vox--2020-04-29--Russia’s coronavirus outbreak is getting bad. Putin says the worst is yet to come.

Russia ’ s much-feared coronavirus crisis is here — and it doesn ’ t look like it ’ s slowing down anytime soon .
Russia was always going to struggle if a large outbreak occurred in the country , and experts predicted one almost certainly would due to the country ’ s proximity to China and tightly packed cities , including the capital , Moscow .
Hospitals in urban areas lack reliable medical equipment and staff to operate them , to say nothing of the state of medical facilities in rural areas .
But few expected it to be this @ @ @ @ @ @ @ Russia reported nearly 100,000 confirmed coronavirus cases and nearly 1,000 deaths .
Those numbers make Russia the eighth-hardest-hit country in the world .
Russian President Vladimir Putin on Tuesday admitted that the country had a shortage of critical personal protective equipment for health care workers , and warned that the worst the pandemic is yet to come .
“ Ahead of us is a new stage , perhaps the most intense stage of the fight against the epidemic , ” he said in a national address , in which he also announced an @ @ @ @ @ @ @ until May 11 .
“ The risks of getting infected are at the highest level , and the threat , the mortal danger of the virus persists.
” “ Russia has managed to slow down the spread of the epidemic , but we haven ’ t passed the peak yet , ” Putin continued .
His pessimism is warranted .
Hospitals have become overrun with patients , leaving ambulances stuck idling in long lines outside hospitals just to deliver sick patients .
At least one driver had to wait about 15 hours .
@ @ @ @ @ @ @ unit beds before the end of this week .
And nurses have quit en masse to protest poor working conditions and low pay .
Millions of Russians could lose their jobs this year due to the lockdown and oil revenues , which make up a significant portion of Russia ’ s economy , have dropped sharply as people around the world have stopped traveling and business have shuttered due to the coronavirus .
As if that weren ’ t bad enough , a top Russian nuclear official said Tuesday that the virus is @ @ @ @ @ @ @ towns ” — places where nuclear research is conducted in Russia , including the birthplace of the Soviet atomic bomb — by getting top scientists sick .
This is perhaps the biggest test has Putin faced during his 20 years in power .
He markets himself as Russia ’ s hero , the only man who can restore the former Soviet Union ’ s greatness and bring stability to his country .
Anything that messes with that image — such as a nationwide health crisis — ruins the myth he and his allies @ @ @ @ @ @ @ for him , and the millions of Russians counting on his leadership , is that when it comes to fighting the coronavirus , macho posturing and disinformation just don ’ t cut it .
Russia ’ s health care system is quickly reaching capacity , if it hasn ’ t already Earlier this month , Michael Favorov , who led the US Centers for Disease Control and Prevention ’ s Eastern European and Central Asian programs , told me that Russia is “ probably in the early stage of the same epidemic which @ @ @ @ @ @ @ now.
” “ They are facing significant increases of cases within the next month ” in the capital and beyond , “ and a significant increase in the number of deaths.
” Favorov ’ s prediction seems to have come true .
Just look at the chart below , with coronavirus statistics from Our World in Data .
After a late start , Russia ’ s daily confirmed cases ( in purple ) have steadily risen over the past month , more so than in previous European epicenters like Spain and Italy .
@ @ @ @ @ @ @ overwhelm Russia ’ s health care system .
A viral video circulating throughout Russia , filmed by an ambulance driver who says he waited nine hours to drop off a patient , shows a long line of ambulances waiting silently to get into a hospital just outside Moscow .
Yelena Alikhashkina , a patient who feared she had the coronavirus , told Radio Free Europe/Radio Liberty two weeks ago about her experience .
“ I waited 3.5 hours for the ambulance , ” she said , and it didn ’ t get much @ @ @ @ @ @ @ in the ambulance , she said , it took 40 minutes before anybody answered the hotline to tell the ambulance where to take her .
And when she finally arrived at the designated hospital , “ there were 30 ambulances already in the line.
” Judy Twigg , an expert on Russia ’ s health care system at Virginia Commonwealth University , told me the long lines could be a function of Russia ’ s policy to have some hospitals treat only coronavirus patients while others handle only non-infected clients .
While that @ @ @ @ @ @ @ more efficient , it limits the amount of space available to those with the disease .
Dr. Vasiliy Vlassov , an epidemiologist at the Higher School of Economics in Moscow , told me that the “ government continues to open more and more hospitals for Covid-19 patients , and they are filled quickly.
” Thus , it seems the amount of patients continues to reach the country ’ s health care capacity .
But the situation inside Russia ’ s coronavirus hospitals isn ’ t great , either .
Experts say a lot @ @ @ @ @ @ @ including ventilators , break down with alarming frequency .
Russia is having more produced , but it ’ s unclear if those who need them will have them in time , especially as the rich hoard them .
Further , Russia generally is short of the equipment that goes with ventilators , like oxygen and anesthetic sedatives .
And the country appears to be short of well-trained 24/7 intensive care nurses needed to care for patients on ventilators .
Putin himself acknowledged on Tuesday that there is a shortage of protective equipment for @ @ @ @ @ @ @ facilities had all the necessary equipment , it doesn ’ t appear they would have the requisite space for patients .
The hospital Alikhashkina visited , for example , stopped admitting new patients on April 13 due to overcrowding .
That was bound to happen , as a 2017 study from the Moscow-based Center for Economic and Political Reforms found the number of hospitals halved in Russia between 2000 — Putin ’ s first year in power — and 2015 .
If Russia continues to have around 6,000 confirmed coronavirus cases per day @ @ @ @ @ @ @ last 10 days , Twigg said hospitals in Moscow and St. Petersburg “ will get overwhelmed soon , as it looks like they ’ re already at capacity.
” Physicians like Irina Sheikina , from the capital ’ s Hospital No .
15 , agree .
“ There are already nearly 1,500 patients , all with pneumonia , ” she told the same outlet .
“ There are not enough beds .
They put patients wherever there is free space.
” The lack of beds is a widespread problem .
Earlier this month @ @ @ @ @ @ @ had about 70,000 hospital beds .
That amount clearly wasn ’ t enough to handle the quick spike in Russia ’ s coronavirus cases .
Now , hospitals in Moscow and elsewhere in the country are seeking extra beds wherever they can .
As they struggle to do so , the hope is a makeshift hospital currently under construction outside Moscow might help with the overflow by taking about 500 more patients .
But in one area at least , conditions are so bad that some professionals have decided it ’ s no @ @ @ @ @ @ @ health care system .
Over a dozen members of the nursing staff from Kommunarka hospital , the top coronavirus facility in Moscow , abruptly quit together on Monday because they didn ’ t have enough protective gear , food to eat , or some of the $ 132 million in bonuses Putin promised the nation ’ s physicians .
A video from the Moscow Times shows one of the nurses explaining why she left the hospital .
“ I worked for two days straight , sometimes three , ” the unnamed medical professional @ @ @ @ @ @ @ .
They started handing out unsanitary [ used ] equipment to us.
” “ No one paid us for extra shifts , ” she continued .
“ I want people to listen to us finally , and I want us to be paid the money Vladimir Putin has promised us , especially for those working in these conditions.
” From almost every angle , then , Russia ’ s coronavirus crisis has hit — and hit hard .
“ We in Russia are still in doubt about what is going on in the @ @ @ @ @ @ @ of standing by as the coronavirus swept across the globe .
On January 30 , the Kremlin closed its large , far-eastern border with China and suspended the issue of electronic visas to Chinese people .
Days later , it evacuated Russians in China on military airplanes and threatened to deport foreigners who tested positive for the disease .
That same month , passengers flying into Moscow from China , Iran , and South Korea — the coronavirus epicenters at the time — had to undergo tests once they stepped off the plane @ @ @ @ @ @ @ would have their temperatures checked and be ordered to quarantine for 14 days at home .
Experts told me those measures , while tough , at best limited the number of infected people in the country and perhaps prevented an even larger outbreak than the one Russia is currently experiencing .
But it ’ s clear that Putin and his team have gotten more serious as the coronavirus crisis got more serious , too .
In an April 1 videoconference , Putin told government members to tell him truthful information when he needs @ @ @ @ @ @ @ work should correspond to what is happening at present , ” he said .
That , for VCU ’ s Twigg , was surprising .
“ It was an implicit admission that what ’ s been going on until now was everybody lying to each other , ” she told me .
Now Putin is extending lockdowns , telling citizens that the worst is yet to come , and having new hospitals built .
There ’ s no question that he ’ s taking the crisis seriously , but the state of Russia @ @ @ @ @ @ @ it isn ’ t ready for the moment .
That goes against the kind of bravado Putin ’ s regime showed earlier in the year .
Russian propaganda claimed earlier this month that the country was better prepared than the United States for what was coming , even noting how Putin had offered President Donald Trump assistance .
In fact , a Russian plane with medical equipment was dispatched to the US .
Some experts still suspect that the country ’ s official coronavirus statistics aren ’ t fully transparent , perhaps in @ @ @ @ @ @ @ better than it is .
Pro-Kremlin accounts on social media usually still focus on the low number of deaths , for example , as a way to say Putin has everything under control .
“ We in Russia are still in doubt about what is going on in the country , ” Vlassov , the epidemiologist , told me .
“ It ’ s not only doubt in the state ’ s statistics , but also in the picture in the social media.
” “ The number of lethal cases ascribed to Covid-19 @ @ @ @ @ @ @ .
