vox--2020-04-02--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 .
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 @ @ @ @ @ @ @ generate results in as little as 15 minutes .
Other companies and labs are jostling to develop serological tests in the US as well .
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 @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ 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 , @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ , 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 @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ , 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 @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ , 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.


vox--2020-04-02--Wilbur Ross’s prediction about the coronavirus helping the US economy could not have been more wrong

Over the last two weeks , nearly 10 million Americans have filed unemployment claims — meaning the coronavirus crisis has already resulted in the US economy shedding more jobs than the entire Great Recession .
In light of that grim reality , it ’ s worth remembering comments Commerce Secretary Wilbur Ross made about the coronavirus in January that reveal the Trump administration ’ s minimizing approach to the crisis early on .
For those who don ’ t remember , during an interview on Maria Bartiromo ’ s Fox Business show on January 30 — 10 days after the @ @ @ @ @ @ @ Ross made a case that the virus , which at that time was mostly hurting China , would ultimately be a good thing for the American job market .
“ I don ’ t want to talk about a victory lap over a very unfortunate , very malignant disease , ” Ross began .
“ But the fact is , it does give business yet another thing to consider when they go through their review of their supply chain .
It ’ s another risk factor that people need to take into account @ @ @ @ @ @ @ to accelerate the return of jobs to North America.
” As I wrote at the time , Ross ’ s economic analysis was obviously flawed — the SARS pandemic , for instance , wiped nearly $ 40 billion off world markets in 2002 and 2003 .
More importantly , from a moral standpoint , reducing a disease that had already at that time killed nearly 200 people to a money-making opportunity was a window into the type of thinking that often carries the day in the Trump administration .
Little could viewers have @ @ @ @ @ @ @ how spectacularly wrong Ross would end up being .
Ross was far from alone among Trump officials in being wrong about the coronavirus While you ’ d be hard-pressed to find a take that has aged worse than Wilbur Ross arguing that the coronavirus would be good for US jobs , it ’ s worth noting that he was far from the only Trump administration official to make such rosy comments about the coronavirus .
The remarks were criticized at the time they were made and look even more boneheaded now .
For @ @ @ @ @ @ @ the country in the crucial period between late February and early March , both Trump economic adviser Larry Kudlow and senior counselor Kellyanne Conway told reporters that the coronavirus was “ contained.
” On the same day as Conway ’ s remarks , Kudlow — who has made many wrongheaded predictions about major economic developments in the past 20 years but was appointed to a top administration job by Trump anyway — went on CNBC and urged investors to “ buy the dip.
” ( The Dow is down more than 4,000 points @ @ @ @ @ @ @ nobody in the administration worked harder to downplay the situation than Trump himself .
Eight days before Ross ’ s infamous Fox Business comments , Trump made his first public comments about the coronavirus in an interview with CNBC in which he claimed that “ we have it totally under control .
It ’ s one person coming from China .
It ’ s going to be just fine.
” Not only did Trump turn out to be completely wrong about having the coronavirus “ under control , ” but he was way @ @ @ @ @ @ @ .
On February 24 — the day before the CDC warned of the coronavirus that “ disruption to everyday life might be severe ” — Trump tweeted that the “ stock market is starting to look very good to me.
” The Dow has fallen more than 6,000 points since then .
Now , of course , Trump is trying to pretend that he took the coronavirus seriously from the beginning and has done as much as could ’ ve been expected from any president to stop its spread .
He ’ s @ @ @ @ @ @ @ go away on its own to suggesting that if 200,000 Americans die from Covid-19 , it ’ ll be evidence he ’ s done “ a very good job.
” Meanwhile , Ross is reportedly working remotely these days from his estate in Palm Beach , Florida .
Not only has the coronavirus been a disaster for US jobs , but , in an ironic twist , it has made it harder for the man who offered that woefully misguided take on America ’ s economic prospects to do his .
The news @ @ @ @ @ @ @ follow Aaron Rupar on Twitter , and read more of Vox ’ s policy and politics coverage .

Over the last two weeks, nearly 10 million Americans have filed unemployment claims — meaning the coronavirus crisis has already resulted in the US economy shedding more jobs than the entire Great Recession.
In light of that grim reality, it’s worth remembering comments Commerce Secretary Wilbur Ross made about the coronavirus in January that reveal the Trump administration’s minimizing approach to the crisis early on.
For those who don’t remember, during an interview on Maria Bartiromo’s Fox Business show on January 30 — 10 days after the first US coronavirus case was recorded — Ross made a case that the virus, which at that time was mostly hurting China, would ultimately be a good thing for the American job market.
