usatoday--2020-07-29--'The virus beat us': Colleges are increasingly going online for fall 2020 semester as COVID-19 cases

Call it coronavirus déjà vu .
After planning ways to reopen campuses this fall , colleges are increasingly changing their minds , dramatically increasing online offerings or canceling in-person classes outright .
This sudden shift will be familiar to students whose spring plans were interrupted by the rapid spread of the coronavirus .
Now , COVID-19 cases in much of the country are much higher than in the spring , and rising in many places .
In many cases , the colleges had released plans for socially distant in-person classes only a few weeks ago , hoping to beat the @ @ @ @ @ @ @ Robert Kelchen , a professor of higher education at Seton Hall University , “ the virus beat us.
” Just as in the spring , students have been left scrambling to adjust their class schedules and living arrangements , faced with paying expensive tuition for online classes and rent for an apartment they may not need .
Digital classes are still unappealing to many , and the chances of in-person instruction for next semester remain murky .
Just this week , Miami University in Ohio said all undergraduate classes would be held virtually @ @ @ @ @ @ @ Virginia University announced its classes would start on August 21 , about a week later than originally planned , and that most upper-division courses would be taught online or through a hybrid of in-person and online courses .
And George Washington University in Washington , D.C. , said it was forgoing its plans for the fall semester and would hold undergraduate and most graduate classes online , joining colleges such as the California State University system and Harvard that had already made that decision .
“ We know just how much many of @ @ @ @ @ @ @ campus this fall , and we understand that this news is disappointing , ” George Washington said in a statement .
Schools are going online , too : Despite CDC recommendations , most major districts going online as COVID-19 cases spike That news would have been good to know before Arianna Miskin , a graduate student at the university studying for a master ’ s of public health , signed a lease in Washington .
She had been living in the neighboring city of Arlington , Virginia , and wanted to move to @ @ @ @ @ @ @ the city .
For now , she said will remain in the city while trying to finish her coursework .
Miskin said the university has communicated well about its reactions to the pandemic , which she called a “ once-in-a-lifetime event.
” But she wishes the administration acted earlier in the summer .
“ We were n't asked until June whether we preferred online or hybrid-on-campus , ” with some classes online and some in-person , she said .
“ The semester starts in a month .
They moved too late.
” More @ @ @ @ @ @ @ COVID-19 cases continue to rise .
The Chronicle of Higher Education has been tracking the plans for roughly 1,260 colleges throughout the summer .
Earlier this year , nearly two-thirds of institutions had planned on in-person instruction .
As of Tuesday , about 49 % said they were on that track .
About a third were planning for a semester that would include a mix of online and in-person classes , while 13 % were planning for online instruction .
Some colleges , such as the University of California at Berkeley , have @ @ @ @ @ @ @ they ’ ll start the semester remotely with a chance of some in-person instruction later into the semester .
Kelchen expects more schools to announce changes to the fall semester in the next week or so .
Colleges have waited to cancel in-person classes in hopes that public health would improve .
A huge motivator : Colleges need students on campus to bring in tuition and room-and-board money , and to help at-risk students persist toward their degrees .
Plus , many are worried about a backlash from students , lawmakers or the @ @ @ @ @ @ @ White House to some state governments for education institutions to reopen fully .
Trump administration : Guidance bars new foreign students from US if they 're taking online classes Administrators now have weeks left before the fall semester and little expectation that anything substantial will change , Kelchen said .
One looming alternative : Colleges could reopen their campuses and bring in students from across the country , then have to send students home after a few weeks because of an outbreak .
After all , Kelchen said : “ Major League Baseball @ @ @ @ @ @ @ testing and safety for players in their state , ” he said .
“ Their season is on the brink after three games.
” Even if campuses reopen , ‘ anything is possible ’ In deciding whether to reopen , colleges must consider more than just their local COVID-19 case rate .
Many of their students come from across the country .
So while the college ’ s city or state might be seeing flat or dropping case rates , administrators must weigh the country ’ s rising caseload as a whole .
@ @ @ @ @ @ @ , will prohibit students who live in states on the New York mandatory quarantine list from attending class in person during the fall semester .
Others say they will require some students to spend two weeks in quarantine before starting classes .
That raises the question of who should be required to quarantine , said Gerri Taylor , co-chair of the American College Health Association ’ s COVID-19 task force .
Should institutions require only out-of-state students to quarantine ?
Should that rule also apply to international students ?
Bringing students back to @ @ @ @ @ @ @ – and few universities have a comprehensive or affordable solution .
Plus , testing addresses a limited time frame .
A person might test negative , but they could be positive three days later , Taylor said .
“ Who wants to go and get tested every couple of days or even once a week ?
” Taylor said .
“ I think that would be a difficult sell for college students.
” Still , the most certain aspect of the fall will be a constant presence of uncertainty .
Colleges that are @ @ @ @ @ @ @ to move courses online , looking at the number of COVID-19 cases in the community and the number on campus , among students but also faculty and staff .
“ Anything is possible , ” Taylor said .
“ I think families also have to have contingency plans.
” Dickinson College , a private liberal arts college in Carlisle , Pennsylvania , was one of earlier universities to announce plans to forgo an in-person fall semester in favor of a digital one .
That was after it told students in June that officials @ @ @ @ @ @ @ that time , said the college ’ s president , Margee Ensign , the window for testing results in that region was about two days .
But as the summer deepened , the wait for test results grew longer , she said , and college officials couldn ’ t find someone who could offer results more quickly .
She said the state ’ s rollout of contact tracing was inadequate , and there was little federal guidance .
By July 15 , the college had made the decision to move to remote instruction @ @ @ @ @ @ @ were disappointed , Ensign said , and the move may lead to financial or recruitment concerns down the line .
But , she added , people have framed the decision as though it was online courses versus traditional in-person classes .
“ Really , it 's remote versus in-person in a pandemic , ” Ensign said .
“ We came to the conclusion that the fully remote , we could make that a better experience , actually , because faculty now have extra time to prepare for that.
” Dickinson obviously isn ’ @ @ @ @ @ @ @ who aren ’ t living on campus , and it ’ s waiving a 4 % tuition increase and its student activity fees .
Other colleges , such as George Washington , are offering a tuition discount .
( GWU ’ s is 10 % for undergraduates who live off campus . )
That may not be enough for some students , who feel the tuition goes toward in-person instruction plus the college ’ s social experience .
But colleges say it ’ s not actually cheaper to provide digital instruction if faculty @ @ @ @ @ @ @ they ’ re losing revenue from housing and dining plans .
The bottom line : College students are frustrated , no matter what option their university is currently taking .
Some students at institutions such as the University of Pittsburgh are pushing their universities to move instruction online .
And students at Kansas State University are frustrated that their college changed their in-person course to online instruction , then charged a special fee for digital courses .
Others , like Hannah Landry , a sophomore at Texas A & M University , are @ @ @ @ @ @ @ Most of her classes are being offered online .
To help make her decision , she ran a Twitter poll .
She thought her peers would overwhelmingly tell her to go back to campus .
Instead , she found some had encouraged her to stay with family in west Texas , where COVID-19 rates are low , because she could save money and avoid exposure to coronavirus .
The college is still offering some in-person courses , she said , but she is worried about moving back to College Station in the fall @ @ @ @ @ @ @ doing the same thing .
She said she also wants to see her family multiple times during the semester , but some of them are older and at higher risk for coronavirus .
And when it comes down to it , she is not just not sure who she can trust .
“ I just don ’ t think us kids are self-disciplined enough to not go out in public and be with people , ” she said .
“ I just think the numbers are going to skyrocket.
” Education coverage at @ @ @ @ @ @ @ by a grant from the Bill and Melinda Gates Foundation .
The Gates Foundation does not provide editorial input .

'The virus beat us': Colleges are increasingly going online for fall 2020 semester as COVID-19 cases rise
Show Caption Hide Caption Coronavirus reopening: College fall 2020 plans vary widely Online learning, single rooms in hotels as dorms and staggered scheduling are just some of the ideas in motion for 2020's fall semester. USA TODAY
Call it coronavirus déjà vu. After planning ways to reopen campuses this fall, colleges are increasingly changing their minds, dramatically increasing online offerings or canceling in-person classes outright.
This sudden shift will be familiar to students whose spring plans were interrupted by the rapid spread of the coronavirus. Now, COVID-19 cases in much of the country are much higher than in the spring, and rising in many places.
