npr--2020-05-18--Pompeo Blasts WHO And China For Excluding Taiwan From This Week's Health Assembly

Pompeo Blasts WHO And China For Excluding Taiwan From This Week 's Health Assembly Secretary of State Mike Pompeo on Monday blasted the head of the World Health Organization for bowing to Chinese pressure and not inviting Taiwan to attend the body 's annual meeting , damaging its credibility at a crucial time .
The World Health Assembly started on Monday amid the worst pandemic in modern history .
Taiwan has won worldwide plaudits for its deft handling of the coronavirus , despite close links to China , where the disease first emerged .
The self-ruled island has reported just @ @ @ @ @ @ @ .
But since it is not a United Nations member , Taiwan required an invitation to attend the assembly as an observer — which was not forthcoming , despite a strong push in recent weeks with backing from the United States , Japan , New Zealand and others .
The Chinese government in Beijing considers Taiwan a province of China and says the central government represents the island 's interests sufficiently in the WHO .
Pompeo said WHO Director-General Tedros Adhanom Ghebreyesus had the legal power and precedent to include it this year @ @ @ @ @ @ @ not to invite Taiwan under pressure from the People 's Republic of China ( PRC ) .
The Director-General 's lack of independence deprives the Assembly of Taiwan 's renowned scientific expertise on pandemic disease , and further damages the WHO 's credibility and effectiveness at a time when the world needs it the most , '' Pompeo said in a statement .
Taiwan attended the health assembly as an observer from 2009 to 2016 , when relations with China were warmer .
Chinese Foreign Ministry spokesman Zhao Lijian said last week the @ @ @ @ @ @ @ Party to recognize that both sides of the Taiwan Strait are part of China was to blame for the lack of an invitation .
`` As a result , the political foundation for the Taiwan region to participate in WHO has ceased to exist , '' he told a news conference last week .
`` The DPP understands this only too well .
It goes without saying that with China and the vast majority of members firmly opposed to the participation of the Taiwan region , the WHO [ director-general ] could not @ @ @ @ @ @ @ statement on Monday , Taiwan 's Foreign Minister Joseph Wu expressed `` deep regret and strong dissatisfaction that the World Health Organization Secretariat has yielded to pressure from the Chinese government . ''
Taiwan had decided to drop the issue for now , but Wu said it would follow up later in the year on a proposal submitted to the WHO by its diplomatic allies to review the island democracy 's status in light of its handling of COVID-19 .
Meanwhile , Wu said Taiwan will continue to provide `` big-hearted '' assistance @ @ @ @ @ @ @ and other medical equipment .

Pompeo Blasts WHO And China For Excluding Taiwan From This Week's Health Assembly
Enlarge this image toggle caption Andrew Harnik/AP Andrew Harnik/AP
Updated at 9:41 p.m. ET
Secretary of State Mike Pompeo on Monday blasted the head of the World Health Organization for bowing to Chinese pressure and not inviting Taiwan to attend the body's annual meeting, damaging its credibility at a crucial time.
The World Health Assembly started on Monday amid the worst pandemic in modern history.
Taiwan has won worldwide plaudits for its deft handling of the coronavirus, despite close links to China, where the disease first emerged. The self-ruled island has reported just 440 confirmed cases and seven virus-related deaths.
But since it is not a United Nations member, Taiwan required an invitation to attend the assembly as an observer — which was not forthcoming, despite a strong push in recent weeks with backing from the United States, Japan, New Zealand and others.
The Chinese government in Beijing considers Taiwan a province of China and says the central government represents the island's interests sufficiently in the WHO.
Pompeo said WHO Director-General Tedros Adhanom Ghebreyesus had the legal power and precedent to include it this year.
"Yet, he instead chose not to invite Taiwan under pressure from the People's Republic of China (PRC). The Director-General's lack of independence deprives the Assembly of Taiwan's renowned scientific expertise on pandemic disease, and further damages the WHO's credibility and effectiveness at a time when the world needs it the most," Pompeo said in a statement.
Taiwan attended the health assembly as an observer from 2009 to 2016, when relations with China were warmer.
In a statement on Monday, Taiwan's Foreign Minister Joseph Wu expressed "deep regret and strong dissatisfaction that the World Health Organization Secretariat has yielded to pressure from the Chinese government."
Taiwan had decided to drop the issue for now, but Wu said it would follow up later in the year on a proposal submitted to the WHO by its diplomatic allies to review the island democracy's status in light of its handling of COVID-19.
Meanwhile, Wu said Taiwan will continue to provide "big-hearted" assistance to others, donating millions of masks and other medical equipment.
A handful of WHA delegates advocated Taiwan's participation in remarks during the proceedings on Monday.
China's Permanent Representative to the UN office in Geneva, Chen Xu, said such comments "seriously violated" relevant UN resolutions and "undermined the global solidarity against the pandemic."
"China strongly protests and firmly opposes this behavior," he said through a translator. "The Taiwan authorities refused to accept the 'one China' principle. As a result, the political basis for its participation in the WHA no longer exists."


npr--2020-05-18--The Serbian President's 'Very Dystopian And Creepy' Political Rally

The Serbian President 's 'Very Dystopian And Creepy ' Political Rally A bespectacled man flashes a game-show smile as he saunters onto a stage facing walls filled with 100-plus screens .
On each of those screens is a person applauding and cheering .
The man — Serbian President Aleksandar Vucic — faces the crowd of screens and launches into a 20-minute campaign speech .
The people on the screens clap and whoop at each talking point .
At the end , he waves and walks away from the lectern .
`` Like 'Black Mirror , ' '' said a headline @ @ @ @ @ @ @ to the sci-fi series .
`` This is what a political rally looks like in the time of corona . ''
`` Looks very dystopian and creepy , '' tweeted Sergej Dojcinovic , a Serbian student in Amsterdam .
As recently as last week , Vucic 's supporters were still gathering in person to support the populist president , who has run Serbia either as prime minister or president since 2014 .
The virtual rally , which took place Saturday , came ahead of Serbia 's parliamentary elections , scheduled for June 21 @ @ @ @ @ @ @ of the coronavirus pandemic .
Serbia , which has confirmed more than 10,000 COVID-19 cases and 230 deaths , has begun lifting its coronavirus restrictions and the parliament voted earlier this month to end a state of emergency .
Vucic , whose Serbian Progressive Party has been criticized for stifling opposition and harassing independent media , is expected to win next month 's election .
The leader of a small , right-wing party is on a hunger strike to try to postpone elections for another six months , saying Serbia 's political system @ @ @ @ @ @ @ democratic conditions '' to hold them now .
Vucic , a former propagandist for Serbian strongman Slobodan Milosevic , is pushing ahead .
`` They can shout insults at us , '' he said in a tweet about his virtual rally .
`` But we must show what a modern Serbia looks like .
The Serbia of the future . ''
There 's no roadmap for virtual campaigns .
But the idea is not completely new .
In 2007 , former U.S. House Speaker Newt Gingrich celebrated his conservative policies through an appearance @ @ @ @ @ @ @ elections in 2017 , leftist Jean-Luc Mélenchon transported himself to seven rallies at once using holograms .

The Serbian President's 'Very Dystopian And Creepy' Political Rally
TRT World YouTube
A bespectacled man flashes a game-show smile as he saunters onto a stage facing walls filled with 100-plus screens. On each of those screens is a person applauding and cheering. The man — Serbian President Aleksandar Vucic — faces the crowd of screens and launches into a 20-minute campaign speech. The people on the screens clap and whoop at each talking point. At the end, he waves and walks away from the lectern.
"Like 'Black Mirror,'" said a headline in Austria's Der Standard, referring to the sci-fi series. "This is what a political rally looks like in the time of corona."
"Looks very dystopian and creepy," tweeted Sergej Dojcinovic, a Serbian student in Amsterdam.
As recently as last week, Vucic's supporters were still gathering in person to support the populist president, who has run Serbia either as prime minister or president since 2014. The virtual rally, which took place Saturday, came ahead of Serbia's parliamentary elections, scheduled for June 21. They were postponed in April because of the coronavirus pandemic.
Serbia, which has confirmed more than 10,000 COVID-19 cases and 230 deaths, has begun lifting its coronavirus restrictions and the parliament voted earlier this month to end a state of emergency.
Vucic, whose Serbian Progressive Party has been criticized for stifling opposition and harassing independent media, is expected to win next month's election. The leader of a small, right-wing party is on a hunger strike to try to postpone elections for another six months, saying Serbia's political system has "neither the health nor the democratic conditions" to hold them now.
Vucic, a former propagandist for Serbian strongman Slobodan Milosevic, is pushing ahead. "They can shout insults at us," he said in a tweet about his virtual rally. "But we must show what a modern Serbia looks like. The Serbia of the future."
There's no roadmap for virtual campaigns. But the idea is not completely new. In 2007, former U.S. House Speaker Newt Gingrich celebrated his conservative policies through an appearance on Second Life. And during French elections in 2017, leftist Jean-Luc Mélenchon transported himself to seven rallies at once using holograms.


npr--2020-05-18--Azar Accuses WHO Of Failure That 'Cost Many Lives' In COVID-19 Pandemic

