npr--2020-04-24--'Under No Circumstance': Lysol Maker, Officials Reject Trump's Disinfectant Idea

Please , everyone , do not try what the president just suggested at home .
That is the consensus from doctors , at least one manufacturer and even President Trump 's own administration , after he speculated about possible treatments for the coronavirus during his task force briefing Thursday .
After introducing research reflecting the disinfectant capabilities of ultraviolet light on surfaces , Trump mused that scientists may try to find a way to place strong disinfectants directly inside the body to treat a patient 's infection .
`` I see the disinfectant — where it knocks it out in @ @ @ @ @ @ @ is there a way we can do something like that , by injection inside or almost a cleaning ? ''
Trump floated , with a caveat that one would `` have to use medical doctors . ''
( You can read his full remarks here . )
When asked about the comments on Friday , Trump told reporters that he was simply asking the question `` sarcastically '' — `` just to see what would happen . ''
`` That was done in the form of a sarcastic question to a reporter , @ @ @ @ @ @ @ , response coordinator of the coronavirus task force , treated the question seriously during the briefing , however .
And she was the first to answer the president when he asked if `` the heat and the light '' was an avenue to explore : `` Not as a treatment , '' she said .
A wide array of medical , business and government professionals have elaborated on her straightforward response , but the basic message from all of them remains largely the same — and crystal clear : This is absolutely not @ @ @ @ @ @ @ .
Among the voices warning strongly against ingesting disinfectant is the Environmental Protection Agency , part of Trump 's own administration .
In guidance issued Thursday , the EPA outlined what constitutes safe and effective use of disinfectants to combat the spread of the virus , along with this firm reminder : `` Never apply the product to yourself or others .
Do not ingest disinfectant products . ''
Less than a week before Trump 's suggestion , federal prosecutors obtained an injunction against the sale of a product marketed as a `` @ @ @ @ @ @ @ the coronavirus , according to its sellers .
Last year , the Food and Drug Administration warned against the product , which was then being marketed as a treatment for other ailments , saying that `` when mixed according to package directions , they become a strong chemical that is used as bleach . ''
`` They are not meant to be swallowed by people , '' the FDA said last August .
After Trump made his comments , officials in Washington state made clear that their general advice has not changed .
@ @ @ @ @ @ @ or inject yourself with any kind of disinfectant , '' Washington 's Emergency Management Division tweeted late Thursday , adding : `` Just do n't make a bad situation worse . ''
But it has not just been authorities warning against trying out one of the theories Trump mused on .
The manufacturer of Lysol and Dettol , two disinfectants that commonly use bleach for cleaning household surfaces , echoed the cautionary point .
`` As a global leader in health and hygiene products , we must be clear that under no circumstance @ @ @ @ @ @ @ the human body ( through injection , ingestion or any other route ) , '' Reckitt Benckiser said in a statement released after the president 's briefing , in response to `` recent speculation and social media activity . ''
`` As with all products , '' the company added , `` our disinfectant and hygiene products should only be used as intended and in line with usage guidelines .
Please read the label and safety information . ''
The World Health Organization has also warned explicitly that UV lamps are not a @ @ @ @ @ @ @ Now , it is worth noting that researchers have found that a powerful form of UV light known as UVC , as well as disinfectants such as bleach , can effectively render the virus inactive — albeit on surfaces .
The trouble is , those things can have an extremely harmful effect when applied directly on , or ingested by , humans .
This is not the first time that Trump 's comments about possible treatments for the coronavirus have elicited a wave of warnings from medical professionals .
Last month , the @ @ @ @ @ @ @ as chloroquine and azithromycin as potentially `` one of the biggest game changers in the history of medicine '' — but its effects remain largely unproven and , at least in one instance after Trump discussed the chemical , have proven deadly .
The National Institute of Allergy and Infectious Diseases earlier this week recommended against consuming those drugs together as a coronavirus treatment .
The FDA on Friday also cautioned against the use of the chloroquine and a related drug , hydroxychloroquine , `` outside a hospital setting or a clinical trial @ @ @ @ @ @ @ cause abnormal heart rhythms such as QT interval prolongation and a dangerously rapid heart rate called ventricular tachycardia . ''
White House Press Secretary Kayleigh McEnany cast the controversy as a product of media bias against the president .
`` President Trump has repeatedly said that Americans should consult with medical doctors regarding coronavirus treatment , a point that he emphasized again during yesterday 's briefing , '' she said in a statement released Friday .
`` Leave it to the media to irresponsibly take President Trump out of context and run with @ @ @ @ @ @ @ General Jerome M. Adams also encouraged Americans on Friday to consult doctors before giving any medication to themselves or their loved ones .
He said : `` Your safety is paramount , and doctors and nurses are have years of training to recommend what 's safe and effective . ''

'Under No Circumstance': Lysol Maker, Officials Reject Trump's Disinfectant Idea
Enlarge this image toggle caption Alex Brandon/AP Alex Brandon/AP
Updated at 1:49 p.m. ET
Please, everyone, do not try what the president just suggested at home.
That is the consensus from doctors, at least one manufacturer and even President Trump's own administration, after he speculated about possible treatments for the coronavirus during his task force briefing Thursday. After introducing research reflecting the disinfectant capabilities of ultraviolet light on surfaces, Trump mused that scientists may try to find a way to place strong disinfectants directly inside the body to treat a patient's infection.
"I see the disinfectant — where it knocks it out in a minute, one minute. And is there a way we can do something like that, by injection inside or almost a cleaning?" Trump floated, with a caveat that one would "have to use medical doctors." (You can read his full remarks here.)
When asked about the comments on Friday, Trump told reporters that he was simply asking the question "sarcastically" — "just to see what would happen."
"That was done in the form of a sarcastic question to a reporter," he explained.
Dr. Deborah Birx, response coordinator of the coronavirus task force, treated the question seriously during the briefing, however. And she was the first to answer the president when he asked if "the heat and the light" was an avenue to explore: "Not as a treatment," she said.
A wide array of medical, business and government professionals have elaborated on her straightforward response, but the basic message from all of them remains largely the same — and crystal clear: This is absolutely not something that viewers should think about trying.
Among the voices warning strongly against ingesting disinfectant is the Environmental Protection Agency, part of Trump's own administration. In guidance issued Thursday, the EPA outlined what constitutes safe and effective use of disinfectants to combat the spread of the virus, along with this firm reminder: "Never apply the product to yourself or others. Do not ingest disinfectant products."
Less than a week before Trump's suggestion, federal prosecutors obtained an injunction against the sale of a product marketed as a "master mineral solution" that could treat the coronavirus, according to its sellers. Last year, the Food and Drug Administration warned against the product, which was then being marketed as a treatment for other ailments, saying that "when mixed according to package directions, they become a strong chemical that is used as bleach."
"They are not meant to be swallowed by people," the FDA said last August.
After Trump made his comments, officials in Washington state made clear that their general advice has not changed. "Please don't eat Tide pods or inject yourself with any kind of disinfectant," Washington's Emergency Management Division tweeted late Thursday, adding: "Just don't make a bad situation worse."
But it has not just been authorities warning against trying out one of the theories Trump mused on. The manufacturer of Lysol and Dettol, two disinfectants that commonly use bleach for cleaning household surfaces, echoed the cautionary point.
"As a global leader in health and hygiene products, we must be clear that under no circumstance should our disinfectant products be administered into the human body (through injection, ingestion or any other route)," Reckitt Benckiser said in a statement released after the president's briefing, in response to "recent speculation and social media activity."
"As with all products," the company added, "our disinfectant and hygiene products should only be used as intended and in line with usage guidelines. Please read the label and safety information."
The World Health Organization has also warned explicitly that UV lamps are not a safe treatment to disinfect the coronavirus.
Now, it is worth noting that researchers have found that a powerful form of UV light known as UVC, as well as disinfectants such as bleach, can effectively render the virus inactive — albeit on surfaces. The trouble is, those things can have an extremely harmful effect when applied directly on, or ingested by, humans.
This is not the first time that Trump's comments about possible treatments for the coronavirus have elicited a wave of warnings from medical professionals. Last month, the president hailed a combination of chemicals known as chloroquine and azithromycin as potentially "one of the biggest game changers in the history of medicine" — but its effects remain largely unproven and, at least in one instance after Trump discussed the chemical, have proven deadly.
The National Institute of Allergy and Infectious Diseases earlier this week recommended against consuming those drugs together as a coronavirus treatment.
The FDA on Friday also cautioned against the use of the chloroquine and a related drug, hydroxychloroquine, "outside a hospital setting or a clinical trial." It says both "can cause abnormal heart rhythms such as QT interval prolongation and a dangerously rapid heart rate called ventricular tachycardia."
White House Press Secretary Kayleigh McEnany cast the controversy as a product of media bias against the president.
"President Trump has repeatedly said that Americans should consult with medical doctors regarding coronavirus treatment, a point that he emphasized again during yesterday's briefing," she said in a statement released Friday. "Leave it to the media to irresponsibly take President Trump out of context and run with negative headlines."
U.S. Surgeon General Jerome M. Adams also encouraged Americans on Friday to consult doctors before giving any medication to themselves or their loved ones.
He said: "Your safety is paramount, and doctors and nurses are have years of training to recommend what's safe and effective."


npr--2020-04-25--Praised For Curbing COVID-19, New Zealand's Leader Eases Country's Strict Lockdown

