vox--2020-03-30--Trump faces pressure from a federal judge to release detained migrant kids as coronavirus spreads

A federal judge on Saturday confronted the Trump administration on its treatment of an especially vulnerable population — migrant children in US custody — as the coronavirus pandemic rages .
Judge Dolly Gee of the US District Court in Los Angeles instructed the Health and Human Services Department ( HHS ) and Immigration and Customs Enforcement ( ICE ) on Saturday to either promptly release migrant children from custody or explain why they must be kept in detainment amid the pandemic , which has killed more than 2,500 in the US as of March 30 , according to the New @ @ @ @ @ @ @ to do so by April 10 , Gee said she will order the government to release about 3,400 children in HHS custody and hundreds more in ICE family detention centers , to either their family members or foster parents .
She also said she decided against ordering their immediate release due to the risk of exposing them to the virus , given current travel restrictions .
While children generally have a low risk of becoming seriously ill due to the coronavirus , four children in HHS custody — all of which are housed @ @ @ @ @ @ @ already tested positive and may have spread it to others , including caretakers and people with underlying health conditions who are more likely to face severe complications .
Because coronavirus poses “ unprecedented threats ” to the children themselves and those who interact with them , Gee ruled that keeping them in detention likely violates a decades-old agreement that lays out basic standards for their care .
That agreement — known as the the “ Flores settlement ” — mandates that the government release migrant children “ without unnecessary delay , ” and @ @ @ @ @ @ @ conditions ” in the meantime .
Gee also appointed an independent monitor to ensure that the government is maintaining such conditions for children in its detention facilities , which she described as “ hotbeds for contagion.
” It ’ s not the first time federal courts have found detention conditions for migrant children lacking .
Well before the coronavirus hit , Gee ordered the government to provide migrant children with basic necessities , including toothbrushes and soap , under the same settlement agreement .
The government ’ s measures to curb coronavirus in @ @ @ @ @ @ @ government has made efforts to mitigate the spread of coronavirus in its immigration detention facilities , which house both children and adults , but social contact still poses a serious risk to vulnerable populations .
HHS has stopped sending children in its custody to New York , California , and Washington state , which currently have the highest numbers of confirmed coronavirus cases in the US .
It also requires twice-daily temperature checks of children in custody , provides Covid-19 testing , and isolates those found to have tested positive for the virus @ @ @ @ @ @ @ , instituted social distancing in its facilities so far . )
ICE , which has 38,000 immigrants in detention in more than 130 private and state-run facilities nationwide , was comparatively slower to respond to the pandemic .
Only as of March 27 — and only after outcry from immigrant advocates — did ICE begin distributing hand sanitizer and soap more widely to detainees .
It also instituted more regular and thorough cleaning in common areas , put schooling on hold in certain states , and encouraged social distancing at mealtimes and in @ @ @ @ @ @ @ t announced any plans to release immigrants , many of whom have no previous criminal convictions .
Despite these measures , medical experts nevertheless fear that immigrants in detention remain particularly vulnerable to Covid-19 , the illness caused by the novel coronavirus .
Detainees housed in tight quarters can ’ t maintain social distancing , and medical resources — including personnel , testing kits , and personal protective equipment — are limited in detention centers .
Lawmakers and advocates have been calling for their release , especially for detainees who are older or @ @ @ @ @ @ @ more susceptible to the virus .
According to the Centers for Disease Control and Prevention , that includes people with blood disorders , chronic kidney disease , chronic liver disease , compromised immune systems , current or recent pregnancy , endocrine disorders , metabolic disorders , heart disease , lung disease , and neurological and neurodevelopmental conditions .
The American Civil Liberties Union and the Northwest Immigrant Rights Project have already sued ICE to seek the release of vulnerable detainees at one detention center in Tacoma , Washington , which is just outside @ @ @ @ @ @ @ Covid-19 outbreak in the US .
Children themselves don ’ t appear to be vulnerable to the virus unless they have a preexisting health condition that puts them at risk .
But the effects of social isolation in detention can be particularly harmful to them , exacerbating psychological trauma and mental health issues during a critical developmental period .
They may also be able to carry the virus without exhibiting symptoms , potentially spreading it to those with whom they come in contact .

A federal judge on Saturday confronted the Trump administration on its treatment of an especially vulnerable population — migrant children in US custody — as the coronavirus pandemic rages.
Judge Dolly Gee of the US District Court in Los Angeles instructed the Health and Human Services Department (HHS) and Immigration and Customs Enforcement (ICE) on Saturday to either promptly release migrant children from custody or explain why they must be kept in detainment amid the pandemic, which has killed more than 2,500 in the US as of March 30, according to the New York Times.
If the agencies fail to do so by April 10, Gee said she will order the government to release about 3,400 children in HHS custody and hundreds more in ICE family detention centers, to either their family members or foster parents. She also said she decided against ordering their immediate release due to the risk of exposing them to the virus, given current travel restrictions.
While children generally have a low risk of becoming seriously ill due to the coronavirus, four children in HHS custody — all of which are housed at facilities in New York — have already tested positive and may have spread it to others, including caretakers and people with underlying health conditions who are more likely to face severe complications.
Because coronavirus poses “unprecedented threats” to the children themselves and those who interact with them, Gee ruled that keeping them in detention likely violates a decades-old agreement that lays out basic standards for their care.
That agreement — known as the the “Flores settlement” — mandates that the government release migrant children “without unnecessary delay,” and keep them in “safe and sanitary conditions” in the meantime.
Gee also appointed an independent monitor to ensure that the government is maintaining such conditions for children in its detention facilities, which she described as “hotbeds for contagion.”
It’s not the first time federal courts have found detention conditions for migrant children lacking. Well before the coronavirus hit, Gee ordered the government to provide migrant children with basic necessities, including toothbrushes and soap, under the same settlement agreement.
The government’s measures to curb coronavirus in immigration detention aren’t enough
The government has made efforts to mitigate the spread of coronavirus in its immigration detention facilities, which house both children and adults, but social contact still poses a serious risk to vulnerable populations.
HHS has stopped sending children in its custody to New York, California, and Washington state, which currently have the highest numbers of confirmed coronavirus cases in the US. It also requires twice-daily temperature checks of children in custody, provides Covid-19 testing, and isolates those found to have tested positive for the virus. (It has not, however, instituted social distancing in its facilities so far.)
ICE, which has 38,000 immigrants in detention in more than 130 private and state-run facilities nationwide, was comparatively slower to respond to the pandemic. Only as of March 27 — and only after outcry from immigrant advocates — did ICE begin distributing hand sanitizer and soap more widely to detainees. It also instituted more regular and thorough cleaning in common areas, put schooling on hold in certain states, and encouraged social distancing at mealtimes and in common areas.
But it hasn’t announced any plans to release immigrants, many of whom have no previous criminal convictions.
Despite these measures, medical experts nevertheless fear that immigrants in detention remain particularly vulnerable to Covid-19, the illness caused by the novel coronavirus. Detainees housed in tight quarters can’t maintain social distancing, and medical resources — including personnel, testing kits, and personal protective equipment — are limited in detention centers.
Lawmakers and advocates have been calling for their release, especially for detainees who are older or have underlying health conditions that make them more susceptible to the virus. According to the Centers for Disease Control and Prevention, that includes people with blood disorders, chronic kidney disease, chronic liver disease, compromised immune systems, current or recent pregnancy, endocrine disorders, metabolic disorders, heart disease, lung disease, and neurological and neurodevelopmental conditions.
The American Civil Liberties Union and the Northwest Immigrant Rights Project have already sued ICE to seek the release of vulnerable detainees at one detention center in Tacoma, Washington, which is just outside Seattle, the original epicenter of the Covid-19 outbreak in the US.
Children themselves don’t appear to be vulnerable to the virus unless they have a preexisting health condition that puts them at risk. But the effects of social isolation in detention can be particularly harmful to them, exacerbating psychological trauma and mental health issues during a critical developmental period. They may also be able to carry the virus without exhibiting symptoms, potentially spreading it to those with whom they come in contact.


