npr--2020-04-24--'It's The Wild West': To Meet Pandemic-Fueled Demand, Factories Turn To Making Masks

'It 's The Wild West ' : To Meet Pandemic-Fueled Demand , Factories Turn To Making Masks In the pre-COVID-19 era , Michael Crotty 's company , Golden Pacific Fashion and Design , based in Shanghai , sold curtains .
But since the global economy ground to a halt , nobody 's buying curtains .
They 're buying masks .
`` It 's pandemonium at its highest level , '' says Crotty .
`` It 's the Wild West and it really is a unique situation where these factories that can make these goods are in the driver 's seat @ @ @ @ @ @ @ pandemic has created a global free-for-all for manufacturing protective equipment , particularly face masks .
And that 's meant factories like Crotty 's have begun making them to meet demand .
Fortunately for Crotty , his Chinese suppliers quickly purchased automation equipment and converted their assembly lines into mask-making powerhouses .
His suppliers ' factories have ramped up production and are now able to make at least 15 million masks a week .
`` This was a way to transition and keep the business rolling , '' says the 70-year-old businessman .
`` @ @ @ @ @ @ @ thousands of people going out of business .
And it 's a disaster .
We 're fortunate that these products fall under our business model . ''
Crotty , with decades of manufacturing experience in China , now produces the KN95 , the Chinese version of the N95 respirator mask , designed to block 95 % of small particles when worn properly .
He says his first order for 5,000 masks came from a Chicago hospital where his daughter works .
`` So now I 'm busier than I 've been in a @ @ @ @ @ @ @ `` The only significant difference is that in the curtain business , we had 10 customers and we knew all of them for a long time .
And it was a simple process . ''
These days , he says he 's getting calls from hospitals , schools , even people who claim to be close to Indian Prime Minister Narendra Modi and Turkish President Recep Tayyip Erdogan .
`` And I was told that Erdogan mandated that every Turkish citizen was to be given five free masks , '' he says .
@ @ @ @ @ @ @ in Turkey .
So that 's over 400 million masks for free to the population .
That 's just one country . ''
Crotty says his suppliers now have leverage over their clients and they 're asking for at least a 50 % deposit before taking an order .
Fulfilling an order , though , especially if it 's headed to the U.S. , can be a challenge .
To crack down on fakes , Chinese customs authorities have begun inspecting exports labeled for medical use , a process that can cause massive @ @ @ @ @ @ @ `` So then you say to the hospital , 'We can get it out of China customs , but you 've got to label it for personal or commercial use , not for medical purpose , ' and then the U.S. customs is going to look at that for a hospital group and they say , 'They 're not using this for medical use ? '
'' Crotty says .
In Prague , another executive , Brian Yamato , has also converted some of his company 's assembly lines to manufacture masks .
@ @ @ @ @ @ @ company that sells ultrasonic welding equipment to mask manufacturers .
Yamato 's team thought : Why not make our own masks ?
`` And we just started kind of setting up and experimenting and working with it .
We went through , I think , our fourth mask design now , '' he says with a chuckle .
Dukane 's Czech factory has made 50,000 masks so far , but has n't sold a single one .
Yamato has donated them to the Czech government .
At first , he says , he @ @ @ @ @ @ @ certifications for his brand-new mask line .
The European Union 's strict regulations make it a tough place to introduce a new product like this .
But he was assured by the Czech government that it would n't be a problem .
This is , they told him , an emergency , and the entire world has never seen anything like it .

'It's The Wild West': To Meet Pandemic-Fueled Demand, Factories Turn To Making Masks
Enlarge this image toggle caption Jon Nazca/Reuters Jon Nazca/Reuters
Updated on April 28 at 10:30 a.m. ET
In the pre-COVID-19 era, Michael Crotty's company, Golden Pacific Fashion and Design, based in Shanghai, sold curtains. But since the global economy ground to a halt, nobody's buying curtains. They're buying masks.
"It's pandemonium at its highest level," says Crotty. "It's the Wild West and it really is a unique situation where these factories that can make these goods are in the driver's seat at the moment."
The COVID-19 pandemic has created a global free-for-all for manufacturing protective equipment, particularly face masks. And that's meant factories like Crotty's have begun making them to meet demand.
Fortunately for Crotty, his Chinese suppliers quickly purchased automation equipment and converted their assembly lines into mask-making powerhouses. His suppliers' factories have ramped up production and are now able to make at least 15 million masks a week.
Enlarge this image toggle caption Michael Crotty Michael Crotty
"This was a way to transition and keep the business rolling," says the 70-year-old businessman. "There's going to be thousands and thousands of people going out of business. And it's a disaster. We're fortunate that these products fall under our business model."
Crotty, with decades of manufacturing experience in China, now produces the KN95, the Chinese version of the N95 respirator mask, designed to block 95% of small particles when worn properly. He says his first order for 5,000 masks came from a Chicago hospital where his daughter works.
"So now I'm busier than I've been in a long time," he says. "The only significant difference is that in the curtain business, we had 10 customers and we knew all of them for a long time. And it was a simple process."
These days, he says he's getting calls from hospitals, schools, even people who claim to be close to Indian Prime Minister Narendra Modi and Turkish President Recep Tayyip Erdogan.
"And I was told that Erdogan mandated that every Turkish citizen was to be given five free masks," he says. "There are about 83 million people in Turkey. So that's over 400 million masks for free to the population. That's just one country."
Crotty says his suppliers now have leverage over their clients and they're asking for at least a 50% deposit before taking an order.
Fulfilling an order, though, especially if it's headed to the U.S., can be a challenge. To crack down on fakes, Chinese customs authorities have begun inspecting exports labeled for medical use, a process that can cause massive delays for exports to U.S. hospitals.
"So then you say to the hospital, 'We can get it out of China customs, but you've got to label it for personal or commercial use, not for medical purpose,' and then the U.S. customs is going to look at that for a hospital group and they say, 'They're not using this for medical use?'" Crotty says.
That's why, he says, there are shipping containers from China filled with masks sitting in the Port of Los Angeles. U.S. customs won't release them to American hospitals because they aren't labeled properly, he says.
In an emailed statement, U.S. Customs and Border Protection spokesperson Kelly Cahalan tells NPR that CBP is working with its partners in the government, including the Food and Drug Administration, "to ensure that medical devices related to COVID-19 response are cleared through U.S. Customs and Border Protection as expeditiously as possible while verifying that the devices are authorized and safe for use. ...However, goods that are not properly labeled ...would be detained for clearance or adjudication through the FDA."
In Prague, another executive, Brian Yamato, has also converted some of his company's assembly lines to manufacture masks. He works for Dukane, an Illinois-based company that sells ultrasonic welding equipment to mask manufacturers.
Yamato's team thought: Why not make our own masks? "And we just started kind of setting up and experimenting and working with it. We went through, I think, our fourth mask design now," he says with a chuckle.
Dukane's Czech factory has made 50,000 masks so far, but hasn't sold a single one. Yamato has donated them to the Czech government.
At first, he says, he was worried about not having the right certifications for his brand-new mask line. The European Union's strict regulations make it a tough place to introduce a new product like this. But he was assured by the Czech government that it wouldn't be a problem. This is, they told him, an emergency, and the entire world has never seen anything like it.


npr--2020-04-24--Georgia Businesses Start To Reopen As Trump Distances Himself From State's Governor

