Why the US is experiencing a coronavirus plateau

News Network
June 9, 2020

Washington, Jun 9: When epidemiologists talked about "flattening the curve," they probably didn't mean it this way: the US hit its peak coronavirus caseload in April, but since that time the graph has been on a seemingly unending plateau.

That's unlike several other hard-hit countries which have successfully pushed down their numbers of new cases, including Spain and Italy, which now have bell-shaped curves.

Experts say the prolonged nature of the US epidemic is the result of the cumulative impact of regional outbreaks, as the virus that started out primarily on the coasts and in major cities moves inward.

Layered on top of that are the effects of lifting lockdowns in parts of the country that are experiencing rising cases, as well as a lapse in compliance with social distancing guidelines because of economic hardship, and in some cases a belief that the threat is overstated.

"The US is a large country both in geography and population, and the virus is at very different stages in different parts of the country," Tom Frieden, a former director of the Centers for Disease Control and Prevention told AFP.

The US saw more than 35,000 new cases for several days in April. While that figure has declined, it has still been exceeding 20,000 regularly in recent days.

By contrast, Italy was regularly hitting more than 5,000 cases per day in March but is currently experiencing figures in the low hundreds.

"We did not act quickly and robustly enough to stop the virus spreading initially, and data indicate that it travelled from initial hotspots along major transport routes into other urban and rural areas," added Frieden, now CEO of the non-profit Resolve to Save Lives.

To wit: the East Coast states of New York, New Jersey and Massachusetts accounted for about 50 percent of all cases until about a month or so ago -- but now the geographic footprint of the US epidemic has shifted to the Midwest and southeast, including Florida.

Another key problem, said Jennifer Nuzzo, an epidemiologist at Johns Hopkins, is that the United States is still not doing enough testing, contact tracing and isolation.

After coming late to the testing party -- for reasons ranging from technical issues to regulatory hurdles -- the US has now conducted more COVID-19 tests than any other country.

It even has one of the highest per capita rates per country of 62 per 1,000 people, according to the website ourworldindata.org -- better than Germany (52 per 1,000) and South Korea (20 per 1,000).

But according to Nuzzo, these numbers are misleading, because "the amount of testing that a country should do should be scaled to the size of its epidemic.

"The United States has the largest epidemic in the world so obviously we need to do a lot more testing than any other country."

For Johns Hopkins, the more important metric is the positivity rate -- that is, out of all tests conducted, how many came back positive for COVID-19.

As of June 7, the United States had an average daily positivity rate of 14 percent, well above the World Health Organization guideline of 5 percent over two weeks before social distancing guidelines should be relaxed.

By contrast, Germany, which has tested far fewer people in relation to its population, has a positivity rate of 5 percent.

Even if testing were scaled up, carrying out tests in of itself does very little good without the next steps -- finding out who was exposed and then asking them to isolate.

Here also, too many US states are lagging woefully behind.

Texas, which is experiencing a surge in cases after relaxing its lockdown, is a case in point. The state targeted hiring a modest 4,000 tracers by June, but according to local reports is still more than a thousand shy of even that goal.

Opt-in app based efforts have also been slow to get off the ground.

Then there is the fact that some people are growing tired of lockdowns, while others don't have the economic luxury of being able to stay home for prolonged periods.

The government sent some 160 million Americans a single stimulus check of up to $1,200 back in April but it's not clear whether more will be forthcoming.

Still others, particularly in so-called red states under Republican leadership, have chafed under restrictions and mask-wearing guidelines that they see as an affront to their personal freedom.

"The US is kind of on the extreme of the individual liberty side," Sten Vermund, dean of the Yale School of Public Health, told AFP.

Part of this has to do with mixed messaging from Republican leaders, including President Donald Trump, said Nuzzo.

"We have had at the highest political level an assertion that this is a situation that's been overblown, and that maybe certain protective behaviors are not necessary," she said.

More recently, tens of thousands of people across the country have taken to the streets to protest the killing on an unarmed black man by police, risking coronavirus infection to demonstrate against the public health threat of racialized state violence.

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News Network
June 2,2020

Oakland, Jun 2: Facebook employees are using Twitter to register their frustration over CEO Mark Zuckerberg's decision to leave up posts by President Donald Trump that suggested protesters in Minneapolis could be shot.

While Twitter demoted and placed a warning on a tweet about the protests that read, in part, that “when the looting starts the shooting starts,” Facebook has let it stand, with Zuckerberg laying out his reasoning in a Facebook post Friday.

