vox--2020-03-14--The infuriating experience of coronavirus testing, explained by a patient

Devin , a 35-year-old living in Chicago , woke up on Tuesday morning and felt sick .
He had body aches , a fever , and a dry cough .
His doctor recommended he go to an emergency room that had access to the coronavirus test .
Devin had reasons to think he could be at risk of the infection : he had been traveling in Southeast Asia for much of February .
He had also broken his arm upon returning , putting him in contact with other patients at hospitals and doctors ’ offices the week before his symptoms @ @ @ @ @ @ @ tested him for the flu , but it came back negative .
However , he was showing lung inflammation on an X-ray , so he answered questionnaires to assess his risk of having been infected by the coronavirus and his risk of developing a severe case of Covid-19 .
But Devin noticed something that surprised him in the questions : they were very narrowly focused on whether he had been to China or Italy specifically or if he ’ d potentially come into contact with somebody already known to have the novel coronavirus @ @ @ @ @ @ @ criteria for a test at that time , so they sent him home , the doctor even telling him he didn ’ t need to self-quarantine .
“ I guess where I took issue with this diagnostic is it completely ignores the potential and the risk for community spread .
There is no algorithm for determining that , ” he told me .
“ If they had asked me , I could tell them I was in your ER .
I was in a doctor ’ s office .
I was at an @ @ @ @ @ @ @ was at my PT ’ s office.
” Devin wasn ’ t convinced , and started letting people with whom he ’ d been in contact know about how he was feeling .
He found out somebody at his physical therapist ’ s office has a father with lung cancer , exactly the kind of person most at risk from the Covid-19 disease .
Within 24 hours , the hospital called him : you should come back in and get tested for coronavirus .
Devin got tested Thursday evening , and as of @ @ @ @ @ @ @ for a result .
The scary part is we don ’ t know how many Devins — people with good reason to worry about coronavirus , but who have gone untested because they didn ’ t meet restrictive testing criteria — are out there .
As of Saturday , the United States had still tested less than 21,000 people , a far lower rate than most other countries .
There are about 2,500 confirmed Covid-19 cases in the US as of March 14 .
But because so few people have been tested , @ @ @ @ @ @ @ much higher .
“ Of course the catch-22 of that is hardly anybody is being tested , so how would you know ?
” said Devin .
( He asked me to identify him by his first name only , given his employer ’ s role in his story . )
There were reasons for the criteria to be so rigid ; tests have been in short supply for weeks .
The US now has the capacity to perform 26,000 tests per day , as testing supply finally starts to catch up with @ @ @ @ @ @ @ to the American Enterprise Institute ’ s tracker .
As of Friday , the Illinois Department of Public Health was recommending doctors consider a patient ’ s symptoms as well as a few other select criteria ( travel to affected areas , medical risk , and whether they live in or work at a health care facility ) when deciding whether to order a test from the state lab .
But the number of tests is still vanishingly small compared to the potential scale of the problem .
The head of the Ohio @ @ @ @ @ @ @ stop over from Illinois , thinks as many as 100,000 of that state ’ s residents could be infected by the coronavirus .
Devin ’ s experience demonstrates the risk of undertesting .
After his first ER visit , the doctor told him he didn ’ t need to self-quarantine .
Devin took his own precautions , but others likely won ’ t be so careful .
There are other stories like this .
Vox ’ s Brian Resnick spoke recently with a California physician assistant who had been trying to get a @ @ @ @ @ @ @ patient had a chain of contact with someone who had tested positive for the coronavirus .
That physician assistant hadn ’ t yet succeeded .
So long as America ’ s testing capacity is lacking , people like Devin could slip through the cracks .
Below is our interview , edited and condensed for clarity and length .
You said you had been in Southeast Asia recently .
Start me there .
I was there for about 2½ weeks .
I got back the last Saturday of February , the 28th .
I @ @ @ @ @ @ @ and then Manila , the capital of the Philippines , for a week , with a layover in Malaysia .
My company was very concerned about all this .
They said if you don ’ t feel comfortable , don ’ t go .
Also we had to change our flights four times .
One flight went through Hong Kong , so that had to be changed .
They were very proactive .
No one else I was traveling with has gotten sick or shown any symptoms .
So there is a decent @ @ @ @ @ @ @ in Chicago .
So you get home at the end of February .
So I get home .
The next day I break my elbow .
It was beautiful in Chicago , in the 50s .
I took a bike ride , and the Lakeshore Trail in Chicago has been really damaged by the lake coming up .
I was trying to avoid a section that ’ d been damaged , and this kid jutted out from his parents .
I had to choose between a pothole and the kid .
I went @ @ @ @ @ @ @ and my nose at the base of the septum .
I went to the ER , which ends up being the ER I go back to for the [ Covid-19 ] test twice .
That ’ s Sunday , February 29 .
Monday , I call and make appointments .
Tuesday I ’ m at my doctor ’ s office .
Wednesday I ’ m at my orthopedic surgeon ’ s appointment .
Then fast forward to this past Monday , March 9 .
I have my first physical therapy session .
Then @ @ @ @ @ @ @ feeling well .
How are you feeling then ?
At that point , I was feeling feverish and achy .
Then I woke up Tuesday and I was full-blown sick .
I ’ ve got the dry cough and all these other symptoms .
I immediately called my doctor ’ s office .
They took this very seriously and were trying to call around and get answers .
They were super frustrated .
They kept calling and not being able to find out anything .
So it took over 24 hours to finally @ @ @ @ @ @ @ of the hospitals in Chicago that has the test kit , which also happens to be the same ER I ’ d been at for my elbow .
So I go Wednesday evening .
They do a chest X-ray and it shows inflammation of the lungs , but not pneumonia .
My fever had not been bad .
It had been a low-grade fever .
The problem is , about two hours before I went in , I ’ d taken Tylenol , which had knocked it down .
So I wasn ’ @ @ @ @ @ @ @ there .
They did the X-ray .
They did the flu swab , took some blood .
The flu came back negative .
The X-ray showed lung inflammation .
The doctor actually called my cell phone so they could do the Illinois Department of Public Health questionnaire while I ’ m in the hospital , because they wanted to limit exposure .
She was at a desk in the ER , calling me on the phone to do the questionnaire .
The questionnaire is for two algorithms : your risk of exposure and @ @ @ @ @ @ @ The risk of exposure side is based on two things .
Where you ’ ve traveled , which is very narrow , because it ’ s only taking into account the most high-risk places .
Were you in China , Korea , Italy ?
The other exposure question is have you been around someone who is a known patient ?
Of course the catch-22 of that is hardly anybody is being tested , so how would you know ?
Then the second question , I don ’ t have any underlying conditions .
@ @ @ @ @ @ @ breath .
So the risk of getting sick was fairly low .
I guess where I took issue with this diagnostic is it completely ignores the potential and the risk for community spread .
There is no algorithm for determining that .
If they had asked me , I could tell them I was in your ER .
I was in a doctor ’ s office .
I was at an ortho ’ s office .
And I was at my PT ’ s office .
I was also at a group gathering @ @ @ @ @ @ @ people .
I had a few friends over Friday night and we were in close quarters and one of them is a Chicago Public Schools teacher .
But they ’ re not asking you any of that in the diagnostic test ?
No .
There ’ s no algorithm about risk for community spread .
So you get through that questionnaire and then what happens ?
I wait for about three hours .
They come back .
The doctor comes in only wearing a mask and says IDPH isn ’ t testing you @ @ @ @ @ @ @ , you don ’ t have to self-quarantine .
I am fascinated by this kind of stuff , a layperson reading a lot of books about pandemics and stuff like that .
I ’ m probably not quite your average patient .
She says this to me and I think , ‘ Okay , you don ’ t actually know that.
’ A diagnostic was done to assess risk .
The discharge nurse comes in not even wearing a mask and I go home .
I decided I was just gon na do @ @ @ @ @ @ @ Called the ortho office and the PT office , which ends up being a good thing because one of the people I ’ ve been in contact with , her dad has lung cancer .
At this point , I don ’ t know , but I want to give you this information so you guys can do what you want with it .
Then Thursday , at about 6 pm , I get a call .
They say that IDPH did a re-review of the charts and that they are starting to @ @ @ @ @ @ @ test more people by lowering the risk threshold ?
Yeah .
So I should come in and be tested .
I go back in .
In the 24 hours since I ’ d been there , they ’ ve erected a barrier around the ER check-in desk .
They ’ ve implemented a whole bunch of protocols , like no guests coming back in the ER , stuff like that .
I got put back in my little isolation room .
They take my vitals and then they did the nose and throat @ @ @ @ @ @ @ with the doctor about the fact that Wednesday they completely botched this .
Did they seem frustrated with the situation ?
I mean , that ER was swamped .
But they apologized and basically said , hey , even in the last 24 hours , you ’ ve seen the barriers put up and these precautions being taken .
We ’ ve already had an additional training between then and now .
They know they ’ ve got to do better .
They ’ re trying .
I don ’ t fault them @ @ @ @ @ @ @ bad diagnostics .
But their handling of it afterward was pretty bad .
So now I ’ m just waiting to hear back .
They said it was up to three days .
Since then , I ’ ve just been self-quarantining and letting everybody know .

