A second, hidden pandemic will follow covid-19. We need to plan for it.

the novel coronavirus. Practically every online message my patients have sent since mid-March begins with a disclaimer: “I’m so sorry to bother you, I know you must be so busy, but . . . ” Primary care physicians worry about covid-19. But we’re also concerned about all the other ways Americans’ health may deteriorate during the fight against the pandemic. The intensive care units in which doctors make desperate efforts to save covid-19 patients may be the stuff of your nightmares. But what keeps me awake at night are the calm hallways and empty doctors’ schedules outside emergency rooms and ICU wards. A second, hidden pandemic will follow covid-19. The question isn’t so much whether it will happen, but how bad it will be. Many diets will slump. Expecting the typical American to keep up with regular exercise under the circumstances is probably a joke. Patients will avoid filling their prescriptions, out of fear of pharmacies or financial desperation. And mental-health issues will flare as the economy worsens and people are stuck at home for weeks. Unnerving anecdotal reports suggest that the problem could go even deeper. Cardiologists have observed that hospital volumes for the most severe type of heart attack, known as a STEMI, are mysteriously low. Neurologists are also reporting fewer strokes. While it is possible that social distancing is somehow lowering the risk of acute problems such as stroke and heart attack, I fear this is a sign that people are avoiding hospitals — even in extreme circumstances. Loss of health-care access is a well-known cause of further death and illness after natural disasters. My colleagues at the Harvard T.H. Chan School of Public Health found that, after Hurricane Maria hit Puerto Rico, the leading cause of death was interrupted access to health care. My research revealed that after Hurricane Sandy shut down the Veterans Affairs hospital in Manhattan for six months, veterans had worse blood-pressure control for at least two years after reopening, compared to veterans in Connecticut whose access was uninterrupted. Covid-19 does not carry the physical destruction of a hurricane. But the reduction in access to health care could rival the aftermath of a large hurricane, and it wouldn’t just hit one stretch of coast or one island. While we may not be ready to reopen the country, there are things we can do to make it easier for Americans to get some of


Saudi Arabia announces a cease-fire in Yemen as aid agencies brace for the spread of the coronavirus

the spread of the virus would devastate Yemen, a deeply impoverished country with a health system badly crippled by the war. No coronavirus cases have officially been reported in Yemen, but international aid agencies are bracing for an outbreak, in part because tens of thousands of Yemenis are being sent home from Saudi Arabia, which has more than 3,000 confirmed cases, according to an aid worker who focuses on Yemen. The country’s internationally recognized government, which is backed by Saudi Arabia and is fighting the Houthis, had agreed to the latest Saudi cease-fire proposal, according to Saudi officials, who spoke to reporters Wednesday on the condition of anonymity to discuss an initiative that had not been officially announced. It was not clear whether the Houthis would cooperate. Mohammed Abdul Salam, a spokesman for the movement, said in a Twitter message Wednesday that the Houthis had sent a proposal to end the war to the United Nations, but it did not specifically mention the Saudi initiative. Numerous past cease-fires, offered by the Saudis or the Houthis, have faltered. The latest is aimed at ending some of the deadliest clashes of the war, as the rebels and government forces battle in northern and central Yemen. Violence over the past 10 days has killed more than 270 people, government officials and tribal leaders told the Associated Press. As coronavirus looms, U.S. proceeding with major reduction of aid to Yemen The clashes, which began in mid-January, set back what diplomats said were promising direct negotiations between Saudi Arabia and the Houthis. The devastating coronavirus pandemic might have provided a new opportunity to halt the hostilities. United Nations and Western officials have been pressing the Yemeni parties and Saudi Arabia to reduce the violence and thus help halt the spread of the virus. The fears that it could ravage Yemen are real: 50 percent or more of the country’s health infrastructure is destroyed or damaged, and Yemen’s people — many malnourished or otherwise weakened by war — are “highly susceptible to disease,” according to the aid worker, who spoke on the condition of anonymity to discuss the scenarios being considered by relief agencies. “They don’t have the hospital facilities to respond to this. If they have 200 ventilators in the country, I’d be stunned,” the aid worker said, adding that the United Nations had mounted a concerted effort to prepare for any possible outbreak. kareem.fahim@washpost.com