“I know many people are upset that we've left the President's posts up, but our position is that we should enable as much expression as possible unless it will cause imminent risk of specific harms or dangers spelled out in clear policies,” Zuckerberg wrote.

Trump's comment evoked the civil-rights era by borrowing a phrase used in 1967 by Miami's police chief to warn of an aggressive police response to unrest in black neighborhoods.

On Monday, Facebook employees staged a virtual “walkout” to protest the company's decision not to touch the Trump posts according to a report in the New York Times, which cited anonymous senior employees at Facebook.

The Times report says “dozens” of Facebook workers “took the day off by logging into Facebook's systems and requesting time off to support protesters across the country." “I work at Facebook and I am not proud of how we're showing up.

The majority of coworkers I've spoken to feel the same way. We are making our voice heard,” tweeted Jason Toff, a director of product management at Facebook who's been at the company for a year.

Toff, who has a verified Twitter account, had 131,400 “likes” and thousands of retweets of his comment. He did not immediately respond to a message seeking comment on Monday.

“I don't know what to do, but I know doing nothing is not acceptable. I'm a FB employee that completely disagrees with Mark's decision to do nothing about Trump's recent posts, which clearly incite violence. I'm not alone inside of FB.

There isn't a neutral position on racism,” tweeted another employee, design manager Jason Stirman.

Stirman did not immediately respond to a request for comment on Monday. Sara Zhang, a product designer at the company, tweeted that Facebook's “decision to not act on posts that incite violence ignores other options to keep our community safe.

The policy pigeon holes us into addressing harmful user-facing content in two ways: keep content up or take it down.” “I believe that this is a self-imposed constraint and implore leadership to revisit the solution,” she continued. Zhang declined to comment to The Associated Press.

Representatives for Facebook did not immediately respond to messages for comment.

Twitter has historically taken stronger stances than its larger rival, including a complete ban on political advertisements that the company announced last November.

That's partly because Facebook, a much larger company with a broader audience,targeted by regulators over its size and power, has more to lose. And partly because the companies' CEOs don't always see eye to eye on their role in society.

Over the weekend, Twitter changed the background and logo if its main Twitter account to black from its usual blue in support of the Black Lives Matter protesters and added a #blacklivesmatter hashtag. Facebook did the same with its own logo on its site, though without the hashtag.

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News Network
July 2,2020

Los Angeles, Jul 2: New daily coronavirus cases in the United States soared past 50,000 for the first time Wednesday, as the World Health Organization delivered a grave warning that the global pandemic is accelerating.

Restaurants, bars and beaches in the world's worst-hit nation closed from California to Florida, as states reeling from yet another surge in the deadly virus braced for Independence Day festivities.

Global infections have hit their highest level in the past week, WHO data showed, with chief Tedros Adhanom Ghebreyesus saying new cases topped "160,000 on every single day."

The grim milestone came as the European Union left the United States, Brazil and Russia off its final list of nations safe enough to allow residents to enter its borders.

With more than 52,000 new COVID-19 cases in the United States alone in the past 24 hours, according to a Johns Hopkins University tally, several US states imposed 14-day quarantines on visitors in the buildup to the long weekend's July 4 celebrations.

California suspended indoor dining at restaurants in Los Angeles and several counties, while New York scrapped plans to allow restaurants to seat customers inside from next week.

President Donald Trump reiterated his belief that the contagion will "at some point... sort of just disappear, I hope."

But the US leader who has yet to be seen in public wearing a face mask during the pandemic added he would have "no problem" doing so.

EU travel ban eased

The rollbacks came as the European Union reopened its borders to visitors from 15 countries.

The bloc hopes relaxing restrictions on countries from Algeria to Uruguay will breathe life into its tourism sector, choked by a ban on non-essential travel since mid-March.

Travelers from China, where the virus first emerged late last year, will be allowed to enter the EU only if Beijing reciprocates.

And Brazil -- which has suffered the most deaths globally for the last week, and is the second-worst affected country overall -- was excluded entirely.

It topped 60,000 total fatalities Wednesday, after suffering 1,000 deaths in just 24 hours.

However, with over 10 million known infections worldwide and more than 500,000 deaths, the pandemic is "not even close to being over", the WHO warned.

Data provided by the UN health agency for the seven days from June 25-July 1 showed the highest number of new daily cases ever recorded came on June 28, when over 189,500 new cases were registered worldwide.