In many cases, the colleges had released plans for socially distant in-person classes only a few weeks ago, hoping to beat the coronavirus.
Coronavirus: How access to the internet is not created equal As schools debate about returning to online learning, the lack of internet access for many Americans is a big sticking point. Just the FAQs, USA TODAY
“Instead,” said Robert Kelchen, a professor of higher education at Seton Hall University, “the virus beat us.”
Just as in the spring, students have been left scrambling to adjust their class schedules and living arrangements, faced with paying expensive tuition for online classes and rent for an apartment they may not need. Digital classes are still unappealing to many, and the chances of in-person instruction for next semester remain murky.
Just this week, Miami University in Ohio said all undergraduate classes would be held virtually through at least September 21. West Virginia University announced its classes would start on August 21, about a week later than originally planned, and that most upper-division courses would be taught online or through a hybrid of in-person and online courses. And George Washington University in Washington, D.C., said it was forgoing its plans for the fall semester and would hold undergraduate and most graduate classes online, joining colleges such as the California State University system and Harvard that had already made that decision.
“We know just how much many of you were looking forward to being on campus this fall, and we understand that this news is disappointing,” George Washington said in a statement.
Schools are going online, too: Despite CDC recommendations, most major districts going online as COVID-19 cases spike
That news would have been good to know before Arianna Miskin, a graduate student at the university studying for a master’s of public health, signed a lease in Washington. She had been living in the neighboring city of Arlington, Virginia, and wanted to move to be closer to her school and in the city.
For now, she said will remain in the city while trying to finish her coursework.
Miskin said the university has communicated well about its reactions to the pandemic, which she called a “once-in-a-lifetime event.” But she wishes the administration acted earlier in the summer.
“We weren't asked until June whether we preferred online or hybrid-on-campus,” with some classes online and some in person, she said. “The semester starts in a month. They moved too late.”
More universities are likely to follow suit if COVID-19 cases continue to rise.
The Chronicle of Higher Education has been tracking the plans for roughly 1,260 colleges throughout the summer. Earlier this year, nearly two-thirds of institutions had planned on in-person instruction. As of Tuesday, about 49% said they were on that track. About a third were planning for a semester that would include a mix of online and in-person classes, while 13% were planning for online instruction.
Some colleges, such as the University of California at Berkeley, have put off an official decision, saying they’ll start the semester remotely with a chance of some in-person instruction later into the semester.
Kelchen expects more schools to announce changes to the fall semester in the next week or so. Colleges have waited to cancel in-person classes in hopes that public health would improve. A huge motivator: Colleges need students on campus to bring in tuition and room-and-board money, and to help at-risk students persist toward their degrees. Plus, many are worried about a backlash from students, lawmakers, or the public, with pressure ranging from the White House to some state governments for education institutions to reopen fully.
Trump administration: Guidance bars new foreign students from US if they're taking online classes
Administrators now have weeks left before the fall semester and little expectation that anything substantial will change, Kelchen said.
One looming alternative: Colleges could reopen their campuses and bring in students from across the country, then have to send students home after a few weeks because of an outbreak.
After all, Kelchen said: “Major League Baseball's spending incredible amounts of money on testing and safety for players in their state,” he said. “Their season is on the brink after three games.”
Even if campuses reopen, ‘anything is possible’
In deciding whether to reopen, colleges must consider more than just their local COVID-19 case rate. Many of their students come from across the country. So while the college’s city or state might be seeing flat or dropping case rates, administrators must weigh the country’s rising caseload as a whole.
Some institutions, such as Ithaca College, will prohibit students who live in states on the New York mandatory quarantine list from attending class in person during the fall semester. Others say they will require some students to spend two weeks in quarantine before starting classes.
That raises the question of who should be required to quarantine, said Gerri Taylor, co-chair of the American College Health Association’s COVID-19 task force. Should institutions require only out-of-state students to quarantine? Should that rule also apply to international students?
Bringing students back to campus also introduces questions about coronavirus testing – and few universities have a comprehensive or affordable solution.
Plus, testing addresses a limited time frame. A person might test negative, but they could be positive three days later, Taylor said. “Who wants to go and get tested every couple of days or even once a week?” Taylor said. “I think that would be a difficult sell for college students.”
Still, the most certain aspect of the fall will be a constant presence of uncertainty. Colleges that are reopening must plan for if and when to move courses online, looking at the number of COVID-19 cases in the community and the number on campus, among students but also faculty and staff.
“Anything is possible,” Taylor said. “I think families also have to have contingency plans.”
In-person classes – during a pandemic?
Dickinson College, a private liberal arts college in Carlisle, Pennsylvania, was one of earlier universities to announce plans to forgo an in-person fall semester in favor of a digital one. That was after it told students in June that officials hoped to offer face-to-face classes.
Around that time, said the college’s president, Margee Ensign, the window for testing results in that region was about two days. But as the summer deepened, the wait for test results grew longer, she said, and college officials couldn’t find someone who could offer results more quickly. She said the state’s rollout of contact tracing was inadequate, and there was little federal guidance.
By July 15, the college had made the decision to move to remote instruction for students.
Of course, students were disappointed, Ensign said, and the move may lead to financial or recruitment concerns down the line. But, she added, people have framed the decision as though it was online courses versus traditional in-person classes.
“Really, it's remote versus in-person in a pandemic,” Ensign said. “We came to the conclusion that the fully remote (classes), we could make that a better experience, actually, because faculty now have extra time to prepare for that.”
Dickinson obviously isn’t charging room and board for students who aren’t living on campus, and it’s waiving a 4% tuition increase and its student activity fees. Other colleges, such as George Washington, are offering a tuition discount. (GWU’s is 10% for undergraduates who live off campus.)
College students are frustrated
That may not be enough for some students, who feel the tuition goes toward in-person instruction plus the college’s social experience.
But colleges say it’s not actually cheaper to provide digital instruction if faculty salaries remain the same. Plus, they’re losing revenue from housing and dining plans.
The bottom line: College students are frustrated, no matter what option their university is currently taking.
Some students at institutions such as the University of Pittsburgh are pushing their universities to move instruction online. And students at Kansas State University are frustrated that their college changed their in-person course to online instruction, then charged a special fee for digital courses.
Hey @KState I see the $210 fee you added to my account for an online course. Do you think a 22.4% up charge is fair when you changed the course format after I enrolled? — Cameron Koger (@cameron45koger) July 23, 2020
Others, like Hannah Landry, a sophomore at Texas A&M University, are grappling over where they should live. Most of her classes are being offered online. To help make her decision, she ran a Twitter poll.
For the fall semester should I... (all my classes are online btw) — Hannah Paige💞 (@Hannah0926Paige) July 23, 2020
She thought her peers would overwhelmingly tell her to go back to campus. Instead, she found some had encouraged her to stay with family in west Texas, where COVID-19 rates are low because she could save money and avoid exposure to coronavirus.
The college is still offering some in-person courses, she said, but she is worried about moving back to College Station in the fall when thousands of her peers might be doing the same thing.
She said she also wants to see her family multiple times during the semester, but some of them are older and at higher risk for coronavirus. And when it comes down to it, she is not just not sure who she can trust.
“I just don’t think us kids are self-disciplined enough to not go out in public and be with people,” she said. “I just think the numbers are going to skyrocket.”
Education coverage at USA TODAY is made possible in part by a grant from the Bill and Melinda Gates Foundation. The Gates Foundation does not provide editorial input.


usatoday--2020-07-29--What went wrong during the Northeast's first COVID-19 spike and is the region ready for another?

In early March , Dr. Jeffrey Shaman watched from his New York City home as political leaders debated how best to control the first cases of the new coronavirus .
It soon led to screaming at the television .
Shaman , an infectious disease expert at Columbia University , said he thought city schools should have been closed right then , in the first week of March , or at least by the second week of the month .
`` It was definitely too slow , '' he told the USA TODAY Network .
`` I could not believe the @ @ @ @ @ @ @ in New York ultimately closed March 16 when the state had 950 COVID-19 cases and nine deaths .
New York and New Jersey have gone on to have the most coronavirus deaths in the nation , nearly 32,600 ( including 4,600 probable deaths in New York City ) and 15,700 , respectively .
That was followed by 8,500 in Massachusetts ; 8,400 in California ; 7,600 in Illinois and 7,100 in Pennsylvania .
