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As States Rush to Reopen, Scientists Fear a Coronavirus Comeback As States Rush to Reopen, Scientists Fear a Coronavirus Comeback
(1 day later)
Millions of working people and small-business owners who cannot earn money while sheltering at home are facing economic ruin. So dozens of states, seeking to ease the pain, are coming out of lockdown.Millions of working people and small-business owners who cannot earn money while sheltering at home are facing economic ruin. So dozens of states, seeking to ease the pain, are coming out of lockdown.
Most have not met even minimal criteria for doing so safely, and some are reopening even as coronavirus cases rise, inviting disaster. The much-feared “second wave” of infection may not wait until fall, many scientists say, and instead may become a storm of wavelets breaking unpredictably across the country.Most have not met even minimal criteria for doing so safely, and some are reopening even as coronavirus cases rise, inviting disaster. The much-feared “second wave” of infection may not wait until fall, many scientists say, and instead may become a storm of wavelets breaking unpredictably across the country.
The reopenings will proceed nonetheless. The question now, scientists say, is whether the nation can minimize the damage by intelligently adopting new tactics.The reopenings will proceed nonetheless. The question now, scientists say, is whether the nation can minimize the damage by intelligently adopting new tactics.
Evidence is mounting that masks — if worn in public places, by everyone — are far more effective at stopping transmission than was previously realized. Across the nation, testing remains wholly inadequate, but home-use nasal swabs and saliva tests are on the way that may provide a clearer picture of where the virus is.Evidence is mounting that masks — if worn in public places, by everyone — are far more effective at stopping transmission than was previously realized. Across the nation, testing remains wholly inadequate, but home-use nasal swabs and saliva tests are on the way that may provide a clearer picture of where the virus is.
Americans are lining up for antibody tests that may reveal who has some immunity, perhaps opening paths back to normal life for them. Early (but still controversial) surveys suggest that more Americans may carry antibodies than initially thought.Americans are lining up for antibody tests that may reveal who has some immunity, perhaps opening paths back to normal life for them. Early (but still controversial) surveys suggest that more Americans may carry antibodies than initially thought.
Employers are moving to design safer workplaces. A modestly effective antiviral treatment has been found. And laboratories around the world are racing toward the grail — a vaccine — at an unprecedented pace.Employers are moving to design safer workplaces. A modestly effective antiviral treatment has been found. And laboratories around the world are racing toward the grail — a vaccine — at an unprecedented pace.
But while it may still be possible to blunt the impact of the reopenings, the nation is finding even this goal difficult.But while it may still be possible to blunt the impact of the reopenings, the nation is finding even this goal difficult.
As the weather warms, Americans are already struggling to stay at home or remain six feet apart on crowded beaches, hiking trails and park playgrounds. Every crowd may have some silent carriers of the virus.As the weather warms, Americans are already struggling to stay at home or remain six feet apart on crowded beaches, hiking trails and park playgrounds. Every crowd may have some silent carriers of the virus.
Outside New York, California and a few other states, many Americans refuse to wear masks, and governors and mayors have waffled over whether to order them to. The dispute has even led to threats and a killing.Outside New York, California and a few other states, many Americans refuse to wear masks, and governors and mayors have waffled over whether to order them to. The dispute has even led to threats and a killing.
Fifty brands of antibody tests are available, but many are inaccurate. Many states are moving too quickly for employers and retailers to make environments safe. And the lockdowns have become entwined in partisan politics, with some libertarian extremists, gun-rights advocates and anti-vaccine activists painting them as an infringement of personal freedoms.Fifty brands of antibody tests are available, but many are inaccurate. Many states are moving too quickly for employers and retailers to make environments safe. And the lockdowns have become entwined in partisan politics, with some libertarian extremists, gun-rights advocates and anti-vaccine activists painting them as an infringement of personal freedoms.
Deaths are already far higher than the 60,000 once predicted by August. Even President Trump has begun to talk of a toll that may reach 100,000, perhaps more.Deaths are already far higher than the 60,000 once predicted by August. Even President Trump has begun to talk of a toll that may reach 100,000, perhaps more.
Some epidemiological models predict three times that many within months — closer to the 240,000 that the White House’s coronavirus task force predicted in March before switching to a new, more optimistic model.Some epidemiological models predict three times that many within months — closer to the 240,000 that the White House’s coronavirus task force predicted in March before switching to a new, more optimistic model.