vox--2020-03-30--Trump says 200,000 Americans could die from coronavirus, because he’s done “a very good job”

President Donald Trump just dramatically redefined success on the country ’ s response to the coronavirus .
Barely a month ago , Trump claimed the coronavirus would go away on its own .
Then he said it paled in comparison to the 2009 H1N1 flu outbreak , which killed about 12,500 Americans .
Now he ’ s saying that the estimates showing Covid-19 could kill 100,000 Americans — roughly equivalent to two Vietnam Wars or 38 September 11 attacks — actually reflect how effective he ’ s been .
During a news conference on Sunday , Trump said that a @ @ @ @ @ @ @ the range of 100,000 to 200,000 people would indicate that his administration has “ done a very good job.
” “ You ’ re talking about 2.2 million deaths , ” Trump said , referring to an Imperial College study that identified 2.2 million people as the high end of how many Americans could die if no measures were taken to slow the spread of coronavirus .
“ So if we can hold that down , as we ’ re saying , to 100,000 , it ’ s a horrible number , maybe @ @ @ @ @ @ @ so we have between 100 [ thousand ] and 200,000 , we altogether have done a very good job.
” The president acknowledging that as many as 200,000 people could die from the coronavirus is a somewhat stunning admission — especially considering that as recently as last week , Trump was pushing an absurdly dangerous talking point about relaxing social distancing in time for churches to be packed on Easter .
But it also previews the sort of argument he ’ s preparing to make during the upcoming election about how his handling @ @ @ @ @ @ @ no matter the outcome , and regardless of his past statements .
It ’ s good that the president is finally being realistic , but it doesn ’ t change the fact that he spent crucial weeks dithering and downplaying Trump ’ s comments on Sunday indicate that experts have talked some sense into him since last week .
During an appearance on CNN earlier in the day , Dr. Anthony Fauci , director of the National Institute of Allergy and Infectious Diseases , cited the same range of expected deaths as Trump @ @ @ @ @ @ @ s newfound realism represents a dramatic departure from not only what he was saying last week but also ( and perhaps more importantly ) from what he was saying during the crucial period in February and early March , when the virus was spreading largely undetected , in part because of his government ’ s failure to quickly devise an effective and widely available coronavirus test .
On February 26 , for instance , Trump noted that there were only 15 known cases of coronavirus in the country , and claimed that “ @ @ @ @ @ @ @ to be down to close to zero , that ’ s a pretty good job we ’ ve done.
” Two days later , he said , “ It ’ s going to disappear .
One day , it ’ s like a miracle , it will disappear.
” There are now more than 148,000 confirmed cases of coronavirus in the country as of March 30 , according to the Johns Hopkins tracker .
On March 9 , Trump posted a tweet suggesting that the measures taken by state governments to shut down @ @ @ @ @ @ @ spread of the virus wouldn ’ t be necessary because tens of thousands of people die from the flu each year ( including more than 30,000 in the 2018- ’ 19 season ) , yet “ [ n ] othing is shut down , life & the economy go on.
” During a press conference four days later , Trump compared his government ’ s handling of the coronavirus favorably with that of the Obama administration ’ s response to H1N1 .
“ Interestingly , if you go back — please — if @ @ @ @ @ @ @ , it was nothing like this , ” he said .
“ They didn ’ t do testing like this .
And actually , they lost approximately 14,000 people .
And they didn ’ t do the testing .
They started thinking about testing when it was far too late.
” Trump ’ s claim about the number of Americans who died from H1N1 in 2009 and 2010 is false .
A CDC study conducted years after the fact found that about 12,500 died .
And ProPublica recently detailed how the Obama administration @ @ @ @ @ @ @ of an H1N1 test that became available for use just two weeks after the first case was detected .
Trump , by contrast , oversaw a botched CDC test-development process that put the US behind the curve when it comes to detecting the spread of the coronavirus .
He absurdly tried to blame Obama for this on Sunday .
Of course , Trump lying about Obama is no surprise .
But what ’ s important is that instead of leveling with Americans about the coronavirus threat in a manner that likely would ’ @ @ @ @ @ @ @ , Trump kept downplaying it as the virus spread and his government bungled the effort to start testing people .
It ’ s good that he ’ s finally being realistic , but the reality is we ’ re now at the point where an outcome in which 100,000 Americans die sounds like getting off easy .
Consider South Korea , by contrast .
South Korea and the United States reported their first coronavirus cases on the same day , January 20 .
But while Trump was trying to wish the virus away @ @ @ @ @ @ @ .
The Guardian details the difference between the South Korean and US responses : Within a week of its first confirmed case , South Korea ’ s disease control agency had summoned 20 private companies to the medical equivalent of a war-planning summit and told them to develop a test for the virus at lightning speed .
A week after that , the first diagnostic test was approved and went into battle , identifying infected individuals who could then be quarantined to halt the advance of the disease .
Some 357,896 tests later @ @ @ @ @ @ @ won the coronavirus war .
On Friday only 91 new cases were reported in a country of more than 50 million .
The US response tells a different story .
Two days after the first diagnosis in Washington state , Donald Trump went on air on CNBC and bragged : “ We have it totally under control .
It ’ s one person coming from China .
It ’ s going to be just fine.
” Not only was it not “ fine , ” but Trump ’ s rhetoric and complacency also @ @ @ @ @ @ @ those failures , however , Trump on Monday told Fox & Friends that he “ [ could not ] imagine any president being able to do more than we ’ ve done.
” Trump will claim victory no matter how many Americans die During his news conference Sunday , Trump repeatedly brought up the Imperial College study that concluded as many as 2.2 million Americans would have died from coronavirus had the government not done anything .
“ A lot of people were saying , maybe we shouldn ’ t do anything [ @ @ @ @ @ @ @ it .
Ride it like a cowboy .
Ride that sucker right through .
That ’ s where the 2.2 million [ deaths ] come in , ” Trump said .
“ That is not acceptable.
” Trump seemed to be trying to draw a contrast between the scenario where the government literally did nothing and the path America is now on .
With his reelection on the line , he set the stage to eventually proclaim that even 200,000 Americans deaths from the coronavirus would be proof that he saved lives .
@ @ @ @ @ @ @ people could ’ ve been spared had Trump taken the coronavirus more seriously early on .
And it ’ s true that this is a truly unprecedented situation that almost any administration may have struggled with .
But we do know that almost everything Trump said and did about the outbreak from January until a couple of weeks ago — with the exception of restricting travel from China after the virus had already started spreading here in the United States — was a fiasco .
Trump is trying to rewrite history .
If @ @ @ @ @ @ @ it would only be a successful outcome relative to the disastrous situation we now find ourselves in after weeks of wishful thinking and inaction from the president — a state of affairs that stands in contrast not only to the Obama administration ’ s handling of the H1N1 and the 2014 Ebola crises , but also to how governments like South Korea have responded to the current crisis .
The news moves fast .
To stay updated , follow Aaron Rupar on Twitter , and read more of Vox ’ s policy and @ @ @

