vox--2020-04-18--What the US can learn from other countries using phones to track Covid-19

If and when lockdown restrictions are lifted in the US , would you agree to let the government anonymously track your interactions with people within a 6-foot radius to control the spread of Covid-19 ?
That ’ s an increasingly urgent question as President Trump and state governors debate how and when to safely reopen the US economy — and as technology is being touted as a solution that would help people reenter public life .
And tech giants are stepping up .
Last week , Apple and Google announced a plan to turn phones into opt-in Covid-19 tracking machines @ @ @ @ @ @ @ planned , make it easier for health officials to identify and alert people if they ’ ve been exposed to the virus .
The idea is familiar because similar tech-based efforts have been underway for weeks and even months in countries like Singapore , China , and Taiwan , where Covid-19 hit earlier than in the US .
But what works in one country won ’ t necessarily work in the US .
Some of these Covid-19 tracking technologies — like mandatory electronic wristbands in Hong Kong that tip off authorities when people @ @ @ @ @ @ @ implausible in the US , where for years civil rights advocates have fought to protect people ’ s online privacy and push back against government surveillance .
Apple and Google ’ s system is being designed to protect the identities of people who use it , but concerns abound that outside parties ( including the US government itself ) could try to de-anonymize that data .
The stakes are incredibly high for these tools .
If they work as intended , they could help end a once-in-a-lifetime public health crisis .
But if @ @ @ @ @ @ @ sense of confidence in our abilities to control the virus and allow it to spread further .
On top of all that , even if these tech solutions successfully slow Covid-19 ’ s spread in the US , they pose serious , yet-to-be-determined risks to Americans ’ privacy .
With all that in mind , here ’ s what we can learn from other countries ’ tech-based responses to the coronavirus as the US develops its own .
Technology can help , but it ’ s just one part of an effective strategy @ @ @ @ @ @ @ help stop the spread of the coronavirus is with digital contact tracing , which is the process of identifying people who may have come into contact with the virus .
Traditionally , contact tracing has required human involvement .
When someone tests positive for the virus , public health investigators get in touch with them , learn about everyone they ’ ve been in contact within a certain time frame , and then manually track down and notify all those contacts .
Digital contact tracing automates a part of this process by relying @ @ @ @ @ @ @ out their ongoing web of physical interactions .
The Apple-Google system will use a smartphone ’ s Bluetooth signal to create a log of the people the phone ’ s user has come into close proximity with , while keeping people ’ s identities and locations anonymous .
As Recode previously described , “ It works a bit like exchanging contact information with everyone you meet , except everything is designed to be anonymous and automatic.
” This type of contact-tracing technology is already helping contain the spread of Covid-19 in countries like @ @ @ @ @ @ @ limitations .
“ Technology is not a silver bullet , but one way to get information , ” said Anne Liu , a global health public health expert at Columbia University who worked on efforts to digitize information collected from patients during the Ebola epidemic .
With that caveat , Liu went on to say of the new public health technologies we ’ re seeing in East Asian countries , “ I do think some of this can be especially promising for something that ’ s moving at the speed that Covid-19 is @ @ @ @ @ @ @ attracted praise early in the pandemic for its initial success at curbing the spread of the virus .
In March , the country released TraceTogether , an app that uses Bluetooth technology to help public health officials do contact tracing .
Much like the Apple-Google tool , Singapore ’ s app automated the process of tracking down every person a given person came into contact within a two-week period .
It works by allowing users to log in the app if they test positive for Covid-19 and the tool then anonymously notifies everyone @ @ @ @ @ @ @ the TraceTogether app is one important part of Singapore ’ s overall solution , it ’ s only a supplement to a broader , intense series of policy interventions .
Those include shutting its borders to Chinese travelers in early February , banning large-scale gatherings , imposing quarantine measures , and mobilizing a team of dedicated contact tracers to investigate cases manually .
Despite all this , the country ’ s government is still grappling with containing a recent resurgence in new cases .
It ’ s hard to say yet if the @ @ @ @ @ @ @ public health .
As of April 1 , only 12 percent of people in Singapore had opted to download the contact-tracing app .
One of the key government officials helping release this app explained these limitations of the technology and made the case for governments to continue investing in human beings to do manual contact tracing in addition to any tools they ’ re rolling out .
“ If you ask me whether any Bluetooth contact-tracing system deployed or under development anywhere in the world is ready to replace manual contact tracing , @ @ @ @ @ @ @ that the answer is , ‘ No , ’ ” Jason Bay , the product lead for TraceTogether , Singapore ’ s nationwide Bluetooth contact-tracing system , wrote in a blog post on Friday .
Singapore ’ s experience suggests that even if there ’ s widespread adoption of Apple and Google ’ s contact-tracing tools when they are released , there are limits to their effectiveness .
In the US , mandatory app-based contact tracing isn ’ t on the table for now .
But in other countries , digital health-tracking is @ @ @ @ @ @ @ technology pulls people ’ s health data — especially without their input — it poses serious privacy concerns .
China is an example of what is at stake .
The country ’ s government has long employed technology like facial recognition to control the activity of its citizens , including to target ethnic minorities .
Now , in response to the pandemic , it is partnering with major tech companies to expand that mass digital surveillance network and tie it to people ’ s health data .
As the spread of Covid-19 in @ @ @ @ @ @ @ , local governments ( outside of Wuhan , where the virus originated ) began lifting strict lockdown orders .
Soon after , private companies — in partnership with the Chinese government agencies — began rolling out app add-ons that help the government determine who can start safely leaving their house again without infecting others .
Now , before people can do things like ride the subway or enter a crowded shopping mall , they have to prove they ’ re at low risk of having Covid-19 .
They do that by scanning a @ @ @ @ @ @ @ their cellphone that ’ s either green ( likely Covid-19 free ) , yellow ( at risk of Covid-19 ) , or red ( likely Covid-19 positive ) .
It ’ s not known exactly how the code is calculated , but it ’ s loosely based on information like a user ’ s location and their medical and travel history , which is informed in part by a government questionnaire .
Tested positive for Covid-19 or have recently traveled to Wuhan ?
You ’ re in the red .
Healthy and no @ @ @ @ @ @ @ re in the green .
Currently , people generate these codes in Alipay and WeChat , which are mega-apps in China that nearly every citizen has installed on their phones and that they use to do everything from chatting to buying basic goods to hailing rides .
And in South Korea , the government hasn ’ t issued people with QR health codes , but it is broadcasting detailed information about infected people ’ s whereabouts .
When someone in South Korea tests positive for Covid-19 , government health authorities send regional text @ @ @ @ @ @ @ them has the disease and linking to a central website with more information .
While the government doesn ’ t share people ’ s names , it does provide details on the website , such as the person ’ s age range , gender , and places they recently visited — which has led people to publicly speculate about their neighbors ’ marital affairs and other private matters .
Some have argued that this could lead to stigma around being tested for the virus and discourage people from doing so .
The contact-tracing @ @ @ @ @ @ @ is notably more privacy-centric than the methods we ’ re seeing in China or South Korea , but it still poses concerns .
The two companies have now committed to shutting down the tool once the pandemic is over — which was a key issue for many privacy experts — but other concerns abound .
There are still ways that even the randomly generated Bluetooth keys meant to anonymize users could be linked back to real identities .
Apple and Google are also leaving it up to public health authorities to develop and @ @ @ @ @ @ @ contact tracing tool .
It ’ s conceivable that those authorities could introduce their own ways to circumvent privacy protections if their governments so desire .
The UK ’ s National Health Service , it was recently reported , was looking into ways to identify users of a contact-tracing app it was developing .
In the US , Sen. Richard Blumenthal , who is typically on the side of pro-privacy legislation , has already asked Apple and Google how the companies will assure users that the tool protects their privacy .
That said @ @ @ @ @ @ @ the American Civil Liberty Union ’ s boxes for what a privacy-friendly contact-tracing tool must do .
People need to use it for it to be effective For any technological contact-tracing tool to work , it has to have a high percentage of the country using it .
But just how high ?
Experts aren ’ t sure yet .
A Singapore government official working on the country ’ s contact-tracing app said it would need to see something like two-thirds of the population or more using it .
One researcher at Oxford @ @ @ @ @ @ @ of digital contact tracing apps told the Wall Street Journal that you need about 60 percent of the population to opt in for such a tool to be effective .
In a press call last week , Apple and Google cited that Oxford research and a similar range for their system to potentially be effective .
In China , health-tracking digital QR codes are used by wide swaths of the population .
In the Zheijang province , which is home to 50 million people , the local government says about 90 percent of @ @ @ @ @ @ @ Of course , that ’ s because those apps are all but necessary to get around and do basic day-to-day activities like go to work , enter the market , or ride public transit .
In countries where the apps are opt-in rather than mandatory , we ’ re not seeing adoption rates nearly that high yet .
