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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
(2 months 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.
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.
Updated June 1, 2020
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
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.
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.
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.)
More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
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.
Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.
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.