Georgia Businesses Start To Reopen As Trump Distances Himself From State 's Governor Unfazed by mounting criticism from mayors in his state and President Trump , Georgia Gov .
Brian Kemp forged ahead with his decision to allow businesses across the state to reopen Friday , as the confirmed coronavirus death toll in the United States passes 50,000 people .
Kemp , a Republican serving in his first term , was one of the last governors to impose a stay-at-home order for his state , which took effect on April 3 .
Citing `` favorable data , enhanced testing and @ @ @ @ @ @ @ '' Kemp said Monday that some businesses once deemed nonessential , like fitness centers , tattoo parlors and nail salons , can welcome back customers starting Friday .
In a tweet on Friday , the president reiterated his most recent stance that it was too soon for Georgia to reopen .
`` I ( or @ VP ) never gave Governor Brian Kemp an OK on those few businesses outside of the Guidelines .
FAKE NEWS !
, '' he said , despite praising the governor earlier this week .
`` Spas , @ @ @ @ @ @ @ barber shops should take a little slower path , but I told the Governor to do what is right for the great people of Georgia ( & USA ) ! ''
The president has been urging governors throughout the country to begin lifting restrictions .
During the White House coronavirus task force briefing on Tuesday , Trump appeared to laud the Georgia governor 's decision to follow his cue , calling Kemp `` a very capable man . ''
`` He knows what he 's doing .
He 's done a very good @ @ @ @ @ @ @ .
As NPR reported , Georgia has not met a series of benchmarks the White House outlined in its guidelines for states to begin reopening , including demonstrating a downward trajectory of COVID-19 cases over 14 days .
Not all businesses in Georgia that could reopen in Georgia chose to , but for some , appointments books filled quickly .
In Savannah on Friday , David Huynh had 60 appointments scheduled at his nail salon , which has been closed since last month , as The Associated Press reported .
He said the @ @ @ @ @ @ @ to the month his shop was shuttered .
`` We lost graduations , proms and weddings , '' Huynh said .
`` Already I see stores closing down permanently .
... A lot of people do n't realize if the nation stays shut down any longer , there will be severe consequences . ''
Neda Honarvar , the founder of Tough Love Yoga in Atlanta , did not mince words when asked whether she would open back up Friday .
`` I 'm just not willing to put myself or our teachers or @ @ @ @ @ @ @ , '' Honarvar told reporter Emma Hurt of member station WABE .
Starting on Monday , movie theaters can open and restaurants will be allowed to serve to dine-in customers , subject to some safety restrictions .
Jennifer Shaffer of Dublin-based Deano 's Italian told WABE that she is confident she can reopen while also protecting the health of the staff and its patrons .
`` We 're just going to do everything we need to do to make sure our customers and our staff are safe , '' Shaffer said .
She @ @ @ @ @ @ @ wear face masks and gloves while serving .
Shaffer said she plans to only keep her business at roughly a third of its capacity .
In the city of Macon , Marian Searcy , a barber , said he was ready to get started .
He told Georgia Public Broadcasting that just before lunchtime , every seat at Edward 's Barber Shop was full , as was the waiting area .
`` It 's always smart to have a nest egg saved up , but there 's nothing like working every day , @ @ @ @ @ @ @ `` Just me being a man and the stress of me being a man , to provide for my household , that 's my drive for coming back to work , '' Searcy said .
The Atlanta Journal-Constitution noted that at Studio 151 in the town of Dallas , located roughly 30 miles west of Atlanta , the salon 's owner said bookings began as early as 6:30 a.m. '' A sign on the door spelled out salon protocols , including those required by the state and additional measures to keep employees and @ @ @ @ @ @ @ .
Atlanta Mayor Keisha Lance Bottoms said it was `` unacceptable '' to have people going out in public and called on residents to remain at home .
`` Listen to the scientists .
There 's nothing essential about going to a bowling alley or getting a manicure in the middle of a pandemic , '' she said on ABC 's Good Morning America on Friday .
`` I think to make an assumption that we are out of the woods is not based on anything other than a desire to open up @ @ @ @ @ @ @ that there are some that are willing to sacrifice lives for the sake of the economy and that is unacceptable to me , '' she added .
Savannah Mayor Van Johnson said the governor 's decision was `` reckless '' on CNN earlier this week , adding he was `` beyond disturbed '' by it .
Georgia Department of Public Health reported that as of Friday afternoon , there have been 892 deaths in the state related to COVID-19 .

Georgia Businesses Start To Reopen As Trump Distances Himself From State's Governor
Enlarge this image toggle caption Grant Blankenship/Georgia Public Broadcasting Grant Blankenship/Georgia Public Broadcasting
Unfazed by mounting criticism from mayors in his state and President Trump, Georgia Gov. Brian Kemp forged ahead with his decision to allow businesses across the state to reopen Friday, as the confirmed coronavirus death toll in the United States passes 50,000 people.
Kemp, a Republican serving in his first term, was one of the last governors to impose a stay-at-home order for his state, which took effect on April 3.
Citing "favorable data, enhanced testing and approval of our health care professionals," Kemp said Monday that some businesses once deemed nonessential, like fitness centers, tattoo parlors and nail salons, can welcome back customers starting Friday.
In a tweet on Friday, the president reiterated his most recent stance that it was too soon for Georgia to reopen.
"I (or @VP) never gave Governor Brian Kemp an OK on those few businesses outside of the Guidelines. FAKE NEWS!," he said, despite praising the governor earlier this week. "Spas, beauty salons, tattoo parlors, & barber shops should take a little slower path, but I told the Governor to do what is right for the great people of Georgia (& USA)!"
The president has been urging governors throughout the country to begin lifting restrictions. During the White House coronavirus task force briefing on Tuesday, Trump appeared to laud the Georgia governor's decision to follow his cue, calling Kemp "a very capable man."
Enlarge this image toggle caption Brynn Anderson/AP Brynn Anderson/AP
"He knows what he's doing. He's done a very good job as governor," Trump said.
As NPR reported, Georgia has not met a series of benchmarks the White House outlined in its guidelines for states to begin reopening, including demonstrating a downward trajectory of COVID-19 cases over 14 days.
Not all businesses in Georgia that could reopen in Georgia chose to, but for some, appointments books filled quickly.
In Savannah on Friday, David Huynh had 60 appointments scheduled at his nail salon, which has been closed since last month, as The Associated Press reported.
He said the loss of business is not just confined to the month his shop was shuttered.
"We lost graduations, proms and weddings," Huynh said. "Already I see stores closing down permanently. ... A lot of people don't realize if the nation stays shut down any longer, there will be severe consequences."
Neda Honarvar, the founder of Tough Love Yoga in Atlanta, did not mince words when asked whether she would open back up Friday.
"I'm just not willing to put myself or our teachers or our students at risk of getting sick," Honarvar told reporter Emma Hurt of member station WABE.
Starting on Monday, movie theaters can open and restaurants will be allowed to serve to dine-in customers, subject to some safety restrictions.
Jennifer Shaffer of Dublin-based Deano's Italian told WABE that she is confident she can reopen while also protecting the health of the staff and its patrons.
"We're just going to do everything we need to do to make sure our customers and our staff are safe," Shaffer said.
She added every employee will be required to wear face masks and gloves while serving. Shaffer said she plans to only keep her business at roughly a third of its capacity.
In the city of Macon, Marian Searcy, a barber, said he was ready to get started. He told Georgia Public Broadcasting that just before lunchtime, every seat at Edward's Barber Shop was full, as was the waiting area.
"It's always smart to have a nest egg saved up, but there's nothing like working every day," Searcy told the member station.
"Just me being a man and the stress of me being a man, to provide for my household, that's my drive for coming back to work," Searcy said.
The Atlanta Journal-Constitution noted that at Studio 151 in the town of Dallas, located roughly 30 miles west of Atlanta, the salon's owner said bookings began as early as 6:30 a.m.
"A sign on the door spelled out salon protocols, including those required by the state and additional measures to keep employees and customers safe," the AJC reported.
Atlanta Mayor Keisha Lance Bottoms said it was "unacceptable" to have people going out in public and called on residents to remain at home.
"Listen to the scientists. There's nothing essential about going to a bowling alley or getting a manicure in the middle of a pandemic," she said on ABC's Good Morning America on Friday.
"I think to make an assumption that we are out of the woods is not based on anything other than a desire to open up businesses. And what I believe is that there are some that are willing to sacrifice lives for the sake of the economy and that is unacceptable to me," she added.
Savannah Mayor Van Johnson said the governor's decision was "reckless" on CNN earlier this week, adding he was "beyond disturbed" by it.
Georgia Department of Public Health reported that as of Friday afternoon, there have been 892 deaths in the state related to COVID-19.


npr--2020-04-24--Coronavirus FAQs: Does A Bigger Dose Make You Sicker? Can You Go To The Dentist?