Dr. Anthony S. Fauci, the task force’s chief medical adviser, has said he expects cases to spike in closed environments like nursing homes, prisons and factories.Dr. Anthony S. Fauci, the task force’s chief medical adviser, has said he expects cases to spike in closed environments like nursing homes, prisons and factories.
“We’re not reopening based on science,” said Dr. Thomas R. Frieden, a former director of the C.D.C. in the Obama administration. “We’re reopening based on politics, ideology and public pressure. And I think it’s going to end badly.”“We’re not reopening based on science,” said Dr. Thomas R. Frieden, a former director of the C.D.C. in the Obama administration. “We’re reopening based on politics, ideology and public pressure. And I think it’s going to end badly.”
The effects of the reopenings will not be immediately apparent, and in the absence of widespread testing, it will be hard to know where the country stands in the fight against the virus.The effects of the reopenings will not be immediately apparent, and in the absence of widespread testing, it will be hard to know where the country stands in the fight against the virus.
It takes two or three weeks for the newly infected who become severely ill to need hospitalization. An initial calm may encourage more Americans to drop their guard or more governors to ease restrictions.It takes two or three weeks for the newly infected who become severely ill to need hospitalization. An initial calm may encourage more Americans to drop their guard or more governors to ease restrictions.
“I do worry that people will stay home enough in the states that open earliest so that we don’t immediately see the second wave, and then other states will draw the wrong lessons,” said Dr. Leana Wen, a former health commissioner of Baltimore.“I do worry that people will stay home enough in the states that open earliest so that we don’t immediately see the second wave, and then other states will draw the wrong lessons,” said Dr. Leana Wen, a former health commissioner of Baltimore.
Social distancing has proved effective at interrupting viral transmission in places where it was embraced. But now even formerly terrified New Yorkers, living at the center of the nation’s outbreak, are clearly wearying of it.Social distancing has proved effective at interrupting viral transmission in places where it was embraced. But now even formerly terrified New Yorkers, living at the center of the nation’s outbreak, are clearly wearying of it.
Central Park, which was so quiet in late March that the birdsong was startlingly loud, is often crowded with joggers, strollers and cyclists. Avenues that were ghostly canyons now have far more cars, Mayor Bill de Blasio has complained, and steady traffic has returned to some local highways.Central Park, which was so quiet in late March that the birdsong was startlingly loud, is often crowded with joggers, strollers and cyclists. Avenues that were ghostly canyons now have far more cars, Mayor Bill de Blasio has complained, and steady traffic has returned to some local highways.
Viruses persist only because they can exploit human interactions: a stray cough, a plume of virions behind a jogger, a bicycle handle no one has disinfected.Viruses persist only because they can exploit human interactions: a stray cough, a plume of virions behind a jogger, a bicycle handle no one has disinfected.
Nationwide, there are still about 25,000 new confirmed cases a day of Covid-19, the disease caused by the coronavirus. Most are probably within families, experts said, or among health workers and emergency personnel exposed on the job.Nationwide, there are still about 25,000 new confirmed cases a day of Covid-19, the disease caused by the coronavirus. Most are probably within families, experts said, or among health workers and emergency personnel exposed on the job.
But there have also been hot spots of hundreds of cases in meat and poultry plants, veterans’ hospitals and nursing homes in rural states.But there have also been hot spots of hundreds of cases in meat and poultry plants, veterans’ hospitals and nursing homes in rural states.
To keep the toll from rising, some factories making essential goods, like ventilators, have placed workstations six feet apart and made temperature checks and masks mandatory.To keep the toll from rising, some factories making essential goods, like ventilators, have placed workstations six feet apart and made temperature checks and masks mandatory.
Food plants are installing plastic barriers between workers and on cafeteria tables, requiring masks, checking symptoms at entrances and doing more cleaning. Most nursing homes no longer accept visitors.Food plants are installing plastic barriers between workers and on cafeteria tables, requiring masks, checking symptoms at entrances and doing more cleaning. Most nursing homes no longer accept visitors.
As well intentioned as these stopgap measures may be, they are part of a headlong rush back to “normal life” that few experts condone.As well intentioned as these stopgap measures may be, they are part of a headlong rush back to “normal life” that few experts condone.
