FDA, shaking its professional staff to the core and undermining its credibility as it approaches one of the most important and fraught decisions in its history...
Two decades of pandemic war games failed to account for Donald Trump (Amy Maxmen & Jeff Tollefson, Nature, 8-4-2020) The scenarios foresaw leaky travel bans, a scramble for vaccines and disputes between state and federal leaders, but none could anticipate the current levels of dysfunction in the United States.
Scientists express doubts about coronavirus treatment touted as breakthrough by Trump (Washington Post Coronavirus Update, 8-24-2020) On eve of the Republican convention, Trump fakes a victory in the pandemic, but "Scientists express doubts about coronavirus treatment touted as breakthrough by Trump: President Trump announced Sunday that he had cleared up a regulatory 'logjam to grant emergency authorization for convalescent plasma to treat covid-19. But his administration's own scientists are calling for more studies to definitively show it works. The announcement came after Trump without evidence accused the so-called 'deep state' at the Food and Drug Administration of holding up treatments for political reasons. Physicians and scientists criticized the announcement, saying the administration is misleading the public by overstating the evidence that plasma treatment actually works." [By "deep state" he means the part of the government that works full-time.]
What a US exit from the WHO means for COVID-19 and global health (Nature, 5-27-2020) As President Trump terminates the US relationship with the agency, experts foresee incoherence, inefficiency and a resurgence of deadly diseases.
Fires and Pepper Spray in Seattle as Police Protests Widen Across U.S. (Mike Baker and Nicholas Bogel-Burroughs, NY Times, 7-25-2020) Weeks of violent clashes between federal agents and protesters in Portland, Ore., galvanized thousands of people to march through the streets of American cities on Saturday, injecting new life into protests that had largely waned in recent weeks. Scroll down for video that shows how President Trump’s deployment ignited chaos. Peaceful protests were already happening for weeks when federal officers arrived on July 4. States have complained about the presence of federal troops. Trump has doubled down, sending more troops.

Why America Feels Like a Post-Soviet State (Masha Gessen, New Yorker, 7-29-2020) One persistent Soviet trait is the ways in which Russian institutions handle information—what we might call “the culture of reporting upstairs.” The best-known example is the Soviet government’s coverup of the extent, nature, and danger of the Chernobyl nuclear disaster. This wasn’t only, or even primarily, a matter of suppressing uncomfortable truths. What drove officials to lie was not so much a desire to conceal the facts from ordinary people as it was a need to supply the leadership with upbeat reports. For many officials, before and after Chernobyl, the production of cheerful stories that were entirely divorced from reality was a full-time job.
We ran the CDC. No president ever politicized its science the way Trump has. (Tom Frieden, Jeffrey Koplan, David Satcher and Richard Besser, WashPost, 7-14-2020) "The four of us led the CDC over a period of more than 15 years, spanning Republican and Democratic administrations alike. We cannot recall over our collective tenure a single time when political pressure led to a change in the interpretation of scientific evidence."
Trump Returns to the Coronavirus Daily Briefing and Still Refuses to Face Reality (Amy Davidson Sorkin, Opinion, New Yorker, 7-22-2020) “We're leading the world,” he said, which is true only if the destination is off a cliff.
How Trump Is Helping Tycoons Exploit the Pandemic (Jane Mayer, New Yorker, 7-13-2020) The secretive titan behind one of America’s largest poultry companies, who is also one of the President’s top donors, is ruthlessly leveraging the coronavirus crisis—and his vast fortune—to strip workers of protections.
Trump's Covid-19 data reporting switch draws outcry from health groups (Adriel Bettelheim, Politico, 7-15-2020) Experts said orders to bypass the CDC could make it harder to track the virus, while others warned of unusual political interference. See also Trump Administration Strips C.D.C. of Control of Coronavirus Data (Sheryl Gay Stolberg, NY Times, 7-14-2020) Hospitals have been ordered to bypass the Centers for Disease Control and Prevention and send all patient information to a central database in Washington at HHS, raising questions about transparency. Public health experts have long expressed concerns that the Trump administration is politicizing science and undermining its health experts. Going forward, hospitals should report detailed information on a daily basis directly to the new centralized system, which is managed by TeleTracking, a health data firm that was awarded a “noncompetitive, multimillion-dollar contract” for a “duplicative health data system.” Also involved: Palantir, co-founded by Peter Thiel, a billionaire Trump supporter. (H/T Heather Cox Richardson, 7-16-2020)
The President Is Shilling Beans (Masha Gessen, New Yorker, 7-16-2020) Donald Trump is changing the office beyond recognition, and he is doing it in plain view. "As abuse of power goes, though, advertising Goya is almost negligible: smaller than the Ukraine scandal, or making pandemic aid to states conditional on loyalty and gratitude to the President, or threatening to withhold funding to school districts that do not reopen for in-person instruction. We’ve learned to move past Trump’s use of the Presidency as a protection racket and extortion machine..."
White House effort to undermine Fauci is criticized by public health experts, scientists and Democrats (Laurie McGinley and Yasmeen Abutaleb, WaPo, 7-13-2020) “It’s shocking,” said Janis Orlowski, chief health care officer of the Association of American Medical Colleges. “When you begin to discredit scientists like Fauci, who are national treasures, you are in serious trouble.”
Abroad, Trump leaves the US isolated, ridiculed, and pitied (Steve Benen, MNS, NBC News, 6/3/2020)
Trump has turned America into a pitiful pariah (Max Boot, WashPost, 6-2-2020) "Our allies are mortified; our enemies are gleeful, because Trump has handed them a priceless gift. Every tinpot dictator can now savor a moment of unearned moral superiority over a country that has spent decades lecturing them on human rights.... "
White House Left States On Their Own To Buy Ventilators. Inside Their Mad Scramble. (Rachana Pradhan, KHN, 6-15-2020) As Jared Kushner, Trump’s son-in-law and a senior adviser, said in a daily press briefing April 3: “The notion of the federal stockpile was, it’s supposed to be our stockpile. It’s not supposed to be states’ stockpiles that they then use.” State officials said they never expected the federal stockpile to supply every state with all it needed, but the lack of coordination to route supplies to the most urgent hot spots and opaque communication compounded the problem. Some worry that even with an expanded stockpile, there is no plan to distribute them rationally.
This Is Trump’s Fault (David Frum, The Atlantic, 4-7-2020) "That the pandemic occurred is not Trump’s fault. The utter unpreparedness of the United States for a pandemic is Trump’s fault. The loss of stockpiled respirators to breakage because the federal government let maintenance contracts lapse in 2018 is Trump’s fault. The failure to store sufficient protective medical gear in the national arsenal is Trump’s fault. That states are bidding against other states for equipment, paying many multiples of the pre-crisis price for ventilators, is Trump’s fault. Air travelers summoned home and forced to stand for hours in dense airport crowds alongside infected people? That was Trump’s fault too. Ten weeks of insisting that the coronavirus is a harmless flu that would miraculously go away on its own? Trump’s fault again." And so on.
World looks on in horror as Trump flails over pandemic despite claims US leads way (Julian Borger in Washington, Helen Davidson in Sydney, Leyland Cecco in Toronto, Daniel Boffey in Brussels Philip Oltermann in Berlin, Angela Giuffrida in Rome, Tom Phillips in Rio de Janeiro and Emmanuel Akinwotu in London, The Guardian, 5-15-2020) The US has emerged as a global hotspot for the pandemic, a giant petri dish for the Sars-CoV-2 virus. As the death toll rises, Trump’s claims to global leadership have became more far-fetched. Around the globe, the “America first” response pursued by the Trump administration has alienated close allies. In Canada, it was the White House order in April to halt shipments of critical N95 protective masks to Canadian hospitals that was the breaking point....The editor of the Global Times tweeted: “US system used to be appealing to many Chinese people. But through the pandemic, Chinese saw US government’s incompetence in outbreak control, disregard for life and its overt lies. Washington’s political halo has little left."
“There’s No Boogeyman He Can Attack”: Angry at Kushner, Trump Awakens to the COVID-19 Danger (Gabriel Sherman, Vanity Fair, 3-16-2020) For weeks, Trump and his son-in-law saw the novel coronavirus mostly as a media and political problem. But the spiraling cases, plunging markets, and a Mar-a-Lago cluster finally opened eyes.
How the Coronavirus Shattered Trump’s Serene Confidence (David Remnick, New Yorker, 3-22-2020) COVID-19 is unimpressed and unimpeded by the President’s bluster. And the prolonged process of his humbling has put untold numbers of Americans at risk. What got his attention? The President listened when he received a visit at Mar-a-Lago from Tucker Carlson, who broke ranks with his Fox News colleagues and urged serious action. Misinformation and cant, along with a kindred scorn for science and professional expertise: these things are pathogens, too.
Trump Challenges Authority, Independence of Agency Watchdogs Eric Tucker, Matthew Daly, and Mary Clare Jalonick, Associated Press, 4-8-2020) "In four days, Trump has fired one inspector general tied to his impeachment, castigated another he felt was overly critical of the coronavirus response and sidelined a third meant to safeguard against wasteful spending of the coronavirus funds. The actions have sent shock waves across the close-knit network of watchdog officials in government, creating open conflict between a president reflexively resistant to outside criticism and an oversight community tasked with rooting out fraud, misconduct and abuse."

     Ellen Nakashima reported (WaPo): “We wanted inspectors general because of an out-of-control president named Richard Nixon, and this president is trying to destroy them,” said Danielle Brian, executive director of the Project on Government Oversight. “What’s happened this week has been a total full-on assault on the IG system.”
Chaos rocks Trump White House on virus' most tragic day (Stephen Collinson, CNN, 4-8-2020) The chaos and confusion rocking President Donald Trump's administration on the most tragic day yet of the coronavirus pandemic was exceptional even by his own standards. Trump set out Tuesday to cement his image of a wartime leader facing down an "invisible enemy" at a dark moment as the country waits for the virus to peak and with the economy languishing in suspended animation... But instead of putting minds at rest, Trump's wild performance instead put on a display many of the personal and political habits that have defined his tumultuous presidency. See also Trump says he's considering ending funding to World Health Organization (CBS News, 4-7-2020) The man does not read or remember the daily briefings he gets.

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Trump’s Inaccurate Claims on Hydroxychloroquine (Linda Qiu, FactCheck, WashPost, 5-21-2020) The president falsely described scientific research around the malaria drug, falsely denied the existence of a federal warning against it and argued, with no evidence, that large numbers of health care workers were taking it.
Trump: “Every Country” Spreads Lies About the Coronavirus, What’s the Big Deal? (Bess Levin, Vanity Fair, 3-30-2020) You want to know the real threat to America? Windmills.
He Could Have Seen What Was Coming: Behind Trump’s Failure on the Virus (Eric Lipton, David E. Sanger, Maggie Haberman, Michael D. Shear, Mark Mazzetti and Julian E. Barnes, New York Times, 4-11-2020) “Nobody knew there would be a pandemic or epidemic of this proportion,” President Trump said last month. He has repeatedly said that no one could have seen the effects of the coronavirus coming. An examination of the evidence reveals the president was warned about the potential for a pandemic but that internal divisions, lack of planning and his faith in his own instincts led to a halting response. A timeline of failures to act.
Why did Matt Drudge turn on Donald Trump? (Bob Norman, Columbia Journalism Review,  1-29-2020)
Trump to New York: Drop Dead (Jennifer Senior, Opinion, New York Times, 3-24-2020) 'So it’s essentially come to this: President Trump is treating each of our 50 states as individual contestants on “The Apprentice” — pitting them against one another for scarce resources, daring them to duke it out — rather than mobilizing a unified national response to a pandemic.'

Jared Kushner Is Going to Get Us All Killed (Michelle Goldberg, Opinion, NY Times, 4-2-2020) Trump's son-in-law has no business running the coronavirus response. He has a long track record of overconfidence in the face of repeated failure. .
Trump Congratulates Businesses for Helping Fight Coronavirus. But His Own Company Has Been Absent. (Peter Elkind, ProPublica, 1-2-2020) 'ProPublica examined the seven hotel properties and dozen U.S. country clubs owned by the Trump Organization and could find no sign that any are taking the sorts of civic-minded steps the president has urged....In Florida, Trump’s Mar-A-Lago club, where the membership initiation fee is $200,000, remained open and seemingly disdainful of social distancing until March 21, after reports of coronavirus infections spread at crowded Trump fundraisers, a reception for Brazil’s president and a glittery party for Trump Jr.’s girlfriend, where guests danced in a conga line on March 7. This prompted Politico to describe the 20-acre resort as “a gilded petri dish.”

