Updated 8-28-23 (Bethesda, MD)
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Updated 8-28-23 (Bethesda, MD)
Posted by Pat McNees. This blog post has become a full website page, with categories, so it's easy to find what you're looking for. Go here:
Or click on one of the categories on that page, here:
Pandemic: The big picture
Social distancing and sheltering in place
Testing, testing, testing--and contact tracing
What patients with Covid19 experience
The race for effective vaccines and anti-viral treatments
Where things went wrong in the U.S.
Where in the world things went right
Politics and the coronavirus
Trump's handling of the pandemic
Why Covid-19 is so dangerous
Who is harmed most by the coronavirus?
Reliable sources of information (and against misinformation)
Death and the coronavirus
Remembering victims of the coronavirus
A salute to medical workers and others who help
Coronavirus humor and inspiration
Facts and tips that don't fit elsewhere
This was updated daily until 5-8-2020, when the entries were re-arranged in a more organized format and then updated further with more entries. For the time being I will leave the following copy below, but at some point I'll delete it as redundant.
A roundup of articles not so much about the coronavirus (SARS-CoV-2) but about how we're managing or mismanaging or stretching the truth about or fighting about how to manage the coronavirus. Let me know of any upbeat stories, as I'm mostly finding stories on the negative side. For basic info about surviving COVID-19 see What you need to know about coronavirus.
• 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.
• 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."
• 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.
• 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.
• Those We’ve Lost (New York Times) The coronavirus pandemic has taken an incalculable death toll. This series is designed to put names and faces to the numbers.
• 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."
• Trump’s Claim That U.S. Tested More Than All Countries Combined Is ‘Pants On Fire’ Wrong (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.
• 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."
• 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.
• ‘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.
• ‘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.”'
• 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 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.
• 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.
• 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.”
• $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)
• NYC morgues near capacity, DHS briefing warns (Politico, 3-25-2020)
• On keeping a diary or journal of the pandemic
• 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 these were sold out.]
• 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).
• 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.
• 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.
• 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) See also 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.
• 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.
• 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...
• 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 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."
• We Are Living in a Failed State (George Packer, The Atlantic, June 2020) The coronavirus didn’t break America. It revealed what was already broken.
• ‘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.
• 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.
• 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.
“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.” (3-16-2020)
• What If We Have to Decide Who Gets a Ventilator? (Daniela J. Lamas, Opinion, NY Times, 4-2-2020) Thinking about the choices we could have to make as we treat patients with the coronavirus breaks my heart. (Dr. Lamas is a critical care doctor.) See also this story about Italy's first Covid-19 patient: 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."
• '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."
• 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 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.
• 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)
• 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."
• Coronavirus Misinformation Tracking Center (NewsGuard)
• 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.
• 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, NY 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.
• 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)
• 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.)
• 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."
• '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.”
• Those We’ve Lost to the Coronavirus (New York Times obits of people who have died in the pandemic)
• Married for 50 years, a couple are separated by the coronavirus (Joshua Schneyer, Reuters, 4-10-2020)
• 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.
• 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.
• 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."
• 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?
• 100 Days That Changed the World (Michael Safi, The Guardian, 4-8-2020)
• 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.
• 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."
• 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.
• A Nurse Bought Protective Supplies for Her Colleagues Using GoFundMe. The Hospital Suspended Her. (Marshall Allen, ProPublica, 4-7-2020) Olga Matievskaya and her fellow intensive care nurses raised more than $12,000 to buy (on eBay) and distribute protective gear for their colleagues, who say they felt inadequately protected against COVID-19. But rather than thanking the staff, hospital administrators on Saturday suspended Matievskaya for distributing "unauthorized" protective gear.
• 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.
• 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.
• '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.
• A new battle zone for the coronavirus looms: the developing world (Paul Salopek, National Geographic, 4-6-2020) People in Mandalay, Myanmar’s second-largest city, are coming together in the face of a possible catastrophe.
• The Digital Burnout Was Coming. The Pandemic Is Expediting It. (Mary Alice Miller, Vanity Fair, 4-10-2020) 'A new book about our relationship with digital devices has come at the precise moment in which we’ve never been more dependent on them for working, socializing, and staying informed. Equal parts memoir and reported nonfiction, Attention: A Love Story, out now, chronicles author Casey Schwartz’s lifelong obsession with humanity’s ability—or lack thereof—to focus, with an emphasis on how the shift to an “attention economy” exacerbates the ancient conundrum of living in the here and now.'
“This is a rich inquiry into what it means to pay (and maintain) attention in a world increasingly permeated with distraction and interference.”—Publisher’s Weekly
• Medical Professionals Tap AI to Combat COVID-19 (Samuel Greengard, CACM, 4-9-2020) Healthcare experts and hospitals are turning to artificial intelligence (AI) and the Internet of Things (IoT) to aid in the battle against coronavirus.
• 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.
• 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)
• 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.
• 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.
• 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)
• Reliable sources for updates on COVID-19 (roundup links)
• 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.
• 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.'
• 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.
• 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.”
• Why did Matt Drudge turn on Donald Trump? (Bob Norman, CJR, 1-29-2020)
• 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.
• 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.
• 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.
• 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." (And home t.p. is better quality.)
• A rare investment mechanism is helping to fund some health tech companies’ coronavirus projects (Kate Sheridan, STAT, 4-8-2020)
• 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."
• 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."
• 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, ProPubloica, 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.