Many models for safely reopening the economy have been issued, including one from the National Center for Disaster Preparedness at Columbia, and others from Harvard, CovidActNow and Resolve to Save Lives.Many models for safely reopening the economy have been issued, including one from the National Center for Disaster Preparedness at Columbia, and others from Harvard, CovidActNow and Resolve to Save Lives.
Most reopening criteria, including the White House’s relatively vague guidelines, say that at a minimum a state should have 14 days of declining cases before it even considers reopening. Almost no state reopening now has met that low standard.Most reopening criteria, including the White House’s relatively vague guidelines, say that at a minimum a state should have 14 days of declining cases before it even considers reopening. Almost no state reopening now has met that low standard.
Virtually all guidelines emphasize comprehensive testing and systematic contact tracing.Virtually all guidelines emphasize comprehensive testing and systematic contact tracing.
Testing is a sore point. Virtually everyone but Mr. Trump says there are too few tests, but everyone disagrees about how many are needed.Testing is a sore point. Virtually everyone but Mr. Trump says there are too few tests, but everyone disagrees about how many are needed.
At a minimum, a state must do enough random testing — including among people with no symptoms — to detect a surge of cases anywhere within its borders. Otherwise, the first unmistakable sign that something is wrong will be the wail of sirens as oxygen-starved patients are taken to a local emergency room.At a minimum, a state must do enough random testing — including among people with no symptoms — to detect a surge of cases anywhere within its borders. Otherwise, the first unmistakable sign that something is wrong will be the wail of sirens as oxygen-starved patients are taken to a local emergency room.
By then, it may be too late to stop a flood of patients over the next week that will overwhelm that hospital.By then, it may be too late to stop a flood of patients over the next week that will overwhelm that hospital.
In rural America — even in relatively wealthy states like Texas — financially struggling hospitals often have few ventilators, and ambulances must drive long distances.In rural America — even in relatively wealthy states like Texas — financially struggling hospitals often have few ventilators, and ambulances must drive long distances.
When hospitals run short on supplies or ambulances fail to promptly reach victims of pneumonia, heart attacks, strokes or car accidents, many lives may be lost, as happened in New York.When hospitals run short on supplies or ambulances fail to promptly reach victims of pneumonia, heart attacks, strokes or car accidents, many lives may be lost, as happened in New York.
New York has tested more citizens than any other state has — more than twice as many per capita as California, and more than three times as many as Texas. To spot outbreaks early, the Harvard model advocates scaling up, to 20 million tests a day nationwide.New York has tested more citizens than any other state has — more than twice as many per capita as California, and more than three times as many as Texas. To spot outbreaks early, the Harvard model advocates scaling up, to 20 million tests a day nationwide.
Adm. Brett P. Giroir, the coronavirus task force’s chief of testing strategy, recently said there was “absolutely no way on earth” that goal could be reached, and that eight million tests a month, or about 270,000 a day, might be possible by June.Adm. Brett P. Giroir, the coronavirus task force’s chief of testing strategy, recently said there was “absolutely no way on earth” that goal could be reached, and that eight million tests a month, or about 270,000 a day, might be possible by June.
Paul M. Romer, a Nobel Prize-winning economist at New York University, has called for daily rapid tests for every worker in contact with others — meaning 20 to 30 million tests a day.Paul M. Romer, a Nobel Prize-winning economist at New York University, has called for daily rapid tests for every worker in contact with others — meaning 20 to 30 million tests a day.
At $10 a test, he has conceded, such an undertaking would cost at least $ 1.5 billion a week, but even that is far cheaper, he argued, than the damage now being done by keeping the country locked down.At $10 a test, he has conceded, such an undertaking would cost at least $ 1.5 billion a week, but even that is far cheaper, he argued, than the damage now being done by keeping the country locked down.
For now, the lofty goal of tracing and testing the contacts of every infected person remains unthinkable. Epidemiological models in the United States and data from China suggest that each case generates about 50 contacts, so the 25,000 new daily cases in the United States generate another 1.3 million contacts to find each day.For now, the lofty goal of tracing and testing the contacts of every infected person remains unthinkable. Epidemiological models in the United States and data from China suggest that each case generates about 50 contacts, so the 25,000 new daily cases in the United States generate another 1.3 million contacts to find each day.