This raises questions about how the US will be able to convince enough people to download the app , as compared to China ’ s more mandatory enforcement .
What happens after people are notified @ @ @ @ @ @ @ app tell you you ’ ve been exposed to Covid-19 is helpful , but it ’ s only the first step we ’ re seeing in effective international responses to controlling the pandemic .
For these notifications to be of any use , people need access to proper testing , health care systems , and financial support to get through a period of quarantine and potential illness , public health experts cautioned .
If you don ’ t have that , you risk social unrest .
South Korea , for example , had @ @ @ @ @ @ @ aggressive testing that has been free of cost to its citizens .
It also pioneered the drive-through testing model that other countries like the US have followed .
But access to these resources may be harder to roll out at scale in the US , where there ’ s still a shortage of tests and delays in lab processing , and where health care systems in hot spots such as New York City are overwhelmed .
The US has surpassed South Korea in the total number of tests , but adjusted for population @ @ @ @ @ @ @ of the rate of South Korea .
Apple and Google say that in their digital contact-tracing system , once someone is notified they may have been exposed to Covid-19 , they ’ ll receive a message urging them to get tested and self-quarantine .
But being cautioned to get tested is one thing ; actually having easy access to a test is another .
“ If you start coming into contact with someone Covid-19-positive , what is the ability for someone to be evaluated and also tested ?
” said Dr. Andrew Chan @ @ @ @ @ @ @ disease at the Harvard T.H .
Chan School of Public Health .
“ Contact tracing won ’ t be helpful in and of itself if we can ’ t act on the information we gather.
” Chan recently helped create a mobile app that helps people self-report and track Covid-19 symptoms .
The app has been used to confirm previously unknown symptoms of the disease , such as loss of smell and taste , and to understand where the disease is spreading without relying on people getting tested .
He said he ’ @ @ @ @ @ @ @ technologies around contact tracing but emphasized the need for public health agencies to provide adequate resources to follow up on this new data .
What happens next Extensive contact tracing is less useful in a region that ’ s in the middle of an outbreak — like New York and California — where there ’ s widespread community transmission and people are already sheltering in place in their homes .
But , in the future , when the number of cases in those states eventually declines and when businesses begin to reopen , @ @ @ @ @ @ @ society .
If someone is deemed high-risk because of exposure to an anonymous contact , they would stay at home for two weeks before they go back to the office or anywhere outside their home .
With contact tracing like that , Liu said , “ you can do more of a targeted quarantine , because it can target who to keep in quarantine rather than everyone , ” said Liu .
“ Once you have the contacts [ of someone who is diagnosed with Covid-19 ] , then you know who should @ @ @ @ @ @ @ happening by force in places like Taiwan , where most people are free to go to work , restaurants , and public places .
But for the tens of thousands of people in Taiwan who are under quarantine , the government is “ geofencing ” them in their homes by tracking their cellphone signals and using police enforcement .
China has a similar approach : If your QR health code is red , you have to stay put in your home .
But no system is absolutely effective , and it ’ s @ @ @ @ @ @ @ US adapts certain parts of different countries ’ strategies to use technology to reopen the economy .
New technology will only help if it ’ s complemented by sound policy and swift leadership , two things President Trump ’ s administration has botched , with disastrous consequences .
Successfully using new technology will also require open-mindedness and cooperation between the private and public sectors — without violating people ’ s basic rights to privacy .
And it ’ s not just the US that faces this challenge .
Places outside Asia , such @ @ @ @ @ @ @ Iceland , are all considering using similar digital contact-tracing tools , and they face the same policy challenges .
It ’ s an unprecedented task for an unprecedented time — but taking into consideration what other countries ’ methods are working well , and with what consequences , can help US leaders better understand how to create a system that may work for everyone .
Open Sourced is made possible by Omidyar Network .
All Open Sourced content is editorially independent and produced by our journalists .
Every day at Vox , we @ @ @ @ @ @ @ and provide you , and our audience around the world , with information that has the power to save lives .
Our mission has never been more vital than it is in this moment : to empower you through understanding .
Vox ’ s work is reaching more people than ever , but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn .
Your financial contribution will not constitute a donation , but it will enable our staff to continue to offer free articles , @ @ @ @ @ @ @ and volume that this moment requires .
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If and when lockdown restrictions are lifted in the US, would you agree to let the government anonymously track your interactions with people within a 6-foot radius to control the spread of Covid-19?
That’s an increasingly urgent question as President Trump and state governors debate how and when to safely reopen the US economy — and as technology is being touted as a solution that would help people reenter public life.
And tech giants are stepping up. Apple and Google have announced a plan to turn phones into opt-in Covid-19 tracking machines that would, if all goes as planned, make it easier for health officials to identify and alert people if they’ve been exposed to the virus.
The idea is familiar because similar tech-based efforts have been underway for weeks and even months in countries like Singapore, China, and Taiwan, where Covid-19 hit earlier than in the US.
But what works in one country won’t necessarily work in the US. Some of these Covid-19 tracking technologies — like mandatory electronic wristbands in Hong Kong that tip off authorities when people under quarantine leave their homes — seem implausible in the US, where for years civil rights advocates have fought to protect people’s online privacy and push back against government surveillance. Apple and Google’s system is being designed to protect the identities of people who use it, but concerns abound that outside parties (including the US government itself) could try to de-anonymize that data.
The stakes are incredibly high for these tools. If they work as intended, they could help end a once-in-a-lifetime public health crisis. But if ineffective, they could provide a false sense of confidence in our abilities to control the virus and allow it to spread further. On top of all that, even if these tech solutions successfully slow Covid-19’s spread in the US, they pose serious, yet-to-be-determined risks to Americans’ privacy. With all that in mind, here’s what we can learn from other countries’ tech-based responses to the coronavirus as the US develops its own.
Technology can help, but it’s just one part of an effective strategy
One of the main ways technology can help stop the spread of the coronavirus is with digital contact tracing, which is the process of identifying people who may have come into contact with the virus.
Traditionally, contact tracing has required human involvement. When someone tests positive for the virus, public health investigators get in touch with them, learn about everyone they’ve been in contact within a certain time frame, and then manually track down and notify all those contacts.
Digital contact tracing automates a part of this process by relying on people’s phones to map out their ongoing web of physical interactions. The Apple-Google system will use a smartphone’s Bluetooth signal to create a log of the people the phone’s user has come into close proximity with, while keeping people’s identities and locations anonymous. As Recode previously described, “It works a bit like exchanging contact information with everyone you meet, except everything is designed to be anonymous and automatic.”
This type of contact-tracing technology is already helping contain the spread of Covid-19 in countries like Singapore and Taiwan — but it has limitations.
“Technology is not a silver bullet, but one way to get information,” said Anne Liu, a global health public health expert at Columbia University who worked on efforts to digitize information collected from patients during the Ebola epidemic. With that caveat, Liu went on to say of the new public health technologies we’re seeing in East Asian countries, “I do think some of this can be especially promising for something that’s moving at the speed that Covid-19 is moving.”
Take Singapore. Although it’s now facing a spike in new cases, the country attracted praise early in the pandemic for its initial success at curbing the spread of the virus. In March, the country released TraceTogether, an app that uses Bluetooth technology to help public health officials do contact tracing. Much like the Apple-Google tool, Singapore’s app automated the process of tracking down every person a given person came into contact within a two-week period. It works by allowing users to log in the app if they test positive for Covid-19 and the tool then anonymously notifies everyone they’ve recently seen.
But not enough people are using it — as of April 1, only 12 percent of people in Singapore had opted to download the contact tracing app. That figure coupled with the second wave of cases might explain why Singapore’s prime minister, Lee Hsien-loong, made a plea to his citizens to download the app in a national address on Tuesday, April 21.
And while the TraceTogether app is one important part of Singapore’s overall early solution, it was only a supplement to a broader, intense series of policy interventions. Those included shutting its borders to Chinese travelers in early February, banning large-scale gatherings, imposing quarantine measures, and mobilizing a team of dedicated contact tracers to investigate cases manually. Despite all this, the country’s government still couldn’t stop the recent resurgence in new cases, which is concentrated among migrant workers living in crowded dormitories.
One of the key government officials helping release Singapore’s app explained the limitations of the technology and made the case for governments to continue investing in human beings to do manual contact tracing in addition to any tools they’re rolling out.
“If you ask me whether any Bluetooth contact-tracing system deployed or under development anywhere in the world is ready to replace manual contact tracing, I will say, without qualification, that the answer is, ‘No,’” Jason Bay, the product lead for TraceTogether, Singapore’s nationwide Bluetooth contact-tracing system, wrote in a blog post on April 10.
Singapore’s experience suggests that it may be difficult to gain widespread voluntary adoption of Apple and Google’s contact-tracing tools when they are released — and even if that’s achieved — there are limits to their effectiveness.