• Coronavirus and Kids: Comforting Your Child by Fern Reiss (read it on your Kindle)
• Covering the coronavirus story as a journalist
• Trump to New York: Drop Dead (Jennifer Senior, Opinion, NY 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.'
• 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."
• 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.”
• 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.”
• 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.”
• 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)
• 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) The epidemics of the early 21st century revealed a world unprepared, even as the risks continue to multiply. Much worse is coming.
• 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.
• 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.
• 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.
• 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.
• 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."
• 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.” '
• 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)
• 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.
• Journalism Professors Call for an End to Fox News Coronavirus 'Misinformation' in Open Letter to Rupert Murdoch (James Walker, Newsweek, 4-2-2020)
• 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."
• 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 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.” '
• 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.
• 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 COVID Near You, you can help researchers develop a nationwide look at where hotspots of coronavirus are occurring...
• Exponential growth and epidemics: How is COVID-19 currently growing? (video, 3blue1brown.com) A good primer on exponential and logistic growth.
• 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.
• 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.
• 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 and the forthcoming 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."
• 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.
• 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.
• How the Virus Transformed the Way Americans Spend Their Money (Lauren Leatherby and David Gelles, NY Times, 4-11-1010) Fascinating graphics! "Right now, more people are spending money on streaming services and gaming—and even ebooks have seen an uplift."
• 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.
• 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.'
• 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.
• “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 South Korea Flattened the Curve (Max Fisher and Choe Sang-Hun, NY Times, 3-23-2020) The country 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. Read More
Updated 4-29-2020 (click refresh button to get updated version)
(Sheltering in Place)
- Avoid close contact with people who are sick.
- The most common symptoms of coronavirus disease (COVID-19, officially SARS-CoV-2) are fever, dry cough, and shortness of breath -- and, in severe cases, difficulty breathing. In late April CDC added these less common symptoms, by themselves or combined with others: Chills, shaking with chills (rigors), muscle pain, headache, sore throat, new loss of taste or smell.
- Real-time tracking of self-reported symptoms to predict potential COVID-19 (Nature Medicine, 5-11-2020).Association between symptoms and SARS-CoV-2 infection, and ROCs for prediction of the risk of a positive test (see chart)--in declining order: Loss of smell, skipped meals, fatigue, fever, persistent cough, diarrhea, delirium, hoarse voice, shortness of breath, abdominal pain, chest pain. (H/T Abby Rasminsky)
- Experts tell White House coronavirus can spread through talking or even just breathing (CNN, 4-2-2020)
- See also This 3-D Simulation Shows Why Social Distancing Is So Important (NY Times, 4-14-2020) "But as this simulation suggests, and scientists have argued, droplets can travel farther than six feet. And small droplets known as aerosols can remain suspended or travel through the air before they eventually settle on surfaces. This is how they could disperse over the next 20 minutes."
- Avoid touching your eyes, nose, and mouth. Don't pick your nose! The disease is passed mostly by people touching their hands to their face. It's hard to resist, and one reason to wear a mask or bandanna over your nose and mouth may be to train yourself not to touch your face.
- Stay home when you are sick. Keep 6 feet between you and others. If you walk with someone, stand to one side of them (as well as behind or in front of them) to be out of the line of fire if the person in front coughs--as the droplets may still be in the air by the time the person behind gets to the spot where the cough occurred.
- Wash your hands often with soap and water, especially after touching possibly contaminated surfaces. Wet them with warm or cold, clean, running water and then apply soap. When lathering, make sure to get the backs of your hands, between fingers and under nails. Wash your hands for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing. Always wash hands with soap and water if hands are visibly dirty. See World Health Organization's instructions on handwashing, plus this Times article on Why Soap Works (Ferris Jabr, NY Times, 3-13-2020) and The Do’s and Don’ts of Handwashing (illustrated, Katie Camero, Wall Street Journal, 3-12-2020) At the molecular level, soap breaks viruses apart. Remember this the next time you have the impulse to bypass the sink: Other people’s lives are in your hands.
- If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol--preferably 70%. See CDC on handwashing.
- Cover your cough or sneeze with a tissue, then throw the tissue in the trash. The virus is dispersed through respiratory droplets.
- NOTE THAT MANY OF THE SUPPLIES MENTIONED ARE NOT AVAILABLE CURRENTLY, BECAUSE STORES ARE RUNNING SHORT. Stores will restock. Don't panic, and don't hoard.
- Clean and disinfect frequently touched and shared objects and surfaces, including phones (constantly), remote controls, countertops, and refrigerator handles, using a regular household cleaning spray or wipe. ("The dirtiest places in the house are the fridge and the cupboard. Nobody knows who touched the items we've brought home from the store," says a retired NIH employee.) Sanitize the objects you and lots of other people touch, especially people outside your family--like door handles, shared keyboards at schools, salad bar tongs, etc. Here's a list of household cleaning products that will kill viral pathogens. (Center for Biocide Chemistries, American Chemical Council). A long list of products that can be used to disinfect at home—a number of Clorox and Lysol products as well as many other products. Unfortunately, many of these may well be sold out (shelves of many of these products were nearly empty at my largest nearby supermarket on March 12). See Advice for the Public: Basic protective measures (World Health Organization, 2019, updated regularly, with posters). See also CDC's Environmental Cleaning and Disinfection Recommendations (CDC) Interim Recommendations for US Households with Suspected/Confirmed Coronavirus Disease 2019. For a really long, detailed report see Guideline for Hand Hygiene in Health-Care Settings (Morbidity and Mortality Weekly Report, 10-25-02)
- The Coronavirus May Linger On Plastic And Stainless Steel For Days, A Preliminary Study Found (Stephanie M. Lee, Buzzfeed, 3-11-2020)
- Clean your phones and cellphones NIGHTLY (and other obvious germ carriers, such as door knobs and banisters, when possible. If you do touch them, wash your hands.
