npr--2020-05-09--Public Health Experts Say Many States Are Opening Too Soon To Do So Safely

Public Health Experts Say Many States Are Opening Too Soon To Do So Safely As of Friday , in Texas you can go to a tanning salon .
In Indiana , houses of worship are being allowed to open with no cap on attendance .
Meanwhile places like Pennsylvania are taking a more cautious approach , only starting to ease restrictions in some counties based on the number of COVID-19 cases .
By Monday at least 31 states will have partially reopened after seven weeks of restrictions .
The moves come as President Trump pushes for the country to get @ @ @ @ @ @ @ warning that it 's too soon .
`` The early lesson that was learned , really , we learned from the island of Hokkaido in Japan , where they did a really good job of controlling the initial phase of the outbreak , '' said Bob Bednarczyk , assistant professor of Global Health and Epidemiology at the Rollins School of public Health at Emory University in Atlanta .
But then because of that success many of the restrictions on the island were lifted .
Cases and deaths surged in a second wave of @ @ @ @ @ @ @ island was back on lockdown .
`` That 's the concern that we have right now , '' he said .
Bednarczyk is closely following the data from Georgia 's Department of Public Health .
For two weeks now , the state has allowed a lot of businesses to open , businesses that include close contact activities like a haircut or a manicure .
Meanwhile Bednarczyk said the numbers he 's looking at show the state has n't had a sustained decrease in cases .
`` We 've done a pretty good job @ @ @ @ @ @ @ saw early on , '' he said .
`` But the way that it looks to many of us is that we really have n't reached that peak and we 're not coming down the backside of the peak yet . ''
Georgia is not alone This week , Caitlin Rivers , a leading scholar at Johns Hopkins Center for Health Security told a U.S. House Appropriations subcommittee that none of the states meet all the criteria needed to start reopening .
The center laid out the criteria for states to reference before @ @ @ @ @ @ @ adopted them .
They include a 14-day decline in cases , the ability to contact trace , a healthcare system that can safely care for patients including enough protective gear for healthcare workers and enough rapid diagnostic testing .
`` It 's clear to me that we are in a critical moment of this fight , '' Rivers told the subcommittee .
`` We risk complacency in accepting the preventable deaths of 2,000 Americans each day .
We risk complacency in accepting that our healthcare workers do not have what they need to @ @ @ @ @ @ @ risk complacency in recognizing that without continued vigilance , we will again create the conditions that led to us being the worst-affected country in the world . ''
In fact data from Johns Hopkins University shows that cases of COVID-19 in a number of states are actually on the rise .
Meanwhile the University of Washington 's Institute for Health Metrics and Evaluation 's new model says that nearly 135,000 people will have died due to Covid-19 by August 4 .
That 's more than double the last model and takes into consideration @ @ @ @ @ @ @ more than 70,000 people have died in the United States .
Some states like California are taking so-called baby steps to reopen : allowing curbside pick-up at some non-essential shops like florists and the opening of some outdoor recreation .
Gov .
Gavin Newsom left it up to counties to decide whether or not to ease the restrictions in accordance with his order .
Other states are leaping .
For instance , in Georgia residents can get a tattoo .
`` Simply opening up the state does n't mean that everyone gets to @ @ @ @ @ @ @ February , '' said Sandra Elizabeth Ford , the district health director for Dekalb County in the Atlanta metro area .
`` Our messaging has got to be consistent : that there is a new normal .
And while we 're open , we wo n't be able to be open the way we were open before . ''
Georgia Gov .
Brian Kemp 's executive orders supersede all local rules .
So the only thing Ford said her team can do is communicate their own recommendations .
The county is distributing masks @ @ @ @ @ @ @ not be able to get it for themselves .
`` We 're trying to talk about equitable reentry because it 's not just about opening up the state , but we want to open up the state in a way that is equitable , '' Ford said .
`` Make sure that folks who have hourly jobs , for example , that must report to work and have probably reported to work the whole time , are still provided options to be tested , options to have appropriate protective wear and opportunity , @ @ @ @ @ @ @ site . ''
In Dekalb County people speak some 90 languages and dialects .
Also , it 's majority African American .
Data shows that black and brown communities are disproportionately impacted by COVID-19 .
Ford said that 's because of long-standing disparities in access to healthcare .
`` This is an event , but the issues that contribute to the overabundance [ of coronavirus infections ] in people of color is systemic , '' she said .
`` And so for us to not take advantage of this pandemic and try to @ @ @ @ @ @ @ waste . ''
The county has mapped out cases by zip code and is ramping up testing in hard hit areas .
It 's also providing information about resources for mental health services , domestic abuse or the Paycheck Protection Program .
Meanwhile the county is working to ramp up its ability to contact trace .
Dallas County in Texas has stood up a team of infectious disease experts , epidemiologists and others scientists so that local decisions are based on science .
`` Just because you can do something , does n't @ @ @ @ @ @ @ Huang , director of Health and Human Services in Dallas County .
Local leaders can only make recommendations .
The second phase of Texas 's reopening began on Friday after Gov .
Greg Abbott issued another executive order expanding the types of businesses that can welcome customers again .
Now , not only can residents go to a movie theater or a mall _ as long as the businesses limit the number of customers according to the executive order _ they can also use a tanning bed or get their hair cut at @ @ @ @ @ @ @ contradict the governor 's orders .
So when there are areas where we can provide additional clarification and sort of guidance , then that 's what we 're trying to do , '' Huang said .
`` We 're trying to make these recommendations for our own local community based on what we 're seeing here . ''
What they want to see is two weeks of decreases in cases before these businesses open up .
Not only have they not seen that in Huang 's county , but cases actually went up @ @ @ @ @ @ @ are some areas of Texas that might have no cases .
We 've got more than 5,000 .
So things are a little different here , '' Huang said .
`` What we 're trying to do is use this expert committee to really make recommendations based on the science .
So we say , 'even though you can , here 's what the experts recommend in terms of going to get that haircut . '
'' Right now , public health experts recommend that you do n't .

Public Health Experts Say Many States Are Opening Too Soon To Do So Safely
Enlarge this image toggle caption Sergio Flores/AFP via Getty Images Sergio Flores/AFP via Getty Images
As of Friday in Texas, you can go to a tanning salon. In Indiana, houses of worship are being allowed to open with no cap on attendance. Places like Pennsylvania are taking a more cautious approach, only starting to ease restrictions in some counties based on the number of COVID-19 cases.
By Monday, at least 31 states will have partially reopened after seven weeks of restrictions. The moves come as President Trump pushes for the country to get back to work despite public health experts warning that it's too soon.
"The early lesson that was learned, really, we learned from the island of Hokkaido in Japan, where they did a really good job of controlling the initial phase of the outbreak," said Bob Bednarczyk, assistant professor of global health and epidemiology at the Rollins School of Public Health at Emory University in Atlanta.
Because of that success, many of the restrictions on the island were lifted. But cases and deaths surged in a second wave of infections. Twenty-six days later, the island was back on lockdown.
"That's the concern that we have right now," he said.
Bednarczyk is closely following the data from Georgia's Department of Public Health. For two weeks now, the state has allowed a lot of businesses to open, businesses that include close-contact activities like a haircut or a manicure. And Bednarczyk said the numbers he's looking at show the state hasn't had a sustained decrease in cases.
"We've done a pretty good job in controlling that exponential growth that we saw early on," he said. "But the way that it looks to many of us is that we really haven't reached that peak and we're not coming down the backside of the peak yet."
Georgia is not alone
This week, Caitlin Rivers, a leading scholar at Johns Hopkins Center for Health Security told a U.S. House Appropriations subcommittee that none of the states meet all the criteria needed to start reopening.
The center laid out the criteria for states to reference before they ease restrictions, but not all states adopted them. The criteria includes a 14-day decline in cases, the ability to contact trace, a health system that can safely care for patients including enough protective gear for health care workers, and enough rapid diagnostic testing.
"It's clear to me that we are in a critical moment of this fight," Rivers told the subcommittee. "We risk complacency in accepting the preventable deaths of 2,000 Americans each day. We risk complacency in accepting that our health care workers do not have what they need to do their jobs safely. And we risk complacency in recognizing that without continued vigilance, we will again create the conditions that led to us being the worst-affected country in the world."
Enlarge this image toggle caption Chandan Khanna/AFP via Getty Images Chandan Khanna/AFP via Getty Images
In fact, data from Johns Hopkins University shows that cases of COVID-19 in a number of states are on the rise. Meanwhile, the University of Washington's Institute for Health Metrics and Evaluation's new model says that nearly 135,000 people will have died from COVID-19 by Aug. 4. That's more than double the last model and takes into consideration the easing of restrictions. As of Saturday morning, more than 77,000 people have died in the United States.
Some states like California are taking so-called baby steps to reopen: allowing curbside pickup at some nonessential shops like florists and the opening of some outdoor recreation. Gov. Gavin Newsom left it up to counties to decide whether to ease the restrictions in accordance with his order.
Other states are leaping. For instance, in Georgia residents can get a tattoo.
"Simply opening up the state doesn't mean that everyone gets to walk around like they did back in February," said Dr. Sandra Elizabeth Ford, the district health director for Dekalb County in the Atlanta metro area. "Our messaging has got to be consistent: that there is a new normal. And while we're open, we won't be able to be open the way we were open before."
Georgia Gov. Brian Kemp's executive orders supersede all local rules. So the only thing Ford said her team can do is communicate their own recommendations. The county is distributing masks and hand sanitizer to people who might not be able to get it for themselves.
"We're trying to talk about equitable reentry because it's not just about opening up the state, but we want to open up the state in a way that is equitable," Ford said. "Make sure that folks who have hourly jobs, for example, that must report to work and have probably reported to work the whole time, are still provided options to be tested, options to have appropriate protective wear and opportunity, if needed, to be quarantined off site."
Systemic problems
In Dekalb County, people speak some 90 languages and dialects. Also, it's majority African American. Data show that black and brown communities have been disproportionately impacted by COVID-19. Ford said that's because of long-standing disparities in access to health care.
"This is an event, but the issues that contribute to the overabundance [of coronavirus infections] in people of color is systemic," she said. "And so for us to not take advantage of this pandemic and try to change some systemic issues would be a waste."
The county has mapped out cases by ZIP code and is ramping up testing in hard-hit areas. It's also providing information about resources for mental health services, domestic abuse or the Paycheck Protection Program. Meanwhile the county is working to ramp up its ability to contact trace.
Dallas County in Texas has stood up a team of infectious disease experts, epidemiologists and others scientists so that local decisions are based on science.
The message to county residents:
"Just because you can do something, doesn't mean you should," said Philip Huang, director of Dallas County Health and Human Services.
Local leaders can only make recommendations. The second phase of Texas' reopening began on Friday after Gov. Greg Abbott issued an executive order expanding the types of businesses that can welcome customers again. Now, not only can residents go to a movie theater or a mall, as long as the businesses limit the number of customers according to the executive order, but they can also use a tanning bed or get their hair cut at a salon.
"I can't contradict the governor's orders. So when there are areas where we can provide additional clarification and sort of guidance, then that's what we're trying to do," Huang said. "We're trying to make these recommendations for our own local community based on what we're seeing here."
What the officials want to see is two weeks of decreases in cases before these businesses open up. They have not seen that in Huang's county;, instead, cases actually went up in the past week.
"There are some areas of Texas that might have no cases. We've got more than 5,000. So things are a little different here," Huang said. "What we're trying to do is use this expert committee to really make recommendations based on the science. So we say, 'Even though you can, here's what the experts recommend in terms of going to get that haircut.' "
Right now, public health experts recommend that you don't.


