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Scale of China’s Wuhan Shutdown Is Believed to Be Without Precedent Scale of China’s Wuhan Shutdown Is Believed to Be Without Precedent
(about 4 hours later)
In closing off Wuhan, a city of more than 11 million people, China deployed on Thursday morning a centuries-old public health tactic to prevent the spread of infectious disease — this time, a mysterious respiratory infection caused by a coronavirus.In closing off Wuhan, a city of more than 11 million people, China deployed on Thursday morning a centuries-old public health tactic to prevent the spread of infectious disease — this time, a mysterious respiratory infection caused by a coronavirus.
Experts said the stunning scale of the shutdown, isolating a major urban transit hub larger than New York City, was without precedent.Experts said the stunning scale of the shutdown, isolating a major urban transit hub larger than New York City, was without precedent.
“It’s an unbelievable undertaking,” said Dr. Howard Markel, a professor of the history of medicine at the University of Michigan, adding that he had never heard of so many people being cordoned off as a disease-prevention measure.“It’s an unbelievable undertaking,” said Dr. Howard Markel, a professor of the history of medicine at the University of Michigan, adding that he had never heard of so many people being cordoned off as a disease-prevention measure.
Still, “people are going to get out,” he said. “It’s going to be leaky.”Still, “people are going to get out,” he said. “It’s going to be leaky.”
By Thursday evening, China said it planned to extend the shutdown even further. Officials said they would impose travel restrictions on at least four other nearby cities — Huanggang, Ezhou, Chibi and Zhijiang — affecting millions more residents.By Thursday evening, China said it planned to extend the shutdown even further. Officials said they would impose travel restrictions on at least four other nearby cities — Huanggang, Ezhou, Chibi and Zhijiang — affecting millions more residents.
By limiting the movements of millions of people in an attempt to protect public health, China is engaging in a balancing act with a long and complicated history fraught with social, political and ethical concerns.By limiting the movements of millions of people in an attempt to protect public health, China is engaging in a balancing act with a long and complicated history fraught with social, political and ethical concerns.
James G. Hodge Jr., director of the Center for Public Health Law and Policy at Arizona State University, said the shutdown would almost certainly lead to human rights violations and would be patently unconstitutional in the United States.James G. Hodge Jr., director of the Center for Public Health Law and Policy at Arizona State University, said the shutdown would almost certainly lead to human rights violations and would be patently unconstitutional in the United States.
“It could very easily backfire,” he said, adding that the restrictions could prevent healthy people from fleeing the city, perhaps exposing them to greater risk of infection. “In general, this is risky business.”“It could very easily backfire,” he said, adding that the restrictions could prevent healthy people from fleeing the city, perhaps exposing them to greater risk of infection. “In general, this is risky business.”
To combat the spread of the virus, which first appeared at the end of December and has killed at least 17 people and sickened more than 600, the Chinese government said it would cancel planes and trains leaving Wuhan beginning Thursday, and suspend buses, subways and ferries within it.To combat the spread of the virus, which first appeared at the end of December and has killed at least 17 people and sickened more than 600, the Chinese government said it would cancel planes and trains leaving Wuhan beginning Thursday, and suspend buses, subways and ferries within it.
In Huanggang, a city of seven million about 30 miles east of Wuhan, residents would not be allowed to leave the city without special permission, according to a government statement. In Ezhou, which has about one million residents, all rail stations were to be closed.In Huanggang, a city of seven million about 30 miles east of Wuhan, residents would not be allowed to leave the city without special permission, according to a government statement. In Ezhou, which has about one million residents, all rail stations were to be closed.
The practice of isolating people and goods to halt the spread of disease dates at least to the 14th century, when ships arriving in Venice during the plague epidemic were required to anchor off the coast for 40 days. The isolation period gave rise to the term quarantine, from the Italian quaranta giorni, meaning 40 days, according to the Centers for Disease Control and Prevention.The practice of isolating people and goods to halt the spread of disease dates at least to the 14th century, when ships arriving in Venice during the plague epidemic were required to anchor off the coast for 40 days. The isolation period gave rise to the term quarantine, from the Italian quaranta giorni, meaning 40 days, according to the Centers for Disease Control and Prevention.