- Wear gloves; wash or change them daily.
- Wash towels you have touched with unclean hands. Temporarily, make use of paper towels.
- 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)
- We should all wear masks — store-bought or homemade — whenever we're out in public. See 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.
- Develop a care plan. "A care plan is a form that summarizes a person’s health conditions and current treatments. Many care plans include a summary of your health conditions, medications, healthcare providers, emergency contacts, and end-of-life care options (for example, advance directives). People complete their care plans in consultation with their doctor, and if needed, with help from a family member or home nurse aide. Download a fillable care plan form." (CDC)
Further advice from virologist James Robb, MD UC San Diego. Robb has worked with this coronavirus for almost 50 years: COVID-19 has an affinity for pulmonary receptors that is extraordinary. It is most likely to be widespread in the US by mid to late March and April, he says. Here are the precautions Dr. Robb takes and will take (with some comments added). These are the same precautions he currently uses during our influenza seasons, except for the mask and gloves:
1) NO HANDSHAKING! Use a fist bump, slight bow, elbow bump, etc. Or do jazz hands , as CDC recommends.
2) Use ONLY your knuckle to touch light switches. elevator buttons, etc. Lift the gasoline dispenser with a paper towel or use a disposable glove. (Carry disposable gloves in your car.)
3) Open doors with your closed fist or hip - do not grasp the handle with your hand, unless there is no other way to open the door. Especially important on bathroom and post office/commercial doors.
4) Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts.
5) Wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer whenever you return home from ANY activity that involves locations where other people have been.
6) Keep a bottle of hand sanitizer (60% alcohol) available at each of your home's entrances. AND in your car for use after getting gas or touching other contaminated objects when you can't immediately wash your hands.
7) If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more!
Dr. Robb adds: What I have stocked in preparation for the pandemic spread to the US:
1) Latex or nitrile latex disposable gloves for use when going shopping, using the gasoline pump, and all other outside activity when you come in contact with contaminated areas. Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! BUT all the surfaces where these droplets land are infectious for about a week on average - everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon. This virus only has cell receptors for lung cells (it only infects your lungs) The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.
2) When there is ample stock (which so far is not true), acquire disposable surgical masks. Their main value is to to prevent you from touching your [own] nose and/or mouth (We touch our nose/mouth 90X/day without knowing it!). This is the only way this virus can infect you - it is lung-specific.
3) When possible, stock up with hand sanitizers and latex/nitrile gloves (get the appropriate sizes for your family). The hand sanitizers must be alcohol-based and greater than 60% alcohol to be effective.
4) Zinc lozenges may be helpful. (This page from McGill states that Robb was misquoted and, more important, that there is no evidence to support a benefit of zinc for corona virus. There is slight evidence that zinc supplements can reduce the duration of the common cold which is a coronavirus infection, but also zinc can be toxic if you take too much.) There will be NO drugs or vaccines available this year to protect us or limit the infection within us. Only symptomatic support is available.
MORE RESOURCES: Coronavirus (COVID-19)
Essential links, updates, FAQs
(Sheltering in Place)
Sheltering in Place
It takes weeks to see the results.
• It’s Going to Be Difficult (David Leonhardt, NY Times, 4-10-2020) Here is the cruel reality: The places that return too quickly — and cause new outbreaks — will be the ones that end up suffering the longest periods of social distancing in the end. The four next phases: 1. The new abnormal: Large gatherings where people come in close contact, like sporting events, concerts and conferences, could still be a long time off. 2. Testing, testing, testing. The United States remains behind on testing and will need to continue catching up in coming weeks. 3. Contact tracing. Very laborious. 4. Quarantine. People with new cases must be kept away from everyone else, immediately.
• Comprehensive Social Distancing Is Difficult and Necessary. Here's How to Keep Your Family Safe (Asaf Bitton, MD, MPH, on WBUR, 3-14-2020) Originally published as Social Distancing: This Is Not a Snow Day (Ariadne Labs)
• Earthcam: Times Square, New York. And check out a few other cities.
• What We Need to Understand About Asymptomatic Carriers if We’re Going to Beat Coronavirus (Caroline Chen, ProPublica, 4-2-2020) 'What I discovered is that not only can people be infected and experience no symptoms or very mild symptoms for the first few days, but this coincides with when the so-called viral load — the amount of virus being emitted from an infected person's cells — may be the highest...a WHO team found that about 75% of people who were initially classified as "asymptomatic" went on to develop symptoms.
The reason direct contact is more deadly is the viral load. (But still, wipe things down.)
• Social Distancing, Quarantine, and Isolation (CDC) Particulars of keeping your distance to slow the spread.
• Why ‘flattening the curve’ may be the world’s best bet to slow the coronavirus (Helen Branswell, STAT, 3-11-2020) “If you look at the curves of outbreaks, they go big peaks, and then come down. What we need to do is flatten that down,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told reporters Tuesday. “That would have less people infected. That would ultimately have less deaths. You do that by trying to interfere with the natural flow of the outbreak.” See also Does closing schools slow the spread of coronavirus? Past outbreaks provide clues (Jennifer Couzin-Frankel, Science, 3-10-2020) "We know from past epidemics of multiple types of viruses that school closure works. We know that it interrupts adult transmission even if the kids are not vectors. Here, it’s likely that kids are vectors, and preliminary evidence from China suggests that they can be."