Coronavirus FAQs : Does A Bigger Dose Make You Sicker ?
Can You Go To The Dentist ?
Each week we answer some of your pressing questions about the coronavirus and how to stay safe .
Email us your questions at goatsandsoda @ npr.org with the subject line : `` Weekly Coronavirus Questions . ''
Does the size of a viral dose make a difference ?
That is , if you 're exposed to lots of viral particles , will you get sicker ?
While there is a lot we do n't know about SARS-CoV-2 , experts believe they can @ @ @ @ @ @ @ – the amount of virus a person is exposed to makes a difference in whether they get sick and how sick they get .
`` Dose is important in everything we are doing in life , '' says Peter Palese , a leading virologist who is professor and chair of microbiology at the Icahn School of Medicine at Mount Sinai in New York .
`` The same is also true for coronaviruses .
It makes a lot of sense because if you have a lot of virus [ in your environment ] , @ @ @ @ @ @ @ an intensive care unit , then you get many more virus particles in your system and the disease is usually much worse . ''
`` Most viruses , there 's some form of graded response depending on how big your initial exposure is , '' explains Dr. Joshua Rabinowitz , a professor of chemistry and genomics at Princeton .
`` Every virus , if you get one particle of virus , you 're likely to never know it – you 're also likely to really never get sick and never develop an immune @ @ @ @ @ @ @ , there is a gray area where you get some version of sick but not horribly sick — and develop an immune response that is protective against the virus in the future . ''
There have been cases of young , healthy health-care workers getting severely sick with COVID-19 .
That 's what scientists would expect with a virus in which dose plays an important role .
`` If you have someone working in an intensive care unit and the poor physician or the poor nurse gets a hefty dose , then the @ @ @ @ @ @ @ worse than if one just gets a single particle , '' says Palese .
But there are still some unknowns in the matter of dose .
Rabinowitz says researchers do n't yet know exactly how the symptoms of the current coronavirus correlate with the size of the initial dose .
Nor is it known how much of a viral dose causes a person to get sick from COVID-19 , though `` we have very good reason to believe that it requires many virus particles , '' he says .
Understanding the role of @ @ @ @ @ @ @ because during an epidemic where much is out of one 's control , individuals can act to reduce the risk of high-dose exposure — through social distancing and protective measures like masks .
While six feet of distance is recommended , even four feet is better than two feet , Rabinowitz says .
`` They 're probably radically different in terms of both your chance of getting sick and your chance of getting horribly sick if you do get sick . ''
And masks , even if they 're far from 100 % @ @ @ @ @ @ @ be super important , '' says Rabinowitz , `` because they 're dose-reducing agents . ''
How many people are walking around with coronavirus but no symptoms ?
How much are they driving transmission ?
`` Somewhere between 25 and 50 % '' of people with coronavirus are out there with no symptoms , estimated Dr. Anthony Fauci , the immunologist helping to steer the U.S. pandemic policy , at a White House press briefing April 5 , though he acknowledged there 's not much scientific data to back up the claim .
@ @ @ @ @ @ @ differ about that , '' he said .
`` Right now , we 're just guessing . ''
The issue is that , with limited testing available , people who have the virus but show no symptoms are hard to find .
Researchers have confirmed their existence through contact tracing and mass testing in places like nursing homes and the Diamond Princess cruise ship .
People who show no symptoms can fall into two categories — they can be presymptomatic , which means that they 're in the incubation phase and will develop @ @ @ @ @ @ @ or asymptomatic , which means they never develop symptoms .
Based on available data , the World Health Organization thinks that presymptomatic cases are more common than asymptomatic cases , and that some people who are presymptomatic can spread the virus one to three days before showing symptoms .
It 's less clear whether people who are totally asymptomatic are contributing significantly to spread .
The extent to which symptom-less cases are driving transmission is an open question — and it seems to depend on behavior .
In China before lockdown , a @ @ @ @ @ @ @ cases ( including people with mild or no symptoms ) may have been responsible for 79 % of transmission because many of them attended gatherings or traveled while contagious .
Other papers from Singapore and China , from late January on , suggest that presymptomatic cases accounted for 6 % to 13 % of transmission in times of greater COVID-19 awareness .
I have a toothache .
Should I go to the dentist right now ?
If you 're experiencing pain or swelling in your mouth , you should see a dentist , @ @ @ @ @ @ @ clinical affairs at Tufts School of Dental Medicine and president-elect of the Massachusetts Dental Society .
`` Especially if the pain or the swelling is increasing , '' she says .
`` If you go to bed and you 're woken up in the middle of the night because of pain , that 's another indication that , yes , you should see a dentist . ''
As with everything else , coronavirus has complicated dental visits .
The American Dental Association has recommended that dentists restrict their practices to all but urgent @ @ @ @ @ @ @ Some dentists are not seeing even emergency patients right now because the dentists themselves have underlying medical conditions that put them at risk to COVID-19 , Hanlon says .
So if you are in pain , you should call your dentist — but may be referred to a different dentist handling emergency care .
But if it 's not an emergency , do n't go to the dentist right now , says Hanlon .
The American Dental Association has a list of dental issues that can wait , and those that ca n't @ @ @ @ @ @ @ there are patients getting upset with us because we ca n't they ca n't have their teeth cleaned , but we just ca n't take the chance , '' she says .
`` There 's no reason why a patient ca n't wait a couple months to have their teeth cleaned . ''
If you do make an appointment for emergency dental care , expect your dentist to ask you whether you have symptoms of COVID-19 .
When you arrive at the office , you 'll likely be handed a mask , hand @ @ @ @ @ @ @ expect to hang out reading a magazine before your appointment .
`` You should not go into the office until it is your time to go in , '' says Hanlon .
`` What we 're trying to do is make sure we stagger appointments and have adequate time to clean up between patients . ''
Some dental practices may resume regular appointments in the coming weeks , as some state and local governments allow re-opening certain businesses considered `` essential . ''
Last week , the ADA released updated guidance that in @ @ @ @ @ @ @ exercise professional judgment and carefully consider the availability of appropriate PPE [ personal protective equipement ] to minimize risk of virus transmission . ''

Coronavirus FAQs: Does A Bigger Dose Make You Sicker? Can You Go To The Dentist?
Each week we answer some of your pressing questions about the coronavirus and how to stay safe. Email us your questions at goatsandsoda@npr.org with the subject line: "Weekly Coronavirus Questions."
Does the size of a viral dose make a difference? That is, if you're exposed to lots of viral particles, will you get sicker?
While there is a lot we don't know about SARS-CoV-2, experts believe they can answer this question with confidence: Yes – the amount of virus a person is exposed to makes a difference in whether they get sick and how sick they get.
"Dose is important in everything we are doing in life," says Peter Palese, a leading virologist who is professor and chair of microbiology at the Icahn School of Medicine at Mount Sinai in New York. "The same is also true for coronaviruses. It makes a lot of sense because if you have a lot of virus [in your environment], such as when you are working in an intensive care unit, then you get many more virus particles in your system and the disease is usually much worse."
"Most viruses, there's some form of graded response depending on how big your initial exposure is," explains Dr. Joshua Rabinowitz, a professor of chemistry and genomics at Princeton. "Every virus, if you get one particle of virus, you're likely to never know it – you're also likely to really never get sick and never develop an immune response. And for most acute viruses, there is a gray area where you get some version of sick but not horribly sick — and develop an immune response that is protective against the virus in the future."
There have been cases of young, healthy health-care workers getting severely sick with COVID-19. That's what scientists would expect with a virus in which dose plays an important role.
"If you have someone working in an intensive care unit and the poor physician or the poor nurse gets a hefty dose, then the severity of the disease really is much worse than if one just gets a single particle," says Palese.
But there are still some unknowns in the matter of dose. Rabinowitz says researchers don't yet know exactly how the symptoms of the current coronavirus correlate with the size of the initial dose. Nor is it known how much of a viral dose causes a person to get sick from COVID-19, though "we have very good reason to believe that it requires many virus particles," he says.
Understanding the role of dose is important, he says, because during an epidemic where much is out of one's control, individuals can act to reduce the risk of high-dose exposure — through social distancing and protective measures like masks. While six feet of distance is recommended, even four feet is better than two feet, Rabinowitz says. "They're probably radically different in terms of both your chance of getting sick and your chance of getting horribly sick if you do get sick."
And masks, even if they're far from 100% effective? "They're likely to be super important," says Rabinowitz, "because they're dose-reducing agents."
How many people are walking around with coronavirus but no symptoms? How much are they driving transmission?
"Somewhere between 25 and 50%" of people with coronavirus are out there with no symptoms, estimated Dr. Anthony Fauci, the immunologist helping to steer the U.S. pandemic policy, at a White House press briefing April 5, though he acknowledged there's not much scientific data to back up the claim.
"Even among good friends, we differ about that," he said. "Right now, we're just guessing."
The issue is that, with limited testing available, people who have the virus but show no symptoms are hard to find. Researchers have confirmed their existence through contact tracing and mass testing in places like nursing homes and the Diamond Princess cruise ship.
People who show no symptoms can fall into two categories — they can be presymptomatic, which means that they're in the incubation phase and will develop symptoms over the next few days, or asymptomatic, which means they never develop symptoms.
Based on available data, the World Health Organization thinks that presymptomatic cases are more common than asymptomatic cases, and that some people who are presymptomatic can spread the virus one to three days before showing symptoms. It's less clear whether people who are totally asymptomatic are contributing significantly to spread.
The extent to which symptom-less cases are driving transmission is an open question — and it seems to depend on behavior. In China before lockdown, a modeling paper in Science suggests that undiscovered cases (including people with mild or no symptoms) may have been responsible for 79% of transmission because many of them attended gatherings or traveled while contagious. Other papers from Singapore and China, from late January on, suggest that presymptomatic cases accounted for 6% to 13% of transmission in times of greater COVID-19 awareness.
I have a toothache. Should I go to the dentist right now?
If you're experiencing pain or swelling in your mouth, you should see a dentist, says Mary-Jane Hanlon, associate dean for clinical affairs at Tufts School of Dental Medicine and president-elect of the Massachusetts Dental Society.
"Especially if the pain or the swelling is increasing," she says. "If you go to bed and you're woken up in the middle of the night because of pain, that's another indication that, yes, you should see a dentist."
As with everything else, coronavirus has complicated dental visits. The American Dental Association has recommended that dentists restrict their practices to all but urgent and emergency care through April 30.
Some dentists are not seeing even emergency patients right now because the dentists themselves have underlying medical conditions that put them at risk to COVID-19, Hanlon says.
So if you are in pain, you should call your dentist — but may be referred to a different dentist handling emergency care.
But if it's not an emergency, don't go to the dentist right now, says Hanlon. The American Dental Association has a list of dental issues that can wait, and those that can't.
"Believe it or not, there are patients getting upset with us because we can't they can't have their teeth cleaned, but we just can't take the chance," she says. "There's no reason why a patient can't wait a couple months to have their teeth cleaned."
If you do make an appointment for emergency dental care, expect your dentist to ask you whether you have symptoms of COVID-19. When you arrive at the office, you'll likely be handed a mask, hand sanitizer and gloves.
And don't expect to hang out reading a magazine before your appointment.
"You should not go into the office until it is your time to go in," says Hanlon. "What we're trying to do is make sure we stagger appointments and have adequate time to clean up between patients."
Some dental practices may resume regular appointments in the coming weeks, as some state and local governments allow re-opening certain businesses considered "essential." Last week, the ADA released updated guidance that in states considering reopening, "dentists should exercise professional judgment and carefully consider the availability of appropriate PPE [personal protective equipement] to minimize risk of virus transmission."