Azar Accuses WHO Of Failure That 'Cost Many Lives ' In COVID-19 Pandemic Health and Human Services Secretary Alex Azar says the World Health Organization failed in its response to the COVID-19 pandemic – and that it `` cost many lives , '' delivering a sharp criticism of the WHO at the organization 's annual meeting Monday .
`` We must be frank about one of the primary reasons this outbreak spun out of control : There was a failure by this organization to obtain the information that the world needed .
And that failure cost many lives , '' @ @ @ @ @ @ @ , reiterating President Trump 's complaints about the WHO .
`` This can not ever happen again .
The status quo is intolerable , '' the secretary said .
`` WHO must change , and it must become far more transparent and far more accountable . ''
The U.S. supports an independent review of `` every aspect of WHO 's response to the pandemic , '' Azar said .
Dozens of countries agree with the U.S. that the world 's response to the pandemic should be reviewed .
But a European Union-backed resolution @ @ @ @ @ @ @ review at the World Health Assembly this week has a broad focus on improving health systems ' abilities to fight epidemics , rather than investigating the U.S. accusations .
In his remarks about the WHO , Azar echoed some of the complaints critics frequently lodge against the Trump administration : that it failed to heed warning signs of a looming pandemic , and that its response , particularly a bungled approach to testing , is a key reason the U.S. leads the world in confirmed infections and deaths from COVID-19 .
Trump has @ @ @ @ @ @ @ influenced by China and of failing to obtain virus samples from the country .
WHO officials have denied those claims .
Last month , Dr. Mike Ryan , executive director of the WHO 's Health Emergencies Programme , said the virus was identified on Jan. 7 and that on Jan. 12 the genetic sequence `` was shared ... with the world . ''
Ryan also said , `` We alerted the world on Jan. 5 .
Systems around the world , including the U.S. , began to activate their incident management systems on @ @ @ @ @ @ @ has killed almost 90,000 people in the U.S. , ravaging the country 's health care system and its economy .
Two months after widespread shutdowns took effect in many states , the U.S. has now confirmed nearly 1.5 million COVID-19 cases — almost a third of the global total , according to data compiled by Johns Hopkins University .
As Azar delivered his brief speech Monday , he made what seems to be an oblique attack on China , the original epicenter of the coronavirus .
`` In an apparent attempt to conceal @ @ @ @ @ @ @ state made a mockery of their transparency obligations , with tremendous costs for the entire world , '' Azar said .
`` We saw that WHO failed at its core mission of information sharing and transparency when member states do not act in good faith .
Earlier Monday , Chinese President Xi Jinping embraced the idea of a formal review of the international response to the pandemic — but with the stipulation that it should be led by the WHO , and take place after the pandemic is over .
Xi also said @ @ @ @ @ @ @ the next two years to help the global response to the pandemic and boost social and economic activity , particularly in developing countries .
The Trump administration quickly criticized the Chinese pledge , with the White House National Security Council saying the $ 2 billion was merely a `` token '' meant to divert scrutiny – and saying China should pay more .
Accusing China of failing to meet its obligations `` to tell the truth and warn the world of what was coming , '' National Security Council spokesman John Ullyot issued @ @ @ @ @ @ @ source of the outbreak , China has a special responsibility to pay more and to give more . ''
Xi 's funding announcement came a month after Trump said he will suspend U.S. payments to the WHO , pending a review .
The U.S. is the largest single donor to the organization – although as NPR 's David Welna recently reported , the U.S. was already nearly $ 200 million in arrears on its obligations to the WHO when Trump halted payments .
NPR 's Franco Ordoñez , Michele Kelemen and Roberta Rampton @ @ @ @ @

Azar Accuses WHO Of Failure That 'Cost Many Lives' In COVID-19 Pandemic
Enlarge this image toggle caption Andrew Harrer/Bloomberg via Getty Images Andrew Harrer/Bloomberg via Getty Images
Health and Human Services Secretary Alex Azar says the World Health Organization failed in its response to the COVID-19 pandemic – and that it "cost many lives," delivering a sharp criticism of the WHO at the organization's annual meeting Monday.
"We must be frank about one of the primary reasons this outbreak spun out of control: There was a failure by this organization to obtain the information that the world needed. And that failure cost many lives," Azar said at the World Health Assembly, reiterating President Trump's complaints about the WHO.
"This cannot ever happen again. The status quo is intolerable," the secretary said. "WHO must change, and it must become far more transparent and far more accountable."
The U.S. supports an independent review of "every aspect of WHO's response to the pandemic," Azar said.
Dozens of countries agree with the U.S. that the world's response to the pandemic should be reviewed. But a European Union-backed resolution that could lay the groundwork for a review at the World Health Assembly this week has a broad focus on improving health systems' abilities to fight epidemics, rather than investigating the U.S. accusations.
In his remarks about the WHO, Azar echoed some of the complaints critics frequently lodge against the Trump administration: that it failed to heed warning signs of a looming pandemic, and that its response, particularly a bungled approach to testing, is a key reason the U.S. leads the world in confirmed infections and deaths from COVID-19.
Trump has previously accused the WHO of being overly influenced by China and of failing to obtain virus samples from the country. WHO officials have denied those claims. Last month, Dr. Mike Ryan, executive director of the WHO's Health Emergencies Programme, said the virus was identified on Jan. 7 and that on Jan. 12 the genetic sequence "was shared ... with the world."
Ryan also said, "We alerted the world on Jan. 5. Systems around the world, including the U.S., began to activate their incident management systems on Jan. 6."
The coronavirus has killed almost 90,000 people in the U.S., ravaging the country's health care system and its economy. Two months after widespread shutdowns took effect in many states, the U.S. has now confirmed nearly 1.5 million COVID-19 cases — almost a third of the global total, according to data compiled by Johns Hopkins University.
YouTube
As Azar delivered his brief speech Monday, he made what seems to be an oblique attack on China, the original epicenter of the coronavirus.
"In an apparent attempt to conceal this outbreak, at least one member state made a mockery of their transparency obligations, with tremendous costs for the entire world," Azar said. "We saw that WHO failed at its core mission of information sharing and transparency when member states do not act in good faith.
Earlier Monday, Chinese President Xi Jinping embraced the idea of a formal review of the international response to the pandemic — but with the stipulation that it should be led by the WHO, and take place after the pandemic is over.
Xi also said China will provide $2 billion over the next two years to help the global response to the pandemic and boost social and economic activity, particularly in developing countries.
The Trump administration quickly criticized the Chinese pledge, with the White House National Security Council saying the $2 billion was merely a "token" meant to divert scrutiny – and saying China should pay more.
Accusing China of failing to meet its obligations "to tell the truth and warn the world of what was coming," National Security Council spokesman John Ullyot issued a statement saying, "As the source of the outbreak, China has a special responsibility to pay more and to give more."
Xi's funding announcement came a month after Trump said he will suspend U.S. payments to the WHO, pending a review. The U.S. is the largest single donor to the organization – although as NPR's David Welna recently reported, the U.S. was already nearly $200 million in arrears on its obligations to the WHO when Trump halted payments.
NPR's Franco Ordoñez, Michele Kelemen and Roberta Rampton contributed to this report.


npr--2020-05-18--Barr Doesn't Expect Russia Probe To Lead To Criminal Investigation Of Obama Or Biden

Barr Does n't Expect Russia Probe To Lead To Criminal Investigation Of Obama Or Biden U.S. Attorney General William Barr told reporters Monday he does not expect a Justice Department probe examining the origins of the inquiry into Russian election interference will result in criminal investigations into either former President Barack Obama or his vice president , Joe Biden .
A year ago , Barr tasked John Durham , the U.S. attorney for Connecticut , with investigating the origins of the Russia probe .
The review , which was upgraded to a formal criminal investigation later in 2019 , seeks @ @ @ @ @ @ @ the FBI 's investigation into whether Donald Trump 's campaign colluded with Russia to influence the 2016 White House race in Trump 's favor .
`` Under the longstanding standards of the department , criminal charges are appropriate only when we have enough evidence to prove each element of a crime beyond a reasonable doubt .
That is the standard we 're applying , '' Barr said in response to a question about whether the department would investigate Obama and Biden .
`` There 's a difference between an abuse of power and @ @ @ @ @ @ @ of power — no matter how outrageous — is necessarily a federal crime , '' Barr said at an unrelated news conference to discuss last year 's shooting at a U.S. military base in Pensacola , Fla. `` Now , as to President Obama and Vice President Biden , whatever their level of involvement , based on the information I have today , I do n't expect Mr. Durham 's work will lead to a criminal investigation of either man .
Our concern over potential criminality is focused on others . ''
Barr @ @ @ @ @ @ @ the Russia investigation will not be a `` tit-for-tat exercise . ''
When asked if the Justice Department would investigate Obama or Biden — President Trump 's political rivals — Barr said the department would not be used for `` partisan political ends . ''
Speaking at the White House later Monday , Trump said he `` was surprised '' by his attorney general 's remarks about possible investigations into Obama and Biden .
`` I have no doubt they were involved , '' Trump said .
He added that he relies on @ @ @ @ @ @ @ honorable man . ''
The attorney general 's comments come as Trump has promoted a conspiracy theory he has dubbed `` Obamagate '' in which he and his allies push the unfounded allegation that toward the end of his presidency , Obama engaged in various crimes to thwart Trump 's political success , including spying on the Republican 's campaign and wiretapping him .
Trump recently expanded the claim to imply that the Obama administration , through some malpractice , had set up former Trump national security adviser Michael Flynn .
Flynn admitted @ @ @ @ @ @ @ he had had with Russia 's then-ambassador to the United States during the probe into Russia 's interference in the 2016 presidential election .
Despite this admission , the Justice Department earlier this month was looking to drop the charges against the former Army lieutenant general .
Trump and his allies have pounced on the recent disclosure that Biden , the presumptive Democratic presidential nominee , was among a group of Obama administration officials who may have sought to `` unmask '' Flynn when they saw that an unnamed official was in contact @ @ @ @ @ @ @ emerged that the official was Flynn .
U.S. intelligence agencies get thousands of unmasking requests every year , and the Biden campaign has said the effort to tie him to impropriety regarding Flynn is just a political stunt to try to distract Americans from Trump 's failed leadership during the coronavirus pandemic .