President Donald Trump just dramatically redefined success on the country’s response to the coronavirus.
Barely a month ago, Trump claimed the coronavirus would go away on its own. Then he said it paled in comparison to the 2009 H1N1 flu outbreak, which killed about 12,500 Americans. Now he’s saying that the estimates showing Covid-19 could kill 100,000 Americans — roughly equivalent to two Vietnam Wars or 38 September 11 attacks — actually reflect how effective he’s been.
During a news conference on Sunday, Trump said that a final US coronavirus death toll somewhere in the range of 100,000 to 200,000 people would indicate that his administration has “done a very good job.”
“You’re talking about 2.2 million deaths,” Trump said, referring to an Imperial College study that identified 2.2 million people as the high end of how many Americans could die if no measures were taken to slow the spread of coronavirus. “So if we can hold that down, as we’re saying, to 100,000, it’s a horrible number, maybe even less, but to 100,000, so we have between 100 [thousand] and 200,000, we altogether have done a very good job.”
“If we have between 100,000 and 200,000 we’ve all together done a very good job,” Trump says, about up to 200,000 Americans dying of #COVID19.pic.twitter.com/ricnlAbKKK — Jason Sparks (@sparksjls) March 30, 2020
The president acknowledging that as many as 200,000 people could die from the coronavirus is a somewhat stunning admission — especially considering that as recently as last week, Trump was pushing an absurdly dangerous talking point about relaxing social distancing in time for churches to be packed on Easter. But it also previews the sort of argument he’s preparing to make during the upcoming election about how his handling of the crisis was a success — no matter the outcome, and regardless of his past statements.
It’s good that the president is finally being realistic, but it doesn’t change the fact that he spent crucial weeks dithering and downplaying
Trump’s comments on Sunday indicate that experts have talked some sense into him since last week. During an appearance on CNN earlier in the day, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, cited the same range of expected deaths as Trump did hours later.
Dr. Anthony Fauci says there could potentially be between 100,000 to 200,000 deaths related to the coronavirus and millions of cases. “I just don’t think that we really need to make a projection when it’s such a moving target, that you could so easily be wrong,” he adds. #CNNSOTU pic.twitter.com/F2MOHY3xl4 — State of the Union (@CNNSotu) March 29, 2020
But Trump’s newfound realism represents a dramatic departure from not only what he was saying last week but also (and perhaps more importantly) from what he was saying during the crucial period in February and early March, when the virus was spreading largely undetected, in part because of his government’s failure to quickly devise an effective and widely available coronavirus test.
On February 26, for instance, Trump noted that there were only 15 known cases of coronavirus in the country, and claimed that “within a couple of days is going to be down to close to zero, that’s a pretty good job we’ve done.” Two days later, he said, “It’s going to disappear. One day, it’s like a miracle, it will disappear.” There are now more than 148,000 confirmed cases of coronavirus in the country as of March 30, according to the Johns Hopkins tracker.
On March 9, Trump posted a tweet suggesting that the measures taken by state governments to shut down economic activity in hopes of slowing the spread of the virus wouldn’t be necessary because tens of thousands of people die from the flu each year (including more than 30,000 in the 2018-’19 season), yet “[n]othing is shut down, life & the economy go on.”
So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on. At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that! — Donald J. Trump (@realDonaldTrump) March 9, 2020
During a press conference four days later, Trump compared his government’s handling of the coronavirus favorably with that of the Obama administration’s response to H1N1. “Interestingly, if you go back — please — if you go back to the swine flu, it was nothing like this,” he said. “They didn’t do testing like this. And actually, they lost approximately 14,000 people. And they didn’t do the testing. They started thinking about testing when it was far too late.”
Trump’s claim about the number of Americans who died from H1N1 in 2009 and 2010 is false. A CDC study conducted years after the fact found that about 12,500 died. And ProPublica recently detailed how the Obama administration presided over the CDC’s development of an H1N1 test that became available for use just two weeks after the first case was detected.
Trump, by contrast, oversaw a botched CDC test-development process that put the US behind the curve when it comes to detecting the spread of the coronavirus. He absurdly tried to blame Obama for this on Sunday.
"The biggest problem was the test didn't work. That was not from us. That has been there a long time" -- here's Trump trying to blame Obama for faulty coronavirus tests that were developed by the CDC earlier this year pic.twitter.com/v2zXukCpwf — Aaron Rupar (@atrupar) March 29, 2020
Of course, Trump lying about Obama is no surprise. But what’s important is that instead of leveling with Americans about the coronavirus threat in a manner that likely would’ve prompted people to take greater precautions, Trump kept downplaying it as the virus spread and his government bungled the effort to start testing people. It’s good that he’s finally being realistic, but the reality is we’re now at the point where an outcome in which 100,000 Americans die sounds like getting off easy.
Consider South Korea, by contrast. South Korea and the United States reported their first coronavirus cases on the same day, January 20. But while Trump was trying to wish the virus away, South Korean officials sprung into action. The Guardian details the difference between the South Korean and US responses:
Within a week of its first confirmed case, South Korea’s disease control agency had summoned 20 private companies to the medical equivalent of a war-planning summit and told them to develop a test for the virus at lightning speed. A week after that, the first diagnostic test was approved and went into battle, identifying infected individuals who could then be quarantined to halt the advance of the disease. Some 357,896 tests later, the country has more or less won the coronavirus war. On Friday only 91 new cases were reported in a country of more than 50 million. The US response tells a different story. Two days after the first diagnosis in Washington state, Donald Trump went on air on CNBC and bragged: “We have it totally under control. It’s one person coming from China. It’s going to be just fine.”
Not only was it not “fine,” but Trump’s rhetoric and complacency also made it worse. Instead of acknowledging those failures, however, Trump on Monday told Fox & Friends that he “[could not] imagine any president being able to do more than we’ve done.”
Trump will claim victory no matter how many Americans die
During his news conference Sunday, Trump repeatedly brought up the Imperial College study that concluded as many as 2.2 million Americans would have died from coronavirus had the government not done anything.
“A lot of people were saying, maybe we shouldn’t do anything [about the coronavirus]. Just ride it. Ride it like a cowboy. Ride that sucker right through. That’s where the 2.2 million [deaths] come in,” Trump said. “That is not acceptable.”
TRUMP: "We heard people saying maybe we should not do anything [about the coronavirus]. Ride it like a cowboy. Ride that sucker right through. That is where the 2.2 million [deaths] come in ... That is not acceptable." pic.twitter.com/5XerXRltfa — Aaron Rupar (@atrupar) March 29, 2020
Trump seemed to be trying to draw a contrast between the scenario where the government literally did nothing and the path America is now on. With his reelection on the line, he set the stage to eventually proclaim that even 200,000 Americans deaths from the coronavirus would be proof that he saved lives.
We’ll never know how many people could’ve been spared had Trump taken the coronavirus more seriously early on. And it’s true that this is a truly unprecedented situation that almost any administration may have struggled with. But we do know that almost everything Trump said and did about the outbreak from January until a couple of weeks ago — with the exception of restricting travel from China after the virus had already started spreading here in the United States — was a fiasco.
Trump is trying to rewrite history. If 100,000 Americans die from the coronavirus, it would only be a successful outcome relative to the disastrous situation we now find ourselves in after weeks of wishful thinking and inaction from the president — a state of affairs that stands in contrast not only to the Obama administration’s handling of the H1N1 and the 2014 Ebola crises, but also to how governments like South Korea have responded to the current crisis.
The news moves fast. To stay updated, follow Aaron Rupar on Twitter, and read more of Vox’s policy and politics coverage.