npr--2020-05-09--Top 5 Moments From The Supreme Court's 1st Week Of Livestreaming Arguments

Top 5 Moments From The Supreme Court 's 1st Week Of Livestreaming Arguments For the first time in its 231-year history , the Supreme Court justices heard oral arguments remotely by phone and made the audio available live .
The new setup went off largely without difficulties , but produced some memorable moments , including one justice forgetting to unmute and an ill-timed bathroom break .
Here are the top five can't-miss moments from this week 's history-making oral arguments .
A second week of arguments begin on Monday at 10 a.m .
ET .
Here 's a rundown of @ @ @ @ @ @ @ Supreme Court oral arguments are verbal jousting matches .
The justices pepper the lawyers with questions , interrupting counsel repeatedly and sometimes even interrupting each other .
Justice Clarence Thomas , who has sat on the bench for nearly 30 years , has made his dislike of the chaotic process well known , at one point not asking a question for a full decade .
But with no line of sight , the telephone arguments have to be rigidly organized , and each justice , in order of seniority , has an allotted @ @ @ @ @ @ @ out that Thomas , second in seniority , may just have been waiting his turn .
Rather than passing , as had been expected , he has been Mr. Chatty Cathy , using every one of his turns at bat so far .
Thomas broke a year-long silence on Monday in a trademark case testing whether a company can trademark by adding .com to a generic term .
In this case , Booking.com .
`` Could Booking acquire an 800 number , for example , that 's a vanity number — 1-800-BOOKING , @ @ @ @ @ @ @ Justice Ruth Bader Ginsburg participated in Wednesday 's argument from the hospital .
In pain during Tuesday 's arguments , the 87-year-old underwent non-surgical treatment for a gall bladder infection at Johns Hopkins Hospital later that day , according to a Supreme Court press release .
But she was ferocious on Wednesday morning , calling in from her hospital room in a case testing the Trump administration 's new rule expanding exemptions from Obamacare 's birth control mandate for nonprofits and some for-profit companies that have religious or moral objections to birth control @ @ @ @ @ @ @ the Trump administration 's new rules , is that they `` toss to the winds entirely Congress ' instruction that women need and shall have seamless , no-cost , comprehensive coverage , '' she said .
During Wednesday 's second oral argument , Barr v. American Association of Political Consultants , a case in which the justices weighed a First Amendment challenge to a federal rule than bans most robocalls , something very unexpected happened .
Partway through lawyer Roman Martinez 's argument time , a toilet flush could be distinctly heard .
@ @ @ @ @ @ @ spite of the awkward moment .
The flush quickly picked up steam online , becoming the first truly viral moment from the court 's new livestream oral arguments .
4 .
Hello , where are you ?
Justice Sonia Sotomayor , considered one of the most tech-savvy of the justices , experienced a couple of technical difficulties with her mute button .
In both Monday and Tuesday arguments , the first time she was at bat , there were prolonged pauses , prompting Chief Justice John Roberts to call , `` Justice Sotomayor @ @ @ @ @ @ @ hopped on with a brief , `` Sorry , Chief , '' before launching into her questions .
By Wednesday she seemed to have gotten used to the new format , but the trouble then jumped to Thomas , who was entirely missing in action when his turn came .
He ultimately went out of order Wednesday morning .
Oral arguments usually run one hour almost exactly , with lawyers for each side having 30 minutes to make their case .
In an attempt to stick as closely as possible to that format @ @ @ @ @ @ @ of questioning to each justice for each round of questioning .
Chief Justice John Roberts spent the week jumping into exchanges , cutting off both lawyers and justices in the process , to keep the proceedings on track .
Even so the arguments ran longer than usual .
But in Wednesday 's birth control case , oral arguments went a whopping 40 minutes longer than expected .
Justice Alito , for his part , hammered the lawyer challenging the Trump administration 's new birth control rules for more than seven minutes , without @ @ @ @ @ @ @ a decision he wrote in 2014 , Alito said that `` Hobby Lobby held that if a person sincerely believes that it is immoral to perform an act that has the effect of enabling another person to commit an immoral act , the federal court does not have the right to say that this person is wrong on the question of moral complicity .
That is precisely the question here . ''

Top 5 Moments From The Supreme Court's 1st Week Of Livestreaming Arguments
Enlarge this image toggle caption Saul Loeb/AFP via Getty Images Saul Loeb/AFP via Getty Images
For the first time in its 231-year history, the Supreme Court justices heard oral arguments remotely by phone and made the audio available live.
The new setup went off largely without difficulties, but produced some memorable moments, including one justice forgetting to unmute and an ill-timed bathroom break.
Here are the top five can't-miss moments from this week's history-making oral arguments.
A second week of arguments begin on Monday at 10 a.m. ET. Here's a rundown of the cases and how to listen.
1. Justice Clarence Thomas speaks ... a lot
Supreme Court oral arguments are verbal jousting matches. The justices pepper the lawyers with questions, interrupting counsel repeatedly and sometimes even interrupting each other.
Justice Clarence Thomas, who has sat on the bench for nearly 30 years, has made his dislike of the chaotic process well known, at one point not asking a question for a full decade.
But with no line of sight, the telephone arguments have to be rigidly organized, and each justice, in order of seniority, has an allotted 2 minutes for questioning.
It turns out that Thomas, second in seniority, may just have been waiting his turn. Rather than passing, as had been expected, he has been Mr. Chatty Cathy, using every one of his turns at bat so far.
Thomas broke a year-long silence on Monday in a trademark case testing whether a company can trademark by adding .com to a generic term. In this case, Booking.com.
"Could Booking acquire an 800 number, for example, that's a vanity number — 1-800-BOOKING, for example?" Thomas asked.
Thomas breaks his silence 3:51
2. The unstoppable RBG
Justice Ruth Bader Ginsburg participated in Wednesday's argument from the hospital. In pain during Tuesday's arguments, the 87-year-old underwent non-surgical treatment for a gall bladder infection at Johns Hopkins Hospital later that day, according to a Supreme Court press release.
But she was ferocious on Wednesday morning, calling in from her hospital room in a case testing the Trump administration's new rule expanding exemptions from Obamacare's birth control mandate for nonprofits and some for-profit companies that have religious or moral objections to birth control.
"The glaring feature" of the Trump administration's new rules, is that they "toss to the winds entirely Congress' instruction that women need and shall have seamless, no-cost, comprehensive coverage," she said.
Ginsburg weighs in from the hospital 0:50
3. Who flushed?
During Wednesday's second oral argument, Barr v. American Association of Political Consultants, a case in which the justices weighed a First Amendment challenge to a federal rule than bans most robocalls, something very unexpected happened.
Partway through lawyer Roman Martinez's argument time, a toilet flush could be distinctly heard.
The ignored interruption 0:27
Martinez seemed unperturbed and continued speaking in spite of the awkward moment.
The flush quickly picked up steam online, becoming the first truly viral moment from the court's new livestream oral arguments.
4. Hello, where are you?
Justice Sonia Sotomayor, considered one of the most tech-savvy of the justices, experienced a couple of technical difficulties with her mute button.
In both Monday and Tuesday arguments, the first time she was at bat, there were prolonged pauses, prompting Chief Justice John Roberts to call, "Justice Sotomayor?" a few times before she hopped on with a brief, "Sorry, Chief," before launching into her questions.
"Did it again" 0:25
By Wednesday she seemed to have gotten used to the new format, but the trouble then jumped to Thomas, who was entirely missing in action when his turn came. He ultimately went out of order Wednesday morning.
5. Running over time
Oral arguments usually run one hour almost exactly, with lawyers for each side having 30 minutes to make their case. In an attempt to stick as closely as possible to that format, the telephone rules allocate 2 minutes of questioning to each justice for each round of questioning.
The NPR Politics Podcast Supreme Court Firsts: Teleconferences, Livestreams, And A Toilet Flush Supreme Court Firsts: Teleconferences, Livestreams, And A Toilet Flush Listen · 14:29 14:29
Chief Justice John Roberts spent the week jumping into exchanges, cutting off both lawyers and justices in the process, to keep the proceedings on track. Even so the arguments ran longer than usual.
But in Wednesday's birth control case, oral arguments went a whopping 40 minutes longer than expected.
Justice Alito, for his part, hammered the lawyer challenging the Trump administration's new birth control rules for more than seven minutes, without interruption from the chief justice.
Alito takes his time 7:27
Referencing a decision he wrote in 2014, Alito said that "Hobby Lobby held that if a person sincerely believes that it is immoral to perform an act that has the effect of enabling another person to commit an immoral act, the federal court does not have the right to say that this person is wrong on the question of moral complicity. That is precisely the question here."
Christina Peck is NPR's legal affairs intern.


npr--2020-05-09--Chief Medical Officer's Handling Of Coronavirus Inspires Alaskans To #ThinkLikeZink

