npr--2020-05-02--'A Monumental Undertaking': NYC Subway To Disinfect Every Train Each Night

' A Monumental Undertaking ' : NYC Subway To Disinfect Every Train Each Night At a news conference Saturday , Gov .
Andrew Cuomo was not about to understate the scale of the effort to disinfect the New York City subway system .
`` This is such a monumental undertaking , I ca n't even begin to describe it to you , '' Cuomo said during his briefing at a Metropolitan Transportation Authority facility in Queens .
`` The New York City subway system has never been closed .
It operates 24 hours a day because we have a 24-hour @ @ @ @ @ @ @ — for cleanup aimed at fighting the spread of the coronavirus , from 1 to 5 a.m. each day beginning Wednesday .
Cuomo announced the `` unprecedented step '' on Thursday , which will also include cleanings for buses throughout the public transit system every day .
And on Saturday , he made clear the project — which is closing all 472 stations throughout the system for that four-hour spell — will be comprehensive .
`` The MTA is going to literally disinfect every train , '' he told reporters .
`` It @ @ @ @ @ @ @ People have to wear hazmat suits .
They have a number of chemicals that disinfect , but literally , you have to go through the whole train with a misting device , with a spray disinfectant literally on every surface . ''
New York , the epicenter of the outbreak in the United States , has lately seen glimmers of hope — with the number of new infections each day tapering and signs of progress in the number of hospitalizations statewide .
The death toll remains `` obnoxiously and terrifyingly high , '' @ @ @ @ @ @ @ 299 people across the state died in the past day — a slight uptick over the death toll of 289 reported one day prior .
The stay-at-home order instituted by New York has helped sink subway ridership on the order of 90 % .
At the same time , the change has exposed the number of people experiencing homelessness who seek refuge in train cars .
Passengers will be forced to leave the cars and the stations during the cleaning periods .
`` Mental health services , substance abuse [ therapy ] , @ @ @ @ @ @ @ should provide that , '' Cuomo said , casting the operation as an opportunity to connect those in need with the city 's services .
`` The notion of , 'Well , you should let everyone sleep on the train and just stay on the train , the homeless , because that 's good for them ' — it 's not good for them .
We owe them more and we owe them better . ''
The governor also pushed back against critics of New York 's coronavirus lockdown , some of whom @ @ @ @ @ @ @ large gatherings by organizing demonstrations to urge lifting the restrictions .
`` I understand the First Amendment : You have an argument , you want to make your argument , God bless America .
You want to jeopardize your health , God bless you ; you have no right to jeopardize my health , '' he said , noting that he was encouraging law enforcement to enforce an order requiring the use of masks in public across the state .
`` I believe it should be enforced because it 's reckless , it @ @ @ @ @ @ @ `` and it 's not about your life — it 's about other people 's lives .
And you do n't have a right to do that . ''

'A Monumental Undertaking': NYC Subway To Disinfect Every Train Each Night
Enlarge this image toggle caption Kevin P. Coughlin/AP Kevin P. Coughlin/AP
At a news conference Saturday, Gov. Andrew Cuomo was not about to understate the scale of the effort to disinfect the New York City subway system.
"This is such a monumental undertaking, I can't even begin to describe it to you," Cuomo said during his briefing at a Metropolitan Transportation Authority facility in Queens. "The New York City subway system has never been closed. It operates 24 hours a day because we have a 24-hour city."
It will close nevertheless — for cleanup aimed at fighting the spread of the coronavirus, from 1 to 5 a.m. each day beginning Wednesday. Cuomo announced the "unprecedented step" on Thursday, which will also include cleanings for buses throughout the public transit system every day. And on Saturday, he made clear the project — which is closing all 472 stations throughout the system for that four-hour spell — will be comprehensive.
"The MTA is going to literally disinfect every train," he told reporters. "It's smart. It's labor-intensive. People have to wear hazmat suits. They have a number of chemicals that disinfect, but literally, you have to go through the whole train with a misting device, with a spray disinfectant literally on every surface."
New York, the epicenter of the outbreak in the United States, has lately seen glimmers of hope — with the number of new infections each day tapering and signs of progress in the number of hospitalizations statewide. The death toll remains "obnoxiously and terrifyingly high," Cuomo said, explaining that at least 299 people across the state died in the past day — a slight uptick over the death toll of 289 reported one day prior.
Enlarge this image toggle caption Angela Weiss/AFP via Getty Images Angela Weiss/AFP via Getty Images
The stay-at-home order instituted by New York has helped sink subway ridership on the order of 90%. At the same time, the change has exposed the number of people experiencing homelessness who seek refuge in train cars. Passengers will be forced to leave the cars and the stations during the cleaning periods.
"Mental health services, substance abuse [therapy], job training, etc. — we should provide that," Cuomo said, casting the operation as an opportunity to connect those in need with the city's services. "The notion of, 'Well, you should let everyone sleep on the train and just stay on the train, the homeless, because that's good for them' — it's not good for them. We owe them more and we owe them better."
The governor also pushed back against critics of New York's coronavirus lockdown, some of whom have flouted the state's ban on large gatherings by organizing demonstrations to urge lifting the restrictions.
"I understand the First Amendment: You have an argument, you want to make your argument, God bless America. You want to jeopardize your health, God bless you; you have no right to jeopardize my health," he said, noting that he was encouraging law enforcement to enforce an order requiring the use of masks in public across the state.
"I believe it should be enforced because it's reckless, it's irresponsible," he added, "and it's not about your life — it's about other people's lives. And you don't have a right to do that."


npr--2020-05-02--Adults In Spain Get A Bit Of Sunshine As Coronavirus Lockdown Partially Lifts

Adults In Spain Get A Bit Of Sunshine As Coronavirus Lockdown Partially Lifts After waiting out a seven-week coronavirus lockdown and some of the strictest social distancing measures in Western Europe , adults in Spain are being allowed out to play at last .
On Saturday , six days after Spanish children got the chance to exercise outside , authorities offered their counterparts above the age of 14 the opportunity to do the same for the first time since mid-March .
Many across the country enjoyed a balmy spring day , putting on running shoes , breaking out bicycles or @ @ @ @ @ @ @ out for a walk after the national government in Madrid lifted its ban on nonessential outdoor activities .
`` I have been looking forward to this for weeks .
I was joking with my friends that I would be the first out in Madrid , '' one woman out for a jog in Madrid told Reuters on Saturday .
`` I am very happy to be out after six weeks of yoga videos . ''
Spain has so far suffered one of Europe 's worst outbreaks , according to data compiled by Johns @ @ @ @ @ @ @ confirmed cases of the coronavirus and a death toll of more than 24,500 linked to COVID-19 , as of late Saturday afternoon .
In a desperate attempt to slow the spread of the disease , Spanish authorities declared a state of emergency as of March 14 , threatening fines of more than $ 1,000 for anyone who left their home for any activity but those deemed essential , such as visits to the market or pharmacy .
The rules have proven effective , as the number of new cases reported each day in @ @ @ @ @ @ @ the COVID-19 fatality rate has recently fallen .
But they have also chafed at a population increasingly desperate for outdoor activity .
By last Sunday , under pressure from parents and pediatricians , authorities had relented on their blanket ban on children under 14 leaving the house .
Lawmakers partially lifted the ban as part of legislation extending the state of emergency through May 10 .
Now , the freedom to leave one 's home for exercise is staggered : Children have from noon to 7 p.m. and adults from 6 to 10 @ @ @ @ @ @ @ while vulnerable adults and the elderly have their own hours set aside between those windows .
Spain is just one of several European nations to begin gingerly easing the lockdowns that lowered much across the continent last month .
Germany is reopening playgrounds , churches and museums Monday , while British Prime Minister Boris Johnson — a recovered COVID-19 patient himself — has said the United Kingdom is `` past the peak '' of its coronavirus outbreak , promising a timeline next week for cautiously reopening the country .

Adults In Spain Get A Bit Of Sunshine As Coronavirus Lockdown Partially Lifts
Enlarge this image toggle caption Emilio Morenatti/AP Emilio Morenatti/AP
After waiting out a seven-week coronavirus lockdown and some of the strictest social distancing measures in Western Europe, adults in Spain are being allowed out to play at last. On Saturday, six days after Spanish children got the chance to exercise outside, authorities offered their counterparts above the age of 14 the opportunity to do the same for the first time since mid-March.
Many across the country enjoyed a balmy spring day, putting on running shoes, breaking out bicycles or simply slipping on a mask and heading out for a walk after the national government in Madrid lifted its ban on nonessential outdoor activities.
"I have been looking forward to this for weeks. I was joking with my friends that I would be the first out in Madrid," one woman out for a jog in Madrid told Reuters on Saturday. "I am very happy to be out after six weeks of yoga videos."
Spain has so far suffered one of Europe's worst outbreaks, according to data compiled by Johns Hopkins University, with more than 213,000 confirmed cases of the coronavirus and a death toll of more than 24,500 linked to COVID-19, as of late Saturday afternoon. In a desperate attempt to slow the spread of the disease, Spanish authorities declared a state of emergency as of March 14, threatening fines of more than $1,000 for anyone who left their home for any activity but those deemed essential, such as visits to the market or pharmacy.
The rules have proven effective, as the number of new cases reported each day in the country has begun to taper and the COVID-19 fatality rate has recently fallen. But they have also chafed at a population increasingly desperate for outdoor activity. By last Sunday, under pressure from parents and pediatricians, authorities had relented on their blanket ban on children under 14 leaving the house. Lawmakers partially lifted the ban as part of legislation extending the state of emergency through May 10.
Now, the freedom to leave one's home for exercise is staggered: Children have from noon to 7 p.m. and adults from 6 to 10 a.m. and 8 to 11 p.m., while vulnerable adults and the elderly have their own hours set aside between those windows.
Spain is just one of several European nations to begin gingerly easing the lockdowns that lowered much across the continent last month. Germany is reopening playgrounds, churches and museums Monday, while British Prime Minister Boris Johnson — a recovered COVID-19 patient himself — has said the United Kingdom is "past the peak" of its coronavirus outbreak, promising a timeline next week for cautiously reopening the country.