A Maryland Spanish teacher becomes her school’s second victim of the coronavirus

Nearly everyone who crossed paths with Spanish teacher Annis Creese — students, colleagues, her nieces and nephews, even the man who drove the bus she took to work — could feel her warmth, which she projected so strongly that some of the kids she taught called her “Mom.” But not everyone knew her story: the incredible odds she beat to get from St. Vincent and the Grenadines, where she was born to a domestic worker, to a classroom in Hyattsville, Md. The toughness that helped her survive an impoverished childhood, a coup and raising two children on her own. Creese, who was in her final year of teaching Spanish at Northwestern High, died Sunday at age 72 from complications of the novel coronavirus. She is the second educator at Northwestern High and the third school employee in Prince George’s County to die from the virus. Counselor Terrance Burke, who also coached basketball, died March 27 at 54. Eastern Stewart Jr., who managed the Bowie Center for the Performing Arts, died the next day at 71. Creese left behind two grown children and the hundreds of students who passed through her classroom at the Hyattsville high school over her 25 years there. “Ms. Creese was a wonderful colleague and an amazing person,” Principal E. Carlene Murray said in a statement. “Her warm smile welcomed everyone to Northwestern High School. … She was a beautiful woman whose light made all of our lives brighter.” It’s unclear how Creese contracted the virus. Her daughter said she took public buses to get around and had gone to the supermarket. But as the pandemic crests in parts of the United States, students are grappling with the loss of teachers and other educators, despite their schools being shuttered to slow the virus’s spread. Creese was born in St. Vincent and the Grenadines. Her mother sent her to live in Trinidad and Tobago with relatives, who discouraged Creese from studying, her family said. She fell in love with school, even though she frequently had to do her homework by candlelight because her family shut off the lights to save electricity. A principal took an interest in her and advanced her two grade levels. She went on to the University of the West Indies, where students could attend for free, and studied Romance languages. She started her career teaching Spanish there. “She had all these obstacles in her


Cheetah cubs born at National Zoo’s Front Royal facility

A 5-year-old cheetah named Echo gave birth to four cubs Wednesday at the Smithsonian Conservation Biology Institute in Front Royal, Va., the National Zoo said. The zoo posted a live feed of the births on its website, in which one cub could be seen crawling in the straw, chirping and nursing, while the mother cheetah licked the others clean The cubs were sired by a 4-year-old cheetah named Scott. “Animal care staff will leave Echo to bond with and care for her cubs without interference, so it may be some time before they can determine the” cubs’ sex, the zoo said, “It’s thrilling and humbling to witness something as special as an animal birth,” said Steve Monfort, director of the zoo and the institute. “During this extremely tumultuous and isolating time, we want the new cheetah cam and all our live animal webcams to provide much-needed moments of relief and inspiration from our natural world.” “This was Echo’s first pregnancy, but we’re confident in her maternal instincts and abilities,” said Adrienne Crosier, a cheetah reproductive biologist, according to a zoo statement. Because of human conflict, poaching and loss of habitat and prey, there are only an estimated 7,500 to 10,000 cheetahs left in the wild in Africa. As a public health precaution related to covid-19, the Smithsonian’s National Zoo and Conservation Biology Institute are temporarily closed to the public. michael.ruane@washpost.com


World Athletics sets new dates for track and field championships in Oregon

where the University of Oregon is completing a years-long, $200 million renovation of venerated track stadium Hayward Field. World Athletics, the sport’s international governing body, rescheduled the world championships for July 15-24. World Athletics needed to find a window that worked with two other major track and field events, the Birmingham 2022 Commonwealth Games (July 27-Aug. 7) and the European Championships in Munich (Aug. 11-Aug. 21), already set for that summer. Slotting the world championships before those events over a six-week span creates “a bonanza for athletics fans around the world,” World Athletics President Sebastian Coe said in a statement. World Athletics also believes athletes will be able to compete in all three events with careful planning. The world championships, which typically take place every other year, are track and field’s largest stage aside from the Olympics, attracting nearly 2,000 athletes from more than 200 countries. After the International Olympic Committee and Japanese organizers postponed the Olympics to 2021 last month in response to the novel coronavirus pandemic, World Athletics committed to hosting the world championships in Eugene. The only question was when, with the logical answer being moving them back to 2022. “Oregon ’22, as we must now get used to calling it, will be kick-starting a global festival of international track and field championships in the summer of 2022 that will be a fantastic experience,” said Niels de Vos, the executive director of Oregon’s organizing committee. For track and field athletes, the postponement of the Olympics and the world championships means a crowded long-term schedule. A world championships or an Olympics is now scheduled every year between 2021 and 2025. “Some athletes might get burned out,” 200-meter world champion Noah Lyles, a graduate of T.C. Williams High in Alexandria, said last month. “A lot of athletes do need that year break. Personally, I think it would be a little too much. We do need some break year to do something other than go out for championships.” Before the dates were finalized, Coe said that kind of schedule could be an inevitability and that he didn’t think athletes would have trouble adjusting. “It would offer athletics center stage at a very public point of the year,” Coe said last month. “So let’s look at it from a slightly optimistic way of being able to punch our sport into the homes of many more people over a four-year consecutive cycle.”