As the COVID-19 pandemic began to pick up in Alaska , Dr. Anne Zink , the state 's chief medical officer , faced a dilemma .
Should she continue in-person meetings and nightly briefings with Republican Gov .
Mike Dunleavy ?
Or should she opt for a more socially distant form of engagement ?
Zink chose the latter , saying she wanted to model the behavior that she 's been appealing to residents to follow .
She now appears at Dunleavy 's briefings by video .
And over the past two months , she 's become a trusted voice as @ @ @ @ @ @ @ strict social distancing and other public health guidelines adopted by the administration — which doctors groups have credited with keeping the state 's COVID-19 numbers among the lowest in the country .
Zink , who has a Facebook fan club and a # ThinkLikeZink hashtag , is n't the only public health official to acquire a cult-like following during the pandemic : Anthony Fauci , the federal infectious disease expert , has inspired a Saturday Night Live tribute and socks printed with his face , while Ohio 's top doctor , Amy Acton @ @ @ @ @ @ @ imitations .
But Zink is almost surely the only one helping to run her state 's pandemic response from a wood-stove-heated yurt behind her family home .
Zink said she struggled with the decision to relocate there , after a two-week quarantine at her family 's ski cabin south of Anchorage .
Dunleavy , she said , is an `` in-person sort of person . ''
`` But I do n't have to be there in-person for meetings , '' Zink said in a phone interview from the yurt .
`` And the @ @ @ @ @ @ @ one less interaction between people , and one more way to slow the spread of this virus . ''
Zink , 42 , is an emergency room doctor who started as Alaska 's chief medical officer last year , less than six months before the pandemic began .
Since then , she 's been widely praised for her ability to connect with Alaskans , by projecting calm and empathy .
`` We 're doing what she 's asked us to do , because she 's encouraging us — she 's not threatening us @ @ @ @ @ @ @ an Anchorage communications consultant who recently published the blog post , `` Five reasons Dr. Zink is crushing it as a crisis communicator . ''
`` She is the right person at the right moment that we never knew existed , '' Erkmann said .
Zink , who lives with her husband and two daughters in the farming town of Palmer , 40 miles north of Anchorage , calls the attention `` a little surreal . ''
`` I sit by myself at a computer , talking to the computer — all sorts @ @ @ @ @ @ @ in a way that I 'm not always expecting , '' she said .
`` It 's been a struggle with each of these decisions , and this is definitely uncharted territory for all of us . ''
Zink grew up in the Denver area , where both her parents were doctors .
Her maternal grandfather , Al Bartlett , was a University of Colorado Boulder physics professor and a nationally recognized speaker on exponential growth and humans ' inability to comprehend it — a lesson not lost on Zink as she navigates @ @ @ @ @ @ @ about him all the time , '' she said .
`` Particularly in this world of trying to understand exponential growth , and trying to keep our state from getting into a place of exponential growth . ''
During college , Zink spent summers in Alaska as an instructor for the National Outdoor Leadership School , then got a medical degree from Stanford University and did a residency in Utah before moving to Alaska .
Zink said her work as an emergency room doctor gave her a firsthand view of the policy failures @ @ @ @ @ @ @ like its limited treatment options for drug addiction and mental health problems .
At one point , she was punched in the face by a disturbed patient , leaving her with a black eye .
`` I realized that if I wanted to care about my patients , I had to care about the policies in the hospital , '' Zink said in a December episode of the Alaska Landmine podcast .
She and a group of peers worked to reinvigorate Alaska 's chapter of an emergency room doctors advocacy group , the @ @ @ @ @ @ @ work with ACEP took her to lobby in Washington , D.C. , where she made an impression on Sen. Lisa Murkowski , R-Alaska .
`` She was this young , articulate , hard-charging woman that you just think , 'Man , TV shows should revolve around people just like her , ' '' said Murkowski , who 's friendly with Zink and calls herself a `` huge fan . ''
When the state health commissioner offered Zink the chief medical officer job , she with her family in Bhutan — one of a @ @ @ @ @ @ @ year-long sabbatical .
It was not long after Dunleavy , the governor , had been elected , and in his first few months in office , he proposed deep cuts to health care that drew sharp criticism from many providers .
Zink is not registered with a political party and describes her affiliation as the `` party of health . ''
She said she did n't really know the governor or health commissioner , or what it would be like to work with them .
`` But I just also felt like I @ @ @ @ @ @ @ '' she said .
Dunleavy , in a phone interview , said he 's come to trust Zink as an `` honest broker '' who presents him with information and choices , without advocating for a specific position .
`` You get to me by using data .
You do n't get to me by using emotion or threats , '' Dunleavy said .
`` You ask her a question , she 's all facts . ''
The Dunleavy administration 's aggressive measures to contain the coronavirus have undercut emergency room doctors ' @ @ @ @ @ @ @ , and so has the state 's low number of cases , said Dr. Nathan Peimann , president of Alaska 's chapter of the ACEP advocacy group .
`` That was because of the actions of the administration , '' Peimann said .
`` I give Anne and the governor credit . ''
After more than a month of frenetic work organizing Alaska 's initial response to the pandemic , Zink and other top administration officials now face a different and more prolonged challenge : reviving the state 's devastated economy while keeping @ @ @ @ @ @ @ grow increasingly impatient with the limitations on their lives .
Zink is working from her yurt with three phones and three laptops , sometimes starting at 4 a.m. She said she still makes time for runs or walks with her two daughters , but spends most of her days on conference calls and in videoconference meetings — sometimes two or three at once .
Murkowski said she called Zink early on a recent Saturday morning , just to remind her to take care of herself .
`` We exchanged the pleasantries , going @ @ @ @ @ @ @ wanted to spend the next half hour with me , updating me on everything that was going on , and all the good things and where the challenges were , '' Murkowski said .
`` She 's just that type of person . ''

Chief Medical Officer's Handling Of Coronavirus Inspires Alaskans To #ThinkLikeZink
Enlarge this image toggle caption Nathaniel Herz/Alaska Public Media Nathaniel Herz/Alaska Public Media
As the COVID-19 pandemic began to pick up in Alaska, Dr. Anne Zink, the state's chief medical officer, faced a difficult choice.
Should she continue in-person meetings and nightly briefings with Republican Gov. Mike Dunleavy? Or should she opt for a more socially distant form of engagement?
Zink chose the latter, saying she wanted to model the behavior that she has been appealing to residents to follow.
She now appears at Dunleavy's briefings by video. And over the past two months, she has become a trusted voice as she urges Alaskans to follow the strict social distancing and other public health guidelines adopted by the state administration — which doctors groups have credited with keeping the state's COVID-19 numbers among the lowest in the country.
Zink, who has a Facebook fan club and a #ThinkLikeZink hashtag, isn't the only public health official to acquire a cultlike following during the pandemic: Dr. Anthony Fauci, the federal infectious disease expert, has inspired a Saturday Night Live tribute and socks printed with his face, while Ohio's top doctor, Amy Acton, has sparked Internet memes and YouTube imitations.
But Zink is almost surely the only one helping to run her state's pandemic response from a wood-stove-heated yurt behind her family home.
Zink said she struggled with the decision to relocate there, after a two-week quarantine at her family's ski cabin south of Anchorage. Dunleavy, she said, is an "in-person sort of person."
"But I don't have to be there in-person for meetings," Zink said in a phone interview from the yurt. "And the more I can do remotely is just one less interaction between people and one more way to slow the spread of this virus."
Zink, 42, is an emergency room doctor who started as Alaska's chief medical officer last year, less than six months before the pandemic began. Since then, she has been widely praised for her ability to connect with Alaskans by projecting calm and empathy.
"We're doing what she's asked us to do, because she's encouraging us — she's not threatening us," said Sarah Erkmann Ward, an Anchorage communications consultant who recently published the blog post, "Five reasons Dr. Zink is crushing it as a crisis communicator."
Enlarge this image toggle caption Courtesy of Anne Zink Courtesy of Anne Zink
"She is the right person at the right moment that we never knew existed," Ward said.
Zink, who lives with her husband and two daughters in the farming town of Palmer, 40 miles north of Anchorage, calls the attention "a little surreal."
"I sit by myself at a computer, talking to the computer — all sorts of people see it, hear it in a way that I'm not always expecting," she said. "It's been a struggle with each of these decisions, and this is definitely uncharted territory for all of us."
Zink grew up in the Denver area, where both her parents were doctors.
Her maternal grandfather, Al Bartlett, was a University of Colorado Boulder physics professor and a nationally recognized speaker on exponential growth and humans' inability to comprehend it — a lesson not lost on Zink as she navigates the COVID-19 pandemic.
"I think about him all the time," she said, "particularly in this world of trying to understand exponential growth, and trying to keep our state from getting into a place of exponential growth."
During college, Zink spent summers in Alaska as an instructor for the National Outdoor Leadership School, then got a medical degree from Stanford University and did a residency in Utah before moving to Alaska.
Zink said her work as an emergency room doctor gave her a firsthand view of the policy failures of Alaska's social safety net, such as its limited treatment options for drug addiction and mental health problems. At one point, she was punched in the face by a disturbed patient, leaving her with a black eye.
"I realized that if I wanted to care about my patients, I had to care about the policies in the hospital," Zink said in a December episode of the Alaska Landmine podcast.
She and a group of peers worked to reinvigorate Alaska's chapter of an emergency room doctors advocacy group, the American College of Emergency Physicians. Her work with ACEP took her to lobby in Washington, D.C., where she made an impression on Sen. Lisa Murkowski, R-Alaska.
"She was this young, articulate, hard-charging woman that you just think, 'Man, TV shows should revolve around people just like her,' " said Murkowski, who's friendly with Zink and calls herself a "huge fan."
When the state health commissioner offered Zink the chief medical officer job, she was with her family in Bhutan — one of a number of countries where they lived during a yearlong sabbatical. It was not long after Dunleavy, the governor, had been elected that he proposed deep cuts to health care that drew sharp criticism from many providers.
Zink is not registered with a political party and describes her affiliation as the "party of health." She said she didn't really know the governor or health commissioner or what it would be like to work with them.
"But I just also felt like I wouldn't know unless I tried," she said.
Dunleavy, in a phone interview, said he has come to trust Zink as an "honest broker" who presents him with information and choices, without advocating for a specific position.
"You get to me by using data. You don't get to me by using emotion or threats," Dunleavy said. "You ask her a question, she's all facts."
Coronavirus Live Updates Alaska Restaurant Owner: Reopening Far From Profitable, But Still Worth It Alaska Restaurant Owner: Reopening Far From Profitable, But Still Worth It Listen · 4:41 4:41
The Dunleavy administration's aggressive measures to contain the coronavirus have undercut emergency room doctors' initial skepticism about Zink taking the job and so has the state's low number of cases, said Dr. Nathan Peimann, president of Alaska's chapter of the ACEP advocacy group.
"That was because of the actions of the administration," Peimann said. "I give Anne and the governor credit."
After more than a month of frenetic work organizing Alaska's initial response to the pandemic, Zink and other top administration officials now face a different and more prolonged challenge: reviving the state's devastated economy while keeping the virus at bay, as residents grow increasingly impatient with the limitations on their lives.
Zink is working from her yurt with three phones and three laptops, sometimes starting at 4 a.m. She said she still makes time for runs or walks with her two daughters but spends most of her days on conference calls and in videoconference meetings — sometimes two or three at once.
Murkowski said she called Zink early on a recent Saturday morning, just to remind her to take care of herself.
"We exchanged the pleasantries, going back and forth. But then she wanted to spend the next half hour with me, updating me on everything that was going on, and all the good things and where the challenges were," Murkowski said. "She's just that type of person."


npr--2020-05-09--COMIC: Hospitals Turn To Alicia Keys, U2 And The Beatles To Sing Patients Home

COMIC : Hospitals Turn To Alicia Keys , U2 And The Beatles To Sing Patients Home Dr. Grace Farris is @ @ @ @ @ Mount Sinai West in Manhattan .
She also writes a monthly comics column in the @ @ @ @ @ `` Dr Mom . ''
You can find her on Instagram @ coupdegracefarris .