With many countries reeling from the COVID-19 pandemic , New Zealand is proving a model of recovery and is lifting part of its strict lockdown .
Prime Minister Jacinda Ardern has applied her trademark empathy to rally her country of 5 million to attempt what few states have tried : eradicate , not just mitigate , the novel coronavirus .
New Zealand has registered a total of 17 deaths from COVID-19 and 1,456 infection cases , with only two new cases confirmed on Friday .
The country has done better than flatten its coronavirus curve , public health experts say @ @ @ @ @ @ @ mother of a 21-month-old , Ardern , 39 , regularly appears on Facebook Live chats , dressed in a sweatshirt , commiserating with families enduring isolation in their `` bubble , '' as she calls their place of shelter , and assuring children the tooth fairy is still on the job .
When she imposed stringent stay-home rules in late March , she urged people to `` be strong and be kind . ''
American political scientist Van Jackson , who lectures at New Zealand 's Victoria University of Wellington , says communicating @ @ @ @ @ @ @ Some people might write off her cozy chat style `` as soft or fluffy , '' he says .
`` But it reassures people .
It helps maintain a sense of mutuality in society ... and that creates trust with the leader . ''
Daily news conferences with the progressive leftist are shorn of political partisanship , focusing on data and science .
They are , says Jackson , a former Pentagon official during the Obama administration , a contrast to President Trump 's combative briefings .
Conservative critics have condemned her leadership @ @ @ @ @ @ @ that closed national borders , shut down businesses and severely restricted people 's movement for an entire month .
But former Prime Minister Helen Clark told The Atlantic , `` This is the kind of crisis which will make or break leaders .
And this will make Jacinda . ''
Ardern 's handling has won more than 80 % public approval , well above any leader in the Group of Seven wealthy democracies , according to pollster Colmar Brunton .
Political sociologist Marilyn Waring says even as New Zealanders demonstrate remarkable unity in @ @ @ @ @ @ @ own path .
Being at the bottom of the world , she says , they see what other countries do but `` do n't tend to behave like the rest of the world . ''
Jackson says `` social solidarity '' has been the lesson from New Zealand : `` If we 're all in this together , then we 're actually going to get through it better and faster . ''
Jackson notes `` collectivist societies '' are faring better and more efficiently `` than fractured , individualist societies . ''
New @ @ @ @ @ @ @ that provides clear guidelines .
The country is switching from Level 4 , which strongly limits movement and contact , to Level 3 at midnight Monday .
Food delivery and drive-through restaurants are reopening , expanding options for New Zealanders , who are advised to remain close to and work from home .
Auckland University of Technology professor Waring says `` Level 3 is Level 4 , with takeout . ''
Nonetheless , New Zealand eases restrictions on swimming , surfing and fishing with some trepidation .
There is not `` a lot @ @ @ @ @ @ @ Auckland University professor Shaun Hendy told Radio New Zealand , `` so the possibility of reinvasion of the disease is very strong . ''

Praised For Curbing COVID-19, New Zealand's Leader Eases Country's Strict Lockdown
Enlarge this image toggle caption Mark Mitchell/AP Mark Mitchell/AP
With many countries reeling from the COVID-19 pandemic, New Zealand is proving a model of recovery and is lifting part of its strict lockdown.
Prime Minister Jacinda Ardern has applied her trademark empathy to rally her country of 5 million to attempt what few states have tried: eradicate, not just mitigate, the novel coronavirus.
As of Friday, New Zealand has registered a total of 17 deaths from COVID-19 and 1,456 infection cases, with only two new cases confirmed on Friday. The country has done better than flatten its coronavirus curve, public health experts say — it has crushed it.
A mother of a 21-month-old, Ardern, 39, regularly appears on Facebook Live chats, dressed in a sweatshirt, commiserating with families enduring isolation and assuring children the tooth fairy is still on the job. When she imposed stringent stay-home rules in late March, she urged people to "be strong and be kind."
American political scientist Van Jackson, who lectures at New Zealand's Victoria University of Wellington, says communicating is Ardern's "superpower."
Some people might write off her cozy chat style "as soft or fluffy," he says. "But it reassures people. It helps maintain a sense of mutuality in society ... and that creates trust with the leader."
Daily news conferences with the progressive leftist are shorn of political partisanship and focus on data and science. They are, says Jackson, a former Pentagon official during the Obama administration, a contrast to President Trump's combative briefings.
Conservative critics have condemned her leadership as creating a "nanny state" that closed national borders, shut down businesses and severely restricted people's movement for an entire month.
But former Prime Minister Helen Clark told The Atlantic, "This is the kind of crisis which will make or break leaders. And this will make Jacinda."
Ardern's handling has won more than 80% public approval, well above any leader in the Group of Seven wealthy democracies, according to pollster Colmar Brunton.
Political sociologist Marilyn Waring says even as New Zealanders demonstrate remarkable unity in this crisis, they like cutting their own path. Being at the bottom of the world, she says, they see what other countries do but "don't tend to behave like the rest of the world."
Jackson says "social solidarity" has been the lesson from New Zealand: "If we're all in this together, then we're actually going to get through it better and faster." Jackson notes "collectivist societies" are faring better and more efficiently "than fractured, individualist societies."
New Zealand has followed a four-level alert system that provides clear guidelines. The country is switching from Level 4, which strongly limits movement and contact, to Level 3 at midnight Monday.
Food delivery and drive-through restaurants are reopening, expanding options for New Zealanders, who are advised to remain close to and work from home. Auckland University of Technology professor Waring says, "Level 3 is Level 4, with takeout."
Nonetheless, New Zealand eases restrictions on swimming, surfing and fishing with some trepidation.
There is not "a lot of immunity to the disease," Auckland University professor Shaun Hendy told Radio New Zealand, "so the possibility of reinvasion of the disease is very strong."


npr--2020-04-25--As States Open Up, Health Experts Seek To Understand Coronavirus's Early Silent Spread

As States Open Up , Health Experts Seek To Understand Coronavirus 's Early Silent Spread As health officials across the country try to slow the coronavirus pandemic , a growing body of evidence and research suggests the virus may have been silently spreading in different parts of the country far earlier than initially believed and officially reported .
Preliminary results from antibody testing in New York and Florida show that hundreds of thousands , if not millions of people , may have already contracted the virus .
Similar , more controversial , surveys in California suggest wider spread than previously @ @ @ @ @ @ @ Bay Area , health officials have now identified two coronavirus-related deaths that occurred in early February , meaning the first known death from the coronavirus in the U.S. occurred weeks earlier than previously believed .
The earlier deaths , `` are like iceberg tips , '' said Dr. Sara Cody , Santa Clara County 's health director , during the announcement .
Indicators , she said , `` that we had community transmission , probably to a significant degree , far earlier than we had known . ''
According to the Centers for @ @ @ @ @ @ @ reported cases of the coronavirus in the U.S. on Feb. 6 , the day that a 57-year old San Jose woman died after a brief illness with flu-like symptoms .
The coroner in Santa Clara County was suspicious .
The woman , identified by family as Patricia Dowd , was otherwise healthy .
But testing for the coronavirus was limited and the administration 's focus was still directed outwards .
A week earlier , President Donald Trump had blocked travel from China and declared the novel virus a public health emergency , but @ @ @ @ @ @ @ of contracting the virus in the U.S. was low .
Recent travelers were viewed as being most at risk .
To die from the virus though , Dowd must have contracted it days , if not weeks , earlier , suggesting that people were passing it to each other in the Bay Area in late January , if not sooner .
For researchers and practitioners who 've been tracking the virus ' spread , the earlier deaths in Santa Clara County are proof that there were `` invisible chains of transmission '' occurring @ @ @ @ @ @ @ says Alessandro Vespignani , director of the Network Science Institute at Northeastern University .
The first publicly acknowledged case of community spread in the U.S. was a month later on Feb. 27 , when a patient in Sacramento , California , was diagnosed as having COVID-19 , despite having no contact with other known cases and no history of travel .
The state 's lockdown , one of the first statewide stay-at-home orders in the country , would n't go into effect for another three weeks .
During that time , the virus @ @ @ @ @ @ @ Vespignani and other researchers at Northeastern University , using population , travel and disease transmission data , sheds light on that invisible stage of the epidemic .
`` While we had a few cases detected in the United States , we actually already had hundreds and then thousands of transmission events occurring across the country , '' he says .
The preliminary results from an antibody test in New York , released earlier this week , found that one-in-five residents of New York City that were tested may have already contracted the coronavirus @ @ @ @ @ @ @ may have had it statewide , the numbers suggest .
A similar serology survey in Florida , conducted by researchers at the University of Miami , found that as many as 165,000 people in Miami-Dade County , about 6 percent of the population , have antibodies that suggest an earlier infection too .
Health and public officials say that serology tests — that is , tests that look for antibodies to an infection — are vital to understanding the scale of the coronavirus pandemic and are crucial for efforts to reopen parts of @ @ @ @ @ @ @ is an understanding of when the virus first arrived in the U.S. and how it initially spread .
`` This epidemic had been with us for basically one month a half before we realized it was so widespread , '' Vespignani says .
`` What are we doing to make sure we do n't fall into the February trap again ? ''
A pair of studies done by researchers from Stanford University and the University of Southern California made headlines earlier this week , after they suggested that the infection rate in two @ @ @ @ @ @ @ been reported .
In Los Angeles County , the research indicated , hundreds of thousands of people may have been infected by the virus .
Both studies were criticized by outside experts , who , among other things , questioned the reliability of the antibody tests the researchers used .
California officials , anxious to get a better understanding of the virus ' prevalence and history in the state , are looking at other ways to collect data .
At a press conference earlier this week , the state 's governor Gavin Newsom @ @ @ @ @ @ @ to take a similar approach to Santa Clara , looking back at deaths that occurred in January and February for a possible connection to COVID-19 .
Numerous medical examiners in the state said they had not received an official directive from the governor , but that they were screening decedents for possible coronavirus connections as far back as late-January .
Many pointed out that the vast majority of coronavirus deaths would have been classified as `` natural , '' so they would not have been investigated by medical examiners in the first place @ @ @ @ @ @ @ could get a second-look .
Asked by NPR about the directive at a press conference Friday , Newsom deferred to the state 's health director Dr. Sonia Angell .
Angell did not say whether a directive was given , but said the state would continue to work with coroners to understand the progression of COVID-19 in the state 's communities .
`` It is very important for us , as we look forward , to really understand what happened at the beginning of this whole process , '' she said .