• Take Steps to Counter the Loneliness of Social Distancing (Jane E. Brody, NY Times, 3-23-2020) Attempts to avoid coronavirus can increase the risk of physical and emotional harm from limited social contact.
• Social distancing could buy U.S. valuable time against coronavirus (Carolyn Y. Johnson, Lena H. Sun and Andrew Freedman WaPo, 3-10-2020). The United States is at a make-or-break moment with coronavirus that will test of one of the most basic, but inconvenient and disruptive, public health tools in the book: social distancing...The goal isn’t to stop the virus; not anymore. It is to slow it down....By the time it stops feeling silly to consider major life changes, it may be too late.
• The social-distancing deniers have arrived (Zachary B. Wolf, CNN, 4-17-2020) In February and much of March the conservative outlet Fox News fed the coronavirus deniers...Now conservatives are fomenting rebellion against public health guidelines. In their warped telling, people who venture out in public aren't vectors for infection but rather freedom fighters standing up to oppression. Trump appears to back those protesting social distancing measures (The Hill) Fighting with governors about who will "call the shots," Trump's rhetoric jumps toward "Liberate X" messages to states where Republicans are protesting the extension of stay-at-home orders (and where Trump did well in last election), even when official White House guidelines "remain conservative in terms of loosening social distance guidelines." See also 7 Midwestern governors announce their states will coordinate on reopening (CNN, 4-17-2020). In the face of Trump's shilly-shallying about health policy, governors are assuming greater command of pandemic management.
• It’s Okay to Be a Different Kind of Parent During the Pandemic (Mary Katharine Ham, The Atlantic, 4-8-2020) When something outside your control changes your life, it’s what you do with what you can control that really shapes your children.
• Parent Resources (Maryland State Department of Education) Links to many excellent resources to "educate" children and keep them engaged in smart ways. Let me know if there are more pages like this online.
• The Dos and Don’ts of ‘Social Distancing’ (Kaitlyn Tiffany, The Atlantic, 3-12-2020) Experts weigh in on whether you should cancel your dates, dinner parties, and gym sessions. Recommendations for “social distancing”—a term that epidemiologists are using to refer to a conscious effort to reduce close contact between people and hopefully stymie community transmission of the virus.
• Surfaces? Sneezes? Sex? How the Coronavirus Can and Cannot Spread(Heather Murphy, NY Times,3-2-2020) What you need to know about how the virus is transmitted. That page should take you to live updates on the virus, also. See also Heather Cox Richardson's Facebook post, comparing the Philadelphia and St. Louis responses to the 1918 flu epidemic. A political appointee in Philadelphia went ahead with a big parade to raise money for the Liberty Bonds that were funding WWI, wanting to keep morale up. By the end of the season, 12,000 Philadelphians had died. By contrast, the public health commissioner in St. Louis shut down the city, incurring the wrath of local businessmen, but slowing down the infection rate, so by the end of the season only 1,700 died in St. Louis, half the rate in Philadelphia. "The novel coronavirus is spreading in America, but we can still slow it down by social distancing and avoiding crowds." It spreads exponentially. "As grim as things seem right now, the future is ours to shape."
• Why We Should Still Try to Contain The Coronavirus (Healy and Khan, Los Angeles Times, 3-11-2020) "The goal is no longer to prevent the virus from spreading freely from person to person, as it was in the outbreak’s early days. Instead, the objective is to spread out the inevitable infections so that the healthcare system isn’t overwhelmed with patients. Public health officials have a name for this: Flattening the curve."
• Sheltering in Place: What You Need to Know (KQED) What is considered an essential activity, what activities outside the home are okay, and what are essential businesses and infrastructures, etc.
• How to Seek a Safe Respite Outdoors While Social Distancing (Lynn Jolicoeur and Lisa Mullins, KQED, 3-25-2020) Move about as much [as possible], rather than being stagnant ... for prolonged periods of time.
• How Kids' Lit Is Responding to the Coronavirus (Alex Green, Publishers Weekly, 3-17-2020) Children’s authors and publishers are going digital to provide kids with ways to read, draw, engage, and support other children who might need a helping hand. PW lists online resources to help stay-at-home famillies: a free writing course for kids, bilingual videos and teaching guides, a coloring book designed by acclaimed illustrators, access to free books for educators, parents, and librarians, and a hashtag to search for more content on social media.
(PPE means "personal protective equipment")
• PPE: Types of personal protective equipment used to combat COVID-19 (George Petras and Janet Loehrke, USA Today) Personal protection gear, essential for coronavirus workers, is in critically short supply.
• Instructions on how to make a hand-sewn mask (PDF, Johns Hopkins Medicine)
• Deaconess asks public to sew CDC-compliant face masks for staff (Thomas B. Langhorne, Evansville Courier & Press, 3-18-2020) Another set of instructions for home-made masks.
• How to make a mask Instructions for making a mask using a handkerchief and elastic hair bands. Not appropriate for medical personnel
• 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. “People envision these clouds of viruses roaming through the streets coming after them, but the risk of [infection] is higher if you’re closer to the source,” says Linsey Marr, who studies airborne disease transmission at Virginia Tech. “The outside is great as long as you’re not in a crowded park.” Many successful mask-using countries relied on other measures, such as extensive testing and social distancing, and many were ready for the pandemic because of their prior run-in with the 2003 SARS epidemic.