Even under ideal circumstances, a team of five tracers takes about three days to find 50 contacts. So, if the number of trained contact tracers were increased to 100,000 — from 3,000, the most recent tally — the daily case count would still have to drop below 5,000 just to stay even, assuming the tracers worked five-day weeks.Even under ideal circumstances, a team of five tracers takes about three days to find 50 contacts. So, if the number of trained contact tracers were increased to 100,000 — from 3,000, the most recent tally — the daily case count would still have to drop below 5,000 just to stay even, assuming the tracers worked five-day weeks.
But the daily load is barely dropping below 25,000.But the daily load is barely dropping below 25,000.
Digitally automating the job has been proposed. But for Bluetooth and GPS apps like those used in South Korea to work in the United States and find a useful percentage of a victim’s contacts — about 80 percent, calculated Tomas Pueyo, author of an article titled “Coronavirus: How to Do Testing and Contact Tracing” — Apple and Google would have to update their smartphone operating systems with built-in tracking apps that all cellphone owners would by law have to use. Also, neither location data nor Bluetooth could be turned off.Digitally automating the job has been proposed. But for Bluetooth and GPS apps like those used in South Korea to work in the United States and find a useful percentage of a victim’s contacts — about 80 percent, calculated Tomas Pueyo, author of an article titled “Coronavirus: How to Do Testing and Contact Tracing” — Apple and Google would have to update their smartphone operating systems with built-in tracking apps that all cellphone owners would by law have to use. Also, neither location data nor Bluetooth could be turned off.
Americans are unlikely to accept that, Mr. Pueyo conceded.Americans are unlikely to accept that, Mr. Pueyo conceded.
“We fear ‘1984,’” he wrote. “We want to avoid an A.I.-driven world where the government knows our every movement, rates us according to our behavior, and soon tells us what to think.”“We fear ‘1984,’” he wrote. “We want to avoid an A.I.-driven world where the government knows our every movement, rates us according to our behavior, and soon tells us what to think.”
Making masks obligatory has strong potential to cut down transmission, according to new evidence not just from Asia, where masks have long been common, but also from the Czech Republic, Germany, Israel and other countries, according to Masks4All, an advocacy group.Making masks obligatory has strong potential to cut down transmission, according to new evidence not just from Asia, where masks have long been common, but also from the Czech Republic, Germany, Israel and other countries, according to Masks4All, an advocacy group.
The single biggest mistake made in the United States and some European countries that have failed to control their epidemics “is that people aren’t wearing masks,” argued Dr. George F. Gao, the Harvard- and Oxford-trained director of China’s Center for Disease Control.The single biggest mistake made in the United States and some European countries that have failed to control their epidemics “is that people aren’t wearing masks,” argued Dr. George F. Gao, the Harvard- and Oxford-trained director of China’s Center for Disease Control.
Outside New York, California and a few other states, many Americans resist wearing them.Outside New York, California and a few other states, many Americans resist wearing them.
Gov. Mike DeWine of Ohio rescinded an order to wear masks after state residents “felt affronted,” he said. Officials in Stillwater, Okla., dropped a municipal order after store clerks who asked barefaced customers to stay outside were threatened.Gov. Mike DeWine of Ohio rescinded an order to wear masks after state residents “felt affronted,” he said. Officials in Stillwater, Okla., dropped a municipal order after store clerks who asked barefaced customers to stay outside were threatened.
The issue has become mired in politics: the president won’t wear one, some protesters have compared them to Muslim face veils, and a shopper at a supermarket requiring masks wore a Ku Klux Klan hood.The issue has become mired in politics: the president won’t wear one, some protesters have compared them to Muslim face veils, and a shopper at a supermarket requiring masks wore a Ku Klux Klan hood.
In the absence of detailed national reopening standards, governors are setting their own, and some allow far closer human contact than others do.In the absence of detailed national reopening standards, governors are setting their own, and some allow far closer human contact than others do.
It is or will soon be possible in 19 states to get your hair cut or roots dyed, for example. Many states are letting restaurants reopen with restrictions that require six feet between diners, outdoor seating only or disposable menus.It is or will soon be possible in 19 states to get your hair cut or roots dyed, for example. Many states are letting restaurants reopen with restrictions that require six feet between diners, outdoor seating only or disposable menus.
Updated June 2, 2020 Updated June 5, 2020
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.
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.
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.)
More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
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.