Maryland had about 3,500 deaths , while Delaware had 580 , according to federal data .
Infection rates in the @ @ @ @ @ @ @ recent weeks even as they have soared to record highs in more than 30 other states , mostly in the South and West .
Now the question is : How well prepared are Northeast states for another spike of COVID-19 ?
Nowhere in the country is a region more aware of the virus ' impact than the Northeast .
And that experience — with thousands of deaths , overwhelmed hospitals and a shuttered economy — is working to inform how officials respond to an anticipated second wave .
The states have been working @ @ @ @ @ @ @ , but at the same time making independent decisions on when to open or close certain industries .
`` We see the second wave in the distance , '' New York Gov .
Andrew Cuomo said July 17 .
`` It will have an effect on New York .
How bad ?
We don ’ t know .
But we can not stop the virus at our borders .
We ’ re trying everything we can . ''
Shaman 's early warnings about the need for a quick shutdown were not heeded .
@ @ @ @ @ @ @ workers until March 22 , when the state had 114 deaths and more than 15,000 cases .
Shaman co-authored a study in May that said New York could have saved as many as 17,000 lives if it instituted its stay-at-home order two weeks earlier .
`` We didn ’ t pick up and learn quickly from seeing what was happening in China , '' Shaman said .
`` We didn ’ t follow the leads of South Korea and Vietnam and Taiwan to control it , and we dithered and doubted the evidence @ @ @ @ @ @ @ it , which I can understand . ''
He added , `` It ’ s an uncertain time and it ’ s difficult , but this is one of the few instances where leadership really matters . ''
Cuomo has put the blame squarely on the federal government , saying it let more than 3 million Europeans travel to the U.S. , mainly the Northeast , at least six weeks before the pandemic became apparent .
A U.S. Centers for Disease Control and Prevention report July 17 noted that by the time travel @ @ @ @ @ @ @ March 13 , `` importation and community transmission of SARS-CoV-2 had already occurred in NYC . ''
A faster shutdown may also have saved more lives among the most vulnerable population , those in nursing homes and extended care facilities .
About 43 % of New Jersey 's deaths occurred in nursing homes , while nearly 6,300 deaths in New York , or 25 % of the total , were in the facilities .
Nursing home deaths made up nearly 70 % of COVID-19 deaths in Pennsylvania .
The nursing home deaths have @ @ @ @ @ @ @ have better insulated residents from COVID cases , but New York has insisted the problem was due to staff spreading the infection through the homes .
U.S. Rep. Tom Reed , R-N.Y. , is among those calling for an independent investigation of nursing home deaths .
He said in a July 6 statement that blaming staff `` when the state knowingly created COVID hotspots by forcing homes to accept COVID-positive patients is a slap in the face to those who lost a loved one . ''
What Northeast states learned from the first @ @ @ @ @ @ @ daily death toll hit as high as 800 in early April , but now daily deaths are in the single digits and there have been a few days without any deaths reported .
The Northeast is trying to keep it that way , with New York , New Jersey and Connecticut requiring a 14-day quarantine for visitors from states with high infection rates and mandating they fill out questionnaires when they enter New York .
And the states ' phased reopening has been largely successful compared to states in the South and West @ @ @ @ @ @ @ a broad reopening last month .
`` The only way we can keep our positivity rate and our RT , or rate of transmission low , is by taking the precautions that we have across the past four months , '' New Jersey Gov .
Phil Murphy said July 17 .
The pandemic , in many ways , has laid bare fundamental flaws in American society .
COVID-19 racial disparities : Black people dying from coronavirus at much higher rates in cities across the USA Watching the coronavirus spread like wildfire through low-income @ @ @ @ @ @ @ systemic racism fueling disparate health outcomes for generations of Black and Hispanic people .
Stories of nurses and doctors being infected with COVID-19 and dying as hospitals struggled to secure protective masks and gowns exposed gaping holes in emergency preparedness plans and government stockpile systems .
And in the face of new surges across the country , renewed fears of shortages of personal protective equipment and COVID-19 testing supplies further revealed the faults in a medical supply chain over-reliant on Chinese imports .
Yet efforts in the Northeast to shore up regional manufacturing @ @ @ @ @ @ @ infrastructure show promise against a second wave .
New public health responses targeting zip codes hit hardest by COVID-19 deaths also offered a glimmer of hope that key resources , including contact tracing , testing and medical care , would better reach communities of color .
Meanwhile , politically charged debates over reopening plans and mask wearing in public , which New York mandated April 15 to help turn the tide in its coronavirus outbreak , endangered the entire undertaking nationally , experts said .
“ We are seeing unnecessary tens of thousands @ @ @ @ @ @ @ people do not want to believe the evidence , ” said Dr. Gregory Poland , an Infectious Diseases Society of America and Mayo Clinic expert .
“ They make it into a political or cultural or economic or faith-based issue , and it ’ s not , ” he said .
“ The virus knows nothing of those areas .
The virus knows one thing : Find the next susceptible person and infect them.
” That was the case in Delaware : State health officials saw a significant outbreak in April in small @ @ @ @ @ @ @ Hispanics and Haitian immigrant communities .
Many of those residents work in the county ’ s largest industry — chicken processing plants — where to complete their jobs , workers must stand close together , not adhering to social distancing guidelines .
Many of the low-income workers ca n't afford to lose a paycheck , leading to hesitation about whether they should get tested — even if they have been exposed to the virus .
Language barriers led to challenges when the residents tried to access emergency resources and learn what safety precautions @ @ @ @ @ @ @ homes were also devastated in the early weeks of the pandemic , particularly because it was difficult for facilities to obtain protective equipment for employees and they have been historically understaffed .
Because of limited testing in Delaware at the time , only residents with symptoms could receive a COVID-19 test .
Deaths in long-term care facilities have contributed to more than 60 % of the cumulative number of COVID-19 deaths in Delaware .
It has led to Gov .
John Carney requiring all long-term care employees to be tested on a weekly @ @ @ @ @ @ @ problems across the country and every state in America from the beginning of this COVID crisis was the lack of availability of testing , '' Maryland Gov .
Hogan said June 10 .
A quick , cheap test would help stop COVID-19 : So why do n't we have one ?
While Delaware has seen a decrease in the number of daily COVID-19 cases and hospitalizations , the Rehoboth-Dewey Beach ZIP code saw a spike in cases in late June .
Many of these cases involved young people and residents .
In late @ @ @ @ @ @ @ pausing Delaware 's plans to reopen its economy .
Not long after , he mandated that , in eastern Sussex County , customers will no longer be able to sit or stand at a bar .
Instead , beachgoers will have to sit at a table and be served .
“ Too many Delawareans and visitors are not following basic public health precautions , '' Carney said June 25 .
`` Now ’ s not the time to let up . ''
When the coronavirus pandemic hit Pennsylvania in March , Gov .
@ @ @ @ @ @ @ fear — overwhelmed hospitals that had no beds for patients .
Pennsylvania never ran out of hospital beds or life-saving ventilators , even when the virus peaked in April .
But businesses opened in defiance of state orders .
Republican lawmakers tried to end the emergency powers of Wolf , a Democrat .
Millions lost jobs .
Businesses struggled to survive .
Without a bailout , the restaurant industry could end up a shadow of its former self , especially now that the governor has ordered them to either cut back to 25 @ @ @ @ @ @ @ again .
And now , as administrators , parents and politicians argue about whether to send children back to school , Pennsylvania is seeing a surge of fresh cases .
Back to school ?
Despite CDC recommendations , most major schools going online as COVID-19 cases spike This pandemic steered Pennsylvania toward a recession .
The Pandemic Unemployment Assistance and the Paycheck Protection Program helped , but they have an expiration date , and right now “ this virus doesn ’ t , ” Labor and Industry Secretary Jerry Oleksiak said So even @ @ @ @ @ @ @ lock-down , high unemployment and the lingering public health crisis slow the process , leaving economists to agree on one thing : Pennsylvania wo n't to recover from this disaster for years .
`` Ultimately , what ’ s going to work is not enforcement , '' Wolf said May 26 .
`` What ’ s going to work is each and every individual Pennsylvanian , each and every business owner doing everything they can to protect their employees and their customers and protect each other from this disease . ''
'We don @ @ @ @ @ @ @ policy on this' Many experts and health officials attributed the most glaring missteps to the lack of federal government leadership .