Coronavirus puts Trump’s ‘maximum pressure’ under pressure

Want smart analysis of the most important news in your inbox every weekday, along with other global reads, interesting ideas and opinions to know? The White House is in a particularly intense form of crisis mode, Washington’s foreign policy establishment, meanwhile, laments that, at a time of global crisis, Trump has seemingly left the field and abandoned the banner of global leadership. Its denizens issue a steady stream of commentary on what the world may look like when the pandemic passes, though no one knows when that may be. But it’s obvious that global concerns and priorities may change. “The first months of this crisis suggest that the world order that emerges on the other end is likely to be permanently altered,” wrote Ben Rhodes, a former adviser to President Barack Obama. “America’s response to 9/11 committed the familiar mistake of hastening a superpower’s decline through overreach; the Trump presidency, and our failure to respond effectively to COVID-19, show us the dangers of a world in which America makes no effort at leadership at all.” The pandemic casts the signature theme of Trump’s foreign policy in shadow Already, on both sides of the Atlantic, calls are growing for the administration to consider a significant rethink, particularly when it comes to Iran — which, in part through its regime’s own colossal mismanagement, has been ravaged by the coronavirus. The sanctions Trump reimposed on Iran as part of his gambit to smash the 2015 nuclear deal had already crippled the Iranian economy and appear to have enfeebled its public health capacity at a dire time of need. “Iranian medical workers and global public health experts say it is not possible to determine exactly how much U.S. sanctions have affected Iran’s capacity to fight a virus that by official counts has infected more than 35,000 Iranians and killed at least 2,500 — some estimates put the toll far higher — while spawning outbreaks in other countries,” reported The Washington Post’s Erin Cunningham last week. “But they say it is clear that the Iranian health-care system is being deprived of equipment necessary to save lives and prevent wider infection.” Politicians in Europe and Trump’s domestic rivals have all called for either a suspension of sanctions or other temporary measures to expedite humanitarian support for Iran “Just as the COVID-19 pandemic has upended every aspect of the global economy and of human lives and health,


Crime reports for Anne Arundel and Howard counties and for Annapolis

Due to coronavirus and social distancing concerns, •Destruction to a vehicle •Destruction of property/vandalism •Theft from a vehicle •Thefts of vehicle parts and accessories •Tampering with a vehicle •Attempted vehicle theft •Credit or debit card theft •Identify theft •Lost property •Telephone misuse •Trespassing The following were among incidents reported by the Anne Arundel County police. For information, call 410-222-8050. ANNAPOLIS AREA Forest Dr., Holly Dr., DAVIDSONVILLE AREA Howard Grove Rd. and Liberty Nest Ct., ODENTON AREA Maple Ridge Lane, SEVERN AREA Dunfield Ct., WEST RIVER AREA Biltmore Ave., Due to coronavirus and social distancing concerns, These were among incidents reported by the Annapolis Police Department. For information, call 410-268-9000. Bowman Ct., Americana Dr., Croll Dr., Damsel Lane, Hill St., Janwall St. at Tyler Ave., Jefferson Pl., McKendree Ave., Prince George St., Regent St., West St., Forest Dr., Northwest St., Tallwood Rd., Due to coronavirus and social distancing concerns, COLUMBIA AREA Basket Ring Rd., Basket Ring Rd., Clarksville Pike and Centennial Lane, Cobblefield Dr., Columbia 100 Pkwy., Dobbin Center Way, Gerwig Lane, Rockcress Ct., Running Brook Rd. W., Southern Star Terr., Whiteacre Rd., White Acre Rd., Hayshed Lane, Laurel Wreath Way, ELKRIDGE AREA Kit Kat Rd., Railroad Ave., Washington Blvd., Singers Way, ELLICOTT CITY AREA Baltimore National Pike, Boulder Ct., Main St., Meadowridge Rd., Stony Creek Lane, Stony Creek Lane, Walking Stick Rd., HANOVER AREA Southmoor St., JESSUP AREA Montevideo Rd., Washington Blvd., LAUREL AREA All Saints Rd., Bursa Rd., Glen Ridge Dr., Pinenut Ct., Breamore Ct., SAVAGE AREA Fair St., WOODSTOCK AREA Enfield Dr., — Compiled by Lisa M. Bolton