“ I think that it is a result of the misclassification of deaths from [ the disease ] to the other conditions or complications.
” That ’ s happened before : In 2015 , Putin said he wanted to lower the death rate caused by cardiovascular disease in Russia .
Almost immediately , hospitals began to report that fewer people were dying from heart conditions .
What made that more suspicious is that there was a rise — at about the same rate — of deaths from other causes .
No one @ @ @ @ @ @ @ Putin , has the full picture of what the crisis really looks like in Russia .
But based on what ’ s already known , Putin has a lot more work to do .
Every day at Vox , we aim to answer your most important questions and provide you , and our audience around the world , with information that has the power to save lives .
Our mission has never been more vital than it is in this moment : to empower you through understanding .
Vox ’ s work is @ @ @ @ @ @ @ our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn .
Your financial contribution will not constitute a donation , but it will enable our staff to continue to offer free articles , videos , and podcasts at the quality and volume that this moment requires .
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Russia’s much-feared coronavirus crisis is here — and it doesn’t look like it’s slowing down anytime soon.
Russia was always going to struggle if a large outbreak occurred in the country, and experts predicted one almost certainly would due to the country’s proximity to China and tightly packed cities, including the capital, Moscow. Hospitals in urban areas lack reliable medical equipment and staff to operate them, to say nothing of the state of medical facilities in rural areas.
But few expected it to be this bad. As of April 28, Russia reported nearly 100,000 confirmed coronavirus cases and nearly 1,000 deaths. Those numbers make Russia the eighth-hardest-hit country in the world.
Russian President Vladimir Putin on Tuesday admitted that the country had a shortage of critical personal protective equipment for health care workers, and warned that the worst the pandemic is yet to come.
“Ahead of us is a new stage, perhaps the most intense stage of the fight against the epidemic,” he said in a national address, in which he also announced an extension of his nation’s lockdown until May 11. “The risks of getting infected are at the highest level, and the threat, the mortal danger of the virus persists.”
“Russia has managed to slow down the spread of the epidemic, but we haven’t passed the peak yet,” Putin continued.
His pessimism is warranted. Hospitals have become overrun with patients, leaving ambulances stuck idling in long lines outside hospitals just to deliver sick patients. At least one driver had to wait about 15 hours. Moscow might run out of intensive care unit beds before the end of this week. And nurses have quit en masse to protest poor working conditions and low pay.
Millions of Russians could lose their jobs this year due to the lockdown and oil revenues, which make up a significant portion of Russia’s economy, have dropped sharply as people around the world have stopped traveling and business have shuttered due to the coronavirus.
As if that weren’t bad enough, a top Russian nuclear official said Tuesday that the virus is threatening the safety of three “nuclear towns” — places where nuclear research is conducted in Russia, including the birthplace of the Soviet atomic bomb — by getting top scientists sick.
This is perhaps the biggest test has Putin faced during his 20 years in power. He markets himself as Russia’s hero, the only man who can restore the former Soviet Union’s greatness and bring stability to his country. Anything that messes with that image — such as a nationwide health crisis — ruins the myth he and his allies have cultivated for decades.
The problem for him, and the millions of Russians counting on his leadership, is that when it comes to fighting the coronavirus, macho posturing and disinformation just don’t cut it.
Russia’s health care system is quickly reaching capacity, if it hasn’t already
Earlier this month, Michael Favorov, who led the US Centers for Disease Control and Prevention’s Eastern European and Central Asian programs, told me that Russia is “probably in the early stage of the same epidemic which is going on in the United States now.”
“They are facing significant increases of cases within the next month” in the capital and beyond, “and a significant increase in the number of deaths.”
Favorov’s prediction seems to have come true. Just look at the chart below, with coronavirus statistics from Our World in Data. After a late start, Russia’s daily confirmed cases (in purple) have steadily risen over the past month, more so than in previous European epicenters like Spain and Italy.
And those growing numbers are starting to overwhelm Russia’s health care system.
A viral video circulating throughout Russia, filmed by an ambulance driver who says he waited nine hours to drop off a patient, shows a long line of ambulances waiting silently to get into a hospital just outside Moscow.
В Химках образовалась пробка из машин скорой помощи с пациентами, у многих из которых подозревают коронавирус и пневмонию.
Скорые едут в 119 больницу, которая была перепрофилирована для приёма пациентов с COVID-19.#coronavirus #лучшедома #мы24дома #москва24 #м24 pic.twitter.com/XcOisjLDwf — Москва 24 (@infomoscow24) April 11, 2020
Yelena Alikhashkina, a patient who feared she had the coronavirus, told Radio Free Europe/Radio Liberty two weeks ago about her experience.
“I waited 3.5 hours for the ambulance,” she said, and it didn’t get much better after that. After she got in the ambulance, she said, it took 40 minutes before anybody answered the hotline to tell the ambulance where to take her. And when she finally arrived at the designated hospital, “there were 30 ambulances already in the line.”
Judy Twigg, an expert on Russia’s health care system at Virginia Commonwealth University, told me the long lines could be a function of Russia’s policy to have some hospitals treat only coronavirus patients while others handle only non-infected clients. While that may make treatment inside the coronavirus facility more efficient, it limits the amount of space available to those with the disease.
Dr. Vasiliy Vlassov, an epidemiologist at the Higher School of Economics in Moscow, told me that the “government continues to open more and more hospitals for Covid-19 patients, and they are filled quickly.” Thus, it seems the amount of patients continues to reach the country’s health care capacity.
But the situation inside Russia’s coronavirus hospitals isn’t great, either.
Experts say a lot of the equipment Russian hospitals have, including ventilators, break down with alarming frequency. Russia is having more produced, but it’s unclear if those who need them will have them in time, especially as the rich hoard them.
Further, Russia generally is short of the equipment that goes with ventilators, like oxygen and anesthetic sedatives. And the country appears to be short of well-trained 24/7 intensive care nurses needed to care for patients on ventilators. Putin himself acknowledged on Tuesday that there is a shortage of protective equipment for health care workers.
Even if medical facilities had all the necessary equipment, it doesn’t appear they would have the requisite space for patients.
The hospital Alikhashkina visited, for example, stopped admitting new patients on April 13 due to overcrowding. That was bound to happen, as a 2017 study from the Moscow-based Center for Economic and Political Reforms found the number of hospitals halved in Russia between 2000 — Putin’s first year in power — and 2015.
If Russia continues to have around 6,000 confirmed coronavirus cases per day, as it has for about the last 10 days, Twigg said hospitals in Moscow and St. Petersburg “will get overwhelmed soon, as it looks like they’re already at capacity.”
Physicians like Irina Sheikina, from the capital’s Hospital No. 15, agree. “There are already nearly 1,500 patients, all with pneumonia,” she told the same outlet. “There are not enough beds. They put patients wherever there is free space.”
The lack of beds is a widespread problem.
Earlier this month, experts told me the entire country had about 70,000 hospital beds. That amount clearly wasn’t enough to handle the quick spike in Russia’s coronavirus cases. Now, hospitals in Moscow and elsewhere in the country are seeking extra beds wherever they can. As they struggle to do so, the hope is a makeshift hospital currently under construction outside Moscow might help with the overflow by taking about 500 more patients.
But in one area at least, conditions are so bad that some professionals have decided it’s no longer worth serving in Russia’s health care system.
Over a dozen members of the nursing staff from Kommunarka hospital, the top coronavirus facility in Moscow, abruptly quit together on Monday because they didn’t have enough protective gear, food to eat, or some of the $132 million in bonuses Putin promised the nation’s physicians.
A video from the Moscow Times shows one of the nurses explaining why she left the hospital. “I worked for two days straight, sometimes three,” the unnamed medical professional said. “They stopped feeding us. They started handing out unsanitary [used] equipment to us.”
“No one paid us for extra shifts,” she continued. “I want people to listen to us finally, and I want us to be paid the money Vladimir Putin has promised us, especially for those working in these conditions.”
From almost every angle, then, Russia’s coronavirus crisis has hit — and hit hard.
“We in Russia are still in doubt about what is going on in the country”
No one can accuse Putin of standing by as the coronavirus swept across the globe.
On January 30, the Kremlin closed its large, far-eastern border with China and suspended the issue of electronic visas to Chinese people. Days later, it evacuated Russians in China on military airplanes and threatened to deport foreigners who tested positive for the disease.
That same month, passengers flying into Moscow from China, Iran, and South Korea — the coronavirus epicenters at the time — had to undergo tests once they stepped off the plane. Meanwhile, citizens returning from Europe would have their temperatures checked and be ordered to quarantine for 14 days at home.
Experts told me those measures, while tough, at best limited the number of infected people in the country and perhaps prevented an even larger outbreak than the one Russia is currently experiencing.
But it’s clear that Putin and his team have gotten more serious as the coronavirus crisis got more serious, too.
In an April 1 videoconference, Putin told government members to tell him truthful information when he needs it. “The results of our work should correspond to what is happening at present,” he said. That, for VCU’s Twigg, was surprising. “It was an implicit admission that what’s been going on until now was everybody lying to each other,” she told me.
Now Putin is extending lockdowns, telling citizens that the worst is yet to come, and having new hospitals built. There’s no question that he’s taking the crisis seriously, but the state of Russia’s health care system looks like it isn’t ready for the moment.