'Dutch brothels reopen'

According to the United Nations, the coronavirus crisis could cost global tourism and related sectors from $1.2 to $3.3 trillion in lost revenue.

Greece, which has suffered fewer than 200 virus deaths, has seen its economy hit hard by lockdowns and travel restrictions -- all but ending its lucrative tourism season before it began.

Romanian Cojan Dragos was "the first tourist" in one Corfu hotel after driving there with his wife and daughter.

"We have the whole hotel just for us," he told news agency.

Separately, Spain and Portugal held a ceremony as they reopened their land border.

The Netherlands also confirmed the reopening Wednesday of another tourist draw -- its brothels and red-light districts.

"I'm totally booked," said sex worker Foxxy, adding that she had held a "little party" when she heard restrictions would be lifted.

Clusters spur new lockdowns

Russia did not make the EU's list of approved countries so its citizens will be absent from the bloc's tourist hot-spots.

The country, however, enjoyed a public holiday Wednesday as it voted in a referendum to approve constitutional changes allowing President Vladimir Putin to stay in power for another 16 years.

Putin was forced to postpone the vote in April as his government tackled an outbreak that has infected almost 650,000 people -- the third-highest in the world.

In other countries, clusters are still causing problems.

Parts of the Australian city of Melbourne suffered sharp rises in infections, spurring new stay-at-home measures.

The Palestinian Authority announced a five-day lockdown across the West Bank after a surge in confirmed cases.

And textile factories in the central British city of Leicester were suggested as the reason for a spike in infections that has prompted the reimposition of local restrictions.

Americas spike

In the United States, spikes across southern and western states are driving a surge in national infections.

Texas, which again smashed its daily COVID-19 record with over 8,000 new cases, joined Florida and California in closing some beaches for the upcoming holiday weekend.

Apple announced it would close another 30 US stores on Thursday, half of them in California.

A further 700 deaths nationwide took the US past 128,000 deaths in total.

The Pan American Health Organization warned that the death count in Latin America and the Caribbean could quadruple to more than 400,000 by October without stricter public health measures.

The US government announced this week it had bought 92 percent of all remdesivir production -- the first drug to be shown to be relatively effective in treating COVID-19.

Britain and Germany, however, said Wednesday they had sufficient stocks of the drug.

'Corona baby'

In Britain, some 1,500 acts from Ed Sheeran and Coldplay to Paul McCartney and The Rolling Stones urged the county's government to save the live music industry, which has been collapsing because of the coronavirus.

But while lockdown measures have been a disaster for many, some have welcomed the chance to spend more quality time with hard-working partners.

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News Network
February 26,2020

Feb 26: China’s massive travel restrictions, house-to-house checks, huge isolation wards and lockdowns of entire cities bought the world valuable time to prepare for the global spread of the new virus.

But with troubling outbreaks now emerging in Italy, South Korea and Iran, and U.S. health officials warning Tuesday it’s inevitable it will spread more widely in America, the question is: Did the world use that time wisely and is it ready for a potential pandemic?

“It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen — and how many people in this country will have severe illness,” said Dr. Nancy Messonnier of the U.S. Centers for Disease Control and Prevention.

Some countries are putting price caps on face masks to combat price gouging, while others are using loudspeakers on trucks to keep residents informed. In the United States and many other nations, public health officials are turning to guidelines written for pandemic flu and discussing the possibility of school closures, telecommuting and canceling events.

Countries could be doing even more: training hundreds of workers to trace the virus’ spread from person to person and planning to commandeer entire hospital wards or even entire hospitals, said Dr. Bruce Aylward, the World Health Organization’s envoy to China, briefing reporters Tuesday about lessons learned by the recently returned team of international scientists he led.

“Time is everything in this disease,” Aylward said. “Days make a difference with a disease like this.”

The U.S. National Institutes of Health’s infectious disease chief, Dr. Anthony Fauci, said the world is “teetering very, very close” to a pandemic. He credits China’s response for giving other nations some breathing room.

China locked down tens of millions of its citizens and other nations imposed travel restrictions, reducing the number of people who needed health checks or quarantines outside the Asian country.

It “gave us time to really brush off our pandemic preparedness plans and get ready for the kinds of things we have to do,” Fauci said. “And we’ve actually been quite successful because the travel-related cases, we’ve been able to identify, to isolate” and to track down those they came in contact with.

With no vaccine or medicine available yet, preparations are focused on what’s called “social distancing” — limiting opportunities for people to gather and spread the virus.