Washington’s Citi Open hopeful of Aug. 3 opener amid uncertain tennis calendar

first of a three-tournament swing of North American hard-court tournaments that typically serve as a tuneup for the U.S. Open, helping players acclimate to the heat, humidity and fast courts associated with the calendar’s final major. U.S. Open officials have said they are also proceeding with plans to hold the tournament as scheduled, Aug. 31-Sept. 13, while exploring contingencies. The USTA Billie Jean King National Tennis Center, which hosts the two-week event, is being converted to a 350-bed temporary hospital as New York battles its coronavirus crisis. As it stands, the Citi Open would start three weeks after the earliest date that men’s and women’s tournaments could resume, barring an extension of the current suspension of play. With the 2020 Tokyo Olympics now postponed one year, the 2020 Citi Open, if contested as scheduled, also might attract some of the top players who had planned to compete in the Summer Games. Ein, a Washington-based venture capitalist who also owns the Washington Kastles World Team Tennis franchise, acknowledged that having to cancel the Citi Open in his second year of managing the event would be costly. “If the tournament is canceled, we would lose a lot of money,” Ein said, “but the health and safety of everyone in our community is the higher priority. We would hope that doesn’t happen. But if it does, it’s because it’s the right thing to do.” Rescheduling the Citi Open for later in 2020 would be difficult, Ein conceded, given the sport’s crowded calendar. French Open officials angered fellow tournament organizers and many players by seizing the Sept. 20-Oct. 4 window to stage their postponed Grand Slam with minimal consultation. Those dates conflict with the Laver Cup, a star-studded, team-format event co-founded by Roger Federer and Tennis Australia. The new dates, starting just one week after the U.S. Open ends, also represent an unprecedented burden for top players because they are now expected to contest four weeks of Grand Slam events on two radically different surfaces in a five-week span. The men’s field for the 2019 Citi Open, which was won by Australia’s Nick Kyrgios, included eight current or former top-10 players: Daniil Medvedev, Stefanos Tsitsipas, David Goffin, Jo-Wilfried Tsonga, John Isner, Milos Raonic and Marin Cilic. While the 2020 Citi Open’s men’s field hasn’t been unveiled, the women’s event has received a commitment from Coco Gauff, the breakout star of the 2019 season. Given


The Technology 202: Airbnb is reeling from the coronavirus fallout

Airbnb was expected to be the The Wall Street Journal reported last night that Airbnb’s recent $1 billion funding round came with stringent terms. The company is paying more than 10 percent interest on the new funding. The terms “show the distress the home-sharing company is under due to the coronavirus pandemic,” the Journal’s Jean Eaglesham and Kirsten Grind write. The infusion of capital comes as the company’s planned IPO may be “in limbo because of stock market volatility and uncertainty caused by the virus,” Erin Griffith reports in the New York Times. Airbnb is one of several travel-related companies suffering especially deeply during the coronavirus pandemic, when many would-be American and international travelers have been told to stay at home. Many customers told CNBC’s Salvador Rodriguez the company was making them jump through too many hoops to get their money back. The company asked some guests to provide proof they are restricted from traveling, and others fell outside the original travel-date window for refunds. “Airbnb needs to rest this problem before it becomes a larger and more expensive problem for them to solve,” Henry Harteveldt, a travel industry analyst at Atmosphere Research Group, told Salvador. It's an ironic position for the start-up that launched at the precipice of the 2008 financial crisis that is now facing another economic slowdown at a key moment. And Airbnb is under intense pressure to show it can maintain its position as a Silicon Valley powerhouse. An additional $1 billion in the bank could help. Airbnb chief executive Brian Chesky says the money will allow the company to be in a strong strategic position when travel rebounds. He says the company will evolve to address the ways travel may change in the virus’s aftermath. “We’ll see a new flexibility in how people live and work, which means they won’t have to be tethered to one location,” Chesky The company has been aggressively working to preserve its relationships with customers, spokesman Ben Breit told me. “Our community support team has been working around-the-clock against this global crisis to help both hosts and guests throughout a situation that has been challenging for the entire industry,” Breit said. “We activated our Extenuating Circumstances policy to provide guests with full refunds or credit because we believe this is the responsible thing to do given the guidance of governments and health experts.” Airbnb’s promise to offer customers who booked


Big banks took ‘free money’ in 2008. They’re turning their backs now on small businesses, SBA official says.