vox--2020-03-30--Trump could help solve the mask problem. Instead he’s making baseless attacks on New York nurses.

President Donald Trump is attacking New York hospital officials over something that isn ’ t their fault — and is a problem he himself could help solve with the Defense Production Act .
Speaking about the shortage of protective masks throughout the country at a press conference Sunday , Trump brought up New York hospitals ’ dire need for the equipment during the coronavirus pandemic , which has infected over 140,000 Americans as of March 30 .
He suggested there was something strange about the rate at which providers are going through the masks .
“ That statement was made @ @ @ @ @ @ @ years , 10 to 20,000 masks , ” Trump said .
“ Okay , it ’ s a New York hospital .
Very — it ’ s packed all the time .
How do you go from 10 to 20 , to 300,000 ?
10 to 20,000 masks to 300,000 ?
” The answer is that there is a great need for masks at the moment .
Beyond the surging number of patients hospitals are seeing , best practices also dictate those who interact with patients infected with Covid-19 dispose of all the @ @ @ @ @ @ @ are wearing during that interaction — masks included .
Given the shortage of PPE , however , medical professionals have begun to disregard those practices , using sterilization techniques and other methods to extend the life of their gear .
But even with those measures , there is not enough PPE to go around .
But rather than empathize with that distressing scenario , Trump suggested Sunday that the shortage has some sinister origins : Something is going on , and you ought to look into it as reporters .
Where are the @ @ @ @ @ @ @ the back door ?
How do you go from 10,000 to 300,000 ?
And we have that in a lot of different places .
So , somebody should probably look into that , because I just don ’ t see , from a practical standpoint , how that ’ s possible to go from that to that .
And we have that happening in numerous places — not to that extent ; that was the highest number I ’ ve heard .
To make sure he was understood , the president later underscored @ @ @ @ @ @ @ don ’ t think it ’ s hoarding ...
I think maybe it ’ s worse than hoarding.
” The remarks drew criticism from health care workers who did not appreciate being accused of stealing as they risk their lives to treat people with a novel illness , including from the president of the Greater New York Hospital Association , Kenneth Raske , who said in a statement , “ New York ’ s health care workers are treating exploding numbers of Covid-19 patients around the clock — willingly and without complaint .
@ @ @ @ @ @ @ suggesting that PPE is ‘ going out the back door ’ of New York hospitals.
” Trump ’ s campaign responded to this criticism by tweeting a video from a press conference New York Gov .
Andrew Cuomo gave on March 6 , in which he said , “ There have been thefts of medical equipment and masks from hospitals , believe it or not — not just people taking a couple or three , I mean just actual thefts of those products.
” Cuomo went on to say he asked his state @ @ @ @ @ @ @ also suggested it was opportunists who were stealing the equipment and reselling it , saying he ’ d directed officers to “ look at places that are selling masks , medical equipment , protective wear , feeding the anxiety ” — rather than to investigate hospital workers themselves .
It is true that some New York medical professionals have admitted — as a few did to Reuters ’ Nick Brown and Joseph Ax — that they have resorted to stealing PPE .
But not to resell , and not for any nefarious purpose @ @ @ @ @ @ @ working while protecting themselves and their patients .
“ Masks disappear , ” a nurse at New York ’ s Mount Sinai Hospital said .
“ We hide it all in drawers in front of the nurses ’ station.
” Sometimes , Brown and Ax report , the masks are taken from areas of the hospitals that treat other types of patients by those treating coronavirus patients .
This petty theft , a doctor at one hospital told the reporters , is done because the only masks available when the story was published @ @ @ @ @ @ @ been donated by the staff ’ s family members or that team leaders had been able to buy with their own money on the open market .
This reporting would suggest there are some thefts , but hardly on the scale the president has suggested , and only what is needed to keep hospitals running given the federal government had not been able to provide them with badly needed supplies .
Trump can ’ t stop crime , but he could stop masks and ventilators from being in such high demand As Vox @ @ @ @ @ @ @ detail , presidents are empowered to direct manufacturing of needed equipment during crises through the Defense Production Act ( DPA ) .
The law works by giving the federal government priority in ordering raw materials and in taking delivery of goods — even if others are “ in line ” ahead of the federal government , it gets to receive its orders first .
The DPA also allows the government to ask companies to make certain things , like masks , and to give financial or equipment loans to help those companies fulfill @ @ @ @ @ @ @ using the act , or has refused to “ invoke the P ” , as he puts it , in any sweeping way .
He has thus far only used it to require General Motors to speed up production and reduce the cost of their offered ventilators , and has refused to use it to push any other firm to produce anything else .
Saturday , he teased invoking it again in order to get some “ problem children ” to start making needed supplies , but by Sunday said those “ problem @ @ @ @ @ @ @ name , have “ come into line .
And , by the way , General Motors is doing a fantastic job .
I don ’ t think we have to worry about General Motors now.
” One reason Trump has cited for his refusal to use the act is that it would turn the United States into a socialist country .
“ We ’ re a country not based on nationalizing our business , ” Trump said during a coronavirus press conference last week .
“ Call a person over in Venezuela ; @ @ @ @ @ @ @ businesses work out .
Not too well .
The concept of nationalizing our business is not a good concept.
” Of course , as Ward has explained , the DPA doesn ’ t cause companies to be subsumed , or even partly owned , by the federal government — it just directs them to make items the country needs , like masks and ventilators .
All this makes the president ’ s strange accusations sad and ridiculous .
The fact is , New York — and every place in the US currently struggling @ @ @ @ @ @ @ — needs goods that simply do not currently exist .
The scarcity of these materials has anecdotally led to some petty theft and overall led to criminals attempting to profit from a difficult situation .
But spinning up conspiracy theories isn ’ t the way to solve the problem .
Taking responsibility for the production of what citizens need to survive the coronavirus crisis is .
And Trump can do so at any time .