Devin, a 35-year-old living in Chicago, woke up on Tuesday morning and felt sick.
He had body aches, a fever, and a dry cough. His doctor recommended he go to an emergency room that had access to the coronavirus test. Devin had reasons to think he could be at risk of the infection: he had been traveling in Southeast Asia for much of February. He had also broken his arm upon returning, putting him in contact with other patients at hospitals and doctors’ offices the week before his symptoms showed up.
At the hospital on Wednesday they tested him for the flu, but it came back negative. However, he was showing lung inflammation on an X-ray, so he answered questionnaires to assess his risk of having been infected by the coronavirus and his risk of developing a severe case of Covid-19.
But Devin noticed something that surprised him in the questions: they were very narrowly focused on whether he had been to China or Italy specifically or if he’d potentially come into contact with somebody already known to have the novel coronavirus. He didn’t meet the criteria for a test at that time, so they sent him home, the doctor even telling him he didn’t need to self-quarantine.
“I guess where I took issue with this diagnostic is it completely ignores the potential and the risk for community spread. There is no algorithm for determining that,” he told me. “If they had asked me, I could tell them I was in your ER. I was in a doctor’s office. I was at an ortho’s office. And I was at my PT’s office.”
Devin wasn’t convinced, and started letting people with whom he’d been in contact know about how he was feeling. He found out somebody at his physical therapist’s office has a father with lung cancer, exactly the kind of person most at risk from the Covid-19 disease.
Within 24 hours, the hospital called him: you should come back in and get tested for coronavirus. Devin got tested Thursday evening, and as of Saturday afternoon, he was still waiting for a result.
The scary part is we don’t know how many Devins — people with good reason to worry about coronavirus, but who have gone untested because they didn’t meet restrictive testing criteria — are out there.
As of Saturday, the United States had still tested less than 21,000 people, a far lower rate than most other countries. There are about 2,500 confirmed Covid-19 cases in the US as of March 14. But because so few people have been tested, the number of real cases could be much higher.
“Of course the catch-22 of that is hardly anybody is being tested, so how would you know?” said Devin. (He asked me to identify him by his first name only, given his employer’s role in his story.)
There were reasons for the criteria to be so rigid; tests have been in short supply for weeks. The US now has the capacity to perform 26,000 tests per day, as testing supply finally starts to catch up with demand after a slow start, according to the American Enterprise Institute’s tracker. As of Friday, the Illinois Department of Public Health was recommending doctors consider a patient’s symptoms as well as a few other select criteria (travel to affected areas, medical risk, and whether they live in or work at a health care facility) when deciding whether to order a test from the state lab.
But the number of tests is still vanishingly small compared to the potential scale of the problem. The head of the Ohio Department of Health, just a short stop over from Illinois, thinks as many as 100,000 of that state’s residents could be infected by the coronavirus.
Devin’s experience demonstrates the risk of undertesting. After his first ER visit, the doctor told him he didn’t need to self-quarantine. Devin took his own precautions, but others likely won’t be so careful.
There are other stories like this. Vox’s Brian Resnick spoke recently with a California physician assistant who had been trying to get a patient tested since late February because the patient had a chain of contact with someone who had tested positive for the coronavirus. That physician assistant hadn’t yet succeeded.
So long as America’s testing capacity is lacking, people like Devin could slip through the cracks. Below is our interview, edited and condensed for clarity and length.
Dylan Scott
You said you had been in Southeast Asia recently. Start me there.
Devin
I was there for about 2½ weeks. I got back the last Saturday of February, the 28th. I was in southern India for a week and then Manila, the capital of the Philippines, for a week, with a layover in Malaysia.
My company was very concerned about all this. They said if you don’t feel comfortable, don’t go. Also we had to change our flights four times. One flight went through Hong Kong, so that had to be changed. They were very proactive.
No one else I was traveling with has gotten sick or shown any symptoms. So there is a decent possibility I got this through community spread in Chicago.
Dylan Scott
So you get home at the end of February.
Devin
So I get home. The next day I break my elbow. It was beautiful in Chicago, in the 50s. I took a bike ride, and the Lakeshore Trail in Chicago has been really damaged by the lake coming up. I was trying to avoid a section that’d been damaged, and this kid jutted out from his parents. I had to choose between a pothole and the kid. I went with the pothole and broke my elbow and my nose at the base of the septum.
I went to the ER, which ends up being the ER I go back to for the [Covid-19] test twice. That’s Sunday, February 29. Monday, I call and make appointments. Tuesday I’m at my doctor’s office. Wednesday I’m at my orthopedic surgeon’s appointment.
Then fast forward to this past Monday, March 9. I have my first physical therapy session. Then Monday night is when I started not feeling well.
Dylan Scott
How are you feeling then?
Devin
At that point, I was feeling feverish and achy. Then I woke up Tuesday and I was full-blown sick. I’ve got the dry cough and all these other symptoms. I immediately called my doctor’s office. They took this very seriously and were trying to call around and get answers. They were super frustrated. They kept calling and not being able to find out anything.
So it took over 24 hours to finally get told I should go to one of the hospitals in Chicago that has the test kit, which also happens to be the same ER I’d been at for my elbow. So I go Wednesday evening.
They do a chest X-ray and it shows inflammation of the lungs, but not pneumonia. My fever had not been bad. It had been a low-grade fever. The problem is, about two hours before I went in, I’d taken Tylenol, which had knocked it down. So I wasn’t presenting a fever when I went there.
They did the X-ray. They did the flu swab, took some blood. The flu came back negative. The X-ray showed lung inflammation. The doctor actually called my cell phone so they could do the Illinois Department of Public Health questionnaire while I’m in the hospital, because they wanted to limit exposure. She was at a desk in the ER, calling me on the phone to do the questionnaire.
The questionnaire is for two algorithms: your risk of exposure and your risk of getting seriously ill.
The risk of exposure side is based on two things. Where you’ve traveled, which is very narrow, because it’s only taking into account the most high-risk places. Were you in China, Korea, Italy? The other exposure question is have you been around someone who is a known patient? Of course the catch-22 of that is hardly anybody is being tested, so how would you know?
Then the second question, I don’t have any underlying conditions. I wasn’t experiencing shortness of breath. So the risk of getting sick was fairly low.
I guess where I took issue with this diagnostic is it completely ignores the potential and the risk for community spread. There is no algorithm for determining that. If they had asked me, I could tell them I was in your ER. I was in a doctor’s office. I was at an ortho’s office. And I was at my PT’s office. I was also at a group gathering on Friday, it had about 30 people. I had a few friends over Friday night and we were in close quarters and one of them is a Chicago Public Schools teacher.
Dylan Scott
But they’re not asking you any of that in the diagnostic test?
Devin
No. There’s no algorithm about risk for community spread.
Dylan Scott
So you get through that questionnaire and then what happens?
Devin
I wait for about three hours. They come back. The doctor comes in only wearing a mask and says IDPH isn’t testing you. You don’t have coronavirus, you don’t have to self-quarantine.
I am fascinated by this kind of stuff, a layperson reading a lot of books about pandemics and stuff like that. I’m probably not quite your average patient. She says this to me and I think, ‘Okay, you don’t actually know that.’ A diagnostic was done to assess risk.
The discharge nurse comes in not even wearing a mask and I go home. I decided I was just gonna do some of my own contact tracing. Called the ortho office and the PT office, which ends up being a good thing because one of the people I’ve been in contact with, her dad has lung cancer. At this point, I don’t know, but I want to give you this information so you guys can do what you want with it.
Then Thursday, at about 6 pm, I get a call. They say that IDPH did a re-review of the charts and that they are starting to lessen the risk requirement.
Dylan Scott
Trying to test more people by lowering the risk threshold?
Devin
Yeah. So I should come in and be tested. I go back in. In the 24 hours since I’d been there, they’ve erected a barrier around the ER check-in desk. They’ve implemented a whole bunch of protocols, like no guests coming back in the ER, stuff like that. I got put back in my little isolation room. They take my vitals and then they did the nose and throat swab. I had a long conversation with the doctor about the fact that Wednesday they completely botched this.
Dylan Scott
Did they seem frustrated with the situation?
Devin
I mean, that ER was swamped. But they apologized and basically said, hey, even in the last 24 hours, you’ve seen the barriers put up and these precautions being taken. We’ve already had an additional training between then and now. They know they’ve got to do better. They’re trying.
I don’t fault them for the lack of test kits and bad diagnostics. But their handling of it afterward was pretty bad.
So now I’m just waiting to hear back. They said it was up to three days. Since then, I’ve just been self-quarantining and letting everybody know.


vox--2020-03-14--Bernie Sanders wins the Northern Mariana Islands caucuses

Sen. Bernie Sanders just got a small bit of much-needed good news : He won the Northern Mariana Islands caucuses , beating out former Vice President Joe Biden .
The territory — a small string of islands in the Pacific — has just six delegates to the Democratic National Convention in July on offer .
As the Democratic primary progresses and Biden widens his delegate lead , such a small handful of delegates likely won ’ t make much of an impact — but with just two candidates still in the hunt , every delegate helps .
As a territory @ @ @ @ @ @ @ voice in the primary , but not in the general election in November .
However , unlike in the US territory of American Samoa — which voted earlier this month on Super Tuesday — anyone born on the island is automatically an American citizen and could theoretically vote if they move to a US state and register to vote there .
The islands also get a representative in Congress — albeit a nonvoting one , like the nation ’ s capital .
The territory is currently represented by Democrat Gregorio Kilili Camacho Sablan @ @ @ @ @ @ @ of an upset .
There hadn ’ t been any polling to speak of in the territory leading up to the primary , though FiveThirtyEight projected a Biden win in the territory even prior to his March 10 primary victories in Michigan and elsewhere .
Plus , in 2016 , Clinton won the territory over Sanders .
This time around , however , the Northern Mariana Islands ’ tiny electorate — only 167 voters in 2016 — favored the Vermont senator .
It ’ s a small win for the senator as he @ @ @ @ @ @ @ on Tuesday , March 17 , already on the back foot after his delegate losses to Biden .
Next up , he ’ ll take the stage for an 11th primary debate in Arizona — and when he does , he ’ ll have the Northern Mariana Islands in his column .