the trade group. “It’s as if Treasury is begging the banks to participate but setting them up to fail,” Granchelli said. In the webinar, Amato criticized banks for refusing applications from longtime customers during their moment of need. “I can’t tell you how many phone calls I have where a doctor will call me, or a business owner will call me, and say, ‘I’ve been with such and such bank for 25, 30, 40 years … and they say they aren’t taking my [Paycheck Protection Program] application because they’re not involved in the program,'” he said. “That should tell you a lot about what that bank really is focused on, but that’s just my editorializing." The emergency lending program is aimed at helping small businesses hobbled by the current economic crisis, which has devastated some of the country’s most vulnerable employers: small retailers, bars and restaurants, entertainment venues and factories that have all shut their doors. The crisis also presents an unprecedented challenge for the SBA, which has struggled to handle a historic influx of loan applications and scrambled to write the rules for the $349 billion aid program while the program already is in motion. The SBA is the smallest among the “major federal agencies” listed in the president’s budget request, with less than $1 billion in annual funding. For fiscal 2021, it saw an 11 percent funding cut compared with the previous year. During the webinar, Amato also addressed delays to the agency’s disaster loans, a long-standing SBA loan program managed by the government rather than the banks. That program has received extra firepower through legislation passed by Congress last month, the Cares Act, and is meant to give cash advances of up to $10,000 to businesses facing a short-term cash crunch. The program received more than 3 million applications in just three days, he said, and is struggling to deal with the backlog. The agency is bringing in unspecified “third-party private resources” to help it meet the challenge, Amato said. “They are muddling through it. If it were up to me, I would write you a check tomorrow,” he told business owners. “But it is coming. … Be patient." Dalton Bennett and Allie Caren contributed to this report. Have a tip or story idea about how the government is handling the Cares Act and its response to economic fallout caused by the coronavirus? Send an email to


Even as deaths mount, officials see signs pandemic’s toll may not match worst fears

U.S. authorities on Tuesday reported 30,700 more people infected with the novel coronavirus and over 1,800 more deaths — the highest daily death toll so far. But amid the grim data, some officials said they saw grounds for hope that the pandemic’s devastation would at least not be as bad as the direst projections. New York, the state hit hardest by the virus, reported its highest daily death toll: 731. But Democratic Gov. Andrew M. Cuomo said the number of new patients admitted to hospitals appeared to be trending downward. “Right now we’re projecting that we are reaching a plateau in the total number of hospitalizations, and you can see the growth and you see it starting to flatten,” Cuomo told reporters Tuesday. “Change in daily ICU admissions is way down, and that’s good news. The daily intubations number is down, and that’s good news. The discharge rate is right about where it was.” But Cuomo also warned that Americans should not let up on social distancing, saying that was largely responsible for the improved outlook. “This is not an act of God we’re looking at,” Cuomo said. “It’s an act of what society actually does.” Nationwide, one computer model of the disease’s future spread — relied upon by governors and the White House — shifted its estimate of covid-19’s U.S. death toll downward this week. Instead of roughly 94,000 deaths as estimated a week ago, the University of Washington model on Tuesday predicted about 82,000 by late summer. By Wednesday morning, the model had been revised even more dramatically downward. It now predicts a total of 60,400 U.S. deaths by August and forecasts the peak of those deaths arriving in just four days on April 12, instead of April 16 as previously projected. Experts, however, have noted that this particular model’s numbers and projections — while used widely — have been consistently lower than those of other models. In another positive sign, several West Coast states announced this week that they are sending ventilators to New York since their need is now less urgent. California Gov. Gavin Newsom (D) said he will send 500; Oregon is contributing 140; and Washington state — which was an early epicenter — is dispatching 400 ventilators. “Even during this painful week, we see glimmers of very, very strong hope,” President Trump told reporters Tuesday. Vice President Pence added that “we continue to see


States lead the fight against covid-19. That means we all depend on Medicaid now.

programs vary in part because of the Affordable Care Act (ACA), which mandated that states extend Medicaid coverage to low-income adults. Some states refused to do so and went to court; the Supreme Court struck down the mandate in National Federation of Independent Business v. Sebelius. The 14 states that refused to expand Medicaid now include a majority of the nation’s uninsured population. Many states, including some that did take the ACA’s Medicaid expansion, also use waivers to narrow who is eligible for benefits, make it harder for residents to enroll or drop coverage for recipients who cannot prove that they are seeking work. By contrast, other states use waivers to further expand eligibility. And they work with community groups to find and enroll the uninsured, using Spanish and other non-English media to let people know they’re eligible. They send staff into hospitals to enroll newborns and their parents. What services each state covers varies widely as well. Some states maintain “thin” programs that cover little outside of services provided by medical professionals. Elsewhere, Medicaid pays for social services that fall outside traditional definitions of health care, including such things as mental health care, substance abuse or financial literacy counseling; affordable housing supports; transportation services to and from health-care facilities; public health campaigns and educational programs; remediation of lead and other environmental hazards; community health centers and workers who help vulnerable populations navigate the health-care system. And, finally, states differ in how they administer Medicaid. Some states use Medicaid dollars to upgrade their own information technology systems and administrative capacity, administering the program directly or in consultation with publicly owned or nonprofit managed care organizations. Other states outsource, using Medicaid dollars to buy recipients private insurance or to pay for-profit managed care companies to administer their program. Those differences shape whether Medicaid can help states fight covid-19 — or not. So which kinds of states are better positioned to control the spread of the coronavirus? First, states whose residents are mostly insured and used to dealing with the health-care system — which makes them more willing to respond to public health directives and more likely to seek care when they have symptoms. Second, states with health agencies that can act to stop the virus’s spread among groups that don’t see public health campaigns or can’t comply if they do. In California, for instance, officials likely kept the outbreak from getting