Barr Doesn't Expect Russia Probe To Lead To Criminal Investigation Of Obama Or Biden
Enlarge this image toggle caption Jabin Botsford/The Washington Post via Getty Images Jabin Botsford/The Washington Post via Getty Images
Updated at 4:48 p.m. ET
U.S. Attorney General William Barr told reporters Monday he does not expect a Justice Department probe examining the origins of the inquiry into Russian election interference will result in criminal investigations into either former President Barack Obama or his vice president, Joe Biden.
A year ago, Barr tasked John Durham, the U.S. attorney for Connecticut, with investigating the origins of the Russia probe. The review, which was upgraded to a formal criminal investigation later in 2019, seeks to determine whether there was impropriety in the FBI's investigation into whether Donald Trump's campaign colluded with Russia to influence the 2016 White House race in Trump's favor.
"Under the longstanding standards of the department, criminal charges are appropriate only when we have enough evidence to prove each element of a crime beyond a reasonable doubt. That is the standard we're applying," Barr said in response to a question about whether the department would investigate Obama and Biden.
"There's a difference between an abuse of power and a federal crime. Not every abuse of power — no matter how outrageous — is necessarily a federal crime," Barr said at an unrelated news conference to discuss last year's shooting at a U.S. military base in Pensacola, Fla. "Now, as to President Obama and Vice President Biden, whatever their level of involvement, based on the information I have today, I don't expect Mr. Durham's work will lead to a criminal investigation of either man. Our concern over potential criminality is focused on others."
Barr said the investigation into the underpinnings of the Russia investigation will not be a "tit-for-tat exercise." When asked if the Justice Department would investigate Obama or Biden — President Trump's political rivals — Barr said the department would not be used for "partisan political ends."
Speaking at the White House later Monday, Trump said he "was surprised" by his attorney general's remarks about possible investigations into Obama and Biden.
"I have no doubt they were involved," Trump said. He added that he relies on Barr, whom he called an "honorable man."
The attorney general's comments come as Trump has promoted a conspiracy theory he has dubbed "Obamagate" in which he and his allies push the unfounded allegation that toward the end of his presidency, Obama engaged in various crimes to thwart Trump's political success, including spying on the Republican's campaign and wiretapping him.
Trump recently expanded the claim to imply that the Obama administration, through some malpractice, had set up former Trump national security adviser Michael Flynn.
Flynn admitted to lying to the FBI about conversations he had had with Russia's then-ambassador to the United States during the probe into Russia's interference in the 2016 presidential election. Despite this admission, the Justice Department earlier this month was looking to drop the charges against the former Army lieutenant general.
Trump and his allies have pounced on the recent disclosure that Biden, the presumptive Democratic presidential nominee, was among a group of Obama administration officials who may have sought to "unmask" Flynn when they saw that an unnamed official was in contact with the Russian envoy. It later emerged that the official was Flynn.
U.S. intelligence agencies get thousands of unmasking requests every year, and the Biden campaign has said the effort to tie him to impropriety regarding Flynn is just a political stunt to try to distract Americans from Trump's failed leadership during the coronavirus pandemic.
With reporting by NPR's Franco Ordoñez


npr--2020-05-19--Who'll Take The Tortoise? What Happens To Classroom Pets During The Lockdown

Who 'll Take The Tortoise ?
What Happens To Classroom Pets During The Lockdown In the pandemic , families are taking on all kinds of unexpected roles .
Here 's another one : zookeeper .
When the New York City schools closed in March , my son 's teacher , Mary Pfeifer , sent an email to parents , asking who would be willing to invite the classroom pets into their homes — for the duration .
The response was immediate .
`` It 's a very giving community '' says Pfeifer , who teaches pre-K through second grade science @ @ @ @ @ @ @ Pfeifer , as she 's known to her students , knows Holly the Russian tortoise , Frisky the frog , and the other classroom companions are in good hands .
But that does n't stop her from thinking about them .
`` They 're pets .
I miss knowing what they 're doing , '' she says .
`` I worry about the two frogs the most .
They have the most care involved . ''
In addition to Holly and Frisky , there 's Chubby the frog , as well as an @ @ @ @ @ @ @ garden snails , beetles , worms and bugs .
`` Hands-on time with live creatures is invaluable , '' Ms. Pfeifer says .
With short-term changes becoming long term , the families who welcomed the animals into their upended lives are finding companionship , entertainment and learning opportunities .
I was quick to enlist our services when I heard Chubby the frog needed a foster home .
Since arriving in March , we 've discovered a lot about Chubby and the crickets she eats .
Chubby gets two daily mists .
She breathes @ @ @ @ @ @ @ environment to survive .
She 's nocturnal and likes to soak in her pool at night .
We 've learned that frogs use their eyeball muscles to swallow , and we were also relieved to learn that it was the pet trade business that nicknamed her species `` chubby frog , '' rather than PS 58 students .
When we can find Chubby — she 's very good at burrowing into the dirt — my first-grade son , Errol , likes watching her open and close her mouth .
We 've been surprised @ @ @ @ @ @ @ in houses and gardens , have proven delicate in captivity .
And they can be delivered by mail ; who knew ?
Keeping their container free of poo and carcasses is a dirty job that we will not miss when Chubby returns to her forever home .
Crickets do have one good quality : They chirp at night , which we all find very peaceful , and will miss when they leave .
When the Agha family agreed to take in Holly the tortoise , they did n't know what they were getting @ @ @ @ @ @ @ months , Holly has become a source of comfort during the long , unpredictable days of the city 's lockdown .
`` She 's a new experience and something the kids can enjoy , '' says Christine Topalian-Agha , whose 7-year-old son , Aram , is a student of Ms. Pfeifer 's .
Aram is Holly 's primary caretaker , and the tortoise lives in his bedroom , in a 3-foot container with a bath , plants and bark flooring .
He lets her out sometimes to crawl around freely .
Aram has @ @ @ @ @ @ @ titled My Life with Holly .
`` She 's given Aram something very special , '' says Christine , `` something [ of ] his own that he manages and takes care of . ''
`` She sleeps a lot more than I thought she did , '' notes Aram .
`` I also never knew she was Russian . ''
Though the Aghas ' hands are full with work , home-schooling and , for a few terrifying weeks , father Harris Agha 's COVID-19 infection and recovery , Christine says they are @ @ @ @ @ @ @ .
When the tortoise returns to PS 58 , they plan to get one of of their own .
`` We have a lot of bugs , '' explains Cadria Hibbert .
Though not entirely sure who is sheltering inside the Log Hotel from Ms. Pfeifer 's PS 58 science classroom , the Hibberts have confirmed there are two large beetles , two millipedes and what seems to be a growing number of roly-polies .
( The family wonders whether the bugs are mating . )
The Log Hotel , in its terrarium @ @ @ @ @ @ @ the Hibberts ' hermit crab and the LED light station they use to grow garden plants year-round .
`` I like that we now have a whole area on the shelves dedicated to ecosystems , '' says Cadria .
Her daughter Beatrice , 7 , has been studying the Log Hotel 's needs , including what the creatures eat , and she has learned that they like to be sprayed with water throughout the day to keep the soil moist .
`` I was brought up in the countryside with lots of bugs @ @ @ @ @ @ @ `` I 'm glad Beatrice knows what they look like — in New York , you see cockroaches but not much else . ''
The Dally family has a few questions about Frisky : Is he missing the other PS 58 classroom pets ?
Would he like to have more plants in his tank ?
What will we do with him if we go on vacation ?
Frisky arrived at PS 58 as a tadpole six years ago and was raised in the classroom along with his mate , Fiona , who died @ @ @ @ @ @ @ Frisky now lives in a sunny corner of the Dally 's Brooklyn apartment .
An unassuming amphibian , his behavior has surprised the family a couple times .
Every night , dad Charles Dally says Frisky becomes quite noisy .
At first he thought Cleo , 9 , or Emma , 5 , had left the metronome on after piano practice .
`` Tik tok , tik tok .
Now I know it 's Frisky , '' he says .
The Dallys do n't consider Frisky a demanding house guest .
He eats @ @ @ @ @ @ @ cleaned every week or two .
Frisky , according to Cleo and Emma , loves playing with his reflection in the glass walls of his home .
`` Cleo and Emma get a lot of enjoyment out of him , '' says Charles .
`` Especially at the beginning , they watched him a lot .
Now , he 's a part of the environment , kind of like the furniture . ''
In mid-April , it appeared the garden snails were trying to reproduce .
Andrew Goldberg and Gabrielle Paupeck , who @ @ @ @ @ @ @ , sent a picture of the activity to Ms. Pfeifer .
She confirmed their suspicions .
After the tiny , white snail eggs appeared , Ms. Pfeifer received another picture .
She advised the family that the eggs should hatch in another two weeks .
`` I 've been trying to get them to lay eggs for seven years , '' says Ms. Pfeifer .
`` Obviously , the Goldbergs are doing something right . ''
The snails live in a plastic tank with a backdrop that Violet , 7 , drew for @ @ @ @ @ @ @ low maintenance .
`` Occasionally they like a leaf , grape or pepper , but what they really want is carrots , '' explains mom Gabrielle .
`` They also eat chalk to make their shells hard , '' adds 10-year-old Jonah .
When asked whether the snails have changed the family dynamic , dad Andrew Goldberg replies , not so much : `` We all enjoy the snails , but they 're not really a gateway to a dog . ''
Sarah Stacke is a photojournalist who lives in New York City @