There are privacy trade-offs
In the US, mandatory app-based contact tracing isn’t on the table for now. But in other countries, digital health-tracking is essentially government mandated. And any time technology pulls people’s health data — especially without their input — it poses serious privacy concerns.
China is an example of what is at stake. The country’s government has long employed technology like facial recognition to control the activity of its citizens, including to target ethnic minorities. Now, in response to the pandemic, it is partnering with major tech companies to expand that mass digital surveillance network and tie it to people’s health data.
As the spread of Covid-19 in China began to slow down in mid-February, local governments (outside of Wuhan, where the virus originated) began lifting strict lockdown orders. Soon after, private companies — in partnership with the Chinese government agencies — began rolling out app add-ons that help the government determine who can start safely leaving their house again without infecting others.
Now, before people can do things like ride the subway or enter a crowded shopping mall, they have to prove they’re at low risk of having Covid-19. They do that by scanning a government-mandated QR “health code” on their cellphone that’s either green (likely Covid-19 free), yellow (at risk of Covid-19), or red (likely Covid-19 positive).
It’s not known exactly how the code is calculated, but it’s loosely based on information like a user’s location and their medical and travel history, which is informed in part by a government questionnaire. Tested positive for Covid-19 or have recently traveled to Wuhan? You’re in the red. Healthy and no travel to high-risk areas? You’re in the green.
Currently, people generate these codes in Alipay and WeChat, which are mega-apps in China that nearly every citizen has installed on their phones and that they use to do everything from chatting to buying basic goods to hailing rides.
And in South Korea, the government hasn’t issued people with QR health codes, but it is broadcasting detailed information about infected people’s whereabouts. When someone in South Korea tests positive for Covid-19, government health authorities send regional text alerts, notifying residents that someone near them has the disease and linking to a central website with more information. While the government doesn’t share people’s names, it does provide details on the website, such as the person’s age range, gender, and places they recently visited — which has led people to publicly speculate about their neighbors’ marital affairs and other private matters. Some have argued that this could lead to stigma around being tested for the virus and discourage people from doing so.
The contact-tracing system Google and Apple are working on is notably more privacy-centric than the methods we’re seeing in China or South Korea, but it still poses concerns. The two companies have now committed to shutting down the tool once the pandemic is over — which was a key issue for many privacy experts — but other concerns abound. There are still ways that even the randomly generated Bluetooth keys meant to anonymize users could be linked back to real identities.
Apple and Google are also leaving it up to public health authorities to develop and manage the apps that will use their contact tracing tool. It’s conceivable that those authorities could introduce their own ways to circumvent privacy protections if their governments so desire. The UK’s National Health Service, it was recently reported, was looking into ways to identify users of a contact-tracing app it was developing. In the US, Sen. Richard Blumenthal, who is typically on the side of pro-privacy legislation, has already asked Apple and Google how the companies will assure users that the tool protects their privacy. That said, the tool ticked off many of the American Civil Liberty Union’s boxes for what a privacy-friendly contact-tracing tool must do.
People need to use it for it to be effective
For any technological contact-tracing tool to work, it has to have a high percentage of the country using it.
But just how high? Experts aren’t sure yet. A Singapore government official working on the country’s contact-tracing app said it would need to see something like two-thirds of the population or more using it. One researcher at Oxford University who has been modeling the effects of digital contact tracing apps told the Wall Street Journal that you need about 60 percent of the population to opt in for such a tool to be effective. In a press call last week, Apple and Google cited that Oxford research and a similar range for their system to potentially be effective.
In China, health-tracking digital QR codes are used by wide swaths of the population. In the Zheijang province, which is home to 50 million people, the local government says about 90 percent of residents signed up for a code. Of course, that’s because those apps are all but necessary to get around and do basic day-to-day activities like go to work, enter the market, or ride public transit.
In countries where the apps are opt-in rather than mandatory, we’re not seeing adoption rates nearly that high yet.
This raises questions about how the US will be able to convince enough people to download the app, as compared to China’s more mandatory enforcement.
What happens after people are notified of exposure makes a difference
Having an app tell you you’ve been exposed to Covid-19 is helpful, but it’s only the first step we’re seeing in effective international responses to controlling the pandemic.
For these notifications to be of any use, people need access to proper testing, health care systems, and financial support to get through a period of quarantine and potential illness, public health experts cautioned. If you don’t have that, you risk social unrest.
South Korea, for example, had early success flattening its curve thanks to aggressive testing that has been free of cost to its citizens. It also pioneered the drive-through testing model that other countries like the US have followed.
But access to these resources may be harder to roll out at scale in the US, where there’s still a shortage of tests and delays in lab processing, and where health care systems in hot spots such as New York City are overwhelmed. The US has surpassed South Korea in the total number of tests, but adjusted for population, has tested at just 74 percent of the rate of South Korea.
Apple and Google say that in their digital contact-tracing system, once someone is notified they may have been exposed to Covid-19, they’ll receive a message urging them to get tested and self-quarantine. But being cautioned to get tested is one thing; actually having easy access to a test is another.
“If you start coming into contact with someone Covid-19-positive, what is the ability for someone to be evaluated and also tested?” said Dr. Andrew Chan, a professor of immunology and infectious disease at the Harvard T.H. Chan School of Public Health. “Contact tracing won’t be helpful in and of itself if we can’t act on the information we gather.”
Chan recently helped create a mobile app that helps people self-report and track Covid-19 symptoms. The app has been used to confirm previously unknown symptoms of the disease, such as loss of smell and taste, and to understand where the disease is spreading without relying on people getting tested. He said he’s hopeful about the US implementing new technologies around contact tracing but emphasized the need for public health agencies to provide adequate resources to follow up on this new data.
What happens next
Extensive contact tracing is less useful in a region that’s in the middle of an outbreak — like New York and California — where there’s widespread community transmission and people are already sheltering in place in their homes.
But, in the future, when the number of cases in those states eventually declines and when businesses begin to reopen, contact tracing can help people safely reenter society. If someone is deemed high-risk because of exposure to an anonymous contact, they would stay at home for two weeks before they go back to the office or anywhere outside their home.
With contact tracing like that, Liu said, “you can do more of a targeted quarantine, because it can target who to keep in quarantine rather than everyone,” said Liu. “Once you have the contacts [of someone who is diagnosed with Covid-19], then you know who should go into quarantine.”
That’s happening by force in places like Taiwan, where most people are free to go to work, restaurants, and public places. But for the tens of thousands of people in Taiwan who are under quarantine, the government is “geofencing” them in their homes by tracking their cellphone signals and using police enforcement. China has a similar approach: If your QR health code is red, you have to stay put in your home.
But no system is absolutely effective, and it’s plausible to see a world where the US adapts certain parts of different countries’ strategies to use technology to reopen the economy.
New technology will only help if it’s complemented by sound policy and swift leadership, two things President Trump’s administration has botched, with disastrous consequences. Successfully using new technology will also require open-mindedness and cooperation between the private and public sectors — without violating people’s basic rights to privacy.
And it’s not just the US that faces this challenge. Places outside Asia, such as the UK, Australia, and Iceland, are all considering using similar digital contact-tracing tools, and they face the same policy challenges. It’s an unprecedented task for an unprecedented time — but taking into consideration what other countries’ methods are working well, and with what consequences, can help US leaders better understand how to create a system that may work for everyone.
Update, April 22, 2020, 3:40pm: This post has been updated to include information about a second wave of cases in Singapore.
Open Sourced is made possible by Omidyar Network. All Open Sourced content is editorially independent and produced by our journalists.


vox--2020-04-18--The devastating consequences of coronavirus lockdowns in poor countries

The coronavirus pandemic that ’ s shattered lives throughout high-income countries is hitting the developing world as well .
But while many of the world ’ s poor countries affected by the virus have imposed the same social distancing measures as rich ones , the results have not been the same — and the unintended consequences are proving to be deadly .
In most high-income countries , stay-at-home orders have been a cornerstone of the coronavirus response .
But we ’ re learning quickly that taking a one-size-fits-all approach doesn ’ t necessarily fit very well with the needs of @ @ @ @ @ @ @ unrest and suffering is growing by the day .
In Kenya , police beat people for defying a stay-at-home order and shot to death a 13-year-old boy who was standing on his balcony .
Human rights activists in Nigeria say that at least 18 people have been killed by security forces enforcing the lockdown .
In India , news of an impending national lockdown sent millions of laborers fleeing for the rural areas where they hoped they could find food during the shutdown .
They likely carried the coronavirus with them .
“ @ @ @ @ @ @ @ that coronavirus will not be allowed to spread across new areas at any cost , ” Indian President Narendra Modi said in a speech extending the country ’ s lockdown by three weeks .