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Trump Won’t Order Vital Coronavirus Supplies Because Corporate CEOs Asked Him Not To (Bess Levin, Vanity Fair, 3-23-2020) They’re worried it could be bad for business. Thank goodness for stories like Bess Levin's; check them out.
Trump Administration Uses Wartime Powers to Be First in Line on Medical Supplies (Christina Jewett and Lauren Weber, KHN, 4-3-2020) The Trump administration quietly invoked the Defense Production Act to force medical suppliers in Texas and Colorado to sell to it first — ahead of states, hospitals or foreign countries. It took this action more than a week before it announced Thursday that it would use the little-known aspect of the law to force 3M to fill its contract to the U.S. first. Firms face fines or jail time if they don’t comply.The Cold War-era law gives federal officials the power to edge out the competition and force contractors to provide supplies to them before filling orders for other customers....But if the government is going to take more control — which many health and government leaders have urged it to do — it should be transparent about its actions, said Dr. Atul Grover, executive vice president of the Association of American Medical Colleges. He said medical leaders have been whiplashed by their orders for protective gear falling through and speculated that they lost out to federal agencies."
Injections of Bleach? Beams of Light? Trump Is Self-Destructing Before Our Eyes (Frank Bruni, Opinion, NY Times,4-24-2020) The notion that he is bound for four more years is pure superstition. "The unbesotted see and hear the president for what he is: a tone-deaf showman who regards everything, even a mountain of corpses, as a stage." See Trump's disinfectant injections idea comes straight from internet conspiracy theories (Next Web).
Fact-checking Trump’s letter blasting the World Health Organization (Glenn Kessler, WashPost, 5-20-2020) "In previous administrations, a letter to an international organization signed by the U.S. president generally would have been carefully vetted and fact-checked. But President Trump’s May 18 letter to World Health Organization Director General Tedros Adhanom Ghebreyesus contains a number of false or misleading statements."
The Coronavirus Was an Emergency Until Trump Found Out Who Was Dying (Adam Serwer, The Atlantic, 5-8-2020) The pandemic has exposed the bitter terms of our racial contract, which deems certain lives of greater value than others.
In unprecedented move, Treasury orders Trump’s name printed on stimulus checks (Lisa Rein, WaPo, 4-14-2020)The 'looter in chief' is shameless.
Trump and Kushner could reap a pandemic windfall (Dana Milbank, WaPo, 4-14-2020) "[O]ne of its largest provisions, a $170 billion tax giveaway, appears to be tailor-made for the benefit of wealthy real estate investors such as President Trump and his son-in-law...The giveaway, primarily to real estate investors and hedge funds, is larger than the total amount in the legislation for hospitals ($100 billion) and for relief for all state and local governments ($150 billion). Worse, the bonanza for these millionaires and billionaires has little to do with the coronavirus: It lets them offset losses not just from 2020 but from 2018 and 2019, before the pandemic."
Dear Colleague: We Must Insist and Act on the Truth in the Coronavirus Crisis (House Speaker Nancy takes Trump to the woodshed, in a letter to her Democratic colleagues.) See also transcript of her interview with Jake Tapper on CNN's The Lead (4-15-22)

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Trump owed tens of millions to Bank of China (Marc Caputo, Meridith McGraw, and Anita Kumar, Politico, 4-24-2020) Donald Trump is warning “China will own the United States” if Joe Biden is elected president. But in 2012, the Bank of China, a commercial bank owned by the Chinese state, provided more than two hundred million dollars in loans to a New York office building (1290 Avenue of the Americas) that Trump co-owns, Politico reported on Friday. The loans will come due in 2022, “in the middle of what could be Trump’s second term,” the timely article noted. The deal was reported previously by several news outlets in stories about the “maze” of Trump’s finances and a history of how he came to partly own the building.
How Jared Kushner's volunteer force led a fumbling hunt for medical supplies (Nicholas Confessore, Andrew Jacobs, Jodi Kantor, Zolan Kanno-Youngs and Luis Ferré-Sadurní, The New York Times, 5-6-2020) As the United States faced a critical shortage of masks, gloves and other protective equipment to battle the coronavirus pandemic, President Donald Trump's son-in-law Jared Kushner recruited inexperienced, untrained people (a supply-chain task force) to sort through tips on equipment desperately needed to fight the coronavirus while warehouses ran bare and doctors made their own gear. See also Jared Kushner’s Young Consultant Army Was Clueless On Coronavirus (Eric Lutz, Vanity Fair, 5-6-2020) “Trump's son-in-law's volunteer team—pulled from private equity, venture capital and consulting firms—reportedly hampered efforts to procure.... largely served to add an extra layer of confusion to the White House’s already shambolic response...an absolute mess of ineptitude and political favoritism...”
Trump’s Claim That U.S. Tested More Than All Countries Combined Is ‘Pants On Fire’ Wrong (Shefali Luthra, KHN, 5-1-2020) “We’ve tested more than every country combined.” ~ President Donald Trump at White House press briefing on April 27, 2020. In raw numbers, the United States has tested more people than any other individual country — but nowhere near more than “every country combined.” And when you factor in population size — which is essential in understanding how well we are doing — the U.S. still falls short. The U.S. underperforms by several measures, including the per capita rate of testing.
Trump ‘didn’t know people died from the flu.’ It killed his grandfather. (Michael Sainato, The Guardian, 3-7-2020)
Trump lashes out at scientists whose findings contradict him (Jill Colvin, AP) 'Trump has long been skeptical of mainstream science — dismissing human-made climate change as a “hoax,” suggesting that noise from wind turbines causes cancer and claiming that exercise can deplete a body’s finite amount of energy. It’s part of a larger skepticism of expertise and backlash against “elites” that has become increasingly popular among Trump’s conservative base.'
Why the Trump Ploy Stopped Working (David Brooks, NY Times, 4-20-2020) "As the nation unifies, divisiveness falls flat. The polarization industry is loath to admit this, but, once you set aside the Trump circus, we are now more united than at any time since 9/11. The pandemic has reminded us of our interdependence and the need for a strong and effective government....The pandemic has been a massive humanizing force — allowing us to see each other on a level much deeper than politics — see the fragility, the fear and the courage.”

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Combatting the Misinformation Epidemic/Campaign

And conveying the reality of the crisis to skeptics.

 

Do not trust unreliable sources.

When Mr. Trump and Dr. Fauci disagree,

listen to Dr. Fauci.

 

Fighting coronavirus requires scientific know-how, not presidential cheerleading.

 

Fighting the Infodemic: The #CoronaVirusFacts Alliance (Poynter) Led by the International Fact-Checking Network (IFCN) at the Poynter Institute, the #CoronaVirusFacts / #DatosCoronaVirus Alliance unites more than 100 fact-checkers around the world in publishing, sharing and translating facts surrounding the new coronavirus. Updated daily. Scroll down to see various ways to find and study what's in the database.
Coronavirus Misinformation Tracking Center(NewsGuard) Sites identified as publishing materially false information about the virus.
Former Coronavirus Skeptics Describe How Contracting COVID-19 Changed Their Perspective (YouTube Video, Global Hangout, NBC News, 8-7-2020) NBC News speaks to former COVID-19 skeptics who, after catching the virus, now want others to know that it’s all too real.
Top 20 hashtags tweeted by inauthentic accounts (Bot Sentinel)
PSA: Please stop microwaving your books to get rid of coronavirus (Marika Gerken, CNN, 7-4-2020) Library books contain a metallic radio frequency identification (RFID) tag that can and will burn in a microwave and can also catch on fire. Libraries can quarantine each book for 72 hours after it’s returned to them.
Amy Maxmen Unveils Scientific Roadblocks Amid the COVID-19 Pandemic (The Open Notebook, 6-2-2020) “All outbreaks are messy and chaotic. There’s always a lot of public confusion and lack of trust or misinformation. The difference here is that social media is much bigger. When I go to places where most people don’t have smartphones, misinformation isn’t spread as fast.”
How QAnon uses religion to lure unsuspecting Christians (Daniel Burke, CNN Religion Editor, 10-15-2020) "During the pandemic, QAnon-related content has exploded online, growing nearly 175% on Facebook and nearly 63% on Twitter, according to a British think tank...."Where We Go One We Go All" is one of several mottoes of QAnon, a collective of online conspiracists." Pastor John MacArthur of California, an influential evangelical who is battling county officials over the right to continue indoor services at his Grace Community Church, espoused a theme popular in QAnon circles when he misinterpreted CDC data and informed his congregation that "there is no pandemic."
What is QAnon? (CNN, 7-22-2020) CNN's John Avlon explains what fringe conspiracy theory QAnon is and its ties to the GOP party, Republican candidates, and President Donald Trump.
Misinformation on coronavirus is proving highly contagious (David Klepper, AP News, 7-29-2020)
How the Coronavirus Spread QAnon (Ali Breland and Sinduja Rangarajan, Mother Jones, 6-23-2020) Right-wing conspiracies and the pandemic created a petri dish for the child-trafficking hoax. Data shows a spike in QAnon searches after lockdowns started. Interest has yet to return to pre-COVID levels. "Anecdotal examples bolster what the data shows. Internet communities that hadn’t previously done so are now associating with far-right conspiracies like QAnon, impending mass arrests of elites for running pedophile rings, and liberal megadonor George Soros’s supposed plots. Across Instagram, pseudoscience wellness influencers, lifestyle influencers, anti-vaxxers, at least one contributor to Gwyneth Paltrow’s Goop site, and other seemingly unrelated groups have all pivoted to spreading versions of these conspiracies that emerged on the far right. QAnon’s rise appears to have generated enthusiasm for the movement’s goals, including a persistent fringe right-wing push to fire the National Institute of Allergy and Infectious Diseases director, Anthony Fauci..." [Worth a read, as explaining some of the craziness.]
Carefree Amid a Contagion: How to Talk to Covid-19 Skeptics (Teresa Carr, Undark, 3-24-2020) Is there something people who communicate about Covid-19 can do to better convey the gravity of the situation? Experts have some ideas.
Medical School Taught Me How to Talk to Conspiracy Theorists (Yoo Jung Kim, Undark, 6-18-2020) Motivational interviewing, a counseling method used by physicians, offers a way to counter Covid-19 misinformation.
'I thought this was a hoax': Patient in 30s dies after attending 'COVID party' (Gerald Tracy, News4, San Antonio, WOAI/KABB, 7-10-2020) A patient in their 30s died from the coronavirus after attending what's being called a "COVID party," according to Dr. Jane Appleby, chief medical officer of Methodist Healthcare. "This is a party held by somebody diagnosed by the COVID virus and the thought is to see if the virus is real and to see if anyone gets infected," Dr. Appleby said. "Just before the patient died, they looked at their nurse and said 'I think I made a mistake, I thought this was a hoax, but it's not,'" Appleby said. Do not, especially those in the younger demographic, believe you are invincible.
The coronavirus ‘infodemic’ is real. We rated the websites responsible for it (JohnGregory, STAT, 2-28-2020)
The Role of Cognitive Dissonance in the Pandemic (social psychologists Elliot Aronson and Carol Tavris, The Atlantic, 7-15-2020) The minute we make any decision—I think COVID-19 is serious; no, I’m sure it is a hoax—we begin to justify the wisdom of our choice and find reasons to dismiss the alternative.
Coronavirus disease (COVID-19) advice for the public: Myth busters (World Health Organization) These things are not true:

  • There are currently no drugs licensed for the treatment or prevention of COVID-19.
  • Adding pepper to your soup or other meals DOES NOT prevent or cure COVID-19.
  • COVID-19 IS NOT transmitted through houseflies.
  • Spraying and introducing bleach or another disinfectant into your body WILL NOT protect you against COVID-19 and can be dangerous.
  • Drinking methanol, ethanol or bleach DOES NOT prevent or cure COVID-19 and can be extremely dangerous.
  • 5G mobile networks DO NOT spread COVID-19.
  • Exposing yourself to the sun or to temperatures higher than 25C degrees DOES NOT prevent the coronavirus disease (COVID-19).
  • Catching the new coronavirus DOES NOT mean you will have it for life.
  • Being able to hold your breath for 10 seconds or more without coughing or feeling discomfort DOES NOT mean you are free from the coronavirus disease (COVID-19) or any other lung disease.
  • Drinking alcohol does not protect you against COVID-19 and can be dangerous.
  • COVID-19 virus can be transmitted in areas with hot and humid climates.
  • Cold weather and snow CANNOT kill the new coronavirus.
  • Taking a hot bath does not prevent the new coronavirus disease.
  • The new coronavirus CANNOT be transmitted through mosquito bites. And so on.

Tech Companies Aim to Stop COVID-19 Disinformation (Tim Mak, Morning Edition, NPR, 3-16-2020) "Fake news spreads faster and more easily than this virus and is just as dangerous."~ World Health Organization's Director-General Tedros Adhanom.
       John Gregory, the deputy editor of health at NewsGuard, says there are three big buckets of coronavirus misinformation circulating right now. "No. 1, conspiracies about the origins of the virus; two, bad health cures, either ineffective or both ineffective and harmful. And three, minimizing the outbreak, saying it's not as big of a deal as the media is making it out to be." .
PEN America’s Guide on COVID-19 and Disinformation In the United States, text messages encouraged people to stock up on food and supplies in advance of a national quarantine. In Europe and China, a video circulated on WhatsApp and TikTok that appeared to show shoppers mobbing a Dutch supermarket. Both warnings were false, and yet both landed in countless inboxes and feeds.Some messages may have been intended to cause panic, but there’s also been earnest confusion (what we at PEN America define as misinformation, rather than disinformation). Steps to take to evaluate news stories that are blowing up your feed or finding their way into your messaging systems.
Get Ready for a Vaccine Information War (Kevin Roose, The Shift, NY Times, 5-13-2020) Social media is already filling up with misinformation about a Covid-19 vaccine, months or years before one even exists. What if we get a Covid-19 vaccine and half the country refuses to take it? It occurred to me that all the misinformation we’ve seen so far — the false rumors that 5G cellphone towers fuel the coronavirus, that drinking bleach or injecting UV rays can cure it, that Dr. Anthony Fauci is part of an anti-Trump conspiracy — may be just the warm-up act for a much bigger information war when an effective vaccine becomes available to the public.
Journalism Professors Call for an End to Fox News Coronavirus 'Misinformation' in Open Letter to Rupert Murdoch (James Walker, Newsweek, 4-2-2020)
W.H.O. Fights a Pandemic Besides Coronavirus: An ‘Infodemic’ (Matt Richtel, NY Times, 2-6-2020) Medical misinformation on the virus has been driven by ideologues who distrust science and proven measures like vaccines, and by profiteers who scare up internet traffic with zany tales and try to capitalize on that traffic by selling “cures” or other health and wellness products.
Alarm, Denial, Blame: The Pro-Trump Media’s Coronavirus Distortion (Jeremy W. Peters, NY Times, 4-1-2020) Sean Hannity, Rush Limbaugh and other right-wing commentators turned a pandemic into a battle of us vs. them — the kind of battle President Trump has waged for much of his life. "For years, Mr. Limbaugh has encouraged his audience to be suspicious of science as one of his so-called Four Corners of Deceit, which also include government, academia and media.
I’m an Investigative Journalist. These Are the Questions I Asked About the Viral “Plandemic” Video. (Marshall Allen, ProPublica, 5-9-2020) ProPublica health care reporter Marshall Allen describes the questions he asks to assess coronavirus misinformation, starting with a viral video that claims the coronavirus is part of a “hidden agenda.” Questions to ask, with such material: Is the presentation one-sided? Is there an independent pursuit of truth? Is there a careful adherence to the facts? Are those accused allowed to respond? Are all sources named and cited, and if not, is the reason explained? Does the work claim some secret knowledge?
In the Bubble with Andy Slavitz Informative, intelligent interviews about COVID-19. "From his own bubble, health care leader, turnaround expert and #stayhome architect Andy Slavitt is making it his mission to give Americans critical information in real-time but also hope for a path forward."