Who'll Take The Tortoise? What Happens To Classroom Pets During The Lockdown
Enlarge this image toggle caption Sarah Stacke for NPR Sarah Stacke for NPR
In the pandemic, families are taking on all kinds of unexpected roles. Here's another one: zookeeper.
When the New York City schools closed in March, my son's teacher, Mary Pfeifer, sent an email to parents, asking who would be willing to invite the classroom pets into their homes — for the duration.
The response was immediate. "It's a very giving community" says Pfeifer, who teaches pre-K through second grade science at PS 58 in Brooklyn.
Ms. Pfeifer, as she's known to her students, knows Holly the Russian tortoise, Frisky the frog, and the other classroom companions are in good hands. But that doesn't stop her from thinking about them. "They're pets. I miss knowing what they're doing," she says.
Enlarge this image toggle caption Sarah Stacke for NPR Sarah Stacke for NPR
"I worry about the two frogs the most. They have the most care involved."
In addition to Holly and Frisky, there's Chubby the frog, as well as an assortment of invertebrates including walking sticks, garden snails, beetles, worms and bugs. "Hands-on time with live creatures is invaluable," Ms. Pfeifer says.
With short-term changes becoming long term, the families who welcomed the animals into their upended lives are finding companionship, entertainment and learning opportunities.
Chubby the frog
Enlarge this image toggle caption Sarah Stacke for NPR Sarah Stacke for NPR
Bryan Sleeper and Sarah Stacke
Errol Sleeper, 6 years old
Oscar Stacke, 8 months old
I was quick to enlist our services when I heard Chubby the frog needed a foster home. Since arriving in March, we've discovered a lot about Chubby and the crickets she eats.
Chubby gets two daily mists. She breathes through her skin and needs a moist environment to survive. She's nocturnal and likes to soak in her pool at night. We've learned that frogs use their eyeball muscles to swallow, and we were also relieved to learn that it was the pet trade business that nicknamed her species "chubby frog," rather than PS 58 students.
When we can find Chubby — she's very good at burrowing into the dirt — my first-grade son, Errol, likes watching her open and close her mouth.
Enlarge this image toggle caption Sarah Stacke for NPR Sarah Stacke for NPR
We've been surprised that crickets, considered a hardy pest in houses and gardens, have proven delicate in captivity. And they can be delivered by mail; who knew? Keeping their container free of poo and carcasses is a dirty job that we will not miss when Chubby returns to her forever home. Crickets do have one good quality: They chirp at night, which we all find very peaceful, and will miss when they leave.
Holly the Russian tortoise
Enlarge this image toggle caption Sarah Stacke for NPR Sarah Stacke for NPR
Haris Agha and Christine Topalian-Agha
Aram Agha, 6 years old
Ellias Agha, 3 years old
When the Agha family agreed to take in Holly the tortoise, they didn't know what they were getting into. But over the past two months, Holly has become a source of comfort during the long, unpredictable days of the city's lockdown. "She's a new experience and something the kids can enjoy," says Christine Topalian-Agha, whose 6-year-old son, Aram, is a student of Ms. Pfeifer's.
Enlarge this image toggle caption Sarah Stacke for NPR Sarah Stacke for NPR
Aram is Holly's primary caretaker, and the tortoise lives in his bedroom, in a 3-foot container with a bath, plants and bark flooring. He lets her out sometimes to crawl around freely. Aram has written a book about the experience, titled My Life with Holly.
"She's given Aram something very special," says Christine, "something [of] his own that he manages and takes care of."
"She sleeps a lot more than I thought she did," notes Aram. "I also never knew she was Russian."
Though the Aghas' hands are full with work, home-schooling and, for a few terrifying weeks, father Haris Agha's COVID-19 infection and recovery, Christine says they are grateful to have Holly in their lives. When the tortoise returns to PS 58, they plan to get one of of their own.
The Log Hotel
Enlarge this image toggle caption Sarah Stacke for NPR Sarah Stacke for NPR
Cadria and Mark Hibbert
Beatrice Hibbert, 7 years old
James Hibbert, 21 months
"We have a lot of bugs," explains Cadria Hibbert. Though not entirely sure who is sheltering inside the Log Hotel from Ms. Pfeifer's PS 58 science classroom, the Hibberts have confirmed there are two large beetles, two millipedes and what seems to be a growing number of roly-polies. (The family wonders whether the bugs are mating.)
Enlarge this image toggle caption Sarah Stacke for NPR Sarah Stacke for NPR
The Log Hotel, in its terrarium, has found a home next to the Hibberts' hermit crab and the LED light station they use to grow garden plants year-round. "I like that we now have a whole area on the shelves dedicated to ecosystems," says Cadria.
Her daughter Beatrice, 7, has been studying the Log Hotel's needs, including what the creatures eat, and she has learned that they like to be sprayed with water throughout the day to keep the soil moist. "I was brought up in the countryside with lots of bugs like this," says Cadria. "I'm glad Beatrice knows what they look like — in New York, you see cockroaches but not much else."
Frisky the frog
Enlarge this image toggle caption Sarah Stacke for NPR Sarah Stacke for NPR
Charles Dally
Cleo, 9 years old
Emma, 5 years old
The Dally family has a few questions about Frisky: Is he missing the other PS 58 classroom pets? Would he like to have more plants in his tank? What will we do with him if we go on vacation?
Frisky arrived at PS 58 as a tadpole six years ago and was raised in the classroom along with his mate, Fiona, who died last year, Ms. Pfeifer says.
Frisky now lives in a sunny corner of the Dally's Brooklyn apartment. An unassuming amphibian, his behavior has surprised the family a couple times. Every night, dad Charles Dally says Frisky becomes quite noisy. At first he thought Cleo, 9, or Emma, 5, had left the metronome on after piano practice. "Tik tok, tik tok. Now I know it's Frisky," he says.
Enlarge this image toggle caption Sarah Stacke for NPR Sarah Stacke for NPR
The Dallys don't consider Frisky a demanding house guest. He eats food pellets, and his tank gets cleaned every week or two. Frisky, according to Cleo and Emma, loves playing with his reflection in the walls of his home.
"Cleo and Emma get a lot of enjoyment out of him," says Charles. "Especially at the beginning, they watched him a lot. Now, he's a part of the environment, kind of like the furniture."
Garden Snails
Enlarge this image toggle caption Sarah Stacke for NPR Sarah Stacke for NPR
Andrew Goldberg and Gabrielle Paupeck
Jonah Goldberg, 10 years old
Violet Goldberg, 7 years old
In mid-April, it appeared the garden snails were trying to reproduce. Andrew Goldberg and Gabrielle Paupeck, who took the snails home from PS 58, sent a picture of the activity to Ms. Pfeifer. She confirmed their suspicions. After the tiny, white snail eggs appeared, Ms. Pfeifer received another picture. She advised the family that the eggs should hatch in another two weeks.
"I've been trying to get them to lay eggs for seven years," says Ms. Pfeifer. "Obviously, the Goldbergs are doing something right."
Enlarge this image toggle caption Sarah Stacke for NPR Sarah Stacke for NPR
The snails live in a plastic tank with a backdrop that Violet, 7, drew for them. The animals are easy and low maintenance. "Occasionally they like a leaf, grape or pepper, but what they really want is carrots," explains mom Gabrielle. "They also eat chalk to make their shells hard," adds 10-year-old Jonah.
When asked whether the snails have changed the family dynamic, dad Andrew Goldberg replies, not so much: "We all enjoy the snails, but they're not really a gateway to a dog."
Sarah Stacke is a photojournalist who lives in New York City.


npr--2020-05-19--Are There Zombie Viruses — Like The 1918 Flu — Thawing In The Permafrost?