“ I understand the great difficulties you are facing regarding food , the lack of movement .
Some had to stay away from their families .
You are fulfilling duties as disciplined soldiers for the sake of the nation.
” “ It seems like there ’ s a bit of global mimicry , ” Lee Crawfurd of the Center @ @ @ @ @ @ @ tank that studies policy in the developing world , told me .
“ Countries are just doing what seem like the official things , ” even though the same approach causes different problems .
How can lockdowns cause more harm in poor countries than rich ones ?
When almost everyone works in an informal economy and needs to work every day to put food on the table — the situation in some of the poorest countries — calling a halt to economic activity can get rapidly disastrous .
When states have limited budgets @ @ @ @ @ @ @ , lockdowns can result in widespread starvation and rampant disobedience and unrest .
And in dense urban settings where there ’ s limited sanitation , staying home doesn ’ t even prevent the virus from spreading .
Unless they chart a new course , many countries in the developing world are at risk of getting the worst of both worlds — mass poverty from shutdowns and mass illness and deaths from the continued spread of the virus .
In rich countries , lockdowns are rough .
In poor ones , they haven ’ @ @ @ @ @ @ @ lead to greater suffering .
Within the rich world , the advice from epidemiologists has been fairly consistent : People must employ social distancing , even at substantial economic costs , to prevent the virus from sweeping through the communities and overloading the hospitals .
When the virus has gotten out of hand , nearly every rich country has enforced a shutdown to reduce the growth of cases .
This has largely worked , though at a terrible price .
From China to Italy , countries that have implemented aggressive orders to stay @ @ @ @ @ @ @ to fall ( it is unclear whether U.S. case numbers are on the same trajectory ) .
Many poor countries have emulated these steps .
El Salvador announced a 30-day national quarantine on March 21 , when it had no known cases .
On March 24 , India shut down the whole country of more than 1 billion people .
Kenya and Rwanda have also locked down , as have parts of Nigeria .
More than half of the world ’ s population is now under some kind of movement restriction .
But @ @ @ @ @ @ @ ’ re not working .
In fact , they may be causing even more suffering .
In El Salvador , crowds of people swarmed the capital begging for aid more than a week after the lockdown was announced .
Researchers in India report that they ’ ve already documented hundreds of deaths caused by the lockdown , including people who died of starvation and migrants fleeing the cities for rural areas who collapsed of exhaustion or were run over on the roads .
Even worse , the lockdowns , in addition to causing @ @ @ @ @ @ @ even stopping the spread of the virus .
Poor countries now represent all of the countries where Covid-19 cases are growing most rapidly .
That ’ s because states don ’ t have the capacity to enforce lockdowns , and citizens don ’ t have the luxury of obeying them , pushing them to disobey government orders out of desperation .
One factor abetting all this is that many cities in the developing world are so dense that the virus ’ s spread will be rampant even if everyone stays home .
“ @ @ @ @ @ @ @ in informal slums , which by definition are crowded and lack sufficient access to water and sanitation facilities meaning any force of isolation or quarantine is impossible .
In some slums the density is as high as 800,000 people per square mile — for comparison , New York City ’ s is 27,000 , ” Asif Saleh and Richard A .
Cash at the Center for Global Development point out .
How do you socially distance amid that kind of density ?
Making matters worse , poor states lack administrative capacity to communicate @ @ @ @ @ @ @ problem-solve in individual situations .
“ Imposing social distancing and enforcing the policy is very difficult when institutional capacity is limited around the country , ” Yale development economist Ahmed Mushfiq Mobarak has argued .
“ Something that China can impose is not possible for us to impose on a large scale in Bangladesh.
” Lockdowns have also prompted people to leave dense cities , where they had gone to find work , for their homes in rural areas .
In India , after the lockdown was issued , the streets were filled @ @ @ @ @ @ @ Economist Martin Ravallion argues that such migration threatens “ to spread the virus even faster , and especially into poor and vulnerable rural populations .
We are likely to see outbreaks throughout the rural areas of countries that have imposed strict lockdowns.
” Stay in lockdown and starve — or break quarantine to feed your family ?
Most people in developing countries are part of an informal economy , and so they ’ re hard to target with financial aid — and that ’ s if a country can afford to offer it @ @ @ @ @ @ @ and need the money they earn each day or each week to feed their family .
That makes it impossible for them to comply with social distancing rules .
“ If you ’ re a day-wage laborer in a rural area of a developing country , and you don ’ t have much of a buffer of savings , you may be reliant on your wage earnings in a given day or a given week in order to feed your family , ” Mobarak argues .
“ If their family is going hungry @ @ @ @ @ @ @ going to follow all of your guidelines.
” “ The choice before you is often to stay home and fail to provide the evening meal for your family , or to brave it out into the city and try and fend for your family , ” Zimbabwe human rights lawyer Karsten Noko wrote for Al Jazeera .
And indeed , developing countries that have imposed lockdowns have seen widespread defiance of those lockdowns .
Governments have frequently responded with escalating police violence to try to make people stay home .
But if people @ @ @ @ @ @ @ ’ ll be willing to risk the consequences of breaking quarantine if it means getting work and feeding their family .
The lack of medical capacity is also a problem Even rich countries have struggled — as they ’ ve locked down — with the question of what to do next .
Is the plan just to drag out the epidemic to keep case numbers below hospital capacity ?
To stay shut down until we have a vaccine ?
( No country in the world can afford such a shutdown . )
Those @ @ @ @ @ @ @ countries .
Much of the focus of suppressing the virus in rich countries has been building hospital capacity so that people are not turned away from needed medical care .
In much of the world , though , that ’ s not achievable .
When the outbreak in the US began , the country scrambled to make sure it had enough ventilators for the hundreds of thousands of people who were expected to need them if the outbreak spread uncontrolled .
Nigeria , with 200 million people , has around 500 ventilators .
@ @ @ @ @ @ @ 5 million people ) has three .
Liberia is believed to have none .
Sending more ventilators won ’ t help , either : They require specialized medical knowledge to use , which is rarer in developing countries .
Poor nations also tend to have very few doctors per capita and little personal protective equipment ( PPE ) .
“ Most African nations , if not all , do not have what they need to combat this pandemic , ” Dr. Jerry Brown , who led Liberia ’ s Ebola response and is @ @ @ @ @ @ @ Simply put , trying to solve Covid-19 with an increase in hospital capacity is not realistic in the world ’ s poorest countries .
Unless a cheap , straightforward treatment regime is developed , the only way to protect people in those countries from the virus is to prevent them from catching it — which leads back to the dilemma of lockdowns that might cause greater harm .
“ If there ’ s zero health care capacity , flattening the curve doesn ’ t help very much , ” Crawfurd told me .
@ @ @ @ @ @ @ countries slow down their outbreaks until richer countries have learned more about the best treatments , and those treatments start to be mass-produced .
“ Buying time , ” Crawfurd said , might make a significant difference — not because it increases medical capacity but because more will be known about the virus and how to fight it .
The rich world can ’ t afford to ignore everyone else But if lockdowns in the developing world are having such bad impacts , why have they happened at all ?
Some observers have @ @ @ @ @ @ @ public health authorities are imitating the advice from the rich world — with no regard for whether it fits the situation in front of them .
“ WHO guidelines on pandemics tend to internationalise interventions that ignore the variable experiences of a large part of the world , ” the University of Central Lancashire ’ s George Ogola , who studies international media , writes .
“ Governments across the continent have instituted the WHO guidelines and followed in the footsteps of Europe , China and the US , ” he adds .
@ @ @ @ @ @ @ that those countries have more state capacity , more resources , far more hospitals , and the ability to support their locked-down populations with an expanded welfare state .
Trying to apply one-size-fits-all solutions in poorer countries could produce famine on top of a health crisis .
The gathering tragedy in the developing world needs our attention .
Suffering in distant parts of the world is often ignored by people in rich countries even in the best of times .
It ’ s even easier to ignore right now .
The pandemic is @ @ @ @ @ @ @ ways drawn people ’ s attention closer to home .
We know some of what needs to be done to help the developing world — lots of monetary aid and fast , shipments of medical supplies so doctors can keep seeing patients .
But there ’ s little will to do it , as o states fight among themselves for desperately needed equipment .
There have been a few steps taken to protect the developing world .
The G20 just agreed to a 12-month “ debt standstill , ” meaning the world ’ @ @ @ @ @ @ @ on their debt to rich countries for the next year .
That should free up significant money for coronavirus response .
But it falls far short of what developing-world experts have been calling for .
The emerging consensus is that what ’ s needed is a comprehensive aid package from rich countries that enables achievable policies like scaling up PPE purchases , universal aid to help avert mass starvation , quarantines for the sick , and access to treatments and vaccines once we know what the best options are .