• So what if I think I might be infected? (WashingtonPost, 3-13-2020) If you feel sick and are worried about the coronavirus, call your doctor. Don’t rush to the ER. Testing is still limited, and most cases are relatively mild. There is no treatment for COVID-19.
Know how it spreads. (See below)
Take steps to protect yourself: Clean your hands often. Avoid close contact.
Take steps to protect others: Stay home if you’re sick. Cover coughs and sneezes. Wear a face mask if you are sick. Clean and disinfect (with instructions).
•Psst, After You Wash Your Hands, Clean Your Smartphone (Slate)
• COVID NEAR YOU How are you feeling? Contribute your health status daily and help track the COVID-19 pandemic.
• How to Clean and Disinfect Yourself, Your Home, and Your Stuff (Jess Grey, Wired, 3-19-2020) Including how to do your laundry!
Failure to control the virus will mean millions of deaths.
• So what if I think I might be infected? (WashingtonPost, 3-13-2020) If you feel sick and are worried about the coronavirus, call your doctor. Don’t rush to the ER. Testing is still limited, and most cases are relatively mild. There is no treatment for COVID-19.
Know how it spreads. (See below)
Take steps to protect yourself: Clean your hands often. Avoid close contact.
Take steps to protect others: Stay home if you’re sick. Cover coughs and sneezes. Wear a face mask if you are sick. Clean and disinfect (with instructions).
• Food Safety Tips (YouTube video, Dr. Jeffrey VanWingen) He demonstrates how to unpack your groceries. See also Food Safety and Coronavirus: A Comprehensive Guide (J. Kenji López-Alt, Serious Eats, 3-20-2020) Questions about COVID-19 and food safety, answered.
• Keeping the Coronavirus from Infecting Health-Care Workers (Atul Gawande, New Yorker, 3-21-2020) What Singapore’s and Hong Kong’s success is teaching us about the pandemic."The factors that appear to be important in protecting health-care workers from the disease have been insuring meticulous hand hygiene and cleaning; restricting clinics and hospitals to necessary patient visits; shifting as much care as possible to virtual channels (such as phone and video); and applying standard droplet precautions (surgical mask, gloves, and gown) with respiratory patients."
• Coronavirus grocery list: What items you need to buy in case of self-quarantine (Today show) The foods you may need to have in case you or your family needs to self-quarantine.
• Matt Walker: Why sleep matters now more than ever Having sleep problems? Listen to this TED talk by Matt Walker, neuroscientist and author of Why We Sleep, including whether "blue light" or other types of light are a problem.
• When Mr. Trump and Dr. Fauci disagree, listen to Dr. Fauci.
• Remdesivir Shows Modest Benefits in Coronavirus Trial (Gina Kolata, Peter Baker and Noah Weilan, NY Times, 4-29-2020) Hope soared nonetheless. The F.D.A. is likely to issue an emergency approval, a senior official said. The improvement in recovery times “doesn’t seem like a knockout 100 percent,” Dr. Fauci conceded, but “it is a very important proof of concept, because what it has proven is that a drug can block this virus.” Sitting at Dr. Fauci’s side, President Trump said, “Certainly it’s positive, it’s a very positive event.” In past weeks, he has repeatedly hailed remdesivir as a potential “game changer,” despite spotty evidence. Business leaders, scientists and politicians alike are scrambling to find ways to fight an insidious epidemic and to reopen a devastated economy. The virus has claimed at least 60,000 lives in the United States, and more than 200,000 worldwide. There have been precious few reasons for optimism, and the markets seized on the news.
• Remdesivir Just Became The First Drug to Show a 'Clear-Cut' Effect in Treating COVID-19 (Issam Ahmed, Science Alert, 4-30-2020)
• Data on Gilead drug raises hopes in pandemic fight, Fauci calls it 'highly significant' (Deena Beasley, Manas Mishra, Reuters, 4-29-2020) Preliminary results from a U.S. government trial showing that patients given remdesivir recovered 31% faster than those given a placebo, were hailed by Dr. Anthony Fauci as “highly significant.” “This is really quite important,” Fauci told reporters at the White House, likening it to a moment in 1986 “when we were struggling for drugs for HIV and we had nothing.” See Reuters Explainer: What does new data say about Gilead's experimental coronavirus drug? (Nancy Lapid, 4-29-2020) The data also suggest a possible survival benefit with remdesivir, although the difference was not statistically significant, meaning it might have been due to chance and not Gilead’s drug. Comparing the drug to a placebo should give researchers definitive answers about remdesivir’s effect on the illness. While the study did meet its primary goal, the promising NIAID data are from an interim analysis. The trial’s final results will likely not be known until sometime next month.
• 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)
• Rolling updates on coronavirus disease (COVID 19) (World Health Organization) "We need facts, not fear, we need science, not rumors, we need solidarity, not stigma.”
• Kaiser Health Network, Kaiser Family Foundation (invaluable resource, especially on policy) Follow @KHNews And/or listen to KHN's What the Health? podcasts
• 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
• 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.
• 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)
When Mr. Trump and Dr. Fauci disagree, listen to Dr. Fauci. Fighting coronavirus requires scientific knowhow, not presidential cheerleading.
• 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)
• 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."