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Conspiracy theories

"Don't believe everything you think" ~ bumper sticker seen in D.C.


Why Coronavirus Conspiracy Theories Flourish. And Why It Matters. (Max Fisher, NY Times, 4-8-2020)Unseen villains. Top-secret cures. In their quest for reassurance during the pandemic, many people are worsening more than just their own anxiety.
What Is QAnon? (Robin Young and Serena McMahon, Here and Now, WBUR, 8-6-2020) "QAnon is a far-right conspiracy theory and loosely organized network centered around the belief that the U.S. is controlled by a cabal of child sex trafficking, Democratic elites hell-bent on bringing down President Trump....Followers believe these elites, led by Dr. Anthony Fauci, have gone so far as to manufacture the coronavirus to bring Trump down. They heed cryptic online dispatches of someone named Q who's anonymous — hence QAnon — who claims the highest government security clearance.
"QAnon adherence includes people young and old of many backgrounds who try to push their “deep state” narrative into the mainstream. They show up at Trump rallies in Q merchandise, shirts and hats. The group grew out of Pizzagate, the conspiracy theory pushed by Alex Jones, which falsely claimed Hillary Clinton was running a child sex trafficking ring out of a Washington, D.C. pizza parlor. QAnon started on 4Chan, a message board website “well known for hosting white nationalists and white supremacists,” Kaplan says.
Pandemics Go Hand in Hand with Conspiracy Theories (By Frederick Kaufman, New Yorker, 5-13-2020) From the Illuminati to “COVID-19 is a lie,” how pandemics have produced contagions of fear.
The Dangerous Coronavirus Conspiracy Theories Targeting 5G Technology, Bill Gates, and a World of Fear (Amy Davidson Sorkin, New Yorker, 4-24-2020) If people believe that they are being deceived—or even targeted—by public-health authorities, why would they follow their directives?
“Immune to Evidence”: How Dangerous Coronavirus Conspiracies Spread (Marshall Allen, ProPublica, 5-17-2020) Conspiratorial videos and websites about COVID-19 are going viral. Here’s how one of the authors of “The Conspiracy Theory Handbook” says you can fight back. One big takeaway: Focus your efforts on people who can hear evidence and think rationally.
The Conspiracy Theory handbook by Stephan Lewandowsky and John Cook (PDF, free online). Distinguish between real conspiracies and conspiracy theories, between conventional thinking and (the seven traits of) conspiratorial thinking. Understand why conspiracy theories are so popular, how they do damage, and how to protect the public against them. Read how to talk to a conspiracy theorist.
Who Believes in the Moon Landing? (Dorothy Wickenden, New Yorker, 7-22-19) A significant percentage of Americans believe the moon landing was a government hoax. How does the conspiracy theory continue to thrive? Check out More New Yorker stories about conspiracy theories.
Wikipedia's list of conspiracy theories
Faced with an appalling US coronavirus death toll, the right denies the figures (Adam Gabbatt, The Guardian, 5-15-2020) Fox News is foremost in promoting the idea that official figures are inflated, whereas experts believe more people have died.
Coronavirus is a breeding ground for conspiracy theories – here’s why that’s a serious problem (Daniel Jolley and Pia Lamberty, The Conversation, 2-28-2020) One conspiracy theory proposes that the coronavirus is actually a bio-weapon engineered by the CIA as a way to wage war on China. Others are convinced that the UK and US governments introduced the coronavirus as a way to make money from a potential vaccine.The novel coronavirus continues to spread around the world, with new cases being reported all the time. Spreading just as fast, it seems, are conspiracy theories that claim powerful actors are plotting something sinister to do with the virus. Our research into medical conspiracy theories shows that this has the potential to be just as dangerous for societies as the outbreak itself.'
Conspiracy theorists, far-right extremists around the world seize on the pandemic (Marc Scott and Steven Overly, Politico, 5-12-2020) Civil rights advocates have warned for months that the coronavirus could aid recruiting for the most extreme white-supremacist and neo-Nazi groups.
How to respond to your family's coronavirus conspiracy theories (Shira Feder, The Insider, 5-12-2020)There are ways to respectfully debate conspiracy theories with your family, though sometimes it's best to just end the conversation.
'Obamagate': Fox News focuses on (Martin Pengelly, The Guardian, 5-14-2020) Trump has dubbed the brouhaha ‘the greatest political crime’ in US history despite being unable to say what it is. In recent days, the US president’s favourite network has elevated the spurious “Obamagate” scandal over all other subjects, most obviously the deaths of more than 84,000 Americans in a pandemic which the Trump administration has failed to contain.
• • Time's List of Conspiracy Theories (1989) On the 40th anniversary of the moon landing — or was it just a sinister hoax? — TIME looks at 10 of the world's most enduring conspiracy theories.
What’s New About Conspiracy Theories? (Elizabeth Kolbert, New Yorker, 4-15-19) Outsiders have always had a weakness for paranoid fantasies. Now our leaders are conspiracists, too.
The epic battle against coronavirus misinformation and conspiracy theories (Philip Ball & Amy Maxmen, Nature, 5-27-2020) Analysts are tracking false rumours about COVID-19 in hopes of curbing their spread.
America’s far right is energised by covid-19 lockdowns (A political virus, The Economist, 5-17-2020) 'Extremists see the pandemic as the prelude to the apocalyptic “boogaloo” ...The spreading of conspiracy theories is central to the extreme right’s activities. Some claim the virus is a hoax. Others blame the Chinese, the Jews or even Bill Gates. Some claim that the federal government is using the virus as a pretext to confiscate weapons and enforce “medical martial law”. Extremists also spread more familiar conspiracy theories, decrying 5G networks and vaccinations, which help introduce the uninitiated to their ideology.'
W.H.O. Fights a Pandemic Besides Coronavirus: An ‘Infodemic’ (Matt Richtel, NY Times, 2-6-2020)
• “Shadowland,” an Atlantic series about conspiracy thinking in America
---The Paranoid Style in American Entertainment (Megan Garber, The Atlantic, 5-13-2020) How the mechanisms of reality TV taught us to trust no one.
---Birtherism of a Nation (Adam Serwer, The Atlantic, 5-1302020) The conspiracy theories surrounding Obama’s birthplace and religion were much more than mere lies. They were ideology.
---Something in the Air (Kaitlyn Tiffany, The Atlantic, 5-13-2020). The coronavirus pandemic is sparking baseless theories about the dangers of 5G. But the fear that wireless technology is slowly killing us isn’t new—and it doesn’t appear to be going away anytime soon.
---The Conspiracy Theorists Are Winning (Jeffrey Goldberg, The Atlantic, 5-13-2020) America is losing its grip on Enlightenment values and reality itself.
---The Prophecies of Q (Adrienne LaFrance, The Atlantic, 5-13-2020) American conspiracy theories are entering a dangerous new phase. "You know that a small group of manipulators, operating in the shadows, pull the planet’s strings. You know that they are powerful enough to abuse children without fear of retribution. You know that the mainstream media are their handmaidens, in partnership with Hillary Clinton and the secretive denizens of the deep state. You know that only Donald Trump stands between you and a damned and ravaged world."
---The Conspiracies Are Coming From Inside the House (Renée DiResta, The Atlantic, 3-10-2020) After 2016, Americans are alert to Russian election interference, but domestic influencers are spreading discord on their own.
---The Normalization of Conspiracy Culture (Adrienne LaFrance, The Atlantic, 6-17-17) People who share dangerous ideas don’t necessarily believe them. Donald Trump may be the most famous conspiracy theorist in America, but a close second is the Infowars talk-radio personality Alex Jones, who has made a name for himself spewing reprehensible theories. He claimed the Sandy Hook Elementary School massacre was a hoax.
---The Conspiracy Museum: A speculative address (Robin Sloan, The Atlantic, 4-16-2041(!)) This short story is part of “Shadowland,” a project about conspiracy thinking in America.
Misinformation about coronavirus finds new avenues on unexpected sites (Elizabeth Dwoskin, Washington Post, 5-20-2020) During the pandemic, Facebook, Twitter and YouTube have adopted a more aggressive approach to policing misinformation than in the past. They have introduced new rules, such as removing posts that contradict guidance from public health agencies, deny that the virus exists, or promote bogus scientific claims. With social media giants taking down more content, unlikely services such as Google Drive and the Internet Archive and the app TikTok are becoming conduits for material such as the “Plandemic” video.
Covering the coronavirus amid infection, misinformation and scared sources (Emilia Díaz-Struck, Scilla Alecci, Will Fitzgibbon, Jelena Cosic, Delphine Reuter, and others, Press Freedom, International Consortium of Investigative Journalists, 5-7-2020) Journalists covering the coronavirus from Hungary to Chile are not only faced with the risk of contagion. They are battling secretive governments, restricted movement, misinformation and sources who are too scared to speak.  (Scroll to bottom for links to more fact-checking sites.)

Social Media Posts Spread Bogus Coronavirus Conspiracy Theory (FactCheck.org)
The coronavirus ‘infodemic’ is real. We rated the websites responsible for it (John Gregory, First Opinion, STAT 2-28-2020) “I’m an editor at NewsGuardNewsGuard, which rates the credibility of news and information websites. Our ongoing analyses show that misinformation about the outbreak is clearly beating reliable information when it comes to engagement on social media worldwide. NewsGuard has rated the credibility and transparency of more than 3,200 news and information sites in the U.S., accounting for 96% of online engagement, previously reporting that more than 1 in 10 of these sites share health misinformation.” An overview of the misinformation epidemic. conspiracy theories, and the most prolific peddlers of health misinformation.
Coronavirus Misinformation Tracking Center (Newsguard)
FactCheck.org to Work With Facebook on Exposing Viral Fake News (Annenberg Public Policy Center, 12-15-16)
Coronavirus Coverage (FactCheck.org)
SciCheck (FactCheck.org)
Debunking False Stories
The Paranoid Style in American Politics (Richard Hofstadter, Harpers, Nov. 1964) It had been around a long time before the Radical Right discovered it—and its targets have ranged from “the international bankers” to Masons, Jesuits, and munitions makers. This became a book. See Wikipedia entry on this article and topic.
The Truly Paranoid Style in American Politics (Benjamin Wallace-Wells, New York Magazine, 11-25-13) From the JFK assassination to weather control and the New World Order: 50 years of conspiracy theory.

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Problems with personal protective equipment (PPE)


One in five nursing homes still lack sufficient PPE (Liz Seegert, Covering Health, AHCJ, 9-1-2020) Despite promises from the Trump administration, a recent study confirmed that many nursing homes still lack the necessary resources to address the COVID-19 crisis adequately in their facilities. Analysis from a national database reflecting 98% of U.S. nursing homes found that more than one in five reported a severe shortage of PPE and staff from May to July.
These 75 Hand Sanitizers Have Been Recalled By The FDA For Methanol Contamination (Alexandra Sternlicht, Forbes, 7-21-2020)
Wealthy Hospital Taps Craft Breweries For Aid To Buy Masks, Gloves (Phil Galewitz, KHN, 6-16-2020) Although the federal government has poured billions of dollars into hospitals to defray their losses from the coronavirus outbreak, new streams of fundraising have emerged — including health worker-themed beer that adds “a drop in the bucket.” H/T to Kaiser Health Network for most of these links.
Workers Filed More Than 4,100 Complaints About Protective Gear. Some Still Died. (Christina Jewett and Shefali Luthra and Melissa Bailey, KHN, 6-30-2020) As health workers were dying of COVID-19, federal work-safety officials filed just one citation against an employer and rapidly closed complaints about protective gear.
US Nurses at For-Profit Hospital Chain to Strike Over Cuts and PPE Shortages (Michael Sainato, The Guardian and KHN, 6-23-2020) Health care workers report understaffing, long hours and protective equipment shortages at HCA Healthcare hospitals.
‘Please Tell Me My Life Is Worth A LITTLE Of Your Discomfort,’ Nurse Pleads (Anna Almendrala, KHN, 7-7-2020) Health care workers on the front lines of the COVID crisis have spent exhausting months working and self-quarantining off-duty to keep from infecting others, including their families. Encountering people who indignantly refuse face coverings can feel like a slap in the face.
COVID-19: How a PPE shortage could cripple the healthcare system (Tom Castles, MDLinx, 4-10-2020)
We Knew The Coronavirus Was Coming, Yet We Failed 5 Critical Tests (Elisabeth Rosenthal, KHN, 5-11-2020) 1. Ventilators. 2. Testing, the persistent Achilles’ heel in the U.S. response. 3. Testing components and PPE. Conducting tests involves access to a number of components — kits, chemical reagents, swabs, personal protective equipment, known as PPE, and sometimes custom cartridges for machines. Miss any one of those things and testing becomes impossible. It’s like trying to make bread with all the ingredients except yeast. Medical manufacturers, which make dozens of products — some very profitable and some not — have no “incentive” to produce low-margin items in excess of usual needs. 4. Hospitals did not coordinate. 5. The hospital rescue. In the past quarter-century, we have evolved a reimbursement system that showers cash on elective and specialty care and discourages hospitals from serving the health needs of society. The COVID-19 stress test has laid bare a market that is broken, lacking the ability to attend to the public health at a time of desperate need and with a government unwilling — in some ways unable — to force it to do so. This time around, thousands of medical professionals have stoically answered the call to treat the ill, doing their best to plug the long-standing holes and vulnerabilities that the pandemic has revealed.
Sourcing Personal Protective Equipment During the COVID-19 Pandemic (Edward Livingston, Angel Desai, and Michael Berkwits, JAMA, 3-28-2020) Clinicians are encouraged to submit ideas on how to address the impending PPE shortage.

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Coronavirus: The maps, the charts, and the numbers

Who's counting, what are they counting, what are the numbers, and how reliable are they?
One million deaths so far, as of Sept. 29.2020.

