'Ecuador’s Death Toll During Outbreak Is Among the Worst in the World' diff viewer (11/12)

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Ecuador’s Death Toll During Outbreak Is Among the Worst in the World	Ecuador’s Death Toll During Outbreak Is Among the Worst in the World
2020-06-23 21:58:29 UTC	2020-06-24 18:04:43 UTC (about 20 hours later)
QUITO, Ecuador — With bodies abandoned on sidewalks, slumped in wheelchairs, packed into cardboard coffins and stacked by the hundreds in morgues, it is clear that Ecuador has been devastated by the coronavirus.	QUITO, Ecuador — With bodies abandoned on sidewalks, slumped in wheelchairs, packed into cardboard coffins and stacked by the hundreds in morgues, it is clear that Ecuador has been devastated by the coronavirus.
But the epidemic is even worse than many people in the country realize.	But the epidemic is even worse than many people in the country realize.
The death toll in Ecuador during the outbreak was 15 times higher than the official number of Covid-19 deaths reported by the government, according to an analysis of mortality data by The New York Times.	The death toll in Ecuador during the outbreak was 15 times higher than the official number of Covid-19 deaths reported by the government, according to an analysis of mortality data by The New York Times.
The numbers suggest that the South American country is suffering one of the worst outbreaks in the world.	The numbers suggest that the South American country is suffering one of the worst outbreaks in the world.
The figures provide a dire indication of the damage the virus can do to developing countries, where it can quickly overwhelm health care systems and even the government’s ability to keep count of how many people are falling to the disease.	The figures provide a dire indication of the damage the virus can do to developing countries, where it can quickly overwhelm health care systems and even the government’s ability to keep count of how many people are falling to the disease.
“There were people dying at the doors of our clinics and we had no way of helping them,” said Marcelo Castillo, head of an intensive care unit in a private hospital. “Mothers, husbands, asking in tears for a bed, because, ‘You are a doctor, and you have to help us.’”	“There were people dying at the doors of our clinics and we had no way of helping them,” said Marcelo Castillo, head of an intensive care unit in a private hospital. “Mothers, husbands, asking in tears for a bed, because, ‘You are a doctor, and you have to help us.’”
A staggering number of people — about 7,600 more this year — died in Ecuador from March 1 to April 15 than the average in recent years, according to an analysis of official death registration data by The Times.	A staggering number of people — about 7,600 more this year — died in Ecuador from March 1 to April 15 than the average in recent years, according to an analysis of official death registration data by The Times.
That spike stands in stark contrast to the number of deaths that the government has officially attributed to the coronavirus: 503 people by April 15.	That spike stands in stark contrast to the number of deaths that the government has officially attributed to the coronavirus: 503 people by April 15.
Mortality data in the middle of a pandemic is inexact, and it could change. The additional deaths include those from Covid-19, as well as from other causes, including people who could not be treated at hospitals inundated with coronavirus patients.	Mortality data in the middle of a pandemic is inexact, and it could change. The additional deaths include those from Covid-19, as well as from other causes, including people who could not be treated at hospitals inundated with coronavirus patients.
But the data points to an enormous, and sudden, increase in deaths. Three times the usual number of people died in Ecuador during the first two weeks of April, when the number of people falling ill reached a peak — an extraordinary rise that exceeds increases seen in similar data from Spain and the United Kingdom.	But the data points to an enormous, and sudden, increase in deaths. Three times the usual number of people died in Ecuador during the first two weeks of April, when the number of people falling ill reached a peak — an extraordinary rise that exceeds increases seen in similar data from Spain and the United Kingdom.
Ecuador’s beleaguered government, which is also dealing with its worst economic crisis in decades, acknowledged early in the outbreak that its official mortality figures fell far short of reality.	Ecuador’s beleaguered government, which is also dealing with its worst economic crisis in decades, acknowledged early in the outbreak that its official mortality figures fell far short of reality.
“We know that both the number of infections and the number of deaths are falling short,” Ecuador’s president, Lenín Moreno, said in a public address on April 2. “The reality always overtakes the number of tests and the speed of attention” of medical services, he said.	“We know that both the number of infections and the number of deaths are falling short,” Ecuador’s president, Lenín Moreno, said in a public address on April 2. “The reality always overtakes the number of tests and the speed of attention” of medical services, he said.
