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| Virus Hits Europe Harder Than China. Is That the Price of an Open Society? | Virus Hits Europe Harder Than China. Is That the Price of an Open Society? |
| (3 days later) | |
| The macabre milestones keep coming. By Wednesday, Europe had recorded more coronavirus cases and fatalities than China. On Thursday, Italy — by itself — passed China in reported deaths. | The macabre milestones keep coming. By Wednesday, Europe had recorded more coronavirus cases and fatalities than China. On Thursday, Italy — by itself — passed China in reported deaths. |
| While China claims to have lowered its rate of new cases essentially to zero, Europe’s numbers grow faster each day — about 100,000 confirmed infections and 5,000 deaths in all so far — suggesting that the worst is yet to come. | While China claims to have lowered its rate of new cases essentially to zero, Europe’s numbers grow faster each day — about 100,000 confirmed infections and 5,000 deaths in all so far — suggesting that the worst is yet to come. |
| So how is it that the new disease, Covid-19, has hit harder in Europe, which had weeks of warning that the epidemic was coming, than in China, where the virus originated and where there are twice as many people? | So how is it that the new disease, Covid-19, has hit harder in Europe, which had weeks of warning that the epidemic was coming, than in China, where the virus originated and where there are twice as many people? |
| To some extent, experts say, Europeans are paying a price for living in open, affluent democracies, where people are used to free movement, easy travel and independent decision-making, and where governments worry about public opinion. Governments aren’t used to giving harsh orders, and citizens aren’t used to following them. | To some extent, experts say, Europeans are paying a price for living in open, affluent democracies, where people are used to free movement, easy travel and independent decision-making, and where governments worry about public opinion. Governments aren’t used to giving harsh orders, and citizens aren’t used to following them. |
| But China acted with a severity and breadth that stunned the West, making unpopular moves and accepting deep economic damage as the price of containing the disease. It closed off tens of millions of people, prohibiting them from leaving their cities and even their homes, except to get food and medical care, and it imposed lesser restrictions on hundreds of millions, shutting down whole industries in the process. | But China acted with a severity and breadth that stunned the West, making unpopular moves and accepting deep economic damage as the price of containing the disease. It closed off tens of millions of people, prohibiting them from leaving their cities and even their homes, except to get food and medical care, and it imposed lesser restrictions on hundreds of millions, shutting down whole industries in the process. |
| “China has been willing to go to pretty extraordinary lengths, using the army, using the police, locking people in their homes, using drone technology to monitor behavior, setting up roadblocks,” said Dr. Arthur L. Reingold, head of the epidemiology division at the public health school of the University of California, Berkeley. | “China has been willing to go to pretty extraordinary lengths, using the army, using the police, locking people in their homes, using drone technology to monitor behavior, setting up roadblocks,” said Dr. Arthur L. Reingold, head of the epidemiology division at the public health school of the University of California, Berkeley. |
| “Whatever measures have been put in place in Europe really have only been put in place recently, and frankly, and none of them has been as draconian and all-encompassing as what was done in Wuhan,” Dr. Reingold said. | “Whatever measures have been put in place in Europe really have only been put in place recently, and frankly, and none of them has been as draconian and all-encompassing as what was done in Wuhan,” Dr. Reingold said. |
| The consistency and reliability of the numbers from China and some other countries have been questioned, but the overall situation and its direction are clear. While China stumbled in the early going — local and regional officials attempted to censor any talk of an outbreak, and medical gear was in critically short supply — it then addressed the crisis seriously. | The consistency and reliability of the numbers from China and some other countries have been questioned, but the overall situation and its direction are clear. While China stumbled in the early going — local and regional officials attempted to censor any talk of an outbreak, and medical gear was in critically short supply — it then addressed the crisis seriously. |
| The coercive power of an authoritarian government was only one factor. Speed and aggressive action have been essential, and some East Asian governments have used an assertive combination of widespread testing, quarantines for the sick and the quick tracking of their contacts to contain the outbreak without shutting down the economy. | The coercive power of an authoritarian government was only one factor. Speed and aggressive action have been essential, and some East Asian governments have used an assertive combination of widespread testing, quarantines for the sick and the quick tracking of their contacts to contain the outbreak without shutting down the economy. |
| “They saw what SARS did” in 2003 and 2004, “and they prepared for the next one,” said Thomas R. Frieden, a former director of the United States Centers for Disease Control and Prevention. | “They saw what SARS did” in 2003 and 2004, “and they prepared for the next one,” said Thomas R. Frieden, a former director of the United States Centers for Disease Control and Prevention. |
| While China lost precious weeks in the beginning, it then moved faster and more decisively than Western countries have. | While China lost precious weeks in the beginning, it then moved faster and more decisively than Western countries have. |
| China imposed its first big lockdown, of Wuhan and other cities, on Jan. 23, less than a month after local officials there conceded that they were facing a new pathogen, and barely two weeks after the virus was identified. When Wuhan was closed off, there were fewer than 600 confirmed infections worldwide, though testing had barely begun. | China imposed its first big lockdown, of Wuhan and other cities, on Jan. 23, less than a month after local officials there conceded that they were facing a new pathogen, and barely two weeks after the virus was identified. When Wuhan was closed off, there were fewer than 600 confirmed infections worldwide, though testing had barely begun. |