And here ’ @ @ @ @ @ @ @ relief in poor countries is actually much cheaper than paying for it at home , because average income is so much lower .
The US has spent $ 2 trillion at home on mitigating the effects of lockdowns .
We could mitigate their effects in developing countries for a fraction of that .
“ Surely we could just pay for everyone in low-income countries to stay home , ” Crawfurd told me .
Realistically , though , there are no prospects of that larger-scale aid package right now .
And that ’ s @ @ @ @ @ @ @ It ’ s also a strategic failure that could have devastating consequences .
Some experts think the virus is likely to become endemic due to countries that fail to suppress it — meaning it will keep circulating the world regularly and making the regular flu season much much deadlier .
The pandemic should be a reminder that nowhere in the world is safe while many parts of it lack the needed health infrastructure to protect their populations .
But it looks like it ’ ll be a long time before we take that @ @ @ @ @ @ @ meantime , little help will be forthcoming .
Sign up for the Future Perfect newsletter and we ’ ll send you a roundup of ideas and solutions for tackling the world ’ s biggest challenges — and how to get better at doing good .
Future Perfect is funded in part by individual contributions , grants , and sponsorships .
Learn more here .
Every day at Vox , we aim to answer your most important questions and provide you , and our audience around the world , with information that has the @ @ @ @ @ @ @ has never been more vital than it is in this moment : to empower you through understanding .
Vox ’ s work is reaching more people than ever , but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn .
Your financial contribution will not constitute a donation , but it will enable our staff to continue to offer free articles , videos , and podcasts at the quality and volume that this moment requires .
Please consider making a contribution to Vox today .

The coronavirus pandemic that’s shattered lives throughout high-income countries is hitting the developing world as well. But while many of the world’s poor countries affected by the virus have imposed the same social distancing measures as rich ones, the results have not been the same — and the unintended consequences are proving to be deadly.
In most high-income countries, stay-at-home orders have been a cornerstone of the coronavirus response. But we’re learning quickly that taking a one-size-fits-all approach doesn’t necessarily fit very well with the needs of the developing world.
The litany of unrest and suffering is growing by the day. In Kenya, police beat people for defying a stay-at-home order and shot to death a 13-year-old boy who was standing on his balcony. Human rights activists in Nigeria say that at least 18 people have been killed by security forces enforcing the lockdown. In India, news of an impending national lockdown sent millions of laborers fleeing for the rural areas where they hoped they could find food during the shutdown. They likely carried the coronavirus with them.
“My request to all my countrymen is that coronavirus will not be allowed to spread across new areas at any cost,” Indian Prime Minister Narendra Modi said in a speech extending the country’s lockdown by three weeks. “I understand the great difficulties you are facing regarding food, the lack of movement. Some had to stay away from their families. You are fulfilling duties as disciplined soldiers for the sake of the nation.”
“It seems like there’s a bit of global mimicry,” Lee Crawfurd of the Center for Global Development, a London-based think tank that studies policy in the developing world, told me. “Countries are just doing what seem like the official things,” even though the same approach causes different problems.
How can lockdowns cause more harm in poor countries than rich ones? When almost everyone works in an informal economy and needs to work every day to put food on the table — the situation in some of the poorest countries — calling a halt to economic activity can get rapidly disastrous. When states have limited budgets and capacity to support their locked-down population, lockdowns can result in widespread starvation and rampant disobedience and unrest.
Related How the US stacks up to other countries in confirmed coronavirus cases
And in dense urban settings where there’s limited sanitation, staying home doesn’t even prevent the virus from spreading.
Unless they chart a new course, many countries in the developing world are at risk of getting the worst of both worlds — mass poverty from shutdowns and mass illness and deaths from the continued spread of the virus.
In rich countries, lockdowns are rough. In poor ones, they haven’t stopped the virus — and can lead to greater suffering.
Within the rich world, the advice from epidemiologists has been fairly consistent: People must employ social distancing, even at substantial economic costs, to prevent the virus from sweeping through the communities and overloading the hospitals. When the virus has gotten out of hand, nearly every rich country has enforced a shutdown to reduce the growth of cases.
This has largely worked, though at a terrible price. From China to Italy, countries that have implemented aggressive orders to stay home have seen their case numbers start to fall (it is unclear whether U.S. case numbers are on the same trajectory).
Related New unemployment filings are so high only the Great Depression compares
Many poor countries have emulated these steps. El Salvador announced a 30-day national quarantine on March 21, when it had no known cases. On March 24, India shut down the whole country of more than 1 billion people. Kenya and Rwanda have also locked down, as have parts of Nigeria. More than half of the world’s population is now under some kind of movement restriction.
But while these policies are well-intentioned, they’re not working. In fact, they may be causing even more suffering. In El Salvador, crowds of people swarmed the capital begging for aid more than a week after the lockdown was announced. Researchers in India report that they’ve already documented hundreds of deaths caused by the lockdown, including people who died of starvation and migrants fleeing the cities for rural areas who collapsed of exhaustion or were run over on the roads.
Even worse, the lockdowns, in addition to causing all sorts of misery, are not even stopping the spread of the virus. Poor countries now represent all of the countries where Covid-19 cases are growing most rapidly. That’s because states don’t have the capacity to enforce lockdowns, and citizens don’t have the luxury of obeying them, pushing them to disobey government orders out of desperation.
One factor abetting all this is that many cities in the developing world are so dense that the virus’s spread will be rampant even if everyone stays home. “There are 1.2 billion people globally living in informal slums, which by definition are crowded and lack sufficient access to water and sanitation facilities meaning any force of isolation or quarantine is impossible. In some slums the density is as high as 800,000 people per square mile — for comparison, New York City’s is 27,000,” Asif Saleh and Richard A. Cash at the Center for Global Development point out. How do you socially distance amid that kind of density?
Making matters worse, poor states lack administrative capacity to communicate their rules, enforce them, and problem-solve in individual situations.
“Imposing social distancing and enforcing the policy is very difficult when institutional capacity is limited around the country,” Yale development economist Ahmed Mushfiq Mobarak has argued. “Something that China can impose is not possible for us to impose on a large scale in Bangladesh.”
Lockdowns have also prompted people to leave dense cities, where they had gone to find work, for their homes in rural areas. In India, after the lockdown was issued, the streets were filled with migrant workers fleeing the cities. Economist Martin Ravallion argues that such migration threatens “to spread the virus even faster, and especially into poor and vulnerable rural populations. We are likely to see outbreaks throughout the rural areas of countries that have imposed strict lockdowns.”
Stay in lockdown and starve — or break quarantine to feed your family?
Most people in developing countries are part of an informal economy, and so they’re hard to target with financial aid — and that’s if a country can afford to offer it. They often also have no savings and need the money they earn each day or each week to feed their family. That makes it impossible for them to comply with social distancing rules.
“If you’re a day-wage laborer in a rural area of a developing country, and you don’t have much of a buffer of savings, you may be reliant on your wage earnings in a given day or a given week in order to feed your family,” Mobarak argues. “If their family is going hungry that week, they’re not going to follow all of your guidelines.”
“The choice before you is often to stay home and fail to provide the evening meal for your family, or to brave it out into the city and try and fend for your family,” Zimbabwe human rights lawyer Karsten Noko wrote for Al Jazeera.
And indeed, developing countries that have imposed lockdowns have seen widespread defiance of those lockdowns. Governments have frequently responded with escalating police violence to try to make people stay home. But if people expect to starve at home, they’ll be willing to risk the consequences of breaking quarantine if it means getting work and feeding their family.
The lack of medical capacity is also a problem
Even rich countries have struggled — as they’ve locked down — with the question of what to do next. Is the plan just to drag out the epidemic to keep case numbers below hospital capacity? To stay shut down until we have a vaccine? (No country in the world can afford such a shutdown.)
Those questions are even more urgent for developing countries.
Much of the focus of suppressing the virus in rich countries has been building hospital capacity so that people are not turned away from needed medical care. In much of the world, though, that’s not achievable.
When the outbreak in the US began, the country scrambled to make sure it had enough ventilators for the hundreds of thousands of people who were expected to need them if the outbreak spread uncontrolled. Nigeria, with 200 million people, has around 500 ventilators. The Central African Republic (population: 5 million people) has three. Liberia is believed to have none.
Sending more ventilators won’t help, either: They require specialized medical knowledge to use, which is rarer in developing countries. Poor nations also tend to have very few doctors per capita and little personal protective equipment (PPE).
“Most African nations, if not all, do not have what they need to combat this pandemic,” Dr. Jerry Brown, who led Liberia’s Ebola response and is preparing their coronavirus response, said.
Simply put, trying to solve Covid-19 with an increase in hospital capacity is not realistic in the world’s poorest countries. Unless a cheap, straightforward treatment regime is developed, the only way to protect people in those countries from the virus is to prevent them from catching it — which leads back to the dilemma of lockdowns that might cause greater harm.