President Donald Trump is attacking New York hospital officials over something that isn’t their fault — and is a problem he himself could help solve with the Defense Production Act.
Speaking about the shortage of protective masks throughout the country at a press conference Sunday, Trump brought up New York hospitals’ dire need for the equipment during the coronavirus pandemic, which has infected over 140,000 Americans as of March 30. He suggested there was something strange about the rate at which providers are going through the masks.
“That statement was made that they’ve been delivering for years, 10 to 20,000 masks,” Trump said. “Okay, it’s a New York hospital. Very — it’s packed all the time. How do you go from 10 to 20, to 300,000? 10 to 20,000 masks to 300,000?”
The answer is that there is a great need for masks at the moment. Beyond the surging number of patients hospitals are seeing, best practices also dictate those who interact with patients infected with Covid-19 dispose of all the personal protective equipment (PPE) they are wearing during that interaction — masks included.
Given the shortage of PPE, however, medical professionals have begun to disregard those practices, using sterilization techniques and other methods to extend the life of their gear. But even with those measures, there is not enough PPE to go around. But rather than empathize with that distressing scenario, Trump suggested Sunday that the shortage has some sinister origins:
Something is going on, and you ought to look into it as reporters. Where are the masks going? Are they going out the back door? How do you go from 10,000 to 300,000? And we have that in a lot of different places. So, somebody should probably look into that, because I just don’t see, from a practical standpoint, how that’s possible to go from that to that. And we have that happening in numerous places — not to that extent; that was the highest number I’ve heard.
To make sure he was understood, the president later underscored his claim by saying, “I don’t think it’s hoarding ... I think maybe it’s worse than hoarding.”
The remarks drew criticism from health care workers who did not appreciate being accused of stealing as they risk their lives to treat people with a novel illness, including from the president of the Greater New York Hospital Association, Kenneth Raske, who said in a statement, “New York’s health care workers are treating exploding numbers of Covid-19 patients around the clock — willingly and without complaint. ... They deserve better than their president suggesting that PPE is ‘going out the back door’ of New York hospitals.”
Trump’s campaign responded to this criticism by tweeting a video from a press conference New York Gov. Andrew Cuomo gave on March 6, in which he said, “There have been thefts of medical equipment and masks from hospitals, believe it or not — not just people taking a couple or three, I mean just actual thefts of those products.”
President Trump is listening to health care professionals. Some have reported that people are stealing large numbers of masks and medical equipment from hospitals.
Governor Andrew Cuomo asked the state police to investigate this in New York. pic.twitter.com/kDlFDCdiGg — Trump War Room - Text TRUMP to 88022 (@TrumpWarRoom) March 29, 2020
Cuomo went on to say he asked his state police to investigate the thefts, but also suggested it was opportunists who were stealing the equipment and reselling it, saying he’d directed officers to “look at places that are selling masks, medical equipment, protective wear, feeding the anxiety” — rather than to investigate hospital workers themselves.
It is true that some New York medical professionals have admitted — as a few did to Reuters’ Nick Brown and Joseph Ax — that they have resorted to stealing PPE. But not to resell, and not for any nefarious purpose: only so that they can keep working while protecting themselves and their patients.
“Masks disappear,” a nurse at New York’s Mount Sinai Hospital said. “We hide it all in drawers in front of the nurses’ station.”
Sometimes, Brown and Ax report, the masks are taken from areas of the hospitals that treat other types of patients by those treating coronavirus patients. This petty theft, a doctor at one hospital told the reporters, is done because the only masks available when the story was published on March 27 were those that had been donated by the staff’s family members or that team leaders had been able to buy with their own money on the open market.
This reporting would suggest there are some thefts, but hardly on the scale the president has suggested, and only what is needed to keep hospitals running given the federal government had not been able to provide them with badly needed supplies.
Trump can’t stop crime, but he could stop masks and ventilators from being in such high demand
As Vox’s Alex Ward has explained in detail, presidents are empowered to direct manufacturing of needed equipment during crises through the Defense Production Act (DPA).
The law works by giving the federal government priority in ordering raw materials and in taking delivery of goods — even if others are “in line” ahead of the federal government, it gets to receive its orders first. The DPA also allows the government to ask companies to make certain things, like masks, and to give financial or equipment loans to help those companies fulfill those requests.
Trump has wavered on using the act, or has refused to “invoke the P”, as he puts it, in any sweeping way. He has thus far only used it to require General Motors to speed up production and reduce the cost of their offered ventilators, and has refused to use it to push any other firm to produce anything else.
Saturday, he teased invoking it again in order to get some “problem children” to start making needed supplies, but by Sunday said those “problem children,” which he refused to name, have “come into line. And, by the way, General Motors is doing a fantastic job. I don’t think we have to worry about General Motors now.”
One reason Trump has cited for his refusal to use the act is that it would turn the United States into a socialist country.
“We’re a country not based on nationalizing our business,” Trump said during a coronavirus press conference last week. “Call a person over in Venezuela; ask them how did nationalization of their businesses work out. Not too well. The concept of nationalizing our business is not a good concept.”
Of course, as Ward has explained, the DPA doesn’t cause companies to be subsumed, or even partly owned, by the federal government — it just directs them to make items the country needs, like masks and ventilators.
All this makes the president’s strange accusations sad and ridiculous. The fact is, New York — and every place in the US currently struggling to treat high volumes of Covid-19 patients — needs goods that simply do not currently exist.
The scarcity of these materials has anecdotally led to some petty theft and overall led to criminals attempting to profit from a difficult situation. But spinning up conspiracy theories isn’t the way to solve the problem. Taking responsibility for the production of what citizens need to survive the coronavirus crisis is. And Trump can do so at any time.


vox--2020-03-30--The 2020 election calendar

The 2020 election calendar

Share All sharing options for : The 2020 election calendar The Democratic presidential primary has been going on for months .
But 2020 — the election year — is here , and it ’ s an understatement to say that it will be a busy year in US politics .
March began with Super Tuesday on March 3 : the biggest delegate prize of the primary calendar .
As the year continues , the primary calendar is scheduled to run through June , followed by the Democratic and Republican conventions ( in July and August , respectively ) , and @ @ @ @ @ @ @ .
However , concerns about the Covid-19 coronavirus have led several states to move their primaries later in the calendar , including a last-minute change in Ohio .
That ’ s where this calendar comes in .
Here are the most important events of the 2020 election cycle .
Bookmark this page to refer back to , add it to your Google Calendar by clicking the plus sign on the bottom right of this page , or subscribe through a calendar app of your choice .
This page and the calendar subscriptions will @ @ @ @ @ @ @ Alaska primary ( D ; results will be available no later than 11:59 pm on April 11 ) • Hawaii primary ( D ; results will be available “ late May ” according to interim Hawaii Democratic Party Chair Kate Stanley ) Read all of our coverage from the June debates here .
Read all of our coverage from the July debates here .
Read all of our coverage of the September debate here .
• Second town hall on climate change on MSNBC Read all of our coverage from the October debate @ @ @ @ @ @ @ from the November debate here .
Read all of our coverage from the December debate here .
Read all of our coverage from the Iowa caucuses here .
Read all of our coverage from the New Hampshire primaries here .
Read all of our coverage from the South Carolina primary here .
Read all of our coverage from Super Tuesday here .
Read all of our coverage from the March 10 primaries here .
Read all of our coverage from the March 17 primaries here .