The mystery of how a tiger caught covid-19 has experts chasing their tails

Genetic analyses suggest the coronavirus, officially SARS-CoV-2, is most genetically similar to a germ found in an endangered, scaly anteater called a pangolin. Some scientists have theorized pangolins traded on the illegal wildlife market were an intermediate host that allowed the virus to infect humans. “Until we find a virus in a host that pretty unambiguously looks like a recent common ancestor of SARS-CoV-2, we may never know for sure,” said Tom Friedrich, a virologist at the University of Wisconsin. “There may even be more than one.” The animal world is rife with viruses — at least 320,000 kinds are known to infect mammals alone. Through habitat fragmentation, pollution and climate change, humans have created the conditions for those viruses to flourish. In a study published Wednesday in the journal Science, a team of researchers from China reported that domestic cats can become infected with SARS-CoV-2 and can even contract the virus through the air. The virus settles in cats’ nasal passages, trachea and lungs. “Surveillance … in cats should be considered as an adjunct to elimination of covid-19 in humans,” the researchers wrote. They also studied ferrets, dogs, pigs, chickens and ducks. Of those, only ferrets were susceptible to the disease. It’s still rare, and a bit weird, that the coronavirus spilled from an animal to a human and then somehow back to a third animal. On March 27, Nadia was seen coughing in her exhibit for the first time. By then the zoo had been closed 11 days. The next week her sister, Azul, two Amur tigers, and three African lions in a different facility looked sick. In a city that has become the epicenter of the outbreak in America, staff immediately suspected the coronavirus. But they had to prove it. Nadia was tranquilized with a low-weight dart Thursday at her exhibit to allow a team of about six veterinarians and staff to gather around her. They conducted an ultrasound, took several nose swabs and extracted blood for tests. “We wanted to rule out all the obvious causes,” Calle said. “With what’s going on in New York City with covid, we wanted that examination as well.” Because so many sick humans are waiting to be tested amid an equipment shortage in New York, Calle felt obligated to explain that Nadia’s test was specifically designed for felines. “There’s no competition for tests,” he said. Nadia’s samples were sent to


A leading model now estimates tens of thousands fewer covid-19 deaths by summer

At a sober press briefing in the White House last week, members of President Trump's coronavirus task force unveiled data supporting the need to continue the national effort to limit the spread of the virus. Even while maintaining policies aimed at limiting person-to-person contact, the administration projected between 100,000 and 240,000 Americans would die of covid-19, the disease caused by the virus. One slide, using data from the Institute for Health Metrics and Evaluation at the University of Washington, showed a predicted peak in the daily death toll from the disease arriving in the middle of April. Anthony S. Fauci, a key member of the task force, made an important point about those projections the day before. “Models are as good as the assumptions you put into them, and as we get more data, then you put it in and that might change,” he said. That point was soon reinforced, with the IHME estimate shifting upward soon after the White House briefing. Late Tuesday night, however, the IHME estimate shifted in the other direction. While the model last week projected nearly 94,000 deaths by late summer, its new estimate puts the toll by August at 60,400 — a decline of 26 percent from the model’s previous estimate. What's more, the day with the most projected deaths was shifted from over 3,100 deaths on April 16 to 2,200 deaths on April 12. This is unequivocally good news, but it carries with it several caveats. The first is that the accuracy of the IHME model already has been called into question by officials fighting the virus. In Colorado, IHME’s estimates indicate the state’s peak daily death toll already passed — an assertion public health officials in the state believe inaccurate. “We are confident our peak has not hit,” the head of the Colorado Department of Public Health and Environment told reporters this week, according to the Denver Post. The Post reported last week that Washington, D.C., is relying on a separate model offering a starkly different picture for how the virus will affect the district. At the time, IHME saw the peak number of deaths arriving in mid-April. The D.C. model, developed by Penn Medicine, estimates the peak will come in late June. That variance is a function of the difficulty of modeling the pandemic, something FiveThirtyEight explored last month. Models should get more accurate as the actual peak approaches — though