The criticism spanned from the CDC distributing faulty test kits to states , which delayed the pandemic response in January and February , to mixed messages coming from the Trump administration regarding the threat posed by current spikes in COVID-19 cases .
“ We don ’ t really have a clear national policy on this , and that ’ s been pretty evident , ” said Dr. Michael Mendoza , health commissioner @ @ @ @ @ @ @ .
In the absence of a universal plan , some states ignored , or shunned , lessons learned in the Northeast , threatening to undo the communal sacrifices that helped reduce infections in New York and New Jersey .
“ When our messages and our data became politicized and distorted … that ’ s when it became very difficult for us , ” Mendoza said .
Amid the chaotic early weeks of the pandemic this spring , the politically fueled confusion proved especially harmful due to limited scientific understanding at the time of @ @ @ @ @ @ @ appeared in many people .
More : The White House has sent conflicting messages on wearing masks and the new coronavirus cases As intensive care units filled up , state officials scrambled to boost hospital bed capacity .
Fears that hospitals would run out of lifesaving breathing machines ignited interstate competition over ventilators , as opposed to a coordinated national response .
Ultimately , the flawed preparedness plan and scattershot emergency response helped delay the revelations unfolding today , such as the prospect that all Americans wearing face-coverings in public could dramatically decrease @ @ @ @ @ @ @ six weeks .
In dissecting the myriad of pandemic-related failures , Poland of the Mayo Clinic evoked findings of the 9/11 Commission report that delved into the terrorist attacks of Sept. 11 , 2001 .
“ We believe the fundamental problem was one of imaginability , though we had been warned many times and many ways , we failed to imagine it was possible and therefore failed to prepare , ” he said , recounting the report .
“ I think that singular statement is precisely applicable to the pandemic , ” Poland @ @ @ @ @ @ @ that one thing that has happened is that our deniability has been stripped away and our imaginability enlivened.
” New York and New Jersey have reopened many businesses but have kept some closed .
New Jersey has not allowed the resumption of indoor dining , while New York has outside New York City .
Malls , casinos and amusement parks have remained shuttered in New York , but New Jersey and Pennsylvania have opened them with safety precautions .
And New York tightened restrictions on outdoor dining , requiring alcohol purchases to be @ @ @ @ @ @ @ large drinking scenes .
It 's a process that Northeast governors continue to evaluate based on daily monitoring of the rates of infection .
The concern is that the rapid spread of disease in the bulk of the country will eventually cause a spike in states that have been successful in tamping down the virus .
`` This second wave is just going to be other states infecting us again for a second time , '' Cuomo said July 16 on MSNBC .
`` There 's no vaccine yet , '' New Jersey @ @ @ @ @ @ @ All we 've got is social distancing , wearing a face covering whenever you are out in public , and certainly whenever you 're indoors , washing your hands frequently with soap and water for at least 20 seconds . ''
Republican lawmakers in New Jersey allege Murphy cut state lawmakers out when he crafted coronavirus-related orders , unfairly allowed big-box retailers to remain open while forcing smaller stores to close .
He limited outdoor gatherings , then showed up at Black Lives Matters rallies where protesters were not socially distanced .
Those @ @ @ @ @ @ @ to result in spikes of COVID-19 cases .
But , like other Northeast states , Murphy ’ s strategy began to look smarter in July .
As states like California , Texas and Florida , which reopened sooner than New Jersey , began to see virus cases surge , their governors hastily re-closed businesses they had allowed to reopen .
Now , Murphy hopes to not join those states in having to change course .
`` We should all take pride in the fact we want to get this exactly as right as @ @ @ @ @ @ @

Joseph Spector, David Robinson, Terrence T. McDonald and Meredith Newman, USA TODAY NETWORK

What went wrong during the Northeast's first COVID-19 spike, and is the region ready for another?
Show Caption Hide Caption US hits 150,000 COVID-19 deaths, states reconsider reopenings The US recently topped 4 million confirmed COVID-19 cases and now has reached another unenviable milestone. USA TODAY
In early March, Dr. Jeffrey Shaman watched from his New York City home as political leaders debated how best to control the first cases of the new coronavirus.
It soon led to screaming at the television.
Shaman, an infectious disease expert at Columbia University, said he thought city schools should have been closed right then, in the first week of March, or at least by the second week of the month.
"It was definitely too slow," he told the USA TODAY Network. "I could not believe the schools were still open."
Schools in New York ultimately closed March 16 when the state had 950 COVID-19 cases and nine deaths.
New York and New Jersey have gone on to have the most coronavirus deaths in the nation, nearly 32,600 (including 4,600 probable deaths in New York City) and 15,700, respectively.
That was followed by 8,500 in Massachusetts; 8,400 in California; 7,600 in Illinois; and 7,100 in Pennsylvania. Maryland had about 3,500 deaths, while Delaware had 580, according to federal data.
US coronavirus map: Tracking the COVID-19 outbreak nationwide
Infection rates in the Northeast have fallen to record lows in recent weeks even as they have soared to record highs in more than 30 other states, mostly in the South and West.
Now the question is: How well prepared are Northeast states for another spike of COVID-19?
Nowhere in the country is a region more aware of the virus' impact than the Northeast.
And that experience – with thousands of deaths, overwhelmed hospitals and a shuttered economy – is working to inform how officials respond to an anticipated second wave.
The states have been working together to try to thwart a spike but at the same time making independent decisions on when to open or close certain industries.
"We see the second wave in the distance," New York Gov. Andrew Cuomo said July 17. "It will have an effect on New York. How bad? We don’t know. But we cannot stop the virus at our borders. We’re trying everything we can."
Late shutdowns, European travel and nursing homes fueled virus' early days
Shaman's early warnings about the need for a quick shutdown were not heeded. New York didn't close to nonessential workers until March 22, when the state had 114 deaths and more than 15,000 cases.
Shaman co-wrote a study in May that said New York could have saved as many as 17,000 lives if it instituted its stay-at-home order two weeks earlier.
"We didn’t pick up and learn quickly from seeing what was happening in China," Shaman said.
"We didn’t follow the leads of South Korea and Vietnam and Taiwan to control it, and we dithered and doubted the evidence and worried about the economic repercussions of it, which I can understand."
New York's stay-at-home order: Should state leaders have acted sooner?
He added, "It’s an uncertain time and it’s difficult, but this is one of the few instances where leadership really matters."
Cuomo has put the blame squarely on the federal government, saying it let more than 3 million Europeans travel to the U.S., mainly the Northeast, at least six weeks before the pandemic became apparent.
A U.S. Centers for Disease Control and Prevention report July 17 noted that by the time travel restrictions from Europe were put in place March 13, "importation and community transmission of SARS-CoV-2 had already occurred in NYC."
A faster shutdown may also have saved more lives among the most vulnerable population, those in nursing homes and extended care facilities.
About 43% of New Jersey's deaths occurred in nursing homes, while nearly 6,300 deaths in New York, or 25% of the total, were in the facilities. Nursing home deaths made up nearly 70% of COVID-19 deaths in Pennsylvania.
The nursing home deaths have drawn heavy scrutiny over whether states should have better insulated residents from COVID-19 cases, but New York has insisted the problem was the result of staff spreading the infection through the homes.
U.S. Rep. Tom Reed, R-N.Y., is among those calling for an independent investigation of nursing home deaths.
He said in a statement July 6 that blaming staff "when the state knowingly created COVID hotspots by forcing homes to accept COVID-positive patients is a slap in the face to those who lost a loved one."
New Jersey nursing home deaths: Police find 18 bodies in 'makeshift' facility
What Northeast states learned from the first wave of the pandemic
New York's daily death toll hit as high as 800 in early April, but now daily deaths are in the single digits, and there have been a few days without any deaths reported.
The Northeast is trying to keep it that way: New York, New Jersey and Connecticut are requiring a 14-day quarantine for visitors from states with high infection rates and requiring they fill out questionnaires when they enter New York.
And the states' phased reopening has been largely successful compared with states in the South and West that now are shutting down businesses after a broad reopening last month.
"The only way we can keep our positivity rate and our RT, or rate of transmission, low is by taking the precautions that we have across the past four months," New Jersey Gov. Phil Murphy said July 17.
The pandemic, in many ways, has laid bare fundamental flaws in American society.
