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Coronavirus Cases Seemed to Be Leveling Off. Not Anymore. Coronavirus Cases Seemed to Be Leveling Off. Not Anymore.
(32 minutes later)
The news seemed to be positive: The number of new coronavirus cases reported in China over the past week suggested that the outbreak might be slowing — that containment efforts were working.The news seemed to be positive: The number of new coronavirus cases reported in China over the past week suggested that the outbreak might be slowing — that containment efforts were working.
But on Thursday, officials added more than 14,840 new cases to the tally of the infected in Hubei Province alone, bringing the total number to 48,206, the largest one-day increase so far recorded. The death toll in the province rose to 1,310, including 242 new deaths.But on Thursday, officials added more than 14,840 new cases to the tally of the infected in Hubei Province alone, bringing the total number to 48,206, the largest one-day increase so far recorded. The death toll in the province rose to 1,310, including 242 new deaths.
The sharp rise in reported cases illustrates how hard it has been for scientists to grasp the extent and severity of the coronavirus outbreak in China, particularly inside the epicenter, where thousands of sick people remain untested for the illness.The sharp rise in reported cases illustrates how hard it has been for scientists to grasp the extent and severity of the coronavirus outbreak in China, particularly inside the epicenter, where thousands of sick people remain untested for the illness.
Confronted by so many people with symptoms and no easy way to test them, authorities appear to have changed the way the illness is identified.Confronted by so many people with symptoms and no easy way to test them, authorities appear to have changed the way the illness is identified.
Hospitals in Wuhan, China — the largest city in Hubei Province and the center of the epidemic — have struggled to diagnose infections with scarce and complicated tests that detect the virus’s genetic signature directly. Other countries, too, have had such issues.Hospitals in Wuhan, China — the largest city in Hubei Province and the center of the epidemic — have struggled to diagnose infections with scarce and complicated tests that detect the virus’s genetic signature directly. Other countries, too, have had such issues.
Instead, officials in Hubei now seem to be including infections diagnosed by using lung scans of symptomatic patients. This shortcut will help get more patients into needed care, provincial officials said. Adding them to the count could make it easier for the authorities to decide how to allocate resources and assess treatment options.Instead, officials in Hubei now seem to be including infections diagnosed by using lung scans of symptomatic patients. This shortcut will help get more patients into needed care, provincial officials said. Adding them to the count could make it easier for the authorities to decide how to allocate resources and assess treatment options.
But the change also shows the enormous number of people in Hubei who are sick and have not been counted in the outbreak’s official tally. It also raises the question whether the province, already struggling, is equipped to deal with the new patients.But the change also shows the enormous number of people in Hubei who are sick and have not been counted in the outbreak’s official tally. It also raises the question whether the province, already struggling, is equipped to deal with the new patients.
The few experts to learn of the new numbers on Wednesday night were startled. Lung scans are an imperfect means to diagnose patients. Even patients with ordinary seasonal flu may develop pneumonia visible on a lung scan.The few experts to learn of the new numbers on Wednesday night were startled. Lung scans are an imperfect means to diagnose patients. Even patients with ordinary seasonal flu may develop pneumonia visible on a lung scan.
“We’re in unknown territory,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University in Nashville.“We’re in unknown territory,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University in Nashville.
In China, health officials have been under exceptional strain. Hospitals are overwhelmed, and huge new shelters are being erected to warehouse patients. Medical resources are in short supply. It’s never been clear who is being tested.In China, health officials have been under exceptional strain. Hospitals are overwhelmed, and huge new shelters are being erected to warehouse patients. Medical resources are in short supply. It’s never been clear who is being tested.
Health workers have gone door to door in Wuhan to check people for symptoms. The prospect of forced isolation may be deterring some people with respiratory illnesses from presenting themselves at health facilities to seek health care, some experts say, making the dimensions of the epidemic even less clear.Health workers have gone door to door in Wuhan to check people for symptoms. The prospect of forced isolation may be deterring some people with respiratory illnesses from presenting themselves at health facilities to seek health care, some experts say, making the dimensions of the epidemic even less clear.
“You have to be sick, the authorities need to find you, or you find them, and they need to test you,” said Dr. Arthur Reingold, an epidemiologist at the University of California, Berkeley.“You have to be sick, the authorities need to find you, or you find them, and they need to test you,” said Dr. Arthur Reingold, an epidemiologist at the University of California, Berkeley.
The push to prioritize lung scans seems to have begun with a social media campaign by a physician in Wuhan, who last week called for using the scans to simplify the screening of patients and to accelerate their hospitalization and treatment.The push to prioritize lung scans seems to have begun with a social media campaign by a physician in Wuhan, who last week called for using the scans to simplify the screening of patients and to accelerate their hospitalization and treatment.
Lung scans produce immediate results, she said, and Wuhan was running short of testing kits.Lung scans produce immediate results, she said, and Wuhan was running short of testing kits.
Even before today’s news, experts complained that epidemiological information from China has been incomplete, threatening containment efforts.Even before today’s news, experts complained that epidemiological information from China has been incomplete, threatening containment efforts.