of the virus. “The pandemic is only just getting its boots on in other places,” Hanage said. He added he remains “incredibly anxious” about smaller communities around the nation, where the virus can take hold and trigger new hot spots. “They can be hit as hard or harder than urban areas, because they lack resources to deal and probably won’t be testing until too late,” he said. Marynia Kolak, assistant director of health informatics at the University of Chicago’s Center for Spatial Data Science, who is part of a team studying county-level data on the outbreak, agreed that localized outbreaks remain a problem. “It would be great if things suddenly get better, but from all the data we have, it suggest we’re just beginning to approach the peak for several regions of the country,” Kolak said. “It’s all happening region by region,” she added. “A lot of parts of the country have just started to expand as hotspots in the past one or two weeks." While the IHME model tries to estimate the peak in each state, there’s another constraint to keep in mind: it looks forward for only a few months. There is a chance the coronavirus might recede over the summer and resurge in fall, echoing the pattern we see with the seasonal flu. The IHME’s estimate of 60,000 deaths takes us only to August and excludes any potential deaths that might occur in the fall and winter if the virus continues to spread without effective treatments or a vaccine. The model also depends on the social distancing efforts encouraged by the White House of staying in place through May. It doesn’t tackle what happens after that point. If federal and local leaders ease restrictions without other interventions in place, it could result in a resurgence of infections — and deaths. Perhaps the most important thing to keep in mind about the shift in the IHME model is the warning Fauci offered last week. The model depends on the data and if the data change, so will the model. The downward shift in the estimated death toll reflects positive changes in the data states are reporting about the effects of the virus. Shifts in the opposite direction can mean the model’s prediction gets grimmer. “For people to get lax now is the worst case scenario,” Kolak said of the need to maintain the current containment efforts. “If anything,


As coronavirus fears grow, doctors and nurses face abuse, attacks

erupt in violence, not just against health professionals but medical facilities. Protesters in Abidjan, the commercial capital of Ivory Coast, tried to destroy a coronavirus testing center under construction on Monday. Videos on social media showed people ripping planks of wood off the structure as police fired tear gas canisters. Some told reporters they did not want the facility so close to their homes. “They want to kill us,” one told Reuters. Health Ministry officials said the center was not even designed to treat patients with covid-19, the disease the virus causes, but rather to test for the virus. Medical professionals worry the attacks and insults could demoralize health workers just when they’re most needed. “If we continue to harass them, more of them will quit their jobs, and our health-care system would be in danger,” said Reigner Antiquera, president of the Alliance of Young Nurse Leaders and Advocates in the Philippines. In Mexico, suspicion of nurses is so widespread that many have stopped going to work in their uniforms. Maria Luisa Castillo, a 30-year nursing veteran, has worn her white uniform proudly. But on a recent afternoon, after working the daytime shift at Guadalajara’s Civil Hospital, it proved a liability. She was standing alone at a bus stop. A bus approached, she tried to wave it down, and it zoomed on by — to the next block, where it stopped and deposited passengers. “It was clear they didn’t want to pick me up,” the 51-year-old nurse said. She was among at least a half-dozen nurses in western Jalisco state who have filed complaints of discrimination or other harassment in recent weeks. In response, the state government is providing free transportation for nurses, along with face masks. Further north, in Durango state, officials summoned bus companies to explain that there was no health risk in transporting health workers. “We see how in Italy a nurse leaves her home to go to work and people applaud,” said Fernando Ríos Quiñones, a spokesman for the state health department. “But here we see these sad situations.” He said special buses were now dropping employees off at hospitals, and taxi drivers were offering 30 percent discounts to doctors and nurses. Sandra Alemán has heard the advice: Don’t wear your uniform in public. But last Friday, while driving to a public hospital in the city of San Luis Potosí for the night shift, the 32-year-old


Olympic flame no longer on display in Japan because of coronavirus concerns

The Olympic flame, a popular attraction since its arrival in Japan last month, has been taken from display with the Summer Games postponed until next year because of the global outbreak of the novel coronavirus. The flame, which arrived from Greece on March 20, had been on display in Fukushima since March 24, when the Games were pushed back, and was set to remain there through the end of April. “Tokyo 2020 will now keep the flame in an undisclosed location to prevent people from gathering,” Tokyo organizers said in a statement to the Associated Press. The Japanese portion of the Olympic torch relay was to begin March 26 in Fukushima, the site of the first competition of the Tokyo Games, two days ahead of the Opening Ceremonies. Organizers are expected to stick to a similar timetable next year. Although the flame is expected to remain with Tokyo organizers for now, eventually it is expected to take on added significance. “The Olympic flame could become the light at the end of the tunnel in which the world finds itself at present,” Thomas Bach, head of the International Olympic Committee, said upon announcing the postponement. Michael Payne, the former marketing director of the IOC, told the AP that the flame “would provide a very powerful inspiration, a bright light as the world goes through these difficult times.” Japanese Prime Minister Shinzo Abe issued a state of emergency for about a month in Tokyo and six other prefectures that were most seriously affected by the virus but has opted against declaring a lockdown. The Olympic torch was lit in early March in a ceremony that was the first in more than 35 years to be held without spectators in Greece. The Japanese leg of the torch relay was to have begun March 26 in Fukushima as part of a four-month journey through Japan’s 47 prefectures.