By contrast, Gov. Andrew M. Cuomo of New York has refused to even set a date for easing restrictions everywhere in the state, although three regions will be allowed to partially reopen on May 15. Although hospitalizations and deaths are steadily declining, he said, they are still dropping too slowly.By contrast, Gov. Andrew M. Cuomo of New York has refused to even set a date for easing restrictions everywhere in the state, although three regions will be allowed to partially reopen on May 15. Although hospitalizations and deaths are steadily declining, he said, they are still dropping too slowly.
“All of this inconvenience, all of this turmoil, for what?” he asked this month. “To keep 100,000 people out of our hospitals, that’s for what.”“All of this inconvenience, all of this turmoil, for what?” he asked this month. “To keep 100,000 people out of our hospitals, that’s for what.”
When restrictions are lifted, he said, the state’s least-affected central counties will go first and each economic sector will be phased in slowly: construction and factory jobs first, and retail establishments that can deliver goods curbside. Next: banks, insurance, law firms and other professions. Then restaurants and hotels, and finally entertainment, sports and schools.When restrictions are lifted, he said, the state’s least-affected central counties will go first and each economic sector will be phased in slowly: construction and factory jobs first, and retail establishments that can deliver goods curbside. Next: banks, insurance, law firms and other professions. Then restaurants and hotels, and finally entertainment, sports and schools.
One of the most difficult decisions is when to open primary schools. Doing so is crucial to getting young parents back to work, but scientists are still unsure about how much children spread the disease to their families. France is reopening its schools this week, as are some regions of Australia and much of Europe, so there may be some data soon on the question.One of the most difficult decisions is when to open primary schools. Doing so is crucial to getting young parents back to work, but scientists are still unsure about how much children spread the disease to their families. France is reopening its schools this week, as are some regions of Australia and much of Europe, so there may be some data soon on the question.
Unlike New York State, Florida, Tennessee and Texas are reopening as their cases and deaths are spiking to new highs, which means, experts said, that it is impossible to know when or how high they will peak.Unlike New York State, Florida, Tennessee and Texas are reopening as their cases and deaths are spiking to new highs, which means, experts said, that it is impossible to know when or how high they will peak.
If that happened, a wave of unexpected deaths could deliver some sharp political shocks, researchers predicted.If that happened, a wave of unexpected deaths could deliver some sharp political shocks, researchers predicted.
“Excess fatalities may mean some serious consequences for the governors,” said Dr. Irwin Redlener, director of the disaster preparedness center at Columbia.“Excess fatalities may mean some serious consequences for the governors,” said Dr. Irwin Redlener, director of the disaster preparedness center at Columbia.
Frustrated Americans, eager to break out of lockdowns, often do not realize how lax this country’s strictures are compared with those imposed elsewhere.Frustrated Americans, eager to break out of lockdowns, often do not realize how lax this country’s strictures are compared with those imposed elsewhere.
In Chinese cities, only a tiny corps of essential workers was allowed to leave home for months. There was virtually no travel between cities.In Chinese cities, only a tiny corps of essential workers was allowed to leave home for months. There was virtually no travel between cities.
People lucky enough to live in apartment complexes with internal gardens could walk there; others had to stay indoors, unable to shop even for food or medicine. Building committees pooled grocery orders and distributed them internally.People lucky enough to live in apartment complexes with internal gardens could walk there; others had to stay indoors, unable to shop even for food or medicine. Building committees pooled grocery orders and distributed them internally.
No city in China was allowed to reopen until it had reached 14 days of zero new cases — a standard that no American city is expected to meet.No city in China was allowed to reopen until it had reached 14 days of zero new cases — a standard that no American city is expected to meet.
In Italy, many residents were not allowed to go more than 200 yards from their homes without written government authorization. Police roadblocks enforcing that rule were everywhere.In Italy, many residents were not allowed to go more than 200 yards from their homes without written government authorization. Police roadblocks enforcing that rule were everywhere.
If deaths in the United States surged, harsh measures like those could, in theory, be imposed.If deaths in the United States surged, harsh measures like those could, in theory, be imposed.
The 1918 Spanish flu provides some lessons.The 1918 Spanish flu provides some lessons.
A new analysis of that epidemic from the National Bureau of Economic Research in Cambridge, Mass., concluded that various lockdown measures had “clear success” in lowering death rates. But they ultimately failed to curb overall mortality in most cities because they were lifted prematurely.A new analysis of that epidemic from the National Bureau of Economic Research in Cambridge, Mass., concluded that various lockdown measures had “clear success” in lowering death rates. But they ultimately failed to curb overall mortality in most cities because they were lifted prematurely.