npr--2020-04-24--Workers Sue Smithfield Foods, Allege Conditions Put Them At Risk For COVID-19

Workers Sue Smithfield Foods , Allege Conditions Put Them At Risk For COVID-19 Smithfield Foods , one of the biggest meat producers in the country , is operating its plant in Milan , Mo.
, `` in a manner that contributies '' to the spread of the coronavirus , according to a federal lawsuit filed Thursday in Kansas City .
The suit , brought by a plant worker identified as Jane Doe and by a nonprofit that advocates for plant workers , accuses Smithfield of failing to provide workers with sufficient protective equipment ; forcing them to work shoulder to @ @ @ @ @ @ @ wash their hands ; discouraging them from taking sick leave ; and failing to implement a plan for testing and contact tracing .
`` Put simply , workers , their family members , and many others who live in Milan and in the broader community may die – all because Smithfield refused to change its practices in the face of this pandemic , '' the suit states .
The lawsuit says that `` Smithfield is so unwilling to acknowledge its responsibilities to its workers and the communities where it operates that it recently @ @ @ @ @ @ @ of the disease in its South Dakota plant ... '' Smithfield 's South Dakota plant , which handles 5 % of U.S. pork production , has become a coronavirus hot spot , with 783 workers testing positive for the virus so far and two of them dying .
The first worker there tested positive for the virus on March 24 , but the plant was not closed until April 14 .
Smithfield also shut down its plants in Martin City , Mo.
, and Cudahy , Wis. , last week because they rely @ @ @ @ @ @ @ plant , according to a Smithfield press release .
Another giant meat processor , Cargill Foods , recently confirmed that workers at its Marshall , Mo.
, facility had tested positive for COVID-19 , the disease caused by the coronavirus .
Cargill declined to say how many individuals had tested positive but said all staff who came in contact with them were being quarantined for 14 days .
The plant , which employs some 620 people , remains open .
In a statement , Keira Lombardo , executive vice president of corporate affairs @ @ @ @ @ @ @ the company does not comment on pending litigation but then said : `` The health and safety of our employees is our top priority at all times .
The allegations contained in the complaint are without factual or legal merit and include claims previously made against the company that have been investigated and determined to be unfounded .
We look forward to aggressively defending the company in court . ''
The lawsuit does n't seek money damages .
Rather , it asks for an injunction to force Smithfield to comply with Centers for @ @ @ @ @ @ @ David Muraskin , a lawyer for the plaintiffs , said he was not aware of any other lawsuits seeking changes in production processes at plants , rather than monetary damages .
`` All we want , all we are asking for is for it to aggressively defend its workers , '' Muraskin said .
`` If they do that our claims go away . ''
Muraskin said his legal advocacy group , Public Justice , served Smithfield Friday morning , and plans to file other similar suits going forward .
The plaintiff identified @ @ @ @ @ @ @ cut floor '' cutting pig meat for up to 11 hours a day , according to the suit .
It says she 's using a pseudonym because she fears retaliation for speaking out against Smithfield .
Doe says in the suit that she 's aware of at least eight co-workers who have had to stay home after displaying COVID-19 symptoms .
Sullivan County , where the plant is located , has yet to report any confirmed cases of COVID-19 , but the county health department says it does n't know how many people @ @ @ @ @ @ @ , the Rural Workers Community Alliance , is a small nonprofit that advocates for workers in northern Missouri , including employees at the Milan plant .
Its single staff member , Axel Fuentes , lives in Kirksville — as do many plant workers — and Fuentes says in the suit that he fears for the health and safety of his family because his job brings him in close contact with plant workers .
Before the suit was filed , Fuentes said workers told him that they saw people working with COVID-19 symptoms because @ @ @ @ @ @ @ Workers are still being assigned negative points when they do not attend work , which eventually can end in the termination of the employment , '' Fuentes said .
Under a stay-at-home order issued by the Missouri health department on April 3 , meat processing facilities are allowed to remain open but are supposed to observe CDC and other public health guidelines to protect their workers .
The lawsuit , however , says that Smithfield has failed to satisfy even minimum public health guidelines .
For example , it says it was n't @ @ @ @ @ @ @ the plant reported receiving a mask .
And as of April 20 , most of them were getting just one simple surgical mask from Smithfield every week and could get a new one only if the first one broke , according to the suit .
It also alleges that , in an effort to process as much meat as possible `` as cheaply as possible , '' workers are forced to stand so closely together `` that they are literally touching . ''
More than 150 of America 's largest meat processing plants @ @ @ @ @ @ @ coronavirus infection is already among the nation 's highest , according to an investigation by USA Today and the Midwest Center for Investigative Reporting .
`` These facilities represent more than 1 in 3 of the nation 's biggest beef , pork and poultry processing plants , '' the news outlets reported .
`` Rates of infection around these plants are higher than those of 75 % of other U.S. counties , the analysis found . ''

Workers Sue Smithfield Foods, Allege Conditions Put Them At Risk For COVID-19
Enlarge this image toggle caption Stephen Groves/AP Stephen Groves/AP
Smithfield Foods, one of the biggest meat producers in the country, is operating its plant in Milan, Mo., "in a manner that contributies" to the spread of the coronavirus, according to a federal lawsuit filed Thursday in Kansas City.
The suit, brought by a plant worker identified as Jane Doe and by a nonprofit that advocates for plant workers, accuses Smithfield of failing to provide workers with sufficient protective equipment; forcing them to work shoulder to shoulder; giving them insufficient opportunities to wash their hands; discouraging them from taking sick leave; and failing to implement a plan for testing and contact tracing.
"Put simply, workers, their family members, and many others who live in Milan and in the broader community may die – all because Smithfield refused to change its practices in the face of this pandemic," the suit states.
The lawsuit says that "Smithfield is so unwilling to acknowledge its responsibilities to its workers and the communities where it operates that it recently blamed 'certain cultures' for the spread of the disease in its South Dakota plant ..."
Smithfield's South Dakota plant, which handles 5% of U.S. pork production, has become a coronavirus hot spot, with 783 workers testing positive for the virus so far and two of them dying. The first worker there tested positive for the virus on March 24, but the plant was not closed until April 14.
Smithfield also shut down its plants in Martin City, Mo., and Cudahy, Wis., last week because they rely on raw materials from the South Dakota plant, according to a Smithfield press release.
Another giant meat processor, Cargill Foods, recently confirmed that workers at its Marshall, Mo., facility had tested positive for COVID-19, the disease caused by the coronavirus. Cargill declined to say how many individuals had tested positive but said all staff who came in contact with them were being quarantined for 14 days. The plant, which employs some 620 people, remains open.
In a statement, Keira Lombardo, executive vice president of corporate affairs and compliance for Smithfield Foods, said the company does not comment on pending litigation but then said: "The health and safety of our employees is our top priority at all times. The allegations contained in the complaint are without factual or legal merit and include claims previously made against the company that have been investigated and determined to be unfounded. We look forward to aggressively defending the company in court."
The lawsuit doesn't seek money damages. Rather, it asks for an injunction to force Smithfield to comply with Centers for Disease Control and public health guidelines.
David Muraskin, a lawyer for the plaintiffs, said he was not aware of any other lawsuits seeking changes in production processes at plants, rather than monetary damages.
"All we want, all we are asking for is for it to aggressively defend its workers," Muraskin said. "If they do that our claims go away."
Muraskin said his legal advocacy group, Public Justice, served Smithfield Friday morning, and plans to file other similar suits going forward.
The plaintiff identified as Jane Doe works on the "cut floor" cutting pig meat for up to 11 hours a day, according to the suit. It says she's using a pseudonym because she fears retaliation for speaking out against Smithfield.
Doe says in the suit that she's aware of at least eight co-workers who have had to stay home after displaying COVID-19 symptoms.
Sullivan County, where the plant is located, has yet to report any confirmed cases of COVID-19, but the county health department says it doesn't know how many people have been tested.
The other plaintiff, the Rural Workers Community Alliance, is a small nonprofit that advocates for workers in northern Missouri, including employees at the Milan plant. Its single staff member, Axel Fuentes, lives in Kirksville — as do many plant workers — and Fuentes says in the suit that he fears for the health and safety of his family because his job brings him in close contact with plant workers.
Before the suit was filed, Fuentes said workers told him that they saw people working with COVID-19 symptoms because they feared losing their jobs.
"Workers are still being assigned negative points when they do not attend work, which eventually can end in the termination of the employment," Fuentes said.
Under a stay-at-home order issued by the Missouri health department on April 3, meat processing facilities are allowed to remain open but are supposed to observe CDC and other public health guidelines to protect their workers.
The lawsuit, however, says that Smithfield has failed to satisfy even minimum public health guidelines. For example, it says it wasn't until April 16 that any worker at the plant reported receiving a mask. And as of April 20, most of them were getting just one simple surgical mask from Smithfield every week and could get a new one only if the first one broke, according to the suit.
It also alleges that, in an effort to process as much meat as possible "as cheaply as possible," workers are forced to stand so closely together "that they are literally touching."
More than 150 of America's largest meat processing plants operate in counties where the rate of coronavirus infection is already among the nation's highest, according to an investigation by USA Today and the Midwest Center for Investigative Reporting.
"These facilities represent more than 1 in 3 of the nation's biggest beef, pork and poultry processing plants," the news outlets reported. "Rates of infection around these plants are higher than those of 75% of other U.S. counties, the analysis found."