Sen. Bernie Sanders just got a small bit of much-needed good news: He won the Northern Mariana Islands caucuses, beating out former Vice President Joe Biden.
The territory — a small string of islands in the Pacific — has just six delegates to the Democratic National Convention in July on offer.
As the Democratic primary progresses and Biden widens his delegate lead, such a small handful of delegates likely won’t make much of an impact — but with just two candidates still in the hunt, every delegate helps.
As a territory, the Northern Mariana Islands gets a voice in the primary, but not in the general election in November. However, unlike in the US territory of American Samoa — which voted earlier this month on Super Tuesday — anyone born on the island is automatically an American citizen and could theoretically vote if they move to a US state and register to vote there.
The islands also get a representative in Congress — albeit a nonvoting one, like the nation’s capital. The territory is currently represented by Democrat Gregorio Kilili Camacho Sablan.
Sanders’s victory is something of an upset. There hadn’t been any polling to speak of in the territory leading up to the primary, though FiveThirtyEight projected a Biden win in the territory even prior to his March 10 primary victories in Michigan and elsewhere. Plus, in 2016, Clinton won the territory over Sanders.
This time around, however, the Northern Mariana Islands’ tiny electorate — only 167 voters in 2016 — favored the Vermont senator.
It’s a small win for the senator as he heads into another major round of primaries on Tuesday, March 17, already on the back foot after his delegate losses to Biden. Next up, he’ll take the stage for an 11th primary debate in Arizona — and when he does, he’ll have the Northern Mariana Islands in his column.


vox--2020-03-14--The US needs a lot more hospital beds to prepare for a spike in coronavirus cases

As confirmed cases of the novel coronavirus continue to increase across the United States — there are , as of March 14 , over 2,000 reported cases across 49 states — one of the biggest issues doctors could face is simply finding space to treat patients requiring medical assistance .
There is some question as to whether the US has enough hospital beds to treat all those who could become infected .
Available data on hospital capacity suggests the country does not .
According to the Organisation for Economic Co-operation and Development , the US has 2.8 hospital beds per @ @ @ @ @ @ @ countries with serious coronavirus outbreaks have more on average : China has 4.3 , South Korea has 12.3 , and Italy has 3.2 per 1,000 people .
Despite this , all have had difficulties handling their respective influxes of infected people at hospitals .
In Italy , which has been hit particularly hard , doctors and hospitals have become so overwhelmed that the Italian College of Anesthesia , Analgesia , Resuscitation and Intensive Care has published guidelines calling for doctors to approach patients with a wartime triage sensibility ; and it has discussed @ @ @ @ @ @ @ care .
One advantage the US has over the Italian health care system is a greater number of intensive care unit ( ICU ) beds .
But while the US has more ICU beds than European countries do on average , the availability of those beds is still deeply concerning .
“ It ’ s estimated that we have about 45,000 intensive care unit beds in the United States .
In a moderate outbreak , about 200,000 Americans would need one , ” Aaron Carroll , a professor at the Indiana University School @ @ @ @ @ @ @ York Times , recently wrote .
USA Today said that its most “ conservative ” analysis based on data from the American Hospital Association , US Census , CDC and World Health Organization found that “ there could be almost six seriously ill patients for every existing hospital bed.
” But that estimate , which assumes an infection rate similar to ordinary infection rates of the flu , is based on the idea that all hospital beds would be empty .
In reality , two-thirds are generally full .
With that occupancy rate @ @ @ @ @ @ @ 17 patients per open bed .
One reason so many beds are currently occupied is that hospitals across the US are already working to treat flu patients .
The coronavirus pandemic has coincided with the tail end of peak flu season , which continues through March .
Anthony Fauci , director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health , has said this year ’ s flu is on track to be as bad as the 2017-2018 season , the most lethal in a decade .
@ @ @ @ @ @ @ some of their “ surge capacity ” — their ability to absorb a big increase in the volume of patients — and that bed availability is particularly limited currently .
These statistics may sound grim , but are only cause for concern — not alarm .
There are a number of measures that can be taken both on the governmental and personal levels that can help ensure hospital capacity does not become an issue .
For instance , China has shown that it ’ s possible to mitigate bed limitations by rapidly building @ @ @ @ @ @ @ into practice the “ social distancing ” ( essentially avoiding nonessential social interaction ) the CDC has recommended could not only dramatically slow the spread of disease , but could also reduce the odds that the number of people needing coronavirus treatment surges past hospital capacity .
The novel coronavirus was first reported in China , and the country has pursued containment and mitigation efforts aggressively .
One of those tactics included building hospitals packed with beds extremely quickly .
The city of Wuhan , where the coronavirus first started , built two @ @ @ @ @ @ @ to sick people in just weeks .
Construction teams of some 7,000 workers built the facilities at a breakneck pace , and the hospitals were designed to be used exclusively for patients with confirmed cases of coronavirus .
In its assessment of China ’ s response to the novel coronavirus , the World Health Organization cited the construction of new hospitals as a key initiative that helped save lives in China .
The Trump administration has not signaled any plans to launch a similar initiative in the US , and given the reticence @ @ @ @ @ @ @ anti-coronavirus spending in recent weeks , any proposal to build new hospitals could face some congressional censure .
But there is also plenty of precedent for the US government being aggressive about producing materials for crisis .
For example , during World War II the US transformed automobile factories into efficient producers of aircraft , tanks , trucks , and guns to help with the war effort .
It ’ s certainly possible for the government to take a similar attitude toward directly working to make sure hospitals are adequately equipped to deal @ @ @ @ @ @ @ ICUs .
According to the Harvard Global Health Institute , the coronavirus could end up causing between 10 million and 34 million hospital visits — and about a fifth of those patients will require intensive care .
In light of the fact that there isn ’ t enough space in hospitals to deal with an explosive outbreak , it ’ s important to do what can be done to slow transmission .
As Carroll summed it up in the Times : “ A crucial thing to understand about the coronavirus threat — and @ @ @ @ @ @ @ Italy — is the difference between the total number of people who might get sick and the number who might get sick at the same time.
” And public behavior is going to play a big factor in determining if and when there ’ s a huge surge beyond the health care system ’ s capacity .
Experts say social distancing and hygienic practices like methodically washing one ’ s hands and cleaning potentially infected surfaces could slow the pace at which coronavirus spreads through the population , if enough people observe these @ @ @ @ @ @ @ flatten the curve ” of new coronavirus cases , ensuring that hospital capacity isn ’ t dramatically exceeded : Epidemiologists use the term social distancing for efforts to reduce close contact between people that could accelerate the spread of disease .
That means everything from keeping a distance of at least 6 feet from other people in public to avoiding crowded gatherings like concerts .
Research indicates cities that aggressively implement social distancing rules historically have slowed the transmission of the flu among their residents and saved lives in the process .
Experts @ @ @ @ @ @ @ if the hospital system isn ’ t overwhelmed .
It ’ s incumbent on the government and its citizens to take whatever steps they can to ensure that doesn ’ t happen .

As confirmed cases of the novel coronavirus continue to increase across the United States — there are, as of March 14, over 2,000 reported cases across 49 states — one of the biggest issues doctors could face is simply finding space to treat patients requiring medical assistance.
There is some question as to whether the US has enough hospital beds to treat all those who could become infected. Available data on hospital capacity suggests the country does not.
According to the Organisation for Economic Co-operation and Development, the US has 2.8 hospital beds per 1,000 people. By contrast, other countries with serious coronavirus outbreaks have more on average: China has 4.3, South Korea has 12.3, and Italy has 3.2 per 1,000 people.
Despite this, all have had difficulties handling their respective influxes of infected people at hospitals. In Italy, which has been hit particularly hard, doctors and hospitals have become so overwhelmed that the Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care has published guidelines calling for doctors to approach patients with a wartime triage sensibility; and it has discussed a potential age limit for access to care.
One advantage the US has over the Italian health care system is a greater number of intensive care unit (ICU) beds. But while the US has more ICU beds than European countries do on average, the availability of those beds is still deeply concerning. “It’s estimated that we have about 45,000 intensive care unit beds in the United States. In a moderate outbreak, about 200,000 Americans would need one,” Aaron Carroll, a professor at the Indiana University School of Medicine and analyst for the New York Times, recently wrote.
USA Today said that its most “conservative” analysis based on data from the American Hospital Association, US Census, CDC and World Health Organization found that “there could be almost six seriously ill patients for every existing hospital bed.” But that estimate, which assumes an infection rate similar to ordinary infection rates of the flu, is based on the idea that all hospital beds would be empty. In reality, two-thirds are generally full. With that occupancy rate taken into account, there would be 17 patients per open bed.
One reason so many beds are currently occupied is that hospitals across the US are already working to treat flu patients. The coronavirus pandemic has coincided with the tail end of peak flu season, which continues through March. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, has said this year’s flu is on track to be as bad as the 2017-2018 season, the most lethal in a decade. This means hospitals are already eating into some of their “surge capacity” — their ability to absorb a big increase in the volume of patients — and that bed availability is particularly limited currently.
These statistics may sound grim, but are only cause for concern — not alarm. There are a number of measures that can be taken both on the governmental and personal levels that can help ensure hospital capacity does not become an issue.
For instance, China has shown that it’s possible to mitigate bed limitations by rapidly building hospitals to meet demand. And putting into practice the “social distancing” (essentially avoiding nonessential social interaction) the CDC has recommended could not only dramatically slow the spread of disease, but could also reduce the odds that the number of people needing coronavirus treatment surges past hospital capacity.
China built hospitals to treat coronavirus victims quickly
The novel coronavirus was first reported in China, and the country has pursued containment and mitigation efforts aggressively. One of those tactics included building hospitals packed with beds extremely quickly.
The city of Wuhan, where the coronavirus first started, built two makeshift hospitals to offer 2,000 additional beds to sick people in just weeks. Construction teams of some 7,000 workers built the facilities at a breakneck pace, and the hospitals were designed to be used exclusively for patients with confirmed cases of coronavirus.
In its assessment of China’s response to the novel coronavirus, the World Health Organization cited the construction of new hospitals as a key initiative that helped save lives in China.
The Trump administration has not signaled any plans to launch a similar initiative in the US, and given the reticence of some Republican lawmakers to approve additional anti-coronavirus spending in recent weeks, any proposal to build new hospitals could face some congressional censure. But there is also plenty of precedent for the US government being aggressive about producing materials for crisis.
For example, during World War II the US transformed automobile factories into efficient producers of aircraft, tanks, trucks, and guns to help with the war effort. It’s certainly possible for the government to take a similar attitude toward directly working to make sure hospitals are adequately equipped to deal with a potential surge in visits to ICUs.
Social distancing could help hospitals manage patient care
According to the Harvard Global Health Institute, the coronavirus could end up causing between 10 million and 34 million hospital visits — and about a fifth of those patients will require intensive care.
In light of the fact that there isn’t enough space in hospitals to deal with an explosive outbreak, it’s important to do what can be done to slow transmission. As Carroll summed it up in the Times: “A crucial thing to understand about the coronavirus threat — and it’s playing out grimly in Italy — is the difference between the total number of people who might get sick and the number who might get sick at the same time.”
And public behavior is going to play a big factor in determining if and when there’s a huge surge beyond the health care system’s capacity.
Experts say social distancing and hygienic practices like methodically washing one’s hands and cleaning potentially infected surfaces could slow the pace at which coronavirus spreads through the population, if enough people observe these practices. This in turn could “flatten the curve” of new coronavirus cases, ensuring that hospital capacity isn’t dramatically exceeded:
Epidemiologists use the term social distancing for efforts to reduce close contact between people that could accelerate the spread of disease. That means everything from keeping a distance of at least 6 feet from other people in public to avoiding crowded gatherings like concerts. Research indicates cities that aggressively implement social distancing rules historically have slowed the transmission of the flu among their residents and saved lives in the process.
Experts say Covid-19 will be much more manageable if the hospital system isn’t overwhelmed. It’s incumbent on the government and its citizens to take whatever steps they can to ensure that doesn’t happen.