That goes against the kind of bravado Putin’s regime showed earlier in the year. Russian propaganda claimed earlier this month that the country was better prepared than the United States for what was coming, even noting how Putin had offered President Donald Trump assistance. In fact, a Russian plane with medical equipment was dispatched to the US.
Some experts still suspect that the country’s official coronavirus statistics aren’t fully transparent, perhaps in an effort to make the situation look better than it is. Pro-Kremlin accounts on social media usually still focus on the low number of deaths, for example, as a way to say Putin has everything under control.
“We in Russia are still in doubt about what is going on in the country,” Vlassov, the epidemiologist, told me. “It’s not only doubt in the state’s statistics, but also in the picture in the social media.”
“The number of lethal cases ascribed to Covid-19 are still low,” he continued. “I think that it is a result of the misclassification of deaths from [the disease] to the other conditions or complications.”
That’s happened before: In 2015, Putin said he wanted to lower the death rate caused by cardiovascular disease in Russia. Almost immediately, hospitals began to report that fewer people were dying from heart conditions. What made that more suspicious is that there was a rise — at about the same rate — of deaths from other causes.
No one in the world, except for maybe Putin, has the full picture of what the crisis really looks like in Russia. But based on what’s already known, Putin has a lot more work to do.


vox--2020-04-29--Why it can be so hard to tell if you have Covid-19

Why it can be so hard to tell if you have Covid-19 Share All sharing options for : Why it can be so hard to tell if you have Covid-19 What are the signs you have been infected with the Covid-19 coronavirus ?
That ’ s become a surprisingly tricky question to answer , and it ’ s hampering the fight against the disease .
The CDC has updated its guidelines to include chills , muscle pain , sore throat , headache , and a new loss of taste or smell as symptoms of Covid-19 , in addition to fever @ @ @ @ @ @ @ .
Some patients infected with SARS-CoV-2 , the virus that causes Covid-19 , have experienced symptoms like vomiting and loss of taste and smell .
Some people ’ s Covid-19 symptoms overlap with those of other illnesses like influenza , making these infections hard to distinguish without testing .
And some infected patients have reported no symptoms at all .
“ As this pandemic unfolds , it ’ s becoming very clear that the symptoms of Covid vary quite a lot from person to person , and there are a lot of symptoms @ @ @ @ @ @ @ were related to Covid , ” said Andrew Chan , a professor of immunology and infectious disease at the Harvard TH Chan School of Public Health .
“ As a result , it ’ s really put us behind in our ability to identify people with Covid infections , and probably resulted in a lot of people walking around with Covid and not knowing it.
” That has made responding to the crisis all the more frustrating and confusing for health officials , particularly in the United States , where tests for the @ @ @ @ @ @ @ outward sign of the illness , and in a pinch can serve as a proxy for a test .
Many hospitals are already telling patients with Covid-19 symptoms to presume they have the virus and to self-isolate , not even testing to confirm the presence of the virus .
A cluster of symptoms can highlight an emerging hotspot for the virus within a population .
But without a clear picture of how Covid-19 manifests , it ’ s difficult to even approximate the true extent of the pandemic .
And without a sense @ @ @ @ @ @ @ ’ s hard for health workers to take proper precautions and offer the right treatments to their patients .
As a result , many communities have been forced to resort to blunt , blanket , and disruptive measures to contain the pandemic , like shelter-in-place orders .
Relaxing these restrictions would require a major effort to test the public for the virus , trace movements , and build up health care capacity with beds , ventilators , masks , and workers .
Yet there are parts of the US that have yet to @ @ @ @ @ @ @ the spread of Covid-19 .
Nonetheless , researchers are coming up with new ways to track the virus , going back to patient records to see what signs are associated with the illness .
They ’ re also asking people to self-report their symptoms and tracking them with a mobile app .
They ’ re finding that some mild , easily brushed-off symptoms could actually be a harbinger of the disease .
This knowledge could help slow the pandemic and reveal new approaches to fighting the virus .
Some symptoms of the Covid-19 @ @ @ @ @ @ @ are hard to track Many of the guidelines for Covid-19 symptoms are based on what scientists have learned from past cases , particularly China , where the virus emerged and spread rapidly in January and February .
The World Health Organization , for instance , looked at more than 55,000 confirmed Covid-19 cases in China .
They found in February that the most common symptoms were fever ( 87.9 percent of confirmed cases ) and dry cough ( 67.7 percent ) — followed by fatigue ( 38.1 percent ) , sputum [ phlegm @ @ @ @ @ @ @ shortness of breath ( 18.6 percent ) , sore throat ( 13.9 percent ) , and headache ( 13.6 percent ) .
But the patients they looked at weren ’ t necessarily representative of everybody who had the virus there — just the ones who received testing and treatment .
In the study , about 80 percent of the patients had mild to moderate disease , 13.8 percent had severe disease , and 6.1 percent were in critical condition .
It ’ s likely that many infected patients with very minor or no @ @ @ @ @ @ @ , which would mean their symptoms ( or lack thereof ) were underrepresented in those statistics .
Other studies have shown that symptoms such as gastrointestinal problems could herald the illness .
A preliminary non-peer-reviewed study of 204 patients in China found that more than half of them experienced symptoms like diarrhea , vomiting , and abdominal pain .
Another preliminary study , this time from Germany , found that some Covid-19 patients had symptoms more like that of the common cold , like a runny nose .
Researchers in Italy also reported @ @ @ @ @ @ @ associated with Covid-19 .
And doctors in the US have described neurological symptoms like confusion and seizures in some Covid-19 patients , particularly in the elderly .
These vague and sometimes contradictory symptoms may reflect how the virus interacts with underlying conditions in some patients , like diabetes and high blood pressure , or just differences in susceptibility .
This kind of variation is a phenomenon physicians have already seen in other infections .
“ For example , for influenza , most people will show up with fevers , body aches , and @ @ @ @ @ @ @ people will show up with diarrhea and vomiting , ” said David Pride , associate director of microbiology at the University of California San Diego , in an email .
“ What we are experiencing with Covid-19 is probably just mirroring what we see in a number of other illnesses where it affects a subset of people in different ways.
” There ’ s also a huge range in how severe Covid-19 can be , even within certain subgroups .
There are elderly patients who have shrugged off the virus .
There are @ @ @ @ @ @ @ Many of these reports of less-common symptoms still need wider validation before they can be used as clinical guidelines .
But they illustrate just how confusing it can be for patients and doctors to track Covid-19 without adequate testing .
A smartphone app has uncovered another likely symptom of Covid-19 : A loss of taste and smell Before the CDC ’ s guidance changed , there were murmurs that anosmia , a loss of the sense of smell , and ageusia , a loss of the sense of taste , could signal a @ @ @ @ @ @ @ Gobert , who tested positive for the virus , said on Twitter that it was one of his most noticeable symptoms .
The son of UK sports broadcaster Gary Lineker quaffed vinegar and lemon juice on Instagram to show off his loss of taste after getting Covid-19 .
Doctors at the British Rhinological Society said in March they noticed “ a rapidly growing number of reports of a significant increase in the number of patients presenting with anosmia in the absence of other symptoms.
” Writing in the BMJ , researchers at Newcastle @ @ @ @ @ @ @ here is now enough evidence to take this symptom much more seriously.
” Researchers in the United Kingdom recently bolstered that idea with data .
Using a Covid symptom tracker app for smartphones launched on March 24 , scientists pooled daily reports from more than 1.5 million users of their symptoms or lack thereof .
They found that a peculiar loss of taste or smell had strong links to testing positive for Covid-19 .
“ The strongest association between any of those symptoms and having a positive test was having a loss of @ @ @ @ @ @ @ Spector , a professor of molecular epidemiology at King ’ s College London and lead researcher in the study .
In the study , 579 app users reported testing positive for Covid-19 .
And 59 percent of those said they lost their sense of smell or taste .
That ’ s a higher rate than the Covid-19-positive app users reported for fever or any other symptoms .
The likely mechanism here has to do with how the SARS-CoV-2 virus works .
Researchers in the US and UK reported in a preliminary study that @ @ @ @ @ @ @ in nasal passages , in both mice and humans .
That “ could lead to anosmia or other forms of olfactory dysfunction , ” the researchers wrote .
Spector cautioned that being unable to taste your coffee or smell wildflowers is not a definitive sign of Covid-19 .
A loss of taste and smell is associated with other upper respiratory tract infections as well as some allergies .
In most cases , the loss of these senses isn ’ t permanent .
That ’ s why Spector ’ s team used their app @ @ @ @ @ @ @ combination of symptoms was most closely associated with a positive virus test rather than examining any individual symptom .
Using the model , Spector and his team calculated that among the 400,000 app users who self-reported symptoms but did not get a Covid-19 test at all , about 50,000 of them were likely infected with the virus .
“ As this pandemic unfolds , it ’ s becoming very clear that the symptoms of Covid vary quite a lot from person to person ” In places that lack adequate testing , Spector said @ @ @ @ @ @ @ some point serve as an early warning sign of a rising wave of Covid-19 — and allow potentially infected people to take precautions like self-isolation .
And since they found that lost taste and smell can precede other symptoms by weeks , this could give health workers longer lead time to anticipate a spike in hospital visits .
“ We liken it to a radar , ” Spector said .
The research is still in its early stages and may not be suited for making treatment decisions for individual people .
But symptoms @ @ @ @ @ @ @ guidelines that determine who should be tested for Covid-19 or take precautions .