“I don’t want to talk about a victory lap over a very unfortunate, very malignant disease,” Ross began. “But the fact is, it does give business yet another thing to consider when they go through their review of their supply chain. It’s another risk factor that people need to take into account. So I think it will help to accelerate the return of jobs to North America.”
Secretary Wilbur Ross says coronavirus will be good for [checks notes] American jobs: "I think it will help to accelerate the return of jobs to North America." pic.twitter.com/Y4SbDIcTi4 — Aaron Rupar (@atrupar) January 30, 2020
As I wrote at the time, Ross’s economic analysis was obviously flawed — the SARS pandemic, for instance, wiped nearly $40 billion off world markets in 2002 and 2003. More importantly, from a moral standpoint, reducing a disease that had already at that time killed nearly 200 people to a money-making opportunity was a window into the type of thinking that often carries the day in the Trump administration.
Little could viewers have known at the time, however, how spectacularly wrong Ross would end up being.
Ross was far from alone among Trump officials in being wrong about the coronavirus
While you’d be hard-pressed to find a take that has aged worse than Wilbur Ross arguing that the coronavirus would be good for US jobs, it’s worth noting that he was far from the only Trump administration official to make such rosy comments about the coronavirus. The remarks were criticized at the time they were made and look even more boneheaded now.
For instance, as the coronavirus spread across the country in the crucial period between late February and early March, both Trump economic adviser Larry Kudlow and senior counselor Kellyanne Conway told reporters that the coronavirus was “contained.”
Kellyanne Conway, March 6: “It is being contained.” pic.twitter.com/H4nsvpG1Tp — j.d. durkin (@jiveDurkey) April 1, 2020
On the same day as Conway’s remarks, Kudlow — who has made many wrongheaded predictions about major economic developments in the past 20 years but was appointed to a top administration job by Trump anyway — went on CNBC and urged investors to “buy the dip.” (The Dow is down more than 4,000 points since then.)
Kudlow: Buy on the dip, on COVID-19 "this is contained", "relatively contained." pic.twitter.com/iF4Nheem4i — Josh Marshall (@joshtpm) March 6, 2020
Of course, nobody in the administration worked harder to downplay the situation than Trump himself. Eight days before Ross’s infamous Fox Business comments, Trump made his first public comments about the coronavirus in an interview with CNBC in which he claimed that “we have it totally under control. It’s one person coming from China. It’s going to be just fine.”
Trump asked in January about whether or not he's worried about a pandemic: "No. Not at all. And we're -- we have it totally under control. It's one person coming in from China, and we have it under control. It's, uh, gonna be just fine." pic.twitter.com/sTuK85dFZY — Robert Maguire (@RobertMaguire_) March 17, 2020
Not only did Trump turn out to be completely wrong about having the coronavirus “under control,” but he was way off about its economic impact, too. On February 24 — the day before the CDC warned of the coronavirus that “disruption to everyday life might be severe” — Trump tweeted that the “stock market is starting to look very good to me.”
The Coronavirus is very much under control in the USA. We are in contact with everyone and all relevant countries. CDC & World Health have been working hard and very smart. Stock Market starting to look very good to me! — Donald J. Trump (@realDonaldTrump) February 24, 2020
The Dow has fallen more than 6,000 points since then.
Now, of course, Trump is trying to pretend that he took the coronavirus seriously from the beginning and has done as much as could’ve been expected from any president to stop its spread. He’s gone from saying that the coronavirus would go away on its own to suggesting that if 200,000 Americans die from Covid-19, it’ll be evidence he’s done “a very good job.”
Meanwhile, Ross is reportedly working remotely these days from his estate in Palm Beach, Florida. Not only has the coronavirus been a disaster for US jobs, but, in an ironic twist, it has made it harder for the man who offered that woefully misguided take on America’s economic prospects to do his.
The news moves fast. To stay updated, follow Aaron Rupar on Twitter, and read more of Vox’s policy and politics coverage.


vox--2020-04-02--How Trump’s impeachment trial foreshadowed his handling of the coronavirus crisis

President Donald Trump ’ s frustration with Democratic governors who have the temerity to criticize his administration ’ s flailing response to the coronavirus isn ’ t just leading him to post sour tweets about them .
It ’ s also reflected in disparities surrounding which states are receiving the medical resources they need to keep patients alive and health care workers healthy .
It ’ s a situation at least one woman , Stanford law professor Pamela Karlan , saw coming , and warned about during Trump ’ s impeachment trial .
In hindsight , her comments look remarkably @ @ @ @ @ @ @ recall , was all about Trump ’ s abuses of power as it pertained to his efforts to leverage foreign aid to Ukraine into investigations of his domestic political foes .
