'As Trump Pushes to Reopen, Government Sees Virus Toll Nearly Doubling' diff viewer (10/11)

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As Trump Pushes to Reopen, Government Sees Virus Toll Nearly Doubling	As Trump Pushes to Reopen, Government Sees Virus Toll Nearly Doubling
2020-06-24 10:18:28 UTC	2020-06-24 15:27:24 UTC (about 5 hours later)
WASHINGTON — As President Trump presses states to reopen their economies, his administration is privately projecting a steady rise in coronavirus infections and deaths over the next several weeks, reaching about 3,000 daily deaths on June 1 — nearly double the current level.	WASHINGTON — As President Trump presses states to reopen their economies, his administration is privately projecting a steady rise in coronavirus infections and deaths over the next several weeks, reaching about 3,000 daily deaths on June 1 — nearly double the current level.
The projections, based on data collected by various agencies, including the Centers for Disease Control and Prevention, and laid out in an internal document obtained Monday by The New York Times, forecast about 200,000 new cases each day by the end of May, up from about 30,000 cases now. There are currently about 1,750 deaths per day, the data shows.	The projections, based on data collected by various agencies, including the Centers for Disease Control and Prevention, and laid out in an internal document obtained Monday by The New York Times, forecast about 200,000 new cases each day by the end of May, up from about 30,000 cases now. There are currently about 1,750 deaths per day, the data shows.
They are not the only ones forecasting more carnage. Another model, closely watched by the White House, raised its fatality projections on Monday to more than 134,000 American deaths from Covid-19, the disease caused by the coronavirus, by early August. The Institute for Health Metrics and Evaluation at the University of Washington more than doubled its previous projection of about 60,000 total deaths, an increase that it said partly reflects “changes in mobility and social distancing policies.”	They are not the only ones forecasting more carnage. Another model, closely watched by the White House, raised its fatality projections on Monday to more than 134,000 American deaths from Covid-19, the disease caused by the coronavirus, by early August. The Institute for Health Metrics and Evaluation at the University of Washington more than doubled its previous projection of about 60,000 total deaths, an increase that it said partly reflects “changes in mobility and social distancing policies.”
The numbers underscore a sobering reality: While the United States has been hunkered down for the past seven weeks, the prognosis has not markedly improved. As states reopen — many without meeting White House guidelines that call for a steady decline in coronavirus cases or in the number of people testing positive over a 14-day period — the cost of the shift is likely to be tallied in funerals.	The numbers underscore a sobering reality: While the United States has been hunkered down for the past seven weeks, the prognosis has not markedly improved. As states reopen — many without meeting White House guidelines that call for a steady decline in coronavirus cases or in the number of people testing positive over a 14-day period — the cost of the shift is likely to be tallied in funerals.
“There remains a large number of counties whose burden continues to grow,” the C.D.C. warned, alongside a map that offered a detailed view of the growth of the pandemic.	“There remains a large number of counties whose burden continues to grow,” the C.D.C. warned, alongside a map that offered a detailed view of the growth of the pandemic.
The projections amplify the primary fear of public health experts: that a reopening of the economy will put the nation right back where it was in mid-March, when cases were rising so rapidly in some parts of the country that patients were dying on gurneys in hospital hallways amid overloaded health systems.	The projections amplify the primary fear of public health experts: that a reopening of the economy will put the nation right back where it was in mid-March, when cases were rising so rapidly in some parts of the country that patients were dying on gurneys in hospital hallways amid overloaded health systems.
Under the White House’s reopening plan, called “Opening Up America Again,” states considering relaxing stay-at-home policies are supposed to show a “downward trajectory” either in the number of new infections or positive tests as a percent of total tests over 14 days, and a “robust testing program” for at-risk health care workers.	Under the White House’s reopening plan, called “Opening Up America Again,” states considering relaxing stay-at-home policies are supposed to show a “downward trajectory” either in the number of new infections or positive tests as a percent of total tests over 14 days, and a “robust testing program” for at-risk health care workers.