Alicia Keys, U2, And The Beatles Sing Recovered COVID-19 Patients Home : Shots - Health News Call them victory anthems. Every time a patient with COVID-19 is well enough to be discharged, hospitals in New York and elsewhere play songs of celebration over the intercom. A doctor explains.


npr--2020-05-09--Roy Horn Of Siegfried and Roy Dies of COVID-19 At Age 75

Roy Horn Of Siegfried and Roy Dies of COVID-19 At Age 75 Magician and animal trainer Roy Horn , of the legendary Las Vegas duo Siegfied and Roy , died Friday from complications related to COVID-19 .
Horn tested positive last week .
He was 75 .
`` The world has lost one of the greats of magic , but I have lost my best friend , '' Siegfried Fischbacher said of his partner in a statement .
`` Roy was a fighter his whole life including during these final days .
I give my heartfelt appreciation to the team @ @ @ @ @ @ @ Mountain View Hospital who worked heroically against this insidious virus that ultimately took Roy 's life . ''
Roy Horn was born in Germany in 1944 .
He and Siegfried began their act in Las Vegas in 1967 .
In 1989 they began a 14-year run at the Mirage Resort performing illusions with exotic animals , making tigers , lions , even elephants vanish and reappear .
In October of 2003 , Roy Horn was performing with a 400-pound white tiger named Mantecore when the great cat grabbed him by the throat before @ @ @ @ @ @ @ .
Horn suffered a stroke and paralysis .
The US Department of Agriculture investigated the incident and produced a 233-page report .
But it did not determine why the tiger acted as it did .
As USDA spokesman Jim Rogers told NPR 's Steve Inskeep in 2005 , `` We do try to understand why animals in this situation may turn on a trainer ...
There have been cases in the past where it was something as simple as somebody turning their back on an animal or changing a costume without allowing the @ @ @ @ @ @ @ In this instance , I do n't believe there was a reason that we determined for the animal turning on Mr .
Horn . ''
Horn survived and partially recovered , returning to the stage with the same cat for one performance in 2010 .
He has insisted the tiger was reacting to the stroke and acting to save him and not the other way around .
A statement from the duo 's publicist says Roy referred to Mantecore as `` my lifesaver . ''
Said Siegfried Fischbacher on Friday : `` Roy @ @ @ @ @ @ @ odds . ''

Roy Horn Of Siegfried And Roy Dies Of COVID-19 At Age 75
Enlarge this image toggle caption Louie Traub/AP Louie Traub/AP
Magician and animal trainer Roy Horn, of the legendary Las Vegas duo Siegfried and Roy, died Friday from complications related to COVID-19. Horn tested positive last week. He was 75.
"The world has lost one of the greats of magic, but I have lost my best friend," Siegfried Fischbacher said of his partner in a statement.
"Roy was a fighter his whole life including during these final days. I give my heartfelt appreciation to the team of doctors, nurses and staff at Mountain View Hospital who worked heroically against this insidious virus that ultimately took Roy's life."
Roy Horn was born in Germany in 1944. He and Siegfried began their act in Las Vegas in 1967. In 1989 they began a 14-year run at the Mirage Resort performing illusions with exotic animals, making tigers, lions, even elephants vanish and reappear.
In October of 2003, Roy Horn was performing with a 400-pound white tiger named Mantecore when the great cat grabbed him by the throat before a stunned audience and dragged him offstage. Horn suffered a stroke and paralysis.
The US Department of Agriculture investigated the incident and produced a 233-page report. But it did not determine why the tiger acted as it did. As USDA spokesman Jim Rogers told NPR's Steve Inskeep in 2005, "We do try to understand why animals in this situation may turn on a trainer... There have been cases in the past where it was something as simple as somebody turning their back on an animal or changing a costume without allowing the animal to become familiar with it. In this instance, I don't believe there was a reason that we determined for the animal turning on Mr. Horn."
Horn survived and partially recovered, returning to the stage with the same cat for one performance in 2010. He has insisted the tiger was reacting to the stroke and acting to save him and not the other way around. A statement from the duo's publicist says Roy referred to Mantecore as "my lifesaver."
Said Siegfried Fischbacher on Friday: "Roy's whole life was about defying the odds."


npr--2020-05-09--In Northern Virginia, A Grassroots Push To Help Latinos Combat Coronavirus

In Northern Virginia , A Grassroots Push To Help Latinos Combat Coronavirus As Latino households across the country are pummeled by the virus outbreak , staff from Neighborhood Health , a chain of medical clinics in northern Virginia , have stepped up testing efforts in areas where that community is hardest-hit .
Of the health center 's 30,000 patients , 50 % are Latino immigrants hailing from Central America .
They are predominantly low-income and uninsured .
And though they make up half of the patient population , Latinos represent nearly 90 % of those who have tested positive for @ @ @ @ @ @ @ On one day earlier this month , the medical team 's endeavors took them to a small parking lot near Four Mile Run park in the city of Alexandria .
A large blue tent set up at the entrance of the lot marks one of five makeshift coronavirus testing sites .
`` The next walk-up patient can come up , '' says Jessica Alvarenga , a medical assistant administering tests at the booth , over a walkie-talkie .
Meanwhile , mask-clad people on foot form two lines while carloads of patients pull in @ @ @ @ @ @ @ The testing rates in some minority communities across the country is much lower , '' says Dr. Basim Khan , primary care physician and executive director of Neighborhood Health .
`` So , not only are they getting more disproportionately impacted , but you 're also seeing that the response is not as robust as it needs to be . ''
Latinos make up about 18 % of the U.S. population .
But when the Centers for Disease Control and Prevention recently analyzed provisional COVID-19 deaths and racial and ethnic data in areas @ @ @ @ @ @ @ , it found Latinos made up about 27 % of coronavirus deaths .
Khan hopes to change that narrative for his patients whose homes line the border of Arlington County and Alexandria , an area called Arlandria .
An influx of Salvadoran immigrants in the 1980s earned it the nickname `` Chirilagua , '' after the city on the Pacific coast of El Salvador .
Neighborhood Health has tested more than 800 patients for COVID-19 so far .
Khan says members of the Latino community struggle to isolate themselves even after they 've @ @ @ @ @ @ @ jobs deemed `` essential '' — sometimes with no protective gear .
And language barriers and questions over immigration status can make it harder for Latinos to access the health care systems or unemployment benefits that could provide relief .
`` Because they have this illness , they 're obviously not able to work and they 're struggling to keep food on the table , '' Khan says .
`` It 's been a really stressful and challenging situation for a lot of our patients who have tested positive . ''
Virginia Gov @ @ @ @ @ @ @ will begin `` phase one '' of reopening on May 15 .
But , for some , it 's not so easy to move forward .
Silsa Ortiz de Catalan , 47 , is among the Neighborhood Health patients who live in crowded conditions at home .
Catalan contracted coronavirus in late March and spread the disease to her entire family of four .
Catalan , her husband and two adult sons share a one-bedroom apartment .
`` I was working without gloves and without a mask , '' she says in Spanish @ @ @ @ @ @ @ Health worker .
`` I started to feel like I had a fever and I started shaking , but I did n't pay too much attention , so I kept working , '' Catalan says .
Her bones and throat were aching , but she worked through the pain for several days at a well-known craft store .
The Guatemala native says her latest COVID-19 test came back negative , indicating she 's recovered , but she has another problem : After being out of work for five weeks , how is she @ @ @ @ @ @ @ May ?
According to a recent Washington Post-Ipsos survey , 20 % of Latinos say they 've been laid off or furloughed since the outbreak began — compared to 11 % of whites and 12 % of workers of other races .
African Americans and Latinos are also dying of COVID-19 at the highest rates .
When a patient 's positive test result comes in from the lab , medical staff at Neighborhood Health reach out to the patient to discuss symptoms and determine the level of monitoring needed .
For those with @ @ @ @ @ @ @ recommend the delivery of a pulse oximeter to the patient to check oxygen levels on their own .
Meanwhile , another group of workers at the clinic conducts contact tracing with patients that test positive .
They also provide the families with food .
As businesses across the country reopen , Khan is urging government officials to focus on the communities most impacted with more aggressive testing .
`` First of all , it 's just the right thing to do .
But second is it reduces the likelihood of broader spread , @ @ @ @ @ @ @ as good as our weakest link . ''