Professor Hodge said quarantines could be effective if they selectively isolate only those who have been infected or are suspected of infection. The response in Wuhan, with the establishment of a “cordon sanitaire”-type boundary, goes much further than that.Professor Hodge said quarantines could be effective if they selectively isolate only those who have been infected or are suspected of infection. The response in Wuhan, with the establishment of a “cordon sanitaire”-type boundary, goes much further than that.
“Quarantine would be saying ‘You can’t leave your own home, can’t go to school, work or church,’” he said. But the Chinese authorities “have drawn a line around this city and said, ‘No one in and no one out.’ That type of thing is obviously an excessive response.”“Quarantine would be saying ‘You can’t leave your own home, can’t go to school, work or church,’” he said. But the Chinese authorities “have drawn a line around this city and said, ‘No one in and no one out.’ That type of thing is obviously an excessive response.”
In recent years, governments have imposed other large-scale measures to prevent the spread of infectious diseases.In recent years, governments have imposed other large-scale measures to prevent the spread of infectious diseases.
Updated June 22, 2020 Updated June 24, 2020
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Sierra Leone, a country of about seven million people, said “everybody” was expected to stay indoors for three days in September 2014, as 7,000 teams of health and community workers went door to door to find hidden Ebola patients.Sierra Leone, a country of about seven million people, said “everybody” was expected to stay indoors for three days in September 2014, as 7,000 teams of health and community workers went door to door to find hidden Ebola patients.
Earlier that year, Liberian officials placed West Point, a sprawling slum in Monrovia where 60,000 to 120,000 people were crammed into shacks, under an Ebola quarantine. The order led to deadly clashes with soldiers and may have helped to spread the disease, experts said, forcing people to crowd together for basic humanitarian aid.Earlier that year, Liberian officials placed West Point, a sprawling slum in Monrovia where 60,000 to 120,000 people were crammed into shacks, under an Ebola quarantine. The order led to deadly clashes with soldiers and may have helped to spread the disease, experts said, forcing people to crowd together for basic humanitarian aid.
During the SARS outbreak of 2003, Canadian health officials asked anyone in Ontario who had even one symptom of the respiratory infection to stay home for a few days out of fear that the disease might spread during the Easter holiday weekend.During the SARS outbreak of 2003, Canadian health officials asked anyone in Ontario who had even one symptom of the respiratory infection to stay home for a few days out of fear that the disease might spread during the Easter holiday weekend.
In Beijing, at least 4,000 residents who had been exposed to the virus were kept in isolation, and 300 college students who had had contact with infected people were sequestered in a military camp for two weeks.In Beijing, at least 4,000 residents who had been exposed to the virus were kept in isolation, and 300 college students who had had contact with infected people were sequestered in a military camp for two weeks.
Historians have noted that quarantines have often targeted marginalized populations.Historians have noted that quarantines have often targeted marginalized populations.
During the plague epidemic of the 14th century, European city-states posted armed guards on roads and access points to keep out merchants, people with leprosy and minority groups such as Jews, according to Eugenia Tognotti, a researcher in Italy who has written on the history of quarantine.During the plague epidemic of the 14th century, European city-states posted armed guards on roads and access points to keep out merchants, people with leprosy and minority groups such as Jews, according to Eugenia Tognotti, a researcher in Italy who has written on the history of quarantine.
And during a wave of cholera outbreaks in Europe in the 1830s, Naples restricted the movement of prostitutes and beggars, who were thought to be carriers of the contagion, she wrote.And during a wave of cholera outbreaks in Europe in the 1830s, Naples restricted the movement of prostitutes and beggars, who were thought to be carriers of the contagion, she wrote.
Russian Jews brought typhus fever into the Lower East Side of Manhattan in 1892, Dr. Markel said. It was not only infected people who were rounded up and quarantined on an island off the Bronx, however, but also their neighbors and others whom they had simply greeted on the street.Russian Jews brought typhus fever into the Lower East Side of Manhattan in 1892, Dr. Markel said. It was not only infected people who were rounded up and quarantined on an island off the Bronx, however, but also their neighbors and others whom they had simply greeted on the street.
“That’s the darker side of quarantine — its misuse as a social tool rather than its scientific use as a medical tool,” Dr. Markel said.“That’s the darker side of quarantine — its misuse as a social tool rather than its scientific use as a medical tool,” Dr. Markel said.
Mihir Zaveri contributed reporting.Mihir Zaveri contributed reporting.