While the details underpinning that scandal may have seemed obscure to many Americans , Karlan in December sounded an alarm about what Trump ’ s behavior could entail in the event of a domestic crisis like the one the country now faces .
Referring to Trump ’ s effort to use congressionally appropriated foreign aid as a quid pro quo for political @ @ @ @ @ @ @ to think about what it would look like if Trump subjected governors to similar treatment .
“ Imagine living in a part of Louisiana or Texas that ’ s prone to devastating hurricanes and flooding , ” Karlan said .
“ What would you think if you lived there , and your governor asked for a meeting with the president to discuss getting disaster aid that Congress has provided for .
What would you think if that president said , ‘ I would like you to do us a favor .
I ’ @ @ @ @ @ @ @ ’ ll send the disaster relief , once you brand my opponent a criminal.
’ Wouldn ’ t you know in your gut that such a president had abused his office ?
” The professor ’ s point was that while Trump using his public office to try and force the Ukrainian government may not seem like an obvious abuse of power to some Americans , it clearly would in a hypothetical situation where he dealt with their elected officials in the same manner .
Unfortunately , less than four months after Karlan @ @ @ @ @ @ @ outlined has come uncomfortably close to reality .
But instead of wanting Democratic governors to investigate the Bidens , Trump is demanding they refrain from saying bad things about him .
Trump is playing with two sets of rules : One for governors who support him and another for ones who don ’ t During an interview with Fox News last Tuesday , Trump responded to Democratic governors like Andrew Cuomo ( NY ) , Gretchen Whitmer ( MI ) , and Jay Inslee ( WA ) criticizing the inadequacy of the federal @ @ @ @ @ @ @ with blue state leaders as “ a two-way street.
” “ They have to treat us well , also .
They can ’ t say , ‘ Oh , gee , we should get this , we should get that , ’ ” Trump added .
Last Friday , Trump took things up a notch by telling reporters he had directed the official running the White House ’ s response effort , Vice President Mike Pence , to not call Inslee and Whitmer — even as hospitals in each of their states approached @ @ @ @ @ @ @ cases — because they aren ’ t “ appreciative ” enough of his efforts .
“ When they ’ re not appreciative to me , they ’ re not appreciative to the Army Corps , they ’ re not appreciative to FEMA , ” Trump said .
“ It ’ s not right.
” This is more than just rhetoric .
On Wednesday , the Washington Post reported that while staunch Trump ally Florida Gov .
Ron DeSantis ( R ) “ promptly ” received all of the supplies he asked for from @ @ @ @ @ @ @ governors such as Wisconsin , Illinois , and Massachusetts ( not to mention New York and Michigan ) were not having the same luck .
It ’ s not clear that Trump ’ s political grudges are driving that disparity , but the Post reported some officials are “ wondering whether politics is playing a role in the response.
” Asked about his disparate treatment of Florida ( a state that ’ s crucial for his reelection hopes ) and Massachusetts ( a state he won ’ t win in 2020 ) during @ @ @ @ @ @ @ dodged .
Tellingly , on Thursday , Trump took to Twitter to attack New York for allegedly getting off to “ a late start ” in its coronavirus response efforts .
But Trump has had no such criticism for DeSantis , who belatedly issued a state-at-home order on Wednesday — nearly two weeks after Cuomo did — as coronavirus cases in his state exploded .
Nor has he criticized any Republican governor in the way he ’ s gone after Democratic ones .
Ideally , the president of the United States would carry @ @ @ @ @ @ @ not he views people impacted by them as on his political team .
This president , however , seemingly can ’ t help himself from using official acts to advance his own ends .
Karlan tried to warn the nation about this in December .
Ultimately , Republican senators didn ’ t listen .
And now , Americans in blue states that could really use some lifesaving help from the federal government are living with the consequences .
The news moves fast .
To stay updated , follow Aaron Rupar on Twitter , @ @ @ @ @ @ @ policy and politics coverage .

President Donald Trump’s frustration with Democratic governors who have the temerity to criticize his administration’s flailing response to the coronavirus isn’t just leading him to post sour tweets about them. It’s also reflected in disparities surrounding which states are receiving the medical resources they need to keep patients alive and health care workers healthy.
It’s a situation at least one woman, Stanford law professor Pamela Karlan, saw coming, and warned about during Trump’s impeachment trial. In hindsight, her comments look remarkably prescient.
That trial, you might recall, was all about Trump’s abuses of power as it pertained to his efforts to leverage foreign aid to Ukraine into investigations of his domestic political foes. While the details underpinning that scandal may have seemed obscure to many Americans, Karlan in December sounded an alarm about what Trump’s behavior could entail in the event of a domestic crisis like the one the country now faces.