As States Reopen, Health Experts Seek To Understand Coronavirus's Early Silent Spread
Enlarge this image toggle caption Mark J. Terrill/AP Mark J. Terrill/AP
As health officials across the country try to slow the coronavirus pandemic, a growing body of evidence and research suggests the virus may have been silently spreading in different parts of the country far earlier than initially believed and officially reported.
Preliminary results from antibody testing in New York and Florida show that hundreds of thousands, if not millions, of people, may have already contracted the virus. Similar, and more controversial, surveys in California suggest wider spread than previously acknowledged.
And in the state's Bay Area, health officials have now identified two coronavirus-related deaths that occurred in early February, meaning the first known death from the coronavirus in the U.S. occurred weeks earlier than previously believed.
The earlier deaths "are like iceberg tips," said Dr. Sara Cody, Santa Clara County's health director, during the announcement. They are indicators, she said, "that we had community transmission, probably to a significant degree, far earlier than we had known."
According to the Centers for Disease Control and Prevention, there were only 11 reported cases of the coronavirus in the U.S. on Feb. 6, the day that a 57-year-old San Jose woman died after a brief illness with flu-like symptoms. The coroner in Santa Clara County was suspicious. The woman, identified by family as Patricia Dowd, was otherwise healthy.
But testing for the coronavirus was limited, and the Trump administration's focus was still directed outwards. A week earlier, President Trump had blocked travel from China and declared the novel virus a public health emergency, but his administration repeatedly emphasized that the risk of contracting the virus in the U.S. was low. Recent travelers were viewed as being most at risk.
This epidemic had been with us for basically one month and a half before we realized it was so widespread. What are we doing to make sure we don't fall into the February trap again?
To die from the virus though, Dowd must have contracted it days, if not weeks, earlier, suggesting that people were passing it among one another in the Bay Area in late January, if not sooner.
"Invisible chains of transmission"
For researchers and practitioners who've been tracking the virus's spread, the earlier deaths in Santa Clara County are proof that there were "invisible chains of transmission" occurring in various U.S. cities in mid-January, says Alessandro Vespignani, director of the Network Science Institute at Northeastern University.
The first publicly acknowledged case of community spread in the U.S. was a month later on Feb. 27, when a patient in Sacramento, Calif., was diagnosed as having COVID-19, despite having no contact with other known cases and no history of travel. The state's lockdown, one of the first statewide stay-at-home orders in the country, wouldn't go into effect for another three weeks.
During that time, the virus silently spread.
A model created by Vespignani and other researchers at Northeastern University, using population, travel and disease transmission data, sheds light on that invisible stage of the epidemic.
"While we had a few cases detected in the United States, we actually already had hundreds and then thousands of transmission events occurring across the country," he says.
The preliminary results from an antibody test in New York, released earlier this week, found that 1 in 5 residents of New York City who were tested may have already contracted the coronavirus. As many as 2.7 million people may have had it statewide, the numbers suggest.
A similar serology survey in Florida, conducted by researchers at the University of Miami, found that as many as 165,000 people in Miami-Dade County, about 6% of the population, have antibodies that suggest an earlier infection too.
Health and public officials say that serology tests — that is, tests that look for antibodies to an infection — are vital to understanding the scale of the coronavirus pandemic and are crucial for efforts to reopen parts of the country.
So, too, is an understanding of when the virus first arrived in the U.S. and how it initially spread.
"This epidemic had been with us for basically one month and a half before we realized it was so widespread," Vespignani says. "What are we doing to make sure we don't fall into the February trap again?"
Understanding California's timeline
A pair of studies done by researchers from Stanford University and the University of Southern California made headlines earlier this week, after they suggested that the infection rate in two California communities were far greater than had been reported. In Los Angeles County, the research indicated, hundreds of thousands of people may have been infected by the virus.
Both studies were criticized by outside experts, who, among other things, questioned the reliability of the antibody tests the researchers used.
California officials, anxious to get a better understanding of the virus's prevalence and history in the state, are looking at other ways to collect data.
At a press conference earlier this week, the state's governor, Gavin Newsom, said he directed county medical examiners to take a similar approach to Santa Clara, looking back at deaths that occurred in January and February for a possible connection to COVID-19.
Numerous medical examiners in the state said that they had not received an official directive from the governor, but that they were screening decedents for possible coronavirus connections as far back as late-January.
Many pointed out that the vast majority of coronavirus deaths would have been classified as "natural," so they would not have been investigated by medical examiners, limiting the number of deaths that could get a second look.
Asked by NPR about the directive at a press conference Friday, Newsom deferred to the state's health director Dr. Sonia Angell.
Angell did not say whether a directive was given, but said the state would continue to work with coroners to understand the progression of COVID-19 in the state's communities.
"It is very important for us, as we look forward, to really understand what happened at the beginning of this whole process," she said.
Elizabeth Baker and Brooklyn Riepma contributed to this report.


npr--2020-04-25--When Is It Safe To Ease Social Distancing? Here's What One Model Says For Each State

When Is It Safe To Ease Social Distancing ?
Here 's What One Model Says For Each State Across the U.S. state leaders are now grappling with the challenging decision of when to relax the social distancing restrictions that have helped keep COVID-19 in check .
Already this week , Georgia 's governor has allowed businesses ranging from gyms , to hair salons , to movie theaters to re-open — despite not meeting many of the White House 's guidelines for phase 1 of reopening .
South Carolina 's governor has taken a similar tack – including re-opening the state @ @ @ @ @ @ @ other states including Tennessee and Ohio , say they will allow their stay-at-home orders to expire next week , with varying degrees of social distancing required beyond that point .
But how should states decide when to reopen ?
Epidemiologists and other public health specialists are warning against moving too fast .
They note that the coronavirus is still circulating .
Cases could spiral up to catastrophic levels all over again unless proper measures are taken .
The consensus view is that states should n't open up unless they have a robust system @ @ @ @ @ @ @ testing to see who is infected , tracing their contacts , and isolating and quarantining as needed .
Unfortunately , there 's widespread concern that most states will not be ready to launch such a system any time soon — due to continued issues with testing capacity , as well as the limited staffing at state and local health departments .
So one team of disease modelers – from the University of Washington 's Institute for Health Metrics or IHME — has come up with a different standard .
They are asking the @ @ @ @ @ @ @ of new infections that states could handle with their current testing and contact tracing capacity ?
IHME 's answer : one new infection per million people in a given state .
They estimate that states with this level of transmission should be able to keep outbreaks from flaring up even once people start mingling again , though the researchers stress that states would still need to limit large gatherings .
IHME 's team built a model to forecast when each state will reach that threshold of one-new-infection-per-million .
Their main finding is that @ @ @ @ @ @ @ May 10 , just five states are projected to get there — Alaska , Hawaii , Montana , West Virginia , and Vermont .
Twenty-one states wo n't reach the threshold until the beginning of June or later .
These include two of the states whose governors have been most aggressive about reopening — Georgia and South Carolina .
Similarly , Ohio is not projected to meet the standard until May 14 ; Tennessee not until May 20 .
For a chart of the projected date for each state , scroll below or @ @ @ @ @ @ @ .
Ali Mokdad , a professor of health metrics sciences at IHME , says the team came up with the one-new-infection-per-million standard based on some surveying they did of the existing capacities of local health departments around the country .
But , he adds , `` it was very difficult for us to be sure .
So we made a very conservative estimate . ''
And , he says , already , `` states are starting to reach out to us saying , ' I can do more than that , so [ @ @ @ @ @ @ @ your data shows on when we 'll reach , for example , two cases per million ? '
'' On the other hand , Mokdad warns that the bar for opening up might actually need to be raised still higher in light of new research made public Thursday estimating that about 20 % of New York City residents have already been infected with COVID-19 .
That 's many times the number of confirmed cases .
And it suggests the coronavirus is being spread by people who are asymptomatic to a far greater extent @ @ @ @ @ @ @ have accounted for .
`` It confused a lot of us , '' says Mokdad .
`` We 're having long meetings about it . ''
Among the implications is that a locality where infections are down to one per million might nonetheless need far more testing capacity than IHME 's current approach suggests , because officials will need to ensure that workers returning to jobs in crowded industries – such as meat packing plants – are not asymptomatic spreaders of the disease .
`` We have to be very careful of that @ @ @ @ @ @ @ caveat : IHME 's model is just one of many that have been created to map the progression of COVID-19 and some other models offer less rosy projections about the trend line of infection rates .
In general , models of this sort should not be taken as literal predictions of the future .
They can be useful tools for gauging the likely trend line of an emerging disease and the likely impact of various response strategies .
But models are inherently subject to error since they are based on numerous assumptions that @ @ @ @ @ @ @ right now .
Do n't see the graphic above ?
Click here .