npr--2020-05-02--Gilead Lobbying Rose As Interest In COVID-19 Treatment Climbed

Gilead Sciences , the drugmaker behind the experimental COVID-19 treatment remdesivir , spent more on lobbying Congress and the administration in the first quarter of 2020 than it ever has before , according to federal filings .
The pharmaceutical company spent $ 2.45 million on lobbying in the first three months of the year , a 32 % increase over the $ 1.86 million it spent in the first quarter of 2019 .
The first quarter is also when Congress drafted and passed the Coronavirus Aid , Relief and Economic Security Act , which contained numerous provisions affecting the pharmaceutical @ @ @ @ @ @ @ of vaccines and treatments in response to the pandemic .
Early drafts of the legislation included a provision stipulating that COVID-19 vaccines , drugs and tests be affordable if they were developed with taxpayer funds .
But the final bill included additional language that undercut that requirement .
The lobbying spike also coincided with Gilead 's ramping up clinical testing of remdesivir , an antiviral drug that has become the most closely watched COVID-19 treatment under development .
On Friday , the Food and Drug Administration authorized the emergency use of remdesivir for @ @ @ @ @ @ @ .
The move would make it easier for patients to receive the intravenous medicine .
But the remdesivir supply is limited and Gilead said the U.S. government will coordinate its distribution to hospitals in cities most affected by COVID-19 .
The agency 's decision came two days after results from two significant remdesivir trials became public .
`` The data shows that remdisivir has a clear-cut , significant , positive effect in diminishing the time to recovery '' from COVID-19 , said Anthony Fauci , director of the National Institute for Allergy and @ @ @ @ @ @ @ institute sponsored .
He said the drug would become `` the standard of care . ''
The same day , however , a study by Chinese researchers published in The Lancet found remdesivir did n't do better than a placebo when treating seriously ill COVID-19 patients on such measures as survival and time to clinical improvement .
Gilead says its lobbying expenditures increased sharply last quarter because in 2019 , the company joined the trade group PhRMA , or the Pharmaceutical Research and Manufacturers of America .
A portion of annual membership dues @ @ @ @ @ @ @ added to first quarter lobbying disclosures , and this is the first year Gilead is paying dues for the full year , said company spokesman Chris Ridley .
He said `` nearly all '' of the additional $ 590,000 over its first quarter 2019 lobbying went toward PhRMA dues .
PhRMA declined to comment on this statement .
PhRMA is considered one of the most influential trade groups on Capitol Hill , sending 183 lobbyists to advocates on the industry 's behalf last year as Congress debated drug price bills that eventually stalled @ @ @ @ @ @ @ Politics , a nonprofit that tracks campaign finance and lobbying .
And the trade group 's members spent even more .
`` They see dollar signs ahead and they do n't want the federal government to get in their way , '' says Ben Wakana , executive director of Patients for Affordable Drugs , an advocacy group .
He said that he suspects Gilead is laying the groundwork to push back against congressional attempts to control the prices of COVID-19 drugs .
Rep. Jan Schakowsky , D-Ill. , says Gilead 's track record @ @ @ @ @ @ @ priced out of reach if the Food and Drug Administration clears the way for it to be used for COVID-19 .
`` We have seen one after another of these drugs come on the market , which are fantastic , and except that they end up being out of reach for most consumers , '' she said in an interview with NPR .
`` We can not tolerate as human beings , as Americans , for this to be an opportunity now for price gouging . ''
Gilead 's pricing of past drugs @ @ @ @ @ @ @ its hepatitis C cure in 2013 , the cost was $ 1,000 a pill .
And the company is in a legal battle with the federal government over patents for Truvada , an HIV medicine the FDA also approved for use in protecting people at high risk of infection .
Truvada has a list price of more than $ 22,000 a year , according to GoodRx , a website that helps patients get discounts on drugs .
The price has kept many patients from getting access to the drug , patient advocates say @ @ @ @ @ @ @ last year .
Gilead is donating the first 1.5 million doses of remdesivir , but the company has declined to say what remdesivir 's price might be after that .
During a conference call with investors on Thursday about first quarter earnings , analysts asked Gilead CEO Daniel O'Day whether they could expect similar returns on remdesivir as they 've seen with the company 's other products .
`` There is no rulebook out there , other than that we need to be very thoughtful about how we can make sure we provide @ @ @ @ @ @ @ the globe , '' he said on the call .
`` And do that in a sustainable way for the company , for ... shareholders , and we acknowledge that . ''
Taxpayers helped fund research for remdesivir and other potential vaccines and treatments , so Schakowsky added a line to the CARES Act to make sure drugmakers do n't set exorbitant prices .
`` The line in the bill essentially said that any drug that was made with any money from taxpayers would have to have reasonable pricing , '' she said @ @ @ @ @ @ @ problem arose when another line made its way into the final bill that undercut the pricing assurance .
It reads : `` The [ Health and Human Services ] Secretary shall not take actions that delay the development of such products . ''
During a House Committee on Energy and Commerce hearing in February , Schakowsky asked Health and Human Services Secretary Alex Azar to promise that coronavirus treatments would be affordable for everyone .
He declined , and told her , `` We ca n't control that price because we need the @ @ @ @ @ @ @ is a former executive of pharmaceutical company Eli Lilly & Co. '' It seems to me then that we are in a hostage situation if that 's the view of the federal government and the people in charge , '' Schakowsky said .
`` If this is what they want to extract from consumers in order to cure it , it 's immoral .
And it will end in a lot of deaths because people wo n't be able to afford their drugs . ''
Both Gilead and PhRMA declined to say whether @ @ @ @ @ @ @ that barred HHS from doing anything that would delay product development .
As for pricing of COVID-19 treatments , the company and the trade group say they 're mindful of concerns .
`` We 've publicly committed that , should remdesivir be proven safe and effective , we are committed to making the medicine both accessible and affordable to governments and patients around the world , '' Gilead 's Ridley wrote in an email .
`` Our industry is working around the clock to develop treatments and vaccines to address the COVID-19 public @ @ @ @ @ @ @ , '' PhRMA spokeswoman Holly Campbell wrote in an email .
`` The industry 's priority continues to be making sure patients have access to safe , effective and affordable therapies . ''
Pharmaceutical and health product lobbying has grown over time , hitting nearly $ 300 million in 2019 , according to the Center for Responsive Politics .
Spending can also be cyclical , depending on which bills are on the table , says Tim LaPira , an associate political science professor at James Madison University .
Companies may ramp up lobbying @ @ @ @ @ @ @ '' because of ongoing litigation or an upcoming merger , he says .
`` It makes sense for a company to temporarily ramp up their lobbying as part of their bigger effort to , you know , quell the backlash , '' LaPira says , adding that lobbying can also help streamline the regulatory process for a new product .
Gilead , AbbVie and Regneron are among the pharmaceutical companies that spent more on lobbying in the first quarter than they ever had in previous quarters , according to data from the Center @ @ @ @ @ @ @ They all are working on experimental COVID-19 treatments .
AbbVie 's HIV drug Kaletra is being studied in COVID-19 patients , and the company spent an additional $ 90,000 above its previous biggest lobbying quarter , for a total of $ 2.98 million in the most recent quarter .
AbbVie did not respond to NPR 's request for comment .
Similar studies are also underway for Regeneron 's arthritis drug Kevzara .
The company , which is also working on antibody-based treatments , spent $ 370,000 on lobbying in the first quarter , @ @ @ @ @ @ @ last quarter of 2019 , its previous highest quarter .
`` Our lobbying spend in Q1'20 increased slightly over the prior quarter due in part to increased interactions with various government agencies around the COVID-19 pandemic and our work to develop a treatment/preventative approach , '' Regeneron spokeswoman Alexandra Bowie wrote in an email .
`` In terms of pricing , we are working hard to beat COVID-19 and make treatments that are affordable and accessible . ''