“If there’s zero health care capacity, flattening the curve doesn’t help very much,” Crawfurd told me.
The best hope might be that developing countries slow down their outbreaks until richer countries have learned more about the best treatments, and those treatments start to be mass-produced. “Buying time,” Crawfurd said, might make a significant difference — not because it increases medical capacity but because more will be known about the virus and how to fight it.
The rich world can’t afford to ignore everyone else
But if lockdowns in the developing world are having such bad impacts, why have they happened at all? Some observers have argued that, as panic mounts, public health authorities are imitating the advice from the rich world — with no regard for whether it fits the situation in front of them.
“WHO guidelines on pandemics tend to internationalise interventions that ignore the variable experiences of a large part of the world,” the University of Central Lancashire’s George Ogola, who studies international media, writes. “Governments across the continent have instituted the WHO guidelines and followed in the footsteps of Europe, China and the US,” he adds.
The problem, of course, is that those countries have more state capacity, more resources, far more hospitals, and the ability to support their locked-down populations with an expanded welfare state. Trying to apply one-size-fits-all solutions in poorer countries could produce famine on top of a health crisis.
The gathering tragedy in the developing world needs our attention. Suffering in distant parts of the world is often ignored by people in rich countries even in the best of times. It’s even easier to ignore right now. The pandemic is global, but it has in many ways drawn people’s attention closer to home.
We know some of what needs to be done to help the developing world — lots of monetary aid and fast, shipments of medical supplies so doctors can keep seeing patients. But there’s little will to do it, as o states fight among themselves for desperately needed equipment.
There have been a few steps taken to protect the developing world. The G20 just agreed to a 12-month “debt standstill,” meaning the world’s poorest countries can stop making payments on their debt to rich countries for the next year. That should free up significant money for coronavirus response.
But it falls far short of what developing-world experts have been calling for. The emerging consensus is that what’s needed is a comprehensive aid package from rich countries that enables achievable policies like scaling up PPE purchases, universal aid to help avert mass starvation, quarantines for the sick, and access to treatments and vaccines once we know what the best options are.
And here’s the thing: Paying for virus relief in poor countries is actually much cheaper than paying for it at home, because average income is so much lower. The US has spent $2 trillion at home on mitigating the effects of lockdowns. We could mitigate their effects in developing countries for a fraction of that. “Surely we could just pay for everyone in low-income countries to stay home,” Crawfurd told me.
Realistically, though, there are no prospects of that larger-scale aid package right now.
And that’s a moral failure by rich countries. It’s also a strategic failure that could have devastating consequences. Some experts think the virus is likely to become endemic due to countries that fail to suppress it — meaning it will keep circulating the world regularly and making the regular flu season much much deadlier. The pandemic should be a reminder that nowhere in the world is safe while many parts of it lack the needed health infrastructure to protect their populations.
But it looks like it’ll be a long time before we take that lesson to heart — and in the meantime, little help will be forthcoming.
Correction, April 20: An earlier version of this story misstated Modi’s title. He is the prime minister of India.
Sign up for the Future Perfect newsletter and we’ll send you a roundup of ideas and solutions for tackling the world’s biggest challenges — and how to get better at doing good.
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vox--2020-04-18--The US reportedly ordered millions of N95 masks from unproven suppliers

The United States government has ordered 20 million N95 masks for health care workers through a set of suppliers that are overwhelmingly unproven and untested , according to a new report from the Wall Street Journal .
At least 80 percent of the masks , which are due to be delivered by the end of May , are being ordered from vendors which either haven ’ t done business with the government before or haven ’ t previously provided medical equipment specifically to the government .
The government ’ s heavy reliance on untested suppliers of medical equipment raises questions @ @ @ @ @ @ @ and whether they will be delivered in a timely fashion .
Some of the vendors have already missed delivery deadlines and dropped out of the process because of supply problems , according to the Wall Street Journal .
Additionally , the parent company of one vendor is going through bankruptcy and has been accused of fraud in lawsuits .
The masks are being purchased for about $ 6 each through the $ 110 million contract — a price that is more expensive than the typical price of an N95 mask before the pandemic @ @ @ @ @ @ @ with current market rates .
The fact that the government is counting on untested suppliers for a crucial piece of personal protective equipment ( PPE ) for health care providers is a worrying prospect at a time when there are widespread shortages of masks , gowns , gloves and other critical equipment for health care providers dealing with the coronavirus pandemic .
N95 masks are more complex — and more complicated to make — than a surgical mask .
As Recode ’ s Rebecca Heilweil explains , certified N95 masks are “ special @ @ @ @ @ @ @ , N95 masks are built so that 95 percent of very small airborne particles can ’ t get through .
These masks also need to be approved by the CDC ’ s National Institute for Occupational Safety and Health and , depending on the type , the Food and Drug Administration .
In order to fulfill those requirements , N95 masks must be constructed so that they seal tightly around one ’ s mouth and nose , unlike surgical or cloth masks which are loose-fitting .
...
The masks themselves are difficult to @ @ @ @ @ @ @ specialized equipment to meet stringent regulatory standards .
The federal government has placed separate PPE orders from traditional suppliers as well — including orders for 600 million N95 masks from huge , prominent vendors like 3M and Honeywell International Inc , according to the Journal .
But those orders extend through next year , and those vendors also supply masks to many other clients .
Taking a gamble on untested suppliers has already proved troublesome for other governments .
For example , the British government spent $ 20 million on coronavirus antibody tests @ @ @ @ @ @ @ to not work .
When the government makes rushed contracts with less well-known vendors they also may be more likely to be susceptible to attempted fraud .
The Justice Department recently disrupted a foreign criminal scheme in which two people or organizations attempted to fraudulently sell nearly 40 million N95 masks to health care providers in the US .
Every day at Vox , we aim to answer your most important questions and provide you , and our audience around the world , with information that has the power to save lives .
@ @ @ @ @ @ @ than it is in this moment : to empower you through understanding .
Vox ’ s work is reaching more people than ever , but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn .
Your financial contribution will not constitute a donation , but it will enable our staff to continue to offer free articles , videos , and podcasts at the quality and volume that this moment requires .
Please consider making a contribution to Vox today .

The United States government has ordered 20 million N95 masks for health care workers through a set of suppliers that are overwhelmingly unproven and untested, according to a new report from the Wall Street Journal.
At least 80 percent of the masks, which are due to be delivered by the end of May, are being ordered from vendors which either haven’t done business with the government before or haven’t previously provided medical equipment specifically to the government. The government’s heavy reliance on untested suppliers of medical equipment raises questions about the quality of the masks, and whether they will be delivered in a timely fashion.
Some of the vendors have already missed delivery deadlines and dropped out of the process because of supply problems, according to the Wall Street Journal. Additionally, the parent company of one vendor is going through bankruptcy and has been accused of fraud in lawsuits.
The masks are being purchased for about $6 each through the $110 million contract — a price that is more expensive than the typical price of an N95 mask before the pandemic began, but is roughly in line with current market rates.
The fact that the government is counting on untested suppliers for a crucial piece of personal protective equipment (PPE) for health care providers is a worrying prospect at a time when there are widespread shortages of masks, gowns, gloves and other critical equipment for health care providers dealing with the coronavirus pandemic.
N95 masks are more complex — and more complicated to make — than a surgical mask. As Recode’s Rebecca Heilweil explains, certified N95 masks are “special”:
Unlike a conventional surgical mask, N95 masks are built so that 95 percent of very small airborne particles can’t get through. These masks also need to be approved by the CDC’s National Institute for Occupational Safety and Health and, depending on the type, the Food and Drug Administration. In order to fulfill those requirements, N95 masks must be constructed so that they seal tightly around one’s mouth and nose, unlike surgical or cloth masks which are loose-fitting. ... The masks themselves are difficult to make, in part because they require specialized equipment to meet stringent regulatory standards.
The federal government has placed separate PPE orders from traditional suppliers as well — including orders for 600 million N95 masks from huge, prominent vendors like 3M and Honeywell International Inc, according to the Journal. But those orders extend through next year, and those vendors also supply masks to many other clients.
Taking a gamble on untested suppliers has already proved troublesome for other governments. For example, the British government spent $20 million on coronavirus antibody tests from an unknown manufacturer that turned out to not work.
When the government makes rushed contracts with less well-known vendors they also may be more likely to be susceptible to attempted fraud. The Justice Department recently disrupted a foreign criminal scheme in which two people or organizations attempted to fraudulently sell nearly 40 million N95 masks to health care providers in the US.


vox--2020-04-18--Nearly two-thirds of Americans think Trump acted too slowly to fight coronavirus

Nearly two-thirds of Americans believe President Donald Trump acted too slowly in responding to the coronavirus in the United States , according to a new report from the nonpartisan Pew Research Center , reflecting a disconnect between how the public and the president views his performance .