npr--2020-04-24--ExxonMobil Starts Making Hand Sanitizer, Following Liquor Companies

ExxonMobil has reconfigured a facility in Louisiana to manufacture medical-grade hand sanitizer , with a production target of 160,000 gallons , to be donated to health care providers and first responders .
ExxonMobil 's shift to sanitizer comes as oil companies are squeezed by plummeting demand , a global oil glut and rock-bottom crude prices .
Liquor companies made a similar pivot more than a month ago , after shortages of hand sanitizer were first becoming apparent .
Bacardi shifted production at its rum distillery in Puerto Rico to make and donate hand sanitizer ; Anheuser Busch InBev repurposed its @ @ @ @ @ @ @ sanitizer to give away ; and small craft distilleries around the country figured out how to make and package hand sanitizer , often donating it to their local communities .
Hand sanitizer can be made out of either ethyl alcohol , like the ethanol in alcoholic beverages , or isopropyl alcohol , which is typically derived from fossil fuels .
ExxonMobil has long manufactured isopropyl alcohol as one of its many products , and in late March , it announced publicly that it was helping with the coronavirus effort by continuing to manufacture @ @ @ @ @ @ @ the customers and areas that need it most . ''
On April 24 , the company announced the new measure to create hand sanitizer in-house and donate it to the front lines .

ExxonMobil Starts Making Hand Sanitizer, Following Liquor Companies
Enlarge this image toggle caption Prakash Mathema/AFP via Getty Images Prakash Mathema/AFP via Getty Images
ExxonMobil has reconfigured a facility in Louisiana to manufacture medical-grade hand sanitizer, with a production target of 160,000 gallons, to be donated to health care providers and first responders.
ExxonMobil's shift to sanitizer comes as oil companies are squeezed by plummeting demand, a global oil glut and rock-bottom crude prices.
Liquor companies made a similar pivot more than a month ago, after shortages of hand sanitizer were first becoming apparent.
Bacardi shifted production at its rum distillery in Puerto Rico to make and donate hand sanitizer; Anheuser Busch InBev repurposed its process for making non-alcoholic beer to create sanitizer to give away; and small craft distilleries around the country figured out how to make and package hand sanitizer, often donating it to their local communities.
Hand sanitizer can be made out of either ethyl alcohol, like the ethanol in alcoholic beverages, or isopropyl alcohol, which is typically derived from fossil fuels.
ExxonMobil has long manufactured isopropyl alcohol as one of its many products, and in late March, it announced publicly that it was helping with the coronavirus effort by continuing to manufacture isopropyl alcohol and "providing it to the customers and areas that need it most."
On April 24, the company announced the new measure to create hand sanitizer in-house and donate it to the front lines.


npr--2020-04-24--Facebook Launches Rival To Video-Meeting App Zoom

Facebook is rolling out a video-call competitor to Zoom , aimed at groups of up to 50 people .
The new feature , called Messenger Rooms , allows anyone with a Facebook account to create a video meeting and invite their friends to join , even if those people are not Facebook users .
Video conferencing has become a staple for many people stuck at home during the coronavirus pandemic .
It 's how they keep up with work , school , family , friends and activities .
Zoom has become wildly popular , with 300 million people now participating @ @ @ @ @ @ @ , the company said on Wednesday .
However , Zoom 's ease of use — initially , users just needed to click a single link to join a meeting — has made the service a target for abuse .
In `` Zoombombing '' attacks , unwanted intruders have disrupted meetings with pornography and racist harassment .
Zoom has since taken steps to improve security , including requiring participants to enter passwords by default .
Facebook has the potential to reach a much broader audience .
It says it has seen surging use of @ @ @ @ @ @ @ WhatsApp , with more than 700 million people making voice or video calls every day .
CEO Mark Zuckerberg said in a livestreamed announcement on Friday that the ability to connect over live video has `` emerged as especially important during this pandemic . ''
Beyond video conferencing for work , he said , `` there are even more social uses of this , just for people to stay connected . ''
Messenger Rooms looks eerily similar to Zoom and functions in much the same way .
Participants can join without downloading an @ @ @ @ @ @ @ the popular video app Houseparty : Facebook users will see notifications at the top of their news feed about new `` rooms '' their friends have created , so they can `` drop in '' as they want .
`` I 've really enjoyed testing this , '' Zuckerberg said .
He described dropping into rooms with his friends as `` this neat , serendipitous and spontaneous interaction . ''
The company said Messenger Rooms will have default settings to protect meetings from intruders .
People who create the rooms can control who @ @ @ @ @ @ @ make a room open to anyone they are friends with on Facebook , or they can invite specific people .
Hosts can also create a link to invite people who are not on Facebook .
Those links are less secure , as recipients could share them with others , who could then join rooms .
Facebook will not require passwords to join .
The platform says it is reducing the potential for abuse by allowing hosts to `` lock '' rooms so that no new participants can join .
And if a host @ @ @ @ @ @ @ .
Users can also report a room for violating Facebook 's rules .
The social network is likely to face skepticism over how it treats users ' personal data , given its patchy track record on privacy .
Facebook said it does not listen to or watch video and audio calls , but it will collect data from rooms `` to provide the service and improve the product experience . ''
It said it will not run ads in rooms , and audio and video wo n't be used for ad targeting .
@ @ @ @ @ @ @ from their Web browsers .
Facebook said it will collect some information on them , including what device and browser they are using , and ask them to share their names to identify themselves in meetings .
Facebook will roll out Messenger Rooms worldwide over the next few weeks .

Facebook Launches Rival To Video-Meeting App Zoom
Enlarge this image toggle caption Facebook Facebook
Facebook is rolling out a video-call competitor to Zoom, aimed at groups of up to 50 people.
The new feature, called Messenger Rooms, allows anyone with a Facebook account to create a video meeting and invite their friends to join, even if those people are not Facebook users.
Video conferencing has become a staple for many people stuck at home during the coronavirus pandemic. It's how they keep up with work, school, family, friends and activities.
Zoom has become wildly popular, with 300 million people now participating in meetings on its platform every day, the company said on Wednesday.
However, Zoom's ease of use — initially, users just needed to click a single link to join a meeting — has made the service a target for abuse. In "Zoombombing" attacks, unwanted intruders have disrupted meetings with pornography and racist harassment. Zoom has since taken steps to improve security, including requiring participants to enter passwords by default.
Facebook has the potential to reach a much broader audience. It says it has seen surging use of its two messaging apps, Messenger and WhatsApp, with more than 700 million people making voice or video calls every day.
CEO Mark Zuckerberg said in a livestreamed announcement on Friday that the ability to connect over live video has "emerged as especially important during this pandemic." Beyond video conferencing for work, he said, "there are even more social uses of this, just for people to stay connected."
Messenger Rooms looks eerily similar to Zoom and functions in much the same way. Participants can join without downloading an app. It also mirrors elements of the popular video app Houseparty: Facebook users will see notifications at the top of their news feed about new "rooms" their friends have created, so they can "drop in" as they want.
"I've really enjoyed testing this," Zuckerberg said. He described dropping into rooms with his friends as "this neat, serendipitous and spontaneous interaction."
The company said Messenger Rooms will have default settings to protect meetings from intruders. People who create the rooms can control who is allowed to join. They can make a room open to anyone they are friends with on Facebook, or they can invite specific people.
Hosts can also create a link to invite people who are not on Facebook. Those links are less secure, as recipients could share them with others, who could then join rooms. Facebook will not require passwords to join. The platform says it is reducing the potential for abuse by allowing hosts to "lock" rooms so that no new participants can join. And if a host removes someone, the room automatically locks.
Users can also report a room for violating Facebook's rules.
The social network is likely to face skepticism over how it treats users' personal data, given its patchy track record on privacy. Facebook said it does not listen to or watch video and audio calls, but it will collect data from rooms "to provide the service and improve the product experience." It said it will not run ads in rooms, and audio and video won't be used for ad targeting.
People without Facebook accounts can join meetings from their Web browsers. Facebook said it will collect some information on them, including what device and browser they are using, and ask them to share their names to identify themselves in meetings.
Facebook will roll out Messenger Rooms worldwide over the next few weeks.


npr--2020-04-24--FDA Warns Against Wide Use Of The Drugs Trump Hailed As 'Game Changers'