vox--2020-03-14--The House coronavirus bill’s paid leave provision would leave out millions of workers

The House of Representatives passed a sweeping coronavirus financial aid package early Saturday morning aimed at easing the economic toll that the novel coronavirus takes on individuals .
Passed with bipartisan support , the emergency measure strengthens existing unemployment insurance and food assistance programs , and will provide free diagnostic testing for the virus .
But another portion of the bill , providing paid leave options for people who are infected or need to give care , has been criticized for a key shortcoming : it doesn ’ t cover everyone .
In a country with no federal paid leave @ @ @ @ @ @ @ paid leave through their employer , either .
While some local jurisdictions , including 12 states and Washington , DC , have their own paid leave programs , a quarter of American workers , or about 33.6 million , receive no form of paid sick leave , with the lowest-paid workers being especially vulnerable .
In the face of a virus that has been deemed a global pandemic , limiting exposure to other people is a central means of staving off the spread .
Allowing people to stay home and self-isolate is a @ @ @ @ @ @ @ even if H.R .
6201 , the Families First Coronavirus Response Act , is enacted , millions of working people will still be left without a way to take time off from work and continue to make a living .
The paid leave portion of the new bill applies only to companies with 500 or fewer employees , requiring them to offer up to 14 days of paid leave .
That can include infected people , caretakers , and guardians whose children ’ s schools have been closed .
But as the New @ @ @ @ @ @ @ at companies with 501 or more employees comprise about half of all workers .
Many of these companies already offer some form of paid sick time — 89 percent of them , according to the US Bureau of Labor Statistics .
And some of those large companies have begun offering their own Covid-19-related sick leave policies , too .
In the restaurant industry , where only a quarter of workers receive paid sick days , Chipotle and McDonald ’ s have said they will offer sick leave programs ( although some employees have @ @ @ @ @ @ @ attempting to take leave in the past ) .
Advocates for the bill ’ s passage argue , as the Times editorial states , “ such voluntary policies are an inadequate substitute for legislation.
” Even before the bill ’ s House passage — which goes to the Senate next and which President Trump has indicated he would sign — the virus had put a spotlight on the financial precarity that millions of workers face in the event of a standard illness , much less a global pandemic in which public health officials @ @ @ @ @ @ @ feel ill .
But that is easier said than done for millions of American workers .
Employees in the service industry especially , like food workers or personal care assistants , are much less likely than their peers in more lucrative fields to have paid time off if they get sick .
But they also make less money in general , meaning a lost day of work hurts their families ’ budgets more .
That gives them a strong motivation to go into work — even if they ’ re not feeling well @ @ @ @ @ @ @ close contact with the rest of humanity , they are a potent vector for spreading contagions , particularly those as infectious as coronaviruses .
It ’ s a recipe for making a bad outbreak even worse , all because America hasn ’ t decided to guarantee paid sick leave for all workers .
According to the Pew Research Center , people who don ’ t have paid leave are disproportionately lower-wage workers .
Ninety-two percent of workers in the top quarter of earners , receiving hourly wages of greater than $ 32.21 , @ @ @ @ @ @ @ , compared to 51 percent of workers in the lowest-earning quarter , who make $ 13.80 or less an hour .
That number drops even further for those in the lowest-earning tenth : 31 percent of Americans earning $ 10.80 an hour or less receive any form of paid sick leave .
Low-wage people are also most affected by missing out on a paycheck if they do end up becoming sick .
And many of those jobs can not be transitioned during a quarantine : It ’ s easier to work from home @ @ @ @ @ @ @ if you clean offices , prepare food , or take care of sick people in their homes or in a care facility , for example .
In early drafts of the House bill , Democrats attempted to build in a permanent paid leave program that would address some of these issues .
Facing pushback from Trump , what ultimately passed was an emergency funding bill that is only in effect through the year , in response to this specific public health emergency .
With exemptions also built in for employees of large companies @ @ @ @ @ @ @ the same position they were in before the coronavirus aid package was passed : choosing between following public health guidelines and staying home , or taking home a paycheck and potentially becoming a vector of illness .

The House of Representatives passed a sweeping coronavirus financial aid package early Saturday morning aimed at easing the economic toll that the novel coronavirus takes on individuals. Passed with bipartisan support, the emergency measure strengthens existing unemployment insurance and food assistance programs, and will provide free diagnostic testing for the virus.
But another portion of the bill, providing paid leave options for people who are infected or need to give care, has been criticized for a key shortcoming: it doesn’t cover everyone. In a country with no federal paid leave program, millions of Americans receive no paid leave through their employer, either. While some local jurisdictions, including 12 states and Washington, DC, have their own paid leave programs, a quarter of American workers, or about 33.6 million, receive no form of paid sick leave, with the lowest-paid workers being especially vulnerable.
In the face of a virus that has been deemed a global pandemic, limiting exposure to other people is a central means of staving off the spread. Allowing people to stay home and self-isolate is a key part of that effort. But even if H.R. 6201, the Families First Coronavirus Response Act, is enacted, millions of working people will still be left without a way to take time off from work and continue to make a living.
The paid leave portion of the new bill applies only to companies with 500 or fewer employees, requiring them to offer up to 14 days of paid leave. That can include infected people, caretakers, and guardians whose children’s schools have been closed. But as the New York Times editorial board noted, workers at companies with 501 or more employees comprise about half of all workers.
Many of these companies already offer some form of paid sick time — 89 percent of them, according to the US Bureau of Labor Statistics. And some of those large companies have begun offering their own Covid-19-related sick leave policies, too. In the restaurant industry, where only a quarter of workers receive paid sick days, Chipotle and McDonald’s have said they will offer sick leave programs (although some employees have said they’ve faced retaliation for attempting to take leave in the past). Advocates for the bill’s passage argue, as the Times editorial states, “such voluntary policies are an inadequate substitute for legislation.”
Even before the bill’s House passage — which goes to the Senate next and which President Trump has indicated he would sign — the virus had put a spotlight on the financial precarity that millions of workers face in the event of a standard illness, much less a global pandemic in which public health officials warn people to stay home if they feel ill.
As Vox’s Dylan Scott wrote:
But that is easier said than done for millions of American workers. Employees in the service industry especially, like food workers or personal care assistants, are much less likely than their peers in more lucrative fields to have paid time off if they get sick. But they also make less money in general, meaning a lost day of work hurts their families’ budgets more. That gives them a strong motivation to go into work — even if they’re not feeling well. And because these workers come in close contact with the rest of humanity, they are a potent vector for spreading contagions, particularly those as infectious as coronaviruses. It’s a recipe for making a bad outbreak even worse, all because America hasn’t decided to guarantee paid sick leave for all workers.
According to the Pew Research Center, people who don’t have paid leave are disproportionately lower-wage workers. Ninety-two percent of workers in the top quarter of earners, receiving hourly wages of greater than $32.21, receive some form of paid sick leave, compared to 51 percent of workers in the lowest-earning quarter, who make $13.80 or less an hour. That number drops even further for those in the lowest-earning tenth: 31 percent of Americans earning $10.80 an hour or less receive any form of paid sick leave.
Low-wage people are also most affected by missing out on a paycheck if they do end up becoming sick. And many of those jobs cannot be transitioned during a quarantine: It’s easier to work from home if you have a desk job than if you clean offices, prepare food, or take care of sick people in their homes or in a care facility, for example.
In early drafts of the House bill, Democrats attempted to build in a permanent paid leave program that would address some of these issues. Facing pushback from Trump, what ultimately passed was an emergency funding bill that is only in effect through the year, in response to this specific public health emergency.
With exemptions also built in for employees of large companies, many workers will find themselves in the same position they were in before the coronavirus aid package was passed: choosing between following public health guidelines and staying home, or taking home a paycheck and potentially becoming a vector of illness.