'We're witnessing history': Why George Floyd's death, COVID-19 inequality sparked protests
COVID-19 racial disparities: Black people dying from coronavirus at much higher rates in cities across the USA
Watching the coronavirus spread like wildfire through low-income communities plagued by overcrowded housing underscored the systemic racism fueling disparate health outcomes for generations of Black and Hispanic people.
Stories of nurses and doctors being infected with COVID-19 and dying as hospitals struggled to secure protective masks and gowns exposed gaping holes in emergency preparedness plans and government stockpile systems.
And in the face of new surges across the country, renewed fears of shortages of personal protective equipment and COVID-19 testing supplies further revealed the faults in a medical supply chain over-reliant on Chinese imports.
Yet efforts in the Northeast to shore up regional manufacturing of basic medical goods and COVID-19 testing infrastructure show promise against a second wave.
New public health responses targeting zip codes hit hardest by COVID-19 deaths also offered a glimmer of hope that key resources, including contact tracing, testing and medical care, would better reach communities of color.
Meanwhile, politically charged debates over reopening plans and mask wearing in public, which New York ordered April 15 to help turn the tide in its coronavirus outbreak, endangered the entire undertaking nationally, experts said.
“We are seeing unnecessary tens of thousands of deaths and illnesses and disruption because people do not want to believe the evidence,” said Dr. Gregory Poland, an Infectious Diseases Society of America and Mayo Clinic expert.
“They make it into a political or cultural or economic or faith-based issue, and it’s not,” he said. “The virus knows nothing of those areas. The virus knows one thing: Find the next susceptible person and infect them.”
Delaware's meat plants, nursing homes hit hard as testing lagged
That was the case in Delaware: State health officials saw a significant outbreak in April in small towns in Sussex County, particularly among Hispanics and Haitian immigrant communities.
Many of those residents work in the county’s largest industry – chicken processing plants – where to complete their jobs, workers must stand close together, not adhering to social distancing guidelines.
Cheap chicken, beef came at a cost: How American meat plants bred coronavirus hot spots.
Many of the low-income workers can't afford to lose a paycheck, leading to hesitation about whether they should get tested – even if they have been exposed to the virus.
Language barriers led to challenges when the residents tried to access emergency resources and learn what safety precautions they needed to take.
Delaware nursing homes were also devastated in the early weeks of the pandemic, particularly because it was difficult for facilities to obtain protective equipment for employees and they have been historically understaffed.
Because of limited testing in Delaware at the time, only residents with symptoms could receive a COVID-19 test.
Deaths in long-term care facilities have contributed to more than 60% of the cumulative number of COVID-19 deaths in Delaware. It has led to Gov. John Carney requiring all long-term care employees to be tested on a weekly basis.
"One of the biggest problems across the country and every state in America from the beginning of this COVID crisis was the lack of availability of testing," Maryland Gov. Hogan said June 10.
A quick, cheap test would help stop COVID-19: So why don't we have one?
While Delaware has seen a decrease in the number of daily COVID-19 cases and hospitalizations, the Rehoboth-Dewey Beach ZIP code saw a spike in cases in late June. Many of these cases involved young people and residents.
In late June, Carney announced that he is pausing Delaware's plans to reopen its economy. Not long after, he mandated that, in eastern Sussex County, customers will no longer be able to sit or stand at a bar. Instead, beachgoers will have to sit at a table and be served.
“Too many Delawareans and visitors are not following basic public health precautions," Carney said June 25. "Now’s not the time to let up."
Pennsylvania sees harsh economic effects
When the coronavirus pandemic hit Pennsylvania in March, Gov. Tom Wolf scrambled to prevent his biggest fear: overwhelmed hospitals that had no beds for patients.
Pennsylvania never ran out of hospital beds or lifesaving ventilators, even when the virus peaked in April.
But businesses opened in defiance of state orders. Republican lawmakers tried to end the emergency powers of Wolf, a Democrat.
Millions lost jobs. Businesses struggled to survive. Without a bailout, the restaurant industry could end up a shadow of its former self, especially now that the governor has ordered them to either cut back to 25% of their dine-in capacity or close again.
And now, as administrators, parents and politicians argue about whether to send children back to school, Pennsylvania is seeing a surge of fresh cases.
Back to school? Despite CDC recommendations, most major schools going online as COVID-19 cases spike
This pandemic steered Pennsylvania toward a recession. The Pandemic Unemployment Assistance and the Paycheck Protection Program helped, but they have an expiration date, and right now “this virus doesn’t,” Labor and Industry Secretary Jerry Oleksiak said
So even as the state crawls out from economic lock-down, high unemployment and the lingering public health crisis slow the process, leaving economists to agree on one thing: Pennsylvania won't to recover from this disaster for years.
"Ultimately, what’s going to work is not enforcement," Wolf said May 26. "What’s going to work is each and every individual Pennsylvanian, each and every business owner doing everything they can to protect their employees and their customers and protect each other from this disease."
Coronavirus: How vaccines are developed and tested Pressure to create a coronavirus vaccine is increasing by the day, but for a safe vaccine to enter the market, it takes time. Just the FAQs, USA TODAY
'We don’t really have a clear national policy on this'
Many experts and health officials attributed the most glaring missteps to the lack of federal government leadership.
The criticism spanned from the CDC distributing faulty test kits to states, which delayed the pandemic response in January and February, to mixed messages coming from the Trump administration on the threat posed by spikes in COVID-19 cases.
“We don’t really have a clear national policy on this, and that’s been pretty evident,” said Dr. Michael Mendoza, health commissioner of Monroe County in upstate New York.
In the absence of a universal plan, some states ignored, or shunned, lessons learned in the Northeast, threatening to undo the communal sacrifices that helped reduce infections in New York and New Jersey.
“When our messages and our data became politicized and distorted … that’s when it became very difficult for us,” Mendoza said.
Amid the chaotic early weeks of the pandemic this spring, the politically fueled confusion proved especially harmful because of limited scientific understanding at the time of how the coronavirus stealthily spread before symptoms appeared in many people.
More: The White House has sent conflicting messages on wearing masks and the new coronavirus cases
As intensive care units filled up, state officials scrambled to boost hospital bed capacity. Fears that hospitals would run out of lifesaving breathing machines ignited interstate competition over ventilators as opposed to a coordinated national response.
Ultimately, the flawed preparedness plan and scattershot emergency response helped delay the revelations unfolding today, such as the prospect that all Americans wearing face coverings in public could dramatically decrease the virus’ spread in four to six weeks.
In dissecting the myriad of pandemic-related failures, Poland of the Mayo Clinic evoked findings of the 9/11 Commission report that delved into the terrorist attacks of Sept. 11, 2001.
“We believe the fundamental problem was one of imaginability, though we had been warned many times and many ways, we failed to imagine it was possible and therefore failed to prepare,” he said, recounting the report.
“I think that singular statement is precisely applicable to the pandemic,” Poland said, adding, “I hope that one thing that has happened is that our deniability has been stripped away and our imaginability enlivened.”
Northeast states continue to limit reopening
New York and New Jersey have reopened many businesses but have kept some closed.
New Jersey has not allowed the resumption of indoor dining, while New York has outside New York City.
Malls, casinos and amusement parks have remained shuttered in New York, but New Jersey and Pennsylvania have opened them with safety precautions.
And New York tightened restrictions on outdoor dining, requiring alcohol purchases to be accompanied by food to cut down on large drinking scenes.
It's a process that Northeast governors continue to evaluate based on daily monitoring of the rates of infection. The concern is that the rapid spread of disease in the bulk of the country will eventually cause a spike in states that have tamped down the virus.
"This second wave is just going to be other states infecting us again for a second time," Cuomo said July 16 on MSNBC.
"There's no vaccine yet," New Jersey's Murphy warned July 17. "All we've got is social distancing, wearing a face covering whenever you are out in public, and certainly whenever you're indoors, washing your hands frequently with soap and water for at least 20 seconds."
Republican lawmakers in New Jersey say Murphy cut state lawmakers out when he crafted coronavirus-related orders, unfairly allowing big-box retailers to remain open while forcing smaller stores to close.
He limited outdoor gatherings, then showed up at Black Lives Matters rallies where protesters were not socially distanced. Those rallies, however, were not shown to result in spikes of COVID-19 cases.
But, as in other Northeast states, Murphy’s strategy began to look smarter in July.