Gilead Lobbying Rose As Interest In COVID-19 Treatment Climbed
Enlarge this image toggle caption Andrew Harnik/AP Andrew Harnik/AP
Gilead Sciences, the drugmaker behind the experimental COVID-19 treatment remdesivir, spent more on lobbying Congress and the administration in the first quarter of 2020 than it ever has before, according to federal filings.
The pharmaceutical company spent $2.45 million on lobbying in the first three months of the year, a 32% increase over the $1.86 million it spent in the first quarter of 2019.
The first quarter is also when Congress drafted and passed the Coronavirus Aid, Relief and Economic Security Act, which contained numerous provisions affecting the pharmaceutical industry, including funding for the development of vaccines and treatments in response to the pandemic.
Early drafts of the legislation included a provision stipulating that COVID-19 vaccines, drugs and tests be affordable if they were developed with taxpayer funds. But the final bill included additional language that undercut that requirement.
The lobbying spike also coincided with Gilead's ramping up clinical testing of remdesivir, an antiviral drug that has become the most closely watched COVID-19 treatment under development.
On Friday, the Food and Drug Administration authorized the emergency use of remdesivir for patients hospitalized with severe cases of COVID-19. The move would make it easier for patients to receive the intravenous medicine. But the remdesivir supply is limited and Gilead said the U.S. government will coordinate its distribution to hospitals in cities most affected by COVID-19.
The agency's decision came two days after results from two significant remdesivir trials became public.
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"The data shows that remdisivir has a clear-cut, significant, positive effect in diminishing the time to recovery'' from COVID-19, said Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, about a study his institute sponsored. He said the drug would become "the standard of care."
The same day, however, a study by Chinese researchers published in The Lancet found remdesivir didn't do better than a placebo when treating seriously ill COVID-19 patients on such measures as survival and time to clinical improvement.
Gilead says its lobbying expenditures increased sharply last quarter because in 2019, the company joined the trade group PhRMA, or the Pharmaceutical Research and Manufacturers of America.
A portion of annual membership dues expected to go toward lobbying is typically added to first quarter lobbying disclosures, and this is the first year Gilead is paying dues for the full year, said company spokesman Chris Ridley. He said "nearly all" of the additional $590,000 over its first quarter 2019 lobbying went toward PhRMA dues. PhRMA declined to comment on this statement.
PhRMA is considered one of the most influential trade groups on Capitol Hill, sending 183 lobbyists to advocates on the industry's behalf last year as Congress debated drug price bills that eventually stalled, according to the Center for Responsive Politics, a nonprofit that tracks campaign finance and lobbying. And the trade group's members spent even more.
"They see dollar signs ahead and they don't want the federal government to get in their way," says Ben Wakana, executive director of Patients for Affordable Drugs, an advocacy group. He said that he suspects Gilead is laying the groundwork to push back against congressional attempts to control the prices of COVID-19 drugs.
Rep. Jan Schakowsky, D-Ill., says Gilead's track record makes her worry that remdesivir could be priced out of reach if the Food and Drug Administration clears the way for it to be used for COVID-19.
"We have seen one after another of these drugs come on the market, which are fantastic, and except that they end up being out of reach for most consumers," she said in an interview with NPR. "We cannot tolerate as human beings, as Americans, for this to be an opportunity now for price gouging."
Gilead's pricing of past drugs has drawn criticism. When it launched its hepatitis C cure in 2013, the cost was $1,000 a pill.
And the company is in a legal battle with the federal government over patents for Truvada, an HIV medicine the FDA also approved for use in protecting people at high risk of infection.
Truvada has a list price of more than $22,000 a year, according to GoodRx, a website that helps patients get discounts on drugs. The price has kept many patients from getting access to the drug, patient advocates say. The issue prompted a congressional hearing last year.
Gilead is donating the first 1.5 million doses of remdesivir, but the company has declined to say what remdesivir's price might be after that. During a conference call with investors on Thursday about first quarter earnings, analysts asked Gilead CEO Daniel O'Day whether they could expect similar returns on remdesivir as they've seen with the company's other products.
"There is no rulebook out there, other than that we need to be very thoughtful about how we can make sure we provide access of our medicines to patients around the globe," he said on the call. "And do that in a sustainable way for the company, for ... shareholders, and we acknowledge that."
Taxpayers helped fund research for remdesivir and other potential vaccines and treatments, so Schakowsky added a line to the CARES Act to make sure drugmakers don't set exorbitant prices.
"The line in the bill essentially said that any drug that was made with any money from taxpayers would have to have reasonable pricing," she said. But, she added, a problem arose when another line made its way into the final bill that undercut the pricing assurance. It reads: "The [Health and Human Services] Secretary shall not take actions that delay the development of such products."
During a House Committee on Energy and Commerce hearing in February, Schakowsky asked Health and Human Services Secretary Alex Azar to promise that coronavirus treatments would be affordable for everyone. He declined, and told her, "We can't control that price because we need the private sector to invest." Azar is a former executive of pharmaceutical company Eli Lilly & Co.
"It seems to me then that we are in a hostage situation if that's the view of the federal government and the people in charge," Schakowsky said. "If this is what they want to extract from consumers in order to cure it, it's immoral. And it will end in a lot of deaths because people won't be able to afford their drugs."
Both Gilead and PhRMA declined to say whether they pushed for the CARES Act wording that barred HHS from doing anything that would delay product development.
As for pricing of COVID-19 treatments, the company and the trade group say they're mindful of concerns.
"We've publicly committed that, should remdesivir be proven safe and effective, we are committed to making the medicine both accessible and affordable to governments and patients around the world," Gilead's Ridley wrote in an email.
PhRMA expressed similar sentiments.
"Our industry is working around the clock to develop treatments and vaccines to address the COVID-19 public health crisis and save patients' lives," PhRMA spokeswoman Holly Campbell wrote in an email. "The industry's priority continues to be making sure patients have access to safe, effective and affordable therapies."
Pharmaceutical and health product lobbying has grown over time, hitting nearly $300 million in 2019, according to the Center for Responsive Politics. Spending can also be cyclical, depending on which bills are on the table, says Tim LaPira, an associate political science professor at James Madison University.
Companies may ramp up lobbying to put on a "charm offensive" because of ongoing litigation or an upcoming merger, he says.
"It makes sense for a company to temporarily ramp up their lobbying as part of their bigger effort to, you know, quell the backlash," LaPira says, adding that lobbying can also help streamline the regulatory process for a new product.
Gilead, AbbVie and Regneron are among the pharmaceutical companies that spent more on lobbying in the first quarter than they ever had in previous quarters, according to data from the Center for Responsive Politics compiled for NPR. They all are working on experimental COVID-19 treatments.
AbbVie's HIV drug Kaletra is being studied in COVID-19 patients, and the company spent an additional $90,000 above its previous biggest lobbying quarter, for a total of $2.98 million in the most recent quarter. AbbVie did not respond to NPR's request for comment.
Similar studies are also underway for Regeneron's arthritis drug Kevzara. The company, which is also working on antibody-based treatments, spent $370,000 on lobbying in the first quarter, which is $30,000 higher than the last quarter of 2019, its previous highest quarter.
"Our lobbying spend in Q1'20 increased slightly over the prior quarter due in part to increased interactions with various government agencies around the COVID-19 pandemic and our work to develop a treatment/preventative approach," Regeneron spokeswoman Alexandra Bowie wrote in an email. "In terms of pricing, we are working hard to beat COVID-19 and make treatments that are affordable and accessible."


npr--2020-05-02--Coronavirus World Map: Tracking The Spread Of The Outbreak

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

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


npr--2020-05-02--Tracking The Pandemic: How Quickly Is The Coronavirus Spreading State By State?

Tracking The Pandemic : How Quickly Is The Coronavirus Spreading State By State ?
Since the first coronavirus case was confirmed in the United States on Jan. 21 , over one million people in the U.S. have confirmed cases of COVID-19 .
On April 12 , the U.S. became the nation with the most deaths globally , but there are early signs that the U.S. case and death counts may be leveling off , as the growth of new cases and deaths plateaus .
The pattern is n't consistent across the country , as new hot spots emerge and others @ @ @ @ @ @ @ state 's case count is growing , click here .
Click here to see a global map of confirmed cases and deaths .
In response to mounting cases , state and federal authorities have emphasized a social distancing strategy , widely seen as the best available means to slow the spread of the virus .
Most states have put in place measures such as closing schools and nonessential businesses and ordering citizens to stay home as much as possible .
It 's not clear how long such measures need to be in place @ @ @ @ @ @ @ Wuhan , the city in China where the virus originated , a strictly enforced lockdown and widespread testing have slowed the outbreak dramatically , enough to bring an end to the 76-day lockdown .
A large portion of U.S. cases are centered on New York City .
Since March 20 , New York state , Connecticut and New Jersey have accounted for around 50 % of all U.S. cases .
As of April 9 , nearly 60 % of all deaths from COVID-19 have been in these three states .
While New York @ @ @ @ @ @ @ , as seen below , it notched between 8,000 and 10,000 new cases each day between March 31 and April 12 .
To understand how one state 's outbreak compares with another 's , it 's helpful to look at not just the daily counts but the rate of change day over day .
In the following chart , we display cases on a logarithmic scale , meaning that every axis line is 10 times greater than the previous one .
This type of scale emphasizes the rate of change .
When case @ @ @ @ @ @ @ 's curve trends sharply upward , as New York 's does over the first 15 days past 100 cases .
Generally , this is evidence of unbridled community transmission of the disease .
As new cases slow , the curve bends toward horizontal , showing that the state 's outbreak may be leveling off .
This does n't mean the number of cases has stopped growing , but the rate of growth has slowed , which could signify that social distancing measures are having an effect .
In some areas , there are @ @ @ @ @ @ @ the earliest outbreaks — such as California and Washington — seem to be having success at suppressing the disease .
The outlook in Washington has improved to the point that the state has returned unused Army hospital beds it had received in preparation for a peak in cases .
Elsewhere , limited access to testing may make the number of cases look smaller than it really is .
As testing becomes more readily available , we are likely to see the number of confirmed cases continue to grow , even if not at @ @ @ @ @ @ @ used here are compiled by the Center for Systems Science and Engineering at Johns Hopkins University from several sources , including the Centers for Disease Control and Prevention ; the World Health Organization ; national , state and local government health departments ; 1point3acres ; and local media reports .
The JHU team automates its data uploads and regularly checks them for anomalies .
State-by-state testing and hospitalization data are still being assessed for reliability .
State-by-state recovery data are unavailable at this time .
There may be discrepancies between what you see @ @ @ @ @ @ @ local health department 's website .
Stephanie Adeline , Alyson Hurt , Connie Hanzhang Jin , Ruth Talbot and Thomas Wilburn contributed to this story .