When Is It Safe To Ease Social Distancing? Here's What One Model Says For Each State
Enlarge this image toggle caption Dustin Chambers/Bloomberg via Getty Images Dustin Chambers/Bloomberg via Getty Images
Updated April 28, 5:00 p.m. ET
Across the U.S., state leaders are grappling with the challenging decision of when to relax the social distancing restrictions that have helped keep COVID-19 in check.
Already this week, Georgia's governor has allowed businesses such as gyms, hair salons and movie theaters to reopen — despite not meeting many of the White House's guidelines for Phase 1 of reopening. South Carolina's governor has taken a similar tack — including reopening the state's beaches.
And the governors of other states such as Tennessee and Ohio say they will allow their stay-at-home orders to expire next week, with varying degrees of social distancing required beyond that point.
But how should states decide when to reopen? Epidemiologists and other public health specialists warn against moving too fast. They note that the coronavirus is still circulating. Cases could spiral up to catastrophic levels all over again unless proper measures are taken.
The consensus view is that states shouldn't open up unless they have a robust system to detect and quash new flare-ups by testing to see who is infected, tracing their contacts, and isolating and quarantining as needed.
Unfortunately, there's widespread concern that most states will not be ready to launch such a system any time soon because of continued problems with testing capacity, as well as limited staffing at state and local health departments.
So one team of disease modelers — from the University of Washington's Institute for Health Metrics and Evaluation or IHME — has come up with a different standard. They are asking the question: What is the maximum number of new infections that states could handle with their current testing and contact tracing capacity?
IHME's answer: 1 new infection per million people in a given state. They estimate that states with this level of transmission should be able to keep outbreaks from flaring up even after people start mingling again, though the researchers stress that states would still need to limit large gatherings.
IHME's team built a model to forecast when each state will reach that threshold of 1 new infection per million. Their main finding is that very few states are close.
By May 10, only West Virginia is projected to get there. More than 20 states won't reach the threshold until the beginning of June or later. These include two of the states whose governors have been most aggressive about reopening — Georgia and South Carolina. In addition, Ohio is not projected to meet the standard until May 16; Tennessee not until May 24.
For a chart of the projected date for each state, scroll below or click here.
But first several caveats.
Ali Mokdad, a professor of health metrics sciences at IHME, says the team came up with the 1-new-infection-per-million standard based on some surveying they did of the existing capacities of local health departments across the country. But, he says, "it was very difficult for us to be sure. So we made a very conservative estimate." And, he says, already, "states are starting to reach out to us saying, 'I can do more than that, so [instead] can you tell me what your data shows on when we'll reach, for example, two cases per million?' "
On the other hand, Mokdad warns that the bar for opening up might actually need to be raised still higher in light of new research made public Thursday estimating that about 20% of New York City residents have already been infected with COVID-19. That's many times the number of confirmed cases. And it suggests the coronavirus is being spread by people who are asymptomatic to a far greater extent than IHME's team and other modelers have accounted for. "It confused a lot of us," says Mokdad. "We're having long meetings about it."
Among the implications is that a locality where infections are down to 1 per million might nonetheless need far more testing capacity than IHME's current approach suggests because officials will need to ensure that workers returning to jobs in crowded industries — such as meatpacking plants — are not asymptomatic spreaders of the disease. "We have to be very careful of that," says Mokdad.
A final caveat: IHME's model is just one of many that have been created to map the progression of COVID-19, and some other models offer less rosy projections about the trend line of infection rates. In general, models of this sort should not be taken as literal predictions of the future. They can be useful tools for gauging the likely trend line of an emerging disease and the likely impact of various response strategies. But models are inherently subject to error because they are based on numerous assumptions that scientists can only make educated guesses about right now.
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npr--2020-04-25--L.A. Reaches Legal Settlement With Company For "False Advertising" Of COVID-19 Test

L.A .
Reaches Legal Settlement With Company For `` False Advertising '' Of COVID-19 Test In late March , the California company RootMD started advertising `` at-home Covid-19 exposure and immunity tests '' for consumers worried about the coronavirus .
For $ 249 , the company said it would mail out a test kit — including a `` lancet '' that buyers could use to prick their finger and collect a blood sample .
Then , the company promised , consumers could mail that sample back to `` certified MD immunologists '' to test for antibodies to the coronavirus , @ @ @ @ @ @ @ At the time , the Food and Drug Administration had not authorized any at-home tests for COVID-19 .
But the company 's marketing materials appeared to suggest the FDA had vetted the RootMD kits .
On Instagram and Twitter , the company 's messages included the hashtags `` # FDA # Approved . ''
On its website , the company 's messaging was different .
The site stated that `` the test has not yet completed the several month investigation periods by the FDA to be labeled as approved . ''
Still , @ @ @ @ @ @ @ issued guidance `` allowing its use under emergency provisions . ''
In fact , the FDA has made clear that any tests sold under its emergency guidance are only for use in health care settings , and that the policy `` does not apply to at home testing '' - including home collection of test samples .
The RootMD test soon caught the attention of the city attorney of Los Angeles , who in a lawsuit filed this week alleged that the company violated food and drug regulations , as well as laws @ @ @ @ @ @ @ a settlement reached on Thursday , the company agreed to pay a $ 5,000 penalty , refund all customers and cease all sales of COVID-19 tests unless it receives authorization from the FDA .
In an interview before the lawsuit was filed , RootMD 's co-founder , Dr. Elroy Vojdani , said he had sold around 800 kits .
He expressed regret about statements made by the company on social media , but he maintained that RootMD had complied with FDA guidelines .
Vojdani said he had already ceased sales of the test @ @ @ @ @ @ @ , and said the company was offering refunds to customers .
In response to the lawsuit , RootMD issued a statement saying , `` All of our blood collection and laboratory testing materials used were of the highest standard . ''
The company also said it `` follows all governing regulations . ''
An attorney for RootMD did not respond to a request for comment on the settlement .
The L.A. city attorney 's office declined to comment for this story .
RootMD launched in 2020 with an emphasis on treatments for `` @ @ @ @ @ @ @ Bowel Syndrome , and even offers a `` GutCheck '' at-home blood test .
The company says it can `` analyze your blood to find the root cause of disease '' and develop a personalized treatment plan that will often include the use of dietary supplements .
Amid the coronavirus pandemic , Vojdani appeared in a Facebook Live video and recommended a variety of supplements to help combat the spread of the virus .
Some of those supplements were also available through his medical practice and its online shop .
There has been @ @ @ @ @ @ @ to the coronavirus .
But experts have warned that no supplements have been shown to effectively treat the coronavirus , and some may even cause harm if taken in excessive doses .
One of Vojdani 's recommendations , colloidal silver spray , has come under intense scrutiny from federal regulators and medical experts at the Mayo Clinic and the National Institutes of Health , among others , who say it is neither safe nor effective for treating any medical conditions .
The FDA has also warned several companies against marketing silver products as @ @ @ @ @ @ @ , including the conspiracy theorist Alex Jones of InfoWars and the televangelist Jim Bakker .
In his Facebook Live video , Vojdani claimed , `` Colloidal silver is very well demonstrated to have antiviral properties and antibacterial properties '' and recommended `` using colloidal silver spray in the nose as a preventative measure . ''
NPR asked Vojdani for comment , given the warnings among medical and government authorities that colloidal silver spray is ineffective and potentially unsafe .
In a statement , he said his medical practice `` stresses the importance of @ @ @ @ @ @ @ .
That includes being mindful of what one eats , how much one exercises , and what type of energy one puts out into the world . ''
With RootMD 's expansion into COVID-19 testing , Vojdani joined a growing number of scientists and researchers across the country who have been conducting blood tests that look for antibodies — also known as serology tests — to try to determine how many people have been exposed to the coronavirus .
The FDA has allowed a large number of companies to sell COVID-19 blood tests @ @ @ @ @ @ @ other health care settings .
But as the L.A. city attorney 's office notes in its suit against RootMD , the FDA has not authorized any at-home tests for COVID-19 , and that includes collecting blood samples at home .
One reason why , according to experts , is that even in lab settings , blood tests can come with certain limitations .
For one , it remains unclear whether people with antibodies to the virus are actually immune .
But visitors to the RootMD website got a different message .
If your @ @ @ @ @ @ @ RootMD site claimed , `` you will be able to confidently put those around you at ease by helping them know with certainty that they ca n't contract the coronavirus from you . ''
Experts say that is untrue .
`` There is just no data on whether someone with antibodies against the virus is protected from reinfection , '' explained Matthew Frieman , a professor at the University of Maryland School of Medicine who researches coronaviruses , in an email .
In response to questions from NPR , Vojdani himself voiced concern @ @ @ @ @ @ @ RootMD site , agreeing it was problematic .
The company has since removed the claim from its site .
`` I did not approve that message being put on the website , '' he said .
`` I feel really bad that that statement was on the website .
I do n't agree with it . ''
Another issue with at least some of the serology tests for the coronavirus now on the market is that they can be inaccurate , providing an unacceptably high percentage of false positive or negative results .
@ @ @ @ @ @ @ data on how those tests perform , '' according to Kelly Wroblewski of the Association of Public Health Laboratories .
Vojdani himself said he found problems with the accuracy of his kits .
He said he was using test kits from three separate manufacturers .
He said he tested samples from the same sources on all the kits , and found `` tremendous variation '' in the results .
`` Obviously , that was a little bit eye-opening and concerning , '' he said .
On April 7 , the Los Angeles city @ @ @ @ @ @ @ , and the company stopped selling test kits the next day .
Vojdani said the halt in test sales was due to his concerns about the tests ' accuracy , and not the legal inquiry .
`` We do n't want to be distributing false information to people . ''
he said .
`` And these tests are super important and super needed . ''
The FDA has agreed that serology testing is an important part of the country 's response to the coronavirus .
But this week , Dr. Stephen Hahn , @ @ @ @ @ @ @ warning to companies manufacturing and marketing these tests , saying the agency would `` go after '' those that make misleading claims .
`` It 's not okay for someone to say that a test has been authorized or approved by FDA when it has n't , '' said Hahn .