Referring to Trump’s effort to use congressionally appropriated foreign aid as a quid pro quo for political favors, Karlan asked members of Congress to think about what it would look like if Trump subjected governors to similar treatment.
“Imagine living in a part of Louisiana or Texas that’s prone to devastating hurricanes and flooding,” Karlan said. “What would you think if you lived there, and your governor asked for a meeting with the president to discuss getting disaster aid that Congress has provided for. What would you think if that president said, ‘I would like you to do us a favor. I’ll meet with you, and I’ll send the disaster relief, once you brand my opponent a criminal.’ Wouldn’t you know in your gut that such a president had abused his office?”
The professor’s point was that while Trump using his public office to try and force the Ukrainian government may not seem like an obvious abuse of power to some Americans, it clearly would in a hypothetical situation where he dealt with their elected officials in the same manner.
Pamela Karlan: “What would you think if, when your governor asked the federal government for the disaster assistance that Congress has provided, the President responded, ‘I would like you to do us a favor.’ I’ll... send the disaster relief once you brand my opponent a criminal.” pic.twitter.com/J96FY30k3y — House Judiciary Dems (@HouseJudiciary) December 4, 2019
Unfortunately, less than four months after Karlan uttered those words, the hypothetical she outlined has come uncomfortably close to reality. But instead of wanting Democratic governors to investigate the Bidens, Trump is demanding they refrain from saying bad things about him.
Trump is playing with two sets of rules: One for governors who support him and another for ones who don’t
During an interview with Fox News last Tuesday, Trump responded to Democratic governors like Andrew Cuomo (NY), Gretchen Whitmer (MI), and Jay Inslee (WA) criticizing the inadequacy of the federal coronavirus response effort by describing his relationship with blue state leaders as “a two-way street.”
“They have to treat us well, also. They can’t say, ‘Oh, gee, we should get this, we should get that,’” Trump added.
Last Friday, Trump took things up a notch by telling reporters he had directed the official running the White House’s response effort, Vice President Mike Pence, to not call Inslee and Whitmer — even as hospitals in each of their states approached the point of being overwhelmed by coronavirus cases — because they aren’t “appreciative” enough of his efforts.
“When they’re not appreciative to me, they’re not appreciative to the Army Corps, they’re not appreciative to FEMA,” Trump said. “It’s not right.”
This is more than just rhetoric. On Wednesday, the Washington Post reported that while staunch Trump ally Florida Gov. Ron DeSantis (R) “promptly” received all of the supplies he asked for from the federal government, states with Democratic governors such as Wisconsin and Illinois (not to mention New York and Michigan) were not having the same luck. It’s not clear that Trump’s political grudges are driving that disparity, but the Post reported some officials are “wondering whether politics is playing a role in the response.”
Asked about his disparate treatment of Florida (a state that’s crucial for his reelection hopes) and Massachusetts (a state he won’t win in 2020) during a news conference on Monday, Trump dodged.
REPORTER: Florida has reportedly had 100% of their requests for supplies from the national strategic stockpile filled but Massachusetts has not. Why is that?
TRUMP, dodging: "I was on the call yesterday with the governors & they were happy with the job we are doing" pic.twitter.com/5PHJG25C7m — Aaron Rupar (@atrupar) March 29, 2020
Tellingly, on Thursday, Trump took to Twitter to attack New York for allegedly getting off to “a late start” in its coronavirus response efforts. But Trump has had no such criticism for DeSantis, who belatedly issued a state-at-home order on Wednesday — nearly two weeks after Cuomo did — as coronavirus cases in his state exploded. Nor has he criticized any Republican governor in the way he’s gone after Democratic ones.
Ideally, the president of the United States would carry out his duties regardless of whether or not he views people impacted by them as on his political team. This president, however, seemingly can’t help himself from using official acts to advance his own ends.
Karlan tried to warn the nation about this in December. Ultimately, Republican senators didn’t listen. And now, Americans in blue states that could really use some lifesaving help from the federal government are living with the consequences.
The news moves fast. To stay updated, follow Aaron Rupar on Twitter, and read more of Vox’s policy and politics coverage.


vox--2020-04-02--Tiger King is a mesmerizing train wreck. Here are more stories just like it.

Tiger King : Murder , Mayhem , and Madness , Netflix ’ s eye-popping series about the real lives of two exotic animal breeders , has become a sensation online .
Viewers have been buzzing about its trademark mullets and animal-print fashion , creating endless memes , and clamoring for more .