The study — which featured 4,917 US adults , and was taken from April 7 to 12 — did find a partisan split in attitudes on the president ’ s early response .
Republicans overall were more likely to agree with the president ’ s claim that he acted “ way too early @ @ @ @ @ @ @ by the virus , with 66 percent saying they feel Trump reacted quickly .
Among Republicans who described themselves as moderate or liberal , however , a slight majority — 53 percent — said Trump acted too slowly .
Similarly , Republicans living in counties with high death tolls were also less aligned with the president ’ s view of his response — 43 percent of those living where there have been a high number of deaths said Trump should have done more , sooner .
Democrats everywhere , and of all ideologies @ @ @ @ @ @ @ early response , with 92 percent of Democrats overall saying the president should have acted faster .
When asked about how they see the president now , the poll found that 39 percent of the public thinks Trump is telling the truth about the pandemic , 52 percent believe he ’ s pretending the situation is better than it is , and 8 percent feel he ’ s overexaggerating the seriousness of the situation .
And the researchers found , as others have this week , that most Americans ( in this case @ @ @ @ @ @ @ state governments will lift social distancing restrictions too quickly — even as conservative groups protest stay-at-home orders across the country .
Americans ’ criticism of Trump stands in contrast with his own assessment of his work : He ’ s said he ’ s acted quickly to combat the virus , citing his decision to restrict travel to China on January 31 as proof of his decisive action .
As Vox ’ s Aaron Rupar has noted , however , “ the fact of the matter is the virus was already spreading within @ @ @ @ @ @ @ at best , the travel restrictions bought the federal government time that it didn ’ t use particularly well.
” Beyond that decision , the Trump administration has downplayed the severity of the virus from the beginning , and largely failed to take early widespread actions that could have slowed the spread of the disease in the US , which instead is now projected to kill tens of thousands of Americans .
National security advisers warned Trump about the virus ’ s expected spread through the country in early January , shortly after @ @ @ @ @ @ @ weeks ticked by , Trump minimized the problem in his messaging , did little to address testing shortages , and delayed declaring a national emergency to unlock aid funding .
And while his tune has changed in recent weeks , experts say the early sluggish response likely has had lasting effects on the virus ’ s spread in communities and how deadly it has become .
A series of delays and ill preparation hampered the US response to the coronavirus The US ’ problems handling the coronavirus pandemic began in April 2018 , @ @ @ @ @ @ @ team that handles pandemic responses as he repeatedly called for cuts to the budget for the Centers for Disease Control and Prevention .
By the time the coronavirus came to the US , officials had to rebuild a coordinated response team they had dismantled years before .
The Trump administration restricted travel from China in late January , the day after the World Health Organization declared a global health emergency .
He has often cited this as an example of an early , decisive move to help stop the virus .
But as @ @ @ @ @ @ @ , and Italy through late February , Trump officials said the virus was contained in the US and that the country was “ pretty close to airtight.
” Throughout February , the administration seems to have done little to prepare for the pandemic to come , and as Rupar noted , did not have anything to highlight from that month in a White House video produced to highlight Trump ’ s coronavirus accomplishments .
And by late February , as US officials warned of major disruptions ahead , Trump insisted “ it ’ @ @ @ @ @ @ @ , it ’ s like a miracle , it will disappear.
” Even in March , as people began dying in Washington state and elsewhere , administration officials assured the public that the US was “ way ahead of the curve ” on preparing for the virus , said that “ the vast majority of Americans are not at risk for this virus , ” and the Trump campaign refused to cancel campaign rallies .
Finally , in mid-March , Trump agreed to recommend social distancing around the country and declared a national @ @ @ @ @ @ @ in funding to help states get more resources as medical supplies in some states were already running thin .
Supplies have continued to be hard to come by , which experts have said is due in part to the dismantling of the pandemic preparedness team before the crisis began .
“ The US … was not prepared , ” Jen Kates , senior vice president and director of global health and HIV policy at the Kaiser Family Foundation , told Vox ’ s German Lopez .
“ A good preparedness plan would have @ @ @ @ @ @ @ Vox , we aim to answer your most important questions and provide you , and our audience around the world , with information that has the power to save lives .
Our mission has never been more vital than it is in this moment : to empower you through understanding .
Vox ’ s work is reaching more people than ever , but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn .
Your financial contribution will not constitute a donation , but it will @ @ @ @ @ @ @ free articles , videos , and podcasts at the quality and volume that this moment requires .
Please consider making a contribution to Vox today .

Nearly two-thirds of Americans believe President Donald Trump acted too slowly in responding to the coronavirus in the United States, according to a new report from the nonpartisan Pew Research Center, reflecting a disconnect between how the public and the president views his performance.
The study — which featured 4,917 US adults, and was taken from April 7 to 12 — did find a partisan split in attitudes on the president’s early response. Republicans overall were more likely to agree with the president’s claim that he acted “way too early” in responding to the threat posed by the virus, with 66 percent saying they feel Trump reacted quickly. Among Republicans who described themselves as moderate or liberal, however, a slight majority — 53 percent — said Trump acted too slowly.
Similarly, Republicans living in counties with high death tolls were also less aligned with the president’s view of his response — 43 percent of those living where there have been a high number of deaths said Trump should have done more, sooner.
Democrats everywhere, and of all ideologies, found fault with Trump’s early response, with 92 percent of Democrats overall saying the president should have acted faster.
When asked about how they see the president now, the poll found that 39 percent of the public thinks Trump is telling the truth about the pandemic, 52 percent believe he’s pretending the situation is better than it is, and 8 percent feel he’s overexaggerating the seriousness of the situation. And the researchers found, as others have this week, that most Americans (in this case, 66 percent) are concerned that state governments will lift social distancing restrictions too quickly — even as conservative groups protest stay-at-home orders across the country.
Americans’ criticism of Trump stands in contrast with his own assessment of his work: He’s said he’s acted quickly to combat the virus, citing his decision to restrict travel to China on January 31 as proof of his decisive action. As Vox’s Aaron Rupar has noted, however, “the fact of the matter is the virus was already spreading within US borders by this time, so at best, the travel restrictions bought the federal government time that it didn’t use particularly well.”
Beyond that decision, the Trump administration has downplayed the severity of the virus from the beginning, and largely failed to take early widespread actions that could have slowed the spread of the disease in the US, which instead is now projected to kill tens of thousands of Americans.
National security advisers warned Trump about the virus’s expected spread through the country in early January, shortly after cases began spreading in China. As weeks ticked by, Trump minimized the problem in his messaging, did little to address testing shortages, and delayed declaring a national emergency to unlock aid funding. And while his tune has changed in recent weeks, experts say the early sluggish response likely has had lasting effects on the virus’s spread in communities and how deadly it has become.
A series of delays and ill preparation hampered the US response to the coronavirus
The US’ problems handling the coronavirus pandemic began in April 2018, when the Trump administration began disbanding the team that handles pandemic responses as he repeatedly called for cuts to the budget for the Centers for Disease Control and Prevention. By the time the coronavirus came to the US, officials had to rebuild a coordinated response team they had dismantled years before.
The Trump administration restricted travel from China in late January, the day after the World Health Organization declared a global health emergency. He has often cited this as an example of an early, decisive move to help stop the virus. But as the virus ravaged China, South Korea, and Italy through late February, Trump officials said the virus was contained in the US and that the country was “pretty close to airtight.”
Throughout February, the administration seems to have done little to prepare for the pandemic to come, and as Rupar noted, did not have anything to highlight from that month in a White House video produced to highlight Trump’s coronavirus accomplishments. And by late February, as US officials warned of major disruptions ahead, Trump insisted “it’s going to disappear. One day, it’s like a miracle, it will disappear.”
Even in March, as people began dying in Washington state and elsewhere, administration officials assured the public that the US was “way ahead of the curve” on preparing for the virus, said that “the vast majority of Americans are not at risk for this virus,” and the Trump campaign refused to cancel campaign rallies.
Finally, in mid-March, Trump agreed to recommend social distancing around the country and declared a national emergency, which unlocked $42.6 billion in funding to help states get more resources as medical supplies in some states were already running thin.
Supplies have continued to be hard to come by, which experts have said is due in part to the dismantling of the pandemic preparedness team before the crisis began.
“The US … was not prepared,” Jen Kates, senior vice president and director of global health and HIV policy at the Kaiser Family Foundation, told Vox’s German Lopez. “A good preparedness plan would have helped address this.”


vox--2020-04-18--Americans are using the #TwitterFoodBank hashtag to help each other buy groceries amid the recession

On Saturday , the top trending Twitter hashtag in the United States was # TwitterFoodBank .