Spector also noted that the data from the app is skewed toward people who say they ’ re between 20 and 60 years old .
Older people who may not typically use smartphones are underrepresented in his data .
So are people in rural areas of the UK ( the app just launched in the United States this week ) .
However , as more people sign up for the app , both those who are sick and those who @ @ @ @ @ @ @ better picture of the pandemic and answer critical questions about the dangers of the virus , who is most at risk , and how best to limit its spread .
Spector is also collaborating with Harvard ’ s Chan and other researchers on the symptom-tracking app .
Chan said that one of the key benefits of widespread symptom tracking is not necessarily finding the specific symptoms but being able to identify a sudden spike in symptoms , whatever they may be .
“ If it ’ s just one person that feels this @ @ @ @ @ @ @ what to make of that , ” he said .
“ But if many people are feeling the same way with subtle symptoms then that is something that ’ s really worth sitting up and taking notice about.
” People transmitting Covid-19 before they have symptoms is a huge public health threat Another complicating factor about Covid-19 is that people can spread the virus before they have symptoms , which can take up to two weeks to appear .
And so people can transmit the disease to others unknowingly .
Some virus spreaders @ @ @ @ @ @ @ entire infection .
According to the CDC ’ s Morbidity and Mortality Weekly Report from April 1 , 2020 , asymptomatic transmission “ increases the challenges of COVID-19 containment measures.
” Tactics like self-isolation or quarantines depend on early detection of potential infections , so without outward signs of illness , they become much less effective at slowing the disease .
It ’ s also still not clear just how many people are out there spreading the virus without noticeable symptoms .
Chan said that it may be the case that many purported @ @ @ @ @ @ @ but that they ’ re so mild that the infected don ’ t connect the dots between their experiences and Covid-19 .
“ There probably are some people who are truly asymptomatic , meaning they have the infection but feel perfectly well , ” Chan said .
“ But there are probably people who have much more subtle symptoms or they may just assume that it ’ s related to something else.
” To find the people transmitting the virus without symptoms , researchers need widespread testing to confirm cases of Covid-19 .
@ @ @ @ @ @ @ active infections , scientists are also looking at serological testing , which can reveal who was previously infected with the virus ( and may now have immunity to it ) .
That information can help scientists see if patients overlooked any other potential signs of infection .
However , this would require public health officials to test more than the critically ill or health workers on the front lines ; they will need far more widespread testing of the population at large to truly start to gain ground against the Covid-19 pandemic .
@ @ @ @ @ @ @ pandemic control measures like social distancing would require a massive coordinated effort to train health workers , to gather data , to trace contacts with the virus , and to manufacture all the equipment necessary .
It would also require the public to remain vigilant about adhering to social distancing guidelines until then and to maintain good hygiene through tactics like proper handwashing .
But right now , the US is still struggling with widespread testing shortages .
There are not enough testing kits to go around , as well as dwindling supplies @ @ @ @ @ @ @ personal protective equipment for workers collecting samples , as well as doctors and nurses .
That means health officials still have to make tough decisions about who to test , and they will likely remain in the dark about the true scope of the pandemic as cases and deaths continue to mount .

Why it can be so hard to tell if you have Covid-19
Share All sharing options for: Why it can be so hard to tell if you have Covid-19
What are the signs you have been infected with the coronavirus? That’s a surprisingly tricky question to answer, and it’s hampering the fight against the disease.
The Centers for Disease Control and Prevention updated its guidelines in late April to include a new loss of taste or smell as a symptom of Covid-19, along with signs such as chills, repeated shaking with chills, muscle pain, sore throat, and headache. That’s in addition to fever, cough, and shortness of breath, considered to be more common.
Some patients infected with SARS-CoV-2, the virus that causes Covid-19, have experienced symptoms like vomiting, rashes, and lesions on toes. Some people’s Covid-19 symptoms overlap with those of other illnesses like influenza, making these infections hard to distinguish without testing. And some infected patients have reported no symptoms at all.
“As this pandemic unfolds, it’s becoming very clear that the symptoms of Covid vary quite a lot from person to person, and there are a lot of symptoms that we previously didn’t appreciate were related to Covid,” said Andrew Chan, a professor of immunology and infectious disease at the Harvard TH Chan School of Public Health. “As a result, it’s really put us behind in our ability to identify people with Covid infections, and probably resulted in a lot of people walking around with Covid and not knowing it.”
Related What to do if you have symptoms of the new coronavirus
That has made responding to the crisis all the more frustrating and confusing for health officials, particularly in the United States, where tests for the virus remain scarce. Symptoms are an outward sign of the illness, and in a pinch can serve as a proxy for a test. Many hospitals are already telling patients with Covid-19 symptoms to presume they have the virus and to self-isolate, not even testing to confirm the presence of the virus.
A cluster of symptoms can highlight an emerging hotspot for the virus within a population. But without a clear picture of how Covid-19 manifests, it’s difficult to even approximate the true extent of the pandemic. And without a sense of what to look for, it’s hard for health workers to take proper precautions and offer the right treatments to their patients.
As a result, many communities have been forced to resort to blunt, blanket, and disruptive measures to contain the pandemic, like shelter-in-place orders. Relaxing these restrictions would require a major effort to test the public for the virus, trace movements, and build up health care capacity with beds, ventilators, masks, and workers. Yet there are parts of the US that are lifting even these crude measures to limit the spread of Covid-19.
Nonetheless, researchers are coming up with new ways to track the virus, going back to patient records to see what signs are associated with the illness. They’re also asking people to self-report their symptoms and tracking them with a mobile app. They’re finding that some mild, easily brushed-off symptoms could actually be a harbinger of the disease. This knowledge could help slow the pandemic and reveal new approaches to fighting the virus.
Some symptoms of the Covid-19 coronavirus are common, but milder signs are hard to track
Many of the guidelines for Covid-19 symptoms are based on what scientists have learned from past cases, particularly China, where the virus emerged and spread rapidly in January and February. The World Health Organization, for instance, looked at more than 55,000 confirmed Covid-19 cases in China. They found in February that the most common symptoms were fever (87.9 percent of confirmed cases) and dry cough (67.7 percent) — followed by fatigue (38.1 percent), sputum [phlegm] production (33.4 percent), shortness of breath (18.6 percent), sore throat (13.9 percent), and headache (13.6 percent).
But the patients they looked at weren’t necessarily representative of everybody who had the virus there — just the ones who received testing and treatment. In the study, about 80 percent of the patients had mild to moderate disease, 13.8 percent had severe disease, and 6.1 percent were in critical condition.
It’s likely that many infected patients with very minor or no symptoms were not captured by the study, which would mean their symptoms (or lack thereof) were underrepresented in those statistics.
Other studies have shown that symptoms such as gastrointestinal problems could herald the illness. A preliminary non-peer-reviewed study of 204 patients in China found that more than half of them experienced symptoms like diarrhea, vomiting, and abdominal pain.
Another preliminary study, this time from Germany, found that some Covid-19 patients had symptoms more like that of the common cold, like a runny nose. Researchers in Italy also reported that feelings of discomfort and malaise were associated with Covid-19. And doctors in the US have described neurological symptoms like confusion and seizures in some Covid-19 patients, particularly in the elderly.
These vague and sometimes contradictory symptoms may reflect how the virus interacts with underlying conditions in some patients, like diabetes and high blood pressure, or just differences in susceptibility. This kind of variation is a phenomenon physicians have already seen in other infections.
“For example, for influenza, most people will show up with fevers, body aches, and malaise. But a smaller subset of people will show up with diarrhea and vomiting,” said David Pride, associate director of microbiology at the University of California San Diego, in an email. “What we are experiencing with Covid-19 is probably just mirroring what we see in a number of other illnesses where it affects a subset of people in different ways.”
There’s also a huge range in how severe Covid-19 can be, even within certain subgroups. There are elderly patients who have shrugged off the virus. There are children that have died from it.
Many of these reports of less-common symptoms still need wider validation before they can be used as clinical guidelines. But they illustrate just how confusing it can be for patients and doctors to track Covid-19 without adequate testing.
A smartphone app has uncovered another likely symptom of Covid-19: A loss of taste and smell
Before the CDC’s guidance changed, there were murmurs that anosmia, a loss of the sense of smell, and ageusia, a loss of the sense of taste, could signal a Covid-19 infection. Utah Jazz player Rudy Gobert, who tested positive for the virus, said on Twitter that it was one of his most noticeable symptoms. The son of UK sports broadcaster Gary Lineker quaffed vinegar and lemon juice on Instagram to show off his loss of taste after getting Covid-19.
Doctors at the British Rhinological Society said in March they noticed “a rapidly growing number of reports of a significant increase in the number of patients presenting with anosmia in the absence of other symptoms.” Writing in the BMJ, researchers at Newcastle University said, “[T]here is now enough evidence to take this symptom much more seriously.”
Researchers in the United Kingdom and the United States recently bolstered that idea with data. Using a Covid symptom tracker app for smartphones launched on March 24, scientists have pooled daily reports from more than 2.6 million users (2.45 million in the UK and 168,000 in the US) of their symptoms or lack thereof. In a May 11 paper in the journal Nature Medicine, they found that a peculiar loss of taste or smell had strong links to testing positive for Covid-19.