LA Reaches Legal Settlement With Company For 'False Advertising' Of COVID-19 Test
Enlarge this image toggle caption Mel Melcon/Los Angeles Times via Getty Mel Melcon/Los Angeles Times via Getty
In late March, the California company RootMD started advertising "at-home Covid-19 exposure and immunity tests" for consumers worried about the coronavirus. For $249, the company said it would mail out a test kit — including a "lancet" that buyers could use to prick their finger and collect a blood sample. Then, the company promised, consumers could mail that sample back to "certified MD immunologists" to test for antibodies to the coronavirus, and get results within 48 hours.
At the time, the Food and Drug Administration had not authorized any at-home tests for COVID-19. But the company's marketing materials appeared to suggest the FDA had vetted the RootMD kits. On Instagram and Twitter, the company's messages included the hashtags "#FDA #Approved."
On its website, the company's messaging was different. The site stated that "the test has not yet completed the several month investigation periods by the FDA to be labeled as approved." Still, the company claimed, the FDA had issued guidance "allowing its use under emergency provisions."
In fact, the FDA has made clear that any tests sold under its emergency guidance are only for use in health care settings, and that the policy "does not apply to at home testing" — including home collection of test samples.
The RootMD test soon caught the attention of the city attorney of Los Angeles, who in a lawsuit filed this week alleged that the company violated food and drug regulations, as well as laws against false advertising. As part of a settlement reached on Thursday, the company agreed to pay a $5,000 penalty, refund all customers and cease all sales of COVID-19 tests unless it receives authorization from the FDA.
In an interview before the lawsuit was filed, RootMD's co-founder, Dr. Elroy Vojdani, said he had sold around 800 kits. He expressed regret about statements made by the company on social media, but he maintained that RootMD had complied with FDA guidelines. Vojdani said he had already ceased sales of the test kits due to concerns about their accuracy, and said the company was offering refunds to customers.
In response to the lawsuit, RootMD issued a statement saying, "All of our blood collection and laboratory testing materials used were of the highest standard." The company also said it "follows all governing regulations."
An attorney for RootMD did not respond to a request for comment on the settlement. The LA city attorney's office declined to comment for this story.
RootMD's origins
RootMD launched in 2020 with an emphasis on treatments for "chronic gut conditions" such as irritable bowel syndrome, and even offers a "GutCheck" at-home blood test. The company says it can "analyze your blood to find the root cause of disease" and develop a personalized treatment plan that will often include the use of dietary supplements.
Amid the coronavirus pandemic, Vojdani appeared in a Facebook Live video and recommended a variety of supplements to help combat the spread of the virus. Some of those supplements were also available through his medical practice and its online shop.
There has been a surge in supplement sales in response to the coronavirus. But experts have warned that no supplements have been shown to effectively treat the coronavirus, and some may even cause harm if taken in excessive doses.
One of Vojdani's recommendations, colloidal silver spray, has come under intense scrutiny from federal regulators and medical experts at the Mayo Clinic and the National Institutes of Health, among others, who say it is neither safe nor effective for treating any medical conditions. The FDA has also warned several companies against marketing silver products as a treatment or preventive measure for COVID-19, including the conspiracy theorist Alex Jones of InfoWars and the televangelist Jim Bakker.
In his Facebook Live video, Vojdani claimed, "Colloidal silver is very well demonstrated to have antiviral properties and antibacterial properties" and recommended "using colloidal silver spray in the nose as a preventative measure."
NPR asked Vojdani for comment, given the warnings among medical and government authorities that colloidal silver spray is ineffective and potentially unsafe. In a statement, he said his medical practice "stresses the importance of being proactive in our approach to health. That includes being mindful of what one eats, how much one exercises, and what type of energy one puts out into the world."
Limitations of blood tests
With RootMD's expansion into COVID-19 testing, Vojdani joined a growing number of scientists and researchers across the country who have been conducting blood tests that look for antibodies — also known as serology tests — to try to determine how many people have been exposed to the coronavirus.
The FDA has allowed a large number of companies to sell COVID-19 blood tests for use in labs, hospitals and other health care settings. But as the LA city attorney's office notes in its suit against RootMD, the FDA has not authorized any at-home tests for COVID-19, and that includes collecting blood samples at home.
One reason why, according to experts, is that even in lab settings, blood tests can come with certain limitations. For one, it remains unclear whether people with antibodies to the virus are actually immune.
But visitors to the RootMD website got a different message.
If your test results came back positive, the RootMD site claimed, "you will be able to confidently put those around you at ease by helping them know with certainty that they can't contract the coronavirus from you."
Experts say that is untrue.
"There is just no data on whether someone with antibodies against the virus is protected from reinfection," explained Matthew Frieman, a professor at the University of Maryland School of Medicine who researches coronaviruses, in an email.
In response to questions from NPR, Vojdani himself voiced concern about the testing claim made on the RootMD site, agreeing it was problematic. The company has since removed the claim from its site.
"I did not approve that message being put on the website," he said. "I feel really bad that that statement was on the website. I don't agree with it."
Enlarge this image toggle caption Alex Brandon/AP Alex Brandon/AP
Concerns about accuracy
Another issue with at least some of the serology tests for the coronavirus now on the market is that they can be inaccurate, providing an unacceptably high percentage of false positive or negative results.
"There's not a lot of data on how those tests perform," according to Kelly Wroblewski of the Association of Public Health Laboratories.
Vojdani himself said he found problems with the accuracy of his kits. He said he was using test kits from three separate manufacturers. He said he tested samples from the same sources on all the kits, and found "tremendous variation" in the results.
"Obviously, that was a little bit eye-opening and concerning," he said.
On April 7, the Los Angeles city attorney's office says it contacted RootMD, and the company stopped selling test kits the next day.
Vojdani said the halt in test sales was due to his concerns about the tests' accuracy, and not the legal inquiry.
"We don't want to be distributing false information to people." he said. "And these tests are super important and super needed."
The FDA has agreed that serology testing is an important part of the country's response to the coronavirus. But this week, Dr. Stephen Hahn, the FDA commissioner, also issued a warning to companies manufacturing and marketing these tests, saying the agency would "go after" those that make misleading claims.
"It's not OK for someone to say that a test has been authorized or approved by FDA when it hasn't," said Hahn.


npr--2020-04-25--In Parkland, Another Senior Year Ends In Turmoil. But This Time, 'It's Not Just Us'

In Parkland , Another Senior Year Ends In Turmoil .
But This Time , 'It 's Not Just Us' Friday , March 13 , was the last time Alexandra Sullivan saw her fellow yearbook staffers in person .
`` We were trying to get as many pictures of people as possible 'cause we knew we would n't be able to take any more , '' Sullivan , 18 , says .
Like most U.S. public school students , Sullivan is learning from home now .
And much like her lessons , her work on the yearbook continues .
Sullivan is @ @ @ @ @ @ @ Douglas High School in Parkland , Fla. She 's one of 10 seniors who were also on staff two years ago , when a gunman opened fire at their school .
Back then , she and her classmates had to adapt to an unimaginable tragedy .
Now , they have to adapt again – this time , to the pandemic .
`` This book has to get done and we 'll do whatever we have to do to finish it , '' she says , `` which is exactly how we approached the @ @ @ @ @ @ @ , the yearbook 's co-editor-in-chief , was also on staff when the shooting happened .
She says there 's a collective grief among seniors over what their class — which has already lost so much — is losing now .
They wo n't be able to dance together at prom , or walk across the stage at graduation .
`` This class especially has gotten screwed over so much through the past four years , '' Tibbetts , 18 , says .
`` The last two months were supposed to be the best @ @ @ @ @ @ @ up for everything that we 've been through .
And it 's really hard on us to kind of just watch it all disappear . ''
Amid all the uncertainty , she says , one thing is clear : The yearbook must get done , and it must get to students .
High school yearbooks are like time capsules .
They record theater productions , which teams went to state finals , who was voted most likely to succeed .
And when a news event makes history – leaving a mark on students @ @ @ @ @ @ @ 's job to document it .
At Stoneman Douglas , that 's meant changing plans just weeks before the yearbook is due .
Yearbook advisor Sarah Lerner says , `` Having done one under unthinkable circumstances before , I hate to say that we 're kind of , you know , used to it , but , for the seniors on staff , we are . ''
Two years ago , after the shooting , the yearbook staff pivoted to include remembrances of the victims .
Tibbetts and Sullivan stepped up to help @ @ @ @ @ @ @ was needed at the last minute , while other yearbook staffers took time to attend funerals .
This year , they 're making room for two new spreads about the pandemic .
`` One of them is more of a factual-based one , how it 's affected our community , including businesses , '' Tibbetts explains .
`` The other spread is focused on the effect it 's had on us personally , both with online schooling and especially with seniors . ''
Logistically , putting the yearbook together and writing the new @ @ @ @ @ @ @ 2018 , they ca n't be in the same room with each other to finish the design .
`` We have to social distance and our parents would n't let us go out , '' Tibbetts says .
They mainly rely on a group chat with everyone on the staff .
`` It can get hectic , '' Tibbetts says , `` especially when it 's all happening at like 12 a.m. '' Lerner and her students missed the original deadline to finish the book , on April 6 .
But the printer @ @ @ @ @ @ @ being flexible with Stoneman Douglas and other yearbook staffs across the country .
Lerner says she 's aiming to get the book in by the end of April .
Once the printed copies come back , more than 1,200 books will somehow have to be distributed to students .
Lerner has some ideas for how to do that safely .
However , there 's one important yearbook tradition they may not be able to save .
`` We may not actually get to sign books this year , '' Lerner says .
And @ @ @ @ @ @ @ `` As a teacher , I really like to get my students to sign my book , you know , and I like to sign theirs and I like to see the kids carrying them around at school . ''
Lerner says she 's sad that might not happen this year .
But at least this time , the students of Marjory Stoneman Douglas High School are n't on their own .
`` Unlike the 2018 books , this situation is not unique to us , '' she says .
`` So there @ @ @ @ @ @ @ are going through the same issue .
It 's not just us . ''