The premise is simple : families in need tweet using the hashtag , explain how they ’ re struggling economically , and leave their account name with Square ’ s Cash app , which enables strangers reading their tweet to send money their way .
# TwitterFoodBank has been championed by Michigan private equity investor Bill Pulte and the nonprofit Team Giving , which says it ’ s inspired by Pulte ’ s habit of giving out large sums of money to strangers on @ @ @ @ @ @ @ seed funding from Pulte .
Team Giving has also been soliciting donations through its Cash app account , $ TGcom , and says it ’ s sending money in $ 100 increments to families using the hashtag to express their need : Team Giving retweeted families receiving their $ 100 all day , including their names and images .
Recipient families have been posting overjoyed tweets and videos expressing their gratitude .
The giving here is inspiring in some ways : people really are struggling , and it ’ s heartwarming to see @ @ @ @ @ @ @ others by sending money directly .
But # TwitterFoodBank has many of the same downsides as the use of GoFundMe and other crowdfunding vehicles to cover medical expenses and emergency bills .
It ’ s both a reflection of the inadequacy of the government safety net ( the government has more resources to help people immediately than private donors ever will ) and an imposition on the families asking for help .
Families often find it embarrassing , and an invasion of personal privacy , to be forced to lay out their personal @ @ @ @ @ @ @ beg strangers online for financial help , as Rachel Monroe documented in a recent piece on GoFundMe .
Moreover , the nature of crowdfunding creates a kind of competition where struggling people have to compete to craft the most compelling pitch to potential funders .
There ’ s something demeaning about being forced to put on an elaborate presentation , in public , where anyone on the internet can see you , in order to keep your family fed .
How to provide relief to families suffering during the Covid-19 pandemic Giving through @ @ @ @ @ @ @ , but many families who don ’ t use Twitter are suffering now , too .
There have been 22 million unemployment claims filed since social distancing measures began in earnest in March — and many hoping to apply say they ’ ve been unable to , due to clogged phone lines and broken websites .
And millions of other Americans have seen their wages reduced as hours and salaries are cut as cost-saving measures .
So , if you want to help those worst off during this crisis , there are a @ @ @ @ @ @ @ that are worth considering .
The best domestic coronavirus-focused charity to donate to in the US , in my opinion , is GiveDirectly ’ s Covid-19 cash program .
GiveDirectly has partnered with Propel , a company that works on benefit delivery to recipients of the Supplemental Nutrition Assistance Program ( SNAP , aka food stamps ) — it identifies SNAP recipients and directs money to them .
Under GiveDirectly ’ s program , each household gets $ 1,000 as a one-time payment .
As of this writing , GiveDirectly reports having helped @ @ @ @ @ @ @ of $ 5 million .
Google announced a $ 2 million gift ( half from the company itself , half from CEO Sundar Pichai ) to GiveDirectly ’ s efforts , meaning they ’ ll scale up even more soon .
You can also donate , and volunteer , closer to home .
The National Coalition for the Homeless maintains a directory of local homeless shelters ; homelessness is the closest thing in the US to the extreme poverty common in parts of the developing world , and you can reach out to @ @ @ @ @ @ @ need donations or volunteers .
Many won ’ t be interested in taking on new personnel given the increased risk of residents getting infected , but it ’ s worth asking .
Likewise , you can consult Feeding America ’ s list of food pantries to find one in your area .
Remember , though : If you want to give , give cash , not food .
It ’ s a lot more flexible for food banks and prevents them from having to deal with wasted food no one wants .
But @ @ @ @ @ @ @ help people abroad , too .
GiveDirectly is distributing cash to families affected by the Covid-19 crisis in Africa as well , and groups like the Center for Global Development and the Global Health and Development charitable fund provide funding for efforts to strengthen health systems in poor countries .
Donating to prevent the next pandemic could avert even more suffering ; the Center for Health Security and Nuclear Threat Initiative are two excellent groups working on pandemic prevention .
Every day at Vox , we aim to answer your most important questions @ @ @ @ @ @ @ around the world , with information that has the power to save lives .
Our mission has never been more vital than it is in this moment : to empower you through understanding .
Vox ’ s work is reaching more people than ever , but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn .
Your financial contribution will not constitute a donation , but it will enable our staff to continue to offer free articles , videos , and podcasts at the quality @ @ @ @ @ @ @ Please consider making a contribution to Vox today .
Sign up for the Future Perfect newsletter and we ’ ll send you a roundup of ideas and solutions for tackling the world ’ s biggest challenges — and how to get better at doing good .
Future Perfect is funded in part by individual contributions , grants , and sponsorships .
Learn more here .

On Saturday, the top trending Twitter hashtag in the United States was #TwitterFoodBank. The premise is simple: families in need tweet using the hashtag, explain how they’re struggling economically, and leave their account name with Square’s Cash app, which enables strangers reading their tweet to send money their way.
#TwitterFoodBank has been championed by Michigan private equity investor Bill Pulte and the nonprofit Team Giving, which says it’s inspired by Pulte’s habit of giving out large sums of money to strangers on Twitter and that it’s received seed funding from Pulte.
Drop your cash app, use hashtag #TwitterFoodBank — Bill Pulte (@pulte) April 18, 2020
Team Giving has also been soliciting donations through its Cash app account, $TGcom, and says it’s sending money in $100 increments to families using the hashtag to express their need:
Throughout the day we are going to post pictures 10 families at a time who received the $100 to feed themselves. Here are the first 10!#TwitterFoodBank pic.twitter.com/MLVKojagQT — TeamGiving.com (@TeamGivingCom) April 18, 2020
Team Giving retweeted families receiving their $100 all day, including their names and images. Recipient families have been posting overjoyed tweets and videos expressing their gratitude.
The giving here is inspiring in some ways: people really are struggling, and it’s heartwarming to see strangers on Twitter expressing their solidarity with others by sending money directly. But #TwitterFoodBank has many of the same downsides as the use of GoFundMe and other crowdfunding vehicles to cover medical expenses and emergency bills. It’s both a reflection of the inadequacy of the government safety net (the government has more resources to help people immediately than private donors ever will) and an imposition on the families asking for help.
Families often find it embarrassing, and an invasion of personal privacy, to be forced to lay out their personal financial lives in detail so they can beg strangers online for financial help, as Rachel Monroe documented in a recent piece on GoFundMe. Moreover, the nature of crowdfunding creates a kind of competition where struggling people have to compete to craft the most compelling pitch to potential funders. There’s something demeaning about being forced to put on an elaborate presentation, in public, where anyone on the internet can see you, in order to keep your family fed.
How to provide relief to families suffering during the Covid-19 pandemic
Giving through #TwitterFoodBank will certainly help some people, but many families who don’t use Twitter are suffering now, too. There have been 22 million unemployment claims filed since social distancing measures began in earnest in March — and many hoping to apply say they’ve been unable to, due to clogged phone lines and broken websites. And millions of other Americans have seen their wages reduced as hours and salaries are cut as cost-saving measures. So, if you want to help those worst off during this crisis, there are a few more targeted options than a hashtag that are worth considering.
The best domestic coronavirus-focused charity to donate to in the US, in my opinion, is GiveDirectly’s Covid-19 cash program. GiveDirectly has partnered with Propel, a company that works on benefit delivery to recipients of the Supplemental Nutrition Assistance Program (SNAP, aka food stamps) — it identifies SNAP recipients and directs money to them.
Under GiveDirectly’s program, each household gets $1,000 as a one-time payment. As of this writing, GiveDirectly reports having helped 4,500 families, and given a total of $5 million. Google announced a $2 million gift (half from the company itself, half from CEO Sundar Pichai) to GiveDirectly’s efforts, meaning they’ll scale up even more soon.
You can also donate, and volunteer, closer to home. The National Coalition for the Homeless maintains a directory of local homeless shelters; homelessness is the closest thing in the US to the extreme poverty common in parts of the developing world, and you can reach out to your local shelter to see if they need donations or volunteers. Many won’t be interested in taking on new personnel given the increased risk of residents getting infected, but it’s worth asking.
Likewise, you can consult Feeding America’s list of food pantries to find one in your area. Remember, though: If you want to give, give cash, not food. It’s a lot more flexible for food banks and prevents them from having to deal with wasted food no one wants.
But it’s worth considering donating to help people abroad, too. GiveDirectly is distributing cash to families affected by the Covid-19 crisis in Africa as well, and groups like the Center for Global Development and the Global Health and Development charitable fund provide funding for efforts to strengthen health systems in poor countries. Donating to prevent the next pandemic could avert even more suffering; the Center for Health Security and Nuclear Threat Initiative are two excellent groups working on pandemic prevention.
Sign up for the Future Perfect newsletter and we’ll send you a roundup of ideas and solutions for tackling the world’s biggest challenges — and how to get better at doing good.
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