A quarter of the world's COVID-19 deaths have happened in the US, a country with only 4.25 percent of the world's population. Where are deaths concentrated:  in nursing homes, veterans' hospitals, and long-term care facilities; among black people and people on Native American lands; among people with pre-existing conditions such as diabetes and heart conditions among people who will lose their jobs if they don't show up for work; wherever people gather in groups in close contact, particularly indoors. Older adults and people with underlying medical conditions in particular are at higher risk for severe illness from COVID-19.
‘A Mind-Numbing Figure’: COVID-19 Has Killed 1,000,000 People So Far (KHN roundup of news stories, 9-29-2020) One million deaths. The United States is the source of 20 percent of those worldwide deaths. Reuters: "The number of deaths from the novel coronavirus this year is now double the number of people who die annually from malaria - and the death rate has increased in recent weeks as infections surge in several countries."
Superspreading Database Now Has 1500+ Entries (9-23-2020) From all continents, including Antarctica. See article about database (Koen Swinkels, Medium, 6-12-2020) and links to blog, etc., about superspreader project and blog posts and bubble map with timeline. Click around and find much data, around the world.
Why Are Deaths From COVID So Controversial? (Joe Graedon, People's Pharmacy, 10-16-2020) How many people have died from SARS-CoV-2? Many people don’t believe it’s that many. New data suggests deaths from COVID are even higher.
Just a few nations driving much of world's COVID-19 surge (Lisa Schnirring, CIDRAP News, 7-23-2020) "[T]wo thirds of the world's cases have been reported from just 10 countries and... half of the cases are from just three countries: the United States, Brazil, and India." two thirds of the world's cases have been reported from just 10 countries and that half of the cases are from just three countries: the United States, Brazil, and India.
Where the Virus Is Sending People to Hospitals (Lazaro Gamio, Sarah Mervosh and Keith Collins, NY Times, 7-23-2020) "About as many people are now known to be hospitalized with the coronavirus in the United States as during any other time in the pandemic, matching the previous peak in April....The worst-hit areas in Texas and Florida have approached the peak rates of hospitalization that New York, New Orleans, Chicago and other cities hit in the spring. A wide and growing expanse of hot spots around the country — including Las Vegas, Nashville and Tulsa, Okla. — have worsened over the past two weeks."
America Is Reopening. But have we flattened the curve? (Johns Hopkins coronavirus tracker). On this chart, showing the status in each state, the greener (as I see it bluer) the background, the bigger the downward trend of new cases in that state; the redder the background, the bigger the upward trend of new cases in this state. How is your state doing?

 


World Hits Grim Milestone Of 20 Million Reported Coronavirus Cases (Emma Reynolds, CNN, 8-10-2020) The world has reached the grim milestone of 20 million confirmed coronavirus cases and is edging closer to 750,000 deaths globally, according to figures from Johns Hopkins University. The seven-day average for new daily cases has been above a quarter of a million for two weeks. Case numbers have soared exponentially since the first were reported in China in December. The world recorded one million cases more than three months later, on April 2. The tally hit 10 million cases less than three months after that, on June 28, and it has taken just six weeks to double.
More Americans Have Officially Died of Coronavirus Than Number Who Were Killed in WWI The total number of confirmed deaths in the U.S. hit 116,854 Tuesday, just passing the 116,516 American service members believed to have died in the first World War.
How to Understand COVID-19 Numbers (Caroline Chen, graphics by Ash Ngu, ProPublica, 7-21-2020) Viewed in isolation or presented without context, coronavirus numbers don’t always give an accurate picture of how the pandemic is being handled. How to navigate the figures.
KFF Charts of the Week. Examples: U.S. Has Higher Number of COVID-19 Cases per Capita Compared to Other Countries That Reopened Schools; Adults at Greater Risk of Severe Illness When Infected With Coronavirus If Kids Go Back to In-Person School; In Medicare, Black and Hispanic Individuals Account for Disproportionate Share of COVID-19 Cases and Hospitalizations; In 18 States, Deaths in Long-Term Care Facilities Account for at Least Half of Their COVID-19 Deaths; Where Each State Stands on Coronavirus Testing This Week.
Over 150,000 Americans Dead With Rate Speeding Up To 1 Every Minute (KHN Morning Briefing, 7-30-2020) The United States blew past another tragic milestone, reporting 150,000 deaths due to the COVID-19 outbreak. New case counts and the death rate continue to climb to record or near-record levels -- especially in Texas.
Your state’s Covid-19 epidemic, explained in 5 maps (German Lopez, Vox, 8-5-2020) These maps show how your state is doing. What the maps show clearly, state-by-state: Most states have uncontrolled Covid-19 outbreaks. The coronavirus is spreading too quickly in most states. Most states’ positive rates for tests are too high. Most states’ hospitals don’t have much space for Covid-19 patients (aren't prepared for a surge).
Wall Street Journal: Daily U.S. Coronavirus Cases Climb Back Above 70,000 (David Hall, Wall Street Journal, 7-30-2020 ) Some states reported record death tolls, while parts of Asia faced a resurgence in infections. Total confirmed coronavirus cases world-wide rose above 17 million Thursday, with the U.S. accounting for more than a quarter of that number, according to data compiled by Johns Hopkins University. New coronavirus cases in the U.S. climbed back above 70,000 as some states reported record death tolls, while parts of Asia faced a resurgence in infections. Total confirmed coronavirus cases world-wide rose above 17 million Thursday, with the U.S. accounting for more than a quarter of that number, according to data compiled by Johns Hopkins University.
Rising Cases in Long-term Care Facilities Are Cause for Concern (Priya Chidambaram, KFF, 7-21-2020) Data shows that younger people make up a growing percentage of new coronavirus cases in cities and states, and much recent media coverage has focused on the resurgence of the pandemic being driven by cases among younger adults. Less attention has been paid to recent trends in cases among residents and staff in long-term care facilities and how these relate to surges in “hotspot” states. Long-term care cases in “hotspot states” with wider community transmission have risen at four times the rate as long-term care cases in non-hotspot states.Long-term care cases in “hotspot states” with wider community transmission have risen at four times the rate as long-term care cases in non-hotspot states.
Where are the COVID-19 Hotspots? Tracking State Outbreaks (Jennifer Kates, Jennifer Tolbert, Kendal Orgera, Josh Michaud, and Larry Levitt, KFF, 6-30-2020) In particular, click on
COVID-19: Metrics by State, which brings up a slightly slow-loading map. Hover your mouse over a state and it gives you current data, but also the map is color-coded to show hotspots.
Coronavirus in the U.S.: Latest Map and Case Count (New York Times, updated regularly) A series of graphic depictions of cases and deaths shows where things are worsening or getting better.
U.S. currently hospitalized with COVID-19 (graphic, COVID Tracking Project) Links to charts for other figures on same page.
U.S. Coronavirus Deaths Top 140,000 As World Sets Daily Record In New Cases (Matthew S. Schwartz, Suzanne Nuyen, WBUR News, 7-18-2020) Over a 24-hour period, the world saw nearly 260,000 new coronavirus cases — a new record. Deaths were also on the rise, with 7,360 new fatalities reported Saturday in the highest one-day increase since May. The United States, Brazil, India and South Africa accounted for more than 165,000 of the cases. The median age of people getting infected in Florida continues to drop, DeSantis said. In Miami-Dade County, the median age is 41; in Orange County, it's 29; and in Seminole County, it's 26.
Florida’s count of coronavirus deaths is missing some cases (Kathleen McGrory and Rebecca Woolington, Tampa Bay Times, 4-11-2020) "The state health department is counting coronavirus deaths only for people who claimed residency in Florida. The medical examiners, who are legally responsible for certifying fatalities from diseases that constitute a threat to public health, are counting anyone who died in Florida, including snowbirds and visitors. Some snowbirds are being excluded in the state’s count. By Friday, another group had 40 more fatalities. And pneumonia deaths that could be COVID-related are not being counted as COVID."
A Second Coronavirus Death Surge Is Coming (Alexis C. Madrigal, The Atlantic, 7-15-2020) There was always a logical explanation for why cases rose through the end of June while deaths did not. This summer surge in deaths was entirely predictable by looking honestly at the case and hospitalization data that preceded it.
COVID 19 Dashboard Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU) World statistics, graphic and in actual numbers. Play with the charts.
Texas Newspaper Prints 43-Page Obituary Section As Coronavirus Deaths Soar ( Soo Kim, Newsweek, 7-13-2020)
Coronavirus Map: Tracking the Global Outbreak (New York Times) Click on: Total cases, total deaths, globally. Map, Country table, New cases, Tips, Latest News)
Cases in the U.S. (CDC). Total cases, total deaths. Click on Cases, Data, and Surveillance
Live Updates from CNN (Coronavirus pandemic: Updates from around the world)
Daily new confirmed COVID-19 deaths (Our World in Data) Shown is the rolling 7-day average. Limited testing and challenges in the attribution of the cause of death means that the number of confirmed deaths may not be an accurate count of the true number of deaths from COVID-19.
Coronavirus tracked: the latest figures as countries start to reopen (graphs and numbers) Financial Times analyzes the scale of outbreaks and the number of deaths around the world. See also Exiting lockdowns: tracking governments’ changing coronavirus responses (FT Visual & Data Journalism Team)
Why the US has the world's highest number of Covid-19 deaths (Jeffrey Sachs, Opinion, CNN, 4-12-2020) Americans will continue to die in large numbers until our country mounts a coherent response to the epidemic.
Covid-19: Lost on the Frontline (David Robson, BBC, 5-13-19)
Atul Gawande on Twitter (with graphic charts) "Yes, the mortality curve is flat and the young are the biggest source of cases unlike before. But hospital beds in these states are filling. And there's too little testing and tracing to find cases and isolate them from the general population."
Staffing levels, not just hotspots, can predict nursing home COVID deaths, study says (Liz Seegert, Covering Health, AHCJ, 7-8-2020) At least 55,000 deaths, more than 42% of the U.S. total, have been linked to nursing homes, assisted living and other long-term care facilities. Now a new academic study supports what many already suspected: residents of long-term care facilities with lower nurse staffing levels, poorer quality scores, and higher concentrations of disadvantaged residents suffer from higher rates of confirmed COVID-19 cases and deaths.
My Mother Died of the Coronavirus. It’s Time She Was Counted. (Elisabeth Rosenthal, KHN, 5-27-2020) "And we are fooling ourselves: Not having an accurate, standard, honest, nationwide way to tally COVID cases will only add to the current tragedy. First of all, states, agencies and workplaces are all counting differently, sometimes bending, I suspect, to political convenience. For states, avoiding robust testing and reporting is a good way to make sure new cases decrease for 14 days (a CDC recommendation for reopening). But it deprives those same states of crucial information for rational decisions. For assisted living facilities, nursing homes and other businesses, there is pressure not to know. Who wants to be known as a place where 20%, 30% or 50% of the residents or workers have gotten COVID-19?"
Singapore’s Covid-19 case fatality rate is remarkably low. Why?(Dylan Scott, Vox, 5-20-2020) "Death rates can be the byproduct of lots of testing — and a little randomness. Singapore can be thankful that its worst outbreaks have been in dorms full of young workers instead of nursing homes, as we’ve seen in the United States and Europe. Some credit is also certainly due to the testing-and-tracing programs, the travel restrictions, and Singapore’s strong health care system (disparities for migrant workers notwithstanding). "Some of these things could be applicable in America: The country could do better testing and tracing, and it could build a stronger health system. The US does have a relatively young population compared to other countries and so more testing could potentially reveal a more widespread outbreak — and, paradoxically, a lower death rate — than the current data suggests.But the coronavirus has already infiltrated nursing homes in the US."
The Tricky Math Behind Coronavirus Death Predictions: Computer models are based on assumptions, data that change frequently (Brianna Abbott and Paul Overberg, WSJ, 5-5-2020) "The near doubling of coronavirus death predictions in a closely followed model this week underscored a frustrating reality for officials: Many basic facts about the virus remain unknown....Researchers have strained to pin down basic bits of information about the disease, such as its infectiousness. Undercounted infections and deaths have blinded public-health authorities and modelers alike to the full scope of the pandemic."
In 18 States, Deaths in Long-Term Care Facilities Account for at Least Half of Their COVID-19 Deaths (KFF, 5-18-2020) Chart shows where.
Nearly 600 — And Counting — US Health Workers Have Died of COVID-19 (Christina Jewett and Melissa Bailey and Danielle Renwick, The Guardian and KFF, 6-6-2020)
These Updating Charts Show How the Coronavirus Is Spreading Across the US (Peter Aldhous and Jeremy Singer-Vine, BuzzFeed, 3-9-2020) Follow the latest data on COVID-19 cases and deaths in the US.
A State-by-State Look at Coronavirus in Prisons (The Marshall Project) The Marshall Project is collecting data on COVID-19 infections in state and federal prisons.By June 9, at least 43,967 people in prison had tested positive for the illness, an 8 percent increase from the week before. Much of the remarkable growth in coronavirus cases has been due to some states—Michigan, Ohio, Tennessee, Texas among them—that began aggressively testing nearly everyone at prisons where people had become sick.

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Reliable sources of information and updates on COVID-19

See also Combatting the Misinformation Epidemic/Campaign
"We need facts, not fear, we need science, not rumors, we need solidarity, not stigma."