Tracking the coronavirus around the U.S.: See how your state is doing
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Note: This page was last updated on Feb. 1, 2023. It will no longer be updated. For current data on COVID cases and deaths, demographics, and hospitalizations, consult the Centers for Disease Control and Prevention.
As of Feb. 1, there have been more than 101 million confirmed coronavirus infections in the U.S. and more than 1 million people have died of COVID-19. In the graphics below, explore the trends in your state.
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The above charts show average new cases per 100,000 people for each state over the last 12 months.
Note: Actual cases may be substantially higher, since many who test positive with at-home tests don't report their cases.
For additional data about COVID-19 in the U.S, including cases and deaths, demographics, and hospitalizations, consult the Centers for Disease Control and Prevention website.
To show trends, the table below shows the change in average new cases per day in each state, week over week for the last 28 days. States marked in shades of red have growing outbreaks; those in shades of green, are declining.
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Methodology
The graphics on this page pull from data compiled by the Center for Systems Science and Engineering at Johns Hopkins University from several sources, including the Centers for Disease Control and Prevention; the World Health Organization; national, state and local government health departments; 1point3acres; and local media reports.
The JHU team automates its data uploads and regularly checks them for anomalies. This may result in occasional data discrepancies on this page as the JHU team resolves anomalies and updates its feeds. There may be discrepancies between what you see here and what you see on your local health department's website. Figures shown do not include cases on cruise ships.
Fluctuations in the numbers may happen as health authorities review old cases, process testing backlogs or update their methodologies. The JHU team maintains a list of such changes.
This story was originally published on March 16, 2020. Elena Renken was a co-author on that version. Sean McMinn and Audrey Carlsen contributed to this story. Carmel Wroth edited this story.


npr--2020-05-02--As Coronavirus Restrictions Ease, Many Still Wary

As Coronavirus Restrictions Ease , Many Still Wary As states around the country begin lifting stay-at-home orders , individuals face their own choice over whether it feels safe to resume activities we all used to take for granted .
We asked NPR listeners to tell us how they are making these decisions and nearly 250 people responded .
In general , it 's clear that even as local officials lift restrictions , many people plan to wait longer before resuming their old routines .
`` As long as there are new cases , I think it 's not really safe @ @ @ @ @ @ @ freelance graphic designer and graduate student in Grand Rapids , Mich. Michigan Gov .
Gretchen Whitmer extended her `` Stay Home , Stay Safe '' order through May 15 , with some changes .
For example golfing and boating are allowed now .
But Silas says even going to a park with her 8-year-old son does n't feel comfortable yet .
`` Because there 's just too many people and you can never be too sure .
I think especially when the weather is really nice here in Michigan , people get kind @ @ @ @ @ @ @ Montana Gov .
Steve Bullock 's stay-at-home order expired this past week .
Businesses can open if they follow physical distancing and other guidelines .
Still , on the Fort Belknap Indian Reservation , Camille Stein is taking more precautions than Montana recommends .
That means more hours at home with her three daughters , who typically are busy with sports .
Stein plans to maintain restrictions for a few weeks and monitor the number of COVID-19 cases .
She 's also still deciding what to do this summer when her daughters usually @ @ @ @ @ @ @ 're looking at too [ that ] we 're nervous about .
Would we even want to send our kids to swimming ? ''
wonders Stein .
Some NPR listeners told us they have n't had the luxury of sheltering in place during the coronavirus pandemic .
Marnie Shale lives in Bloomington , Ind.
, and was stocking grocery shelves even as other businesses were closed .
`` People were not staying home from the grocery store , in fact it was extremely crowded .
So I was on my knees and people @ @ @ @ @ @ @ get things ...
So I thought well , I 'm not isolated to begin with , '' Shale says .
She 's also a nurse and plans to start a new job at a long-term care facility soon .
Without the ability to shelter in place , Shale says she looks forward to eating out in restaurants again .
The only things she 's not comfortable doing are long distance travel such as flying or taking a cruise .
In Georgia , Gov .
Brian Kemp was one of the last to issue @ @ @ @ @ @ @ first to reopen businesses , including nail and hair salons .
`` I was n't pleased with the decision to open us back up , '' says Regina Ellis , co-owner of Esuites , a salon in Albany .
Ellis says she knows people who have died from the coronavirus .
While she 's sympathetic to workers who need to earn a living , she 's watching infection rates and plans to wait a few more weeks before going back to work herself .
`` They do n't want to come to the @ @ @ @ @ @ @ look good in a casket , '' she says .
The state of Arizona also is starting to lift restrictions on some retail businesses , though Gov .
Doug Ducey has extended social distancing guidelines through May 15 .
South of Phoenix in the city of Casa Grande , Episcopal Priest Dave Rickert says he 's sticking with online-only services for now .
`` I 'm going to go a couple Sundays , let my other parishes — my sister and brother parishes — kind of be guinea pigs , '' Rickert says @ @ @ @ @ @ @ services he 's thinking about changes , such as removing some pews to create more distance between people .
Across the country decisions governors make get a lot of attention .
But it 's clear that millions of individual decisions also will determine how quickly we all return to our normal routines .

As Coronavirus Restrictions Ease, Many Still Wary
Enlarge this image toggle caption Jeff Brady/NPR Jeff Brady/NPR
As states around the country begin lifting stay-at-home orders, individuals face their own choice over whether it feels safe to resume activities we all used to take for granted.
We asked NPR listeners to tell us how they are making these decisions and nearly 250 people responded.
In general, it's clear that even as local officials lift restrictions, many people plan to wait longer before resuming their old routines.
"As long as there are new cases, I think it's not really safe," says Naomi Silas, a freelance graphic designer and graduate student in Grand Rapids, Mich.
Michigan Gov. Gretchen Whitmer extended her "Stay Home, Stay Safe" order through May 15, with some changes. For example golfing and boating are allowed now. But Silas says even going to a park with her 8-year-old son doesn't feel comfortable yet.
"Because there's just too many people and you can never be too sure. I think especially when the weather is really nice here in Michigan, people get kind of careless," Silas says.
Montana Gov. Steve Bullock's stay-at-home order expired this past week. Businesses can open if they follow physical distancing and other guidelines.
Still, on the Fort Belknap Indian Reservation, Camille Stein is taking more precautions than Montana recommends. That means more hours at home with her three daughters, who typically are busy with sports.
Stein plans to maintain restrictions for a few weeks and monitor the number of COVID-19 cases. She's also still deciding what to do this summer when her daughters usually are swimming
"That's something we're looking at too [that] we're nervous about. Would we even want to send our kids to swimming?" wonders Stein.
Some NPR listeners told us they haven't had the luxury of sheltering in place during the coronavirus pandemic. Marnie Shale lives in Bloomington, Ind., and was stocking grocery shelves even as other businesses were closed.
"People were not staying home from the grocery store, in fact it was extremely crowded. So I was on my knees and people are above me, reaching over to get things... So I thought well, I'm not isolated to begin with," Shale says.
She's also a nurse and plans to start a new job at a long-term care facility soon. Without the ability to shelter in place, Shale says she looks forward to eating out in restaurants again. The only things she's not comfortable doing are long distance travel such as flying or taking a cruise.
In Georgia, Gov. Brian Kemp was one of the last to issue stay-at-home orders and he's among the first to reopen businesses, including nail and hair salons.
"I wasn't pleased with the decision to open us back up," says Regina Ellis, co-owner of Esuites, a salon in Albany.
Ellis says she knows people who have died from the coronavirus. While she's sympathetic to workers who need to earn a living, she's watching infection rates and plans to wait a few more weeks before going back to work herself.
Ellis says her customers understand.
"They don't want to come to the salon just to look good — to look good in a casket," she says.
The state of Arizona also is starting to lift restrictions on some retail businesses, though Gov. Doug Ducey has extended social distancing guidelines through May 15.
South of Phoenix in the city of Casa Grande, Episcopal Priest Dave Rickert says he's sticking with online-only services for now.
"I'm going to go a couple Sundays, let my other parishes — my sister and brother parishes — kind of be guinea pigs," Rickert says.
When it feels safe to resume services he's thinking about changes, such as removing some pews to create more distance between people.
Across the country decisions governors make get a lot of attention. But it's clear that millions of individual decisions also will determine how quickly we all return to our normal routines.


npr--2020-05-03--Gowns For Medical Staff, Made Of Same Material As Masks, In Short Supply

Gowns For Medical Staff , Made Of Same Material As Masks , In Short Supply Production of N95 masks has @ @ @ @ @ workers now say there 's a shortage of gowns as the two protective gears are @ @ @ @ @ .

Gowns For Medical Staff, Made Of Same Material As Masks, In Short Supply
Production of N95 masks has increased, but health care workers now say there's a shortage of gowns as the two protective gears are competing for the same materials.
LULU GARCIA-NAVARRO, HOST:
The scramble for N95 masks has become less intense for many hospitals because of increased production. However, there's an unintended consequence. Health care workers now say it's difficult to get disposable hospital gowns, the kind that protects them from bringing the coronavirus home. That's because both gowns and masks are competing for the same material. NPR's Cheryl Corley reports.
CHERYL CORLEY, BYLINE: There are two types of medical gowns that health care workers typically use. There are sterilized surgical gowns, and the others are called isolation gowns. Those gowns are made out of laminate non-woven fabric called SMS, and they are impenetrable, protecting medical workers and patients from any exchange of bodily fluids or bacteria.
CASSIE SAUER: They're just, like, physically garbage bags with arms.
CORLEY: Cassie Sauer, head of the Washington State Hospital Association, says that may be a bit of an exaggeration. But there are posts on social media which show photos of nurses - some in New York - wearing garbage bags over other protective gear. The Centers for Disease Control suggest different strategies hospitals can use to deal with shortages. So what many are doing, says Ngozi Ezike, the public health director in Illinois, is operating under what the CDC calls crisis care guidelines.
NGOZI EZIKE: Crisis care guidelines means that you might have to use tactics that you don't usually use to make sure that you extend the limited resources that may be available.
CORLEY: That means everything from sterilizing and reusing a gown, if possible, instead of throwing it away and using alternative material. That's where the garbage bags have come in. Paul Pater, an emergency room nurse at the University of Illinois Chicago Hospital, worries about cross-contamination, though, if reusing gowns is the solution.
PAUL PATER: That's one of the things that people don't really understand about a lot of these PPE items that we have - is that they're designed to be used once and for a short duration of time.
CORLEY: Cassie Sauer in Washington state says it's been challenging to find a supplier for gowns. But recently, the hospital association got a donation and was able to buy $100,000 worth from China.
SAUER: I find this a very surprising shortage. This feels like you get plastic sheeting you sew into a gown. It's not building a ventilator. This is something America should be producing right now for itself, I think.
CORLEY: But here's the problem, says Chaun Powell. He's a health care executive at Premier Inc. Isolation gowns, N95 masks and surgical masks are all made of the same raw material.
CHAUN POWELL: So regardless of whether or not we manufacture it or China manufactures - whether it be the raw materials or the finished goods, there simply isn't enough to meet the current demands.
CORLEY: Roland Thompson (ph) is the vice president of the North American branch of a Chinese investment firm in Hong Kong. He uses his contacts to help bring PPE to Washington state. He says when it comes to which product to produce - an N95 mask or an isolation gown - with the raw material that is available, manufacturers keep one straightforward observation in mind.
ROLAND THOMPSON: You can make dozens of masks with the same fabric that makes one gown.
CORLEY: And that's why isolation gowns instead of N95 masks are now the No. 1 concern of many hospitals across the country.
Cheryl Corley, NPR News, Chicago.
(SOUNDBITE OF FILA BRAZILLIA AND BERNARD MOSS'S "AIRLOCK HOMES")
Copyright © 2020 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.