In Parkland, Another Senior Year Ends In Turmoil. But This Time, 'It's Not Just Us'
Enlarge this image Dani Pendergast for NPR Dani Pendergast for NPR
Friday, March 13, was the last time Alexandra Sullivan saw her fellow yearbook staffers in person.
"We were trying to get as many pictures of people as possible 'cause we knew we wouldn't be able to take any more," Sullivan, 18, says.
Like most U.S. public school students, Sullivan is learning from home now. And much like her lessons, her work on the yearbook continues.
Sullivan is the yearbook profiles editor at Marjory Stoneman Douglas High School in Parkland, Fla. She's one of 10 seniors who were also on staff two years ago, when a gunman opened fire at their school. Back then, she and her classmates had to adapt to an unimaginable tragedy. Now, they have to adapt again – this time, to the pandemic.
"This book has to get done and we'll do whatever we have to do to finish it," she says, "which is exactly how we approached the '18 book."
Senior Caitlynn Tibbetts, the yearbook's co-editor-in-chief, was also on staff when the shooting happened. She says there's a collective grief among seniors over what their class — which has already lost so much — is losing now. They won't be able to dance together at prom, or walk across the stage at graduation.
"This class especially has gotten screwed over so much through the past four years," Tibbetts, 18, says. "The last two months were supposed to be the best, and they were supposed to make up for everything that we've been through. And it's really hard on us to kind of just watch it all disappear."
The last two months were ... supposed to make up for everything that we've been through. And it's really hard on us to kind of just watch it all disappear.
Amid all the uncertainty, she says, one thing is clear: The yearbook must get done, and it must get to students.
High school yearbooks are like time capsules. They record theater productions, which teams went to state finals, who was voted most likely to succeed.
And when a news event makes history – leaving a mark on students and society – it's the yearbook's job to document it. At Stoneman Douglas, that's meant changing plans just weeks before the yearbook is due.
Yearbook advisor Sarah Lerner says, "Having done one under unthinkable circumstances before, I hate to say that we're kind of, you know, used to it, but, for the seniors on staff, we are."
Two years ago, after the shooting, the yearbook staff pivoted to include remembrances of the victims. Tibbetts and Sullivan stepped up to help write them, and anything else that was needed at the last minute, while other yearbook staffers took time to attend funerals.
This year, they're making room for two new spreads about the pandemic.
"One of them is more of a factual-based one, how it's affected our community, including businesses," Tibbetts explains. "The other spread is focused on the effect it's had on us personally, both with online schooling and especially with seniors."
Logistically, putting the yearbook together and writing the new sections has been a challenge. Unlike 2018, they can't be in the same room with each other to finish the design.
"We have to social distance and our parents wouldn't let us go out," Tibbetts says.
They mainly rely on a group chat with everyone on the staff. "It can get hectic," Tibbetts says, "especially when it's all happening at like 12 a.m."
Lerner and her students missed the original deadline to finish the book, on April 6. But the printer, Walsworth, says the company is being flexible with Stoneman Douglas and other yearbook staffs across the country. Lerner says she's aiming to get the book in by the end of April.
Once the printed copies come back, more than 1,200 books will somehow have to be distributed to students. Lerner has some ideas for how to do that safely.
However, there's one important yearbook tradition they may not be able to save.
"We may not actually get to sign books this year," Lerner says. And that's been hard to accept.
"As a teacher, I really like to get my students to sign my book, you know, and I like to sign theirs and I like to see the kids carrying them around at school."
Lerner says she's sad that might not happen this year. But at least this time, the students of Marjory Stoneman Douglas High School aren't on their own.
"Unlike the 2018 books, this situation is not unique to us," she says. "So there's comfort in knowing that all staffs are going through the same issue. It's not just us."


npr--2020-04-25--Congressional Watchdog To Review Federal Coronavirus Response

The CARES act , the $ 2 trillion coronavirus response legislation Congress approved late last month , calls for a government watchdog , the Government Accountability Office , to monitor the spending and the overall federal response to the pandemic .
And while President Trump has pushed back on other oversight , it will be difficult for him to block the GAO 's work .
The GAO is a nonpartisan agency that is a part of Congress .
`` We 've been given a very broad oversight role under the CARES Act , '' Nicole Clowers , the managing director @ @ @ @ @ @ @ , told NPR .
`` We 're required to provide ongoing monitoring and oversight of the nation 's preparedness for response to recovery from the pandemic , as well as examining the impacts of the pandemic on the economy , public health , as well as homeland security , '' she said .
Clowers said the GAO is also tracking how that $ 2 trillion is being spent .
And she said the agency has already gotten to work .
`` Some of the more immediate things that we 're starting with include @ @ @ @ @ @ @ issues around the stockpile , including the management of the stockpile and the distribution of the equipment , the availability of the personal protective equipment , as well as infection control at nursing homes . ''
It is a broad mandate , but Clowers said the agency has experience .
It oversaw spending on the Troubled Asset Relief Program and the economic stimulus bill in 2008 , measures Congress approved in the Great Recession .
The CARES Act contained $ 20 million for the GAO to hire additional staff .
University of Maryland @ @ @ @ @ @ @ worked with the agency , and she says the GAO is up to the task .
`` They 're used to doing complicated audits , and they 're used to writing reports that are objective , '' Steinzor said .
`` Now , the downside of all of that is they are the group that dares to be boring , but arguably you need that . ''
Congress initially tried to find other avenues for oversight of the CARES Act by establishing a panel of inspectors general to oversee the money and a @ @ @ @ @ @ @ money distributed to corporations .
But President Trump removed the official set to lead the panel , and in a signing statement issued with the CARES Act , said he can limit the information the special IG receives from the Treasury Department .
The GAO however , is beyond the president 's reach , Steinzor said .
`` He ca n't fire them ; he can stonewall them .
This administration is historical in terms of the amount of stonewalling that it just does , '' she said .
`` But they will @ @ @ @ @ @ @ , and they will just keep their head down and keep on walking toward the goal . ''
The GAO weighed in during the president 's impeachment , finding Trump violated the law when he withheld congressionally approved foreign assistance to Ukraine .
Clowers said the GAO has long worked with Republicans and Democrats , and she 's confident the agency will be able to do so as it looks into the government response to the pandemic .
`` We have long-standing relationships — independent but long-standing relationships — with agencies , '' @ @ @ @ @ @ @ believe that will help us maintain good relations , good working relationships moving forward . ''
The GAO is to report its findings every 60 days .
Its first report is due at the end of June .

Congressional Watchdog To Review Federal Coronavirus Response
Enlarge this image toggle caption Sue Ogrocki/AP Sue Ogrocki/AP
The CARES Act, the $2 trillion coronavirus response legislation Congress approved late last month, calls for a government watchdog, the Government Accountability Office, to monitor the spending and the overall federal response to the pandemic. And while President Trump has pushed back on other oversight, it will be difficult for him to block the GAO's work.
The GAO is a nonpartisan agency that is a part of Congress. "We've been given a very broad oversight role under the CARES Act," Nicole Clowers, the managing director of the GAO's health care team, told NPR.
"We're required to provide ongoing monitoring and oversight of the nation's preparedness for response to recovery from the pandemic, as well as examining the impacts of the pandemic on the economy, public health, as well as homeland security," she said.
Clowers said the GAO is also tracking how that $2 trillion is being spent. And she said the agency has already gotten to work.
"Some of the more immediate things that we're starting with include looking at testing for the virus, issues around the stockpile, including the management of the stockpile and the distribution of the equipment, the availability of the personal protective equipment, as well as infection control at nursing homes," she said.
It is a broad mandate, but Clowers said the agency has experience. It oversaw spending on the Troubled Asset Relief Program and the economic stimulus bill in 2008, measures Congress approved in the Great Recession. The CARES Act contained $20 million for the GAO to hire additional staff.
University of Maryland School of Law professor Rena Steinzor has worked with the agency, and she says the GAO is up to the task.
"They're used to doing complicated audits, and they're used to writing reports that are objective," Steinzor said. "Now, the downside of all of that is they are the group that dares to be boring, but arguably you need that."
Congress initially tried to find other avenues for oversight of the CARES Act by establishing a panel of inspectors general to oversee the money and a special inspector general to watch over the money distributed to corporations.
But President Trump removed the official set to lead the panel, and in a signing statement issued with the CARES Act, said he can limit the information the special IG receives from the Treasury Department.
The GAO, however, is beyond the president's reach, Steinzor said.
"He can't fire them; he can stonewall them. This administration is historical in terms of the amount of stonewalling that it just does," she said. "But they will find a way to talk to people, and they will just keep their head down and keep on walking toward the goal."
The GAO weighed in during the president's impeachment, finding Trump violated the law when he withheld congressionally approved foreign assistance to Ukraine.
Clowers said the GAO has long worked with Republicans and Democrats, and she's confident the agency will be able to do so as it looks into the government response to the pandemic.
"We have longstanding relationships — independent but longstanding relationships — with agencies," she said, adding, "I believe that will help us maintain good relations, good working relationships moving forward."
The GAO is to report its findings every 60 days. Its first report is due at the end of June.