In Northern Virginia, A Grassroots Push To Help Latinos Combat Coronavirus
Enlarge this image toggle caption Andrew Caballero-Reynolds/AFP via Getty Images Andrew Caballero-Reynolds/AFP via Getty Images
As Latino households across the country are pummeled by the virus outbreak, staff from Neighborhood Health, a chain of medical clinics in northern Virginia, have stepped up testing efforts in areas where that community is hardest-hit.
Of the health center's 30,000 patients, 50% are Latino immigrants hailing from Central America. They are predominantly low-income and uninsured. And though they make up half of the patient population, Latinos represent nearly 90% of those who have tested positive for COVID-19 at the group's clinics.
On one day earlier this month, the medical team's endeavors took them to a small parking lot near Four Mile Run park in the city of Alexandria. A large blue tent set up at the entrance of the lot marks one of five makeshift coronavirus testing sites.
"The next walk-up patient can come up," says Jessica Alvarenga, a medical assistant administering tests at the booth, over a walkie-talkie.
Meanwhile, mask-clad people on foot form two lines while carloads of patients pull in for their respective drive-through appointments.
"The testing rates in some minority communities across the country is much lower," says Dr. Basim Khan, primary care physician and executive director of Neighborhood Health. "So, not only are they getting more disproportionately impacted, but you're also seeing that the response is not as robust as it needs to be."
Latinos make up about 18% of the U.S. population. But when the Centers for Disease Control and Prevention recently analyzed provisional COVID-19 deaths and racial and ethnic data in areas where more than 100 people had died, it found Latinos made up about 27% of coronavirus deaths.
Khan hopes to change that narrative for his patients whose homes line the border of Arlington County and Alexandria, an area called Arlandria. An influx of Salvadoran immigrants in the 1980s earned it the nickname "Chirilagua," after the city on the Pacific coast of El Salvador.
Neighborhood Health has tested more than 800 patients for COVID-19 so far. Khan says members of the Latino community struggle to isolate themselves even after they've tested positive. They often work low-paying jobs deemed "essential" — sometimes with no protective gear.
And language barriers and questions over immigration status can make it harder for Latinos to access the health care systems or unemployment benefits that could provide relief.
"Because they have this illness, they're obviously not able to work and they're struggling to keep food on the table," Khan says. "It's been a really stressful and challenging situation for a lot of our patients who have tested positive."
Virginia Gov. Ralph Northam announced that the state will begin "phase one" of reopening on May 15.
But, for some, it's not so easy to move forward.
Silsa Ortiz de Catalan, 47, is among the Neighborhood Health patients who live in crowded conditions at home. Catalan contracted coronavirus in late March and spread the disease to her entire family of four. Catalan, her husband and two adult sons share a one-bedroom apartment.
"I was working without gloves and without a mask," she says in Spanish, her words interpreted by a Neighborhood Health worker.
"I started to feel like I had a fever and I started shaking, but I didn't pay too much attention, so I kept working," Catalan says. Her bones and throat were aching, but she worked through the pain for several days at a well-known craft store.
The Guatemala native says her latest COVID-19 test came back negative, indicating she's recovered, but she has another problem: After being out of work for five weeks, how is she going to pay the past-due rent for May?
According to a recent Washington Post-Ipsos survey, 20% of Latinos say they've been laid off or furloughed since the outbreak began — compared to 11% of whites and 12% of workers of other races. African Americans and Latinos are also dying of COVID-19 at the highest rates.
When a patient's positive test result comes in from the lab, medical staff at Neighborhood Health reach out to the patient to discuss symptoms and determine the level of monitoring needed. For those with more acute symptoms, the doctor will recommend the delivery of a pulse oximeter to the patient to check oxygen levels on their own.
Meanwhile, another group of workers at the clinic conducts contact tracing with patients that test positive. They also provide the families with food.
As businesses across the country reopen, Khan is urging government officials to focus on the communities most impacted with more aggressive testing.
"First of all, it's just the right thing to do. But second is it reduces the likelihood of broader spread," he says. "We're as good as our weakest link."


npr--2020-05-09--For Most States, At Least A Third Of COVID-19 Deaths Are In Long-Term Care Facilities

For Most States , At Least A Third Of COVID-19 Deaths Are In Long-Term Care Facilities Coronavirus fatalities in long-term care facilities have surpassed a grim threshold in much of the country , accounting for at least a third of the deaths in 26 states and more than half in 14 of those .
The data , which was published by the Kaiser Family Foundation , reports tallies from a variety of care facilities , including nursing homes , adult care residences , and other skilled nursing care settings .
However , it does not break out those categories separately @ @ @ @ @ @ @ to meet a federal reporting deadline Friday .
The striking figures offer only a partial glimpse of the devastating impact of the virus on patients , residents and staff members ahead of the new mandate that requires officials to disclose coronavirus cases and deaths in nursing homes and long-term living residences to the Centers for Disease Control and Prevention .
Priya Chidambaram , a policy analyst with the foundation , was part of the research team compiling information from state dashboards , official statements and other sources .
She called the latest statistics @ @ @ @ @ @ @ really make you think about what the true national numbers will be when we eventually do get data from all 50 states , '' Chidambaram said .
She expects that skilled nursing facilities will continue to be hot spots for the spread of the virus now that 18 states that have so far declined to publicly report data , hand information over to the CDC .
According to the report , New Hampshire and Pennsylvania reported the highest share of coronavirus deaths — 72 % and 70 % respectively .
However , the @ @ @ @ @ @ @ from state to state .
In the case of New Hampshire , 66 of 114 total deaths occurred in long-term care facilities .
Whereas , in Pennsylvania the slightly lower percentage represents a much greater death toll — 2,355 of 3,364 deaths .
`` It is not necessarily correlated to the challenges that states might be facing in long-term care facilities , '' Chidambaram said .
One theory is that those residences are simply conducting more thorough testing than is being done among the general public .
New York has the highest number @ @ @ @ @ @ @ the country .
It also has the highest death rate in what Kaiser Family Foundation describes as long-term care facilities .
As of Wednesday , the foundation reported 5,215 people died from the virus in long-term care facilities in New York — 20 % of the state 's total number of dead .
New Jersey had the second-highest rate with 4,556 reported cases in their facilities , 53 % of the state 's total death toll .
Until now , most states volunteered a patchwork of metrics at their own discretion .
But @ @ @ @ @ @ @ Medicare and Medicaid Services demands that states report coronavirus-related information to the CDC on a weekly basis .
It also requires states to divulge additional data , including Personal Protective Equipment and hand hygiene supplies , resident access to testing , and staffing shortages .
Officials with the American Health Care Association , the trade organization for most nursing homes , has called the outbreak `` devastating . ''
The group urged the federal government to prioritize testing to all residents and caregivers of nursing homes and assisted living communities , regardless of @ @ @ @ @ @ @ it is virtually impossible for us to know who in our facilities , whether they are residents or caregivers , are COVID positive – making it extremely difficult to stop the spread of the virus , '' officials said in a letter this week .
Increased testing may show where hot spots are , but they still do n't address the underlying causes fueling the spread of coronavirus .
`` It was certainly expected that nursing homes would be hit but it was not inevitable that they 'd be hit this hard , @ @ @ @ @ @ @ director of New York-based Long Term Care Community Coalition , said .
The group advocates for greater oversight of skilled nursing facilities .
`` I 'm afraid what we 're seeing now is the failure to ensure that nursing homes are providing appropriate staffing , '' Mollot said , `` that they are undertaking effective and appropriate measures to control infections and prevent infections in their facilities . ''
States have been granted a two-week grace period to submit their data .
The CDC expects to make the information available sometime before the @ @ @ @ @

For Most States, At Least A Third Of COVID-19 Deaths Are In Long-Term Care Facilities
Enlarge this image toggle caption John Minchillo/AP John Minchillo/AP
Coronavirus fatalities in long-term care facilities have surpassed a grim threshold in much of the country, accounting for at least a third of the deaths in 26 states and more than half in 14 of those.
The data, which was published by the Kaiser Family Foundation, reports tallies from a variety of care facilities, including nursing homes, adult care residences, and other skilled nursing care settings. However, it does not break out those categories separately.
The report comes as states prepared to meet a federal reporting deadline Friday.
The striking figures offer only a partial glimpse of the devastating impact of the virus on patients, residents and staff members ahead of the new mandate that requires officials to disclose coronavirus cases and deaths in nursing homes and long-term living residences to the Centers for Disease Control and Prevention.
Priya Chidambaram, a policy analyst with the foundation, was part of the research team compiling information from state dashboards, official statements and other sources. She called the latest statistics "shocking."
"It does really make you think about what the true national numbers will be when we eventually do get data from all 50 states," Chidambaram said.
She expects that skilled nursing facilities will continue to be hot spots for the spread of the virus now that 18 states that have so far declined to publicly report data, hand information over to the CDC.
According to the report, New Hampshire and Pennsylvania reported the highest share of coronavirus deaths — 72% and 70% respectively.
However, the total deaths behind those ratios vary widely from state to state. In the case of New Hampshire, 66 of 114 total deaths occurred in long-term care facilities. Whereas, in Pennsylvania the slightly lower percentage represents a much greater death toll — 2,355 of 3,364 deaths.
"It is not necessarily correlated to the challenges that states might be facing in long-term care facilities," Chidambaram said. One theory is that those residences are simply conducting more thorough testing than is being done among the general public.
New York has the highest number of overall deaths related to COVID-19 in the country. It also has the highest death rate in what Kaiser Family Foundation describes as long-term care facilities.
As of Wednesday, the foundation reported 5,215 people died from the virus in long-term care facilities in New York — 20% of the state's total number of dead. New Jersey had the second-highest rate with 4,556 reported cases in their facilities, 53% of the state's total death toll.
Until now, most states volunteered a patchwork of metrics at their own discretion. But the new rule from the Centers for Medicare and Medicaid Services demands that states report coronavirus-related information to the CDC on a weekly basis. It also requires states to divulge additional data, including Personal Protective Equipment and hand hygiene supplies, resident access to testing, and staffing shortages.
Officials with the American Health Care Association, the trade organization for most nursing homes, has called the outbreak "devastating." The group urged the federal government to prioritize testing to all residents and caregivers of nursing homes and assisted living communities, regardless of symptoms.
"Without expanded testing, it is virtually impossible for us to know who in our facilities, whether they are residents or caregivers, are COVID positive – making it extremely difficult to stop the spread of the virus," officials said in a letter this week.
Increased testing may show where hot spots are, but they still don't address the underlying causes fueling the spread of coronavirus.
"It was certainly expected that nursing homes would be hit but it was not inevitable that they'd be hit this hard," Richard Mollot, of the executive director of New York-based Long Term Care Community Coalition, said. The group advocates for greater oversight of skilled nursing facilities.
"I'm afraid what we're seeing now is the failure to ensure that nursing homes are providing appropriate staffing," Mollot said, "that they are undertaking effective and appropriate measures to control infections and prevent infections in their facilities."
States have been granted a two-week grace period to submit their data. The CDC expects to make the information available sometime before the end of the month.


npr--2020-05-09--Elon Musk Says Tesla Suing California County, Moving Headquarters Out of State