It ’ s not hard to see why , given that Tiger King ’ s story is a mesmerizing train wreck .
We follow Joe Schreibvogel , a.k.a .
Joe Maldonado , a.k.a .
Joe Exotic , a polyamorous exotic cat breeder who once offered animal pettings at @ @ @ @ @ @ @ feud with Carole Baskin , a zealous breeder turned activist , who the show suggests may have murdered her first husband and fed him to tigers .
If that one sentence isn ’ t enough head-turning drama already , Tiger King follows the ups and downs of Schriebvogel ’ s attempts to have Baskin killed as their hate-fueled obsession with each other reaches murderous levels .
Schriebvogel was recently given a lengthy prison sentence for animal cruelty and for the attempts on Baskin ’ s life .
And some Florida investigators are now @ @ @ @ @ @ @ of Baskin ’ s husband , thanks to the show .
Tiger King ’ s success with Netflix viewers is predictable — after all , it ’ s a classic depiction of greed , paranoia , and good intentions gone horribly awry .
It helps that the seven-episode series does offer a sobering look at the deeply abusive culture of exotic pet breeding and trafficking .
But what ’ s likely most delicious for average watchers is that any larger moral intent is tempered by a quirky true crime vibe and the kind @ @ @ @ @ @ @ episode of Jersey Shore .
But what if you ’ re a Tiger King devotee now wanting more ?
It ’ s hard to find another story that neatly combines all the unique elements that Tiger King manages to corral into one place .
We ’ ve done our best to bring you a sampler of stories that might scratch the itch — starting with more Tiger King content that ’ s already out there .
Here are six stories to check out .
Be warned that some of the following content may @ @ @ @ @ @ @ , which some readers may find disturbing or graphic .
The Tiger King production team wasn ’ t the only group following around the pair of dysfunctional animal lovers .
Journalist Robert Moor also spent several years tracking down Carole Baskin as well as a host of people who worked with Joe Exotic — or , perhaps more accurately , people who escaped the “ cult ” he ’ s accused of leading at his Wynnewood , Oklahoma , animal park .
The result is a short but engaging podcast .
Joe Exotic @ @ @ @ @ @ @ the premium podcast platform Wondery Plus , but the first three of its six half-hour episodes , along with a couple of bonus interviews , are available for free on most podcast platforms .
And even those three episodes alone make for a mesmerizing binge .
Where the Netflix series unfolds much like a reality show , the podcast focuses on first-person narratives .
Carole glibly discusses everything from planning her love life via hypnosis to adopting big cats at the spur of the moment to taking out teenage bullies with an Amway @ @ @ @ @ @ @ ’ s mysterious disappearance .
As hard as it might be to fathom , the podcast covers plenty of wild stories the Netflix series didn ’ t get around to , which makes it seem like a perfect complement .
Joe ’ s long-suffering assistant Aaron Stone wearily narrates having to crawl into a crate to hold a frightened spray-painted sheep .
We learn that Joe was attempting to pass off the sheep as an adult tiger in one of his animal acts by giving it black and white stripes .
In addition @ @ @ @ @ @ @ one of Joe ’ s previous partners is in prison on murder charges .
Joe himself recruited marginalized employees : people released from prison , rehab patients .
Joe ’ s world is one where he calmly lectures the crying children in his audience on the importance of keeping guns around so that he can shoot anyone who tries to harm his cats .
Through a steady stream of interviews and recorded footage , the podcast prods beneath the veneer of spectacle and adventure that Joe creates , to get a more personal @ @ @ @ @ @ @ Exotic mainly sticks to the story in chronological order , which makes the events a bit easier to follow than the Netflix series .
Its more serious , journalistic tone also helps .
Despite that , the podcast frequently feels as though it ’ s supplemental material , extra reading for the Tiger King geek rather than the main event .
( For instance , in the three free episodes , the show doesn ’ t have time to touch on the mysterious death of Joe ’ s partner , Travis Maldonado .
@ @ @ @ @ @ @ provides is the sense that every real-life character in this story flirts with danger — not just because they dally with fierce wildlife , but also because the kind of person who dallies with fierce wildlife is also the kind of person who maybe feeds their husband to tigers .
In the environment in which the podcast unfolds , it ’ s easy to understand how Joe came to think hiring a hit man was no big deal .
2 ) The story of the Zanesville Animal Escape The opening episode of Tiger @ @ @ @ @ @ @ the whole truth is even stranger than you might expect just from watching the Netflix show .
In 2011 , a 62-year-old Vietnam War veteran named Terry Thompson uncaged and released 56 exotic pets he ’ d been keeping on his estate , unofficially known as the Muskingum County Animal Farm , into the wilds of suburbia .