Are There Zombie Viruses — Like The 1918 Flu — Thawing In The Permafrost ?
Editor 's note : There 's been speculation on the media and via Twitter that DNA fragments of the now-defunct 1918 flu pathogen could be preserved under the permafrost and might pose a potential threat to humans if the warming Earth continues to melt layers of frozen soil .
A few years ago , we investigated that question : Could this pathogen — and others — be revived ?
Last summer , Zac Peterson was on the adventure of a lifetime .
The 25-year-old teacher @ @ @ @ @ @ @ cabin , high above the Arctic Circle on the northern coast of Alaska .
They had pitched tents right on the beach .
Over the course of a month , Peterson watched a gigantic pod of beluga whales swim along the beach , came face-to-face with a hungry polar bear invading their campsite and helped dig out the skull of a rare type of polar bear .
But the most memorable thing happened right at the end of the trip .
`` I noticed a red spot on the front of my leg @ @ @ @ @ @ @ was about the size of a dime .
It felt hot and hurt to touch . ''
The spot grew quickly .
`` After a few days , it was the size of a softball , '' he says .
Peterson realized he had a rapidly spreading skin infection .
And he thought he knew where he might have picked it up : a creature preserved in the permafrost .
In the past few years , there has been a growing fear about a possible consequence of climate change : zombie pathogens .
@ @ @ @ @ @ @ for centuries in frozen ground — coming back to life as the Arctic 's permafrost starts to thaw .
The idea resurfaced in the summer of 2016 , when a large anthrax outbreak struck Siberia .
A heat wave in the Arctic thawed a thick layer of the permafrost , and a bunch of reindeer carcasses started to warm up .
The animals had died of anthrax , and as their bodies thawed , so did the bacteria .
Anthrax spores spread across the tundra .
Dozens of people were hospitalized , and @ @ @ @ @ @ @ surface , it looked as if zombie anthrax had somehow come back to life after being frozen for 70 years .
What pathogen would be next ?
Smallpox ?
The 1918 flu ?
The media took the idea of `` zombie pathogens '' and ran with it .
`` Climate change ... could awaken Earth 's forgotten pathogens , '' The Atlantic wrote in November .
`` Many of these pathogens may be able to survive a gentle thaw — and if they do , researchers warn , they could reinfect humanity .
@ @ @ @ @ @ @ turning into reality : infectious microbes emerging from a deep freeze , '' Scientific American wrote .
But something is a little fishy about these `` zombie pathogen '' stories : The evidence presented is as holey as Swiss cheese .
The key researcher cited is a biologist who studies amoeba viruses , not human viruses .
These so-called monster viruses have evolved to live in cold soil , deep underground , not in warm , human flesh above ground .
And in terms of zombie bacteria , anthrax is a red herring @ @ @ @ @ @ @ '' from soils all over the world for millennia , even longer .
The bacteria survive by hibernating in the ground until conditions are right and then spring back to life .
Back in the Middle Ages , it was common to see fields of dead sheep in Europe , wiped out by `` zombie '' anthrax .
The French called these fields champs maudits , or the `` cursed fields . ''
Now there are some tantalizing hints that the Arctic is , indeed , a frozen champ maudits , filled with @ @ @ @ @ @ @ Across the permafrost — which covers an area twice the size of the U.S. — there are tens of thousands of bodies preserved in the frozen soil .
Some of these people died of smallpox .
And some died of the 1918 flu — a strain of influenza that swept the globe and killed more than 50 million people .
But is there actually any evidence that these deadly viruses could survive a `` gentle thaw '' and then start a new outbreak ?
To figure that out , I headed up to @ @ @ @ @ @ @ Zac Peterson was last summer , to see exactly what type of creatures — and diseases — are hiding in the permafrost .
`` We 've got a head right here '' Up on top of an ocean bluff , Zac Peterson and a few students are on their knees , digging inside a hole that 's about the size of a Volkswagen minivan .
In 2013 , a severe storm ripped off a big chunk of the bluff .
Now the 800-year-old cabin is teetering on the edge of a cliff , @ @ @ @ @ @ @ .
The team is trying to pull off an emergency excavation before the cabin crumbles into the ocean .
Hunters have been using this spot for thousands of years .
At one end of the house , somebody was storing fresh kills .
`` We 've got a head right here , and a main body right there , '' says Peterson , as he points to two mummified seals , lying face up in a soup of thawing permafrost and decaying sea mammal flesh inside the cabin .
The seals are starting @ @ @ @ @ @ @ seeping out of their bodies and beginning to decay .
The whole area smells like a rotting tuna fish sandwich .
Peterson 's pants are covered in black , oily goo .
The seals have been buried in permafrost for about 70 years .
They are incredibly well-preserved .
You can see their skin , their whiskers and even something that looks like a flipper .
`` That 's what 's so amazing about Arctic sites , '' says Anne Jensen , an archaeologist with the Ukpeavik Iupiat Corp. who is leading the @ @ @ @ @ @ @ , '' she says .
`` It 's like the animal just keeled over and died right then . ''
Then something even creepier appears in the ice : a human molar .
`` It 's just a tooth , '' Jensen says .
`` People lose them all the time .
And then just throw them out . ''
Now , this hunting cabin is n't built on a burial ground .
Jensen does n't think any bodies are buried near here .
But Jensen is a world expert on excavating human @ @ @ @ @ @ @ 've probably dug up as many burials as anybody , `` she says .
`` I would prefer not to be excavating burials .
But I 've spent a lot of my career doing that . ''
She has excavated everything from individual body parts — one time , she found just an upper arm in the ice , she says — to a massive cemetery , right here along the coast .
In the late 1990s , the graves in the cemetery started washing into the sea because this stretch of the @ @ @ @ @ @ @ government called Jensen in to save the bodies .
She saved dozens .
But a few hundred remain , threatened by erosion .
Sometimes these mummified human bodies — which can be centuries old — are just as well-preserved as the seals in the log cabin , Jensen says .
`` The little frozen girl from Uquitavik , she was actually better preserved than the seals , '' Jensen says .
`` She was about the age my daughter was at the time , so it was really sad . ''
Buried in @ @ @ @ @ @ @ Back in 1994 , erosion exposed the body of a 6-year-old girl completely encased in ice for about 800 years .
`` Water had seeped into her burial , '' Jensen says .
`` So we took her out as a block of ice . ''
The little girl was carefully wrapped in a duck-skin parka with a fur-trimmed collar .
Her parents had buried her with a little sled inside their meat cellar .
Her body was so well-preserved that Jensen shipped her to Anchorage so doctors could do a full autopsy @ @ @ @ @ @ @ Zimmerman , a paleopathologist at the University of Pennsylvania who has been studying mummified bodies for 30 years .
`` When you open up frozen bodies from Alaska , all the organs are right in place and easily identified , '' Zimmerman says .
`` It 's not like Egyptian mummies where everything is shrunk and dried up . ''
Doctors can easily see why a person died .
For the little frozen girl , it was starvation .
But Zimmerman has seen infections in bodies excavated from permafrost .
In one case @ @ @ @ @ @ @ seemed to have died of pneumonia .
When Zimmerman looked for the bacteria inside the body , there they were , frozen in time .
`` We could see them under the microscope , inside the lungs , '' Zimmerman says .
But were these `` zombie '' bacteria ?
Could they come back to life and infect other people ?
Zimmerman tried to revive the bacteria .
He took a smidge of tissue from the lungs .
Warmed it up .
Fed it .
`` But nothing grew , '' Zimmerman says @ @ @ @ @ @ @ '' Zimmerman says he was n't surprised the bacteria were dead .
Pneumonia bacteria have evolved to live in people at body temperature , not cold soil .
`` We 're dealing with organisms that have been frozen for hundreds of years , '' he says .
`` So I do n't think they would come back to life . ''
But what about viruses — like smallpox or the 1918 flu ?
`` I think it 's extremely unlikely , '' Zimmerman says .
In 1951 , a graduate student decided to @ @ @ @ @ @ @ to a tiny town near Nome , Alaska , and dug up a mass grave of people who had died of the 1918 flu .
He cut out tiny pieces of the people 's lungs and brought them back home .
Then he tried to grow the virus in the lab .
`` I had hoped that I would be able to isolate a living virus , '' Hultin told NPR in 2004 .
`` And I could n't .
The virus was dead .
`` In retrospect , maybe that was a @ @ @ @ @ @ @ A good thing , yes .
But here 's the disturbing part .
Hultin tried to capture the 1918 flu virus again , 45 years later .
By this time he was a pathologist in San Francisco .
He heard scientists were trying to sequence the virus 's genome .
So at age 73 , Hultin went back to Alaska .
And he took a piece of lung from a woman he named Lucy .
`` Using his wife 's pruning shears , Hultin opened Lucy 's mummified rib cage .
There he @ @ @ @ @ @ @ tissue he needed , '' the San Francisco Chronicle reported .
`` Her lungs were magnificent , full of blood , '' Hultin told the paper .
At the same time , a Canadian team of scientists went hunting for the 1918 flu virus in Norway .
They dug up seven bodies .
But none of them were frozen , and the team failed to recover any virus particles .
In the 1990s , Russian scientists intentionally tried to revive smallpox from a body in their permafrost .
They recovered pieces of the @ @ @ @ @ @ @ in the lab .
All these attempts — and all these failures — make you wonder : Maybe it is n't melting permafrost we should worry about when it comes to zombie pathogens , but what scientists do in the lab .
It 's not over until the fat seal sings When I finished writing this story in December , I ended it with a faint warning about the dangers of human curiosity .
I was convinced that the only way `` pathogens '' would rise up from the permafrost was if a @ @ @ @ @ @ @ creatures in the lab .
The chance of it happening naturally seemed infinitesimally small .
But then I received an email from Zac Peterson : `` After kneeling in defrosted marine mammal goo ... doctors treated me for a seal finger infection , '' Peterson wrote .
A photo showed a purplish-red infection covering the front of his knee .
Seal finger is a bacterial infection that hunters contract from handling the body parts of seals .
The infection can spread rapidly into the joints and bones .
Sometimes people lose fingers and @ @ @ @ @ @ @ 's infection to see if it really was seal finger .
It responded well to simple antibiotics — the treatment for seal finger .
The only seals Peterson had handled were those in the log cabin .
Those seals had been frozen in permafrost for decades .
`` Even if there 's a possibility it was something else , '' Peterson wrote , `` I still tell people that I got infected by an 800-year-old strain of a seal hunter 's disease that was trapped in ice . ''
Peterson just might be @ @ @ @ @ @ @ '' rising from Alaska 's thawing permafrost .