The COVID Tracking Project @The Atlantic. See Journalist describes role in helping compile, publicize national data on COVID-19 (Bara Vaida, Covering Health, AHCJ, 8-31-2020). Sign up for COVID-19 Data Dispatch
Coronavirus: COVID-19 (Kaiser Family Foundation)
Johns Hopkins Coronavirus Research Center
Coronavirus Tracker (Kaiser Family Foundation, or KFF) Global confirmed cases.
Covid-19 Dashboard (Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU)
Deaths and number of cases(Washington Post) And places with highest 7-day rolling average of daily new reported cases per 100,000 residents.
CDC COVID Data Tracker (U.S. Cases and Deaths by State)
CoronaTracker (World Health Organization) Country counts.
Rolling updates on coronavirus disease (COVID 19) (World Health Organization)

Covid-19 Tracker (STAT and AppliedXLabs)

BMJ's Coronavirus (covid-19) Hub
Covering Coronavirus: Resources for journalists (Writers and Editors, a sister site)
Covering COVID-19 (Poynter's daily coronavirus briefing for journalists)
Covid-19 is one of Wikipedia’s biggest challenges ever. Here’s how the site is handling it. (Travis M. Andrews, Washington Post, 8-7-2020) "Anyone with an Internet connection can edit the online crowdsourced encyclopedia.As the pandemic overtook the globe, it sparked one of Wikipedia’s largest challenges: to chronicle a massive news event in real time as information constantly shifted and misinformation constantly spread, putting the site’s tried and true process to the test....As of the end of July, according to Wikimedia Foundation spokeswoman Chantal De Soto, more than 67,000 editors had collaborated to create more than 5,000 Wikipedia articles in 175 different languages about covid-19 and its various impacts. Some of these, including the disease’s main English-language article, are sensitive pages restricted to certain trusted users (a decision made by other Wikipedia volunteers), De Soto said....By the end of July, the main English-language covid-19 article had been edited 22,000 times by more than 4,000 editors."
COVID-19 Tracker (American Enterprise Institute, a conservative think tank). Maps (updated daily by Dr. Scott Gottlieb and his research assistant) show a CV19 Lab Testing Dashboard, county level predictive risk, testing progress, mitigation strategies, and how you can help (PPE and convalescent blood plasma).
COVID-19 fact checking and misinformation tracking (Writers and Editors site)
Coronavirus Disease 2019 (COVID-19) Situation Summary (CDC updates) Includes background information, including relationship to MERS and SARS betacoronaviruses.This is an emerging, rapidly evolving situation and CDC will provide updated information as it becomes available, in addition to updated guidance. Follow CDC Twitter feed: @CDCgov
Covid19 Cases in United States (CDC map and data) and Preventing and treating coronavirus disease 2019 (COVID-19) (CDC)
Kaiser Health Network, Kaiser Family Foundation (invaluable resource, especially on policy) Follow @KHNews And/or listen to KHN's What the Health? podcasts
Coronavirus Tips: Frequently Asked Questions and Advice (New York Times)
MedlinePlus Twitter feed (National Library of Medicine, NIH, @MedlinePlus)
Spotlight on Coronavirus (Science Friday with Ira Flatow, National Public Radio, @scifri). Listen to useful explanations such as Coronavirus: Sanitizing, According to Science
NCBI SARS-CoV-2 Resources (National Center for Biotechnology Information, National Library of Medicine) Sars-CoV-2 Sequences and more advanced science on the topic. See The National Library of Medicine is Expanding Access to Coronavirus Literature through PubMed Central.
Boston’s infectious disease specialists’ message to the public: Don’t be cavalier about the coronavirus (Boston Infectious Disease Specialists, Boston Globe, 3-13-2020) Main take-aways:
    (1) Testing capacity is still woefully lacking, and we therefore must conserve Covid-19 testing for those most in need.
    (2) The community must begin social distancing immediately.
    (3) The public should help in conserving vital medical resources, such as health care provider time and personal protective equipment, such as masks and gloves.
Help Researchers Track COVID-19 (Bob Hirshon, Scientific American, 3-26-2020) By entering your health status, even if you’re feeling fine, at the Web site
Preventing COVID-19 Spread in Communities (CDC)
CDC Guidance for Travelers
• The best way to see where the disease has spread, and how much: COVID-19 map (Johns Hopkins University & Medicine). See also their Coronavirus Resource Center and its Situation Reports.
Coronavirus updates, NY Times. See especially Tracking Every Coronavirus Case in the U.S.: Full Map (Jerome Groopman, 4-1-2020)
Washington Post: daily live updates
NIH Updates on coronavirus (National Institutes of Health)
Annals of Internal Medicine
Coronavirus articles (STAT)
The New Yorker’s coronavirus news coverage and analysis temporarily free for all readers. See A New Study Questions the Effectiveness of a Potential “Game Changer” Against the Coronavirus
PBS News updates
BBC News, including Coronavirus and fake news – what to believe?.
Fact Checker (Glenn Kessler, WaPo). See Fact-checkers, right, left, an center (sites checking for truthfulness and accuracy).
Helen Branswell, Scientific American.
 Coronavirus stories (Politico) Politico Nightly: Coronavirus Special Edition
What We Need to Understand About Asymptomatic Carriers if We’re Going to Beat Coronavirus (Caroline Chen, ProPublica, 4-2-2020)
Hydroxychloroquine For COVID-19: Cure-All Or Flim-Flam? (Anita Bartholomew, Forbes, 4-8-2020) Clear and balanced reporting.
Coronavirus podcasts:
--- Coronavirus Daily podcast (NPR, audio)
--- Coronavirus: Fact vs Fiction (CNN, host: Dr. Sanjay Gupta)
--- COVID-19: What you need to know (ABC Audio)
COVID Near You, you can help researchers develop a nationwide look at where hotspots of coronavirus are occurring...
Covering the COVID-19 pandemic: Resources for journalists (Pat's Writers and Editors site)
W.H.O. Fights a Pandemic Besides Coronavirus: An ‘Infodemic’ (Matt Richtel, NY Times, 2-6-2020) Medical misinformation on the virus has been driven by ideologues who distrust science and proven measures like vaccines, and by profiteers who scare up internet traffic with zany tales and try to capitalize on that traffic by selling “cures” or other health and wellness products.
Exponential growth and epidemics: How is COVID-19 currently growing? (video, 3blue1brown.com) A good primer on exponential and logistic growth.
In a pandemic, what is essential journalism? (Alexandria Neason, CJR, 4-2-2020) "Journalists routinely enter dangerous or risky situations in the interest of informing the public, but most such decisions—to travel to a conflict zone, for instance, or to report from the eye of a dangerous storm—harbor risk for a limited number of people. Here and now, on the other hand, what we consider basic journalistic practice is in some ways diametrically opposed to the communal good."
How the COVID Tracking Project fills the public health data gap (Emily Sohn, CJR, 3-24-2020)
Virtual conversations with medical and science writers in New York (SciWritersNYC, SWINY, YouTube videos of thoughtful journalistic interviews with experts about Covid-19 and other topics)
COVID-19 Q&A Part 4 (YouTube, 4-11-2020) Dr. Karen Duca, PHD, MBA, answers questions in an ongoing series focusing on the science of COVID-19 (host Kristen Kosinski). See also Part 2 (4-1-2020), Part 3, 4-11-2020, via Facebook, Part 5, 4-23-2020, Part 6, 4-27-2020.
How YouGov became the UK's best but most controversial pollster (Chris Stokel, Wired, 11-28-19) It started with market research. It ended with correctly predicting Theresa May's election fiasco. Here's YouGov's Covid-19 Public Monitor.

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Combatting the Misinformation Epidemic/Campaign

Do not trust unreliable sources.

When Mr. Trump and Dr. Fauci disagree, listen to Dr. Fauci.

Fighting coronavirus requires scientific knowhow, not presidential cheerleading.

 


Fauci debunks coronavirus death misinformation promoted by Trump (WaPo, 9-1-2020) White House coronavirus adviser Anthony S. Fauci on Tuesday refuted online misinformation amplified by President Trump that the virus’s death toll has been vastly overstated in the United States. The U.S. has reported more than 6 million coronavirus cases and over 180,000 deaths.
Coronavirus Misinformation Tracking Center (NewsGuard) Sites identified as publishing materially false information about the virus.
The coronavirus ‘infodemic’ is real. We rated the websites responsible for it (JohnGregory, STAT, 2-28-2020)
State Health Facts (Kaiser Family Foundation) State facts in terms of Demographics and the Economy, Disparities, Health Costs & Budgets, Health Coverage & Uninsured, Health Insurance & Managed Care, Health Reform, Health Status, HIV/AIDS, Medicaid & CHIP, Medicare, Providers & Service Use, Women's Health.
Covid-19 is one of Wikipedia’s biggest challenges ever. Here’s how the site is handling it. (Travis Andrews, WaPo, 8-7-2020) A surprising ‘ray of hope’ amid pandemic misinformation: Wikipedia. More than 67,000 editors have worked on covid-19, and the main English-language article has more than 70 million pageviews.
Coronavirus disease (COVID-19) advice for the public: Myth busters (World Health Organization) There are currently no drugs licensed for the treatment or prevention of COVID-19. Adding pepper to your soup or other meals DOES NOT prevent or cure COVID-19. COVID-19 IS NOT transmitted through houseflies. Spraying and introducing bleach or another disinfectant into your body WILL NOT protect you against COVID-19 and can be dangerous. Drinking methanol, ethanol or bleach DOES NOT prevent or cure COVID-19 and can be extremely dangerous. 5G mobile networks DO NOT spread COVID-19.Exposing yourself to the sun or to temperatures higher than 25C degrees DOES NOT prevent the coronavirus disease (COVID-19). You can recover from the coronavirus disease (COVID-19). Catching the new coronavirus DOES NOT mean you will have it for life. Being able to hold your breath for 10 seconds or more without coughing or feeling discomfort DOES NOT mean you are free from the coronavirus disease (COVID-19) or any other lung disease. Drinking alcohol does not protect you against COVID-19 and can be dangerous. COVID-19 virus can be transmitted in areas with hot and humid climates. Cold weather and snow CANNOT kill the new coronavirus. Taking a hot bath does not prevent the new coronavirus disease. The new coronavirus CANNOT be transmitted through mosquito bites. And so on.
Tipsheet: Covering the Coronavirus Epidemic Effectively without Spreading Misinformation (Laura Helmuth, Open Notebook, 3-2-2020) E.g., Avoid false balance. Experienced health, science, and environment reporters know not to give equal time to creationists, climate change deniers, anti-vaxxers, or flat Earthers. There’s no need to tell some “other side” of coronavirus when the other side is nonsense.
Tech Companies Aim to Stop COVID-19 Disinformation (Tim Mak, Morning Edition, NPR, 3-16-2020) "Fake news spreads faster and more easily than this virus and is just as dangerous."~ World Health Organization's Director-General Tedros Adhanom.
       John Gregory, the deputy editor of health at NewsGuard, says there are three big buckets of coronavirus misinformation circulating right now. "No. 1, conspiracies about the origins of the virus; two, bad health cures, either ineffective or both ineffective and harmful. And three, minimizing the outbreak, saying it's not as big of a deal as the media is making it out to be."
Get Ready for a Vaccine Information War (Kevin Roose, The Shift, NY Times, 5-13-2020) Social media is already filling up with misinformation about a Covid-19 vaccine, months or years before one even exists. What if we get a Covid-19 vaccine and half the country refuses to take it? It occurred to me that all the misinformation we’ve seen so far — the false rumors that 5G cellphone towers fuel the coronavirus, that drinking bleach or injecting UV rays can cure it, that Dr. Anthony Fauci is part of an anti-Trump conspiracy — may be just the warm-up act for a much bigger information war when an effective vaccine becomes available to the public.
Journalism Professors Call for an End to Fox News Coronavirus 'Misinformation' in Open Letter to Rupert Murdoch (James Walker, Newsweek, 4-2-2020)
W.H.O. Fights a Pandemic Besides Coronavirus: An ‘Infodemic’ (Matt Richtel, NY Times, 2-6-2020) Medical misinformation on the virus has been driven by ideologues who distrust science and proven measures like vaccines, and by profiteers who scare up internet traffic with zany tales and try to capitalize on that traffic by selling “cures” or other health and wellness products.
Alarm, Denial, Blame: The Pro-Trump Media’s Coronavirus Distortion (Jeremy W. Peters, NY Times, 4-1-2020) Sean Hannity, Rush Limbaugh and other right-wing commentators turned a pandemic into a battle of us vs. them — the kind of battle President Trump has waged for much of his life. "For years, Mr. Limbaugh has encouraged his audience to be suspicious of science as one of his so-called Four Corners of Deceit, which also include government, academia and media.
I’m an Investigative Journalist. These Are the Questions I Asked About the Viral “Plandemic” Video. (Marshall Allen, ProPublica, 5-9-2020) ProPublica health care reporter Marshall Allen describes the questions he asks to assess coronavirus misinformation, starting with a viral video that claims the coronavirus is part of a “hidden agenda.” Questions to ask, with such material: Is the presentation one-sided? Is there an independent pursuit of truth? Is there a careful adherence to the facts? Are those accused allowed to respond? Are all sources named and cited, and if not, is the reason explained? Does the work claim some secret knowledge?
In the Bubble with Andy Slavitz Informative, intelligent interviews about COVID-19. "From his own bubble, health care leader, turnaround expert and #stayhome architect Andy Slavitt is making it his mission to give Americans critical information in real-time but also hope for a path forward."

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Death and the coronavirus


As if mid-June 2020: More Americans Have Officially Died Of Coronavirus Than Number Who Were Killed In WWI (KHN Morning Briefing, 6-17-2020) The total number of confirmed deaths in the U.S. hit 116,854 Tuesday, just passing the 116,516 American service members believed to have died in the first World War.
I’m a Critical Care Doctor. I’m Tired, I’m Mourning, I’m Bracing for More. (Daniela J. Lamas, NY Times, 6-16-2020) We’re keeping empty units available. The virus is still here.
Death in the Time of the Coronavirus (Vicky Gottlieb, Next Avenue, 4-20-2020) What it means to lose and mourn a loved one during the pandemic. "I’m afraid that in the A.C. rush to resume their lives, my friends will forget my mother died. I’m afraid they’ll expect that in the purgatory of isolation I finished grieving. I’m afraid that instead of my mother’s memory being a blessing, she’ll be remembered for dying a generic death in the Time of Corona."
A Funeral Home Director’s View of the Pandemic (funeral director Alexandra Kathryn Mosca, Next Avenue, 4-27-2020) “You see the pain in these people trying to get a funeral home within the fourteen-day time frame.” Antonopoulos is referring to New York City’s contigency plan allowing hospitals to turn over unclaimed remains after 14 days for burial on Hart Island, a mass burial ground.For Anastasio, it’s about something very basic. “People are waiting for this pandemic to be over so they can give their loved one a proper goodbye,” he said.
Tally of number of Covid-19 cases and deaths (Joe Fox, Brittany Renee Mayes, Kevin Schaul and Leslie Shapiro, Washington Post, 2020)
Worldometer's stats on cases and deaths plus interesting graphic displays, especially Distribution of cases outside China
Veterans Affairs orders $300,000 worth of body bags (Betsy Woodruff Swan, Politico, 4-30-2020) More than 8,500 VA patients have been diagnosed with Covid-19 and nearly 500 have died.
A Funeral Home Director’s View of the Pandemic (Alexandra Kathryn Mosca, Next Avenue, 4-27-2020) The pandemic feels like the AIDS crisis and Sept. 11th rolled into one, intensified in unimaginable ways. One of the most affecting moments for Luhring was when, at a nursing home, he had to remove a deceased person from a table where she was being stored with two other remains.
NYC morgues near capacity, DHS briefing warns (Politico, 3-25-2020)
On keeping a diary or journal of the pandemic
Before ‘Tidal Wave’ Of Illness, Nursing Home Thought It Had COVID-19 Contained (Blake Farmer, Nashville Public Radio/KHN, 4-20-2020) An investigation finds that the facility downplayed the outbreak to first responders on 911 calls in late March.Nursing homes are quickly becoming the deadliest battleground in this pandemic, with more than 3,600 deaths...
‘We Ran Out Of Space’: Bodies Pile Up As N.Y. Struggles To Bury Its Dead (Alan Feuer and William K. Rashbaum, NY Times, 4-20-2020) 'The 40-foot trailer has been there for weeks, parked outside the Leo F. Kearns Funeral Home in Queens. Its refrigerator hums in an alley next to a check-cashing establishment. Thirty-six bodies, one atop the other, are stacked on shelves inside. The funeral director, Patrick Kearns, has barely slept since the day he took charge of them. As he lies awake in the middle of the night, he knows there will be more. “It weighs on you, having so many cases in your care,” he said. “The death rate is just so high, there’s no way we can bury or cremate them fast enough.”'