As states like California, Texas and Florida, which reopened sooner than New Jersey, began to see virus cases surge, their governors hastily closed businesses they had allowed to reopen. Now, Murphy hopes to not join those states in having to change course.
"We should all take pride in the fact we want to get this exactly as right as we can," he said.


usatoday--2020-07-29--Leaders were slow to bring COVID-19 testing to Latino communities. Now people are sick.

It was mid-June in California 's Central Valley , and Dr. Patricia Iris was alarmed .
Every COVID-19 patient at Lodi Memorial that day was Latino , even though Latinos make up only 39 % of the city ’ s population .
Testing surveillance in San Joaquin County should have warned Iris that this was coming .
But testing in Latino communities was so limited , it missed the oncoming wave .
Hospital beds swelled with Latino patients .
On June 1 , the county had just 23 patients hospitalized with COVID .
By the end of the month , @ @ @ @ @ @ @ to Iris , were Latino .
The numbers continue to rise .
As of July 20 , hospitals in the county were operating their ICUs at 132 % capacity .
“ People are on waiting lists to get tested , ” said San Joaquin County Public Health Officer Dr. Maggie Park .
“ It ’ s not a good situation at all.
” The same dynamic has played out across the nation , as the virus silently spread among Latinos from workplaces to homes to the community .
Latinos bore the brunt of @ @ @ @ @ @ @ advocates say , inadequate testing is one of the reasons .
In 20 of 27 states that reported positive coronavirus cases by ethnicity , growth among Latinos has outpaced overall growth since Memorial Day , according to a USA TODAY analysis .
Nationwide , Latinos have been four times as likely as whites to be hospitalized , according to data from the U.S. Centers for Disease Control and Prevention .
Although few states or counties publish the ethnicity of people being tested , available data show one key disparity .
The World Health @ @ @ @ @ @ @ of tests in one community come back positive , it ’ s a sign testing isn ’ t widespread enough to find and isolate infectious people , including those without symptoms .
In some places where the non-Latino positivity rate fell below 5 % , Latino rates remained in double digits -- three times as high , or more .
USA TODAY has previously reported that Latinos ’ disproportionate role in meatpacking and other hard-hit industries contributed to outbreaks in some towns .
But as the experience in Lodi and other places show @ @ @ @ @ @ @ testing or educational resources to Latino communities .
Limited testing meant local officials couldn ’ t intervene or offer support services designed to slow spread and minimize the economic harms of isolating .
In San Joaquin County , the first free walk-up testing site opened in May was a two-hour bus ride from Latinos living in the city of Tracy , for example , or a 36-mile drive for anyone with a car .
Arkansas had a single Spanish-speaking caseworker for two counties with large populations of Latinos , one-third of whom speak @ @ @ @ @ @ @ serving low-income Latinos said more than half of its April coronavirus tests came back positive ; Nebraska did not open a new testing site in that neighborhood for weeks , despite local pleas .
Experts say it all added up to needless delays and fewer Latinos being tested .
It meant infectious people kept working instead of isolating , which led to more infections .
It meant they were disconnected from community resources designed to reduce the virus ’ spread .
It meant they were left at home with family members rather than @ @ @ @ @ @ @ By the time local and state leaders realized what they were facing , outbreaks were already well past the point of control .
Testing patients as soon as symptoms start can reduce transmission rates by 80 % .
Delaying three days only reduces transmission by 21 % , according to a study in The Lancet Public Health , a medical journal .
“ Our priorities for testing do not reflect the needs in our communities , ” said Dr. Nirav Shah , a scholar at Stanford University 's Clinical Excellence Research Center .
@ @ @ @ @ @ @ easy to do : add additional capacity to the existing health care system .
That system already had access problems for marginalized communities.
” Latino leaders across the country said public officials haven ’ t listened to their concerns — and then have been caught off guard when coronavirus cut through their families exactly as predicted .
At the Catholic Charities Diocese of Stockton in San Joaquin County , Executive Director Elvira Ramirez says she noticed a lack of testing as early as March .
“ Every time we would ask , ‘ @ @ @ @ @ @ @ seemed as though there was no testing being done , ” Ramirez said .
“ Finally there is something in place , but it seems woefully inadequate to the need.
” Jackie Tobias , of Northwest Arkansas , said that when she lost her sense of smell and taste , she worried that she had contracted coronavirus .
Just a couple days earlier , the Latina human resources professional had visited her parents .
They work at an area poultry processing plant , a high-exposure environment linked to numerous outbreaks nationwide .
“ @ @ @ @ @ @ @ ’ ve been exposed , ” she remembers thinking .
Her primary care doctor had an opening in two days , longer than she wanted to wait .
Screeners at the door to a local safety-net clinic told her she needed an appointment -- a detail not mentioned on the clinic ’ s website -- and it would be a few days to fit her in .
The county health department had no openings and referred her back to the clinic she ’ d visited .
Finally , after looking for help in @ @ @ @ @ @ @ an urgent care clinic 35 minutes away .
The staff told her results would not be back for at least a week .
When her parents sought testing , they were told that , without symptoms , they could only be tested if Tobias ’ results came back positive .
Without test results , they continued to work .
“ If it takes me seven days to get my results before they can get tested and then seven days for them to get their results , ” Tobias thought to herself .
“ @ @ @ @ @ @ @ get tested or get their results back.
” Her mother later developed symptoms that qualified her to be tested .
The test came back positive .
Officials in Arkansas were slow to recognize outbreaks among Latinos and their barriers to testing .
Its increase in Latino cases over the past two months was the biggest out of 27 states that report cases by ethnicity .
Cases among Arkansas Latinos grew five times as fast as cases in the overall population , a USA TODAY analysis found .
On June 10 , Arkansas officials @ @ @ @ @ @ @ in the state ’ s Hispanic and Marshallese communities , groups that dominate the workforce in poultry plants .
By then , COVID-19 had moved beyond mere workplace spread , according to the CDC ’ s report on the outbreaks .
It was spreading in households , at community events , in grocery stores and in shared transport on the way to work .
Later that same month , the state worked to expand testing access for Hispanic and Marshallese residents .
“ The outbreak became very obvious once the testing became free @ @ @ @ @ @ @ tested , ” said Dr. Jose Romero , interim health secretary for Arkansas .
This month , the CDC submitted a 59-page report finding that Arkansas failed to prioritize testing in high-risk environments like meatpacking plants and in multigenerational households , said CDC epidemiologist Angela Hernandez .
Hernandez ’ team also urged Arkansas leaders to focus prevention , support services and testing in Hispanic and Marshallese communities .
“ Rapid control of the spread of COVID-19 will help minimize illness , deaths and the social and economic impact , ” Hernandez wrote in @ @ @ @ @ @ @ Midwest Center for Investigative Reporting .
On Friday , Arkansas legislators voted to delay hearing a request from the state health department to spend $ 7 million of federal funds to expand testing and contact tracing in Latino and Marshallese communities , according to the Arkansas Democrat Gazette .
Across the country , it is difficult to quantify the gaps in testing between Latinos and other ethnic groups because the data isn ’ t public , if it ’ s collected at all .
Only six states disclose the race and ethnicity of @ @ @ @ @ @ @ spotty .
Indiana recorded race and ethnicity in less than half of all tests .
But one measure that is available in a handful of locations highlights the gap in Latino testing that experts have warned about .
In places where it was available by ethnicity , the percentage of Latinos testing positive was usually much higher than the World Health Organization ’ s benchmark of 5 % , by wide margins , even when the target was met for non-Latinos .
“ It basically says that there 's disparities about how often @ @ @ @ @ @ @ ” said Dr. Ali Khan , who became dean of the College of Public Health at the University of Nebraska Medical Center after leading preparedness efforts at the CDC .
In Illinois , the positivity rate for non-Latinos dipped as low as 3 % in late June , according to the state ’ s website .
Yet among Latinos , the rate remained around 10 15 % during the same period .
Outside Austin , Texas , in the town of Pflugerville , non-Latinos had a 4 % positivity rate compared with 29 @ @ @ @ @ @ @ center reported in May .
Samples collected from 35 health facilities in the Baltimore and Washington , D.C. metropolitan area showed white non-Latino whites tested positive a little under 5 % of the time in late May , yet the Latino rate was around 35 % .
Decades of budget cuts to public health programs left county and state officials across the country ill prepared to respond to every challenge that a pandemic presents .
Testing was no exception .