npr--2020-05-03--Belgians Urged To Eat More Fries To Help Potato Farmers Amid Pandemic-Related Glut

Belgians Urged To Eat More Fries To Help Potato Farmers Amid Pandemic-Related Glut With restaurants closed in Belgium until at least June 8 due to the country 's COVID-19 lockdown , piles of potatoes that would have been deep-fried and topped with a glop of mayo have nowhere to go .
Some 750,000 tons of spuds intended for the free market which remain unsold — or those under contract but unable to be processed due to the glut — will only remain edible until the end of June .
Meanwhile , the price for such potatoes has plummeted .
The @ @ @ @ @ @ @ Belgapom , says the solution is beautifully simple : Eat more frites !
Romain Cools points to statistics showing Belgian households typically eat one serving of fries per week and suggests one more wo n't hurt consumers and will really help producers .
`` It will not damage your health if you leave something else a little bit greasy out of your meal , '' Cools counsels .
That will free up space in freezers , he says , all the way from large factories to supermarkets to home kitchens , and allow @ @ @ @ @ @ @ and at risk of rot — to go into processing .
Cools came up with the campaign to eat twice as many fries as he was giving an interview about the crisis in the industry last month .
The attention it 's received from around the world has surprised and amused him .
He 's pleased his advice seems to have spread widely , since Belgium is , by volume , the world 's largest exporter of frozen potato products .
The processed potato industry is worth more than $ 2 billion annually @ @ @ @ @ @ @ are n't only asking for help ; they 're also giving it .
In a new partnership between regional authorities and one industry leader , Pomuni , 25 tons of potatoes are being donated per week to area food banks to help make up for a COVID-related drop in donations .
Cools says Belgapom , which includes all Belgian processors , will team up with supermarkets in the coming weeks to get even more fries out of the freezers .

Belgians Urged To Eat More Fries To Help Potato Farmers Amid Pandemic-Related Glut
Enlarge this image toggle caption Teri Schultz for NPR Teri Schultz for NPR
With restaurants closed in Belgium until at least June 8 due to the country's COVID-19 lockdown, piles of potatoes that would have been deep-fried and topped with a glop of mayo have nowhere to go.
Some 750,000 tons of spuds intended for the free market that remain unsold — and those under contract but unable to be processed due to the glut — will only remain edible until the end of June. Meanwhile, the price for such potatoes has plummeted.
Enlarge this image toggle caption Teri Schultz for NPR Teri Schultz for NPR
The head of Belgium's potato processing association, Belgapom, says the solution is beautifully simple: Eat more frites!
Romain Cools points to statistics showing Belgian households typically eat one serving of fries per week and suggests one more won't hurt consumers and will really help producers.
"It will not damage your health if you leave something else a little bit greasy out of your meal," Cools counsels. That will free up space in freezers, he says, all the way from large factories to supermarkets to home kitchens, and allow more of the potatoes now harvested — and at risk of rot — to go into processing.
Cools came up with the campaign to eat twice as many fries as he was giving an interview about the crisis in the industry last month. The attention it's received from around the world has surprised and amused him. He's pleased his advice seems to have spread widely, since Belgium is, by volume, the world's largest exporter of frozen potato products. The processed potato industry is worth more than $2 billion annually in that country alone.
Potato producers aren't only asking for help; they're also giving it. In a new partnership between regional authorities and one industry leader, Pomuni, 25 tons of potatoes are being donated per week to area food banks to help make up for a COVID-related drop in donations.
Cools says Belgapom, which includes all Belgian processors, will team up with supermarkets in the coming weeks to get even more fries out of the freezers.


npr--2020-05-03--A Flying Photographer Looks Down On Earth In Awe And Sorrow

A Flying Photographer Looks Down On Earth In Awe And Sorrow He describes it as a `` leaf blower with a parachute overhead . ''
Strap in , and `` your body becomes the fuselage '' — and you are the pilot .
Your knees dangle into open air .
For 15 years , the contraption , called a motorized paraglider , has taken photographer George Steinmetz across 25 different countries .
From airport to airport , Steinmetz carried his personal aircraft , which could be disassembled and stashed in three bags , each weighing about 50 pounds , that @ @ @ @ @ @ @ Launching himself over remote swaths of desert , stark Arctic terrains and cheek-by-jowl shorelines , Steinmetz has documented , from the sky , the way human activity has shaped Earth .
The result is The Human Planet : Earth at the Dawn of the Anthropocene , a photographic record of our planet in the anthropocene age — a word that refers to the mark humans have made on the global landscape ( `` anthropos '' is Greek for human ) .
The accompanying text is by science writer Andrew Revkin .
NPR spoke @ @ @ @ @ @ @ to glide over some of the most isolated regions in the world — and about the overwhelming signs he saw of humanity 's footprint .
This interview has been edited for length and clarity .
What inspired you to begin working on The Human Planet ?
The book came out of a project I did for the New York Times Magazine .
They asked me to go and photograph climate change on all seven continents from the air .
And it made me think more globally than I tend to do , and @ @ @ @ @ @ @ I had in my coverage of the planet .
After that was done , I decided it would be interesting to go back through my archive and kind of reinterpret what I 've been seeing for the past 30 years , looking at our fragile planet in a different way .
You 'd been taking aerial photos for National Geographic as well .
I 've been working for National Geographic for over 30 years , and [ aerial photos ] were always the most fun and exciting part of the story .
I @ @ @ @ @ @ @ until finally , I wanted to do a story in the Sahara and realized I had to bring my own aircraft because there were no helicopters or planes to hire in these [ areas of ] Niger and Chad where I wanted to go .
I had to learn how to fly my own thing .
Could you tell us a bit about what it was like taking pictures aerially ?
It 's kind of personal because your body is the aircraft .
It is some physical risk to go and see the @ @ @ @ @ @ @ be fairly committed to taking the picture .
And that made it a much richer experience .
Now , I used drones a lot and drones are wonderful , but you do n't have the same physical commitment .
A lot of the work was done with a motorized paraglider , which is the world 's lightest and slowest motorized aircraft .
You run to take off and land .
It 's a very personal kind of aerial photography , [ because ] there 's no barrier between you and the outside .
@ @ @ @ @ @ @ knees getting in the picture .
I had a lot of unusual experiences flying in very rare places — like getting caught in sandstorms , some bad crashes .
You have a lot of really epic moments where you see things that no one 's ever seen before .
What were some of those epic moments ?
In the empty quarter of Saudi Arabia , [ I flew over ] the world 's largest sand sea .
It 's about the size of France , Belgium and Holland combined without a single permanent @ @ @ @ @ @ @ it 's [ practically ] just an endless field of orange sand dunes .
You feel like you 're hallucinating out there .
I also had a really amazing experience flying in the High Andes in the Altiplano of Bolivia .
There 's a salt lake there called the Salar de Uyuni , the world 's largest salt flat .
It 's very surreal , especially in the spring when the fringes of it are covered in water .
You feel like it 's like something out of a dream .
It 's @ @ @ @ @ @ @ before the coronavirus crisis , but I wonder if the pandemic has added any new layers of meaning to these photos ?
We are in a time when humans have become the dominant force in the land .
I think it 's time to reflect on what we 're all doing with our lives and maybe our place in the world .
And I think a book like this brings up a lot of questions .
What kind of world are we going to leave behind ?

A Flying Photographer Looks Down On Earth In Awe And Sorrow
Enlarge this image toggle caption George Steinmetz George Steinmetz
He describes it as a "leaf blower with a parachute overhead."
Strap in, and "your body becomes the fuselage" — and you are the pilot. Your knees dangle into open air.
For 15 years, the contraption, called a motorized paraglider, has taken photographer George Steinmetz across 25 different countries. From airport to airport, Steinmetz carried his personal aircraft, which could be disassembled and stashed in three bags, each weighing about 50 pounds, that he would proceed to check in.
toggle caption George Steinmetz
Launching himself over remote swaths of desert, stark Arctic terrains and cheek-by-jowl shorelines, Steinmetz has documented, from the sky, the way human activity has shaped Earth. The result is The Human Planet: Earth at the Dawn of the Anthropocene, a photographic record of our planet in the anthropocene age — a word that refers to the mark humans have made on the global landscape ("anthropos" is Greek for human). The accompanying text is by science writer Andrew Revkin.
NPR spoke to Steinmetz about what it was like to glide over some of the most isolated regions in the world — and about the overwhelming signs he saw of humanity's footprint.
This interview has been edited for length and clarity.
toggle caption George Steinmetz
What inspired you to begin working on The Human Planet?
The book came out of a project I did for the New York Times Magazine. They asked me to go and photograph climate change on all seven continents from the air. And it made me think more globally than I tend to do, and it filled in a lot of gaps I had in my coverage of the planet. After that was done, I decided it would be interesting to go back through my archive and kind of reinterpret what I've been seeing for the past 30 years, looking at our fragile planet in a different way.
toggle caption George Steinmetz
You'd been taking aerial photos for National Geographic as well.
I've been working for National Geographic for over 30 years, and [aerial photos] were always the most fun and exciting part of the story. I started doing that more and more, until finally, I wanted to do a story in the Sahara and realized I had to bring my own aircraft because there were no helicopters or planes to hire in these [areas of] Niger and Chad where I wanted to go. I had to learn how to fly my own thing.
toggle caption George Steinmetz
Could you tell us a bit about what it was like taking pictures aerially?
It's kind of personal because your body is the aircraft. It is some physical risk to go and see the world. You have to have to be fairly committed to taking the picture. And that made it a much richer experience. Now, I used drones a lot and drones are wonderful, but you don't have the same physical commitment.
A lot of the work was done with a motorized paraglider, which is the world's lightest and slowest motorized aircraft. You run to take off and land. It's a very personal kind of aerial photography, [because] there's no barrier between you and the outside.
You have to watch out for your knees getting in the picture.
I had a lot of unusual experiences flying in very rare places — like getting caught in sandstorms, some bad crashes. You have a lot of really epic moments where you see things that no one's ever seen before.
toggle caption George Steinmetz
What were some of those epic moments?
In the empty quarter of Saudi Arabia, [I flew over] the world's largest sand sea. It's about the size of France, Belgium and Holland combined without a single permanent point of water or habitation, and it's [practically] just an endless field of orange sand dunes. You feel like you're hallucinating out there. I also had a really amazing experience flying in the High Andes in the Altiplano of Bolivia. There's a salt lake there called the Salar de Uyuni, the world's largest salt flat. It's very surreal, especially in the spring when the fringes of it are covered in water. You feel like it's like something out of a dream. It's really beautiful.
You took these images before the coronavirus crisis, but I wonder if the pandemic has added any new layers of meaning to these photos?
We are in a time when humans have become the dominant force in the land. I think it's time to reflect on what we're all doing with our lives and maybe our place in the world. And I think a book like this brings up a lot of questions. What kind of world are we going to leave behind?