“The strongest association between any of those symptoms and having a positive test was having a loss of smell or taste,” said Tim Spector, a professor of molecular epidemiology at King’s College London who coauthored the study with Harvard’s Andrew Chan.
In the study, 7,178 app users reported testing positive for Covid-19. And 65 percent of those said they lost their sense of smell or taste. That’s a higher rate than the Covid-19-positive app users reported for fever or any other symptoms.
The likely mechanism here has to do with how the SARS-CoV-2 virus works. Researchers in the US and UK reported in a preliminary study that the virus attacks cells associated with smell in nasal passages, in both mice and humans. That “could lead to anosmia or other forms of olfactory dysfunction,” the researchers wrote.
Spector cautioned that being unable to taste your coffee or smell wildflowers is not a definitive sign of Covid-19. A loss of taste and smell is associated with other upper respiratory tract infections as well as some allergies. In most cases, the loss of these senses isn’t permanent.
That’s why Spector’s team used their app data to build a model of what combination of symptoms was most closely associated with a positive virus test rather than examining any individual symptom.
Using the model, Spector and his team calculated that among the 800,000 app users who self-reported symptoms but did not get a Covid-19 test at all, about 140,000, or 17.5 percent, of them were likely infected with the virus.
“As this pandemic unfolds, it’s becoming very clear that the symptoms of Covid vary quite a lot from person to person”
In places that lack adequate testing, Spector said this kind of symptom tracking could at some point serve as an early warning sign of a rising wave of Covid-19 — and allow potentially infected people to take precautions like self-isolation. And since they found that lost taste and smell can precede other symptoms by weeks, this could give health workers longer lead time to anticipate a spike in hospital visits. “We liken it to a radar,” Spector said.
The research may not be suited for making treatment decisions for individual people. But symptoms like anosmia could be added to guidelines that determine who should be tested for Covid-19 or take precautions.
Spector also noted that the data from the app is skewed toward people who say they’re between 20 and 60 years old. Older people who may not typically use smartphones are underrepresented in his data. So are people in rural areas.
However, as more people sign up for the app, both those who are sick and those who are well, researchers can get a better picture of the pandemic and answer critical questions about the dangers of the virus, who is most at risk, and how best to limit its spread.
Chan said that one of the key benefits of widespread symptom tracking is not necessarily finding the specific symptoms but being able to identify a sudden spike in symptoms, whatever they may be.
“If it’s just one person that feels this way, we don’t know what to make of that,” he said. “But if many people are feeling the same way with subtle symptoms then that is something that’s really worth sitting up and taking notice about.”
People transmitting Covid-19 before they have symptoms is a huge public health threat
Another complicating factor about Covid-19 is that people can spread the virus before they have symptoms, which can take up to two weeks to appear. And so people can transmit the disease to others unknowingly. Some virus spreaders may not ever feel sick throughout their entire infection.
According to the CDC’s Morbidity and Mortality Weekly Report from April 1, asymptomatic transmission “increases the challenges of COVID-19 containment measures.” Tactics like self-isolation or quarantines depend on early detection of potential infections, so without outward signs of illness, they become much less effective at slowing the disease.
It’s also still not clear just how many people are out there spreading the virus without noticeable symptoms. Chan said that it may be the case that many purported asymptomatic transmitters do actually have some symptoms but that they’re so mild that the infected don’t connect the dots between their experiences and Covid-19.
“There probably are some people who are truly asymptomatic, meaning they have the infection but feel perfectly well,” Chan said. “But there are probably people who have much more subtle symptoms or they may just assume that it’s related to something else.”
To find the people transmitting the virus without symptoms, researchers need widespread testing to confirm cases of Covid-19. Beyond the current genetic test that identifies active infections, scientists are also looking at serological testing, which can reveal who was previously infected with the virus (and may now have immunity to it). That information can help scientists see if patients overlooked any other potential signs of infection.
However, this would require public health officials to test more than the critically ill or health workers on the front lines; they will need far more widespread testing of the population at large to truly start to gain ground against the Covid-19 pandemic.
In addition to testing, safely lifting pandemic control measures like social distancing would require a massive coordinated effort to train health workers, to gather data, to trace contacts with the virus, and to manufacture all the equipment necessary. It would also require the public to remain vigilant about adhering to social distancing guidelines until then and to maintain good hygiene through tactics like proper handwashing.
But right now, the US is still struggling with widespread testing shortages. There are not enough testing kits to go around, as well as dwindling supplies of masks, gowns, and other personal protective equipment for workers collecting samples, as well as doctors and nurses.
That means health officials still have to make tough decisions about who to test, and they will likely remain in the dark about the true scope of the pandemic as cases and deaths continue to mount.


vox--2020-04-29--What to do if you have symptoms of the new coronavirus

Update , April 29 : The CDC has updated its guidelines to include chills , muscle pain , sore throat , headache , and a new loss of taste or smell as symptoms of Covid-19 , in addition to fever , cough , and shortness of breath .
So you ’ re not feeling well , and you ’ re afraid you might be infected with the new coronavirus disease , Covid-19 .
Given that the United States now has more confirmed cases than any other country , and more are popping up , that might be a reasonable suspicion @ @ @ @ @ @ @ response measures , advising people to stay at home as much as possible .
Several states and cities have now imposed more severe measures like lockdowns and stay-at-home-orders to contain the virus .
But cases of Covid-19 are following an exponential growth trajectory in the US .
That means that the number of infections is rising rapidly in proportion to the number of people infected .
You may have been exposed if you have traveled to a region with novel coronavirus transmission or if you ’ ve been in close contact with someone @ @ @ @ @ @ @ s becoming harder to avoid without social distancing .
And some people spreading the virus may not show any symptoms at all .
Here are some signs you may have the illness : The World Health Organization , based on its research in China , reports the illness can present in different ways , ranging from no symptoms at all to severe pneumonia .
Some symptoms are more frequently seen than others .
Based on confirmed cases in China , the WHO says 88 percent of infected people experienced a fever and 67.7 @ @ @ @ @ @ @ frequent symptoms include thick mucus from coughs ( sputum ) ( 33.4 percent ) , shortness of breath ( 18.6 percent ) , sore throat ( 13.9 percent ) , and headache ( 13.6 percent ) .
It ’ s likely , however , that many infected patients with very minor or no symptoms were not captured by this study , which would mean their symptoms ( or lack thereof ) were underrepresented in those statistics .
“ Covid-19 disease usually begins with mild fever , dry cough , sore throat and malaise @ @ @ @ @ @ @ professor of epidemiology at Harvard Medical School , in an FAQ for the Abundance Foundation .
“ Unlike the coronavirus infections that cause the common cold , it is not usually associated with a runny nose.
” These symptoms emerge five or six days after infection on average , but can show up in as little as a day or as much as two weeks after exposure .
Doctors and researchers have also found some other symptoms associated with Covid-19 , though they haven ’ t been recognized as diagnostic criteria by the @ @ @ @ @ @ @ and Prevention .
A recent , yet-to-be-published German study found that some Covid-19 patients can present with the symptoms of an upper respiratory tract infection , similar to the common cold : runny nose , congestion , and sneezing .
( The study involved a very small number of patients , however . )
In a study of 204 Covid-19 patients , researchers in China found that half of patients experienced gastrointestinal symptoms , including diarrhea , vomiting , and abdominal pain .
The American Academy of Ophthalmology reported that Covid-19 can present @ @ @ @ @ @ @ , itchy eyes .
Using a Covid symptom tracker app for smartphones , researchers in the United Kingdom recently found that a peculiar loss of taste or smell had strong links to testing positive for Covid-19 .
Some researchers now say that anosmia , a loss of the sense of smell , and ageusia , a loss of the sense of taste , should be considered Covid-19 symptoms .
These symptoms can precede others by several days so they can be an early warning sign of infection .
If you have symptoms , @ @ @ @ @ @ @ advises people to seek medical attention immediately if they have trouble breathing or emergency warning signs like persistent chest pain , confusion , and bluish lips .
People with symptoms in one of the high-risk groups — those who are over 65 years old ; people with diabetes , hypertension , or preexisting breathing problems ; or people being treated for cancer — should quickly seek medical advice or treatment .
Call your health care provider before heading to a clinic if you suspect you may have Covid-19 .
That way , the @ @ @ @ @ @ @ visit .
If you ’ re not in a high-risk group and have symptoms , mild or severe , you should also call a health professional — a doctor , a nurse , or a public health official .
They will work with your local health department and figure out whether you need to get tested or get treatment .
And make no mistake : While older people face the highest risks , all age groups can get sick from Covid-19 , so everyone needs to take precautions and pay attention to their @ @ @ @ @ @ @ not to go to the emergency room if your symptoms do not appear to be life-threatening .
Also , don ’ t panic .
Most people who get infected get better , often on their own with just rest , fluids , and fever medication .
If you are advised to stay home , there are several other measures you should take , according to the CDC .
The most important step is to avoid exposing other people to the illness , especially in the early stages of symptoms , when the disease @ @ @ @ @ @ @ home from school or work , avoiding public transit or ride-hail services , and separating yourself from the people and animals in your home .
It also means avoiding sharing household items like towels , dishes , and bedding .
Cover your coughs and sneezes with a tissue over your mouth and nose .
Wash your hands often with soap and water for at least 20 seconds .
Clean the surfaces in your home that you come into contact with regularly , like counters , doorknobs , bedside tables , keyboards , and @ @ @ @ @ @ @ some of the viral particles ... end up on surfaces ( door handles , subway poles , coins ) where they might remain viable , ” Murray writes .