The new coronavirus is highly transmissible and will be difficult to squelch. A single infected “super-spreader” can infect dozens of others. Outbreaks can seem to recede, only to rebound in short order, as the weather or conditions change.The new coronavirus is highly transmissible and will be difficult to squelch. A single infected “super-spreader” can infect dozens of others. Outbreaks can seem to recede, only to rebound in short order, as the weather or conditions change.
Recent clusters of coronavirus cases suggest the new coronavirus not only spreads quickly, but also in ways that are not entirely understood.Recent clusters of coronavirus cases suggest the new coronavirus not only spreads quickly, but also in ways that are not entirely understood.
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In Hong Kong, people living 10 floors apart were infected, and an unsealed pipe was blamed. A British citizen apparently infected 10 people, including some at a ski chalet, before he even knew he was sick.In Hong Kong, people living 10 floors apart were infected, and an unsealed pipe was blamed. A British citizen apparently infected 10 people, including some at a ski chalet, before he even knew he was sick.
In Tianjin, China, at least 33 of 102 confirmed patients had a connection of some sort with a large department store.In Tianjin, China, at least 33 of 102 confirmed patients had a connection of some sort with a large department store.
“This outbreak could still go in any direction,” Dr. Tedros Adhanom Ghebreyesus, director general of the World Health Organization, said on Wednesday.
Updated June 22, 2020Updated June 22, 2020
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.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.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.
“This outbreak could still go in any direction,” Dr. Tedros Adhanom Ghebreyesus, director general of the World Health Organization, said on Wednesday.
A change in diagnosis may make it still harder to track the virus, said Dr. Peter Rabinowitz, co-director of the University of Washington MetaCenter for Pandemic Preparedness and Global Health Security.A change in diagnosis may make it still harder to track the virus, said Dr. Peter Rabinowitz, co-director of the University of Washington MetaCenter for Pandemic Preparedness and Global Health Security.
“It makes it really confusing right now if they’re changing the whole way they screen and detect,” he said. Now estimating the scale of the epidemic “is a moving target.”“It makes it really confusing right now if they’re changing the whole way they screen and detect,” he said. Now estimating the scale of the epidemic “is a moving target.”
It is not uncommon for scientists to refine diagnostic criteria as their understanding of a new disease changes. But when the criteria are changed, experts said, it makes little sense to continue to make week-over-week comparisons.It is not uncommon for scientists to refine diagnostic criteria as their understanding of a new disease changes. But when the criteria are changed, experts said, it makes little sense to continue to make week-over-week comparisons.
“It sounds simplistic, but it’s so very important — what numbers are you counting?” said Dr. Schaffner, the infectious disease specialist.“It sounds simplistic, but it’s so very important — what numbers are you counting?” said Dr. Schaffner, the infectious disease specialist.
Scientists have been wary of the notion that the epidemic has peaked for other reasons, as well.Scientists have been wary of the notion that the epidemic has peaked for other reasons, as well.
Unlike MERS and SARS, both diseases caused by coronaviruses, the virus spreading from China appears to be highly contagious, though it is probably less often fatal.Unlike MERS and SARS, both diseases caused by coronaviruses, the virus spreading from China appears to be highly contagious, though it is probably less often fatal.
It is harder for public health officials to track a rapidly moving epidemic. Scientists often describe these epidemics as a sort of iceberg — their girth and true shape hidden below the surface.It is harder for public health officials to track a rapidly moving epidemic. Scientists often describe these epidemics as a sort of iceberg — their girth and true shape hidden below the surface.
Chaos makes it still more difficult to discern those dimensions. But an accurate grasp of the situation within China is necessary for the safety of the rest of the world, noted Dr. Tedros of the W.H.O.Chaos makes it still more difficult to discern those dimensions. But an accurate grasp of the situation within China is necessary for the safety of the rest of the world, noted Dr. Tedros of the W.H.O.
The country is so central to the world economy that it can easily “seed” epidemics everywhere, he said.The country is so central to the world economy that it can easily “seed” epidemics everywhere, he said.
“Our greatest fear remains the damage this coronavirus could do in a country like D.R.C.,” Dr. Tedros said, referring to the Democratic Republic of Congo, which has been struggling with outbreaks of Ebola and measles.“Our greatest fear remains the damage this coronavirus could do in a country like D.R.C.,” Dr. Tedros said, referring to the Democratic Republic of Congo, which has been struggling with outbreaks of Ebola and measles.
“It’s a huge task to manage a response effectively,” said Dr. Christine Kreuder Johnson, a professor of epidemiology at the University of California, Davis. “This would be true for any country.”“It’s a huge task to manage a response effectively,” said Dr. Christine Kreuder Johnson, a professor of epidemiology at the University of California, Davis. “This would be true for any country.”
“We’re in the dark in terms of knowing what to expect next.”“We’re in the dark in terms of knowing what to expect next.”
Reporting was contributed by Vivian Wang.Reporting was contributed by Vivian Wang.