vox--2020-03-14--The risks in going to the gym during the coronavirus pandemic, explained by experts

Around 20 minutes into a group boot camp fitness class at the Upper East Side location of boutique workout studio Barry ’ s Friday morning , each one of us was ushered out of the room , like kids in a fire drill .
Our instructor , Michael Pugliese , shooed everyone out while he and the cleaning staff grabbed disinfectant wipes and spray ; then they began wiping down the entire sweaty room — from benches , mirrors , weights , and treadmills to the floor .
Six minutes later , we were let back in and allowed to @ @ @ @ @ @ @ cleaning break , extra sanitizing wipes and hand sanitizer in each studio , and shortening all classes by 10 minutes to give staff 20 minutes to spray down and clean the room , are just some of the changes Barry ’ s has implemented in light of the coronavirus pandemic .
And according to public health experts , Barry ’ s intense cleaning is the type of measure all gyms and boutique fitness classes should be taking .
In light of the coronavirus , we ’ ve learned how to wash our hands @ @ @ @ @ @ @ of alcohol is necessary in hand sanitizer to kill the virus ( at least 60 percent ) , and analyzed every informational blast — social distancing , canceled events , transmission guidance — released by public health officials .
But while guidelines from health officials are helpful and awareness about the coronavirus is valuable , it ’ s difficult to figure out which aspects of daily life we should change and which ones we can maintain in order to have some semblance of normalcy in our lives .
With all the information out @ @ @ @ @ @ @ are simultaneously being told to brace for the worst and to keep calm , carry on , and try to live our lives as normally as possible .
For the millions of consumers worldwide that have helped make gyms and boutique fitness into a $ 94 billion industry , according to statistics from the International Health Racquet and Sportsclub Association , it is part of our lives .
Fitness is therapy , exercise , and a de-stressor , which is why in these times of uncertainty , it ’ s a go-to .
@ @ @ @ @ @ @ worst , I fully understand that putting a hold on the gym is a no-brainer .
And in the grand scheme of things , clearly , going to the gym isn ’ t as serious as the dire situations in parts of the world .
But to get a better understanding of where things stand in the middle of the coronavirus outbreak — barring any further escalation — I asked public health experts and officials specializing in transmission and cleanliness protocol for the best practices for going to the gym .
And that @ @ @ @ @ @ @ all .
Going to the gym means taking precautions like wiping down all your equipment Sweat is a constant at gyms and fitness classes .
Every piece of equipment you touch has been touched by someone else ’ s sweat .
And it ’ s even more so when you do the math of how long gyms have held on to their equipment , multiplied by the number of people in and out of a gym in any given hour , afternoon , day , or year .
So is coronavirus-laced sweat a @ @ @ @ @ @ @ through our buckets of sweat ?
“ As a respiratory virus , sweat isn ’ t generally a transmission route , though contaminated skin and hands can be , ” Dr. Tara Smith , a professor of epidemiology at Kent State University , told me over email .
“ Think more about how you might touch your nose and then touch equipment , or cough on a hand and touch equipment , than about the sweat itself.
” The possibility of the virus living on weights or mats makes the gym a risk @ @ @ @ @ @ @ Covid-19 coronavirus infection from surfaces is not yet known , but gym-goers , SoulCyclers , and Barry ’ s Bootcampers , should wipe down all the surfaces they ’ re touching with an approved disinfectant .
They should take on that responsibility even if the gym or facility cleans the equipment as well .
“ I study MRSA ( a bacterium that can survive on surfaces ) so I always wipe off equipment both before and after using it because you never know if the person ahead of you did a good job @ @ @ @ @ @ @ to be extra careful about thorough cleaning , ” Smith told me .
Smith also recommends distancing yourself from fellow gym-goers .
This may mean doing something as simple as not going during the gym ’ s busy hours ( usually before and after work ) , but those hours might be different given the pandemic .
It also means no high-fives or handshakes at the gym .
But maintaining the recommended six feet of social distance from others is all but impossible in sold-out group fitness classes where bikes and stations are @ @ @ @ @ @ @ says to consider that before booking .
The experts maintain , however , that fitness studios and gyms aren ’ t any more or less hazardous than any other social setting we might place ourselves in — that is , barring the virus rapidly escalating and dependent on case/transmission rate in your area .
Gyms are not any more risky than “ anywhere else where you would be touching things and in somewhat close contact with people — but as the virus is spreading , all of those activities are becoming increasingly risky @ @ @ @ @ @ @ group that is likely to be more severely affected by Covid-19 , ” Smith said .
“ I think individuals may want to consider any aspect of how they go out in public during these times , both for themselves and the rest of their community , particularly vulnerable individuals.
” But the most important thing public health experts have stressed over and over applies to everyone and everywhere , including the gym : Stay home if you ’ re not feeling well .
“ The biggest thing right now is to stay @ @ @ @ @ @ @ ” Dr. Saskia Popescu , an infection prevention epidemiologist and biodefense researcher , told me .
“ If you ’ re well , try and practice social distancing and basic infection control measures .
This means don ’ t go to the gym if you ’ re sick .
If you ’ re well and want to work out , try to avoid larger group classes , wipe down your equipment with disinfection wipes , before and after use , use hand hygiene frequently , and avoid touching your face.
” Gyms and @ @ @ @ @ @ @ and SoulCycle are adapting stricter cleaning routines .
But some are shutting down for now .
Barry ’ s decision to require a break mid-class to disinfect the room seems to be the type of “ stepping up ” that Smith stresses .
I also noticed the studio had new sanitizing wipe dispensers , and hand sanitizer in addition to hand soap in the restrooms .
Barry ’ s also said it would cut the number of spots in each class by half beginning Monday , allowing its clients to maintain a safe @ @ @ @ @ @ @ for the company told Vox that it would “ continue to follow all CDC and Department of Public Health guidelines , and will follow best practices as they are released.
” SoulCycle , the expansive and ubiquitous spin class company , has also taken measures like removing the hand weight section from its classes , per a statement issued on March 12 .
Usually , SoulCycle classes involve an “ arms ” series , in which cyclers take a break from pedaling to perform bicep , tricep , and shoulder exercises .
Those @ @ @ @ @ @ @ said it , too , was ramping up the availability of disinfecting wipes and hospital-grade cleaning solution .
On Friday , SoulCycle sent an email to its riders saying that it would cut class sizes in half — a move that seems to be in line with the guidance of social distancing .
National gyms like Equinox and Crunch have also stepped up efforts , sending emails to clients about hygiene practices and promising to step up cleaning efforts with detailed information as to what they plan to do .
There are also @ @ @ @ @ @ @ vaunted bike .
In Beijing , online fitness classes have become trendy as officials there have urged civilians to stay inside and curb their social gatherings during the coronavirus outbreak .
For some gyms and group fitness studios , though , the best practice was shutting down .
Chelsea Piers , a fancy gym and fitness facility with outposts in New York City and Connecticut , has closed through March 31 , 2020 .
Rowgatta , a New York City-based fitness class that combines weightlifting and rowing , has temporarily shut down .
@ @ @ @ @ @ @ protect our staff and to keep our Athletes safe , ” Rowgatta said in an email to its clients .
“ In a time when there is a lack of clear direction from authorities , we must do what we can to lead and contribute to the wellbeing of the community in which we live.
” Similarly , Barry ’ s has temporarily shut down international locations in Italy , Sweden , and Norway , and has promised to waive cancellation fees for clients .
In light of these closings , improvements , @ @ @ @ @ @ @ asked Smith and Popescu what are the most important things gyms should be doing to protect their clients .
“ I think they should be stepping up the cleaning they ’ re doing of all equipment in order to minimize the risk of transmission from weights , machines , mats , and also doorknobs and other surfaces , ” Smith said .
“ We all know that some gym patrons are just terrible at doing this , so gyms should be extra vigilant to do so .
Remind clients to spread out as @ @ @ @ @ @ @ and emphasize hand-washing.
” “ Gyms should be really reinforcing that people should not be there if they ’ re sick — both employees and clients — and providing ample opportunity for hand hygiene ( reminders are great ) , and disinfecting wipes for equipment , ” Popescu said , explaining that sanitizing wipes and disinfecting really help .
“ I also encourage people to really be mindful of not touching their face and take some breaks for hand hygiene , ” Popescu added .
“ If you ’ re in a fitness @ @ @ @ @ @ @ a smaller group of people in a more open space , so you can all have about three to six feet between you .
This is a great time to use the fitness apps and home gyms !
”