When leaving your home , wear a surgical face mask if possible to avoid spreading the virus if you ’ re sick .
Officials are urging the public not to buy N95 masks because they are needed by health workers and are in short supply .
But other face coverings can be used , and the CDC has recommended cloth masks for everyone in @ @ @ @ @ @ @ , pay close attention to your symptoms .
Call your health care provider if your symptoms get worse .
If you have a health emergency and need to call 911 , let the dispatcher know that you may have Covid-19 so responders can prepare .
And everyone , with or without symptoms , should observe social distancing guidelines .
That ’ s because infected people can spread the virus to others , even without experiencing symptoms themselves .
These steps may seem tedious , but remember that they serve to protect not just @ @ @ @ @ @ @ .
Controlling an outbreak is everyone ’ s job .
Every day at Vox , we aim to answer your most important questions and provide you , and our audience around the world , with information that has the power to save lives .
Our mission has never been more vital than it is in this moment : to empower you through understanding .
Vox ’ s work is reaching more people than ever , but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn @ @ @ @ @ @ @ a donation , but it will enable our staff to continue to offer free articles , videos , and podcasts at the quality and volume that this moment requires .
Please consider making a contribution to Vox today .

Update, April 29: The CDC has updated its guidelines to include chills, muscle pain, sore throat, headache, and a new loss of taste or smell as symptoms of Covid-19, in addition to fever, cough, and shortness of breath.
So you’re not feeling well, and you’re afraid you might be infected with the new coronavirus disease, Covid-19. Given that the United States now has more confirmed cases than any other country, and more are popping up, that might be a reasonable suspicion.
Health officials are ramping up the response measures, advising people to stay at home as much as possible. Several states and cities have now imposed more severe measures like lockdowns and stay-at-home-orders to contain the virus.
But cases of Covid-19 are following an exponential growth trajectory in the US. That means that the number of infections is rising rapidly in proportion to the number of people infected. You may have been exposed if you have traveled to a region with novel coronavirus transmission or if you’ve been in close contact with someone who has Covid-19, something that’s becoming harder to avoid without social distancing. And some people spreading the virus may not show any symptoms at all.
Here are some signs you may have the illness:
The World Health Organization, based on its research in China, reports the illness can present in different ways, ranging from no symptoms at all to severe pneumonia.
Some symptoms are more frequently seen than others. Based on confirmed cases in China, the WHO says 88 percent of infected people experienced a fever and 67.7 percent had a dry cough. Less frequent symptoms include thick mucus from coughs (sputum) (33.4 percent), shortness of breath (18.6 percent), sore throat (13.9 percent), and headache (13.6 percent).
It’s likely, however, that many infected patients with very minor or no symptoms were not captured by this study, which would mean their symptoms (or lack thereof) were underrepresented in those statistics.
“Covid-19 disease usually begins with mild fever, dry cough, sore throat and malaise,” writes Megan Murray, a professor of epidemiology at Harvard Medical School, in an FAQ for the Abundance Foundation. “Unlike the coronavirus infections that cause the common cold, it is not usually associated with a runny nose.”
These symptoms emerge five or six days after infection on average, but can show up in as little as a day or as much as two weeks after exposure.
Doctors and researchers have also found some other symptoms associated with Covid-19, though they haven’t been recognized as diagnostic criteria by the WHO or the Centers for Disease Control and Prevention.
A recent, yet-to-be-published German study found that some Covid-19 patients can present with the symptoms of an upper respiratory tract infection, similar to the common cold: runny nose, congestion, and sneezing. (The study involved a very small number of patients, however.)
In a study of 204 Covid-19 patients, researchers in China found that half of patients experienced gastrointestinal symptoms, including diarrhea, vomiting, and abdominal pain.
The American Academy of Ophthalmology reported that Covid-19 can present as conjunctivitis, causing red or pink, itchy eyes.
Using a Covid symptom tracker app for smartphones, researchers in the United Kingdom recently found that a peculiar loss of taste or smell had strong links to testing positive for Covid-19. Some researchers now say that anosmia, a loss of the sense of smell, and ageusia, a loss of the sense of taste, should be considered Covid-19 symptoms. These symptoms can precede others by several days so they can be an early warning sign of infection.
If you have symptoms, what should you do?
The CDC advises people to seek medical attention immediately if they have trouble breathing or emergency warning signs like persistent chest pain, confusion, and bluish lips.
People with symptoms in one of the high-risk groups — those who are over 65 years old; people with diabetes, hypertension, or preexisting breathing problems; or people being treated for cancer — should quickly seek medical advice or treatment. Call your health care provider before heading to a clinic if you suspect you may have Covid-19. That way, the clinic can take appropriate precautions for your visit.
If you’re not in a high-risk group and have symptoms, mild or severe, you should also call a health professional — a doctor, a nurse, or a public health official. They will work with your local health department and figure out whether you need to get tested or get treatment. And make no mistake: While older people face the highest risks, all age groups can get sick from Covid-19, so everyone needs to take precautions and pay attention to their symptoms.
Doctors and health officials advise not to go to the emergency room if your symptoms do not appear to be life-threatening.
Also, don’t panic. Most people who get infected get better, often on their own with just rest, fluids, and fever medication. If you are advised to stay home, there are several other measures you should take, according to the CDC.
The most important step is to avoid exposing other people to the illness, especially in the early stages of symptoms, when the disease is most contagious. That means staying home from school or work, avoiding public transit or ride-hail services, and separating yourself from the people and animals in your home. It also means avoiding sharing household items like towels, dishes, and bedding.
Cover your coughs and sneezes with a tissue over your mouth and nose. Wash your hands often with soap and water for at least 20 seconds. Clean the surfaces in your home that you come into contact with regularly, like counters, doorknobs, bedside tables, keyboards, and phones. “It is possible that some of the viral particles ... end up on surfaces (door handles, subway poles, coins) where they might remain viable,” Murray writes.
When leaving your home, wear a surgical face mask if possible to avoid spreading the virus if you’re sick. Officials are urging the public not to buy N95 masks because they are needed by health workers and are in short supply. But other face coverings can be used, and the CDC has recommended cloth masks for everyone in certain public settings.
All the while, pay close attention to your symptoms. Call your health care provider if your symptoms get worse. If you have a health emergency and need to call 911, let the dispatcher know that you may have Covid-19 so responders can prepare.
And everyone, with or without symptoms, should observe social distancing guidelines. That’s because infected people can spread the virus to others, even without experiencing symptoms themselves.
These steps may seem tedious, but remember that they serve to protect not just you but also the people around you. Controlling an outbreak is everyone’s job.
lease consider making a contribution to Vox today.


vox--2020-04-29--Book recommendations for when you want to change your perspective but can’t travel

Welcome to the latest installment of Vox ’ s Ask a Book Critic , in which I , Vox book critic Constance Grady , provide book recommendations to suit your very specific mood : either how you ’ re feeling right now , or how you ’ d like to be feeling instead .
I ’ ve been slowly easing myself back into work reading , which is always fun , but it also means I rarely get to choose my book by mood .
These are the downsides of getting to read for a living : You might be @ @ @ @ @ @ @ instead find yourself frantically binge-reading a political thriller about a pandemic .
But you , gentle reader , are under no such obligation .
You can choose to read whatever you see fit .
And I ’ m here to make sure you find your way to the book that suits you best .
Let ’ s go .
The recommendation requests below , submitted to me via email and on Twitter , have been edited for length and clarity .
I ’ m looking for a book about an adventure at sea @ @ @ @ @ @ @ It would be awesome if it ’ s queer as well , but it doesn ’ t have to be .
The Lady ’ s Guide to Petticoats and Piracy by Mackenzi Lee is just what you need — pirates , magic , ace heroine exploring the question of whether she might be homoromantic , lots of adventure , and discussion of different modes of femininity .
It ’ s technically a sequel , but it can stand on its own , and the banter is so much fun .
Since I can @ @ @ @ @ @ @ want to experience the world through my reading .
In particular , I want a book that opens my eyes and changes the way I see the world .
Try Freshwater by Akwaeke Emezi , a semi-autobiographical debut novel from a genderqueer Nigerian author .
The main character , Ada , is ogbanje , the term in Igbo cosmology for a child who holds an evil spirit in her body and is born to plague her mother by dying .
The ogbanje narrates most of the book as Ada struggles with depression and @ @ @ @ @ @ @ voice Emezi creates for them is just electric .
I have found myself revisiting some of my old favorites from Dickens .
I ’ d love an author that can introduce me to characters ( dare I call them friends ? )
in our own age .
Donna Tartt is the author people usually call our modern-day Dickens , but I don ’ t know if she ’ s what you ’ re looking for ; her characters are a little darker than Dickens ’ s usually are .
Instead , you might @ @ @ @ @ @ @ .
It ’ s a multi-generational novel about a Korean family that immigrates to Japan just before World War II , and it heavily references both A Tale of Two Cities and Great Expectations .
It ’ s a very rich book , with beautifully drawn and specific characters .
If I were looking for a crossroads of Kelly Link ’ s uncanny slipstream wit , Angela Carter ’ s delicious diction , and Boccaccio ’ s layered narratives , where would I turn ?
Ooh , a tall order !
You might @ @ @ @ @ @ @ elegant and twisty stories that often riff off folklore .