“ Nationally , people didn ’ t recognize the importance of public health @ @ @ @ @ @ @ Joaquin County health officer .
“ Nobody realized what a health officer was until COVID hit.
” From the outset , Park understood that inequities in the healthcare system and in the economy put Latinos at unique risk .
She knew that some Latinos have less access to social services because of language barriers and fears that using public programs would bar them from seeking citizenship .
And , because the federal pandemic stimulus bills excluded non-citizens and mixed-immigration status households , Park suspected some Latinos would feel pressure to work despite the @ @ @ @ @ @ @ County ’ s 48,000 uninsured residents are non-citizens , according to Census estimates , and most are Latinos .
About a quarter of the county ’ s 267,000 Latino residents report they do not speak English well .
But Park wasn ’ t able to launch a radio and billboard messaging campaign in Spanish until July .
“ The truth is , I just got permission to use the funds , ” she said .
Federal funding from the federal CARES Act did not reach the county until May 12 .
By then @ @ @ @ @ @ @ cases .
Park said it took weeks more to design an outreach plan and get it approved .
The county ’ s first free testing site opened April 8 with supplies from the state , in a parking lot near San Joaquin General Hospital south of Stockton .
The site was drive-up only .
According to Census figures , as many as half of households in some Latino neighborhoods of San Joaquin County do not own a vehicle .
In May , the state paid for a second free site that could serve @ @ @ @ @ @ @ requirements for the building and dictated the zip code where it must be located .
Lodi Public Library was the only place that met the state ’ s specifications .
A resident of Tracy without a car would have to take a two-hour bus ride to get to the testing site for an appointment .
As of Saturday , the soonest available appointment was in five days .
Jose Santoyo , 23 , a Lodi native who works as an electrician and has insurance , decided to get tested after coming into contact @ @ @ @ @ @ @ His mom told him about a free , pop-up testing site in a grocery store parking lot .
Santoyo , whose test came back negative , became one of the 300 people tested that day after waiting about a half hour in line .
More than 200 other people were turned away when organizers ran out of tests .
“ If I didn ’ t go to that place , I don ’ t know where I would have gone , ” Santoyo said .
Experts said demand often outpaces capacity at free @ @ @ @ @ @ @ don ’ t face when tested by the family doctor .
“ When we talk about equity , we ’ re not just talking about access .
We ’ re talking about equity in the quality of care , too , ” said Dr. Kathleen Page , who started the Johns Hopkins Organization for Latino Awareness and runs a community testing program in marginalized communities of Baltimore .
Nationally , people in areas with larger minority populations had to travel farther to get to COVID-19 testing sites , a May study in the @ @ @ @ @ @ @ testing is done by private companies , which receive $ 100 in reimbursements for each test they perform .
Shah , the Stanford researcher , said testing companies have no financial incentive to target supplies where they are needed most , to offer hours that meet the scheduling needs of essential workers , or to return results quickly .
The more tests , the more money — regardless of who ’ s tested .
Racial and ethnic disparities in the pandemic are slowly gaining additional scrutiny .
Last month , the U.S. Department @ @ @ @ @ @ @ making labs report race and ethnicity for all coronavirus tests .
The rules take effect on Saturday , more than three months after the federal CARES Act mandated such reporting .
Health experts said equal access to coronavirus testing should have been a focus from the start -- even before data confirmed Latinos were at increased risk to become ill and die .
“ Data will lag behind the community wisdom , ” said Page , the doctor and public health equity expert from Johns Hopkins .
“ What we could ’ ve @ @ @ @ @ @ @ been heard before , in addition to capacity , is trust.
” Jose Rodriguez , president of the Central Valley California nonprofit El Concilio , agreed .
While he appreciates that area hospitals and health departments have worked with his organization in recent weeks , he wishes that their programs were accessible and equitable by original design .
“ Every time there ’ s an outbreak , they come to us rather than ... taking our needs into account while planning , ” said Jose Rodriguez , president of the nonprofit social services @ @ @ @ @ @ @ Central Valley .
As Page set up a free testing site at a Baltimore church last week , she said making health care and social services more accessible would help the entire community .
Without improvements , she said , Latinos will continue to receive less testing and more might delay care .
“ Just last week a man died at home because he didn ’ t know where to go , ” she said .
“ The family said he was worried about the medical bill .
That ’ s really unfortunate @ @ @ @ @ @ @ Jayme Fraser is an investigative reporter with USA TODAY .

Jayme Fraser, Erin Mansfield, Matt Wynn and Scott Linesburgh, USA TODAY Network

Leaders were slow to bring COVID-19 testing to Latino communities. Now people are sick.
Show Caption Hide Caption Why people of color are dying at higher rates from COVID-19 Communities of color are dying at higher rates from the novel coronavirus than white Americans. Here's how structural inequities play a role. Just the FAQs, USA TODAY
It was mid-June in California's Central Valley, and Dr. Patricia Iris was alarmed.
Every COVID-19 patient at Lodi Memorial that day was Latino, even though Latinos make up only 39% of the city’s population.
More: Leer en español
Testing surveillance in San Joaquin County should have warned Iris that this was coming. But testing in Latino communities was so limited, it missed the oncoming wave.
Hospital beds swelled with Latino patients. On June 1, the county had just 23 patients hospitalized with COVID-19. By the end of the month, there were 140. Most, according to Iris, were Latino.
The numbers continue to rise. As of July 20, hospitals in the county were operating their ICUs at 132% capacity.
“People are on waiting lists to get tested,” said San Joaquin County Public Health Officer Dr. Maggie Park. “It’s not a good situation at all.”
The same dynamic has played out across the nation as the virus silently spread among Latinos from workplaces to homes to the community. Latinos bore the brunt of the virus. And, experts and advocates say, inadequate testing is one of the reasons.
In 20 of 27 states that reported positive coronavirus cases by ethnicity, growth among Latinos has outpaced overall growth since Memorial Day, according to a USA TODAY analysis. Nationwide, Latinos have been four times as likely as whites to be hospitalized, according to data from the U.S. Centers for Disease Control and Prevention.
Although few states or counties publish the ethnicity of people being tested, available data show one key disparity. The World Health Organization says if more than 5% of tests in one community come back positive, it’s a sign testing isn’t widespread enough to find and isolate infectious people, including those without symptoms.
In some places where the non-Latino positivity rate fell below 5%, Latino rates remained in double digits – three times as high or more.
USA TODAY has reported that Latinos’ disproportionate role in meatpacking and other hard-hit industries contributed to outbreaks in some towns. But as the experience in Lodi and other places show, government agencies failed to adequately distribute testing or educational resources to Latino communities.
Limited testing meant local officials couldn’t intervene or offer support services designed to slow the spread and minimize the economic harm of isolating.
In San Joaquin County, the first free walk-up testing site opened in May was a two-hour bus ride for Latinos living in the city of Tracy, for example, or a 36-mile drive for anyone with a car. Arkansas had a single Spanish-speaking caseworker for two counties with large populations of Latinos, one-third of whom speak limited English. An Omaha health center serving low-income Latinos said more than half of its coronavirus tests in April came back positive; Nebraska did not open a new testing site in that neighborhood for weeks, despite local pleas.
Experts say it all added up to needless delays and fewer Latinos being tested. It meant infectious people kept working instead of isolating, which led to more infections. It meant they were disconnected from community resources designed to reduce the virus’ spread. It meant they were left at home with family members rather than being safely quarantined at a hotel.
By the time local and state leaders realized what they were facing, outbreaks were already well past the point of control.
Testing patients as soon as symptoms start can reduce transmission rates by 80%. Delaying three days reduces transmission by only 21%, according to a study in The Lancet Public Health, a medical journal.
“Our priorities for testing do not reflect the needs in our communities,” said Dr. Nirav Shah, a scholar at Stanford University's Clinical Excellence Research Center. “They have prioritized what has been easy to do: add additional capacity to the existing health care system. That system already had access problems for marginalized communities.”
Latino leaders across the country said public officials haven’t listened to their concerns – and then have been caught off guard when the coronavirus cut through their families exactly as predicted.
At the Catholic Charities Diocese of Stockton in San Joaquin County, Executive Director Elvira Ramirez says she noticed a lack of testing as early as March.
“Every time we would ask, ‘Well what about testing?’ it seemed as though there was no testing being done,” Ramirez said. “Finally there is something in place, but it seems woefully inadequate to the need.”