FDA Warns Against Wide Use Of The Drugs Trump Hailed As 'Game Changers' President Trump has spiritedly backed hydroxychloroquine and azithromycin , both in his regular news briefings and on his Twitter account .
He has said the two drugs , when taken together to treat the coronavirus , could become `` one of the biggest game changers in the history of medicine . ''
That may well be , eventually — but not right now .
The Food and Drug Administration strongly warned Friday against using hydroxychloroquine or a related compound , chloroquine , for treating or preventing COVID-19 @ @ @ @ @ @ @ or as part of a clinical trial .
The agency said its officials have not approved the anti-malaria drugs for that purpose — and that without close monitoring for side effects , they may lead to life-threatening complications .
`` We understand that health care professionals are looking for every possible treatment option for their patients and we want to ensure we 're providing them with the appropriate information needed for them to make the best medical decisions , '' FDA Commissioner Stephen M. Hahn said .
`` While clinical trials are ongoing @ @ @ @ @ @ @ these drugs for COVID-19 , there are known side effects of these medications that should be considered , '' he added .
`` We encourage health care professionals making individual patient decisions closely screen and monitor those patients to help mitigate these risks . ''
The FDA said it has received reports in its adverse event reporting system and from poison control centers , detailing `` serious heart-related adverse events and death in patients with COVID-19 receiving hydroxychloroquine and chloroquine . ''
These include a rapid heartbeat known as ventricular tachycardia , among @ @ @ @ @ @ @ The reported side effects occurred when the medications were used alone and combined with the antibiotic azithromycin .
The FDA 's announcement comes just several days after a panel convened by the National Institute of Allergy and Infectious Diseases issued a similar warning , specifically about using a combination of hydroxychloroquine and azithromycin .
In its warning earlier this week , the panel laid out guidelines on certain therapies and potential treatments for COVID-19 .
Ultimately , the guidelines found that there was insufficient evidence to recommend any treatment , in particular , @ @ @ @ @ @ @ clinical trials .
Trump , however , has not shared the caution of the scientists supporting his coronavirus task force .
The president repeatedly urged that the drugs receive serious consideration from researchers and patients — and quickly .
`` What do you have to lose ?
They say , 'Take it . '
I 'm not looking at it one way or the other , but we want to get out of this , '' he told a news conference earlier this month .
`` If it does work , it would @ @ @ @ @ @ @ do it early . ''
At least one person lost his life ingesting a form of chloroquine , not long after the president expressed hope on Twitter that the FDA will allow the drugs to `` be put into use IMMEDIATELY . ''
The agency said in its warning Friday that its earlier authorization to use these drugs for COVID-19 was limited to hospital patients when clinical trials are not available or where a patient ca n't participate in a study .
The FDA says patients already taking the drugs for their more @ @ @ @ @ @ @ chloroquine as prescribed and should consult a health care professional if side effects occur .
Chloroquine and hydroxychloroquine are approved to treat malaria .
Hydroxychloroquine is also approved to treat immune system conditions such as lupus and rheumatoid arthritis .
On Friday , after controversy stirred around another of Trump 's midbriefing conjectures , the White House press secretary defended the president 's news briefings , saying that he has `` repeatedly said that Americans should consult with medical doctors regarding coronavirus treatment . ''

FDA Warns Against Wide Use Of The Drugs Trump Hailed As 'Game Changers'
Enlarge this image toggle caption Mandel Ngan/AFP via Getty Images Mandel Ngan/AFP via Getty Images
President Trump has spiritedly backed hydroxychloroquine and azithromycin, both in his regular news briefings and on his Twitter account. He has said the two drugs, when taken together to treat the coronavirus, could become "one of the biggest game changers in the history of medicine."
That may well be, eventually — but not right now.
The Food and Drug Administration strongly warned Friday against using hydroxychloroquine or a related compound, chloroquine, for treating or preventing COVID-19 without strict medical supervision in a hospital or as part of a clinical trial. The agency said its officials have not approved the anti-malaria drugs for that purpose — and that without close monitoring for side effects, they may lead to life-threatening complications.
"We understand that health care professionals are looking for every possible treatment option for their patients and we want to ensure we're providing them with the appropriate information needed for them to make the best medical decisions," FDA Commissioner Stephen M. Hahn said.
"While clinical trials are ongoing to determine the safety and effectiveness of these drugs for COVID-19, there are known side effects of these medications that should be considered," he added. "We encourage health care professionals making individual patient decisions closely screen and monitor those patients to help mitigate these risks."
The FDA said it has received reports in its adverse event reporting system and from poison control centers, detailing "serious heart-related adverse events and death in patients with COVID-19 receiving hydroxychloroquine and chloroquine." These include a rapid heartbeat known as ventricular tachycardia, among other forms of heart rhythm disturbances. The reported side effects occurred when the medications were used alone and combined with the antibiotic azithromycin.
The FDA's announcement comes just several days after a panel convened by the National Institute of Allergy and Infectious Diseases issued a similar warning, specifically about using a combination of hydroxychloroquine and azithromycin.
In its warning earlier this week, the panel laid out guidelines on certain therapies and potential treatments for COVID-19. Ultimately, the guidelines found that there was insufficient evidence to recommend any treatment, in particular, while they await the results of formal clinical trials.
Trump, however, has not shared the caution of the scientists supporting his coronavirus task force. The president repeatedly urged that the drugs receive serious consideration from researchers and patients — and quickly.
"What do you have to lose? They say, 'Take it.' I'm not looking at it one way or the other, but we want to get out of this," he told a news conference earlier this month. "If it does work, it would be a shame if we didn't do it early."
At least one person lost his life ingesting a form of chloroquine, not long after the president expressed hope on Twitter that the FDA will allow the drugs to "be put into use IMMEDIATELY."
The agency said in its warning Friday that its earlier authorization to use these drugs for COVID-19 was limited to hospital patients when clinical trials are not available or where a patient can't participate in a study.
The FDA says patients already taking the drugs for their more widely approved uses should continue hydroxychloroquine and chloroquine as prescribed and should consult a health care professional if side effects occur. Chloroquine and hydroxychloroquine are approved to treat malaria. Hydroxychloroquine is also approved to treat immune system conditions such as lupus and rheumatoid arthritis.
On Friday, after controversy stirred around another of Trump's midbriefing conjectures, the White House press secretary defended the president's news briefings, saying that he has "repeatedly said that Americans should consult with medical doctors regarding coronavirus treatment."


npr--2020-04-24--The South's Handling Of Coronavirus Could Be 'A Macabre Game Of Whack-A-Mole'

The South 's Handling Of Coronavirus Could Be ' A Macabre Game Of Whack-A-Mole' Some Southern states , including Georgia and South Carolina , are among the first in the country to ease restrictions to try get back to business despite factors that make the South particularly vulnerable to the coronavirus pandemic .
And pressure is mounting on other Southern governors to get their economies back up and running .
Outside the Alabama Capitol this week , a few dozen protesters drove by honking their horns , chanting `` freedom '' and demanding to get back to work Republican Gov @ @ @ @ @ @ @ order through April 30 .
Paralegal Melissa Kirby from Athens , Ala. , says she has had enough .
`` If she was worried about safety , she could let the people who are actually in danger self-quarantine , wash their hands more , '' Kirby says .
`` But to force businesses to shut down , that 's not her call . ''
From inside the Capitol , Ivey says that no one wants to open the economy more than she does , but that the state must first increase its testing @ @ @ @ @ @ @ decisions that I 'm going to make are based on data , not desired date , '' Ivey says .
She is taking a more cautious approach than are neighboring states Georgia , Tennessee , Florida and Mississippi , where Republican governors have all moved to reopen at least parts of their economies .
`` I think that we could be heading for a macabre game of whack-a-mole , '' says Thomas LaVeist , dean of the School of Public Health and Tropical Medicine at Tulane University in New Orleans .
He worries @ @ @ @ @ @ @ for COVID-19 — could see a resurgence in cases as surrounding states ease restrictions .
`` Unless the states in the South can coordinate the way the states in the North , East , the West , and the upper Midwest are striving to do , we 're going to have problems , '' he says .
LaVeist says longstanding policy decisions , and population characteristics in the South already put the region at risk in a health pandemic .
He points to high poverty rates , large numbers of uninsured residents , @ @ @ @ @ @ @ and well-being measures .
`` The South is the epicenter for health inequities in this country , '' LaVeist says .
`` We call the South the stroke belt — higher rates of all kind of chronic conditions . ''
Conditions such as high blood pressure , diabetes , obesity and kidney disease have all been identified as factors in COVID-19 deaths .
LaVeist says rural communities in the South are not really resourced to manage an outbreak given the number of rural hospitals that have closed or downsized in recent years .
@ @ @ @ @ @ @ and you 've got sort of this toxic mix of political decisions , policy decisions , resource limitations that just create an opportunity for a pandemic to really just rage in the South , '' LaVeist says .
Another disturbing trend is the high proportion of coronavirus cases and deaths among African-Americans .
The early evidence of that is from Louisiana , where the death toll has now surpassed that of Hurricane Katrina .
African-Americans make up 56 % of reported COVID deaths , but just about one-third of the state 's population @ @ @ @ @ @ @ impacts on African-American residents .
In New Orleans , there are clusters of cases in predominantly black neighborhoods where people mostly work in the tourism industry .
`` This virus has exposed the social and economic fragility of working families , '' says New Orleans Mayor LaToya Cantrell .
She points to a `` tyranny of policies '' that leaves families without a living wage or access to health care .
`` All of this is embedded in really what we 're seeing across the board in the city of New Orleans , @ @ @ @ @ @ @ the state of Louisiana is on the front line as it relates to these matters '' Southern states are also subject to natural disasters .
This month , there have been deadly tornadoes and flash floods ; hurricane season starts June 1 ; and there 's spring flooding on the Mississippi River .
In the river town of Greenville , Miss.
, Mayor Errick Simmons says they 're still reeling from record floods last year with some residents still displaced .
`` In a city that has a 38.6 % poverty rate , @ @ @ @ @ @ @ issues that we 're having , '' Simmons says .
`` The acute nature of the pandemic 's economic downturn is felt more here than many other places . ''
Simmons says demand at food pantries and soup kitchens has nearly tripled in the Mississippi Delta .
Regionwide , eight of the 10 states with the biggest jumps in unemployment claims are in the South .
The pandemic is also renewing calls for expanding Medicaid coverage .
Nine of the 14 states that did not expand Medicaid under the Affordable Care Act are @ @ @ @ @ @ @ Texas has the highest number of uninsured residents .
Rep. Colin Allred , D-Texas , fears those numbers are on the rise based on calls to his office from constituents who have lost their jobs and their health insurance .
`` So now , more than ever , we need to push to expand Medicaid , '' he says .
`` To provide a backstop to our health care coverage for many working people who desperately need it . ''
Allred , whose congressional district includes the Dallas area , is pushing legislation @ @ @ @ @ @ @ states that expand Medicaid , in an effort to sway mostly Republican legislatures and governors to reconsider their repeated rejection of a key part of Obamacare .
Sen. Doug Jones , D-Ala. , is behind the bill .
He says expanding Medicaid would help protect everyone in these uncertain times .
`` The thing that this pandemic has really brought home to people is that our health is dependent on our neighbors health more than we like to have thought about in the past , '' Jones says .
A test of that @ @ @ @ @ @ @ now on the brink of reopening .