I ’ d start with Mr. Fox for her , and then move to either Boy Snow Bird or the short stories in What Is Yours Is Not Yours .
Also check out Carmen Maria Machado ’ s story collection , Her Body and Other Parties , which is very modern-day Angela Carter .
Finally , try Mary Toft ; Or , the Rabbit Queen by Dexter Palmer .
It ’ s based on a true story about a woman in 18th-century England @ @ @ @ @ @ @ rabbit , and Kelly Link gave it a nice blurb .
Because life is so strange right now , I ’ ve found myself drawn to books in which ridiculous things happen , but the author tells it straight .
I ’ m looking for books with manic , maybe delusional but nonetheless weirdly life-affirming energy , rather than the dark grimness we usually associate with absurdism .
Fun and tricky !
Okay , let ’ s see what we can do here .
I think Nell Zink might be your girl , @ @ @ @ @ @ @ an extremely deadpan voice , and when ridiculous things happen in her books , she always tells it straight .
Lincoln in the Bardo is not exactly absurdist , but it has elements of absurdism ( a ghost with a permanent erection ) , and it ’ s got a lovely affirmational ending .
If you ’ d like me to recommend a book for you , email me at constance.grady @ vox.com with the subject line “ Ask a Book Critic.
” The more specific your mood , the better !
Every @ @ @ @ @ @ @ answer your most important questions and provide you , and our audience around the world , with information that has the power to save lives .
Our mission has never been more vital than it is in this moment : to empower you through understanding .
Vox ’ s work is reaching more people than ever , but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn .
Your financial contribution will not constitute a donation , but it will enable our staff to continue @ @ @ @ @ @ @ and podcasts at the quality and volume that this moment requires .
Please consider making a contribution to Vox today .

Welcome to the latest installment of Vox’s Ask a Book Critic, in which I, Vox book critic Constance Grady, provide book recommendations to suit your very specific mood: either how you’re feeling right now, or how you’d like to be feeling instead.
I’ve been slowly easing myself back into work reading, which is always fun, but it also means I rarely get to choose my book by mood. These are the downsides of getting to read for a living: You might be craving something about complicated female friendships but instead find yourself frantically binge-reading a political thriller about a pandemic.
But you, gentle reader, are under no such obligation. You can choose to read whatever you see fit. And I’m here to make sure you find your way to the book that suits you best. Let’s go.
The recommendation requests below, submitted to me via email and on Twitter, have been edited for length and clarity.
I’m looking for a book about an adventure at sea, preferably something sci-fi or fantasy. It would be awesome if it’s queer as well, but it doesn’t have to be.
The Lady’s Guide to Petticoats and Piracy by Mackenzi Lee is just what you need — pirates, magic, ace heroine exploring the question of whether she might be homoromantic, lots of adventure, and discussion of different modes of femininity. It’s technically a sequel, but it can stand on its own, and the banter is so much fun.
Since I can’t travel right now, I want to experience the world through my reading. In particular, I want a book that opens my eyes and changes the way I see the world.
Try Freshwater by Akwaeke Emezi, a semi-autobiographical debut novel from a genderqueer Nigerian author. The main character, Ada, is ogbanje, the term in Igbo cosmology for a child who holds an evil spirit in her body and is born to plague her mother by dying. The ogbanje narrates most of the book as Ada struggles with depression and her gender identity experience, and the voice Emezi creates for them is just electric.
Related Freshwater is an electric debut novel from a major new talent
I have found myself revisiting some of my old favorites from Dickens. I’d love an author that can introduce me to characters (dare I call them friends?) in our own age.
Donna Tartt is the author people usually call our modern-day Dickens, but I don’t know if she’s what you’re looking for; her characters are a little darker than Dickens’s usually are. Instead, you might like Pachinko, by Min Jin Lee. It’s a multi-generational novel about a Korean family that immigrates to Japan just before World War II, and it heavily references both A Tale of Two Cities and Great Expectations. It’s a very rich book, with beautifully drawn and specific characters.
If I were looking for a crossroads of Kelly Link’s uncanny slipstream wit, Angela Carter’s delicious diction, and Boccaccio’s layered narratives, where would I turn?
Ooh, a tall order! You might like Helen Oyeyemi, who writes very elegant and twisty stories that often riff off folklore. I’d start with Mr. Fox for her, and then move to either Boy Snow Bird or the short stories in What Is Yours Is Not Yours. Also check out Carmen Maria Machado’s story collection, Her Body and Other Parties, which is very modern-day Angela Carter. Finally, try Mary Toft; Or, the Rabbit Queen by Dexter Palmer. It’s based on a true story about a woman in 18th-century England said to have given birth to a rabbit, and Kelly Link gave it a nice blurb.
Because life is so strange right now, I’ve found myself drawn to books in which ridiculous things happen, but the author tells it straight. I’m looking for books with manic, maybe delusional but nonetheless weirdly life-affirming energy, rather than the dark grimness we usually associate with absurdism.
Fun and tricky! Okay, let’s see what we can do here.
I think Nell Zink might be your girl, maybe starting with Nicotine. Zink has an extremely deadpan voice, and when ridiculous things happen in her books, she always tells it straight. Lincoln in the Bardo is not exactly absurdist, but it has elements of absurdism (a ghost with a permanent erection), and it’s got a lovely affirmational ending.
If you’d like me to recommend a book for you, email me at constance.grady@vox.com with the subject line “Ask a Book Critic.” The more specific your mood, the better!


vox--2020-04-29--Lawrence Wright’s new pandemic thriller is infuriating to read

Almost any novel about a pandemic would feel unnervingly prescient right now .
But the new thriller The End of October , by Lawrence Wright , feels more prescient than most .
Wright is a writer for the New Yorker who won a Pulitzer for his 2007 nonfiction book The Looming Tower : Al Qaeda and the Road to 9/11 .
In The End of October , out this week , he puts his reporting background to use as he imagines what would happen if a novel virus were to spread across the globe .
And the scenario he conjures @ @ @ @ @ @ @ ’ re currently living through .
The End of October is not a good book if we ’ re talking about sheer storytelling craft .
The plot hums along ably enough , but the characters are flat , the women exist mostly to be sexually assaulted and/or die , and the prose is workmanlike at best .
You ’ re not reading this book to experience a beautiful work of art .
Under normal circumstances , it would be an airport thriller , the kind of book you buy on a whim when @ @ @ @ @ @ @ the plane when you ’ re done .
But under our particular circumstances , in which I deeply hope you are not engaging in any kind of nonessential travel whatsoever , things are different .
What makes The End of October compelling to read right now is that Wright researched the hell out of what kind of infrastructure the US would need to survive a pandemic .
He concluded that we did not have it .
And then he drew on his formidable knowledge of domestic and international politics to imagine what would @ @ @ @ @ @ @ reality .
In The End of October , social distancing helps stave off the worst of a pandemic .
Then social distancing ends and things get really bad .
The second time I put down The End of October and said , “ Oh god , too soon , ” was when Wright ’ s unresponsive president — never named — puts his callow vice president in charge of the pandemic response team .
The pandemic in this case is the result of a novel influenza virus , one quickly dubbed the Kongoli @ @ @ @ @ @ @ ’ s new guidelines against naming illnesses after places haven ’ t filtered through to the world of this book . )
It ’ s a hemorrhagic fever that first emerges in an Indonesian refugee camp among a group of immunocompromised HIV-positive refugees .
But when Wright ’ s hero , a WHO microbiologist named Henry Parsons , visits the camp to investigate the new disease , he accidentally exposes his driver to infection .
And the infected driver , carrying the disease asymptomatically , proceeds to make the pilgrimage to Mecca .
@ @ @ @ @ @ @ realized the danger he was in only too late , manages to talk Saudi Arabian officials into putting Mecca under quarantine , but not for long .
Plus , he knows he ’ s only buying time for scientists to begin planning a global crisis response , anyway : The disease is carried by birds , which means it will inevitably spread across the world .
Meanwhile , the quarantine in Mecca inflames existing global tensions .
Iran attacks Saudia Arabia , claiming that it is holding Iranian citizens without cause .
Russia @ @ @ @ @ @ @ to begin a proxy war , with each superpower blaming the other for the spread of the virus .
In strategic meetings , White House officials dismiss the virus as a distraction .
It may or may not ever reach the US , they reason , but the threat of war with Russia is absolutely concrete .
The first time I put down the book and said , “ Oh god , too soon , ” came during one of those early strategic meetings .
A public health service officer is trying to @ @ @ @ @ @ @ Committee exactly why they should be worried about a pandemic .
First , she says , there ’ s the issue of the timeline .
“ With luck on our side , we could have an experimental vaccine for small-scale testing in six months , ” the officer says .
“ This all takes time , especially scaling up to millions of doses .
But we don ’ t have time.
” The virus is already spreading , and it will arrive in the US well before a vaccine will be ready .
@ @ @ @ @ @ @ grow “ very impatient ” with this lecture .
“ We don ’ t really need a lesson on flu , ” she observes .
She wants to talk about war with Russia .
But it isn ’ t a normal flu , the public health officer explains .
There ’ s no immunity within the general population .
Unless the government takes urgent measures , nearly everyone will catch it .
And many of them will die .
Moreover , once news of the pandemic gets out , there will be the @ @ @ @ @ @ @ There will be runs on the stores , ” the public health officer says .