Are There Zombie Viruses — Like The 1918 Flu — Thawing In The Permafrost?
Editor's note: There has been speculation in the media and via Twitter that DNA fragments of the now-defunct 1918 flu pathogen could be preserved under the permafrost and might pose a potential threat to humans if the warming Earth continues to melt layers of frozen soil. A couple of years ago, NPR investigated that question: Could this pathogen — and others — be revived? A version of this story originally ran in January 2018.
Zac Peterson was on the adventure of a lifetime.
The 25-year-old teacher was helping archaeologists excavate an 800-year-old log cabin, high above the Arctic Circle on the northern coast of Alaska.
They had pitched tents right on the beach. Over the course of a month, Peterson watched a gigantic pod of beluga whales swim along the beach, came face-to-face with a hungry polar bear invading their campsite and helped dig out the skull of a rare type of polar bear.
But the most memorable thing happened right at the end of that summer trip.
"I noticed a red spot on the front of my leg," Peterson says. "It was about the size of a dime. It felt hot and hurt to touch."
The spot grew quickly. "After a few days, it was the size of a softball," he says.
Peterson realized he had a rapidly spreading skin infection. And he thought he knew where he might have picked it up: a creature preserved in the permafrost.
Nano-zombies or red herrings?
In the past few years, there has been a growing fear about a possible consequence of climate change: zombie pathogens. Specifically, bacteria and viruses — preserved for centuries in frozen ground — coming back to life as the Arctic's permafrost starts to thaw.
The idea resurfaced in the summer of 2016 when a large anthrax outbreak struck Siberia.
A heat wave in the Arctic thawed a thick layer of the permafrost, and a bunch of reindeer carcasses started to warm up. The animals had died of anthrax, and as their bodies thawed, so did the bacteria. Anthrax spores spread across the tundra. Dozens of people were hospitalized, and a 12-year-old boy died.
On the surface, it looked as though zombie anthrax had somehow come back to life after being frozen for 70 years. What pathogen would be next? Smallpox? The 1918 flu?
The media took the idea of "zombie pathogens" and ran with it.
"Climate change ... could awaken Earth's forgotten pathogens," The Atlantic wrote. "Many of these pathogens may be able to survive a gentle thaw — and if they do, researchers warn, they could reinfect humanity."
"Scientists are witnessing the theoretical turning into reality: infectious microbes emerging from a deep freeze," Scientific American wrote.
But something is a little fishy about these "zombie pathogen" stories: The evidence presented is as holey as Swiss cheese.
The key researcher cited is a biologist who studies amoeba viruses, not human viruses. These so-called monster viruses have evolved to live in cold soil, deep underground, not in warm, human flesh above ground.
And in terms of zombie bacteria, anthrax is a red herring. Anthrax has been "rising up" from soils all over the world for millennia, even longer. The bacteria survive by hibernating in the ground until conditions are right and then spring back to life. Back in the Middle Ages, it was common to see fields of dead sheep in Europe, wiped out by "zombie" anthrax. The French called these fields champs maudits, or the "cursed fields."
Now there are some tantalizing hints that the Arctic is, indeed, a frozen champ maudits, filled with pathogens even more dangerous than anthrax. Across the permafrost — which covers an area twice the size of the U.S. — there are tens of thousands of bodies preserved in the frozen soil. Some of these people died of smallpox. And some died of the 1918 flu — a strain of influenza that swept the globe and killed more than 50 million people.
But is there actually any evidence that these deadly viruses could survive a "gentle thaw" and then start a new outbreak?
To figure that out, I headed up to the top of the world, where Zac Peterson spent his summer, to see exactly what type of creatures — and diseases — are hiding in the permafrost.
I was not disappointed.
"We've got a head right here"
Up on top of an ocean bluff, Peterson and a few students are on their knees, digging inside a hole that's about the size of a Volkswagen minivan.
In 2013, a severe storm ripped off a big chunk of the bluff. Now the 800-year-old cabin is teetering on the edge of a cliff, near the town of Utqiagvik in Alaska. The team is trying to pull off an emergency excavation before the cabin crumbles into the ocean.
toggle caption Zachary Peterson
Hunters have been using this spot for thousands of years. At one end of the house, somebody was storing fresh kills.
"We've got a head right here, and a main body right there," says Peterson, as he points to two mummified seals lying face-up in a soup of thawing permafrost and decaying sea mammal flesh inside the cabin.
The seals are starting to warm up. Their organs are seeping out of their bodies and beginning to decay. The whole area smells like a rotting tuna sandwich. Peterson's pants are covered in black, oily goo.
toggle caption Zachary Peterson
The seals have been buried in permafrost for about 70 years. They are incredibly well-preserved. You can see their skin, their whiskers and even something that looks like a flipper.
"That's what's so amazing about Arctic sites," says Anne Jensen, an archaeologist with the Ukpeavik Iupiat Corp. who is leading the excavation. "The preservation is amazing," she says. "It's like the animal just keeled over and died right then."
Then something even creepier appears in the ice: a human molar.
"It's just a tooth," Jensen says. "People lose them all the time. And then just throw them out."
Now, this hunting cabin isn't built on a burial ground. Jensen doesn't think any bodies are buried near here. But Jensen is a world expert on excavating human remains from Arctic permafrost.
"I've probably dug up as many burials as anybody, " she says. "I would prefer not to be excavating burials. But I've spent a lot of my career doing that."
She has excavated everything from individual body parts — one time, she found just an upper arm in the ice, she says — to a massive cemetery, right here along the coast.
In the late 1990s, the graves in the cemetery started washing into the sea because this stretch of the Alaska coast is eroding. The local government called Jensen in to save the bodies. She saved dozens. But a few hundred remain, threatened by erosion.
Sometimes these mummified human bodies — which can be centuries old — are just as well-preserved as the seals in the log cabin, Jensen says.
"The little frozen girl from Uquitavik, she was actually better preserved than the seals," Jensen says. "She was about the age my daughter was at the time, so it was really sad."
Buried in the meat cellar with a little sled
Back in 1994, erosion exposed the body of a 6-year-old girl completely encased in ice for about 800 years. "Water had seeped into her burial," Jensen says. "So we took her out as a block of ice."
The little girl was carefully wrapped in a duck-skin parka with a fur-trimmed collar. Her parents had buried her with a little sled inside their meat cellar.
Her body was so well-preserved that Jensen shipped her to Anchorage so doctors could do a full autopsy. One of those doctors was Michael Zimmerman, a paleopathologist at the University of Pennsylvania who has been studying mummified bodies for 30 years.
"When you open up frozen bodies from Alaska, all the organs are right in place and easily identified," Zimmerman says. "It's not like Egyptian mummies where everything is shrunk and dried up."
Doctors can easily see why a person died. For the little frozen girl, it was starvation. But Zimmerman has seen infections in bodies excavated from permafrost. In one case, a mummy from the Aleutian Islands seemed to have died of pneumonia. When Zimmerman looked for the bacteria inside the body, there they were, frozen in time.
"We could see them under the microscope, inside the lungs," Zimmerman says.
But were these "zombie" bacteria? Could they come back to life and infect other people? Zimmerman tried to revive the bacteria. He took a smidge of tissue from the lungs. Warmed it up. Fed it.
"But nothing grew," Zimmerman says. "Not a single cell."
Zimmerman says he wasn't surprised the bacteria were dead. Pneumonia bacteria have evolved to live in people at body temperature, not cold soil.
"We're dealing with organisms that have been frozen for hundreds of years," he says. "So I don't think they would come back to life."
But what about viruses — like smallpox or the 1918 flu? "I think it's extremely unlikely," Zimmerman says.
In 1951, a graduate student decided to test this out. Johan Hultin went to a tiny town near Nome, Alaska, and dug up a mass grave of people who had died of the 1918 flu.
He cut out tiny pieces of the people's lungs and brought them back home. Then he tried to grow the virus in the lab.
"I had hoped that I would be able to isolate a living virus," Hultin told NPR in 2004. "And I couldn't. The virus was dead.
"In retrospect, maybe that was a good thing," Hultin added.
A good thing, yes. But here's the disturbing part. Hultin tried to capture the 1918 flu virus again, 45 years later.
By this time he was a pathologist in San Francisco. He heard scientists were trying to sequence the virus's genome. So at age 73, Hultin went back to Alaska. And he took a piece of lung from a woman he named Lucy.
"Using his wife's pruning shears, Hultin opened Lucy's mummified rib cage. There he found two frozen lungs, the very tissue he needed," the San Francisco Chronicle reported.
"Her lungs were magnificent, full of blood," Hultin told the paper.
At the same time, a Canadian team of scientists went hunting for the 1918 flu virus in Norway. They dug up seven bodies. But none of them were frozen, and the team failed to recover any virus particles.
In the 1990s, Russian scientists intentionally tried to revive smallpox from a body in their permafrost. They recovered pieces of the virus but couldn't grow the virus in the lab.
All these attempts — and all these failures — make you wonder: Maybe it isn't melting permafrost we should worry about when it comes to zombie pathogens, but what scientists do in the lab.
It's not over until the fat seal sings
When I finished writing this story in December, I ended it with a faint warning about the dangers of human curiosity. I was convinced that the only way "pathogens" would rise up from the permafrost was if a scientist bent over backward to resurrect the creatures in the lab. The chance of it happening naturally seemed infinitesimally small.
But then I received an email from Zac Peterson: "After kneeling in defrosted marine mammal goo ... doctors treated me for a seal finger infection," Peterson wrote. A photo showed a purplish-red infection covering the front of his knee.
Seal finger is a bacterial infection that hunters contract from handling the body parts of seals. The infection can spread rapidly into the joints and bones. Sometimes people lose fingers and hands.
The doctors never tested Peterson's infection to see if it really was seal finger. It responded well to simple antibiotics — the treatment for seal finger.
The only seals Peterson had handled were those in the log cabin. Those seals had been frozen in permafrost for decades.
"Even if there's a possibility it was something else," Peterson wrote, "I still tell people that I got infected by an 800-year-old strain of a seal hunter's disease that was trapped in ice."
Peterson just might be the first victim of "zombie bacteria" rising from Alaska's thawing permafrost.


npr--2020-05-19--Are You Ready To Go Back To Work? Share Your Story

Are You Ready To Go Back To Work ?
Share Your Story NPR is reporting on how the pandemic has @ @ @ @ @ financial lives , from our ability to make money to how we spend it .
@ @ @ @ @ to seek help from the government , whether it 's unemployment benefits or business loans @ @ @ @ @ major life decisions because of the economic turmoil .
Now , some states are easing @ @ @ @ @ want to know : Are you ready and able to go back to your normal @ @ @ @ @ Please fill out the form below .
An NPR reporter may reach out to you @ @ @ @ @ submission will be governed by our general Terms of Use and Privacy Policy .
As @ @ @ @ @ we want you to be aware that there may be circumstances in which the exemptions @ @ @ @ @ activities or freedom of expression may override privacy rights you might otherwise have .

Are You Ready To Go Back To Work? Share Your Story
Enlarge this image toggle caption LA Johnson/NPR LA Johnson/NPR
NPR is reporting on how the pandemic has upended every inch of our financial lives, from our ability to make money to how we spend it.
Millions of people have had to seek help from the government, whether it's unemployment benefits or business loans. Some have put off major life decisions because of the economic turmoil.
Now, some states are easing stay-at-home restrictions. And we want to know: Are you ready and able to go back to your normal work and social life?
Please fill out the form below. An NPR reporter may reach out to you for a story.
Your submission will be governed by our general Terms of Use and Privacy Policy. As the Privacy Policy says, we want you to be aware that there may be circumstances in which the exemptions provided under law for journalistic activities or freedom of expression may override privacy rights you might otherwise have.


npr--2020-05-19--With Postmortem Testing, 'Last Responders' Shed Light On Pandemic's Spread

With Postmortem Testing , 'Last Responders ' Shed Light On Pandemic 's Spread As the coronavirus pandemic has unfolded , all eyes have been on the medical workers and public health disease detectives fighting on the front lines ― and sometimes giving their lives — to bring the coronavirus under control .
But as efforts to test for the coronavirus and trace cases continues , medical examiners and coroners play a vital — if often unsung ― role .
These `` last responders '' are typically called on to investigate and determine the causes of deaths that are unexpected or @ @ @ @ @ @ @ home .
In the early days of the outbreak , a scarcity of tests often hampered their efforts .
Now , as that equipment gradually becomes more widely available , these professionals may be able to fill in answers about how people died and if those deaths were related to the coronavirus .
And these confirmed cases can also help investigators trace contacts who may also be infected .
Those changes wo n't happen at once or uniformly across the country , experts predict .
In addition , an increase in postmortem testing @ @ @ @ @ @ @ examiners in the middle of a debate heating up about the true number of COVID-19 casualties .
Determining how many people the virus has killed is an ongoing bone of contention .
Some defenders of the Trump administration 's response charge that death estimates are inflated , often because they include people who were presumed to have died of the disease but not tested for it .
Administration critics counter that the chaotic rollout of testing and treatment led to thousands of needless deaths that are n't represented in the official death toll @ @ @ @ @ @ @ emergence of COVID-19 in the United States , the availability of test kits and testing materials , such as nasal swabs , remains inadequate in many places .
Public health experts agree that broad-based testing is critical for people to safely emerge from lockdown and for businesses and other institutions to safely reopen .
`` Some localities are prioritizing testing sick people over dead people , and that 's probably a good decision if they have limited testing available , '' says Dr. Sally Aiken , the medical examiner for Spokane County , @ @ @ @ @ @ @ the National Association of Medical Examiners .
As availability increases , however , stepping up postmortem COVID-19 testing could uncover important clues about the spread of the virus , experts say .
During the pandemic , many sick people have stayed at home and died there rather than seeking help at hospitals overwhelmed with coronavirus patients .
In April in New York City , for example , a reported 200 residents died at home each day , compared with 20 such deaths before the pandemic , a spokesperson for the city 's medical @ @ @ @ @ @ @ radio station .
Tests were not possible in many of those instances .
But with more tests , such cases are now getting attention .
`` Most of the ones we test are the individuals who die at home , '' says Gary Watts , the coroner in Richland County , S.C. , who is president of the International Association of Coroners and Medical Examiners .
If family or friends say the person had symptoms consistent with COVID-19 , the coroner 's office will typically do a nasal swab to test for the @ @ @ @ @ @ @ test is positive and the office can determine the cause of death without an autopsy , one will generally not be performed .
Coroners and medical examiners have similar responsibilities but their backgrounds are often different .
Coroners are typically elected officials who may or may not have a medical degree .
Medical examiners are typically medical doctors and may have a specialty in forensic pathology .
Like Watts , Dr. Kent Harshbarger , the coroner for Montgomery County , Ohio , which includes the city of Dayton , says his office now @ @ @ @ @ @ @ was involved in suspect deaths , unlike during the pandemic 's early days .
With more postmortem testing , `` you can do better contact tracing , '' he says .
A few medical examiners and coroners are now stepping up testing significantly , performing tests on all the bodies that are brought in , says Aiken .
`` They 're surprised at some of the people who are positive , '' including suicides and car accidents , she says .
One reason for increasing testing is to protect the staff who are @ @ @ @ @ @ @ Melinek , a forensic pathologist in the San Francisco area and CEO of PathologyExpert .
If a body at the morgue is positive for COVID-19 , `` you want to avoid doing an autopsy unless it 's absolutely necessary , '' Melinek says , because of the risk of becoming exposed to the virus through aerosolized particles or blood .
Plus , she noted , the Occupational Safety and Health Administration recommends against performing autopsies in COVID-19 deaths .
Even if coroners and medical examiners are n't doing extensive nasal-swab testing on the @ @ @ @ @ @ @ information later on , some note .
It 's standard practice to take blood samples from patients who are sent to the morgue , and coroners and medical examiners typically keep blood samples on hand for up to a year .
Testing those blood samples for antibodies to the coronavirus , which would indicate a prior infection , could give public health experts a clearer sense of when the virus arrived in the United States and the extent of its spread .
It wo n't identify every undiagnosed infection , since antibodies do @ @ @ @ @ @ @ weeks after infection occurs , according to the federal Centers for Disease Control and Prevention .
People may die before then .
Still , postmortem antibody testing could provide useful information , experts say .
`` If we can figure out when [ the virus ] arrived in the U.S. , we can figure out a lot more about how this virus came through and was undetected , '' Melinek says .
Going forward , as public health experts and politicians contemplate decisions about reopening the country for business and the possibility of @ @ @ @ @ @ @ more concrete information available the better , experts say .
`` Postmortem testing is helpful and important when it is balanced by the logistical feasibility of doing it , '' says Lorna Thorpe , a professor of epidemiology at New York University Grossman School of Medicine .
`` When politics enters this space , it 's nice to have confirmed cases so that it ca n't be critiqued . ''
Kaiser Health News ( KHN ) is a nonprofit news service covering health issues .
It is an editorially independent program of the @ @ @ @ @ @ @ with Kaiser Permanente .