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Remembering victims of the coronavirus

Those We’ve Lost to the Coronavirus (New York Times obits of people who have died in the pandemic) The coronavirus pandemic has taken an incalculable death toll. This series (Those We’ve Lost) is designed to put names and faces to the numbers. 

Lost On The Frontline A collaboration between The Guardian and KHN that aims to document the lives of health care workers in the U.S. who die from COVID-19. Many cases are shrouded in secrecy. The project hopes to become a collective memorial to honor those lost while serving on the front line. See also
Interactive database on the 900+ health care workers who have died during pandemic (The Guardian and KHN) Hundreds of US healthcare workers have died fighting Covid-19. We count them and investigate why.
Over 900 Health Workers Have Died of COVID-19. And the Toll Is Rising. (Danielle Renwick, The Guardian and Shoshana Dubnow, KHN, 8-11-2020) Reporters are working to confirm the cause of death and workplace conditions in each case. They are also writing about the people behind the statistics — their personalities, passions and quirks — and telling the story of every life lost. Exclusive stories by the reporters have revealed that many health care workers are using surgical masks that are far less effective than N95 masks and have put them in jeopardy. Emails obtained via a public records request showed that federal and state officials were aware in late February of dire shortages of PPE. Further investigations found that health workers who contracted the coronavirus and their families now struggle to access death and other benefits in the workers’ compensation system.
A virtual funeral changes perspective (Jack ElHai, Medium, 4-13-2020) "I recently attended a virtual funeral broadcast with Zoom, and the result was that I felt distant from the deceased but close to my fellow mourners." (Shefali Luthra, KHN, 5-1-2020) Among other things, Germany, Ireland, Belgium and Canada have all tested a much larger percentage of the population than the United States has. By any meaningful metric of diagnosing and tracking, the United States is still well behind countries like Germany and Canada.
Why Is the Pandemic Killing So Many Black Americans? Linda Villarosa, a writer for The New York Times Magazine covering racial health disparities, who spoke to Nicole Charles in New Orleans about the death of her husband, Cornell Charles, known as Dickey. He was 51.
‘My Boyfriend Died of COVID-19’ (Video by Olmo Parenti, The Atlantic, 4-20-2020) From the diary of a Chinese girl living in Wuhan during the coronavirus epidemic. As 2019 drew to a close, a young woman, Niuniu, and her fiancé, Tongsheng, looked forward to a bright future. Like many victims of this pandemic, Tongsheng had difficulty accessing medical care. In( mid-January, he died alone in a hospital waiting room.
Married for 50 years, a couple are separated by the coronavirus (Joshua Schneyer, Reuters, 4-10-2020)

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A salute to the medical workers who lose their lives


In Memoriam: Healthcare Workers Who Have Died of COVID-19 (Medscape) (with an A-Z directory) See also Remembering Thousands of the World's Healthcare Workers Lost to COVID (Marcia Frellick, Medscape, 8-21-2020)
Over 900 Health Workers Have Died of COVID-19. And the Toll Is Rising. (Danielle Renwick, The Guardian and Shoshana Dubnow, 8-11-2020) KHN and The Guardian unveil an interactive database documenting front-line health care worker deaths. The majority of them are people of color — and nurses face the highest toll. See the Lost on the Frontline database KHN and The Guardian unveil an interactive database, tracking health care workers who died from COVID-19 and writing about their lives and what happened in their final days. Read their stories. Confirmed deaths by occupation, by race and ethnicity, by state. See also Behind The Byline: Producing “Lost on the Frontline” In this video series on how KHN stories get made, come along as our producer describes the important, though difficult, responsibility of documenting health care worker deaths due to coronavirus.
The Reprieve (This American Life) Michigan has passed its Covid-19 peak, and the state has started opening up. But it’s still been intensely difficult for the staff in the ICU at Henry Ford Hospital in Detroit. We've embedded with them over the past few months, and tracked how this pandemic has changed them and their city.
Lost on the Frontline (The Staffs of Kaiser Health News and The Guardian, 5-12-2020) A pharmacist who refused to let the patients down. A police officer turned nurse. A school nurse who “was a mother to many.” These are some of the people just added to “Lost on the Frontline,” a special series from The Guardian and KHN that profiles health care workers who die of COVID-19.
The Pandemic Experts Are Not Okay (Ed Yong, The Atlantic, 7-7-2020) America isn’t just facing a shortfall of testing kits, masks, or health-care workers. It is also looking at a drought of expertise, as the very people whose skills are sorely needed to handle the pandemic are on the verge of burning out. “As the pandemic once again intensifies, so too does their frustration and fatigue,” Ed Yong reports.
Voices from the Pandemic A collection of accounts from people who have been sharing their personal stories about covid-19. As told to Eli Saslow (Washington Post oral history collection)

---‘It was impossible. It’s still impossible.’ (4-19-2020) Mikaela Sakal, on being an ER nurse in an overwhelmed hospital and the decision she had to make.
---‘Wearing a mask won’t protect us from our history.’ 4-11-2020) Burnell Cotlon, whose grocery store in New Orleans has become a food pantry. "I’ve got 62 tabs in the book now. From zero to 62 in less than a month. It’s page after page of customers on credit. I’m out almost $3,000 so far." When a customer dies, he crosses them off the list.
---‘You’re basically right next to the nuclear reactor.’ (4-5-2020) Cory Deburghgraeve, on performing one of the pandemic’s most dangerous jobs. "I could be the last person some of these patients ever see, or the last voice they hear. A lot of people will never come off the ventilator. That’s the reality of this virus. I force myself to think about that for a few seconds each time I walk into the ICU to do an intubation."
---‘Is this another death I’ll have to pronounce?’ (4-25-2020) Michael Fowler, Dougherty County coroner, on the reopening of Georgia. 'I’m always driving, going back-and-forth between nursing homes, the hospital, and the morgue. All these roads should be empty if you ask me. But now I see people out running errands, rushing back into their lives, and it’s like: “Why? What reason could possibly be good enough?” Sometimes, I think about stopping and showing them one of the empty body bags I have in the trunk. “You might end up here. Is that worth it for a haircut or a hamburger?”'
12 Fraught Hours With E.M.T.s in a City Under Siege. (Jan Hoffman, NY Times, 4-1-2020) "Special units of emergency medical workers in Paterson, N.J., respond to 911 calls for suspected coronavirus.... The crisis has turned an already difficult job upside down. A few weeks ago, a 911 call for “respiratory distress” would have sent emergency medical technicians — E.M.T.s — rushing into the building to examine the man and take his vitals. Now with coronavirus infections sweeping through the region, the emergency medical workers of Paterson, a poor, industrial city in the penumbra of pandemic-stricken New York, are working in a new, upside-down reality: Don’t go in a home, don’t touch the patient, and don’t take anyone to the hospital, unless absolutely necessary."
The survivors of Covid-19 (Mandy Zuo, South China Morning Post, 4-5-2020) As Wuhan cases decline, a visiting doctor remains behind to help the city recover. Second in a SCMP series about Covid-19 survivors.
It's shameful how many health-care workers are dying from Covid-19 (Kent Sepkowitz, CNN, 4-15-2020) See also CDC data for Feb 12-April 9 "Of 9,282 U.S. COVID-19 cases reported among HCP [health care personnel], median age was 42 years, and 73% were female, reflecting these distributions among the HCP workforce. HCP patients reported contact with COVID-19 patients in health care, household, and community settings. Most HCP patients were not hospitalized; however, severe outcomes, including death, were reported among all age groups."
Spiritual Care at the Front Lines of the Pandemic (Jenna Barnett, Sojourners, 5-6-2020) Spiritual care in times like these can look quite casual — like gently showing up. In a typical work week, members of one woman’s spiritual care team spend about 70 percent of their time attending to patients and 30 percent offering care to staff. COVID-19 has nearly flipped that ratio. The chaplains wear masks and have their temperatures checked upon arrival so that they can continue to safely care for both patients and staff.
First Denial, Then Fear: Covid-19 Patients in Their Own Words (Wired) People infected with the coronavirus try to cope as the crisis accelerates. The professionals taking care of them are quickly becoming overwhelmed. This is the start of Wired's living oral history of the Covid-19 pandemic, an attempt to capture in real time the stories playing out across our country, in the words of those who are experiencing the crisis. This installment focuses on people who are ill right now (or suspect they are sick) because of the virus, along with the voices of doctors and health care workers taking care of them.

More to come.

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SARS, MERS, and other forms of coronavirus

 "SARS-CoV-2 is the virus. COVID-19 is the disease that it causes. The two aren't the same. " ~ Ed Yong

 

 

Coronavirus is a family of viruses that are named for the spikes on their surfaces, which have a crown-like appearance.The viruses can cause the common cold or more severe diseases such as SARS (severe acute respiratory syndrome), MERS (Middle East respiratory syndrome) and COVID-19, the latter of which first appeared in late 2019 in Wuhan, China.


Coronavirus (World Health Organization) Coronaviruses are zoonotic, meaning they are transmitted between animals and people. Detailed investigations found that SARS-CoV was transmitted from civet cats to humans and MERS-CoV from dromedary camels to humans. Several known coronaviruses are circulating in animals that have not yet infected humans.
• "In 2002, SARS spread virtually unchecked to 37 countries, causing global panic, infecting more than 8,000 people and killing more than 750. MERS appears to be less easily passed from human to human, but has greater lethality, killing 35% of about 2,500 people who have been infected." ~ The Guardian
Middle East respiratory syndrome coronavirus (MERS-CoV) (WHO Fact Sheet, 3-11-19) Symptoms, source, method of transmission, prevention and treatment, etc. Approximately 35% of reported patients with MERS-CoV infection have died. Approximately 80% of human cases have been reported by Saudi Arabia.
COVID-19, MERS & SARS (NIH/NIAID) Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). A novel coronavirus (nCoV) is a new strain that has not been previously identified in humans.

     Research evidence suggests that SARS-CoV-2, MERS-CoV, and the original SARS-CoV all originated in bats. SARS-CoV then spread from infected civets to people, while MERS-CoV spreads through infected dromedary camels to people. Scientists are trying to determine how SARS-CoV-2 spread to people.    
Middle East respiratory syndrome coronavirus (MERS-CoV) (WHO)
Severe Acute Respiratory Syndrome (SARS)
Scientists Compare Novel Coronavirus with SARS and MERS Viruses (Abby Olena, The Scientist, 2-11-2020) Researchers find 380 amino acid substitutions between 2019-nCoV and severe acute respiratory syndrome (SARS)-related coronaviruses. "We’re all wondering where this virus came from, and we can see from the new sequence and the sequences that we’ve already had for coronaviruses that it’s likely to be a recombinant of a number of different coronaviruses that are known." ~ Rachel Roper, East Carolina University
How Does Wuhan Coronavirus Compare With MERS, SARS and the Common Cold? (Pien Huang , Goats and Soda, NPR, 1-22-2020) Chart shows what the four coronaviruses have in common and how they differ.

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Facts and tips that don't fit elsewhere

 

Swine Flu (H1N1) was very contagious but not very fatal.

SARS virus was very fatal but not very contagious.

Covid19 is both fatal and very contagious.

 


Get My Payment (IRS site to learn when you will get your stimulus check)
PSA: Please stop microwaving your books to get rid of coronavirus (Marika Gerken, CNN, 7-4-2020) Library books contain a metallic radio frequency identification (RFID) tag that can and will burn in a microwave and can also catch on fire. Libraries can quarantine each book for 72 hours after it’s returned to them.