“ Pharmaceuticals , groceries , batteries , gas , guns , you name it .
Hospitals will be overwhelmed , not just with sick people but with the worried well.
” It would be best , she concludes , if the population could just be encouraged to shelter in place : “ borders closed , sports and entertainment facilities shuttered , nonemergency cases discharged from hospitals , schools closed , public meetings postponed , and the government shut @ @ @ @ @ @ @ my Kindle screen and strangle them .
Despite misgivings from government officials , the US does eventually begin to implement social distancing measures , with stores and other businesses shutting their doors .
And those measures are successful .
The virus is quickly contained .
Not that many people die : The death toll is “ within the parameters , ” Lawrence writes , “ of what people thought was an ordinary flu season.
” And so , responding to mounting political pressure to “ let the economy breathe , ” the US @ @ @ @ @ @ @ when things get really bad .
Hospitals run out of ventilators , along with masks , gloves , and diagnostic test kits .
India and China are no longer able to produce essential medicines because they are fighting the pandemic within their own borders , and the US has no stockpiles of those medicines .
The fabric of society begins to crumple .
The CDC predicts that another wave of the disease will arrive within six months , by the end of October .
The End of October is a pulpy book .
@ @ @ @ @ @ @ At this point in the book , things also start to get pulpy .
Or , to put it more accurately , the part of The End of October ’ s already-pulpy plot that has not ended up unexpectedly coming true starts to make itself known .
Russia takes advantage of the global mayhem to attack the US ’ s infrastructure , knocking out the electric grid .
And the mounting conspiracy theory that the virus was manmade turns out to have some truth to it .
But even this plot twist has @ @ @ @ @ @ @ .
One of Wright ’ s major suspects for the question of who designed the virus turns out to be a team of ecofascists , and their rhetoric about how it is the rest of the world that must be saved from human beings is awfully close to the “ we are the virus ” meme that ’ s all over the internet in the real world .
As I read The End of October , I found myself resenting it .
It was such a silly potboiler of a novel , with @ @ @ @ @ @ @ , such infuriatingly clumsy dialogue .
How dare the world in which I am actually living so closely resemble a fucking airport thriller ?
Wright is undoubtedly a gifted reporter and observer of the world , and the fact that he was able to so clearly see where the existing fault lines in our social fabric lay and how they could be exacerbated by a pandemic shows real skill on his part .
But the fact that Wright got so many of his details overwhelmingly right is also a reminder that this pandemic @ @ @ @ @ @ @ It was not difficult to predict .
It was , in fact , something that we were told was coming over and over again , something that the people we elected to protect us from such a pandemic chose to willfully ignore .
This pandemic should not have caught us off our guard .
It should have been as easy to see coming as the final twist in a cheap thriller .
Every day at Vox , we aim to answer your most important questions and provide you , and our audience around @ @ @ @ @ @ @ the power to save lives .
Our mission has never been more vital than it is in this moment : to empower you through understanding .
Vox ’ s work is reaching more people than ever , but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn .
Your financial contribution will not constitute a donation , but it will enable our staff to continue to offer free articles , videos , and podcasts at the quality and volume that this moment requires .
Please @ @ @ @ @ @ @ .

Almost any novel about a pandemic would feel unnervingly prescient right now. But the new thriller The End of October, by Lawrence Wright, feels more prescient than most.
Wright is a writer for the New Yorker who won a Pulitzer for his 2007 nonfiction book The Looming Tower: Al Qaeda and the Road to 9/11. In The End of October, out this week, he puts his reporting background to use as he imagines what would happen if a novel virus were to spread across the globe. And the scenario he conjures is eerily close to the one we’re currently living through.
The End of October is not a good book if we’re talking about sheer storytelling craft. The plot hums along ably enough, but the characters are flat, the women exist mostly to be sexually assaulted and/or die, and the prose is workmanlike at best. You’re not reading this book to experience a beautiful work of art.
Under normal circumstances, it would be an airport thriller, the kind of book you buy on a whim when your flight is delayed and leave on the plane when you’re done. But under our particular circumstances, in which I deeply hope you are not engaging in any kind of nonessential travel whatsoever, things are different.
What makes The End of October compelling to read right now is that Wright researched the hell out of what kind of infrastructure the US would need to survive a pandemic. He concluded that we did not have it. And then he drew on his formidable knowledge of domestic and international politics to imagine what would ensue.
He got disconcertingly close to reality.
In The End of October, social distancing helps stave off the worst of a pandemic. Then social distancing ends and things get really bad.
The second time I put down The End of October and said, “Oh god, too soon,” was when Wright’s unresponsive president — never named — puts his callow vice president in charge of the pandemic response team.
The pandemic in this case is the result of a novel influenza virus, one quickly dubbed the Kongoli flu. (The World Health Organization’s new guidelines against naming illnesses after places haven’t filtered through to the world of this book.) It’s a hemorrhagic fever that first emerges in an Indonesian refugee camp among a group of immunocompromised HIV-positive refugees. But when Wright’s hero, a WHO microbiologist named Henry Parsons, visits the camp to investigate the new disease, he accidentally exposes his driver to infection. And the infected driver, carrying the disease asymptomatically, proceeds to make the pilgrimage to Mecca.
The driver dies. Henry manages to talk Saudi Arabian officials into putting Mecca under quarantine, but not for long. Plus, he knows he’s only buying time for scientists to begin planning a global crisis response, anyway: The disease is carried by birds, which means it will inevitably spread across the world.
Rating: 3 out of 5 vox-mark vox-mark vox-mark vox-mark vox-mark
Meanwhile, the quarantine in Mecca inflames existing global tensions. Iran attacks Saudi Arabia, claiming that it is holding Iranian citizens without cause. Russia and the US use the ensuing conflict to begin a proxy war, with each superpower blaming the other for the spread of the virus. In strategic meetings, White House officials dismiss the virus as a distraction. It may or may not ever reach the US, they reason, but the threat of war with Russia is absolutely concrete.
The first time I put down the book and said, “Oh god, too soon,” came during one of those early strategic meetings. A public health service officer is trying to explain to the National Security Council Deputies Committee exactly why they should be worried about a pandemic.
First, she says, there’s the issue of the timeline. “With luck on our side, we could have an experimental vaccine for small-scale testing in six months,” the officer says. “This all takes time, especially scaling up to millions of doses. But we don’t have time.” The virus is already spreading, and it will arrive in the US well before a vaccine will be ready.
The deputy secretary of state begins to grow “very impatient” with this lecture. “We don’t really need a lesson on flu,” she observes. She wants to talk about war with Russia.
But it isn’t a normal flu, the public health officer explains. There’s no immunity within the general population. Unless the government takes urgent measures, nearly everyone will catch it. And many of them will die.
Moreover, once news of the pandemic gets out, there will be the problem of managing public fear. “There will be runs on the stores,” the public health officer says. “Pharmaceuticals, groceries, batteries, gas, guns, you name it. Hospitals will be overwhelmed, not just with sick people but with the worried well.”
It would be best, she concludes, if the population could just be encouraged to shelter in place: “borders closed, sports and entertainment facilities shuttered, nonemergency cases discharged from hospitals, schools closed, public meetings postponed, and the government shut down.”
In response, “The deputies simply stared at her.”
I wanted to reach through my Kindle screen and strangle them.
Despite misgivings from government officials, the US does eventually begin to implement social distancing measures, with stores and other businesses shutting their doors. And those measures are successful. The virus is quickly contained. Not that many people die: The death toll is “within the parameters,” Lawrence writes, “of what people thought was an ordinary flu season.” And so, responding to mounting political pressure to “let the economy breathe,” the US drops its measures. That’s when things get really bad.
Hospitals run out of ventilators, along with masks, gloves, and diagnostic test kits. India and China are no longer able to produce essential medicines because they are fighting the pandemic within their own borders, and the US has no stockpiles of those medicines. The fabric of society begins to crumple. The CDC predicts that another wave of the disease will arrive within six months, by the end of October.
The End of October is a pulpy book. I resent it for coming true.
At this point in the book, things also start to get pulpy. Or, to put it more accurately, the part of The End of October’s already-pulpy plot that has not ended up unexpectedly coming true starts to make itself known. Russia takes advantage of the global mayhem to attack the US’s infrastructure, knocking out the electric grid. And the mounting conspiracy theory that the virus was manmade turns out to have some truth to it.
But even this plot twist has some unnerving resonances with our own reality. One of Wright’s major suspects for the question of who designed the virus turns out to be a team of ecofascists, and their rhetoric about how it is the rest of the world that must be saved from human beings is awfully close to the “we are the virus” meme that’s all over the internet in the real world.
As I read The End of October, I found myself resenting it. It was such a silly potboiler of a novel, with such unbelievable characters, such leaden sentences, such infuriatingly clumsy dialogue. How dare the world in which I am actually living so closely resemble a fucking airport thriller?
Wright is undoubtedly a gifted reporter and observer of the world, and the fact that he was able to so clearly see where the existing fault lines in our social fabric lay and how they could be exacerbated by a pandemic shows real skill on his part. But the fact that Wright got so many of his details overwhelmingly right is also a reminder that this pandemic did not come out of nowhere. It was not difficult to predict. It was, in fact, something that we were told was coming over and over again, something that the people we elected to protect us from such a pandemic chose to willfully ignore.
This pandemic should not have caught us off our guard. It should have been as easy to see coming as the final twist in a cheap thriller.