Elon Musk Says Tesla Suing California County , Moving Headquarters Out of State Tesla 's CEO Elon Musk is once again voicing his dissatisfaction with shelter-in-place orders .
This time , he says his company is seeking legal recourse and to relocate its corporate headquarters .
Musk tweeted Saturday that the electric auto-maker would `` immediately '' sue the California county that is home to its main manufacturing plant in the United States .
`` The unelected & ignorant 'Interim Health Officer ' of Alameda is acting contrary to the Governor , the President , our Constitutional freedoms & just @ @ @ @ @ @ @ in a series of replies .
The billionaire CEO also vowed that Tesla would relocate its headquarters and future programs out-of-state .
`` Frankly , this is the final straw .
Tesla will now move its HQ and future programs to Texas/Nevada immediately , '' Musk tweeted .
`` If we even retain Fremont manufacturing activity at all , it will be dependen [ sic ] on how Tesla is treated in the future .
Tesla is the last carmaker left in CA . ''
The tweets were in apparent reference to the @ @ @ @ @ @ @ Dr. Erica Pan , and county restrictions still in place to help curb the spread of COVID-19 .
Health officials in Alameda , and five nearby counties , agreed this past week to maintain their current orders .
The announcement came the same day that California Gov .
Gavin Newsom announced he was giving the go-ahead for some businesses — including manufacturers — to begin reopening .
During a video town hall on Friday , Pan explained the county 's order .
`` We are really asking our facilities within the county that @ @ @ @ @ @ @ to wait until we have another week or so under our belt to see what has happened after we did that first round of lifting restrictions , '' Pan said in response to a question mentioning Tesla .
Musk called the county 's decision to keep non-essential businesses closed both `` irrational and detached from reality . ''
In a statement issued Saturday , Alameda County said its health agencies had been in direct communication and `` working closely '' with the team at Tesla 's factory , adding the automaker had been @ @ @ @ @ @ @ . ''
`` This has been a collaborative , good faith effort to develop and implement a safety plan that allows for reopening while protecting the health and well-being of the thousands of employees who travel to and from work at Tesla 's factory , '' the statement read .
Tesla closed its Fremont , Calif. plant with some resistance in March after initially defying the county 's shelter-in-place order .
Musk has since publicly and vocally bristled against the restrictions .
In a call with investors last month , he said the @ @ @ @ @ @ @ '' and called it `` forcibly imprisoning people in their homes against all their constitutional rights . ''
Musk has also downplayed the coronavirus .
In March , he tweeted that infections in the United States would `` probably '' drop by end of April to `` close to zero new cases . ''
Instead , cases have continued to climb , reaching more than 1.3 million cases and 78,000 deaths nationwide as of Saturday , according to tracking by Johns Hopkins University .
Alameda County has registered more than 1,900 cases and @ @ @

Elon Musk Says Tesla Suing California County, Moving Headquarters Out Of State
Enlarge this image toggle caption Brendan Smialowski /AFP via Getty Images Brendan Smialowski /AFP via Getty Images
Tesla's CEO Elon Musk is once again voicing his dissatisfaction with shelter-in-place orders. This time, he says his company is seeking legal recourse and to relocate its corporate headquarters.
Musk tweeted Saturday that the electric auto-maker would "immediately" sue the California county that is home to its main manufacturing plant in the United States.
"The unelected & ignorant 'Interim Health Officer' of Alameda is acting contrary to the Governor, the President, our Constitutional freedoms & just plain common sense!" Musk wrote in a series of replies.
The billionaire CEO also vowed that Tesla would relocate its headquarters and future programs out-of-state.
"Frankly, this is the final straw. Tesla will now move its HQ and future programs to Texas/Nevada immediately," Musk tweeted. "If we even retain Fremont manufacturing activity at all, it will be dependen [sic] on how Tesla is treated in the future. Tesla is the last carmaker left in CA."
The tweets were in apparent reference to the interim health officer of Alameda County, Dr. Erica Pan, and county restrictions still in place to help curb the spread of COVID-19.
Health officials in Alameda, and five nearby counties, agreed this past week to maintain their current orders. The announcement came the same day that California Gov. Gavin Newsom announced he was giving the go-ahead for some businesses — including manufacturers — to begin reopening.
During a video town hall on Friday, Pan explained the county's order.
"We are really asking our facilities within the county that our local health order still prevails and to wait until we have another week or so under our belt to see what has happened after we did that first round of lifting restrictions," Pan said in response to a question mentioning Tesla.
Musk called the county's decision to keep non-essential businesses closed both "irrational and detached from reality."
In a statement issued Saturday, Alameda County said its health agencies had been in direct communication and "working closely" with the team at Tesla's factory, adding the automaker had been "responsive to our guidance and recommendations."
"This has been a collaborative, good faith effort to develop and implement a safety plan that allows for reopening while protecting the health and well-being of the thousands of employees who travel to and from work at Tesla's factory," the statement read.
Tesla closed its Fremont, Calif. plant with some resistance in March after initially defying the county's shelter-in-place order. Musk has since publicly and vocally bristled against the restrictions.
In a call with investors last month, he said the orders were "breaking people's freedoms" and called it "forcibly imprisoning people in their homes against all their constitutional rights."
Musk has also downplayed the coronavirus. In March, he tweeted that infections in the United States would "probably" drop by end of April to "close to zero new cases."
Instead, cases have continued to climb, reaching more than 1.3 million cases and 78,000 deaths nationwide as of Saturday, according to tracking by Johns Hopkins University. Alameda County has registered more than 1,900 cases and 70 deaths.


npr--2020-05-09--Andre Harrell, Founding Father Of Hip-Hop Soul, Dead At 59

Andre Harrell , hip-hop and R & B mogul and founder of the visionary label Uptown Records , has died .
He was 59 years old .
The Revolt network , where Harrell worked as vice chairman , confirmed Harrell 's passing in a statement .
`` Everyone in the REVOLT family is devastated by the loss of our friend , mentor and Vice-Chairman , '' the statement read .
`` Andre 's impact on Hip Hop and the culture and on us has been immeasurable and profound .
May he Rest In Peace . ''
Harrell was born on @ @ @ @ @ @ @ in the Bronx , N.Y. As a teenager , Harrell formed a hip-hop duo with his high school friend , Alonzo Brown , called Dr. Jekyll & Mr. Hyde ( Harrell was the former ) .
The pair saw success with its singles ; `` Genius Rap , '' released in 1981 , was their most notable .
In 1983 , Harrell met Russell Simmons , who brought him into the fold at his label , Def Jam Records .
Within two years , Harrell became vice president and general manager at Def @ @ @ @ @ @ @ left to pursue the creation of his own label , Uptown Records .
Uptown Records became the home of acts that established a new kind of relationship between R & B and hip-hop , one in which the styles of the genres became inextricably enmeshed : Al B .
Sure , Mary J. Blige , Jodeci and Guy ( which featured a New Jack Swing pioneer in Teddy Riley ) were all R & B acts that leaned heavily on the cultural influence of hip-hop , while Heavy D and the Boyz , @ @ @ @ @ @ @ jagged edges of rap with soul samples and R & B collaborations , pushing forth the musical ideals of Harrell .
In 1992 , MCA made a $ 50 million multimedia deal with Uptown , giving Harrell the opportunity to produce films , TV shows and movie soundtracks .
As a result , the mogul produced the 1991 comedy Strictly Business , starring an up-and-coming Halle Berry and Tommy Davidson .
Harrell also executive produced the TV series New York Undercover , which ran during the 1990s .
Harrell is known for coining @ @ @ @ @ @ @ a phrase that described the aesthetic he was driven to encapsulate : simultaneously relatable and remarkable .
Harrell worked to bring that lifestyle to the forefront of mainstream media .
`` My goal is to bring real black America — just as it is , not watered down — to people everywhere through music , through films , through everything we do , '' he told the Los Angeles Times in 1992 .
Second to his impact as Uptown Records founder , Harrell is well known as the man who gave Sean `` @ @ @ @ @ @ @ an intern for the label , his big shot .
Combs would later become an A & R at Uptown , scouting acts like the Notorious B.I.G.
, who would shape the hip-hop and R & B landscape .
Combs would later recruit his former boss to work as vice chairman of Revolt , a music network and media company helmed by Combs .
Throughout his career , Harrell was widely considered a tastemaker .
In a 2018 interview with Ebro Darden , Harrell explained his self-given purpose at the later stages of @ @ @ @ @ @ @ give people direction , in terms of the cultural currency of what things could be . ''

Andre Harrell, Founding Father Of Hip-Hop Soul, Dead At 59
Enlarge this image toggle caption Nick Wass/AP Nick Wass/AP
Andre Harrell, hip-hop and R&B mogul and founder of the visionary label Uptown Records, has died. He was 59 years old.
The Revolt network, where Harrell worked as vice chairman, confirmed Harrell's passing in a statement. "Everyone in the REVOLT family is devastated by the loss of our friend, mentor and Vice-Chairman," the statement read. "Andre's impact on Hip Hop and the culture and on us has been immeasurable and profound. May he Rest In Peace."
Harrell was born on Sept. 26, 1960, and raised in the Bronx, N.Y. As a teenager, Harrell formed a hip-hop duo with his high school friend, Alonzo Brown, called Dr. Jekyll & Mr. Hyde (Harrell was the former). The pair saw success with its singles; "Genius Rap," released in 1981, was their most notable.
In 1983, Harrell met Russell Simmons, who brought him into the fold at his label, Def Jam Records. Within two years, Harrell became vice president and general manager at Def Jam. By 1986, Harrell had left to pursue the creation of his own label, Uptown Records.
Uptown Records became the home of acts that established a new kind of relationship between R&B and hip-hop, one in which the styles of the genres became inextricably enmeshed: Al B. Sure, Mary J. Blige, Jodeci and Guy (which featured a New Jack Swing pioneer in Teddy Riley) were all R&B acts that leaned heavily on the cultural influence of hip-hop, while Heavy D and the Boyz, a hip-hop act, sanded down the jagged edges of rap with soul samples and R&B collaborations, pushing forth the musical ideals of Harrell.
In 1992, MCA made a $50 million multimedia deal with Uptown, giving Harrell the opportunity to produce films, TV shows and movie soundtracks. As a result, the mogul produced the 1991 comedy Strictly Business, starring an up-and-coming Halle Berry and Tommy Davidson. Harrell also executive produced the TV series New York Undercover, which ran during the 1990s.
Harrell is known for coining the term "ghetto fabulous," a phrase that described the aesthetic he was driven to encapsulate: simultaneously relatable and remarkable. Harrell worked to bring that lifestyle to the forefront of mainstream media. "My goal is to bring real black America — just as it is, not watered down — to people everywhere through music, through films, through everything we do," he told the Los Angeles Times in 1992.
Second to his impact as Uptown Records founder, Harrell is well known as the man who gave Sean "Diddy" Combs, who worked as an intern for the label, his big shot. Combs would later become an A&R at Uptown, scouting acts like the Notorious B.I.G., who would shape the hip-hop and R&B landscape. Combs would later recruit his former boss to work as vice chairman of Revolt, a music network and media company helmed by Combs.
Throughout his career, Harrell was widely considered a tastemaker. In a 2018 interview with Ebro Darden, Harrell explained his self-given purpose at the later stages of his career. "I try to give people direction, in terms of the cultural currency of what things could be."