But some of the states moving the quickest are not honoring all of those guidelines.	But some of the states moving the quickest are not honoring all of those guidelines.
In fact, the Trump administration has steered clear of enacting a national policy to prevent its own projections from coming to pass. On a conference call with the nation’s governors on Monday, Vice President Mike Pence cheered on state-level coronavirus testing, and he again promised this week to ship out more tests to all 50 states.	In fact, the Trump administration has steered clear of enacting a national policy to prevent its own projections from coming to pass. On a conference call with the nation’s governors on Monday, Vice President Mike Pence cheered on state-level coronavirus testing, and he again promised this week to ship out more tests to all 50 states.
But a recording of the call, obtained by The Times, made clear that the White House was taking its cues from state governments. Mr. Pence’s upbeat assessment also included some public relations advice for the governors.	But a recording of the call, obtained by The Times, made clear that the White House was taking its cues from state governments. Mr. Pence’s upbeat assessment also included some public relations advice for the governors.
“It’s important that as we see progress being made, and declining hospitalizations and emergency room admissions and positive rates going down, that all of these governors are also aware as they’re increasing testing, the number of cases that are going to be reported are going up,” the vice president said on the call. “But it’s all going to be a matter of making sure that the public sees the whole picture. But it’s all progress.”	“It’s important that as we see progress being made, and declining hospitalizations and emergency room admissions and positive rates going down, that all of these governors are also aware as they’re increasing testing, the number of cases that are going to be reported are going up,” the vice president said on the call. “But it’s all going to be a matter of making sure that the public sees the whole picture. But it’s all progress.”
While the Trump White House is emphasizing testing, experts say a whole range of additional policies are needed to contain the fast-moving virus: isolation of those infected, contact tracing to locate people who interacted with a coronavirus-positive person and quarantines for those people.	While the Trump White House is emphasizing testing, experts say a whole range of additional policies are needed to contain the fast-moving virus: isolation of those infected, contact tracing to locate people who interacted with a coronavirus-positive person and quarantines for those people.
In New York, where the number of overall cases is declining, a cautious-sounding Gov. Andrew M. Cuomo said Monday that the state would monitor four “core factors” to determine if a region is ready to reopen: the number of new infections; the capacity of the health care system; the testing capacity; and the capacity for “contact tracing” to identify people exposed to those who test positive.	In New York, where the number of overall cases is declining, a cautious-sounding Gov. Andrew M. Cuomo said Monday that the state would monitor four “core factors” to determine if a region is ready to reopen: the number of new infections; the capacity of the health care system; the testing capacity; and the capacity for “contact tracing” to identify people exposed to those who test positive.
“While we continue to reduce the spread of the Covid-19 virus, we can begin to focus on reopening, but we have to be careful and use the information we’ve learned so we don’t erase the strides we’ve already made,” Mr. Cuomo said. “Reopening is not going to happen statewide all at once.”	“While we continue to reduce the spread of the Covid-19 virus, we can begin to focus on reopening, but we have to be careful and use the information we’ve learned so we don’t erase the strides we’ve already made,” Mr. Cuomo said. “Reopening is not going to happen statewide all at once.”
Nationally, 27 states had loosened social distancing restrictions in some way as of Monday, and others had announced changes that will take effect in the coming weeks, according to an analysis by the Kaiser Family Foundation. But only 20 of those states meet the caseload or testing criteria set out by the Trump administration.	Nationally, 27 states had loosened social distancing restrictions in some way as of Monday, and others had announced changes that will take effect in the coming weeks, according to an analysis by the Kaiser Family Foundation. But only 20 of those states meet the caseload or testing criteria set out by the Trump administration.
The remaining seven — Indiana, Iowa, Kansas, Minnesota, Mississippi, Nebraska and Wyoming — are still showing a rise in daily infections and positive tests, but have moved toward reopening anyway.	The remaining seven — Indiana, Iowa, Kansas, Minnesota, Mississippi, Nebraska and Wyoming — are still showing a rise in daily infections and positive tests, but have moved toward reopening anyway.