Thompson freed his menagerie of lions , tigers , macaques , horses , and bears before scattering raw meat around himself — presumably because he wanted to be eaten — and then fatally shooting himself @ @ @ @ @ @ @ chaos , which resulted in the killing of 49 of the animals , leading the incident to be dubbed the “ Zanesville animal massacre.
” The best write-up on the Zanesville incident is GQ ’ s profile of the event , which doubles as a study of mayhem playing out in real time and an in-depth look into the life of the man who apparently engineered all this mayhem in his final moments .
Because this story isn ’ t strange enough , however , in the intervening years , a popular theory @ @ @ @ @ @ @ .
If you ’ ve seen Tiger King , it is perhaps no surprise that one of the leading proponents of this conspiracy theory was Joe Exotic himself , who filmed a video about the incident not long after it occurred .
3 ) The behavioral scientist whose experiments led to sex with a dolphin You might have heard of the infamous 1960s science experiment in which a behavioral psychologist named Margaret Lovatt wound up living with — and having regular sex with — a dolphin named Peter .
What often gets overlooked @ @ @ @ @ @ @ only one assistant researcher whose work was overseen by the neuroscientist Dr. John C. Lilly .
Lilly had become convinced that dolphins could be taught to communicate with people , in part by making what he believed were “ human-like sounds through their blowholes.
” If you ’ re up for a frank discussion about marine bestiality , then The Dollop podcast ’ s episode on Lilly ’ s life and antics — which included his belief that dolphins could help humans telepathically communicate with aliens , and his decision to dose dolphins @ @ @ @ @ @ @ , disturbing rundown .
It ’ s also a revealing glimpse into the kind of dubiously ethical acts academics can get away with in the name of scientific research .
One of the most infamous and influential stories of long-term animal abuse is Blackfish .
The acclaimed 2013 documentary tells of a SeaWorld orca whale whose aggression in captivity resulted in the deaths of three people .
Currently streaming on Hulu , Blackfish isn ’ t exactly a comfort watch , but it is an illuminating one .
It seems to have contributed @ @ @ @ @ @ @ its wide release , and ultimately led SeaWorld to announce in 2016 that it would no longer breed orcas in captivity .
In the long saga of humans exploiting animals for pleasure and profit , we have the interesting sideshow of a mostly headless rooster that survived quite happily for two years after its attempted execution in 1945 .
The rooster ’ s owner toured him around the country , where “ Mike the Headless Chicken ” became so popular that an annual festival still takes place in his honor in Fruita , @ @ @ @ @ @ @ ’ s dolphin sex episode , the podcast has a short episode on Mike the Chicken , too : The self-proclaimed “ Prince of Humbugs ” lived a life of fraud , scams , shameless exploitation , and flagrant abuse of both animals and humans .
( Never forget Joice Heth , the enslaved woman Barnum bought , kept , and passed off as George Washington ’ s nursemaid for decades , after which he sold tickets to her autopsy . )
A number of podcasts and documentaries have tried to do justice @ @ @ @ @ @ @ We recommend the New Yorker ’ s trenchant , revealing essay from 2019 , which is also available in audio form .
The Our Fake History podcast did a two-part episode on Barnum that ’ s definitely worth a listen too : If that ’ s not enough Barnum , Howlround ’ s Theatre History podcast has a fun — for relative values of “ fun ” — episode on the origins of the freak show in American pop culture , which ropes in Barnum , his pal Ringling , Venice Beach , @ @ @ @ @ @ @ All of these stories have themes in common with Tiger King : animal ( and sometimes human ) exploitation , ethics gone awry , and , well , general grossness .
But just like Tiger King , despite their admittedly problematic elements , they all contain a kernel of the fascinating and bizarre that ’ s difficult to ignore .
In other words , their stories hold the kind of undeniable appeal that , perhaps , breeds people like John Lilly , P.T .
Barnum , and Joe Exotic to begin with .

Tiger King: Murder, Mayhem, and Madness, Netflix’s eye-popping series about the real lives of two exotic animal breeders, has become a sensation online. Viewers have been buzzing about its trademark mullets and animal-print fashion, creating endless memes, and clamoring for more.