• 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.
• 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.
• 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. 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)
• 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.
• 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."
• 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."
• 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.”
• 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.
• Where Can I Get a Drive-Thru Coronavirus (COVID-19) Test Near Me? (GoodRx, 4-16-2020 )
• 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.
• ‘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 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.
• 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)
• 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."
Failure to control the virus will mean millions of deaths.
• What does the coronavirus do in my body? (Shauna Bennett and Signe Aasberg at NTNU Norway, illustrated by Elfy Chiang and Taiwan) This illustrated story covers how the virus works in the body, how the immune system fights back, and what people can do to protect themselves and improve their immune health. (Click right arrow to advance the story.)
• "SARS-CoV-2 is the virus. COVID-19 is the disease that it causes. The two aren’t the same. " ~ Ed Yong, Why the Coronavirus Is So Confusing (The Atlantic, 4-29-2020) A guide to making sense of a problem that is now too big for any one person to fully comprehend. People can spread the virus before showing symptoms.
• Here’s the Biggest Thing to Worry About With Coronavirus (Aaron E. Carroll, NY Times, 3-12-2020) "A crucial thing to understand about the coronavirus threat — and it’s playing out grimly in Italy — is the difference between the total number of people who might get sick and the number who might get sick at the same time.... Our country has only 2.8 hospital beds per 1,000 people. We don’t have enough ventilators and I.C.U. beds if there’s a significant surge of new cases. As with Italy, the health system could become overwhelmed." We must "flatten the curve."
• Dr. Karen Duca explains Covid-19 (Episode 1: Explaining Covid-19). An excellent YouTube/Zoom series of explanations and Q&As hosted by Kristen Kosinski asking Dr. Duca questions. Follow introductory session with sessions Part 2, Part 3, Part 4,Part 5, Part 6. Find those that follow by searching for the names of the two women. In the first one I landed on (referred by a friend), the doctor was wearing a knitted cap and I thought she was a homeless woman and wondered how she was coming up with such good explanations.
• Do You Want to Die in an I.C.U.? Pandemic Makes Question All Too Real (Paula Span, NY Times, 4-24-2020) Sobering statistics for older patients sharpen the need to draw up advance directives for treatment and share them with their families. See this handy Shared Decision Making Tool for Covid-19 from national hospice group.
• How the Pandemic Will End (Ed Yong, The Atlantic, 3-25-2020) 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.
• This virus is absolutely brutal. @MaggieAstor thread on Twitter: 'My husband and I are recovering from COVID-19. We’re getting better. But it’s taken more than two weeks to say that, and that was with the “mild” version, meaning no trouble breathing. This virus is absolutely brutal. “Mild” is not mild by any normal definition.'
• For Americans With Bills to Pay, Help Is on the Way. Sort Of. ( Paul Kiel and Jeff Ernsthausen, ProPublica, 4-2-2020) Politicians have touted debt relief, but the various proposals are patchwork. Many homeowners and renters won’t get much help; those struggling with credit card, car and other loan payments will get none.
• What the Health: All Coronavirus All the Time (KHN podcast, early April 2020, plus summary) "The ACA was passed on the heels of the Great Recession. The coronavirus outbreak has produced the first big economic downturn since then, and the law’s provisions to expand Medicaid and to provide an insurance option to those without jobs could provide a critical safety net during this crisis.
"About a dozen states running their own ACA insurance marketplaces have opened up enrollment again to let people who did not enroll in the fall but are feeling the pinch from the coronavirus pandemic to reconsider. President Donald Trump said this week that he is mulling a similar move, but the messages from the administration on such action have been confusing.
"People who had insurance through work and have lost their jobs don’t need a special enrollment period to sign up for an Obamacare plan. They are eligible because their job situation changed. However, the administration has not been publicizing that message."
• The Coronavirus, by the Numbers (James Gorman, NY Times, 3-5-2020) Adam Kucharski, a mathematician who studies the spread of disease, explains some of the figures that keep popping up in coronavirus news.
• Exponential growth and epidemics: How is COVID-19 currently growing? (video, 3blue1brown.com) A good primer on exponential and logistic growth.
• Coronavirus: A primer (Dr. Jane A. Culp's excellent explanation of basics, Herald-Star, 3-3-2020; bolding added) "There are seven strains of coronavirus known to cause disease in humans. Four of these strains are the alpha form, and three strains are in the beta form. The world has experienced two other outbreaks of beta coronavirus. The first was in 2002 when severe adult respiratory syndrome was first noted in a Chinese province. This beta coronavirus originated in bats and transmitted the virus to another species — the skivat cat. The skivat cat transmitted the virus to humans. The mortality rate for SARS was 9 percent to 10 percent.
"The second outbreak of a beta coronavirus occurred in 2012 with Middle Eastern respiratory syndrome. MERS originated in camels with transmission to humans. The mortality rate for MERS was at least 36 percent and in some reports listed as being close to 50 percent.
"That brings us to the present with the novel (new) third beta coronavirus causing the disease COVID19. The animal (possibly a bat) to human transmission first occurred in the Chinese city of Wuhan, home to 11 million people. The mortality rate for COVID19 is estimated at 2 percent to 2.5 percent." There are no vaccines yet.
• Analysis: One Sure Thing About COVID-19: No Telling How Many People Have It (Elisabeth Rosenthal, Kaiser Health News, 3-3-2020) It has been nearly three months since the first cases of a new coronavirus pneumonia appeared in Wuhan, China, and it is now a global outbreak. And yet, the world still doesn’t have a clear picture of some basic information about this outbreak.