There has been a surge of infections in the province that includes Ecuador’s business capital, Guayaquil, where residents are thought to have brought the virus home after visiting Spain.	There has been a surge of infections in the province that includes Ecuador’s business capital, Guayaquil, where residents are thought to have brought the virus home after visiting Spain.
In Guayaquil, fatalities during the first two weeks of April were eight times higher than usual, the data indicates — a far greater rise than that of New York City, where fatalities were four times higher in recent weeks.	In Guayaquil, fatalities during the first two weeks of April were eight times higher than usual, the data indicates — a far greater rise than that of New York City, where fatalities were four times higher in recent weeks.
Within weeks of the first case being identified in Guayaquil, hospitals were overflowing and burial systems collapsed under overwhelming demand, leaving dead bodies to pile in the streets and pushing families to bury loved ones in coffins made of cardboard.	Within weeks of the first case being identified in Guayaquil, hospitals were overflowing and burial systems collapsed under overwhelming demand, leaving dead bodies to pile in the streets and pushing families to bury loved ones in coffins made of cardboard.
While the images shocked Latin America and the world, the true scale of the crisis has largely been obscured by the government’s limited ability to determine who has the virus, a situation exacerbated by global shortages of tests and other materials, said Cynthia Viteri, Guayaquil’s mayor.	While the images shocked Latin America and the world, the true scale of the crisis has largely been obscured by the government’s limited ability to determine who has the virus, a situation exacerbated by global shortages of tests and other materials, said Cynthia Viteri, Guayaquil’s mayor.
“We will never know what the real number is, because there are no tests,” Ms. Viteri said.	“We will never know what the real number is, because there are no tests,” Ms. Viteri said.
In early April, the government created a task force to deal with the precipitous climb in the number of dead bodies that needed attention in Guayaquil. At the peak of the crisis, the team collected and authorized the burial of five times as many bodies than would normally be buried in the city on any given day.	In early April, the government created a task force to deal with the precipitous climb in the number of dead bodies that needed attention in Guayaquil. At the peak of the crisis, the team collected and authorized the burial of five times as many bodies than would normally be buried in the city on any given day.
The wave of deaths is all the more disturbing for being impossible to explain. There is no obvious reason for Ecuador to be devastated far more than other countries. Its population is relatively young, and most people live in rural areas, both factors that should reduce the risk, said Jenny Garcia, a demographer who studies Latin America at the Institut National d’Études Démographiques in France.	The wave of deaths is all the more disturbing for being impossible to explain. There is no obvious reason for Ecuador to be devastated far more than other countries. Its population is relatively young, and most people live in rural areas, both factors that should reduce the risk, said Jenny Garcia, a demographer who studies Latin America at the Institut National d’Études Démographiques in France.
That mystery is reflected in the pandemic’s uneven consequences around the world, raising questions no one has been able to answer. Are some places just lucky? Do unknown local factors lead to dramatic differences?	That mystery is reflected in the pandemic’s uneven consequences around the world, raising questions no one has been able to answer. Are some places just lucky? Do unknown local factors lead to dramatic differences?
Medical workers in Guayaquil and local residents who have lost their loved ones described the despair that washed over the city during the peak of the epidemic in early April. The virus spread through the usually bustling port city of three million with bewildering speed, hitting the plush suburban gated community of Samborondón and the working-class district of Febres Cordero particularly hard.	Medical workers in Guayaquil and local residents who have lost their loved ones described the despair that washed over the city during the peak of the epidemic in early April. The virus spread through the usually bustling port city of three million with bewildering speed, hitting the plush suburban gated community of Samborondón and the working-class district of Febres Cordero particularly hard.
“I fall asleep with anxiety, not because I fear infection — I actually don’t think about it — but because of the overload,” said Dr. Castillo, who works in an intensive care unit in Samborondón.	“I fall asleep with anxiety, not because I fear infection — I actually don’t think about it — but because of the overload,” said Dr. Castillo, who works in an intensive care unit in Samborondón.
In another city hospital, the Teodoro Maldonado Carbo, a doctor who did not want to give his name because he has been asked not to speak to the media, described what he said were scenes out of a horror film.	In another city hospital, the Teodoro Maldonado Carbo, a doctor who did not want to give his name because he has been asked not to speak to the media, described what he said were scenes out of a horror film.
~~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.
There were corpses in wheelchairs, in stretchers and on the floor in the emergency area, he said. The smell was such that the staff refused to enter.	There were corpses in wheelchairs, in stretchers and on the floor in the emergency area, he said. The smell was such that the staff refused to enter.