Update March 16, 2020: Since this article was published, the coronavirus outbreak has escalated in the US and New York in particular. Both Barry’s and Peloton have closed their studios. And in an email to some of its New York City members, fitness center Equinox said one of its patrons had tested positive for Covid-19, the disease caused by the novel coronavirus. As the experts we consulted said, spread of the virus makes visits to the gym, and all social interactions, riskier. Follow the guidance of local health and government officials concerning social distancing, even if gyms remain open.
New York Gov. Andrew Cuomo has announced that gyms and casinos in New York, Connecticut, and New Jersey would be closing at 8 pm ET.
Around 20 minutes into a group boot camp fitness class at the Upper East Side location of boutique workout studio Barry’s Friday morning, each one of us was ushered out of the room, like kids in a fire drill. Our instructor, Michael Pugliese, shooed everyone out while he and the cleaning staff grabbed disinfectant wipes and spray; then they began wiping down the entire sweaty room — from benches, mirrors, weights, and treadmills to the floor.
Six minutes later, we were let back in and allowed to continue with the workout.
The mid-session cleaning break, extra sanitizing wipes and hand sanitizer in each studio, and shortening all classes by 10 minutes to give staff 20 minutes to spray down and clean the room, are just some of the changes Barry’s has implemented in light of the coronavirus pandemic. And according to public health experts, Barry’s intense cleaning is the type of measure all gyms and boutique fitness classes should be taking.
In light of the coronavirus, we’ve learned how to wash our hands for 20 seconds, memorized what percentage of alcohol is necessary in hand sanitizer to kill the virus (at least 60 percent), and analyzed every informational blast — social distancing, canceled events, transmission guidance — released by public health officials.
But while guidelines from health officials are helpful and awareness about the coronavirus is valuable, it’s difficult to figure out which aspects of daily life we should change and which ones we can maintain in order to have some semblance of normalcy in our lives. With all the information out there, it feels as though we are simultaneously being told to brace for the worst and to keep calm, carry on, and try to live our lives as normally as possible.
For the millions of consumers worldwide that have helped make gyms and boutique fitness into a $94 billion industry, according to statistics from the International Health Racquet and Sportsclub Association, it is part of our lives. Fitness is therapy, exercise, and a de-stressor, which is why in these times of uncertainty, it’s a go-to.
Granted, if worse comes to the worst, I fully understand that putting a hold on the gym is a no-brainer. And in the grand scheme of things, clearly, not being able to go to the gym isn’t so dire.
But to get a better understanding of where things stand in the middle of the coronavirus outbreak — barring any further escalation — I asked public health experts and officials specializing in transmission and cleanliness protocol for the best practices for going to the gym. And that includes whether we should be going at all.
Going to the gym means taking precautions like wiping down all your equipment
The CDC and the WHO recommend several basic measures to help prevent the spread of Covid-19: Wash your hands often for at least 20 seconds.
Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
Clean and disinfect frequently touched objects.
Practice social distancing, and stay home when you are sick.
Contact a health worker if you have symptoms; fever and a dry cough are most common. Guidance may change. Stay informed, and stay safe, with Vox’s coronavirus coverage hub.
Sweat is a constant at gyms and fitness classes. Every piece of equipment you touch has been touched by someone else’s sweat. And it’s even more so when you do the math of how long gyms have held on to their equipment, multiplied by the number of people in and out of a gym in any given hour, afternoon, day, or year.
So is coronavirus-laced sweat a possibility? Can the illness be transmitted through our buckets of sweat?
“As a respiratory virus, sweat isn’t generally a transmission route, though contaminated skin and hands can be,” Dr. Tara Smith, a professor of epidemiology at Kent State University, told me over email. “Think more about how you might touch your nose and then touch equipment, or cough on a hand and touch equipment, than about the sweat itself.”
The possibility of the virus living on weights or mats makes the gym a risk for transmission. The precise risk of Covid-19 coronavirus infection from surfaces is not yet known, but gym-goers, SoulCyclers, and Barry’s Bootcampers, should wipe down all the surfaces they’re touching with an approved disinfectant. They should take on that responsibility even if the gym or facility cleans the equipment as well.
“I study MRSA (a bacterium that can survive on surfaces) so I always wipe off equipment both before and after using it because you never know if the person ahead of you did a good job, but now is a good time to be extra careful about thorough cleaning,” Smith told me.
Smith also recommends distancing yourself from fellow gym-goers. This may mean doing something as simple as not going during the gym’s busy hours (usually before and after work), but those hours might be different given the pandemic. It also means no high-fives or handshakes at the gym.
But maintaining the recommended six feet of social distance from others is all but impossible in sold-out group fitness classes where bikes and stations are planted next to each other. Smith says to consider that before booking.
The experts maintain, however, that fitness studios and gyms aren’t any more or less hazardous than any other social setting we might place ourselves in — that is, barring the virus rapidly escalating and dependent on case/transmission rate in your area.
Gyms are not any more risky than “anywhere else where you would be touching things and in somewhat close contact with people — but as the virus is spreading, all of those activities are becoming increasingly risky, especially if you are in a group that is likely to be more severely affected by Covid-19,” Smith said. “I think individuals may want to consider any aspect of how they go out in public during these times, both for themselves and the rest of their community, particularly vulnerable individuals.”
But the most important thing public health experts have stressed over and over applies to everyone and everywhere, including the gym: Stay home if you’re not feeling well.
“The biggest thing right now is to stay home if you’re sick,” Dr. Saskia Popescu, an infection prevention epidemiologist and biodefense researcher, told me. “If you’re well, try and practice social distancing and basic infection control measures. This means don’t go to the gym if you’re sick. If you’re well and want to work out, try to avoid larger group classes, wipe down your equipment with disinfection wipes, before and after use, use hand hygiene frequently, and avoid touching your face.”
Gyms and group fitness studios like Barry’s and SoulCycle are adapting stricter cleaning routines. But some are shutting down for now.
Barry’s decision to require a break mid-class to disinfect the room seems to be the type of “stepping up” that Smith stresses. I also noticed the studio had new sanitizing wipe dispensers, and hand sanitizer in addition to hand soap in the restrooms. Barry’s also said it would cut the number of spots in each class by half beginning Monday, allowing its clients to maintain a safe distance from fellow bootcampers.
A spokesperson for the company told Vox that it would “continue to follow all CDC and Department of Public Health guidelines, and will follow best practices as they are released.”
SoulCycle, the expansive and ubiquitous spin class company, has also taken measures like removing the hand weight section from its classes, per a statement issued on March 12. Usually, SoulCycle classes involve an “arms” series, in which cyclers take a break from pedaling to perform bicep, tricep, and shoulder exercises. Those are now eliminated. The company also said it, too, was ramping up the availability of disinfecting wipes and hospital-grade cleaning solution. On Friday, SoulCycle sent an email to its riders saying that it would cut class sizes in half — a move that seems to be in line with the guidance of social distancing.
National gyms like Equinox and Crunch have also stepped up efforts, sending emails to clients about hygiene practices and promising to step up cleaning efforts with detailed information as to what they plan to do.
There are also online classes, including Peloton and its vaunted bike. In Beijing, online fitness classes have become trendy as officials there have urged civilians to stay inside and curb their social gatherings during the coronavirus outbreak.
For some gyms and group fitness studios, though, the best practice was shutting down. Chelsea Piers, a fancy gym and fitness facility with outposts in New York City and Connecticut, has closed through March 31, 2020. Rowgatta, a New York City-based fitness class that combines weightlifting and rowing, has temporarily shut down.
“We must do our part to protect our staff and to keep our Athletes safe,” Rowgatta said in an email to its clients. “In a time when there is a lack of clear direction from authorities, we must do what we can to lead and contribute to the wellbeing of the community in which we live.”
Similarly, Barry’s has temporarily shut down international locations in Italy, Sweden, and Norway, and has promised to waive cancellation fees for clients.
In light of these closings, improvements, and cleaning measures being taken, I asked Smith and Popescu what are the most important things gyms should be doing to protect their clients.
“I think they should be stepping up the cleaning they’re doing of all equipment in order to minimize the risk of transmission from weights, machines, mats, and also doorknobs and other surfaces,” Smith said. “We all know that some gym patrons are just terrible at doing this, so gyms should be extra vigilant to do so. Remind clients to spread out as much as possible in fitness classes, and emphasize hand-washing.”
Popescu offered similar advice.
“Gyms should be really reinforcing that people should not be there if they’re sick — both employees and clients — and providing ample opportunity for hand hygiene (reminders are great), and disinfecting wipes for equipment,” Popescu said, explaining that sanitizing wipes and disinfecting really help.
“I also encourage people to really be mindful of not touching their face and take some breaks for hand hygiene,” Popescu added. “If you’re in a fitness class, try to do one with a smaller group of people in a more open space, so you can all have about three to six feet between you. This is a great time to use the fitness apps and home gyms!”


vox--2020-03-14--Coronavirus is already here. Blocking travelers won’t prevent its spread.