With Postmortem Testing, 'Last Responders' Shed Light On Pandemic's Spread
Enlarge this image toggle caption Charles Rex Arbogast/AP Charles Rex Arbogast/AP
As the coronavirus pandemic has unfolded, all eyes have been on the medical workers and public health disease detectives fighting on the front lines ― and sometimes giving their lives — to bring the coronavirus under control.
But as efforts to test for the coronavirus and trace cases continues, medical examiners and coroners play a vital — if often unsung ― role. These "last responders" are typically called on to investigate and determine the causes of deaths that are unexpected or unnatural, including deaths that occur at home.
In the early days of the outbreak, a scarcity of tests often hampered their efforts. Now, as that equipment gradually becomes more widely available, these professionals may be able to fill in answers about how people died and if those deaths were related to the coronavirus. And these confirmed cases can also help investigators trace contacts who may also be infected.
Those changes won't happen at once or uniformly across the country, experts predict. In addition, an increase in postmortem testing is likely to put coroners and medical examiners in the middle of a debate heating up about the true number of COVID-19 casualties.
Determining how many people the virus has killed is an ongoing bone of contention. Some defenders of the Trump administration's response charge that death estimates are inflated, often because they include people who were presumed to have died of the disease but not tested for it. Administration critics counter that the chaotic rollout of testing and treatment led to thousands of needless deaths that aren't represented in the official death toll.
Even now, months after the emergence of COVID-19 in the United States, the availability of test kits and testing materials, such as nasal swabs, remains inadequate in many places. Public health experts agree that broad-based testing is critical for people to safely emerge from lockdown and for businesses and other institutions to safely reopen.
"Some localities are prioritizing testing sick people over dead people, and that's probably a good decision if they have limited testing available," says Dr. Sally Aiken, the medical examiner for Spokane County, Washington, who is also president of the National Association of Medical Examiners.
As availability increases, however, stepping up postmortem COVID-19 testing could uncover important clues about the spread of the virus, experts say.
During the pandemic, many sick people have stayed at home and died there rather than seeking help at hospitals overwhelmed with coronavirus patients.
In April in New York City, for example, a reported 200 residents died at home each day, compared with 20 such deaths before the pandemic, a spokesperson for the city's medical examiner told WNYC, the local public radio station.
Tests were not possible in many of those instances. But with more tests, such cases are now getting attention.
"Most of the ones we test are the individuals who die at home," says Gary Watts, the coroner in Richland County, S.C., who is president of the International Association of Coroners and Medical Examiners.
If family or friends say the person had symptoms consistent with COVID-19, the coroner's office will typically do a nasal swab to test for the virus, he says. If the test is positive and the office can determine the cause of death without an autopsy, one will generally not be performed.
Coroners and medical examiners have similar responsibilities but their backgrounds are often different. Coroners are typically elected officials who may or may not have a medical degree. Medical examiners are typically medical doctors and may have a specialty in forensic pathology.
Like Watts, Dr. Kent Harshbarger, the coroner for Montgomery County, Ohio, which includes the city of Dayton, says his office now has enough tests to determine if COVID-19 was involved in suspect deaths, unlike during the pandemic's early days.
With more postmortem testing, "you can do better contact tracing," he says.
A few medical examiners and coroners are now stepping up testing significantly, performing tests on all the bodies that are brought in, says Aiken.
"They're surprised at some of the people who are positive," including suicides and car accidents, she says.
One reason for increasing testing is to protect the staff who are handling the bodies, says Dr. Judy Melinek, a forensic pathologist in the San Francisco area and CEO of PathologyExpert.
If a body at the morgue is positive for COVID-19, "you want to avoid doing an autopsy unless it's absolutely necessary," Melinek says, because of the risk of becoming exposed to the virus through aerosolized particles or blood. Plus, she noted, the Occupational Safety and Health Administration recommends against performing autopsies in COVID-19 deaths.
Even if coroners and medical examiners aren't doing extensive nasal-swab testing on the recently deceased, they can provide vital information later on, some note.
It's standard practice to take blood samples from patients who are sent to the morgue, and coroners and medical examiners typically keep blood samples on hand for up to a year. Testing those blood samples for antibodies to the coronavirus, which would indicate a prior infection, could give public health experts a clearer sense of when the virus arrived in the United States and the extent of its spread.
It won't identify every undiagnosed infection, since antibodies don't show up until one to three weeks after infection occurs, according to the federal Centers for Disease Control and Prevention. People may die before then. Still, postmortem antibody testing could provide useful information, experts say.
"If we can figure out when [the virus] arrived in the U.S., we can figure out a lot more about how this virus came through and was undetected," Melinek says.
Going forward, as public health experts and politicians contemplate decisions about reopening the country for business and the possibility of a resurgence of the virus, the more concrete information available the better, experts say.
"Postmortem testing is helpful and important when it is balanced by the logistical feasibility of doing it," says Lorna Thorpe, a professor of epidemiology at New York University Grossman School of Medicine. "When politics enters this space, it's nice to have confirmed cases so that it can't be critiqued."
Kaiser Health News (KHN) is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.


npr--2020-05-19--Community Health Centers Struggling As Fewer People Seek Care During Pandemic