   Nor is it a good idea to spray the books with disinfectant -- not good for the book!
PPP Loan Forgiveness Application Guidance for the Self-Employed, Freelancers and Contractors (Brian Thompson, Forbes,5-18-2020) A useful explanation of PPP loan forgiveness for freelancers. You will almost certainly have to pay a portion of the loan back--still, a good deal. (H/T ASJA)
I Survived COVID-19. How Can I Give Back? (Michele Turk, Next Avenue) A good service piece about donating your plasma, after you recover from COVID-19.
Donating your body to science (Science Care)
What would happen if the world reacted to climate change like it’s reacting to the coronavirus? (Adele Peters, Fast Company, 3-10-2020) What would a fast, coordinated, collective response to climate change look like?
How prepared are you for disaster?
The psychological aspects of dealing with pandemics (American Psychological Association, many stories)
The Smithsonian Is Collecting Coronavirus 'Artifacts' To Document The Pandemic (Mikaela Lefrak, Weekend Edition, NPR, 5-20-2020)
Tips and tricks for grocery shopping online during the coronavirus pandemic (Courtney Campbell, Reviewed.com, USA Today, 4-10-2020)
What Everyone’s Getting Wrong About the Toilet Paper Shortage (Will Oremus, Marker/Medium, 4-2-2020). The home-toilet-paper market is pretty steady, but suddenly demand is up 40%. Demand in the commercial-establishment-toilet-paper market, also typically steady, is way down. "Not only is it not the same product, but it often doesn’t come from the same mills." See also Coronavirus and shopping for supplies: Getting to the bottom of the toilet paper shortage (Brent Schrotenboer, USA Today, 4-8-2020) A fundamental shift in demand for a certain kind of toilet paper for use at home, kinks in the supply chain between factories and stores, hoarding, people going to the bathroom more than normal and at home more. Office TP is typically one-ply; home, two-ply (and softer).
Here’s where you can buy toilet paper right now (Shayna Murphy, Reviewed.com, USA Today, 4-14-2020) Further reading: Toilet paper (Wikipedia's long entry)
The Safe Way to Donate Blood During the Coronavirus Pandemic (Lisa L. Gill, Consumer Reports, 5-8-2020) With blood supplies critically low, giving now can help, especially if you've already recovered from COVID-19.
The little book sellers that could: How indie stores managed to take a slice of Amazon business (Sindya N. Bhanoo, Washington Post, 4-24-2020) The coronavirus pandemic has exacerbated the retail apocalypse, with Neiman Marcus, Macy’s and Gap fighting for survival. But it has also created a few openings for savvy independent retailers who are willing to up their online shopping game. "In January, before life in America was upended by the coronavirus, a start-up called Bookshop.org launched a beta site to sell books online. Its goal was simple: to slice off a sliver of Amazon’s giant share of book sales and push it toward indie bookstores, which have long struggled to maintain footing in the business." A few "independent retailers have rapidly pivoted toward e-commerce, in some cases using strikingly low-tech analog systems to retaliate against Amazon, which itself went live as a small online retailer of books 25 years ago."
How ‘Karen’ Became a Coronavirus Villain (Kaitlyn Tiffany, The Atlantic, 5-6-2020) A popular joke about entitled white women is now a big pandemic meme.
Why I’m Not Coloring My Own Hair During Quarantine—And You Shouldn’t Either (Dawn Weinberger, Reader’s Digest, 4-13-2020) DIY hair color is a disaster waiting to happen.

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Coronavirus humor, observation, and inspiration


With a Kiss I Die (Anthony Lane, Shouts & Murmurs, New York, 8-17-2020) Romeo & Juliet, adapted to Covid-19: When she leans over the balcony without a mask, she sprays Romeo with droplets, etc.
The Pandemic in Six-Word Memoirs (Larry Smith, NY Times, 9-12-2020) "Every day’s a bad hair day."— Leigh Giza
Outside by the funny but serious Israeli author Etgar Keret, part of a New York Times series: The Decameron Project: "When reality is surreal, only fiction can make sense of it....As the Covid-19 pandemic swept the world, we asked 29 authors to write new short stories inspired by the moment. We were inspired by Giovanni Boccaccio’s 'The Decameron,' written as the plague ravaged Florence in the 14th century." Read Rivka Galchen’s essay on that book here. And read the stories in our all-fiction issue here. Includes stories by Margaret Atwood, Edwidge Danticat, Tommy Orange,Charles Yu, Karen Russell, David Mitchell, and a dozen others.
Care home residents recreate record covers (BBC, UK) Residents and carers at a north London care home have been recreating classic album covers to keep themselves occupied during the lockdown. Check out the photos. The residents had "absolutely loved" the creations.
Gee, Anthony Fauci (delightful Randy Rainbow musical number makes fun of Dr. Fauci and the Trumps, one lovingly, the others not so much)
Looking for Love During COVID-19 (Tami Kamin Meyer, Next Avenue, 7-31-2020) Despite the pandemic, older singles are still hoping for connection.
Carefully Forming a ‘Quarantine Bubble’ Can Fight Loneliness (Melissa Hawkins, Next Avenue, 7-24-2020) Contracting the coronavirus is not the only major health risk to consider.
Crisis and Beholding (Benjamin Chan, Hedgehog Review, 5-14-2020) The importance of learning to see beyond our preoccupations.
‘You Never Call Us. We Didn’t Know You Cared.’ (Caroline Shin, NY Times,5-28-2020) How the pandemic healed our broken family.
I Have Learned (Heather Buchanan, The Independent, 3-24-2020) "I have learned that when there is one house on fire, everyone rushes to bring water to stop the flames, but when everyone’s house is on fire, you just try to get out alive."
Coronavirus horse race (Terrence K. Williams) Pretty darned funny.
Your new normal in my old home office during coronavirus (Kevin McKeever, CT Insider, 4-2-2020) What happens when the freelancer's executive-level wife is forced to stay home and share space with him.
10 Positive Updates on the COVID-19 Outbreaks From Around the World (McKinley Corbley, Good News Network, 3-17-2020) 1) US Researchers Deliver First COVID-19 Vaccine to Volunteers in Experimental Test Program. 2) Distilleries Across the United States Are Making Their Own Hand Sanitizers to Give Away for Free. 3) Air Pollution Plummets in Cities With High Rates of Quarantine. And so on.
‘Show Up With Hope’: Anne Lamott’s Plan for Facing Adversity (Anne Lamott, National Geographic, 10-2018) With Earth beset by conflict, climate change, pollution, and other ills, the best-selling author asks: What better time to be hopeful?
Hugh Weber’s twitterfeed on reactions to his 11-year-old’s love letter to the post office .
We're All Home Bound -- The Coronavirus Song (YouTube) Claire and Mel Vatz of Pittsburgh sing a delightful ode to our worldwide crisis, to the tune of the Simon & Garfunkel classic “Homeward Bound.” They did it for friends but it went viral.
Dance Song (for the End of the World) 5-minute Quarantine music video (music by Lizzy Shapiro & The Triggermen, dancing by a delightful variety of people)
The Broadway Coronavirus Medley (YouTube—funny)
A Letter from the Condo Association to Mr. and Mrs. Macbeth (McSweeney’s)
Coronavirus memes capture humor in social distancing, test kits, toilet paper, and family relationships

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COVID-19's economic impact

H/T to WBUR for the links that got this section going.


American Passports Are Useless Now (Yascha Mounk, The Atlantic, 8-14-2020) "I can go just about anywhere with my German passport. But almost no one wants to let in Americans these days. My American passport can gain me access to only a handful of countries—not including Germany or the majority of developed democracies in Asia, Europe, Australia, or South America. The coronavirus is so out of control here that other nations (understandably) fear contamination from our citizens."
•  More Americans file for unemployment as extra $600 benefit ends and COVID-19 surges (Charisse Jones, USA Today, 7-30-2020) The need continues to grow even as an extra $600 a week from the federal government ended, a cushion many economists said was critical to bolster state payments that typically average $370. It's the second week in a row that initial claims have gone up--rising by 12,000--a worrying trend in the wake of a 15 week stretch that saw applications gradually declining.
Second-quarter GDP plunged by worst-ever 32.9% amid virus-induced shutdown (CNBC, 7-30-2020)
To Stay Afloat in the Pandemic, Doctors’ Offices Turn to GoFundMe (Brooke Borel, Undark, 5-9-2020) Small primary care practices are turning to crowdfunding to survive. If they don’t make it, it’s a loss for all of us.
Underfunded and Under Threat (KHN and the AP) A series examining how the U.S. public health front lines have been left understaffed and ill-prepared to save us from the coronavirus pandemic. Hollowed out public health system faces more cuts amid virus. The U.S. public health system has been starved for decades and it lacks the resources to confront the worst health crisis in a century. Sample articles in the series:
---Six Takeaways of the KHN-AP Investigation into the Erosion of Public Health (7-1-2020) (1) Since 2010, spending for state public health departments has dropped by 16% per capita, and for local health departments by 18%. (2) At least 38,000 state and local public health jobs have disappeared since the 2008 recession, leaving a skeletal workforce in what was once viewed as one of the world’s top public health systems. (3) Nearly two-thirds of Americans live in counties that spend more than twice as much on policing as they spend on non-hospital health care, which includes public health. (4) More than three-quarters of Americans live in states that spend less than $100 per person annually on public health. Spending ranges from $32 in Louisiana to $263 in Delaware. (5) Some public health workers earn so little that they qualify for government assistance. During the pandemic, many have found themselves disrespected, ignored or even vilified. (6) States, cities and counties whose tax revenues have declined during the current recession have begun laying off and furloughing public health staffers.
---Essential and in Danger: Coronavirus Sickens, Even Kills Public Health Workers (Laura Ungar, KHN, 7-22-2020) As the coronavirus threatens the nation’s public health army, an outbreak in Maryland reflects the tension between serving the community and protecting workers from a deadly disease.
---Disease-Carrying Mosquitoes Fly Free as Health Departments Focus on Coronavirus (Anna Maria Barry-Jester and Lauren Weber, KHN, 7-16-2020) Health departments and other public agencies tasked with protecting the nation from disease-carrying mosquitoes are overstretched amid the coronavirus pandemic — even as the nation is told it’s safest to be outside. There are more articles in this series.
Here are the newsroom layoffs, furloughs and closures caused by the coronavirus (Poynter) We're updating this list almost daily.
America’s hidden economic crisis: Widespread wage cuts (Politico, 7-19-2020) Employers are using pay cuts to stay afloat during the recession, an unusual move that could signal deep damage to the labor market.
‘A very dark feeling’: Hundreds camp out in Oklahoma unemployment lines (Annie Gowen, WashPost, 7-20-2020) "In the four months since the pandemic began, nearly 50 million workers have filed unemployment claims nationwide, a flood that’s overwhelmed some states, freezing antiquated computer systems and jamming websites and phone lines for days. State benefit agencies in some parts of the country have evoked memories of Great Depression bread lines."
Inside the fight for denied compensation for healthcare workers (Video/TV: Christina Jewett and Hari Sreenivasan, PBS NewsHour/KHN, 7-20-2020) As COVID cases in the U.S. continue to soar, health care workers on the front lines are increasingly getting sick and even dying of the disease. What often happens and how some employers evade paying benefits.
The Looming Bank Collapse (Frank Partnoy, The Atlantic, June-July 2020) After months of living with the coronavirus pandemic, American citizens are well aware of the toll it has taken on the economy: broken supply chains, record unemployment, failing small businesses. Banks learned few lessons from the 2008 crash and the one that may be coming could be worse. Could the U.S. be on the verge of a financial crash? Listen to Partnoy discuss the problem on radio, along with Rep. Katie Porter, Democratic representative from California: Coronavirus Economy: Are Big Banks on the Verge of Financial Crisis? (On Point, WBUR and NPR, 7-9-2020) Could the U.S. be on the verge of a financial crash? Partnoy talks about the risks big banks are taking. "The financial crisis of 2008 was about home mortgages. Hundreds of billions of dollars in loans to home buyers were repackaged into securities called collateralized debt obligations, known as CDOs....In late 2007, banks began disclosing tens of billions of dollars of subprime-CDO losses....Just as easy mortgages fueled economic growth in the 2000s, cheap corporate debt has done so in the past decade, and many companies have binged on it." The CLO, or collateralized loan obligation, "walks and talks like a CDO, but in place of loans made to home buyers are loans made to businesses—specifically, troubled businesses."
The High-Finance Mogul in Charge of Our Economic Recovery (Sheelah Kolhatkar, New Yorker, 7-20-2020) How Treasury Secretary Steven Mnuchin became one of the most consequential policymakers in the world.
Quietly cashing in on coronavirus(Kyle Cheney, The Huddle, Politico, 6-16-2020) “At least four lawmakers or their families have benefited directly from the multibillion-dollar loan program Congress set up to support small businesses rocked by the pandemic.”
In 2008, Everyone Thought The Recession Was Bad. But in 2020, Many Americans’ Views Depend On Their Party. (Michael Tesler, FiveThirtyEight, 6-30-2020) “The U.S. economy is objectively awful right now. The unemployment rate is at levels not seen since the Great Depression and this quarter’s decline in gross domestic product is expected to be the worst on record....Even when Republicans’ outlook on the economy was at its lowest point this year, according to Civiqs data, they still felt more upbeat about the state of the economy than at any point in 2016 before Trump was elected, when the economy was objectively better....And a long line of social science research shows that when political elites are sharply divided — as they are now over the economy — the public follows the lead of the elites. That is, partisan messaging is now so powerful that Americans tend to adopt their party’s standpoint even when that position runs counter to science or objective facts.”
Scenes From a Restaurant That Just Fired Its Entire Staff (Anna Bradley-Smith, Coronavirus Diaries, Slate, 3-16-2020) "We have no sick pay, no holiday pay, no safety net, and no income. We got a promise to rehire us whenever this crisis is under control. But promises can’t pay rent. It’s due in two weeks."
The lives upended around a $20 cheeseburger (Jessica Contrera, Washington Post, 7-7-2020) A cash-strapped rancher, a virus-stricken meatpacker, an underpaid chef, a hungry engineer: The journey of a single burger during a pandemic. "Before the pandemic, the most popular French bistro in the nation’s capital didn’t offer to-go orders...." Narrative nonfiction meets economic analysis. Fascinating, but sets off cravings.
The Fed is cracking down on big banks to guard against risk posed to the financial system from coronavirus (Renae Merle and Rachel Siegel, WaPo, 6-25-2020) "For the first time since the aftermath of the Great Recession, the Federal Reserve is putting new restrictions on how the country’s biggest banks spend capital, with an eye toward protecting the financial system from risks to the economy posed by the coronavirus pandemic."
Big banks stand to earn hundreds of millions from PPP loan fees (Alison Kosik and Anneken Tappe, CNN, 7-7-2020) “America’s largest banks are set to earn hundreds of millions of dollars in fees paid out by the federal government under its Paycheck Protection Program, according to S&P Global.”
Recession Forces Spending Cuts on States, Cities Hit by Coronavirus (David Harrison, WSJ, 7-8-2020) Education takes the brunt of reductions: “State and local governments from Georgia to California are cutting money for schools, universities and other services as the coronavirus-induced recession wreaks havoc on their finances.” Governments have cut 1.5 million jobs since March, with more expected.
How scientific societies are weathering the pandemic’s financial storm (Diana Kwon , Nature, 7-13-2020) As conference cancellations cut revenue, some scholarly organizations are fighting to stay afloat.
Fed officials raised concerns in June that U.S. could enter a much worse recession later this year if coronavirus cases continued to surge (Rachel Siegel, Washington Post, 7-1-2020) Notes from a two-day meeting reveal how interconnected Fed officials view a prolonged economic recession and the pandemic’s continued spread — and why Fed Chair Jerome H. Powell often asserts that lawmakers will need to do more to carry millions of Americans out of this crisis. Powell "has repeatedly said that the path out of this recession, which began in February, will depend on containing the virus and giving Americans the confidence to resume normal working and spending habits."
Lessons from the 2008 financial crisis for our coronavirus recovery today (The Conversation, 7-8-2020) “In this sixth and final episode of Recovery, a series from The Anthill Podcast exploring how the world rebuilt after historic crises, we look at the 2008 global financial crisis." The government response to the crisis had some unintended consequences, says Anastasia Nesvetailova, professor of international political economy at City, University of London. "Low interest rates and easy access to capital made those who were already wealthy even wealthier, drove up asset prices (like property) and failed to stimulate the economy in a way that benefited everyone."
COVID-19-related emergency funds and grants for writers (Writers and Editors website)