npr--2020-04-25--U.K. Prime Minister Boris Johnson To Return To Work Monday

British Prime Minister Boris Johnson is returning to work Monday after recovering from COVID-19 , according to multiple reports citing @ @ @ @ @ been staying at Chequers , the prime minister 's country residence , following his release @ @ @ @ @ ' Hospital , where he was admitted early in April .
He spent three nights @ @ @ @ @ care unit .
He was released from St. Thomas ' nearly two weeks ago .
@ @ @ @ @ recorded a video thanking the hospital 's staff for saving his life .
`` I @ @ @ @ @ a week in which the NHS has saved my life , no question , '' @ @ @ @ @ who tested positive in late March — was viewed as the first major world leader @ @ @ @ @ Prior to his hospitalization , he had been criticized for moving too slowly in his @ @ @ @ @ .
He returns as COVID-19-related deaths in the U.K. surpassed 20,000 , according to data @ @ @ @ @ .

U.K. Prime Minister Boris Johnson To Return To Work Monday
Enlarge this image toggle caption Pippa Fowles/AP Pippa Fowles/AP
British Prime Minister Boris Johnson is returning to work Monday after recovering from COVID-19, according to multiple reports citing Downing Street.
Johnson had been staying at Chequers, the prime minister's country residence, following his release from London's St. Thomas' Hospital, where he was admitted early in April. He spent three nights in the facility's intensive care unit.
He was released from St. Thomas' nearly two weeks ago. Upon being discharged, Johnson recorded a video thanking the hospital's staff for saving his life.
"I have today left hospital after a week in which the NHS has saved my life, no question," he said.
Johnson — who tested positive in late March — was viewed as the first major world leader to have the virus. Prior to his hospitalization, he had been criticized for moving too slowly in his response to the developing pandemic.
He returns as COVID-19-related deaths in the U.K. surpassed 20,000, according to data collected by Johns Hopkins University.


npr--2020-04-25--NYC Poison Control Sees Uptick In Calls After Trump's Disinfectant Comments

New York City says its Poison Control Center received a higher than normal number of calls in the day after President Trump speculated that injecting household disinfectants could be a coronavirus treatment .
The city 's Department of Health and Mental Hygiene said that in an 18-hour period ending at 3 p.m. Friday , the poison control center recorded 30 cases .
These included nine `` specifically about exposure to Lysol , 10 cases specifically about bleach and 11 cases about exposures to other household cleaners , '' department spokesperson Pedro F. Frisneda tells NPR .
That compares to only @ @ @ @ @ @ @ one year ago .
That same day , the city 's health commissioner released a message discouraging New Yorkers from injecting bleach and other disinfectants .
`` Very clearly , disinfectants are not intended for ingestion either by mouth , by ears , by breathing them in — in any way shape or form .
And doing so can put people at great risk , '' said Dr. Oxiris Barbot in a video posted to Twitter .
At Thursday 's daily briefing , Trump conjectured that ingesting disinfectant could be worth looking into @ @ @ @ @ @ @ .
`` I see the disinfectant — where it knocks it out in a minute , one minute .
And is there a way we can do something like that , by injection inside or almost a cleaning ? ''
Trump walked back his remarks the next day , calling it a sarcastic question to reporters , `` just to see what would happen . ''
Public health agencies , medical experts and at least one manufacturer have widely urged against ingesting disinfectants and household cleaners in any form .
Regardless of the @ @ @ @ @ @ @ of exposure to and ingestion of disinfectants and cleaners have increased , according to data from poison control centers .
A report posted online this week by the Centers for Disease Control and Prevention says that cases of exposure to cleaners and disinfectants have gone up 20 % from January through March 2020 compared to the same time period last year .
The CDC notes that the spike in calls began in early March but cautioned that it could not prove a `` definite link between exposures and COVID-19 cleaning efforts . ''
@ @ @ @ @ @ @ be demonstrated , the timing of these reported exposures corresponded to increased media coverage of the COVID-19 pandemic , reports of consumer shortages of cleaning and disinfection products , and the beginning of some local and state stay-at-home orders , '' the report goes on to say .

NYC Poison Control Sees Uptick In Calls After Trump's Disinfectant Comments
Enlarge this image toggle caption Alex Brandon/AP Alex Brandon/AP
New York City says its poison control center received a higher-than-normal number of calls in the day after President Trump speculated that injecting household disinfectants could be a coronavirus treatment.
The city's Department of Health and Mental Hygiene said that in an 18-hour period ending at 3 p.m. Friday, the poison control center recorded 30 cases. These included nine "specifically about exposure to Lysol, 10 cases specifically about bleach and 11 cases about exposures to other household cleaners," department spokesperson Pedro F. Frisneda tells NPR. That compares with only 13 cases for the same time frame one year ago.
That same day, the city's health commissioner released a message discouraging New Yorkers from injecting bleach and other disinfectants.
"Very clearly, disinfectants are not intended for ingestion either by mouth, by ears, by breathing them in — in any way, shape or form. And doing so can put people at great risk," said Dr. Oxiris Barbot in a video posted to Twitter.
At Thursday's daily briefing, Trump conjectured that ingesting disinfectant could be worth looking into as a way to treat the virus.
"I see the disinfectant — where it knocks it out in a minute, one minute. And is there a way we can do something like that, by injection inside or almost a cleaning?"
Trump walked back his remarks the next day, calling them a sarcastic question to reporters, "just to see what would happen."
Public health agencies, medical experts and at least one manufacturer have widely urged against ingesting disinfectants and household cleaners in any form.
Regardless of the impact of the suggestion, reported cases of exposure to and ingestion of disinfectants and cleaners have increased, according to data from poison control centers.
A report posted online this week by the Centers for Disease Control and Prevention says that cases of exposure to cleaners and disinfectants have gone up 20% from January through March 2020 compared with the same time period last year.
The CDC notes that the spike in calls began in early March but cautioned that it could not prove a "definite link between exposures and COVID-19 cleaning efforts."
"Although a causal association cannot be demonstrated, the timing of these reported exposures corresponded to increased media coverage of the COVID-19 pandemic, reports of consumer shortages of cleaning and disinfection products, and the beginning of some local and state stay-at-home orders," the report goes on to say.


npr--2020-04-25--New York To Expand Testing Criteria For Coronavirus, Increase Antibody Testing

New York To Expand Testing Criteria For Coronavirus , Increase Antibody Testing New York state is expanding the criteria for who gets tested for the coronavirus as well as increasing antibody testing to determine how much of the state 's population has been infected .
On Saturday , Gov .
Andrew Cuomo announced that first responders , medical workers and essential employees would be eligible to receive tests for the coronavirus .
The governor also said that he would be authorizing some 5,000 independent pharmacies to serve as sites where the tests could be collected .
`` These people have @ @ @ @ @ @ @ been subjected to the public all during these crisis and they 're public-facing , '' Cuomo said while announcing the expanded criteria .
`` These are the people you interact with . ''
In addition , the state would continue its antibody testing efforts to include transit workers and law enforcement .
Workers at four New York City hospitals — some of the hardest hit by the pandemic — would also be tested for antibodies beginning Saturday .
The invigorated testing effort comes as data suggest the state could be on the downside @ @ @ @ @ @ @ people entering hospitals for COVID-19 dropped to roughly 1,100 Friday , the lowest it has been in 21 days , the governor announced .
`` It 's down to about 1,100 new cases .
Only in this crazy reality would 1,100 new cases be relatively good news , right ? ''
Cuomo said .
Deaths from the disease , however , ticked up slightly to 437 on Friday , up from 422 a day prior .
Drawing comparisons to the flu pandemic of 1918 and World War II , Cuomo urged New Yorkers @ @ @ @ @ @ @ , noting its hardships .
`` One hundred thousand fewer serious infections , that 's what 56 days of our relative living through hell has accomplished .
And that is a heck of an accomplishment , '' Cuomo said .