| “China may have acted late. I have reservations about some measures they implemented, but they controlled the epidemic,” Francois Balloux, an epidemiologist at University College London, wrote on Twitter on Thursday. “Doing so, they gave the world a window of opportunity to prepare, which was squandered.” | “China may have acted late. I have reservations about some measures they implemented, but they controlled the epidemic,” Francois Balloux, an epidemiologist at University College London, wrote on Twitter on Thursday. “Doing so, they gave the world a window of opportunity to prepare, which was squandered.” |
| Europe’s first effort to rope off a broad area — Italy’s much less stringently enforced isolation of the northern region that includes Milan — took effect on March 8, when the country had reported more than 7,300 cases. Spain and France had similar caseloads the following week, when they chose to ban most public outings nationwide. | Europe’s first effort to rope off a broad area — Italy’s much less stringently enforced isolation of the northern region that includes Milan — took effect on March 8, when the country had reported more than 7,300 cases. Spain and France had similar caseloads the following week, when they chose to ban most public outings nationwide. |
| “You have to do strict social distancing within a week of the start of community transmission, otherwise you get an explosion, and once you get that explosion, it’s very hard to contain,” Dr. Frieden said. “The key is not to get to that point, and much of Europe is beyond that point, and New York is beyond that point.” | “You have to do strict social distancing within a week of the start of community transmission, otherwise you get an explosion, and once you get that explosion, it’s very hard to contain,” Dr. Frieden said. “The key is not to get to that point, and much of Europe is beyond that point, and New York is beyond that point.” |
| Some parts of East Asia acted quickly, but with a very different strategy than China’s or Europe’s: aggressive testing and contact-tracing to stop the chain of transmission, without shutting down economic activity. | Some parts of East Asia acted quickly, but with a very different strategy than China’s or Europe’s: aggressive testing and contact-tracing to stop the chain of transmission, without shutting down economic activity. |
| As a result, Singapore, Taiwan and Hong Kong have had few cases, and South Korea, which has tested more than 200,000 people, has brought a large outbreak under control. | As a result, Singapore, Taiwan and Hong Kong have had few cases, and South Korea, which has tested more than 200,000 people, has brought a large outbreak under control. |
| “South Korea showed to the world that it can allow curtailing a pandemic with limited infringements to individual freedom and disruption to the economy and the fabric of society,” Dr. Balloux wrote. | “South Korea showed to the world that it can allow curtailing a pandemic with limited infringements to individual freedom and disruption to the economy and the fabric of society,” Dr. Balloux wrote. |
| Updated June 12, 2020 | Updated June 12, 2020 |
| 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. | |
| 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. |
| Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. | Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. |
| 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. | 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. | 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.) |
| 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. | 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. | 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’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. |
| But that strategy, Dr. Reingold said, is “a herculean undertaking, very resource-intensive” — and one that the United States, in particular, could not replicate. “There’s still a long way to go before testing is readily available here,” he said. | But that strategy, Dr. Reingold said, is “a herculean undertaking, very resource-intensive” — and one that the United States, in particular, could not replicate. “There’s still a long way to go before testing is readily available here,” he said. |
| Epidemiologists also say that wide-scale testing and contact-tracing, like social distancing, work best in containing an outbreak when they are used before the contagion is spreading out of control. | Epidemiologists also say that wide-scale testing and contact-tracing, like social distancing, work best in containing an outbreak when they are used before the contagion is spreading out of control. |
| Put another way, the best response to a serious outbreak is the one that will draw accusations, at first, that the government is overreacting. But experts say it is often impossible to know at the outset which outbreaks are serious. | Put another way, the best response to a serious outbreak is the one that will draw accusations, at first, that the government is overreacting. But experts say it is often impossible to know at the outset which outbreaks are serious. |
| If Italy’s lockdown measures are effective at preventing new infections, it will not become evident in the numbers for a few more days, at least, experts say. In other countries, which took those measures later, the benefit will show up later. | If Italy’s lockdown measures are effective at preventing new infections, it will not become evident in the numbers for a few more days, at least, experts say. In other countries, which took those measures later, the benefit will show up later. |
| At its peak in early February, China reported 3,000 to 4,000 new confirmed infections per day. Italy is now adding cases faster than that, and Europe’s caseload grows by well over 10,000 daily. | At its peak in early February, China reported 3,000 to 4,000 new confirmed infections per day. Italy is now adding cases faster than that, and Europe’s caseload grows by well over 10,000 daily. |
| On Thursday, Italy reported about 41,000 infections and 3,400 deaths. The country’s caseload could double by the end of March and pass China’s official tally, experts say, and other countries might follow. | On Thursday, Italy reported about 41,000 infections and 3,400 deaths. The country’s caseload could double by the end of March and pass China’s official tally, experts say, and other countries might follow. |