Share All sharing options for: The 2020 election calendar
Vox answers your biggest questions about the 2020 US presidential election .
This story is part of a group of stories called
The 2020 presidential election is ramping into high gear.
Joe Biden announced his running mate, California Sen. Kamala Harris, and Democrats and Republicans held their first virtual conventions this summer. Biden and President Donald Trump accepted their parties’ official nominations for president, and the fall campaign season is upon us.
The presidential debates began September 29 and run through October, including the vice presidential debate on October 7. The second presidential debate, scheduled for October 15, was canceled after Trump tested positive for Covid-19, then refused to agree to debate virtually. One more debate is scheduled for October 22.
Election Day itself, of course, will fall on Tuesday, November 3.
Read on for the important events of the 2020 election cycle and bookmark this page to refer back to. You can also add it to your Google Calendar by clicking the plus sign on the bottom right of this page, or subscribe through a calendar app of your choice. This page and the calendar subscriptions will be updated as dates and information change.
And check out our guides on how to vote early and by mail.
September 2020
September 29
Presidential debate in Cleveland, Ohio, at the Case Western Reserve/Cleveland Clinic joint campus
October 2020
October 7
Vice presidential debate in Salt Lake City at the University of Utah
October 22
Presidential debate in Nashville, Tennessee, at Belmont University
November 2020
November 3
Election Day
Past 2020 election coverage
June 2019
June 26-27
Read all of our coverage from the June debates here.
July 2019
July 30-31
Read all of our coverage from the July debates here.
September 2019
September 4
September 12
Read all of our coverage of the September debate here.
September 19-20
October 2019
October 15
Read all of our coverage from the October debate here.
November 2019
November 20
Read all of our coverage from the November debate here.
December 2019
December 19
Read all of our coverage from the December debate here.
January 2020
January 14
February 2020
February 3
Iowa caucuses
Read all of our coverage from the Iowa caucuses here.
February 7
February 11
New Hampshire primaries
Read all of our coverage from the New Hampshire primaries here.
February 19
February 22
Nevada caucuses
February 25
February 29
South Carolina primary
Read all of our coverage from the South Carolina primary here.
March 2020
March 3 (Super Tuesday)
Alabama primaries (D, R)
American Samoa caucuses (D)
Arkansas primaries (D, R)
California primaries (D, R)
Colorado primaries (D, R)
Maine primaries (D, R)
Massachusetts primaries (D, R)
Minnesota primaries (D, R)
North Carolina primaries (D, R)
Oklahoma primaries (D, R)
Tennessee primaries (D, R)
Texas primaries (D, R)
Utah primaries (D, R)
Vermont primaries (D, R)
Virginia primary (D)
Democrats Abroad primary (through March 10)
Read all of our coverage from Super Tuesday here.
March 10
Idaho primaries (D, R)
Michigan primaries (D, R)
Mississippi primaries (D, R)
Missouri primaries (D, R)
North Dakota caucuses (D)
Washington primaries (D, R)
Read all of our coverage from the March 10 primaries here.
March 12
Virgin Islands caucuses
March 14
Guam caucuses (R)
Northern Marianas convention (D)
March 15
March 17
Arizona primary (D)
Florida primaries (D, R)
Illinois primaries (D, R)
Northern Marianas convention (R)
Read all of our coverage from the March 17 primaries here.
March 24
American Samoa caucuses (R)
April 2020
April 7
Wisconsin primaries (D, R; April 7 is the election date and mail-in vote postmark deadline following court rulings, as of 8 pm ET on April 6)
April 10
Alaska primary (D; vote-by-mail only; results will be available no later than 11:59 pm on April 11)
April 17
Wyoming caucuses (D; vote-by-mail only)
April 28
Ohio primaries (D, R; vote-by-mail only)
May 2020
May 2
Kansas primary (D)
Guam caucuses (D)
May 7-9
Wyoming state convention (R)
May 12
Nebraska primaries (D, R)
May 19
Oregon primaries (D, R)
June 2020
June 2
Delaware primaries (D, R)
District of Columbia primaries (D, R)
Indiana primaries (D, R)
Maryland primaries (D, R)
Montana primaries (D, R)
New Mexico primaries (D, R)
Pennsylvania primaries (D, R)
Rhode Island primaries (D, R)
South Dakota primaries (D, R)
June 6
Virgin Islands caucuses (D)
June 7
Puerto Rico primary (R)
June 9
Georgia primaries (D, R)
West Virginia primaries (D, R)
June 23
Kentucky primaries (D, R)
New York primaries (D, R)
July 2020
July 7
New Jersey primaries (D, R)
July 11
Louisiana primaries (D, R)
August 2020
August 11
Connecticut primaries (D, R)
August 17-20
Democratic National Convention in Milwaukee, Wisconsin
Read our coverage of the Democratic convention here.
August 24-27
Republican National Convention in Charlotte, North Carolina
Read our coverage of the Republican convention here.