Failings in Arkansas
Jackie Tobias, of Northwest Arkansas, said that when she lost her sense of smell and taste, she worried that she had contracted the coronavirus.
Just a couple of days earlier, the Latina human resources professional had visited her parents. They work at an area poultry processing plant, a high-exposure environment linked to outbreaks nationwide.
“Maybe my mom was asymptomatic and I’ve been exposed,” she remembers thinking.
Her primary care doctor had an opening in two days, longer than she wanted to wait. Screeners at the door to a local safety-net clinic told her she needed an appointment – a detail not mentioned on the clinic’s website – and it would be a few days to fit her in. The county health department had no openings and referred her back to the clinic she had visited.
Finally, after looking for help in three towns, she was swabbed at an urgent care clinic 35 minutes away.
The staff told her results would not be back for at least a week.
When her parents sought testing, they were told that without symptoms they could be tested only if Tobias’ results came back positive. Without test results, they continued to work.
“If it takes me seven days to get my results before they can get tested and then seven days for them to get their results,” Tobias thought to herself. “Someone could die before they could even get tested or get their results back.”
Her mother later developed symptoms that qualified her to be tested. The test came back positive.
Officials in Arkansas were slow to recognize outbreaks among Latinos and their barriers to testing.
Its increase in Latino cases over the past two months was the biggest out of 27 states that report cases by ethnicity. Cases among Arkansas Latinos grew five times as fast as cases in the overall population, a USA TODAY analysis found.
On June 10, Arkansas officials asked the CDC for help investigating outbreaks in the state’s Hispanic and Marshallese communities, groups that dominate the workforce in poultry plants. By then, COVID-19 had moved beyond mere workplace spread, according to the CDC’s report on the outbreaks. It was spreading in households, at community events, in grocery stores and in shared transport on the way to work.
Later that same month, the state worked to expand testing access for Hispanic and Marshallese residents.
“The outbreak became very obvious once the testing became free and many, many more individuals were tested,” said Dr. Jose Romero, interim health secretary for Arkansas.
This month, the CDC submitted a 59-page report finding that Arkansas failed to prioritize testing in high-risk environments like meatpacking plants and in multigenerational households, said CDC epidemiologist Angela Hernandez.
Hernandez’ team also urged Arkansas leaders to focus prevention, support services and testing in Hispanic and Marshallese communities.
“Rapid control of the spread of COVID-19 will help minimize illness, deaths and the social and economic impact,” Hernandez wrote in an email to USA TODAY and the Midwest Center for Investigative Reporting.
On Friday, Arkansas legislators voted to delay hearing a request from the state health department to spend $7 million of federal funds to expand testing and contact tracing in Latino and Marshallese communities, according to the Arkansas Democrat Gazette.
A key coronavirus benchmark
Across the country, it is difficult to quantify the gaps in testing between Latinos and other ethnic groups because the data isn’t public, if it’s collected at all. Only six states disclose the race and ethnicity of people tested, and the data is spotty. Indiana recorded race and ethnicity in less than half of all tests.
But one measure that is available in a handful of locations highlights the gap in Latino testing that experts have warned about.
In places where it was available by ethnicity, the percentage of Latinos testing positive was usually much higher than the World Health Organization’s benchmark of 5%, by wide margins, even when the target was met for non-Latinos.
“It basically says that there's disparities about how often testing is available in these communities,” said Dr. Ali Khan, who became dean of the College of Public Health at the University of Nebraska Medical Center after leading preparedness efforts at the CDC.
In Illinois, the positivity rate for non-Latinos dipped as low as 3% in late June, according to the state’s website. Yet among Latinos, the rate remained around 10% to 15% during the same period.
Outside Austin, Texas, in the town of Pflugerville, non-Latinos had a 4% positivity rate compared with 29% for Latinos, a local health center reported in May.
Samples collected from 35 health facilities in the Baltimore and Washington, D.C., metropolitan area showed white non-Latino whites tested positive a little under 5% of the time in late May, yet the Latino rate was around 35%.
Decades of budget cuts to public health programs left county and state officials across the country ill-prepared to respond to every challenge that a pandemic presents. Testing was no exception.
“Nationally, people didn’t recognize the importance of public health,” said Park, the San Joaquin County health officer. “Nobody realized what a health officer was until COVID hit.”
From the outset, Park understood that inequities in the health care system and in the economy put Latinos at unique risk. She knew that some Latinos have less access to social services because of language barriers and fears that using public programs would bar them from seeking citizenship.
And, because the federal pandemic stimulus bills excluded noncitizens and mixed-immigration-status households, Park suspected some Latinos would feel pressure to work despite the risk.
About half of San Joaquin County’s 48,000 uninsured residents are noncitizens, according to census estimates, and most are Latinos. About a quarter of the county’s 267,000 Latino residents report they do not speak English well.
But Park wasn’t able to launch a radio and billboard messaging campaign in Spanish until July.
“The truth is, I just got permission to use the funds,” she said.
Federal funding from the federal CARES Act did not reach the county until May 12. By then, Latinos accounted for half of area cases. Park said it took weeks more to design an outreach plan and get it approved.
Similar bureaucratic and practical barriers plagued efforts to launch accessible testing sites.
The county’s first free testing site opened April 8 with supplies from the state, in a parking lot near San Joaquin General Hospital south of Stockton.
The site was drive-up only. According to Census figures, as many as half of households in some Latino neighborhoods of San Joaquin County do not own a vehicle.
In May, the state paid for a second free site that could serve people without a car but set physical requirements for the building and dictated the ZIP code where it must be located. Lodi Public Library was the only place that met the state’s specifications.
A resident of Tracy without a car would have to take a two-hour bus ride to get to the testing site for an appointment. As of Saturday, the soonest available appointment was in five days.
Jose Santoyo, 23, a Lodi native who works as an electrician and has insurance, decided to get tested after coming into contact with two people who had tested positive.
His mother told him about a free, pop-up testing site in a grocery store parking lot. Santoyo, whose test came back negative, became one of the 300 people tested that day after waiting about a half-hour in line. More than 200 other people were turned away when organizers ran out of tests.
“If I didn’t go to that place, I don’t know where I would have gone,” Santoyo said.
Experts said demand often outpaces capacity at free sites, creating delays people with insurance don’t face when tested by the family doctor.
“When we talk about equity, we’re not just talking about access. We’re talking about equity in the quality of care, too,” said Dr. Kathleen Page, who started the Johns Hopkins Organization for Latino Awareness and runs a community testing program in marginalized communities of Baltimore.
Nationally, people in areas with larger minority populations had to travel farther to get to COVID-19 testing sites, a May study in the Journal of Travel Medicine found.
Most testing is done by private companies, which receive $100 in reimbursements for each test they perform.
Shah, the Stanford researcher, said testing companies have no financial incentive to target supplies where they are needed most, to offer hours that meet the scheduling needs of essential workers, or to return results quickly.
The more tests, the more money – regardless of who’s tested.
Missed opportunities
Racial and ethnic disparities in the pandemic are slowly gaining additional scrutiny.
Last month, the U.S. Department of Health and Human Services issued guidelines making labs report race and ethnicity for all coronavirus tests. The rules take effect on Saturday, more than three months after the federal CARES Act required such reporting.
Health experts said equal access to coronavirus testing should have been a focus from the start – even before data confirmed Latinos were at increased risk to become ill and die.
“Data will lag behind the community wisdom,” said Page, the doctor and public health equity expert from Johns Hopkins. “What we could’ve built if those Latino community leaders had been heard before, in addition to capacity, is trust.”
Jose Rodriguez, president of the Central Valley California nonprofit El Concilio, agreed. While he appreciates that area hospitals and health departments have worked with his organization in recent weeks, he wishes that their programs were accessible and equitable by original design.
“Every time there’s an outbreak, they come to us rather than ... taking our needs into account while planning,” said Jose Rodriguez, president of the nonprofit social services organization El Concilio in California’s Central Valley.
As Page set up a free testing site at a Baltimore church last week, she said making health care and social services more accessible would help the entire community. Without improvements, she said, Latinos will continue to receive less testing and more might delay care.
“Just last week a man died at home because he didn’t know where to go,” she said. “The family said he was worried about the medical bill. That’s really unfortunate and could’ve been prevented.”
Jayme Fraser is an investigative reporter with USA TODAY.