Community health centers had been at the front lines of health care in the nation 's poorest neighborhoods even before the spread of the coronavirus .
But in the midst of the pandemic , patients who fear deportation or infection are forcing many centers to close .
Public health officials worry that the populations that these centers serve — mostly people with low incomes and immigrants — are n't getting proper health care and testing , may be unable to quarantine themselves and could contribute to spreading the coronavirus to the wider population .
`` People are worried about COVID-19 @ @ @ @ @ @ @ CEO of Covenant Community Care in Detroit , a nonprofit health center .
`` If patients do n't come in for a visit , we lose money . ''
Covenant serves more than 20,000 patients each year through five locations with a staff of about 200 .
Pettway was forced to furlough about 50 staff members and shut down two full-service dental centers , because dental care is not essential , even though 1,400 patients are on a waiting list .
The lack of patients seeking health care is a direct result of @ @ @ @ @ @ @ .
As of May 18 , the state had more than 51,000 confirmed cases , with Detroit registering more than 10,000 confirmed cases and 1,255 deaths , according to Michigan state health data .
`` Our patient population has been hard hit , no doubt about it , '' Pettway says .
`` Those health disparities that we 've seen due to COVID , they existed long before COVID .
COVID just brought it to light . ''
There 's no better time to argue for affordable access to care for everyone , @ @ @ @ @ @ @ why we need to keep pushing to expand access to medical care for everybody , regardless of the person 's status , Pettway says .
`` Nobody is excluded from the impact of COVID .
And so people who are unable to access care for a variety of reasons , they increase the spread of the virus , '' ultimately impacting all of us , she says .
Community health centers , like Covenant Community Care , were launched in 1965 as part of President Lyndon B. Johnson 's Office of Economic Opportunity @ @ @ @ @ @ @ and the War on Poverty .
Their aim then , as it is now , is to provide comprehensive and affordable primary care to medically underserved populations , regardless of their insurance or immigration status and their ability to pay for services .
Pettway says it 's not atypical for Covenant patients to delay care , especially preventive care .
To many low-income residents , preventive health care is a luxury .
They either ca n't take the time away from work or lack transportation or child care .
`` They were already @ @ @ @ @ @ @ says .
Covenant has been hit hard by the pandemic .
Only one site is open for in-person urgent visits , such as testing for the coronavirus , newborn checkups or an abscess that needs to be drained .
The other four locations are currently serving patients virtually .
Using $ 997,490 from the federal CARES Act , Pettway invested in telehealth software in March to keep the Covenant centers running .
`` We are working very hard not to shut down locations , '' she says .
`` The need is massive @ @ @ @ @ @ @ , Sage Davis , a family nurse practitioner at Covenant , relied heavily on the full panel of a patient 's vital signs , lab work and physical exam .
Now she does n't have that information to make decisions about a patient 's treatment .
Davis is making different calculations , along with her patients .
`` What 's the risk of possible exposure going to medical facilities ?
And then , what 's the risk if we do n't get those lab work right now or we do n't get this @ @ @ @ @ @ @ .
`` It takes a lot of clinical judgment to determine if this is something that we really do need to get right now or if it 's something that can wait .
We really are looking at the patient in front of us and just treating our patient . ''
Davis , who is managing the center 's transition to telehealth , says she constantly reminds her patients to call back if things get worse or change .
A decision made today gets reviewed and assessed , she says .
`` I @ @ @ @ @ @ @ an in-person visit if they need it , '' and that gives Davis peace of mind .
One of the silver linings of telehealth , Davis says , is that before COVID-19 , patients stepped out of their environment to come into the center for care .
`` Now we 're in their environment in a way , '' which Davis says is helpful .
For example , let 's say a patient with diabetes and joint problems walks up the stairs slowly and unsteadily to get a thermometer .
`` I can @ @ @ @ @ @ @ time and effort it takes her to climb that set of stairs , '' she says .
`` Whereas in my office , I 'm cognizant of her joint problem , but I do n't see her climbing stairs . ''
Around the U.S. , 1,400 health center organizations across 14,000 locations in rural and urban areas serve more than 29 million people , most of whom are low income , are uninsured or on Medicaid and Medicare , or are immigrants , according to the National Association of Community Health Centers .
@ @ @ @ @ @ @ the pandemic hit .
`` Financially , these centers are getting a blow in this pandemic , '' says Dr. Ron Yee , chief medical officer for the National Association of Community Health Centers .
`` When you cut your visits by half , that 's going to change your revenue , even though you may make up for it a little bit with virtual visits , '' Yee says .
Virtual visits do n't get reimbursed at the same rate as regular in-person visits .
For example , he says , an @ @ @ @ @ @ @ between $ 13 and $ 93 , while community health centers receive between $ 100 and $ 150 in reimbursement for an in-person appointment .
But it 's not only the coronavirus crisis that concerns Yee .
Community health centers operate on short-term funding , and it expires on Nov. 30 , unless Congress acts .
`` I 'm very worried about the future of our centers , '' Yee says .
And doctors and nurses are struggling in this crisis .
`` Right now health centers are projected to lose about $ @ @ @ @ @ @ @ get through this , to stay whole so that we can be up and running when we get through this pandemic , '' he says , adding that this projection is based on a 60 % decline in visits systemwide .
Community health centers are playing a vital role in this pandemic .
As of May 1 , more than 300,000 patients had been tested for the coronavirus .
In California , a large number of patients at community health centers are recent immigrants , says Dr. Edgar Chavez , who serves as @ @ @ @ @ @ @ , a cluster of three centers in South Los Angeles .
Chavez says patients fear that being tested for the coronavirus will land them on a list to be deported .
This mistrust of the government and reluctance to seek medical care stem from the Trump administration 's public charge rule , Chavez says .
Chaves is working virtually , and his staff is calling patients and checking in on them for depression and anxiety as well as to see if they need to be tested for anything .
`` Telehealth can only @ @ @ @ @ @ @ You still need that lab data point , '' he says with a sigh .
`` We are going to have a lot of people that go without Pap smears , go without mammograms , go without all these different things that we use to improve and maintain their health . ''
Chavez says he worries about the health of his patients .
`` People are n't eating well .
They are not exercising , and they are anxious , '' he says .
`` I fear that we are going to be @ @ @ @ @ @ @ patients with chronic care-related conditions , especially diabetes , hypertension and heart disease . ''
`` It is very tough , '' he says .
`` We 're doing the best that we can , but we 're going to be facing a pretty , pretty tough situation . ''
The need was already massive before this public health crisis hit and it will get worse after the pandemic is over , health care providers say .

Community Health Centers Struggling As Fewer People Seek Care During Pandemic
Enlarge this image toggle caption Maskot/Getty Images/Maskot Maskot/Getty Images/Maskot
Community health centers had been at the front lines of health care in the nation's poorest neighborhoods even before the spread of the coronavirus. But in the midst of the pandemic, patients who fear deportation or infection are forcing many centers to close.
Public health officials worry that the populations that these centers serve — mostly people with low incomes and immigrants — aren't getting proper health care and testing, may be unable to quarantine themselves and could contribute to spreading the coronavirus to the wider population.
"People are worried about COVID-19," says Joslyn Pettway, acting CEO of Covenant Community Care in Detroit, a nonprofit health center. "If patients don't come in for a visit, we lose money."
Business Public Health Officials Worry Coronavirus Could Lead To New Overdose Risks Public Health Officials Worry Coronavirus Could Lead To New Overdose Risks 3:54
Covenant serves more than 20,000 patients each year through five locations with a staff of about 200. Pettway was forced to furlough about 50 staff members and shut down two full-service dental centers, because dental care is not essential, even though 1,400 patients are on a waiting list.
The lack of patients seeking health care is a direct result of Michigan's tough battle against the coronavirus. As of May 18, the state had more than 51,000 confirmed cases, with Detroit registering more than 10,000 confirmed cases and 1,255 deaths, according to Michigan state health data.
"Our patient population has been hard hit, no doubt about it," Pettway says. "Those health disparities that we've seen due to COVID, they existed long before COVID. COVID just brought it to light."
Enlarge this image toggle caption Courtesy of Covenant Community Care Courtesy of Covenant Community Care
There's no better time to argue for affordable access to care for everyone, she adds. The coronavirus pandemic shows why we need to keep pushing to expand access to medical care for everybody, regardless of the person's status, Pettway says.
"Nobody is excluded from the impact of COVID. And so people who are unable to access care for a variety of reasons, they increase the spread of the virus," ultimately impacting all of us, she says.
Community health centers, like Covenant Community Care, were launched in 1965 as part of President Lyndon B. Johnson's Office of Economic Opportunity, propelled by the civil rights movement and the War on Poverty. Their aim then, as it is now, is to provide comprehensive and affordable primary care to medically underserved populations, regardless of their insurance or immigration status and their ability to pay for services.
Pettway says it's not atypical for Covenant patients to delay care, especially preventive care. To many low-income residents, preventive health care is a luxury. They either can't take the time away from work or lack transportation or child care.
"They were already struggling before the pandemic," she says.
Covenant has been hit hard by the pandemic. Only one site is open for in-person urgent visits, such as testing for the coronavirus, newborn checkups or an abscess that needs to be drained. The other four locations are currently serving patients virtually.
Using $997,490 from the federal CARES Act, Pettway invested in telehealth software in March to keep the Covenant centers running.
"We are working very hard not to shut down locations," she says. "The need is massive in Detroit."
Enlarge this image toggle caption Sage Davis Sage Davis
Before the coronavirus, Sage Davis, a family nurse practitioner at Covenant, relied heavily on the full panel of a patient's vital signs, lab work and physical exam. Now she doesn't have that information to make decisions about a patient's treatment.
Davis is making different calculations, along with her patients.
"What's the risk of possible exposure going to medical facilities? And then, what's the risk if we don't get lab work right now or we don't get this imaging right now?" she asks. "It takes a lot of clinical judgment to determine if this is something that we really do need to get right now or if it's something that can wait. We really are looking at the patient in front of us and just treating our patient."
Davis, who is managing the center's transition to telehealth, says she constantly reminds her patients to call back if things get worse or change. A decision made today gets reviewed and assessed, she says.
"I do have options for sending people to an in-person visit if they need it," and that gives Davis peace of mind.
One of the silver linings of telehealth, Davis says, is that before COVID-19, patients stepped out of their environment to come into the center for care.
"Now we're in their environment in a way," which Davis says is helpful.
For example, let's say a patient with diabetes and joint problems walks up the stairs slowly and unsteadily to get a thermometer.
"I can see in the video the amount of time and effort it takes her to climb that set of stairs," she says. "Whereas in my office, I'm cognizant of her joint problem, but I don't see her climbing stairs."
Around the U.S., 1,400 health center organizations across 14,000 locations in rural and urban areas serve more than 29 million people, most of whom are low income, are uninsured or on Medicaid and Medicare, or are immigrants, according to the National Association of Community Health Centers. Almost 2,000 sites have shut down since the pandemic hit.
"Financially, these centers are getting a blow in this pandemic," says Dr. Ron Yee, chief medical officer for the National Association of Community Health Centers.
"When you cut your visits by half, that's going to change your revenue, even though you may make up for it a little bit with virtual visits," Yee says.
Enlarge this image toggle caption Juan Gallegos Juan Gallegos
Virtual visits don't get reimbursed at the same rate as regular in-person visits. For example, he says, an online visit is currently being reimbursed at between $13 and $93, while community health centers receive between $100 and $150 in reimbursement for an in-person appointment.
But it's not only the coronavirus crisis that concerns Yee. Community health centers operate on short-term funding, and it expires on Nov. 30, unless Congress acts.
"I'm very worried about the future of our centers," Yee says.
And doctors and nurses are struggling in this crisis.
"Right now health centers are projected to lose about $7.6 billion between April and September to get through this, to stay whole so that we can be up and running when we get through this pandemic," he says, adding that this projection is based on a 60% decline in visits systemwide.
Community health centers are playing a vital role in this pandemic. As of May 1, more than 300,000 patients had been tested for the coronavirus.
In California, a large number of patients at community health centers are recent immigrants, says Dr. Edgar Chavez, who serves as medical director at Universal Community Health Center, a cluster of three centers in South Los Angeles.
Politics Rule Would Penalize Immigrants To U.S. For Needing Benefits Rule Would Penalize Immigrants To U.S. For Needing Benefits Listen · 8:11 8:11
Chavez says patients fear that being tested for the coronavirus will land them on a list to be deported. This mistrust of the government and reluctance to seek medical care stem from the Trump administration's public charge rule, Chavez says.
Chaves is working virtually, and his staff is calling patients and checking in on them for depression and anxiety as well as to see if they need to be tested for anything.
"Telehealth can only go so far with chronic care. You still need that lab data point," he says with a sigh. "We are going to have a lot of people that go without Pap smears, go without mammograms, go without all these different things that we use to improve and maintain their health."
Chavez says he worries about the health of his patients.
"People aren't eating well. They are not exercising, and they are anxious," he says. "I fear that we are going to be hit with a huge wave of uncontrolled patients with chronic care-related conditions, especially diabetes, hypertension and heart disease."
Chavez's voice trails off.
"It is very tough," he says. "We're doing the best that we can, but we're going to be facing a pretty, pretty tough situation."
The need was already massive before this public health crisis hit and it will get worse after the pandemic is over, health care providers say.