It’s not hard to see why, given that Tiger King’s story is a mesmerizing train wreck. We follow Joe Schreibvogel, a.k.a. Joe Maldonado, a.k.a. Joe Exotic, a polyamorous exotic cat breeder who once offered animal pettings at malls across America, and his ongoing feud with Carole Baskin, a zealous breeder turned activist, who the show suggests may have murdered her first husband and fed him to tigers. If that one sentence isn’t enough head-turning drama already, Tiger King follows the ups and downs of Schriebvogel’s attempts to have Baskin killed as their hate-fueled obsession with each other reaches murderous levels. Schriebvogel was recently given a lengthy prison sentence for animal cruelty and for the attempts on Baskin’s life. And some Florida investigators are now showing renewed interest in the 1997 disappearance of Baskin’s husband, thanks to the show.
Tiger King’s success with Netflix viewers is predictable — after all, it’s a classic depiction of greed, paranoia, and good intentions gone horribly awry. It helps that the seven-episode series does offer a sobering look at the deeply abusive culture of exotic pet breeding and trafficking. But what’s likely most delicious for average watchers is that any larger moral intent is tempered by a quirky true crime vibe and the kind of aesthetic you might find on an episode of Jersey Shore.
But what if you’re a Tiger King devotee now wanting more? It’s hard to find another story that neatly combines all the unique elements that Tiger King manages to corral into one place. We’ve done our best to bring you a sampler of stories that might scratch the itch — starting with more Tiger King content that’s already out there. Here are six stories to check out.
Be warned that some of the following content may contain descriptions or images of animal cruelty, which some readers may find disturbing or graphic.
1) Wondery’s Joe Exotic podcast
The Tiger King production team wasn’t the only group following around the pair of dysfunctional animal lovers. Journalist Robert Moor also spent several years tracking down Carole Baskin as well as a host of people who worked with Joe Exotic — or, perhaps more accurately, people who escaped the “cult” he’s accused of leading at his Wynnewood, Oklahoma, animal park.
The result is a short but engaging podcast. Joe Exotic: Tiger King debuted March 19 on the premium podcast platform Wondery Plus, but the first three of its six half-hour episodes, along with a couple of bonus interviews, are available for free on most podcast platforms. And even those three episodes alone make for a mesmerizing binge.
Where the Netflix series unfolds much like a reality show, the podcast focuses on first-person narratives. Carole glibly discusses everything from planning her love life via hypnosis to adopting big cats at the spur of the moment to taking out teenage bullies with an Amway briefcase, plus her abusive first husband’s mysterious disappearance.
As hard as it might be to fathom, the podcast covers plenty of wild stories the Netflix series didn’t get around to, which makes it seem like a perfect complement. Joe’s long-suffering assistant Aaron Stone wearily narrates having to crawl into a crate to hold a frightened spray-painted sheep. We learn that Joe was attempting to pass off the sheep as an adult tiger in one of his animal acts by giving it black and white stripes.
In addition to Joe’s criminal hijinks, one of Joe’s previous partners is in prison on murder charges. Joe himself recruited marginalized employees: people released from prison, rehab patients. Joe’s world is one where he calmly lectures the crying children in his audience on the importance of keeping guns around so that he can shoot anyone who tries to harm his cats. Through a steady stream of interviews and recorded footage, the podcast prods beneath the veneer of spectacle and adventure that Joe creates, to get a more personal view of the man himself.
Joe Exotic mainly sticks to the story in chronological order, which makes the events a bit easier to follow than the Netflix series. Its more serious, journalistic tone also helps. Despite that, the podcast frequently feels as though it’s supplemental material, extra reading for the Tiger King geek rather than the main event. (For instance, in the three free episodes, the show doesn’t have time to touch on the mysterious death of Joe’s partner, Travis Maldonado.)
The main novel thing the podcast provides is the sense that every real-life character in this story flirts with danger — not just because they dally with fierce wildlife, but also because the kind of person who dallies with fierce wildlife is also the kind of person who maybe feeds their husband to tigers. In the environment in which the podcast unfolds, it’s easy to understand how Joe came to think hiring a hit man was no big deal.
2) The story of the Zanesville Animal Escape
The opening episode of Tiger King references this bizarre incident, but the whole truth is even stranger than you might expect just from watching the Netflix show.
In 2011, a 62-year-old Vietnam War veteran named Terry Thompson uncaged and released 56 exotic pets he’d been keeping on his estate, unofficially known as the Muskingum County Animal Farm, into the wilds of suburbia. Thompson freed his menagerie of lions, tigers, macaques, horses, and bears before scattering raw meat around himself — presumably because he wanted to be eaten — and then fatally shooting himself. Officials responding to the scene found chaos, which resulted in the killing of 49 of the animals, leading the incident to be dubbed the “Zanesville animal massacre.”