The South's Handling Of Coronavirus Could Be 'A Macabre Game Of Whack-A-Mole'
Enlarge this image toggle caption Kim Chandler/AP Kim Chandler/AP
Some Southern states, including Georgia and South Carolina, are among the first in the country to ease restrictions to try get back to business despite factors that make the South particularly vulnerable to the coronavirus pandemic.
And pressure is mounting on other Southern governors to get their economies back up and running. Outside the Alabama Capitol this week, a few dozen protesters drove by honking their horns, chanting "freedom" and demanding to get back to work
Republican Gov. Kay Ivey has issued a stay-at-home order through April 30. Paralegal Melissa Kirby from Athens, Ala., says she has had enough.
National There's Disagreement Over Whether States Are Ready To Reopen There's Disagreement Over Whether States Are Ready To Reopen Listen · 3:44 3:44
"If she was worried about safety, she could let the people who are actually in danger self-quarantine, wash their hands more," Kirby says. "But to force businesses to shut down, that's not her call."
From inside the Capitol, Ivey says that no one wants to open the economy more than she does, but that the state must first increase its testing capacity.
"Remember all of our decisions that I'm going to make are based on data, not desired date," Ivey says.
She is taking a more cautious approach than are neighboring states Georgia, Tennessee, Florida and Mississippi, where Republican governors have all moved to reopen at least parts of their economies.
"I think that we could be heading for a macabre game of whack-a-mole," says Thomas LaVeist, dean of the School of Public Health and Tropical Medicine at Tulane University in New Orleans. He worries that Louisiana — an early hot spot for COVID-19 — could see a resurgence in cases as surrounding states ease restrictions.
"Unless the states in the South can coordinate the way the states in the North, East, the West, and the upper Midwest are striving to do, we're going to have problems," he says.
LaVeist says longstanding policy decisions, and population characteristics in the South already put the region at risk in a health pandemic. He points to high poverty rates, large numbers of uninsured residents, lower minimum wages, and general health and well-being measures.
"The South is the epicenter for health inequities in this country," LaVeist says. "We call the South the Stroke Belt — higher rates of all kind of chronic conditions."
Conditions such as high blood pressure, diabetes, obesity and kidney disease have all been identified as factors in COVID-19 deaths.
LaVeist says rural communities in the South are not really resourced to manage an outbreak given the number of rural hospitals that have closed or downsized in recent years.
"You add all of that together and you've got sort of this toxic mix of political decisions, policy decisions, resource limitations that just create an opportunity for a pandemic to really just rage in the South," LaVeist says.
Enlarge this image toggle caption Wilfredo Lee/AP Wilfredo Lee/AP
Another disturbing trend is the high proportion of coronavirus cases and deaths among African-Americans.
The early evidence of that is from Louisiana, where the death toll has now surpassed that of Hurricane Katrina. African-Americans make up 56% of reported COVID deaths, but just about one-third of the state's population. Other Southern states show similar disproportionate impacts on African-American residents.
In New Orleans, there are clusters of cases in predominantly black neighborhoods where people mostly work in the tourism industry.
"This virus has exposed the social and economic fragility of working families," says New Orleans Mayor LaToya Cantrell.
She points to a "tyranny of policies" that leaves families without a living wage or access to health care.
"All of this is embedded in really what we're seeing across the board in the city of New Orleans," Cantrell says. "And really the state of Louisiana is on the front line as it relates to these matters"
Southern states are also subject to natural disasters. This month, there have been deadly tornadoes and flash floods; hurricane season starts June 1; and there's spring flooding on the Mississippi River.
Planet Money COVID-19 Pandemic Puts Rural Hospitals Under Even More Pressure COVID-19 Pandemic Puts Rural Hospitals Under Even More Pressure Listen · 3:22 3:22
In the river town of Greenville, Miss., Mayor Errick Simmons says they're still reeling from record floods last year with some residents still displaced.
"In a city that has a 38.6% poverty rate, this COVID-19 is exacerbating all of the issues that we're having," Simmons says. "The acute nature of the pandemic's economic downturn is felt more here than many other places."
Simmons says demand at food pantries and soup kitchens has nearly tripled in the Mississippi Delta.
Regionwide, eight of the 10 states with the biggest jumps in unemployment claims are in the South.
The pandemic is also renewing calls for expanding Medicaid coverage. Nine of the 14 states that did not expand Medicaid under the Affordable Care Act are in the South. Of them, Texas has the highest number of uninsured residents.
Rep. Colin Allred, D-Texas, fears those numbers are on the rise based on calls to his office from constituents who have lost their jobs and their health insurance.
"So now, more than ever, we need to push to expand Medicaid," he says. "To provide a backstop to our health care coverage for many working people who desperately need it."
Allred, whose congressional district includes the Dallas area, is pushing legislation that would offer more federal money to states that expand Medicaid, in an effort to sway mostly Republican legislatures and governors to reconsider their repeated rejection of a key part of Obamacare.
Sen. Doug Jones, D-Ala., is behind the bill. He says expanding Medicaid would help protect everyone in these uncertain times.
"The thing that this pandemic has really brought home to people is that our health is dependent on our neighbors health more than we like to have thought about in the past," Jones says.
A test of that dependency is coming with some Southern states now on the brink of reopening.


npr--2020-04-24--She Supports 8 People On $480 A Week And Is Figuring What Payments To Defer

She Supports 8 People On $ 480 A Week And Is Figuring What Payments To Defer Dyan Navejar supports eight people on a weekly wage of $ 480 .
She 's the only one in her family who 's still able to work .
That 's because she can do it from home , answering customer calls as a call center operator in Lexington , Ky .
Her husband lost his job as a dishwasher at a restaurant .
Navejar 's pay is n't nearly enough to both make rent and also feed five children and one grandchild , all @ @ @ @ @ @ @ sometimes eat variations of the same things , like hot dogs , to try to conserve their cash .
`` Food — that 's the biggest thing in my household right now .
These kids can eat , '' she says .
Navejar is now trying to figure out which bills she can defer and which ones she ca n't .
Her utility allowed her to skip payments , given her family situation , and said her services would n't be cut .
But her landlord , who has to meet his own @ @ @ @ @ @ @ Business as usual . ''

She Supports 8 People On $480 A Week And Is Figuring What Payments To Defer
Enlarge this image toggle caption Courtesy of Dyan Navejar Courtesy of Dyan Navejar
Dyan Navejar supports eight people on a weekly wage of $480. She's the only one in her family who's still able to work.
That's because she can do it from home, answering customer calls as a call center operator in Lexington, Ky. Her husband lost his job as a dishwasher at a restaurant.
Navejar's pay isn't nearly enough to both make rent and also feed five children and one grandchild, all living in one house. So they sometimes eat variations of the same things, like hot dogs, to try to conserve their cash.
"Food — that's the biggest thing in my household right now. These kids can eat," she says.
FACES OF THE CORONAVIRUS RECESSION Jobs lost. Businesses in peril. Meetings gone virtual. Faces Of The Coronavirus Recession offers snapshots of working Americans whose lives have been upended by the pandemic.
Navejar is now trying to figure out which bills she can defer and which ones she can't. Her utility allowed her to skip payments, given her family situation, and said her services wouldn't be cut.
But her landlord, who has to meet his own mortgage payments, told her: "Business as usual."
Read more stories in Faces Of The Coronavirus Recession.