New York To Expand Testing Criteria For Coronavirus, Increase Antibody Testing
Enlarge this image toggle caption Kathy Willens/AP Kathy Willens/AP
New York state is expanding the criteria for who gets tested for the coronavirus as well as increasing antibody testing to determine how much of the state's population has been infected.
On Saturday, Gov. Andrew Cuomo announced that first responders, medical workers and essential employees would be eligible to receive tests for the coronavirus. The governor also said that he would be authorizing some 5,000 independent pharmacies to serve as sites where the tests could be collected.
"These people have been carrying the load and they have been subjected to the public all during these crisis and they're public-facing," Cuomo said while announcing the expanded criteria. "These are the people you interact with."
In addition, the state would continue its antibody testing efforts to include transit workers and law enforcement.
Workers at four New York City hospitals — some of the hardest hit by the pandemic — would also be tested for antibodies beginning Saturday.
The invigorated testing effort comes as data suggest the state could be on the downside of its outbreak. The number of people entering hospitals for COVID-19 dropped to roughly 1,100 Friday, the lowest it has been in 21 days, the governor announced.
"It's down to about 1,100 new cases. Only in this crazy reality would 1,100 new cases be relatively good news, right?" Cuomo said.
Deaths from the disease, however, ticked up slightly to 437 on Friday, up from 422 a day prior.
Drawing comparisons to the flu pandemic of 1918 and World War II, Cuomo urged New Yorkers to continue abiding by social distancing restrictions, noting its hardships.
"One hundred thousand fewer serious infections, that's what 56 days of our relative living through hell has accomplished. And that is a heck of an accomplishment," Cuomo said.


npr--2020-04-25--'No Evidence' Yet That Recovered COVID-19 Patients Are Immune, WHO Says

'No Evidence ' Yet That Recovered COVID-19 Patients Are Immune , WHO Says The World Health Organization has pushed back against the theory that individuals can only catch the coronavirus once , as well as proposals for reopening society that are based on this supposed immunity .
In a scientific brief dated Friday , the United Nations agency said the idea that one-time infection can lead to immunity remains unproven and is thus unreliable as a foundation for the next phase of the world 's response to the pandemic .
`` Some governments have suggested that the detection of antibodies @ @ @ @ @ @ @ causes COVID-19 , could serve as the basis for an 'immunity passport ' or 'risk-free certificate ' that would enable individuals to travel or to return to work assuming that they are protected against re-infection , '' the WHO wrote .
`` There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection . ''
The statement comes days after Chile announced it would begin issuing immunity cards that effectively act as passports , allowing travelers to clear security at airports with a @ @ @ @ @ @ @ from the virus .
Authorities and researchers in other countries — such as France and the United Kingdom — have expressed interest in similar ideas , while some officials in the U.S. , such as Los Angeles Mayor Eric Garcetti , have mentioned it as one possible facet of a reopening strategy .
The concept for such a card is largely based on the premise that an individual can only contract the coronavirus once before developing the necessary antibodies to fight it off .
That premise undergirds another common theory : the concept @ @ @ @ @ @ @ if enough people have been infected with the coronavirus — and are therefore immune — its transmission will slow and the risks of infection will diminish even for those who have n't caught it yet .
But these ideas depend to a large degree on the supposition that one can not catch the coronavirus a second time — an idea that world health authorities said leaders should not count on right now .
As of Friday , the WHO said , `` No study has evaluated whether the presence of antibodies to SARS-CoV-2 @ @ @ @ @ @ @ virus in humans . ''
What 's more , data reported from the world 's early COVID-19 hot spots , such as South Korea and China , have shown that a growing number of recovered patients appear to have suffered a relapse of the disease .
By mid-April , Korean health authorities said that just over 2 % of the country 's recovered patients were in isolation again after testing positive a second time .
And in Wuhan , China , data from several quarantine facilities in the city , which house patients @ @ @ @ @ @ @ , show that about 5 % to 10 % of patients pronounced `` recovered '' have tested positive again .
It remains unclear why this is occurring — whether it is a sign of a second infection , a reactivation of the remaining virus in the body or the result of an inaccurate antibody test .
Dozens of antibody tests for the novel coronavirus are already on the market , with varying degrees of reliability and accuracy .
House Democrats have launched an investigation into the antibody tests and whether the Food and @ @ @ @ @ @ @ them , according to CNN .
`` At this point in the pandemic , there is not enough evidence about the effectiveness of antibody-mediated immunity to guarantee the accuracy of an 'immunity passport ' or 'risk-free certificate , ' `` the WHO warned .
`` People who assume that they are immune to a second infection because they have received a positive test result may ignore public health advice .
The use of such certificates may therefore increase the risks of continued transmission . ''

'No Evidence' Yet That Recovered COVID-19 Patients Are Immune, WHO Says
Enlarge this image toggle caption Greg Baker/AFP via Getty Images Greg Baker/AFP via Getty Images
The World Health Organization has pushed back against the theory that individuals can only catch the coronavirus once, as well as proposals for reopening society that are based on this supposed immunity.
In a scientific brief dated Friday, the United Nations agency said the idea that one-time infection can lead to immunity remains unproven and is thus unreliable as a foundation for the next phase of the world's response to the pandemic.
"Some governments have suggested that the detection of antibodies to the SARS-CoV-2, the virus that causes COVID-19, could serve as the basis for an 'immunity passport' or 'risk-free certificate' that would enable individuals to travel or to return to work assuming that they are protected against re-infection," the WHO wrote. "There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection."
The statement comes days after Chile announced it would begin issuing immunity cards that effectively act as passports, allowing travelers to clear security at airports with a document that purportedly shows they have recovered from the virus. Authorities and researchers in other countries — such as France and the United Kingdom — have expressed interest in similar ideas, while some officials in the U.S., such as Los Angeles Mayor Eric Garcetti, have mentioned it as one possible facet of a reopening strategy.
The concept for such a card is largely based on the premise that an individual can only contract the coronavirus once before developing the necessary antibodies to fight it off. That premise undergirds another common theory: the concept, known as herd immunity, that if enough people have been infected with the coronavirus — and are therefore immune — its transmission will slow and the risks of infection will diminish even for those who haven't caught it yet.
But these ideas depend to a large degree on the supposition that one cannot catch the coronavirus a second time — an idea that world health authorities said leaders should not count on right now. As of Friday, the WHO said, "No study has evaluated whether the presence of antibodies to SARS-CoV-2 confers immunity to subsequent infection by this virus in humans."
What's more, data reported from the world's early COVID-19 hot spots, such as South Korea and China, have shown that a growing number of recovered patients appear to have suffered a relapse of the disease.
By mid-April, Korean health authorities said that just over 2% of the country's recovered patients were in isolation again after testing positive a second time. And in Wuhan, China, data from several quarantine facilities in the city, which house patients for observation after their discharge from hospitals, show that about 5% to 10% of patients pronounced "recovered" have tested positive again.
It remains unclear why this is occurring — whether it is a sign of a second infection, a reactivation of the remaining virus in the body or the result of an inaccurate antibody test.
Dozens of antibody tests for the novel coronavirus are already on the market, with varying degrees of reliability and accuracy. House Democrats have launched an investigation into the antibody tests and whether the Food and Drug Administration should increase its enforcement of them, according to CNN.
"At this point in the pandemic, there is not enough evidence about the effectiveness of antibody-mediated immunity to guarantee the accuracy of an 'immunity passport' or 'risk-free certificate,' " the WHO warned.
"People who assume that they are immune to a second infection because they have received a positive test result may ignore public health advice. The use of such certificates may therefore increase the risks of continued transmission."


npr--2020-04-25--Coronavirus World Map: Tracking The Spread Of The Outbreak

Coronavirus World Map : Tracking The Spread Of The Outbreak Since the new coronavirus was first reported in Wuhan , China , in December , the infectious respiratory disease COVID-19 has spread rapidly within China and to neighboring countries and beyond .
The first confirmed coronavirus cases outside China occurred on Jan. 20 , in Japan , Thailand and South Korea .
On Jan. 21 , the first case in the U.S. was identified in Washington state .
On Jan. 24 , the first two European cases were confirmed in France .
By Feb. 1 , eight European nations had @ @ @ @ @ @ @ month later that count had risen to 24 countries with at least 2,200 cases , most of them in Italy .
On March 11 , Italy eclipsed 10,000 cases and the World Health Organization declared the outbreak a pandemic — the first since H1N1 in 2009 .
That 's also when China , the original epicenter , began seeing drops in daily counts of new cases .
March also saw exponential spread of the virus throughout the U.S. , with all 50 states reporting cases by March 17 .
This particular virus , @ @ @ @ @ @ @ the third strain of coronavirus known to frequently cause severe symptoms in humans .
The other two strains cause Middle East respiratory syndrome and severe acute respiratory syndrome .
Click here to see the state-by-state breakdown of cases in the United States .
This story was originally published on March 30 , 2020 .

Coronavirus world map: We've now passed the 600 million mark for infections
Editor's note: This page is no longer being updated. The last update was Sept. 5, 2022. For current data about COVID-19 cases and deaths around the world, Johns Hopkins University and Our World in Data are useful resources.
In late January 2020 only a few dozen COVID-19 infections had been identified outside of China. A year later, the world tallied its first 100 million cases. It took the globe just 7 more months to pass the 200 million mark— then another 5 months to hit 300 million, according to researchers at Johns Hopkins University. Now the virus has spread to every corner of the globe and has been blamed for more than 6 million deaths.
The United States, India and Brazil in that order have had the most COVID cases and the three nations collectively account for almost half of all recorded infections so far in the pandemic.
Explore the chart below to find a country-by-country breakdown of new and total cases since January 2020.
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Explore how the number of coronavirus cases have shifted in different parts of the world over time. The first chart compares each continent to each other, while the next charts highlight the number of cases in select countries by region.
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This story was originally published on March 30, 2020.