The best write-up on the Zanesville incident is GQ’s profile of the event, which doubles as a study of mayhem playing out in real time and an in-depth look into the life of the man who apparently engineered all this mayhem in his final moments. Because this story isn’t strange enough, however, in the intervening years, a popular theory has emerged that Thompson was actually murdered. If you’ve seen Tiger King, it is perhaps no surprise that one of the leading proponents of this conspiracy theory was Joe Exotic himself, who filmed a video about the incident not long after it occurred.
3) The behavioral scientist whose experiments led to sex with a dolphin
You might have heard of the infamous 1960s science experiment in which a behavioral psychologist named Margaret Lovatt wound up living with — and having regular sex with — a dolphin named Peter. What often gets overlooked in that story is that Lovatt was only one assistant researcher whose work was overseen by the neuroscientist Dr. John C. Lilly. Lilly had become convinced that dolphins could be taught to communicate with people, in part by making what he believed were “human-like sounds through their blowholes.”
If you’re up for a frank discussion about marine bestiality, then The Dollop podcast’s episode on Lilly’s life and antics — which included his belief that dolphins could help humans telepathically communicate with aliens, and his decision to dose dolphins with LSD — is a pretty hilarious, disturbing rundown. It’s also a revealing glimpse into the kind of dubiously ethical acts academics can get away with in the name of scientific research.
4) Blackfish
One of the most infamous and influential stories of long-term animal abuse is Blackfish. The acclaimed 2013 documentary tells of a SeaWorld orca whale whose aggression in captivity resulted in the deaths of three people. Currently streaming on Hulu, Blackfish isn’t exactly a comfort watch, but it is an illuminating one. It seems to have contributed to plunges in marine park attendance after its wide release, and ultimately led SeaWorld to announce in 2016 that it would no longer breed orcas in captivity.
Related Why no aquarium has a great white shark
5) Mike the Headless Chicken
In the long saga of humans exploiting animals for pleasure and profit, we have the interesting sideshow of a mostly headless rooster that survived quite happily for two years after its attempted execution in 1945. The rooster’s owner toured him around the country, where “Mike the Headless Chicken” became so popular that an annual festival still takes place in his honor in Fruita, Colorado. If you liked The Dollop’s dolphin sex episode, the podcast has a short episode on Mike the Chicken, too:
6) The life of P.T. Barnum
The self-proclaimed “Prince of Humbugs” lived a life of fraud, scams, shameless exploitation, and flagrant abuse of both animals and humans. (Never forget Joice Heth, the enslaved woman Barnum bought, kept, and passed off as George Washington’s nursemaid for decades, after which he sold tickets to her autopsy.)
A number of podcasts and documentaries have tried to do justice to the “real” Barnum. We recommend the New Yorker’s trenchant, revealing essay from 2019, which is also available in audio form. The Our Fake History podcast did a two-part episode on Barnum that’s definitely worth a listen too:
If that’s not enough Barnum, Howlround’s Theatre History podcast has a fun — for relative values of “fun” — episode on the origins of the freak show in American pop culture, which ropes in Barnum, his pal Ringling, Venice Beach, Coney Island, and much more.
All of these stories have themes in common with Tiger King: animal (and sometimes human) exploitation, ethics gone awry, and, well, general grossness. But just like Tiger King, despite their admittedly problematic elements, they all contain a kernel of the fascinating and bizarre that’s difficult to ignore. In other words, their stories hold the kind of undeniable appeal that, perhaps, breeds people like John Lilly, P.T. Barnum, and Joe Exotic to begin with.


vox--2020-04-02--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 Centers for Disease Control and Prevention ( CDC ) reports that the main symptoms of the illness are fever , coughing , and shortness of breath , appearing between two and 14 days after @ @ @ @ @ @ @ with SARS-CoV-2 , the virus that causes Covid-19 , have experienced completely different 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 that @ @ @ @ @ @ @ 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 virus @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ 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 impose @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ 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 ] @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ 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 In recent weeks , there have been 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 @ @ @ @ @ @ @ 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 , “ @ @ @ @ @ @ @ 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 more than 1.5 million daily user reports 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 smell or taste , ” @ @ @ @ @ @ @ 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 the virus attacks cells associated @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ 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 this kind of symptom tracking @ @ @ @ @ @ @ 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 like anosmia could possibly be @ @ @ @ @ @ @ 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 are well , researchers can @ @ @ @ @ @ @ 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 way , we don ’ @ @ @ @ @ @ @ , ” 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 @ @ @ @ @ @ @ 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 asymptomatic transmitters do actually have @ @ @ @ @ @ @ 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 @ @ @ @ @ @ @ 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 , @ @ @ @ @ @ @ 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 , @ @ @ @ @ @ @ 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
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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.”
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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.