Despite President Donald Trump ’ s sweeping ban on non-US-citizen travelers from Europe and now the UK , the consensus among public health experts is clear : At this point , restricting travel can ’ t prevent the spread of the coronavirus .
Epidemiologists have long observed the failure of travel restrictions to contain other infectious diseases , such as influenza .
It also seems to be true in the case of the coronavirus outbreak so far : China and Italy both adopted stringent restrictions on domestic and international travel but were unable to avert a pandemic .
It ’ @ @ @ @ @ @ @ dropping recently in China , but as epidemiologist Bruce Aylward told Vox ’ s Julia Belluz , that can mostly be attributed to efforts to educate the public , identify cases , and rapidly isolate them .
At this point , it ’ s hard to tell what containment strategies have been effective ; we ’ ll know more in the months to come after various countries ’ real-time experimentation has played out .
Preliminary research suggests travel restrictions could be effective in temporarily delaying the spread of coronavirus by a few days @ @ @ @ @ @ @ , and that could be valuable in terms of buying time for governments and communities to prepare .
But there ’ s only a small window in which the restrictions can be effective , and for the US , that opportunity passed weeks ago .
The Centers for Disease Control and Prevention reported more than 1,600 cases nationwide as of March 13 , but due to insufficient testing , there are likely many more cases that have gone unidentified .
Congress ’ s in-house doctor told staffers on Wednesday that 70 million to @ @ @ @ @ @ @ eventually be infected .
At this point , there ’ s just too much community transmission for travel restrictions to make much of a difference .
“ Border closures have not stopped the spread of this virus or prevented it from becoming a pandemic , ” Jennifer Nuzzo , a senior scholar at the Johns Hopkins Center for Health Security , told Vox .
“ Now that we have local transmission within the United States , looking outward to control the virus makes even less sense.
” Tom Bossert , a former adviser @ @ @ @ @ @ @ response team , argued that the US coronavirus pandemic is past the stage at which a ban on international travelers from Europe would help insulate the public from the virus : How the travel bans played out in China and Italy Joshua Michaud , associate director for global health policy at the Kaiser Family Foundation , said that what happened in China suggests there is a window when restricting travel can have an impact on the spread of a disease .
China ’ s decision to lock down domestic transportation in the Hubei @ @ @ @ @ @ @ coupled with international travel restrictions , led to a delay both in the spread of the epidemic internally and in other countries — one paper estimates by about 2.9 days .
Another paper recently published in Science that has yet to be peer-reviewed determined that the combination of those approaches produced a “ much larger synergistic effect ” than either of them would have alone .
“ It bought other countries some time , ” Thomas Bollyky , director of the global health program at the Council on Foreign Relations , told Vox @ @ @ @ @ @ @ t fully contain the epidemic , in part because a large number of infected people from mainland China went undetected and could have dispersed across the globe , the researchers write .
Since people can be infected without exhibiting symptoms , it ’ s all the more difficult to identify sick people and prevent them from traveling .
It ’ s not yet clear whether travel restrictions in Italy had a similar impact .
Italy was the first European Union country to ban flights to and from China on account of coronavirus , @ @ @ @ @ @ @ Health Organization .
The country , which is suffering from the worst coronavirus epidemic in Europe , remains on total lockdown .
But the US , which in January blocked foreigners who had recently visited China , may have consequently been able to delay the spread of the virus for some time .
Anthony Fauci , the head of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health , and other public health officials “ knew that they couldn ’ t hermetically seal off the US , but @ @ @ @ @ @ @ Michaud said .
Fauci has since testified before Congress backing Trump ’ s latest ban on Europeans and calling for even more travel bans as necessary .
“ If , in fact , the dynamics of the outbreak mandates that , I think they would seriously consider that , ” Fauci told lawmakers on Thursday .
“ I can tell you it would be seriously considered.
” Trump began barring entry for all travelers from Europe for 30 days on Friday .
Americans returning from Europe who submitted to screenings and citizens of @ @ @ @ @ @ @ , however .
The move blindsided European leaders and caused mass panic at European airports , where the cost of last-minute flights to the US skyrocketed to as much as $ 20,000 .
He changed course on Saturday , announcing that the UK and Ireland would be subject to the European restrictions starting on Monday at midnight ET , based on the recommendations of his public health advisers .
But only a fraction of coronavirus cases in the US are coming from Europe at this point : Trevor Bedford , a scientist who @ @ @ @ @ @ @ Research Center , estimates that the number of new infections generated within the US is higher than the number of new infections introduced by Europeans daily by a factor of about 18 to one .
“ Putting in border restrictions does little to blunt the epidemic that we already have here , ” Michaud said .
“ It misplaces emphasis on a relatively small risk.
” Even if there were a pressing threat from Europe that could be averted by instituting travel restrictions , Irwin Redlener , director of the National Center for @ @ @ @ @ @ @ Vox it ’ s not clear that Trump ’ s ban as it is designed would prevent people from coming to the US .
Nothing seems to be stopping Europeans from rerouting their trips to fly to the US through another country .
And there appears to be no scientific justification for initially exempting the UK , which has a higher number of coronavirus cases than other countries in Europe .
“ This is an extraordinarily inept statement of policy , ” he said .
What could be more effective is something Trump @ @ @ @ @ @ @ aided China : domestic travel restrictions .
Trump didn ’ t elaborate on what areas of the US could face domestic travel restrictions , but he did recommend that the public avoid nonessential travel domestically .
As of Saturday , hotspots of transmission that would seem likely targets for such a ban include Washington state , where there are 510 confirmed cases and 37 deaths , and New York state , where there are 524 confirmed cases and one death .
There is already a containment zone in the city of New Rochelle @ @ @ @ @ @ @ has restricted service members ’ domestic travel .
” If you don ’ t have to travel I wouldn ’ t do it ... we want this thing to end , ” Trump said Saturday .
Experts also recommend focusing the US response on ways to reduce domestic transmission of the virus .
Investing in increasing testing would help identify hotspots of infection and inform how officials can most effectively allocate resources in order to prepare for increased pressure on hospitals and the health care system more broadly .
Redlener said the federal @ @ @ @ @ @ @ states and localities to develop public health protocols and educate the public on best practices because , so far , the response has been “ too little , too late.
” “ Coronavirus knows no borders but borders are the only thing that President Trump knows with regard to Covid-19 , ” Bollyky said .

Despite President Donald Trump’s sweeping ban on non-US-citizen travelers from Europe and now the UK, the consensus among public health experts is clear: At this point, restricting travel can’t prevent the spread of the coronavirus.
Epidemiologists have long observed the failure of travel restrictions to contain other infectious diseases, such as influenza. It also seems to be true in the case of the coronavirus outbreak so far: China and Italy both adopted stringent restrictions on domestic and international travel but were unable to avert a pandemic. It’s true that case numbers finally started dropping recently in China, but as epidemiologist Bruce Aylward told Vox’s Julia Belluz, that can mostly be attributed to efforts to educate the public, identify cases, and rapidly isolate them.
At this point, it’s hard to tell what containment strategies have been effective; we’ll know more in the months to come after various countries’ real-time experimentation has played out. Preliminary research suggests travel restrictions could be effective in temporarily delaying the spread of coronavirus by a few days, if not in stopping it entirely, and that could be valuable in terms of buying time for governments and communities to prepare.
But there’s only a small window in which the restrictions can be effective, and for the US, that opportunity passed weeks ago.
The Centers for Disease Control and Prevention reported more than 1,600 cases nationwide as of March 13, but due to insufficient testing, there are likely many more cases that have gone unidentified. Congress’s in-house doctor told staffers on Wednesday that 70 million to 150 million people in the US could eventually be infected. At this point, there’s just too much community transmission for travel restrictions to make much of a difference.
“Border closures have not stopped the spread of this virus or prevented it from becoming a pandemic,” Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security, told Vox. “Now that we have local transmission within the United States, looking outward to control the virus makes even less sense.”
Tom Bossert, a former adviser on the Trump administration’s pandemic response team, argued that the US coronavirus pandemic is past the stage at which a ban on international travelers from Europe would help insulate the public from the virus:
There’s little value to European travel restrictions. Poor use of time & energy. Earlier, yes. Now, travel restrictions/screening are less useful. We have nearly as much disease here in the US as the countries in Europe. We MUST focus on layered community mitigation measures-Now! — Thomas P. Bossert (@TomBossert) March 12, 2020
How the travel bans played out in China and Italy
Joshua Michaud, associate director for global health policy at the Kaiser Family Foundation, said that what happened in China suggests there is a window when restricting travel can have an impact on the spread of a disease.
China’s decision to lock down domestic transportation in the Hubei province, where the virus originated, coupled with international travel restrictions, led to a delay both in the spread of the epidemic internally and in other countries — one paper estimates by about 2.9 days. Another paper recently published in Science that has yet to be peer-reviewed determined that the combination of those approaches produced a “much larger synergistic effect” than either of them would have alone.
“It bought other countries some time,” Thomas Bollyky, director of the global health program at the Council on Foreign Relations, told Vox.
But those policies still couldn’t fully contain the epidemic, in part because a large number of infected people from mainland China went undetected and could have dispersed across the globe, the researchers write. Since people can be infected without exhibiting symptoms, it’s all the more difficult to identify sick people and prevent them from traveling.
It’s not yet clear whether travel restrictions in Italy had a similar impact. Italy was the first European Union country to ban flights to and from China on account of coronavirus, going against the recommendations of the World Health Organization. The country, which is suffering from the worst coronavirus epidemic in Europe, remains on total lockdown.
But the US, which in January blocked foreigners who had recently visited China, may have consequently been able to delay the spread of the virus for some time. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, and other public health officials “knew that they couldn’t hermetically seal off the US, but they could slow the spread,” Michaud said.
Fauci has since testified before Congress backing Trump’s latest ban on Europeans and calling for even more travel bans as necessary.
“If, in fact, the dynamics of the outbreak mandates that, I think they would seriously consider that,” Fauci told lawmakers on Thursday. “I can tell you it would be seriously considered.”
Trump’s European ban makes no sense
Trump began barring entry for all travelers from Europe for 30 days on Friday. Americans returning from Europe who submitted to screenings and citizens of the UK and Ireland were initially exempt, however. The move blindsided European leaders and caused mass panic at European airports, where the cost of last-minute flights to the US skyrocketed to as much as $20,000.
He changed course on Saturday, announcing that the UK and Ireland would be subject to the European restrictions starting on Monday at midnight ET, based on the recommendations of his public health advisers.
But only a fraction of coronavirus cases in the US are coming from Europe at this point: Trevor Bedford, a scientist who studies viruses at the Fred Hutchinson Cancer Research Center, estimates that the number of new infections generated within the US is higher than the number of new infections introduced by Europeans daily by a factor of about 18 to one.
“Putting in border restrictions does little to blunt the epidemic that we already have here,” Michaud said. “It misplaces emphasis on a relatively small risk.”
Even if there were a pressing threat from Europe that could be averted by instituting travel restrictions, Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University, told Vox it’s not clear that Trump’s ban as it is designed would prevent people from coming to the US. Nothing seems to be stopping Europeans from rerouting their trips to fly to the US through another country.
And there appears to be no scientific justification for initially exempting the UK, which has a higher number of coronavirus cases than other countries in Europe.
“This is an extraordinarily inept statement of policy,” he said.
What could be more effective is something Trump hinted at, and a practice that aided China: domestic travel restrictions. Trump didn’t elaborate on what areas of the US could face domestic travel restrictions, but he did recommend that the public avoid nonessential travel domestically. As of Saturday, hotspots of transmission that would seem likely targets for such a ban include Washington state, where there are 510 confirmed cases and 37 deaths, and New York state, where there are 524 confirmed cases and one death. There is already a containment zone in the city of New Rochelle, New York, and the Pentagon has restricted service members’ domestic travel.
”If you don’t have to travel I wouldn’t do it ... we want this thing to end,” Trump said Saturday.
Experts also recommend focusing the US response on ways to reduce domestic transmission of the virus. Investing in increasing testing would help identify hotspots of infection and inform how officials can most effectively allocate resources in order to prepare for increased pressure on hospitals and the health care system more broadly.
Redlener said the federal government also needs to issue guidance to states and localities to develop public health protocols and educate the public on best practices because, so far, the response has been “too little, too late.”
“Coronavirus knows no borders but borders are the only thing that President Trump knows with regard to Covid-19,” Bollyky said.