“It is true that there are parts of the country that are doing better and can begin to look at ways to ease the requirements, but there are large swaths of the country that are not, and the growth that is projected is based mostly on these other parts of the country,” Jennifer Kates, the foundation’s director of global health and H.I.V. policy and an author of the analysis, said in an interview.	“It is true that there are parts of the country that are doing better and can begin to look at ways to ease the requirements, but there are large swaths of the country that are not, and the growth that is projected is based mostly on these other parts of the country,” Jennifer Kates, the foundation’s director of global health and H.I.V. policy and an author of the analysis, said in an interview.
The administration’s forecast, she said, “says we are far from out of the woods on this, and it’s quite concerning.”	The administration’s forecast, she said, “says we are far from out of the woods on this, and it’s quite concerning.”
Before reopening, Ms. Kates said, governors must consider other factors beyond caseload and testing: “Do we have enough I.C.U. beds? How is our hospital capacity? How is our contact tracing?” Based on its own metrics, which urge states to increase the number of tests conducted and the share of their populations tested each week, her analysis concluded that just nine of the 27 states could consider relaxing social distancing requirements.	Before reopening, Ms. Kates said, governors must consider other factors beyond caseload and testing: “Do we have enough I.C.U. beds? How is our hospital capacity? How is our contact tracing?” Based on its own metrics, which urge states to increase the number of tests conducted and the share of their populations tested each week, her analysis concluded that just nine of the 27 states could consider relaxing social distancing requirements.
If anything, the administration’s projections are too optimistic, forecasting experts said Monday. In the projections, the number of actual deaths for one of the last days in April turned out to be slightly lower than what the model showed. But for much of April and parts of May, actual deaths were some 10 times higher than the model predicted.	If anything, the administration’s projections are too optimistic, forecasting experts said Monday. In the projections, the number of actual deaths for one of the last days in April turned out to be slightly lower than what the model showed. But for much of April and parts of May, actual deaths were some 10 times higher than the model predicted.
“The model is overly optimistic and not particularly useful in guiding decisions about the disease’s trajectory,” said Dr. Donald Burke, a professor of epidemiology at the University of Pittsburgh Graduate School of Public Health.	“The model is overly optimistic and not particularly useful in guiding decisions about the disease’s trajectory,” said Dr. Donald Burke, a professor of epidemiology at the University of Pittsburgh Graduate School of Public Health.
~~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.
Dr. George Rutherford, a professor of epidemiology at the University of California, San Francisco, noted that the government’s model has already come in below reported deaths from Covid-19, and that death toll is not counting deaths not officially recorded. “Remember,” he said, “these are reported deaths; the true number is likely higher.”	Dr. George Rutherford, a professor of epidemiology at the University of California, San Francisco, noted that the government’s model has already come in below reported deaths from Covid-19, and that death toll is not counting deaths not officially recorded. “Remember,” he said, “these are reported deaths; the true number is likely higher.”
In the absence of a national policy to slow the virus, state officials have been left to answer a wrenching question: How many deaths are acceptable?	In the absence of a national policy to slow the virus, state officials have been left to answer a wrenching question: How many deaths are acceptable?
The White House distanced itself from the projections, saying the document, dated May 2, was not produced by or presented to the president’s coronavirus task force, which does its own modeling. “The data is not reflective of any of the modeling done by the task force or data that the task force has analyzed,” Judd Deere, Mr. Trump’s deputy press secretary, told reporters on Monday.	The White House distanced itself from the projections, saying the document, dated May 2, was not produced by or presented to the president’s coronavirus task force, which does its own modeling. “The data is not reflective of any of the modeling done by the task force or data that the task force has analyzed,” Judd Deere, Mr. Trump’s deputy press secretary, told reporters on Monday.