That played out in Italy this week. With cases climbing, authorities cut short the popular Venice Carnival and closed down Milan’s La Scala opera house. In Japan, Prime Minister Shinzo Abe called on companies to allow employees to work from home, while the Tokyo Marathon has been restricted to elite runners and other public events have been canceled.

Is the rest of the world ready?

In Africa, three-quarters of countries have a flu pandemic plan, but most are outdated, according to authors of a modeling study published last week in The Lancet medical journal. The slightly better news is that the African nations most connected to China by air travel — Egypt, Algeria and South Africa — also have the most prepared health systems on the continent.

Elsewhere, Thailand said it would establish special clinics to examine people with flu-like symptoms to detect infections early. Sri Lanka and Laos imposed price ceilings for face masks, while India restricted the export of personal protective equipment.

India’s health ministry has been framing step-by-step instructions to deal with sustained transmissions that will be circulated to the 250,000 village councils that are the most basic unit of the country’s sprawling administration.

Vietnam is using music videos on social media to reach the public. In Malaysia, loudspeakers on trucks blare information through the streets.

In Europe, portable pods set up at United Kingdom hospitals will be used to assess people suspected of infection while keeping them apart from others. France developed a quick test for the virus and has shared it with poorer nations. German authorities are stressing “sneezing etiquette” and Russia is screening people at airports, railway stations and those riding public transportation.

In the U.S., hospitals and emergency workers for years have practiced for a possible deadly, fast-spreading flu. Those drills helped the first hospitals to treat U.S. patients suffering from COVID-19, the disease caused by the virus.

Other hospitals are paying attention. The CDC has been talking to the American Hospital Association, which in turn communicates coronavirus news daily to its nearly 5,000 member hospitals. Hospitals are reviewing infection control measures, considering using telemedicine to keep potentially infectious patients from making unnecessary trips to the hospital and conserving dwindling supplies of masks and gloves.

What’s more, the CDC has held 17 different calls reaching more than 11,000 companies and organizations, including stadiums, universities, faith leaders, retailers and large corporations. U.S. health authorities are talking to city, county and state health departments about being ready to cancel mass gathering events, close schools and take other steps.

The CDC’s Messonnier said Tuesday she had contacted her children’s school district to ask about plans for using internet-based education should schools need to close temporarily, as some did in 2009 during an outbreak of H1N1 flu. She encouraged American parents to do the same, and to ask their employers whether they’ll be able to work from home.

“We want to make sure the American public is prepared,” Messonnier said.

How prepared are U.S. hospitals?

“It depends on caseload and location. I would suspect most hospitals are prepared to handle one to two cases, but if there is ongoing local transmission with many cases, most are likely not prepared just yet for a surge of patients and the ‘worried well,’” Dr. Jennifer Lighter, a pediatric infectious diseases specialist at NYU Langone in New York, said in an email.

In the U.S., a vaccine candidate is inching closer to first-step safety studies in people, as Moderna Inc. has delivered test doses to Fauci’s NIH institute. Some other companies say they have candidates that could begin testing in a few months. Still, even if those first safety studies show no red flags, specialists believe it would take at least a year to have something ready for widespread use. That’s longer than it took in 2009, during the H1N1 flu pandemic — because that time around, scientists only had to adjust regular flu vaccines, not start from scratch.

The head of the World Health Organization, Tedros Adhanom Ghebreyesus, said the U.N. health agency’s team in China found the fatality rate between 2% and 4% in the hard-hit city of Wuhan, the virus’ epicenter, and 0.7% elsewhere.

The world is “simply not ready,” said the WHO’s Aylward. “It can get ready very fast, but the big shift has to be in the mindset.”

Aylward advised other countries to do “really practical things” now to get ready.

Among them: Do you have hundreds of workers lined up and trained to trace the contacts of infected patients, or will you be training them after a cluster pops up?

Can you take over entire hospital wards, or even entire hospitals, to isolate patients?

Are hospitals buying ventilators and checking oxygen supplies?

Countries must improve testing capacity — and instructions so health workers know which travelers should be tested as the number of affected countries rises, said Johns Hopkins University emergency response specialist Lauren Sauer. She pointed to how Canada diagnosed the first traveler from Iran arriving there with COVID-19, before many other countries even considered adding Iran to the at-risk list.

If the disease does spread globally, everyone is likely to feel it, said Nancy Foster, a vice president of the American Hospital Association. Even those who aren’t ill may need to help friends and family in isolation or have their own health appointments delayed.

“There will be a lot of people affected even if they never become ill themselves,” she said.

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