npr--2020-05-09--FDA Grants Emergency Use Authorization For 1st Coronavirus Antigen Test

The Food and Drug Administration announced Saturday that it has granted its first emergency authorization to a new type of test that can detect the coronavirus , called an antigen test .
The test looks for protein fragments associated with the virus .
The sample is collected with a nasal swab .
It can produce a result in minutes , the FDA said in a statement .
The agency notes that compared to already approved genetic testing , the antigen test is cheaper and easier to use and could `` potentially scale to test millions of Americans per day '' @ @ @ @ @ @ @ So far , only San Diego-based Quidel Corporation has received authorization for the tests .
That authorization was granted late Friday .
Two other types of tests for the coronavirus have received the emergency authorization .
One , called a polymerase chain reaction , or PCR test , is a molecular diagnostic tool that identifies the virus 's genetic material .
The other is an antibody test .
Antigen testing is not without its shortcomings .
The FDA notes that this test is less reliable at ruling out infection in patients and that @ @ @ @ @ @ @ confirmed with a PCR test prior to making treatment decisions or to prevent the possible spread of the virus due to a false negative . ''
`` Antigen tests are very specific for the virus , but are not as sensitive as molecular PCR tests , '' the agency said .
`` This means that positive results from antigen tests are highly accurate , but there is a higher chance of false negatives , so negative results do not rule out infection . ''
The FDA says that it expects more antigen tests @ @ @ @ @ @ @ will play a critical role in the fight against COVID-19 . ''

FDA Grants Emergency Use Authorization For 1st Coronavirus Antigen Test
Enlarge this image toggle caption Seth Wenig/AP Seth Wenig/AP
The Food and Drug Administration announced Saturday that it has granted its first emergency authorization to a new type of test that can detect the coronavirus, called an antigen test.
The test looks for protein fragments associated with the virus. The sample is collected with a nasal swab. It can produce a result in minutes, the FDA said in a statement. The agency notes that compared to already approved genetic testing, the antigen test is cheaper and easier to use and could "potentially scale to test millions of Americans per day" once multiple manufacturers enter the market.
So far, only San Diego-based Quidel Corporation has received authorization for the tests. That authorization was granted late Friday.
Two other types of tests for the coronavirus have received the emergency authorization. One, called a polymerase chain reaction, or PCR test, is a molecular diagnostic tool that identifies the virus's genetic material. The other is an antibody test.
Antigen testing is not without its shortcomings. The FDA notes that this test is less reliable at ruling out infection in patients and that negative results "may need to be confirmed with a PCR test prior to making treatment decisions or to prevent the possible spread of the virus due to a false negative."
"Antigen tests are very specific for the virus, but are not as sensitive as molecular PCR tests," the agency said. "This means that positive results from antigen tests are highly accurate, but there is a higher chance of false negatives, so negative results do not rule out infection."
The FDA says that it expects more antigen tests to be authorized and that they "will play a critical role in the fight against COVID-19."


npr--2020-05-09--FDA Commissioner Enters Self-Quarantine After Exposure To Coronavirus

The commissioner of the Food and Drug Administration has entered self-quarantine for two weeks after coming into contact with a person who tested positive for the coronavirus .
Stephen Hahn announced his decision to do so in an internal message to staff on Friday , according to an FDA spokesperson .
Hahn has not tested positive himself .
The commissioner `` immediately took a diagnostic test and tested negative for the virus , '' said Stephanie Caccomo , an FDA press officer , in a statement to NPR on Saturday .
Hahn 's decision to self-quarantine — in accordance with @ @ @ @ @ @ @ Control and Prevention — makes him just the latest member of President Trump 's orbit to be exposed to the virus this week .
Vice President Pence 's press secretary , Katie Miller , tested positive for the virus on Friday — `` out of the blue , '' Pence said , with no obvious symptoms .
She is married to Stephen Miller , a senior adviser to Trump .
Her diagnosis followed the news that a U.S. military aide who works in the White House also tested positive .
The FDA did @ @ @ @ @ @ @ had been exposed .
Both Trump and Pence have drawn criticism for breaking with CDC recommendations and appearing in public settings recently without donning some form of face covering .
Earlier this week , Trump announced that testing around the White House would be undertaken daily rather than weekly and that valets working around him will now be required to wear face masks .

Top Health Officials Enter Self-Quarantine After Exposure To Coronavirus
Enlarge this image toggle caption Mandel Ngan/AFP via Getty Images Mandel Ngan/AFP via Getty Images
Updated at 2:05 p.m. ET Sunday
Three members of the White House's coronavirus task force, including Dr. Anthony Fauci, are quarantining themselves after coming into contact with someone who has tested positive for the coronavirus.
Stephen Hahn, commissioner of the Food and Drug Administration, and Robert Redfield, the director of the Centers for Disease Control and Prevention, have decided to self-quarantine for two weeks.
Fauci, the director of the National Institute of Allergy and Infectious Diseases, is beginning a "modified quarantine" after he made a "low risk" contact with a White House staff member who tested positive for the coronavirus, NPR has confirmed.
"Dr. Fauci has tested negative for COVID-19, and he will continue to be tested regularly," a NIAID spokesperson said in a statement to NPR. "He is considered to be at relatively low-risk based on the degree of his exposure. Nevertheless he is taking appropriate precautions to mitigate risk to any of his personal contacts while still allowing him to carry out his responsibilities in this public health crisis."
Fauci told CNN that he will mostly telework from home during his 14-day quarantine.
Hahn announced his decision to self-quarantine — in accordance with guidelines issued by the CDC — in an internal message to staff on Friday, according to an FDA spokesperson.
Hahn has not tested positive himself. The commissioner "immediately took a diagnostic test and tested negative for the virus," said Stephanie Caccomo, an FDA press officer, in a statement to NPR on Saturday.
Also on Saturday, the CDC confirmed to The Washington Post Redfield's decision to place himself in quarantine after his "low-risk" exposure to "a person at the White House who has COVID-19," but has shown no symptoms.
During their quarantines, Redfield, Hahn and Fauci — along with a fourth witness — will testify before a Senate committee on Tuesday by video conference, rather than in person, Sen. Lamar Alexander, R-Tenn., said in a statement on Sunday.
The three senior public health officials are latest members of President Trump's orbit to be exposed to the virus this week.
Vice President Pence's press secretary, Katie Miller, tested positive for the virus on Friday — "out of the blue," Pence said, with no obvious symptoms. She is married to Stephen Miller, a senior adviser to Trump. Her diagnosis followed the news that a U.S. military aide who works in the White House also tested positive.
Still, it remains unclear to whom Hahn, Redfield and Fauci had been exposed.
Both Trump and Pence have drawn criticism for breaking with CDC recommendations and appearing in public settings recently without donning some form of face covering. Earlier this week, Trump announced that testing around the White House would be undertaken daily rather than weekly and that valets working around him will now be required to wear face masks.


npr--2020-05-09--U.K. Airlines, Airports Fear 'Devastating Impact' Of Possible Quarantine Rules

Airlines and airport operators in the United Kingdom are not waiting for the government to publicly confirm their fears .
Already , the groups representing major players in the U.K. 's air travel industry are pushing back on a proposal that would require travelers to quarantine after arriving from outside the country .
A spokesperson for Airlines UK — a trade body with British Airways , easyJet and Ryanair as members — says that the group understands from government officials that plans for a quarantine are in the works , but that details remain scarce at the moment .
`` @ @ @ @ @ @ @ what they are proposing .
Public health must of course be the priority and we will continue to be guided by Sage advice , '' the group said in a statement emailed to NPR , noting that support measures will be necessary to ensure `` that we still have a UK aviation sector once the quarantine period is lifted . ''
`` We will be asking for assurances that this decision has been led by the science and that Government has a credible exit plan , with weekly reviews to ensure the restrictions @ @ @ @ @ @ @ The prime minister 's office declined to comment , suggesting that details about the situation will be addressed in Boris Johnson 's speech Sunday evening .
In his address , Johnson is expected to lay out a road map for the U.K. 's continued coronavirus response , which to this point has included weeks of broad lockdown measures nationwide .
The U.K. has suffered Europe 's highest death toll linked to COVID-19 , with upwards of 31,600 confirmed patients dead , according to data compiled by Johns Hopkins University .
Only the United @ @ @ @ @ @ @ worldwide .
The Times in London reports that under the new restrictions , travelers entering the U.K. — including citizens — would need to self-isolate for 14 days , with fines threatened for violators .
The Airport Operators Association says it has received no word from officials regarding the possible quarantine — though the group 's chief executive , Karen Dee , pushed back strongly on the idea in a statement sent to NPR .
`` Quarantine would not only have a devastating impact on the UK aviation industry , but also on @ @ @ @ @ @ @ enabler for many other industries , such as manufacturers , tourism and the hospitality industry , '' she said , adding that airports in the country `` can not survive a further protracted period without passengers that would be the result of quarantine measures . ''
`` If quarantine is a necessary tool for fighting COVID-19 , '' she said , `` then the Government should act decisively to protect the hundreds of thousands of airport-related and travel-related jobs across the UK . ''