• The New Coronavirus Is a Truly Modern Epidemic (Ed Yong, The Atlantic, 2-3-2020) New diseases are mirrors that reflect how a society works—and where it fails.
• Here’s a Glossary for the Ongoing Coronavirus Outbreak’s Vocabulary (Dan Robitzski, Futurism/Neoscope, 3-2-2020)
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."
• 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?
• 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.
---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. Seealso “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.
• 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)
• CPJ Safety Advisory: Covering the coronavirus outbreak (Committee to Protect Journalists, updated 4-6-2020) Detailed practical advice about how to protect yourself while covering this story. See also CPJ’s interviews with journalists covering the pandemic.
• COVID-19 Reporting Diaries: March 25–31, 2020 (Shira Feder, TheOpenNotebook, 4-7-2020) "Nothing that has come before in the infectious-diseases beat is remotely as huge as this story," says STAT reporter Helen Branswell, one of five journalists reporting on their coverage of this crisis. "The biggest lesson I’ve learned is that when covering a rapidly evolving event like this pandemic, it’s important to be open to new evidence and data, even if it goes against what I’d previously reported," says Garcia de Jesus. "We’re watching science happen in real-time—sometimes that involves conflicting information."
• How can states keep nursing home residents safe during the pandemic? (Liz Seegert, Covering Health, AHCJ, 4-30-2020) An important round-up of info on resources, trends, sources.
• PEN America’s Guide on COVID-19 and Disinformation (PEN America, 3-25-2020)
• How COVID-19 is threatening press freedom: An interview with Joel Simon (Ann Cooper, Journalist's Resource, 4-13-2020) "It’s sobering to see how many governments have taken action against journalists for their COVID-19 coverage....political leaders are being told by experts that they must take dramatic action to stem the spread of a deadly disease but they are worried about the economic and social consequences of doing so. Of course one way to avoid making a difficult decision is suppress any reporting that suggests that COVID-19 is spreading rapidly, and many governments are doing just that."
• Coronavirus: Resources for reporters (First Draft News)
• The COVID Tracking Project collects and publishes the most complete testing data available for US states and territories.
• Data Drum: COVID-19 Data (data from the European Centre for Disease Prevention. Also available as a mobile app.)
• COVID-19 Open Research Dataset (CORD-19) (the Allen Institute for AI in partnership with leading research groups) a free resource of over 45,000 scholarly articles, including over 33,000 with full text, about COVID-19 and the coronavirus family of viruses for use by the global research community.
• Covering COVID-19 and the coronavirus: 5 tips from a Harvard epidemiology professor (Denise-Marie Ordway, Journalist's Resource, 3-6-2020) Choose experts carefully. Distinguish what is known to be true from what is thought to be true — and what’s speculation or opinion. Use caution when citing research findings from “preprints,” or unpublished academic papers. Ask academics for help gauging the newsworthiness of new theories and claims. To prevent misinformation from spreading, news outlets also should fact-check op-eds. Read the work of journalists who cover science topics well.
• The Five Questions Reporters Need to Ask Hospitals and Local Officials About Coronavirus (Charles Ornstein, ProPublica, 3-17-2020) Including: How many beds does each hospital in your state/region have? How many of those beds are already occupied?
• Coronavirus Rumor Control (FEMA)
• Covering the Coronavirus Pandemic (National Association of Broadcasters) Webcast and other resources.
• The Newsroom Guide to COVID-19
• Covering Coronavirus: Resources for Journalists (Dart Center for Journalism & Trauma, 2-28-2020)
• Coronavirus, SARS and Flu Resources (Mike Reilley, Journalist's Toolbox, 4-1-2020) The most extensive set of links for journalists--both general and very specific!
• Presenting Trump and Science as Equals Isn’t Balanced, It’s Dangerous (Neil deMause, Fairness & Accuracy in Reporting, or FAIR, 3-23-2020) Stopping the coronavirus pandemic from taking millions of lives may require news organizations to take sides—but if it’s on the side of science, that’s the kind of bias that journalism needs.
• Tipsheet: Covering the Coronavirus Epidemic Effectively without Spreading Misinformation (Laura Helmuth, The Open Notebook, 3-2-2020)
• I Lived Through SARS and Reported on Ebola. These Are the Questions We Should Be Asking About Coronavirus. (Caroline Chen, ProPublica, 3-5-2020) Instead of asking: How many test kits do you have? Ask this: How many samples are you running per patient? Instead of saying: The mortality rate is X%. Say this: Scientists estimate the mortality rate is X%, based on the information they have.
• Mapping coronavirus, responsibly (Kenneth Field, ESRI, 2-25-2020)
• Covering Coronavirus: Expert Tips for Journalists and Communicators (YouTube video, CDC at National Press Club, 2-10-2020, 1 hr 26 minutes) Streamed live, available with comments via LiveStream replay.
• Use caution when reporting on pandemic potential of Wuhan coronavirus (Bara Vaida, Association of Health Care Journalists, 1-23-2020)
• Despite pronouncements, no quick turnaround likely for COVID-19 treatments, vaccines (Bara Vaida, Covering Health, AHCJ, 3-20-2020) "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. 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." President Trump is absolutely NOT a reliable source, and some of the things he's said have caused harm. See Two studies have some good news and bad news for potential coronavirus treatments (Zeeshan Aleem, Vox, 4-11-2020) Remdesivir looks “hopeful” but hydroxychloroquine has serious side effects, and its benefits for Covid-19 patients are not yet proven.