npr--2020-04-24--India's Lockdown Puts Strain On Call Centers

On the first day of India 's coronavirus lockdown a month ago , Amar Sankrit realized he could n't get to work .
Sankrit , 21 , normally rides a bus two hours each way to a call center outside New Delhi where he has worked for the past year .
His company handles customer service queries for U.S. and U.K. telecom companies .
But on March 25 , all public transit was halted .
He did n't own a laptop , so he could n't work from home .
He worried about losing pay .
On a salary of @ @ @ @ @ @ @ helps support his mother .
`` On that day , the shift was canceled .
We were worried , '' Sankrit says .
`` We contacted our managers .
We asked them what to do . ''
The same day , Nisha Biswal , president of the U.S.-India Business Council , was in her office in Washington , D.C .
Her worries were on a larger scale .
`` When India announced its lockdown , my immediate thought was , 'What will be the impact on the service economy in the United States @ @ @ @ @ @ @ Biswal says .
India handles more than half of the world 's IT outsourcing .
That has earned it the nickname `` the world 's back office . ''
More than 60 % of those operations support clients in the U.S. — everything from credit card companies and airlines to essential emergency services such as hospitals , police and fire departments .
`` X-rays , radiology and diagnostic information is often analyzed in India , '' Biswal tells NPR .
`` Our hospitals are very much linked to services in India . ''
@ @ @ @ @ @ @ Minister Narendra Modi announced that the world 's biggest coronavirus lockdown would take effect at midnight that night , requiring 1.3 billion people to shelter indoors , there was alarm — and economic fallout — around the world .
That lockdown , which includes exemptions for food shopping and medical visits , has since been extended through May 3 .
India has more than 4 million IT workers , including call center employees like Sankrit , and the vast majority could n't get to work .
In the last week of March , @ @ @ @ @ @ @ workers in a variety of industries lost their jobs .
Callers to customer service numbers for airlines , banks and retailers worldwide were left on hold for hours or heard recordings saying help was currently unavailable .
A spokesman for Virgin Media , the U.K. telecom company , told NPR it gave up on trying to staff its call centers in the Indian cities of Pune and Bengaluru and decided to urgently hire staff in the U.K. instead .
Similar disruptions have been reported in the Philippines , another global hub for IT @ @ @ @ @ @ @ lockdown announcement , Mukesh Aghi , head of the U.S.-India Strategic Partnership Forum , which represents U.S. and Indian companies , sent an emergency request to the Indian government asking that it exempt Indian call centers from lockdown restrictions and issue curfew passes for their employees .
`` Obviously , our priority was first with essential services , '' Aghi tells NPR .
`` The challenge was more from ground-level local policemen . ''
Permission was granted swiftly by India 's central government , he says , but the message was n't immediately @ @ @ @ @ @ @ call center employees were stopped on their way to work and turned back .
Aghi says it 's difficult to estimate economic losses from India 's coronavirus lockdown , specifically losses sustained by Indian IT contractors or their U.S. clients .
Some Indian IT companies say losses are likely to come not from their inability to fulfill contracts , but from dwindling demand as clients in the U.S. and elsewhere postpone or shrink projects amid a global economic downturn .
Despite what Aghi calls `` short-term interruptions , '' the National Association of @ @ @ @ @ @ @ trade group , says 70 % to 80 % of call center employees are now working from home .
It 's `` possibly the largest work-from-home scale project anywhere , '' a spokesperson was quoted as saying .
NPR spoke to nine call center employees , including Sankrit .
Three are working from home , and six are not working .
Some of those six are on unpaid furloughs , and some are still receiving full pay .
None had been able to reach their offices since the lockdown took effect .
Working @ @ @ @ @ @ @ when it comes to cybersecurity .
Sensitive personal information — medical records , credit card numbers and other financial data — is suddenly being routed through millions of Indian IT workers ' home computers rather than secure call centers .
There are four essential requirements for employees to work securely from home , says Sagnik Chakraborty , a cybersecurity researcher at Gateway House , a Mumbai-based think tank .
Those requirements are having a `` virtual private network [ VPN ] , encrypted disks , virtual remote desktops and disabling USB ports , @ @ @ @ @ @ @ many employees actually have these tools at home ? ''
Not many .
It has taken Indian companies three days to a week , on average , to shift operations to employees ' homes , Chakraborty says .
The company that employs Sankrit , which he did not want identified since he is not authorized to speak to media on its behalf , offered to house him in a luxury hotel next to his office .
But that posed a problem .
Sankrit lives with his mother and did n't want to leave @ @ @ @ @ @ @ a laptop , paid to install Internet service in the family 's small apartment and sent a supervisor over to install everything .
It 's a cramped space , and Sankrit says he has to balance his keyboard and mouse on his bed .
He misses having a proper desk and chair , he says .
But he 's saving the four hours a day he used to spend commuting to work by bus .
And he 's still employed .
In fact , he says , he 's putting in overtime , @ @ @ @ @ @ @ and running .

India's Lockdown Puts Strain On Call Centers
Enlarge this image toggle caption Pawan Kumar/Reuters Pawan Kumar/Reuters
On the first day of India's coronavirus lockdown a month ago, Amar Sankrit realized he couldn't get to work.
Sankrit, 21, normally rides a bus two hours each way to a call center outside New Delhi where he has worked for the past year. His company handles customer service queries for U.S. and U.K. telecom companies.
But on March 25, all public transit was halted. He didn't own a laptop, so he couldn't work from home. He worried about losing pay. On a salary of about $3,000 a year, Sankrit helps support his mother.
"On that day, the shift was canceled. We were worried," Sankrit says. "We contacted our managers. We asked them what to do."
The same day, Nisha Biswal, president of the U.S.-India Business Council, was in her office in Washington, D.C. Her worries were on a larger scale.
"When India announced its lockdown, my immediate thought was, 'What will be the impact on the service economy in the United States and around the world?'" Biswal says.
India handles more than half of the world's IT outsourcing. That has earned it the nickname "the world's back office." More than 60% of those operations support clients in the U.S. — everything from credit card companies and airlines to essential emergency services such as hospitals, police and fire departments.
"X-rays, radiology and diagnostic information is often analyzed in India," Biswal tells NPR. "Our hospitals are very much linked to services in India."
So on March 24, when Prime Minister Narendra Modi announced that the world's biggest coronavirus lockdown would take effect at midnight that night, requiring 1.3 billion people to shelter indoors, there was alarm — and economic fallout — around the world. That lockdown, which includes exemptions for food shopping and medical visits, has since been extended through May 3.
India has more than 4 million IT workers, including call center employees like Sankrit, and the vast majority couldn't get to work. In the last week of March, India's unemployment rate nearly tripled as workers in a variety of industries lost their jobs.
Callers to customer service numbers for airlines, banks and retailers worldwide were left on hold for hours or heard recordings saying help was currently unavailable.
A spokesman for Virgin Media, the U.K. telecom company, told NPR it gave up on trying to staff its call centers in the Indian cities of Pune and Bengaluru and decided to urgently hire staff in the U.K. instead. Similar disruptions have been reported in the Philippines, another global hub for IT services.
Within hours of Modi's lockdown announcement, Mukesh Aghi, head of the U.S.-India Strategic Partnership Forum, which represents U.S. and Indian companies, sent an emergency request to the Indian government asking that it exempt Indian call centers from lockdown restrictions and issue curfew passes for their employees.
"Obviously, our priority was first with essential services," Aghi tells NPR. "The challenge was more from ground-level local policemen."
Permission was granted swiftly by India's central government, he says, but the message wasn't immediately conveyed to local authorities, and many call center employees were stopped on their way to work and turned back.
Aghi says it's difficult to estimate economic losses from India's coronavirus lockdown, specifically losses sustained by Indian IT contractors or their U.S. clients. Some Indian IT companies say losses are likely to come not from their inability to fulfill contracts, but from dwindling demand as clients in the U.S. and elsewhere postpone or shrink projects amid a global economic downturn.
Despite what Aghi calls "short-term interruptions," the National Association of Software and Service Cos., an Indian trade group, says 70% to 80% of call center employees are now working from home. It's "possibly the largest work-from-home scale project anywhere," a spokesperson was quoted as saying.
NPR spoke to nine call center employees, including Sankrit. Three are working from home, and six are not working. Some of those six are on unpaid furloughs, and some are still receiving full pay. None had been able to reach their offices since the lockdown took effect.
Working from home presents new challenges, particularly when it comes to cybersecurity. Sensitive personal information — medical records, credit card numbers and other financial data — is suddenly being routed through millions of Indian IT workers' home computers rather than secure call centers.
There are four essential requirements for employees to work securely from home, says Sagnik Chakraborty, a cybersecurity researcher at Gateway House, a Mumbai-based think tank.
Those requirements are having a "virtual private network [VPN], encrypted disks, virtual remote desktops and disabling USB ports," Chakraborty explains. "But how many employees actually have these tools at home?"
Not many. It has taken Indian companies three days to a week, on average, to shift operations to employees' homes, Chakraborty says.
The company that employs Sankrit, which he did not want identified since he is not authorized to speak to media on its behalf, offered to house him in a luxury hotel next to his office. But that posed a problem. Sankrit lives with his mother and didn't want to leave her. So his company rented him a laptop, paid to install Internet service in the family's small apartment and sent a supervisor over to install everything.
It's a cramped space, and Sankrit says he has to balance his keyboard and mouse on his bed. He misses having a proper desk and chair, he says. But he's saving the four hours a day he used to spend commuting to work by bus. And he's still employed.
In fact, he says, he's putting in overtime, helping companies around the world stay up and running.