U.K. Airlines, Airports Fear 'Devastating Impact' Of Possible Quarantine Rules
Enlarge this image toggle caption Ben Stansall/AFP via Getty Images Ben Stansall/AFP via Getty Images
Airlines and airport operators in the United Kingdom are not waiting for the government to publicly confirm their fears. Already, the groups representing major players in the U.K.'s air travel industry are pushing back on a proposal that would require travelers to quarantine after arriving from outside the country.
A spokesperson for Airlines UK — a trade body with British Airways, easyJet and Ryanair as members — says that the group understands from government officials that plans for a quarantine are in the works, but that details remain scarce at the moment.
"We need to see the detail of what they are proposing. Public health must of course be the priority and we will continue to be guided by Sage advice," the group said in a statement emailed to NPR, noting that support measures will be necessary to ensure "that we still have a UK aviation sector once the quarantine period is lifted."
"We will be asking for assurances that this decision has been led by the science and that Government has a credible exit plan, with weekly reviews to ensure the restrictions are working and still required."
The prime minister's office declined to comment, suggesting that details about the situation will be addressed in Boris Johnson's speech Sunday evening. In his address, Johnson is expected to lay out a road map for the U.K.'s continued coronavirus response, which to this point has included weeks of broad lockdown measures nationwide.
The U.K. has suffered Europe's highest death toll linked to COVID-19, with upwards of 31,600 confirmed patients dead, according to data compiled by Johns Hopkins University. Only the United States has reported a higher death toll worldwide.
The Times in London reports that under the new restrictions, travelers entering the U.K. — including citizens — would need to self-isolate for 14 days, with fines threatened for violators. The Airport Operators Association says it has received no word from officials regarding the possible quarantine — though the group's chief executive, Karen Dee, pushed back strongly on the idea in a statement sent to NPR.
"Quarantine would not only have a devastating impact on the UK aviation industry, but also on the wider economy. Aviation is an enabler for many other industries, such as manufacturers, tourism and the hospitality industry," she said, adding that airports in the country "cannot survive a further protracted period without passengers that would be the result of quarantine measures."
"If quarantine is a necessary tool for fighting COVID-19," she said, "then the Government should act decisively to protect the hundreds of thousands of airport-related and travel-related jobs across the UK."


npr--2020-05-09--Little Richard, The 'King And Queen' Of Rock And Roll, Dead At 87

Little Richard , The 'King And Queen ' Of Rock And Roll , Dead At 87 Little Richard , the self-described `` king and queen '' of rock and roll and an outsize influence on everyone from David Bowie to Prince , died Saturday in Tullahoma , Tenn .
He was 87 years old .
Bill Sobel , a lawyer for Little Richard , tells NPR that the cause of death was bone cancer .
Rolling Stone was the first to report on Little Richard 's death .
With his ferocious piano playing , growling and gospel-strong vocals , pancake @ @ @ @ @ @ @ tore down barriers starting in the 1950s .
That is no small feat for any artist — let alone a black , openly gay man who grew up in the South .
He was a force of nature who outlived many of the musicians he inspired , from Otis Redding to the late Prince and Michael Jackson .
His peers James Brown and Otis Redding idolized him .
Jimi Hendrix , who once played in Little Richard 's band , said he wanted his guitar to sound like Richard 's voice .
The @ @ @ @ @ @ @ when he first saw Little Richard in a movie .
`` If it had n't have been for him , I probably would n't have gone into music , '' Bowie told Performing Songwriter magazine in 2003 .
Bob Dylan took to Twitter on Saturday to remember Little Richard , writing `` He was my shining star and guiding light back when I was only a little boy .
His was the original spirit that moved me to do everything I would do . ''
Little Richard was an audacious showman in everything @ @ @ @ @ @ @ Out In Beverly Hills , music for children and commercials .
But above all , he was a pioneer of rock and roll , mixing gospel , country , vaudeville and blues into something all his own .
Little Richard was born Richard Wayne Penniman on Dec. 5 , 1932 , in Macon , Ga .
He was one of 12 siblings .
His father was a brick mason , a bootlegger and eventually a nightclub owner .
When Richard was 19 , his father was shot to death outside of his club @ @ @ @ @ @ @ , 1952 .
Little Richard told NPR 's Morning Edition in 1984 that Macon was `` a muddy little town . ''
`` A lot of mud and a lot of cows and a lot of chickens and a lot of pigs , '' he recalled .
`` It was a beautiful place and I was singing all up and down the street loud as I can .
Everybody hollering out there , 'Shut up !
Shut up !
You 're making too much noise ! '
But I was singing 'Tutti Frutti @ @ @ @ @ @ @ ' at the piano at that time . ''
To develop his style , Little Richard borrowed a few things from the performers he admired , like a singer and pianist who went by the name of Esquerita .
Esquerita was openly gay , and he wore make-up and loud clothing .
He also taught Little Richard to play the piano .
Then there was gospel singer Marion Williams , from whom Little Richard said he got his trademark whoop .
Charles White , the author of an authorized biography called The Life @ @ @ @ @ @ @ his voice as `` a fire blizzard across an arctic waste .
I mean , every major rock singer tried to copy his voice . ''
In the 1950s , the music industry — like so much else in America — was segregated .
`` Back at that time , the black records was considered race records , '' Little Richard told Morning Edition .
`` And black records was not played on white stations at the time . ''
White artists like Pat Boone often scored big hits by covering Little Richard @ @ @ @ @ @ @ that he did n't see `` a dime '' from some of those covers .
`` I been knocking for years and they wo n't let me come in , '' he said .
`` I keep coming back , trying it again .
Have n't got nothing .
While I was slipping and sliding , they was keeping and hiding — putting my money in unknown banks . ''
Eventually , Little Richard did make a lot of money from his recordings , movies and TV appearances .
He toured the world @ @ @ @ @ @ @ , a living icon who was both respected and ridiculed .
Little Richard was a man of extremes : A wild pop star and a deeply religious person known to carry his Bible everywhere , and quote from it often .
There were periods during his career when he left show business altogether to preach .
He often said he wanted to be a minister , like others in his family .
The 1970s were rough for Little Richard .
He was drinking and doing drugs daily , a habit that was costing @ @ @ @ @ @ @ `` I just started falling .
I started sinking , '' he told NPR .
`` I just started getting out of it .
I did n't want to make my engagements .
I did n't want to do anything but just party hearty . ''
His younger brother died around this time , and two of his friends were killed .
`` And then I said , 'Well , God is trying to tell me something . '
Then the thought came to me : 'What shall he profit a man if @ @ @ @ @ @ @ lose his own soul ? '
Or 'What shall a man give God in exchange for a soul ? '
And I decided I would give my life to God . ''
It took someone like Little Richard — a fearless performer and gifted musician — to move American music forward .
He liked to remind people he was `` the architect '' of rock and roll .
He did n't build the music by himself , but he was one of its most original designers .

Little Richard, The 'King And Queen' Of Rock And Roll, Dead At 87
Enlarge this image toggle caption Rosemary Matthews/Getty Images Rosemary Matthews/Getty Images
Updated at 7:13 p.m. ET
Little Richard, the self-described "king and queen" of rock and roll and an outsize influence on everyone from David Bowie to Prince, died Saturday in Tullahoma, Tenn. He was 87 years old.
Bill Sobel, a lawyer for Little Richard, tells NPR that the cause of death was bone cancer. Rolling Stone was the first to report on Little Richard's death.
With his ferocious piano playing, growling and gospel-strong vocals, pancake makeup and outlandish costumes, Little Richard tore down barriers starting in the 1950s. That is no small feat for any artist — let alone a black, openly gay man who grew up in the South.
He was a force of nature who outlived many of the musicians he inspired, from Otis Redding to the late Prince and Michael Jackson. His peers James Brown and Otis Redding idolized him. Jimi Hendrix, who once played in Little Richard's band, said he wanted his guitar to sound like Richard's voice. The late David Bowie was 9 years old when he first saw Little Richard in a movie. "If it hadn't have been for him, I probably wouldn't have gone into music," Bowie told Performing Songwriter magazine in 2003.
Bob Dylan took to Twitter on Saturday to remember Little Richard, writing "He was my shining star and guiding light back when I was only a little boy. His was the original spirit that moved me to do everything I would do."
Little Richard was an audacious showman in everything he did: movies like Down and Out In Beverly Hills, music for children and commercials. But above all, he was a pioneer of rock and roll, mixing gospel, country, vaudeville and blues into something all his own.
Little Richard was born Richard Wayne Penniman on Dec. 5, 1932, in Macon, Ga. He was one of 12 siblings. His father was a brick mason, a bootlegger and eventually a nightclub owner. When Richard was 19, his father was shot to death outside of his club: Charles Penniman died on Feb. 15, 1952.
Little Richard told NPR's Morning Edition in 1984 that Macon was "a muddy little town."
"A lot of mud and a lot of cows and a lot of chickens and a lot of pigs," he recalled. "It was a beautiful place and I was singing all up and down the street loud as I can. Everybody hollering out there, 'Shut up! Shut up! You're making too much noise!' But I was singing 'Tutti Frutti' even then. And playing 'Lucille' at the piano at that time."
Stream Little Richard's Greatest Songs
To develop his style, Little Richard borrowed a few things from the performers he admired, like a singer and pianist who went by the name of Esquerita. Esquerita was openly gay, and he wore make-up and loud clothing. He also taught Little Richard to play the piano.
Then there was gospel singer Marion Williams, from whom Little Richard said he got his trademark whoop.
Charles White, the author of an authorized biography called The Life And Times Of Little Richard, described his voice as "a fire blizzard across an arctic waste. I mean, every major rock singer tried to copy his voice."
In the 1950s, the music industry — like so much else in America — was segregated.
"Back at that time, the black records was considered race records," Little Richard told Morning Edition. "And black records was not played on white stations at the time."
YouTube
White artists like Pat Boone often scored big hits by covering Little Richard's songs. And Little Richard claimed that he didn't see "a dime" from some of those covers.
"I been knocking for years and they won't let me come in," he said. "I keep coming back, trying it again. Haven't got nothing. While I was slipping and sliding, they was keeping and hiding — putting my money in unknown banks."
YouTube
Eventually, Little Richard did make a lot of money from his recordings, movies and TV appearances. He toured the world. He was, in many ways, a living icon who was both respected and ridiculed.
Little Richard was a man of extremes: A wild pop star and a deeply religious person known to carry his Bible everywhere, and quote from it often. There were periods during his career when he left show business altogether to preach. He often said he wanted to be a minister, like others in his family.
The 1970s were rough for Little Richard. He was drinking and doing drugs daily, a habit that was costing him hundreds of dollars a day.
"I just started falling. I started sinking," he told NPR. "I just started getting out of it. I didn't want to make my engagements. I didn't want to do anything but just party hearty."
YouTube
His younger brother died around this time, and two of his friends were killed.
"And then I said, 'Well, God is trying to tell me something.' Then the thought came to me: 'What shall he profit a man if he should gain the whole world and lose his own soul?' Or 'What shall a man give God in exchange for a soul?' And I decided I would give my life to God."
It took someone like Little Richard — a fearless performer and gifted musician — to move American music forward. He liked to remind people he was "the architect" of rock and roll. He didn't build the music by himself, but he was one of its most original designers.