School closings and bans on public gatherings typically lasted only 36 days, the report said, and Americans usually tolerated quarantine for only 18 days.School closings and bans on public gatherings typically lasted only 36 days, the report said, and Americans usually tolerated quarantine for only 18 days.
Denver, for example, closed its schools and banned public gatherings for only one month after deaths peaked. Then reopening caused a second, much higher peak of deaths.Denver, for example, closed its schools and banned public gatherings for only one month after deaths peaked. Then reopening caused a second, much higher peak of deaths.
“The lesson for the ongoing coronavirus pandemic in 2020 is that, to curtail overall deaths,” wrote the chief author, Robert J. Barro, such interventions “have to be maintained for substantially longer than a few weeks.”“The lesson for the ongoing coronavirus pandemic in 2020 is that, to curtail overall deaths,” wrote the chief author, Robert J. Barro, such interventions “have to be maintained for substantially longer than a few weeks.”
“Most likely,” he added, “12 weeks work much better than four to six weeks.”“Most likely,” he added, “12 weeks work much better than four to six weeks.”
Dr. Frieden, the former C.D.C. director, now runs Resolve to Save Lives, the public health advocacy group that has issued detailed reopening guidelines.Dr. Frieden, the former C.D.C. director, now runs Resolve to Save Lives, the public health advocacy group that has issued detailed reopening guidelines.
“Every day, I look at the two models for approaching this,” he said. “The China model, which is to use the world’s most authoritarian regime and best digital tracking system to hunt down and stop every case and then wait for a vaccine. So far, it’s working.”“Every day, I look at the two models for approaching this,” he said. “The China model, which is to use the world’s most authoritarian regime and best digital tracking system to hunt down and stop every case and then wait for a vaccine. So far, it’s working.”
By contrast, he said, Sweden is trying to achieve “herd immunity” by letting young, healthy people become infected at what they hope will be slow, steady rates. Primary schools are open, higher ones are closed, everyone is asked to be careful in public and older adults are asked to stay home.By contrast, he said, Sweden is trying to achieve “herd immunity” by letting young, healthy people become infected at what they hope will be slow, steady rates. Primary schools are open, higher ones are closed, everyone is asked to be careful in public and older adults are asked to stay home.
Israel is roughly following Sweden’s model, Dr. Frieden said, just as Asian countries are roughly following China’s.Israel is roughly following Sweden’s model, Dr. Frieden said, just as Asian countries are roughly following China’s.
“And then,” he added, “there’s the American approach, which is: ‘What the hell — I heard something on Fox News. Let’s try it!’”“And then,” he added, “there’s the American approach, which is: ‘What the hell — I heard something on Fox News. Let’s try it!’”
Sweden’s model does look appealing. Television news programs have shown smiling Swedes drinking in outdoor cafes, shopping for clothes, getting their hair restyled and enjoying other little pleasures that Americans have been denied for many weeks now.Sweden’s model does look appealing. Television news programs have shown smiling Swedes drinking in outdoor cafes, shopping for clothes, getting their hair restyled and enjoying other little pleasures that Americans have been denied for many weeks now.
But Sweden is paying a high price, and Dr. Frieden rated its success as “still to be determined.”But Sweden is paying a high price, and Dr. Frieden rated its success as “still to be determined.”
As of Sunday, its per capita death rate is 319 per million Swedes, which is higher than the figure in the United States, which is 242 deaths per million.As of Sunday, its per capita death rate is 319 per million Swedes, which is higher than the figure in the United States, which is 242 deaths per million.
Other Scandinavian countries, with varying degrees of lockdown, have far lower death figures: 91 per million in Denmark, 40 in Norway, 48 in Finland and 29 in Iceland.Other Scandinavian countries, with varying degrees of lockdown, have far lower death figures: 91 per million in Denmark, 40 in Norway, 48 in Finland and 29 in Iceland.
Having 50 states and more territories do competing and uncoordinated experiments in reopening is “daring Mother Nature to kill you or someone you love,” Dr. Frieden said. “Mother Nature bats last, and she bats a thousand.”Having 50 states and more territories do competing and uncoordinated experiments in reopening is “daring Mother Nature to kill you or someone you love,” Dr. Frieden said. “Mother Nature bats last, and she bats a thousand.”