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Life after the coronavirus

Uncharted (The Atlantic, a great series about the world we’re leaving behind, and the one being remade by the pandemic, May 2020)

A mere sampling:
---When Will We Want to Be in a Room Full of Strangers Again? (Helen Lewis, 5-12-2020) Theater, an industry full of optimists, is reckoning with a heartbreaking realization.
---Celebrities Have Never Been Less Entertaining (Spencer Kornhaber, 3-21-2020) Top singers and actors are live-streaming from quarantine, appearing equally bored and technologically inept.
---Good Riddance to the Handshake (Megan Garber, 5-11-2020) A terrible custom is gone for good. Hallelujah.
---Air Travel Is Going to Be Very Bad, for a Very Long Time (James Fallows, 5-11-2020) Flying used to be unpleasant. But scarcity, low demand, and public-health risks could make it unbearable.
---Work From Home Is Here to Stay (Olga Khazan, 5-4-2020) The future of jobs after the pandemic is a blurry mix of work, life, pajamas, and Zoom.


Survivor Corps. Survivor Corps is one of the largest and fastest growing grassroots movements connecting, supporting, educating, motivating and mobilizing COVID-19 survivors to support all Medical, Scientific and Academic research, to help stem the tide of this pandemic and assist in the national recovery. Some of its webinars:
---What We Know About Long Haulers” (Dr. David Putrino, Director, Rehabilitation Innovation, and CPCC: Center for Post Covid Care, Mount Sinai Health System and Diana Berrent, founder of Survivor Corps)
--- “Long Haulers: Symptoms & Strategies” - with Dr. David Putrino, Director, Rehabilitation Innovation and CPCC: Center for Post Covid Care, Mount Sinai Health System and Diana Berrent, Survivor Corps.
---“Convalescent Plasma during COVID-19 Pandemic” - with Dr. Claudia Cohn, MD, PhD, Chief Medical Officer, AABB (American Assoc. Of Blood Banks) and Diana Berrent, Survivor Corps.
---“Survivor Corps & COVID-19” - FPC Briefing at US State Department and Foreign Press Center: with Dr. Eldad Hod, MD, Columbia University (Plasma Trial) and Diana Berrent, Survivor Corps.
Some Recovered COVID Patients Shunned Or Stigmatized (Kaiser Health News Morning Briefing, 7-21-2020) A Mayo Clinic publication interviews people who had the virus who report being treated differently since recovering. For example, Los Angeles Times: Don Udan spent almost three weeks on a ventilator while hospitalized with COVID-19, but he has been slowly returning to his normal life since being discharged April 21. Every so often, though, he has a wake-up call that life may be different for a while. “When I had my appointment to get an ultrasound on my leg, the tech found out I was in a hospital diagnosed with COVID, and she right away left the room,” Udan said. “She kind of freaked out.”
What Will Work-Life Balance Look Like After the Pandemic? (Bobbi Thomason and Heather Williams, Harvard Business Review, 4-16-2020) The Covid-19 crisis has shoved work and home lives under the same roof for many families like ours, and the struggle to manage it all is now visible to peers and bosses. We can hope that one major shift after the pandemic will be a move away from the harmful assumption that a 24/7 work culture is working well for anyone.
What Will Life Be Like After the Pandemic? (Manfred F. R. Kets de Vries, Knowledge, Insead, 4-23-2020) "More than anything, the coronavirus has highlighted existing political, economic and social dysfunctionalities. It has also shown the crisis of leadership. Kets de Vries suggests two possible scenarios:
---Scenario 1: Populations may become more willing to hand over control to governments. As a rule, when we are frightened, we are more willing to cut down on civil liberties. Even when leaders pretend to be democratic, under the right conditions, the inner autocrat may emerge.
---Scenario 2: Crises can also create solidarity. The present pandemic could spur us to tackle issues that we have always been quite aware of but have preferred to ignore. Despite the enormous number of jobs lost, could the pandemic be an opportunity to direct our energies to other kinds of activities? What parts of the economy would we like to restore, and what parts could we do without?

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Quotations and verse to see us through the pandemic

 


Oh, life is a glorious cycle of song,
A medley of extemporanea;
And love is a thing that can never go wrong;
And I am Marie of Romania.
~ Dorothy Parker, in Not So Deep as a Well

 

• Live your life the way you want to be remembered.

• "It is not by muscle, speed, or physical dexterity that great things are achieved, but by reflection, force of character, and judgment; and in these qualities old age is usually not only not poorer, but is even richer." — Cicero (106-43 B.C.)

•"The years between 50 and 70 are the hardest. You are always being asked to do things, and yet you are not decrepit enough to turn them down."~ T. S. Eliot
"BACKWARD, turn backward, O Time, in your flight,
Make me a child again just for to-night!" ~ from the poem Rock Me to Sleep by Elizabeth (Akers) Allen (full text appears on Bartleby.com)

• "Some people are so afraid to die that they never begin to live." ~Henry Van Dyke
• "The idea is to die young as late as possible." ~Ashley Montagu

• David Shields' excellent autobiography of his body, The Thing About Life Is That One Day You'll Be Dead, is a fascinating little book about life and death and about what's happening to your body enroute from one to the other. Don't read it if you don't want to hear the bad news, but it does help explain things like why you have to make more trips to the bathroom as you age. See quotations from the book on the Amazon site. For example: "You're born with 350 bones (long, short, flat, and irregular); as you grow, the bones fuse together: an adult's body has 206 bones. Approximately 70 percent of your body weight is water—which is about the same percentage of the earth's surface that is water."

• "Life may not be the party we expected, but while we're here, we might as well dance." ~ spotted on a tee shirt at Glen Echo's Spanish Ballroom
• "And those who were seen dancing were thought to be insane by those who could not hear the music." ~Friedrich Nietzsche
• "Fate is like a strange, unpopular restaurant filled with odd little waiters who bring you things you never asked for and don't always like." — Lemony Snicket

• "Sexiness wears thin after awhile and beauty fades, but to be married to a man who makes you laugh every day, ah, now that is a treat." — Joanne Woodward
• "Growing older is like climbing a mountain: the higher you get, the more strength you need, but the further you see." — Ingmar Bergman
• "My grandfather always said that living is like licking honey off a thorn." — Louis Adamic

• "The idea is to die young as late as possible." ~Ashley Montagu
• "New poems no longer come to me, with their prodigies of metaphor and assonance. Prose endures. I feel the circles grow smaller, and old age is a ceremony of losses, which is on the whole preferable to dying at forty-seven or fifty-two. When I lament and darken over my diminishments, I accomplish nothing. It’s better to sit at the window all day, pleased to watch birds, barns, and flowers. It is a pleasure to write about what I do." — Donald Hall, Out the Window (The New Yorker, 1-23-12)
• Religion is following the messenger. Spirituality is following the message.
• “We must always take sides. Neutrality helps the oppressor, never the victim. Silence encourages the tormentor, never the tormented.” — Elie Wiesel
• "You only live once, but if you do it right, once is enough." — Mae West
• "The alternative to growing old is dying young." — Sally Field
• "A man is not old until regrets take the place of dreams." — John Barrymore
• "Love lights more fires than hate extinguishes." — Ella Wheeler Wilcox
• "The most common way people give up their power is by thinking they don't have any." — Alice Walker
•"You're never too old to become younger." ~ Mae West

"Joy is the happiness that doesn't depend on what happens." — David Steindl-Rast, a Benedictine monk and teacher, founder of A Network for Grateful Living, author of David Steindl-Rast: Essential Writings
"One rule of the game, in most times and places, is that it’s the young who are beautiful. The beauty ideal is always a youthful one. This is partly simple realism. The young are beautiful. The whole lot of ’em. The older I get, the more clearly I see that and enjoy it...
Attitude is (nearly) everything
"And yet I look at men and women my age and older, and their scalps and knuckles and spots and bulges, though various and interesting, don’t affect what I think of them. Some of these people I consider to be very beautiful, and others I don’t. For old people, beauty doesn’t come free with the hormones, the way it does for the young. It has to do with bones. It has to do with who the person is. More and more clearly it has to do with what shines through those gnarly faces and bodies."
— Ursula LeGuin: Aging and What Beauty Really Means
“Imagination is more important than knowledge. Knowledge is limited. Imagination encircles the world.” ~Albert Einstein
“To enjoy and give enjoyment, without injury to yourself or others; this is true morality.” ~ Nicolas Chamfort
“Usefulness is not impaired by imperfection; you can drink from a chipped cup.” ~ Greta K. Nagel
“The afternoon knows what the morning never suspected.” ~ Robert Frost
"Forever is composed of nows." ~ Emily Dickinson

“In any given moment we have two options: to step forward into growth or to step back into safety.” ~ Abraham Maslow.
"Learn from the mistakes of others. You can't live long enough to make them all yourself." ~ Eleanor Roosevelt
“That is happiness; to be dissolved into something complete and great. When it comes to one, it comes as naturally as sleep.” ~ Willa Cather
“What is to give light must endure burning.” ~ Viktor Frankl
" We are not all born at once, but by bits. The body first, and the spirit later... Our mothers are racked with the pains of our physical birth; we ourselves suffer the longer pains of our spiritual growth."~ Mary Austin
" Life is not a matter of holding good cards, but of playing a poor hand well." ~ Robert Louis Stevenson
"Perhaps one of the gifts of old age is that nothing stands between us and what we see." ~ May Sarton, Kinds of Love
"No one can make you feel inferior without your consent." ~Eleanor Roosevelt
"Love makes your soul crawl out from its hiding place." ~ Zora Neale Hurston
"The enemy is fear. We think it is hate, but it is fear." ~Gandhi
" I am not eccentric. It's just that I am more alive than most people. I am an unpopular electric eel set in a pond of catfish." ~ poet Edith Sitwell
"There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle." ~ Albert Einstein
"Wabi-sabi is flea markets, not warehouse stores; aged wood, not Pergo; rice paper, not glass. It celebrates cracks and crevices and all the other marks that time, weather, and loving use leave behind. It reminds us that we are all but transient beings on this planet--that our bodies as well as the material world around us are in the process of returning to the dust from which we came. Through wabi-sabi, we learn to embrace liver spots, rust, and frayed edges, and the march of time they represent."
~What Is Wabi Sabi?, from the book The Wabi-Sabi House: The Japanese Art of Imperfect Beauty by Robyn Griggs Lawrence and Joe Coca
"Your vocation in life is where your greatest joy meets the world's greatest need." ~ Frederick Buechner
"Aging brings home to us what we have done or failed to do with our lives, our creativity or our waste, our openness to zealous hiding from what really matters. Precisely at this point, age cracks us open, sometimes for the first time, makes us aware of the center, makes us look for it in relation to it. Aging does not mark an end but rather a beginning of making sense of end questions, so that life can have an end in every sense of the word." ~ Ann Belford Ulanov, writing about why older people are able to be such effective ministers, in Aging: On the Way to One’s End (Harper & Row, 1981), p. 122
"Ripe old age, cheerful, useful, and understanding, is one of the finest influences in the world."
~ Ida Tarbell, The Business of Being a Woman
Fame is a bee It has a song—— It has a sting—— Ah, too, it has a wing. ~ Emily Dickinson


“We're all just walking each other home.” ~Ram Dass

Quotations, section 2
“I will age ungracefully until I become an old woman in a small garden, doing whatever the hell I want.” ~ Robin Chotzinoff
The Paradox of Choice. Psychologist Barry Schwartz takes aim at a central tenet of western societies: freedom of choice. In Schwartz's estimation, choice has made us not freer but more paralyzed, not happier but more dissatisfied. "The secret to life is low expectations." Great cartoons.
"If old age in the shape of waning strength says to me often, 'Thou shalt not!' so do my years smile upon me and say to me, 'Thou needst not.'
~ Mary Heaton Vorse, Autobiography of an Elderly Woman (1911)
"Old age would be the most happy of the stage of life, if only it did not know it was the last."
"Time is a dressmaker specializing in alterations." ~Faith Baldwin
What happens to a social media account after a person's death? --Great Lakes Caskets
"After one has lived a life of meaning, death may lose much of its terror, for what we fear most is not really death but a meaningless and absurd life." ~Robert Butler, author of Why Survive? Being Old in America
“The good physician treats the disease; the great physician treats the patient who has the disease.” ~Dr. William Osler
"No matter how fast light travels it finds the darkness has always got there first, and is waiting for it." ~ Terry Pratchett
Living with Lou: Dudley Clendinen on a Good, Short Life by Dudley Clendinen (NYTimes, 7-9-11). Living with Lou Gehrig's disease is about life, when you know there's not much left. And Writer Dudley Clendinen has chosen not to go to the great expense and limited potential of extending his life--but to enjoy what he can of it, while he can. He learned he had the disease when he was 66, and Maryland Morning, an NPR news station, has been airing conversations with him about how he and his daughter Whitney have been dealing with the disease and its implications. Listen to the podcasts: Living with Lou: Dudley Clendinen on a Good, Short Life (Maryland Morning, 2-21-11)
~ Comtesse Diane, Les Glanes de la Vie