npr--2020-05-03--Singapore Was A Shining Star In COVID Control – Until It Wasn't

Singapore Was A Shining Star In COVID Control – Until It Wasn't Early on in the coronavirus pandemic , Singapore was praised as a shining example of how to handle the new virus .
The World Health Organization pointed out that Singapore 's aggressive contact tracing allowed the city-state to quickly identify and isolate any new cases .
It quickly shut down clusters of cases and kept most of its economy — and its schools — open .
Through the beginning of April Singapore had recorded fewer than 600 cases .
By the end of April the case count had @ @ @ @ @ @ @ all of Singapore under a strict lockdown , it has the most coronavirus cases in Southeast Asia .
The vast majority of these cases are in the overcrowded dormitories that house more than 300,000 of Singapore 's roughly one million foreign workers , — and the number of cases is expected to continue to rise in the coming weeks .
`` We have started our testing with the dormitories where there were a high number of cases detected , '' Singapore health minister Gan Kim Yong said in a virtual press briefing this @ @ @ @ @ @ @ April 7 in response to an uptick in cases in the general population — and then began to find a significant numbers of cases in the dorms .
Minister Gan says Singapore is now testing more than 3,000 migrant workers a day but hopes to expand that number .
The virus is spreading so rapidly in the dormitories , however , that the health department has n't been able to test all of the suspected cases .
`` For dormitories where the assessed risk of infection is extremely high , our efforts are @ @ @ @ @ @ @ even without a confirmed COVID 19 test , '' Gan says .
`` This allows us to quickly provide medical care to these patients . ''
Singapore is a small city-state with a population of just under 6 million inhabitants .
On a per capita basis it 's the second richest country in Asia .
But its economy relies heavily on young men from Bangladesh , India and other countries who work in construction and manufacturing jobs .
Singapore has no minimum wage for foreign or domestic employees .
The foreign workers ' @ @ @ @ @ @ @ 250 U.S. per month but a typical salary is $ 500 to $ 600 a month .
Speaking to the press , health minister Gan credited extensive screening in the dorms with finding many workers who are infected with SARS-CoV2 but did n't appear sick .
`` So far , the majority of the cases here have had relatively mild disease or no symptoms .
And they do not require extensive medical intervention , '' Gan said .
`` About 30 percent require closer medical observation due to the underlying health conditions or @ @ @ @ @ @ @ of this week , only a handful of the migrant workers — fewer than 2 dozen — were in hospital intensive care units .
The city is setting up thousands of what it calls `` community care beds '' in convention centers and other public buildings to isolate and treat coronavirus patients .
The hope is that most of the cases can be managed by medical staff in these temporary wards not in hospitals .
So far the city has 10,000 `` community care beds '' and plans to expand this to 20,000 @ @ @ @ @ @ @ that the migrant workers are now being infected , says Mohan Dutta , a professor at Massey University in New Zealand who has done research on these migrant laborers .
He says conditions in the dorms put the workers at significant risk of catching a respiratory disease like COVID-19 .
There are 12 to 20 bunk beds per room .
And even though some of the workers are deemed `` essential '' most are no longer allowed to leave the dormitory .
`` There is little room to move around , they have @ @ @ @ @ @ @ which really contributes to this sense of the rooms being unhygienic , '' says Dutta .
Dutta , who founded CARE , the Center for Culture-Centered Approach to Research & Evaluation , at the National University of Singapore in 2012 , with a focus on marginalized communities , has just published a paper on migrant workers in Singapore during this pandemic .
He says many of them told him they are concerned about whether they 'll get paid during lockdown ( the Singapore Ministry of Manpower insists they will ) and about the @ @ @ @ @ @ @ the dormitories .
Dutta says in many dormitories 100 workers share a block of 5 toilets and 5 shower stalls .
`` There is this sense of panic and fear and part of that is related to this sense of not being able to move outside of the room , '' he says .
`` Everyone is pretty much stuck in the room at such close proximity . ''
Singapore 's health ministry has moved aggressively to try to address the coronavirus outbreaks in their housing blocks .
The government is trying to @ @ @ @ @ @ @ hardest hit dorms but Dutta says it 's impossible to come up with safe , short-term lodging for more than 300,000 workers .
But he does believe there could be long-term changes that would help the workers .
And Dutta hopes this outbreak will force Singapore to examine how it treats this often overlooked population , bringing major changes in how foreign workers are housed and treated .
Meanwhile , the explosion of cases in Singapore over the last 3 weeks has remained primarily among foreign workers .
For example , on May @ @ @ @ @ @ @ among Singapore 's permanent residents and 905 new infections among the workers residing in the dorms .
Michael Merson , the head of the SingHealth Duke-NUS Global Health Institute in Singapore , says it 's unlikely the outbreaks in the dormitories will spill over to the rest of the city .
`` There 's very little mixing between the foreign workers and the rest of the population , '' Merson says .
He 's confident the Singapore health officials will be able to isolate the infected workers and give them , in his @ @ @ @ @ @ @ possible . ''
Nonetheless , the Singapore government has extended the lockdown for the entire city until at least June 1 .

Singapore Was A Shining Star In COVID-19 Control — Until It Wasn't
Enlarge this image toggle caption Ore Huiying/Getty Images Ore Huiying/Getty Images
Early on in the coronavirus pandemic, Singapore was praised as a shining example of how to handle the new virus. The World Health Organization pointed out that Singapore's aggressive contact tracing allowed the city-state to quickly identify and isolate any new cases. It quickly shut down clusters of cases and kept most of its economy — and its schools — open. Through the beginning of April, Singapore had recorded fewer than 600 cases.
By the end of April, however, the case count exceeded 17,000. And not only is all of Singapore now under a strict lockdown, but it has the most coronavirus cases in Southeast Asia.
The vast majority of these cases are in the overcrowded dormitories that house more than 300,000 of Singapore's roughly 1 million foreign workers — and the number of cases is expected to continue to rise in the coming weeks.
"We have started our testing with the dormitories where there were a high number of cases detected," Singapore's health minister, Gan Kim Yong, said in a virtual press briefing this week.
Singapore ordered a lockdown on April 7 in response to an uptick in cases in the general population — and then began to find a significant number of cases in the dorms.
Gan says Singapore is now testing more than 3,000 migrant workers a day but hopes to expand that number. The virus is spreading so rapidly in the dormitories, however, that the Health Ministry hasn't been able to test all of the suspected cases.
"For dormitories where the assessed risk of infection is extremely high, our efforts are focused on isolating those who are symptomatic even without a confirmed COVID-19 test," Gan says. "This allows us to quickly provide medical care to these patients."
Singapore is a small city-state with a population of just under 6 million inhabitants. On a per capita basis, it's the second-richest country in Asia.
But its economy relies heavily on young men from Bangladesh, India and other countries who work jobs in construction and manufacturing. Singapore has no minimum wage for foreign or domestic employees. The foreign workers' salaries can be as low as US$250 per month, but a typical salary is $500 to $600 a month.
Speaking to the media, Gan credited extensive screening in the dorms with finding many workers who are infected with SARS-CoV-2, the coronavirus that causes COVID-19, but who didn't appear sick.
"So far, the majority of the cases here have had relatively mild disease or no symptoms. And they do not require extensive medical intervention," Gan said. "About 30% require closer medical observation due to the underlying health conditions or because of old age."
As of this week, only a handful of the migrant workers — fewer than two dozen — were in intensive care units.
The city-state is setting up thousands of what it calls "community care beds" in convention centers and other public buildings to isolate and treat coronavirus patients. The hope is that most of the cases can be managed by medical staff in these temporary wards, rather than in hospitals. So far the city has 10,000 community care beds and plans to expand to 20,000 by mid-June.
It's no surprise that the migrant workers are now being infected, says Mohan Dutta, a professor at Massey University in New Zealand who has done research on these migrant laborers. He says conditions in the dorms put the workers at significant risk of catching a respiratory disease like COVID-19. There are 12 to 20 bunk beds per room.
And even though some of the workers are deemed "essential," most are no longer allowed to leave the dormitories. "There is little room to move around. They have little room to store their things, which really contributes to this sense of the rooms being unhygienic," says Dutta.
Dutta, who founded CARE, the Center for Culture-Centered Approach to Research and Evaluation, at the National University of Singapore in 2012, with a focus on marginalized communities, has just published a paper on migrant workers in Singapore during this pandemic.
He says many of them told him they are concerned about whether they'll get paid during the lockdown (Singapore's Ministry of Manpower insists they will) and about the overcrowding and lack of sanitation facilities in the dormitories.
Dutta says that in many dormitories, 100 workers share a block of five toilets and five shower stalls.
toggle caption Edgar Su/Reuters
"There is this sense of panic and fear, and part of that is related to this sense of not being able to move outside of the room," he says. "Everyone is pretty much stuck in the room at such close proximity."
Singapore's Health Ministry has moved aggressively to try to address the coronavirus outbreaks in the housing blocks. The government is trying to find alternative accommodations for people in the hardest-hit dorms, but Dutta says it's impossible to come up with safe, short-term lodging for more than 300,000 workers.
But he does believe there could be long-term changes that would help the workers. And Dutta hopes this outbreak will force Singapore to examine how it treats this often overlooked population, bringing major changes in how foreign workers are housed and treated.
Meanwhile, the explosion of cases in Singapore over the last three weeks has remained primarily among foreign workers. For example, on May 1 there were 11 new cases reported among Singapore's permanent residents and 905 new infections among the workers residing in the dorms.
Michael Merson, the head of the SingHealth Duke-NUS Global Health Institute in Singapore, says it's unlikely the outbreaks in the dormitories will spill over to the rest of the city.
"There's very little mixing between the foreign workers and the rest of the population," Merson says. He's confident that Singapore's health officials will be able to isolate the infected workers and give them, in his words, "the best medical care possible."
Nonetheless, the Singaporean government has extended the lockdown for the entire city-state until at least June 1.