vox--2020-03-30--How Covid-19 immunity testing can help people get back to work

Testing to see who has the Covid-19 coronavirus has become one of the most crucial elements of slowing the global pandemic .
And it may also hold the key to a return to normal .
“ Everyone staying home is just a very blunt measure .
That ’ s what you say when you ’ ve got really nothing else , ” Emily Gurley , an associate scientist at the Johns Hopkins Bloomberg School of Public Health , told NPR .
“ Being able to test folks is really the linchpin in getting beyond what we ’ re doing now.
@ @ @ @ @ @ @ also known as “ immunity tests , ” for antibodies to the virus could reveal the true extent of the pandemic and help scientists answer basic questions about Covid-19 and the virus that causes it , SARS-CoV-2 : How many people have been infected with the virus ?
Who may have spread it without knowing it ?
Why do some people have mild illness while others become gravely ill ?
How deadly is the disease ?
What tactics are actually working to slow its spread ?
Serological tests could also potentially allow people @ @ @ @ @ @ @ .
That could be a huge boost to front-line health workers who may have been exposed to the virus but are desperately needed back in action .
Countries are now racing to acquire more of these tests .
The United Kingdom ordered 3.5 million serological tests .
Germany is considering using these tests to issue immunity certificates to people who have survived Covid-19 .
Companies and labs are jostling to develop robust serological tests in the US as well ; one company , Henry Schein , says several hundred thousand of its tests @ @ @ @ @ @ @ scientists are also still learning how long immunity from Covid-19 can last and whether there is a chance that people could be reinfected .
Filling in these blanks will be critical to the recovery from the Covid-19 pandemic .
Let ’ s walk through what we know .
Serological tests can reveal who has defeated Covid-19 and may now be immune In patients who have recovered from Covid-19 or may have carried the virus without realizing it , a serological test can show who carries antibodies , even if the virus is no @ @ @ @ @ @ @ help the immune system identify and eliminate threats .
Once they ’ re made , they help the body neutralize future infections from the same threat .
Establishing who is immune is important for figuring out who can safely return to work .
For example , health workers are facing staffing shortages as Covid-19 spreads through their ranks , and serological tests may soon become necessary to keep hospitals and clinics running .
These tests are also a forensic tool , tracing the spread of the virus through a population .
This can @ @ @ @ @ @ @ Covid-19 outbreak and help scientists get ahead of the next pandemic .
Countries like China and Singapore have already used serological tests for contact tracing to see how the virus has spread .
Serological tests use blood serum , the liquid part of blood , excluding cells and clotting proteins .
Even though SARS-CoV-2 isn ’ t typically present in blood , an infection causes white blood cells to make antibody proteins that help the immune system identify viruses and stop them , or mark infected cells for destruction .
Although these proteins @ @ @ @ @ @ @ blood serum , it can take several days for someone to make these antibodies after an infection .
So a serological test isn ’ t always useful for finding an active infection — and can yield a false negative , showing that someone doesn ’ t have the virus when they actually do .
The results of these tests can also be trickier to interpret than results from the more common RT-PCR tests used to diagnose Covid-19 , which detect the virus ’ s genetic material .
But antibodies can linger long after @ @ @ @ @ @ @ s why serological tests for antibodies can identify past cases of the virus .
“ That ’ s a great screening tool to figure out what proportion of our patient population had it or what proportion of our hospital staff has been exposed to it , ” said David Pride , associate director of microbiology at the University of California San Diego .
Researchers are also studying how to use antibodies collected from previously infected patients to treat current cases of Covid-19 .
The Food and Drug Administration ( FDA ) is now @ @ @ @ @ @ @ recovered patients that contains antibodies to treat emergency cases of the disease , and serological tests can identify potential antibody donors .
( Potential donors can sign up here . )
Serological tests are also cheaper to run than RT-PCR .
An RT-PCR test costs about $ 50 at Medicare rates .
A serological test can be less than $ 10 .
It ’ s faster , too , using techniques like ELISA ( enzyme-linked immunosorbent assay ) .
Here , a tiny piece of the virus is stuck to a plate .
@ @ @ @ @ @ @ present in a blood sample , it will attach to the virus on the plate .
Then a second antibody with an enzyme attached will stick to the virus antibody .
The enzyme then accelerates a reaction that changes the color of the solution , indicating that the patient has at some point mounted an immune response to the virus .
There are other serological testing systems in development as well , including a fingerstick test that can deliver results in as few as 10 minutes .
Meanwhile , RT-PCR tests can take @ @ @ @ @ @ @ samples have to be shipped to an outside lab , it can take days to get results .
( The FDA recently approved a new rapid genetic test that can give a positive result in five minutes . )
Companies are now racing to produce more serological tests , and the FDA has relaxed regulations so more tests can get to doctors faster .
However , as with RT-PCR tests , serological tests are also facing supply shortages and bottlenecks .
And right now , the main task for combating the Covid-19 outbreak @ @ @ @ @ @ @ virus , which makes RT-PCR tests the priority .
But as the US heads deeper into the pandemic , serological tests will become essential to finding a path out .
Researchers still aren ’ t sure how long Covid-19 immunity will last If serological tests are deployed even more broadly , health officials can trace the spread of the illness .
Coupled with widespread RT-PCR tests to find active cases of Covid-19 , scientists could identify hot spots , and governments can more precisely target their tactics .
Rather than blanket shelter-in-place orders @ @ @ @ @ @ @ neighborhoods , and people are most at risk and start to relax quarantines , curfews , and other control measures in some areas .
Widespread testing alongside social distancing can slow the spread of the virus and eventually help restart idled economies and bring countries closer to where they were before the pandemic .
But there are some caveats .
To safely return to work , a patient would have to ensure that they have immunity and that they are no longer spreading the virus .
Since a serological test can only confirm @ @ @ @ @ @ @ need an additional RT-PCR test to establish the latter .
That is , they need to test positive for immunity and negative for the virus itself .
SARS-CoV-2 is also a new virus , so researchers aren ’ t certain how long immunity will last .
The virus could mutate and render past immunity ineffective , although scientists have found that it is mutating slowly , indicating that the protection from a past infection is likely to be effective for a while .
“ You ’ re going to have some degree of @ @ @ @ @ @ @ director of the National Institute of Allergy and Infectious Diseases , told the Doctor Mike YouTube show .
“ It may not be 50 years , but it ’ s certainly going to be a matter of a few years.
” Resolving these questions about immunity is essential to determining whether it ’ s safe to go back to work , particularly in health care .
“ We need to check to make sure the protection is real before doing that on a large scale , but I do think [ serological testing @ @ @ @ @ @ @ the strategy because we ’ ll need to keep health care workers in action , ” said Marc Lipsitch , a professor of epidemiology at Harvard University .
The possibility of protection from the pandemic — and a test to show it — should also not be an incentive to try to get infected in the hope of building immunity .
Covid-19 is a dangerous illness .
While older people are generally most at risk , people of all ages have become seriously ill and have died from it .
Infected people can @ @ @ @ @ @ @ at risk , even if the infected person has no symptoms .
And there are still not nearly enough materials for either widespread RT-PCR or serological testing .
There are also critical shortages in protective equipment for medical staff conducting these tests .
That ’ s making hospitals and clinics think carefully about who needs to be tested right now and moving serological tests for people who aren ’ t sick anymore to the back burner .
Getting the amount of testing needed to end the pandemic is also no trivial task .
@ @ @ @ @ @ @ of not just deploying tests but training a workforce to do them .
In addition , people would have to maintain strict social distancing measures until all the requisite testing is completed , which could take months .
“ It would take a sort of moonshot-level effort , ” wrote Vox ’ s Brian Resnick .
As manufacturers ramp up production to meet the surging testing demand , these supply shortfalls will likely fade .
But in the meantime , some difficult decisions lie ahead .
“ In the US , we ’ @ @ @ @ @ @ @ resource-limited environment , but when it comes to testing for Covid , we still are in a resource-limited environment , ” Pride said .
Ultimately , the threat will fade when enough people are immune to the virus that it can no longer spread easily , or if pockets of Covid-19 are contained until they burn out .
Getting immunity from exposure is a costly and dangerous approach , so the best strategy remains not getting infected in the first place and buying time until researchers can develop and deploy a vaccine .
@ @ @ @ @ @ @ test , test .