vox--2020-03-14--Trump is banning travelers from the UK to combat coronavirus. Domestic travel restrictions could com

Trump is banning travelers from the UK to combat coronavirus. Domestic travel restrictions could come next.

President Donald Trump announced Saturday he will expand his European travel ban to include the United Kingdom starting Monday night in effort to curb the spread of coronavirus .
He said he is weighing domestic travel restrictions as well .
The US began barring entry for all travelers from Europe for 30 days on Friday .
Americans returning from Europe who submitted to screenings and citizens of the UK and Ireland were initially exempt , however .
Trump changed course on Saturday , announcing the UK and Ireland would be subject to the European restrictions starting on Monday at midnight @ @ @ @ @ @ @ his public health advisers .
The announcement comes on the heels of Trump ’ s declaration of a national emergency on Friday — a move that will allow for $ 50 billion in disaster relief funds to be used to combat the coronavirus .
It also followed the passage of a sweeping House bill on Saturday morning that would offer certain workers access to paid leave should they become infected or need to administer care , provide free testing for the virus , and improve both existing unemployment insurance and food assistance programs @ @ @ @ @ @ @ a growing number of confirmed coronavirus cases in the US , and the UK is facing an even more marked increase .
The number of deaths in the UK related to coronavirus doubled overnight to 21 total .
And the number of confirmed cases in the UK climbed to more than 1,100 .
Prime Minister Boris Johnson is consequently expected to ban large gatherings in the UK in an abrupt reversal of strategy — previously , his government made the controversial argument that limiting social contact would not be effective to prevent the @ @ @ @ @ @ @ it argued citizens should be allowed to become infected in hopes of building a broad immunity to the virus .
It isn ’ t clear whether this policy triggered the Trump administration ’ s decision , nor is it clear further travel bans will have much of an effect on limiting domestic coronavirus cases .
The time for travel bans has passed Only a fraction of coronavirus cases in the US are coming from Europe at this point : Trevor Bedford , a scientist who studies viruses at the Fred Hutchinson Cancer Research @ @ @ @ @ @ @ new infections generated within the US is higher than the number of new infections introduced by Europeans daily by a factor of about 18 to one .
Preliminary research suggests that travel restrictions are limited in their effectiveness , and were most useful before community transmission became a factor .
In the initial phase of the public health crisis , travel bans are believed to have temporarily delayed the spread of coronavirus by a few days .
For the US , the small window in which the restrictions can be effective closed weeks @ @ @ @ @ @ @ is something Trump hinted at , and a practice that aided China : domestic travel restrictions .
Trump didn ’ t elaborate on what areas of the US could face domestic travel restrictions , but he did recommend that the public avoid nonessential travel domestically .
As of Saturday , hotspots of transmission that would seem likely targets for such a ban include Washington state , where there are 510 confirmed cases and 37 deaths , and New York state , where there are 524 confirmed cases and one death .
There is @ @ @ @ @ @ @ of New Rochelle , New York , and the Pentagon has restricted service members ’ domestic travel .
” If you don ’ t have to travel I wouldn ’ t do it ... we want this thing to end , ” Trump said Saturday .
Trump also suggested that stores should consider shuttering to limit social contact , praising Apple ’ s move to close all of its stores outside of mainland China on Friday for at least the next two weeks .
“ I think , frankly , it ’ s @ @ @ @ @ @ @ he said .
Trump offered new bans , as his administration promoted caution Trump also announced on Saturday that he got tested for coronavirus .
In recent weeks , he has come into contact with several people who have tested positive for coronavirus , including a Brazilian official , but has resisted being tested .
The results of that test should be available in the coming days , but he said that for now , his body temperature is normal .
The administration also promised additional updates on efforts to conduct mass coronavirus @ @ @ @ @ @ @ , Walgreens , Walmart , and other locations , Vice President Mike Pence told reporters .
And Pence also promised more details about a website the administration claims will allow the public to do a risk assessment for infection .
A number of other administration officials also spoke at the conference , and many said once testing becomes more available , Americans should not let a negative test result give them false confidence about conducting their lives as normal .
Instead , officials said people still need to practice social distancing and regular @ @ @ @ @ @ @ virus .
“ When you tell somebody it ’ s negative , yes , it ’ s reassuring , but the last thing we want is them so reassured that they stop practicing these critical practices that are going to protect all of us , ” Deborah L. Birx , a physician who serves on the White House coronavirus task force , said .
“ This epidemic will be stopped at the community level .
”

President Donald Trump announced Saturday he will expand his European travel ban to include the United Kingdom starting Monday night in effort to curb the spread of coronavirus. He said he is weighing domestic travel restrictions as well.
The US began barring entry for all travelers from Europe for 30 days on Friday. Americans returning from Europe who submitted to screenings and citizens of the UK and Ireland were initially exempt, however. Trump changed course on Saturday, announcing the UK and Ireland would be subject to the European restrictions starting on Monday at midnight ET, based on the recommendations of his public health advisers.
The announcement comes on the heels of Trump’s declaration of a national emergency on Friday — a move that will allow for $50 billion in disaster relief funds to be used to combat the coronavirus. It also followed the passage of a sweeping House bill on Saturday morning that would offer certain workers access to paid leave should they become infected or need to administer care, provide free testing for the virus, and improve both existing unemployment insurance and food assistance programs.
Those measures came in response to a growing number of confirmed coronavirus cases in the US, and the UK is facing an even more marked increase. The number of deaths in the UK related to coronavirus doubled overnight to 21 total. And the number of confirmed cases in the UK climbed to more than 1,100. Prime Minister Boris Johnson is consequently expected to ban large gatherings in the UK in an abrupt reversal of strategy — previously, his government made the controversial argument that limiting social contact would not be effective to prevent the spread of the virus. Instead, it argued citizens should be allowed to become infected in hopes of building a broad immunity to the virus.
It isn’t clear whether this policy triggered the Trump administration’s decision, nor is it clear further travel bans will have much of an effect on limiting domestic coronavirus cases.
The time for travel bans has passed
Only a fraction of coronavirus cases in the US are coming from Europe at this point: Trevor Bedford, a scientist who studies viruses at the Fred Hutchinson Cancer Research Center, estimates that the number of new infections generated within the US is higher than the number of new infections introduced by Europeans daily by a factor of about 18 to one.
Preliminary research suggests that travel restrictions are limited in their effectiveness, and were most useful before community transmission became a factor. In the initial phase of the public health crisis, travel bans are believed to have temporarily delayed the spread of coronavirus by a few days. For the US, the small window in which the restrictions can be effective closed weeks ago.
What could be more effective is something Trump hinted at, and a practice that aided China: domestic travel restrictions. Trump didn’t elaborate on what areas of the US could face domestic travel restrictions, but he did recommend that the public avoid nonessential travel domestically. As of Saturday, hotspots of transmission that would seem likely targets for such a ban include Washington state, where there are 510 confirmed cases and 37 deaths, and New York state, where there are 524 confirmed cases and one death. There is already a containment zone in the city of New Rochelle, New York, and the Pentagon has restricted service members’ domestic travel.
”If you don’t have to travel I wouldn’t do it ... we want this thing to end,” Trump said Saturday.
Trump also suggested that stores should consider shuttering to limit social contact, praising Apple’s move to close all of its stores outside of mainland China on Friday for at least the next two weeks.
“I think, frankly, it’s good if they do it,” he said.
Trump offered new bans, as his administration promoted caution
Trump also announced on Saturday that he got tested for coronavirus. In recent weeks, he has come into contact with several people who have tested positive for coronavirus, including a Brazilian official, but has resisted being tested. The results of that test should be available in the coming days, but he said that for now, his body temperature is normal.
The administration also promised additional updates on efforts to conduct mass coronavirus testing through a private-public partnership at CVS, Walgreens, Walmart, and other locations, Vice President Mike Pence told reporters. And Pence also promised more details about a website the administration claims will allow the public to do a risk assessment for infection.
A number of other administration officials also spoke at the conference, and many said once testing becomes more available, Americans should not let a negative test result give them false confidence about conducting their lives as normal. Instead, officials said people still need to practice social distancing and regular hand-washing to prevent the spread of the virus.
“When you tell somebody it’s negative, yes, it’s reassuring, but the last thing we want is them so reassured that they stop practicing these critical practices that are going to protect all of us,” Deborah L. Birx, a physician who serves on the White House coronavirus task force, said. “This epidemic will be stopped at the community level.”