npr--2020-05-03--From Puzzles To Plastic Straws: Merch Plays A Key Role In Trump's Fundraising

From Puzzles To Plastic Straws : Merch Plays A Key Role In Trump 's Fundraising At a time when jigsaw puzzles may be harder to come by than toilet paper , the hot new item in the Trump campaign online store is a 200-piece puzzle , featuring a faintly smiling President Trump standing in front of an American flag , giving two thumbs up .
The $ 35 puzzle is just the latest example of the campaign capitalizing on in-the-moment merchandise .
Interest in puzzles spiked with people spending much more time at home due to the coronavirus and in @ @ @ @ @ @ @ the trend .
Buying the Trump puzzle , or a Make America Great Again hat or T-shirt , is actually a campaign contribution .
And this merch is an important part of the Trump reelection campaign 's fundraising machine .
And that has n't changed with the pandemic .
The merchandise effort continued cranking , even as COVID-19 started grinding much of the American economy to a halt .
According to an NPR analysis of campaign finance reports , the Trump campaign and its affiliated committees spent more money in March on vendors @ @ @ @ @ @ @ 4.7 million — than any other month since September 2016 — right in the heat of the president 's first campaign .
And according to the digital marketing firm Bully Pulpit Interactive , about 10 % of the campaign 's overall Facebook ad spending this year has been explicitly to market merchandise .
As the extent of the pandemic was becoming apparent at the end of March , that spending bumped up , as it often does at the end of a fundraising period .
`` It 's very much an e-commerce approach @ @ @ @ @ @ @ Breternitz , who was the design director for Massachusetts Sen. Elizabeth Warren 's presidential campaign .
She says selling merch enables campaigns to reach people who would n't ordinarily donate .
It 's easier to say `` Buy this cool hat '' than `` Please just give me money . ''
`` It feels different , '' Breternitz said of buying campaign merchandise .
`` And it 's very much a way of virtue signaling , depending on how you define virtue .
But it 's very much a way of saying , @ @ @ @ @ @ @ I want to wear it on a T-shirt or wear it on a hat . '
`` '' Whether it 's the over one million red MAGA hats sold , plastic straws , or the new Trump-themed puzzle to keep people entertained during quarantine , the campaign merchandise lets supporters be part of this movement with high-quality , made in America Trump gear and products , '' Sarah Matthews , the deputy press secretary for the Trump campaign , said in a statement .
Trump 's 2016 campaign was built around the red @ @ @ @ @ @ @ it became an instant icon , a symbol of support for a candidate and much more .
According to the campaign , it remains the top-selling item in the Trump campaign store , followed by the Keep America Great hat .
`` We 've sold millions and millions of red hats , '' Trump said at a Republican National Committee fundraiser last year .
`` Now you go to a rally , everybody has the red hat . ''
Of course , now no one is going to rallies .
But people are @ @ @ @ @ @ @ an added benefit , those shoppers turn over their contact information which can be used later to solicit donations , invite them to volunteer , or to make sure they vote .
The Trump campaign does a lot of what Breternitz calls rapid-response merch , capturing a moment and converting it into a product .
During the lead-up to impeachment , Trump was talking about former Vice President Joe Biden 's son at a rally , asking , `` Where 's Hunter ? ''
In the middle of his riff he said , @ @ @ @ @ @ @ idea for a new T-shirt . ''
That night , there was a new $ 25 shirt in the Trump online store .
The president claimed the next day that it was a best seller .
It 's not clear how many of the shirts really did sell .
Campaigns now get their merchandise made on demand , so it 's not like there are warehouses full of printed shirts and mugs .
The ultimate rapid response item is the Trump straws .
Last July campaign manager Brad Parscale tweeted grumpily about a @ @ @ @ @ @ @ Just five hours later , plastic Trump straws were available for purchase in the campaign store at a price of 10 for $ 15 .
The campaign had tapped into something many people were annoyed with , fed the outrage , and then converted it to campaign cash .
`` Liberal paper straws do n't work .
STAND WITH PRESIDENT TRUMP and buy your pack of recyclable straws today , '' the item description said .
A campaign official says they 've now sold more than $ 1 million worth of the plastic @ @ @ @ @ @ @ gained notice for its rapid-response merch , including a hugely popular `` billionaire tears '' coffee mug .
But Breternitz says they worried about reputational risk with each new item , wanting to make sure it fit Warren 's brand and would n't offend or otherwise come back to bite them .
With the Trump campaign , she says there is seemingly less worry about being offensive `` because that 's his brand and that 's what people look for from him , '' Breternitz said .
`` He can jump on any @ @ @ @ @ @ @ have to worry if it 's true or not , and he can sell straws off of it . ''
For the Trump campaign , this merch-forward approach is a point of pride , and it has helped fuel its small-dollar fundraising .
In the first quarter of 2020 , the Trump campaign , combined with the Republican National Committee , raised $ 212 million .
That 's even though Trump 's last big-dollar in-person fundraiser was held on March 9 .

From Puzzles To Plastic Straws: Merch Plays A Key Role In Trump's Fundraising
Enlarge this image toggle caption Courtesy of the Trump campaign Courtesy of the Trump campaign
At a time when jigsaw puzzles may be harder to come by than toilet paper, the hot new item in the Trump campaign online store is a 200-piece puzzle, featuring a faintly smiling President Trump standing in front of an American flag, giving two thumbs up.
The $35 puzzle is just the latest example of the campaign capitalizing on in-the-moment merchandise.
Interest in puzzles spiked with people spending much more time at home due to the coronavirus and in mid-April, the Trump campaign jumped on the trend.
Buying the Trump puzzle, or a Make America Great Again hat or T-shirt, is actually a campaign contribution. And this merch is an important part of the Trump reelection campaign's fundraising machine.
And that hasn't changed with the pandemic. The merchandise effort continued cranking, even as COVID-19 started grinding much of the American economy to a halt.
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According to an NPR analysis of campaign finance reports, the Trump campaign and its affiliated committees spent more money in March on vendors that make its merchandise — about $4.7 million — than any other month since September 2016 — right in the heat of the president's first campaign.
And according to the digital marketing firm Bully Pulpit Interactive, about 10% of the campaign's overall Facebook ad spending this year has been explicitly to market merchandise. As the extent of the pandemic was becoming apparent at the end of March, that spending bumped up, as it often does at the end of a fundraising period.
Loading...
"It's very much an e-commerce approach to political marketing," said Raquel Breternitz, who was the design director for Massachusetts Sen. Elizabeth Warren's presidential campaign.
She says selling merch enables campaigns to reach people who wouldn't ordinarily donate. It's easier to say "Buy this cool hat" than "Please just give me money."
"It feels different," Breternitz said of buying campaign merchandise. "And it's very much a way of virtue signaling, depending on how you define virtue. But it's very much a way of saying, 'Here's what I believe, and I want to wear it on a T-shirt or wear it on a hat.' "
"Whether it's the over one million red MAGA hats sold, plastic straws, or the new Trump-themed puzzle to keep people entertained during quarantine, the campaign merchandise lets supporters be part of this movement with high-quality, made in America Trump gear and products," Sarah Matthews, the deputy press secretary for the Trump campaign, said in a statement.
Trump's 2016 campaign was built around the red Make America Great Again hat, and it became an instant icon, a symbol of support for a candidate and much more. According to the campaign, it remains the top-selling item in the Trump campaign store, followed by the Keep America Great hat.
Enlarge this image toggle caption Jim Watson/AFP via Getty Images Jim Watson/AFP via Getty Images
"We've sold millions and millions of red hats," Trump said at a Republican National Committee fundraiser last year. "Now you go to a rally, everybody has the red hat."
Of course, now no one is going to rallies. But people are still buying Trump gear. And as an added benefit, those shoppers turn over their contact information which can be used later to solicit donations, invite them to volunteer, or to make sure they vote.
The Trump campaign does a lot of what Breternitz calls rapid-response merch, capturing a moment and converting it into a product.
During the lead-up to impeachment, Trump was talking about former Vice President Joe Biden's son at a rally, asking, "Where's Hunter?"
In the middle of his riff he said, "Hey fellas, I have an idea for a new T-shirt."
That night, there was a new $25 shirt in the Trump online store. The president claimed the next day that it was a best seller. It's not clear how many of the shirts really did sell. Campaigns now get their merchandise made on demand, so it's not like there are warehouses full of printed shirts and mugs.
The ultimate rapid response item is the Trump straws. Last July campaign manager Brad Parscale tweeted grumpily about a paper straw disintegrating in his beverage.
Just five hours later, plastic Trump straws were available for purchase in the campaign store at a price of 10 for $15.
The campaign had tapped into something many people were annoyed with, fed the outrage, and then converted it to campaign cash.
"Liberal paper straws don't work. STAND WITH PRESIDENT TRUMP and buy your pack of recyclable straws today," the item description said.
A campaign official says they've now sold more than $1 million worth of the plastic Trump straws.
The Warren campaign also gained notice for its rapid-response merch, including a hugely popular "billionaire tears" coffee mug.
But Breternitz says they worried about reputational risk with each new item, wanting to make sure it fit Warren's brand and wouldn't offend or otherwise come back to bite them. With the Trump campaign, she says there is seemingly less worry about being offensive "because that's his brand and that's what people look for from him," Breternitz said. "He can jump on any piece of outrage. He doesn't have to worry if it's true or not, and he can sell straws off of it."
For the Trump campaign, this merch-forward approach is a point of pride, and it has helped fuel its small-dollar fundraising. In the first quarter of 2020, the Trump campaign, combined with the Republican National Committee, raised $212 million. That's even though Trump's last big-dollar in-person fundraiser was held on March 9.