Testing to see who has the Covid-19 coronavirus has become one of the most crucial elements of slowing the global pandemic. And it may also hold the key to a return to normal.
“Everyone staying home is just a very blunt measure. That’s what you say when you’ve got really nothing else,” Emily Gurley, an associate scientist at the Johns Hopkins Bloomberg School of Public Health, told NPR. “Being able to test folks is really the linchpin in getting beyond what we’re doing now.”
In particular, serological tests, also known as “immunity tests,” for antibodies to the virus could reveal the true extent of the pandemic and help scientists answer basic questions about Covid-19 and the virus that causes it, SARS-CoV-2: How many people have been infected with the virus? Who may have spread it without knowing it? Why do some people have mild illness while others become gravely ill? How deadly is the disease? What tactics are actually working to slow its spread?
Serological tests could also potentially allow people who have immunity to return to work. That could be a huge boost to front-line health workers who may have been exposed to the virus but are desperately needed back in action.
Countries are now racing to acquire more of these tests. The United Kingdom ordered 3.5 million serological tests. Germany is considering using these tests to issue immunity certificates to people who have survived Covid-19.
In the US, the Food and Drug Administration on April 2 granted first approval to a serological test for Covid-19, with an Emergency Use Authorization. The test, made by Cellex, can generate results in as little as 15 minutes. Other companies and labs are jostling to develop serological tests in the US as well.
Related 6 things to know about the coronavirus testing disaster in the US
But scientists are also still learning how long immunity from Covid-19 can last and whether there is a chance that people could be reinfected. Filling in these blanks will be critical to the recovery from the Covid-19 pandemic. Let’s walk through what we know.
Serological tests can reveal who has defeated Covid-19 and may now be immune
In patients who have recovered from Covid-19 or may have carried the virus without realizing it, a serological test can show who carries antibodies, even if the virus is no longer present. Antibodies are proteins that help the immune system identify and eliminate threats. Once they’re made, they help the body neutralize future infections from the same threat.
Establishing who is immune is important for figuring out who can safely return to work. For example, health workers are facing staffing shortages as Covid-19 spreads through their ranks, and serological tests may soon become necessary to keep hospitals and clinics running.
These tests are also a forensic tool, tracing the spread of the virus through a population. This can solve some of the unknowns of the Covid-19 outbreak and help scientists get ahead of the next pandemic. Countries like China and Singapore have already used serological tests for contact tracing to see how the virus has spread.
Serological tests use blood serum, the liquid part of blood, excluding cells and clotting proteins. Even though SARS-CoV-2 isn’t typically present in blood, an infection causes white blood cells to make antibody proteins that help the immune system identify viruses and stop them, or mark infected cells for destruction.
Although these proteins can be detected in the bloodstream and blood serum, it can take several days for someone to make these antibodies after an infection. So a serological test isn’t always useful for finding an active infection — and can yield a false negative, showing that someone doesn’t have the virus when they actually do. The results of these tests can also be trickier to interpret than results from the more common RT-PCR tests used to diagnose Covid-19, which detect the virus’s genetic material.
But antibodies can linger long after an infection has faded. That’s why serological tests for antibodies can identify past cases of the virus.
“That’s a great screening tool to figure out what proportion of our patient population had it or what proportion of our hospital staff has been exposed to it,” said David Pride, associate director of microbiology at the University of California San Diego.
Researchers are also studying how to use antibodies collected from previously infected patients to treat current cases of Covid-19. The Food and Drug Administration (FDA) is now allowing doctors to use blood plasma from recovered patients that contains antibodies to treat emergency cases of the disease, and serological tests can identify potential antibody donors. (Potential donors can sign up here.)
Serological tests are also cheaper to run than RT-PCR. An RT-PCR test costs about $50 at Medicare rates. A serological test can be less than $10.
It’s faster, too, using techniques like ELISA (enzyme-linked immunosorbent assay). Here, a tiny piece of the virus is stuck to a plate. If an antibody to the virus is present in a blood sample, it will attach to the virus on the plate. Then a second antibody with an enzyme attached will stick to the virus antibody. The enzyme then accelerates a reaction that changes the color of the solution, indicating that the patient has at some point mounted an immune response to the virus.
There are other serological testing systems in development as well, including a fingerstick test that can deliver results in as few as 10 minutes. Meanwhile, RT-PCR tests can take several hours to run, and if samples have to be shipped to an outside lab, it can take days to get results. (The FDA recently approved a new rapid genetic test that can give a positive result in five minutes.)
However, as with RT-PCR tests, serological tests are also facing supply shortages and bottlenecks. And right now, the main task for combating the Covid-19 outbreak is figuring out who currently has the virus, which makes RT-PCR tests the priority. But as the US heads deeper into the pandemic, serological tests will become essential to finding a path out.
Researchers still aren’t sure how long Covid-19 immunity will last
If serological tests are deployed even more broadly, health officials can trace the spread of the illness. Coupled with widespread RT-PCR tests to find active cases of Covid-19, scientists could identify hot spots, and governments can more precisely target their tactics. Rather than blanket shelter-in-place orders, officials could see which cities, neighborhoods, and people are most at risk and start to relax quarantines, curfews, and other control measures in some areas.
Widespread testing alongside social distancing can slow the spread of the virus and eventually help restart idled economies and bring countries closer to where they were before the pandemic.
But there are some caveats.
To safely return to work, a patient would have to ensure that they have immunity and that they are no longer spreading the virus. Since a serological test can only confirm the former, a patient may still need an additional RT-PCR test to establish the latter. That is, they need to test positive for immunity and negative for the virus itself.
SARS-CoV-2 is also a new virus, so researchers aren’t certain how long immunity will last. The virus could mutate and render past immunity ineffective, although scientists have found that it is mutating slowly, indicating that the protection from a past infection is likely to be effective for a while.
“You’re going to have some degree of durable immunity,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told the Doctor Mike YouTube show. “It may not be 50 years, but it’s certainly going to be a matter of a few years.”
Resolving these questions about immunity is essential to determining whether it’s safe to go back to work, particularly in health care. “We need to check to make sure the protection is real before doing that on a large scale, but I do think [serological testing] will be an important part of the strategy because we’ll need to keep health care workers in action,” said Marc Lipsitch, a professor of epidemiology at Harvard University.
The possibility of protection from the pandemic — and a test to show it — should also not be an incentive to try to get infected in the hope of building immunity. Covid-19 is a dangerous illness. While older people are generally most at risk, people of all ages have become seriously ill and have died from it. Infected people can also spread the virus to others more at risk, even if the infected person has no symptoms.
And there are still not nearly enough materials for either widespread RT-PCR or serological testing. There are also critical shortages in protective equipment for medical staff conducting these tests. That’s making hospitals and clinics think carefully about who needs to be tested right now and moving serological tests for people who aren’t sick anymore to the back burner.
Getting the amount of testing needed to end the pandemic is also no trivial task. It would demand an extraordinary coordinated effort of not just deploying tests but training a workforce to do them. In addition, people would have to maintain strict social distancing measures until all the requisite testing is completed, which could take months. “It would take a sort of moonshot-level effort,” wrote Vox’s Brian Resnick.
As manufacturers ramp up production to meet the surging testing demand, these supply shortfalls will likely fade. But in the meantime, some difficult decisions lie ahead.
“In the US, we’re not accustomed to being in a resource-limited environment, but when it comes to testing for Covid, we still are in a resource-limited environment,” Pride said.
Ultimately, the threat will fade when enough people are immune to the virus that it can no longer spread easily, or if pockets of Covid-19 are contained until they burn out. Getting immunity from exposure is a costly and dangerous approach, so the best strategy remains not getting infected in the first place and buying time until researchers can develop and deploy a vaccine. And in the meantime, test, test, test.