• Finding the latest COVID-19 studies — and covering them thoughtfully (Tara Haelle, Covering Health, AHCJ, 3-20-2020) In the early days of the coronavirus pandemic, most data came from news reports, clinical summaries and preprints. Now more and more peer-reviewed studies are coming out each day, and it's challenging to keep up with them. Several journals have set up dedicated coronavirus sites that can help in keeping up with the research. The Lancet's COVID-19 Resource Centre, JAMA Network's COVID-19 resource center and NEJM's Coronavirus (COVID-19) page all include the newest studies, commentary and related data and information on the pandemic.
• The Simplest Way to Spot Coronavirus Misinformation on Social Media (Will Oremus, OneZero, 3-4-2020) A digital literacy expert shares his method. Fact-check!
• The many challenges of covering the coronavirus (Jon Allsop, CJR, 3-9-2020) The challenge here is to communicate nuance and uncertainty in formats—headlines, tweets, and so on—that reward brevity and clarity.
• What Investigative Reporters Around the World Need to Be Asking About COVID-19 (Amruta Byatnal, Global Investigative Journalism Network, 3-10-2020) Q&A with Thomas Abraham, an expert on infectious disease and global health security, and the author of Twenty-first Century Plague: The Story of SARS and of Polio: The Odyssey of Eradication. Remember that science evolving as rapidly as this is hedged by huge amounts of uncertainty.
• How newsrooms can tone down their coronavirus coverage while still reporting responsibly (Al Tompkins, Poynter, 3-4-2020) When you do anecdotal stories about sickness and death from coronavirus, infuse them with the data that points out the wider context of the issue.
• How to name a coronavirus ( Merrill Perlman, CJR, 2-24-2020)
• 10 tips for journalists covering COVID-19 (Taylor Mulcahey, International Journalism Network, 3-5-2020)
• How to Report on the COVID-19 Outbreak Responsibly (Bill Hanage, Marc Lipsitch, Scientific American, 2-23-2020) Reporting "should distinguish between at least three levels of information: (A) what we know is true; (B) what we think is true—fact-based assessments that also depend on inference, extrapolation or educated interpretation of facts that reflect an individual’s view of what is most likely to be going on; and (C) opinions and speculation."
• COVID-19 reports (Imperial College London)
• COVID-19 Webinar Series (Session 1 of many sessions in Alliance for Health Policy webinar series) Other sessions are listed and linked to along the right side of website.
• FactCheck.org on coronavirus coverage
• CIDRAP COVID-19 Resource Center (Center for Infectious Disease Research and Policy) "You can make a vaccine against anything very quickly. But it needs to be effective and safe. This is a long process that can take months to years, even under optimal conditions." ~ -Michael Osterholm, PhD, MPH
• How the Pandemic Will End (Ed Yong, The Atlantic, 3-25-2020) [Scroll down to II. The Endgame.] There are no existing vaccines for coronaviruses—until now, these viruses seemed to cause diseases that were mild or rare—so researchers must start from scratch. For one vaccine that has been developed, an "initial trial will simply tell researchers if the vaccine seems safe, and if it can actually mobilize the immune system. Researchers will then need to check that it actually prevents infection from SARS-CoV-2. They’ll need to do animal tests and large-scale trials to ensure that the vaccine doesn’t cause severe side effects. They’ll need to work out what dose is required, how many shots people need, if the vaccine works in elderly people, and if it requires other chemicals to boost its effectiveness....“Even if it works, they don’t have an easy way to manufacture it at a massive scale,” said Seth Berkley of Gavi....Berkley and others estimate that it will take 12 to 18 months to develop a proven vaccine, and then longer still to make it, ship it, and inject it into people’s arms."
•COVID-19 Vax Moving at Brisk Clip, but Will It Be Soon Enough? (Ed Susman, MedPage Today, 3-10-2020) At a medical conference, "Anthony Fauci, MD, said the time from sequencing of the virus -- which arose in central China in late December 2019 -- to human trials of a vaccine candidate is expected to move with unprecedented speed -- around 2 months. [But that is just Step 1.] Zunyou Wu, MD, of the Chinese Center for Disease Control and Prevention, shared some key insights on COVID-19 from China:
---The majority of cases arise from close contact of symptomatic cases
---Transmission is driven by family clusters
---Second-degree household attack rates were around 10% early in the outbreak, but fell to 3% with faster isolation
---Virus shedding is highest early in the disease course and can occur 24-48 hours before symptom onset
---Virus shedding usually continues for 7-12 days in mild/moderate cases and for >2 weeks in severe cases.
• Trump is pushing a dangerous, false spin on coronavirus — and the media is helping him spread it (Margaret Sullivan, Washington Post, 3-1-2020) A vaccine is NOT coming along "rapidly." It will probably take a year to a year and a half, says NIH expert Anthony Fauci. [He has since revised that estimate upward because new steps are being taken.] As for Dr. Oz's advocacy for HCQ as a covid treatment, Dr. Anthony Fauci responds: "That was not a very robust study." Fauci also says some may "feel" HCQ is an effective treatment, and "there is a suggestion" it could be, but we can't "make that majestic leap" to assume it's a cure. And Trump, in pushing HCQ as a solution, has helped make the drug scarce for people who rely on it for treating serious conditions.
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.
• 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)