npr--2020-05-03--Ballot Printers Increase Capacity To Prepare For Mail Voting Surge

More Americans than ever before are expected to vote by mail this year because of concerns about the coronavirus .
One challenge facing election officials now : how to print and mail the millions of ballots voters are expected to request in the coming months .
Nearly a quarter of the 136 million presidential ballots cast 2016 were mailed in .
That number could easily grow to well over half this year , especially if the health risk continues .
With many states expected to expand mail-in voting for November , experts warn that existing ballot printing services could quickly @ @ @ @ @ @ @ biggest such vendors in the country is Runbeck Election Services .
The company 's 90,000-square-foot facility in Phoenix , Ariz. is already bustling and things are expected to get a lot busier soon .
`` This year we are going to mail probably around 40 to 50 million pieces .
We 'll print probably close to 80 million , up to 100 million pieces when you count inserts , '' said Jeff Ellington , the company 's president and chief operating officer .
He gave NPR a virtual tour of the facility via @ @ @ @ @ @ @ in-person visit .
Ellington explained that getting ballots to the right voters is a complicated , multi-step process .
States need to decide what their ballots will look like and to get approval from the U.S .
Postal Service for the design of the envelopes .
After those envelopes are secured , companies like Runbeck step in .
`` So I 'm on the production floor looking at one of our HP printing presses and it takes a roll of paper that starts out at a thousand pounds , and then it goes @ @ @ @ @ @ @ and then gets trimmed to size , `` Ellington said , adding that the machine can print about 20,000 ballots an hour .
Standing near the printer are stacks of massive rolls of white paper that will eventually become ballots for millions of American voters .
On this day , the company is producing mailings for Iowa , Nevada , Arizona and Georgia .
The latter 's ballots need to be delivered quickly for Georgia 's June 9 primary , which was delayed from March due to the pandemic .
Ellington shows how @ @ @ @ @ @ @ emerge in neat stacks and are put in plastic bins by workers .
They 're then taken over to another machine called an inserter .
On this day , the inserter puts ballots , instructions and an `` I voted '' sticker into envelopes for Las Vegas voters .
`` You 'll see the ballots being loaded , going down a conveyor belt and then inserted into an envelope , '' Ellington said .
This is one of the most sensitive parts of the process .
Each ballot has a bar code that @ @ @ @ @ @ @ ballot it is — there can be thousands of varieties in a single election — and then determines from a database of voter registration records which person on the list should receive that particular ballot .
`` And then your name and address will be printed on the envelope once that process is complete , '' said Ellington .
Runbeck already has five inserters and has ordered eleven more — the most its manufacturer can produce by November .
Ellington said this will triple the company 's capacity , but is unlikely to @ @ @ @ @ @ @ year 's unprecedented demand with so many voters nervous about going to the polls in person .
His company and others are warning states to decide soon what they plan to do or they could be out of luck .
`` Decision making needs to be right now , '' CEO Michael Runbeck told the U.S. Election Assistance Commission at a recent online hearing about holding an election during a pandemic .
`` We can not gear up , we can not build equipment fast enough if you wait until July to place @ @ @ @ @ @ @ the secretary of state for Washington , which has a long history of widespread mail-in voting , also spoke about the challenges for states trying to quickly shift to a lot more absentee voting .
`` They 're going to need high-speed envelope sorters .
They 're going to need tabulation equipment that can actually count ballots in a faster manner , '' she warned .
And those are only a few things election officials need to consider , Wyman said .
Among the other questions : Do states have their voter registration @ @ @ @ @ @ @ out efficiently and signatures verified ?
How will all those ballots be opened and counted on Election Day ?
Is there enough paper available to provide millions of envelopes on such short notice ?
That 's not to mention educating voters about how to use a form of voting they might not be used to .
`` I am very concerned that with only six months really to implement vote-by-mail or absentee voting in a jurisdiction that it 's going to be a heavy lift , and if it 's not rolled out @ @ @ @ @ @ @ the results of the election , '' Wyman told the commission .
Some states , like Wisconsin and Ohio , have already run into glitches switching to largely vote-by-mail primaries at the last minute .
Back in Phoenix , Jeff Ellington is worried too .
`` There 's approximately 200 million registered voters in the country .
And we will have the capacity to do approximately 20 million [ absentee ballots ] , '' he said .
Not everyone will vote by mail , of course , and some election offices will handle @ @ @ @ @ @ @ their own .
But that still leaves a big gap to fill in a short period of time .

Ballot Printers Increase Capacity To Prepare For Mail Voting Surge
Enlarge this image toggle caption Ash Ponders for NPR Ash Ponders for NPR
More Americans than ever before are expected to vote by mail this year because of concerns about the coronavirus. One challenge facing election officials now: how to print and mail the millions of ballots voters are expected to request in the coming months.
Nearly a quarter of the 136 million presidential ballots cast 2016 were mailed in. That number could easily grow to well over half this year, especially if the health risk continues.
With many states expected to expand mail-in voting for November, experts warn that existing ballot printing services could quickly become overwhelmed.
One of of the biggest such vendors in the country is Runbeck Election Services. The company's 90,000-square-foot facility in Phoenix, Ariz., is already bustling, and things are expected to get a lot busier soon.
Enlarge this image toggle caption Ash Ponders for NPR Ash Ponders for NPR
"This year we are going to mail probably around 40 to 50 million pieces. We'll print probably close to 80 million, up to 100 million pieces when you count inserts," said Jeff Ellington, the company's president and chief operating officer. He gave NPR a virtual tour of the facility via FaceTime because pandemic travel restrictions prevented an in-person visit.
Ellington explained that getting ballots to the right voters is a complicated, multi-step process. States need to decide what their ballots will look like and to get approval from the U.S. Postal Service for the design of the envelopes. After those envelopes are secured, companies like Runbeck step in.
"So I'm on the production floor looking at one of our HP printing presses and it takes a roll of paper that starts out at a thousand pounds, and then it goes through the machine, gets printed, and then gets trimmed to size," Ellington said, adding that the machine can print about 20,000 ballots an hour.
Standing near the printer are stacks of massive rolls of white paper that will eventually become ballots for millions of American voters. On this day, the company is producing mailings for Iowa, Nevada, Arizona and Georgia. The latter's ballots need to be delivered quickly for Georgia's June 9 primary, which was delayed from March due to the pandemic.
Enlarge this image toggle caption Ash Ponders for NPR Ash Ponders for NPR
Ellington shows how another machine folds the ballots, which emerge in neat stacks and are put in plastic bins by workers. They're then taken over to another machine called an inserter. On this day, the inserter puts ballots, instructions and an "I voted" sticker into envelopes for Las Vegas voters.
"You'll see the ballots being loaded, going down a conveyor belt and then inserted into an envelope," Ellington said.
This is one of the most sensitive parts of the process. Each ballot has a bar code that tells the machine exactly what kind of ballot it is — there can be thousands of varieties in a single election — and then determines from a database of voter registration records which person on the list should receive that particular ballot.
"And then your name and address will be printed on the envelope once that process is complete," said Ellington.
Enlarge this image toggle caption Ash Ponders for NPR Ash Ponders for NPR
Runbeck already has five inserters and has ordered 11 more — the most its manufacturer can produce by November. Ellington said this will triple the company's capacity, but is unlikely to meet what's expected to be this year's unprecedented demand with so many voters nervous about going to the polls in person.
His company and others are warning states to decide soon what they plan to do or they could be out of luck.
Enlarge this image toggle caption Ash Ponders for NPR Ash Ponders for NPR
"Decision-making needs to be right now," CEO Kevin Runbeck told the U.S. Election Assistance Commission at a recent online hearing about holding an election during a pandemic. "We cannot gear up, we cannot build equipment fast enough if you wait until July to place your orders."
Kim Wyman, the secretary of state for Washington, which has a long history of widespread mail-in voting, also spoke about the challenges for states trying to quickly shift to a lot more absentee voting.
"They're going to need high-speed envelope sorters. They're going to need tabulation equipment that can actually count ballots in a faster manner," she warned.
And those are only a few things election officials need to consider, Wyman said.
Enlarge this image toggle caption Ash Ponders for NPR Ash Ponders for NPR
Among the other questions: Do states have their voter registration records digitized so ballots can be sent out efficiently and signatures verified? How will all those ballots be opened and counted on Election Day? Is there enough paper available to provide millions of envelopes on such short notice?
That's not to mention educating voters about how to use a form of voting they might not be used to.
"I am very concerned that with only six months really to implement vote-by-mail or absentee voting in a jurisdiction that it's going to be a heavy lift, and if it's not rolled out properly, we will lose confidence in the results of the election," Wyman told the commission.
Some states, like Wisconsin and Ohio, have already run into glitches switching to largely vote-by-mail primaries at the last minute.
Back in Phoenix, Jeff Ellington is worried too.
Enlarge this image toggle caption Ash Ponders for NPR Ash Ponders for NPR
"There's approximately 200 million registered voters in the country. And we will have the capacity to do approximately 20 million [absentee ballots]," he said.
Not everyone will vote by mail, of course, and some election offices will handle the mailing and printing of ballots on their own. But that still leaves a big gap to fill in a short period of time.