Plasma from recovered patients could help treat covid-19 until we find a vaccine

other antiviral medications that they were on at the same time? Despite these questions, doctors should aggressively pursue plasma therapy. We urgently need therapeutic interventions. It’s too painful to see patients — sometimes in their 30s — become confused with air hunger and end up on a ventilator. It’s too painful to FaceTime their families and explain why we don’t have an effective treatment option. Plasma therapy would offer many advantages. A coronavirus vaccine is 12 to 18 months away. Plasma is available now. The price of antiviral medications (when available) may create access issues for patients in resource-limited countries. Plasma is relatively cheap. Coronavirus tests, masks, face shields and ventilators are all scarce resources. Plasma is abundant and will only increase as more patients recover. Convalescent plasma may serve as another stopgap measure against the pandemic before we get to an effective vaccine. The reasons were promising enough that on Friday, the Food and Drug Administration allowed physicians to use convalescent plasma on their covid-19 patients. A multistate consortium of physicians and scientists from 34 institutions had already gone live with a detailed website to help interested doctors and patients. Blood institutes across the nation have started collecting convalescent plasma from test-positive coronavirus donors who have recovered. Donors must be symptom-free for 14 days with a negative follow-up test. Each donor could provide up to three plasma doses, which would be screened for other infectious agents before being infused into the host. Almost 19,000 patients have recovered from covid-19 in the United States, and this allows scientists to conduct robust randomized clinical trials that would give us a lot of insight. Could convalescent plasma be used early in the disease to prevent a patient from getting sick enough to require scarce resources such as ventilators? Could it be used even earlier, like when a health-care worker is exposed to a coronavirus-positive patient who has not yet become symptomatic? Offering convalescent plasma in this scenario may protect yet another scarce resource, our front-line workers, from falling. We can seize this opportunity by providing funding to expand plasma collection capabilities throughout the nation and develop concentrated forms of convalescent plasma. Hyperimmune globulin (H-Ig) is one such option, which allows for the administration of a standardized dose of immunoglobulin in an injection form. That’s one way to scale this treatment nationwide, in far-flung community hospitals, ambulatory settings and drive-through clinics. Imagine how


Maryland forms ‘strike teams’ to combat nursing home coronavirus outbreaks

Maryland Gov. Larry Hogan has launched statewide “strike teams” to respond to the crisis of coronavirus outbreaks at nursing homes and other group living facilities, and he announced a crackdown on businesses that violate social distancing restrictions. Extended-care facilities for the elderly are especially vulnerable to the coronavirus, with high concentrations of at-risk patients and the potential for clusters of fatalities. The death toll at a Richmond-area long-term-care facility reached 32 on Tuesday, with four more residents falling to covid-19, the disease caused by the virus — the largest known outbreak at a single site in the greater Washington area. In Maryland, at least 10 nursing homes in Montgomery County have reported cases of covid-19. The worst outbreak in the state has killed 14 and infected dozens of elderly people at Pleasant View Nursing Home in Carroll County. Those incidents come as the disease continues to spread throughout the region. The District, Virginia and Maryland reported nearly 900 additional coronavirus cases Tuesday and 21 more fatalities, bringing the region’s total to 8,926, with 189 deaths. Hogan (R) said the new strike teams — made up of National Guard, state and local health departments and hospital systems — would provide emergency care, supplies and equipment to assist overburdened nursing homes and extended-care facilities. There are cases among staff and residents at 90 nursing homes and long-term facilities across the state, Hogan said. The number is up from Friday, when there were known cases at 60 Maryland facilities. “The goal here is not to replace a nursing home’s medical team, but provide immediate support,” Hogan said. He touted aggressive steps already taken to limit the spread of the virus in nursing homes, including banning visitor access and staff travel. Montgomery County officials have already assembled “action teams” of county-employed nurses and trained them in infection-control measures, contact-tracing and other epidemiological skills, said Health Officer Travis Gayles. The nurses have been dispatched to facilities where patients or staff have tested positive. The county has supplied all nursing homes with about two to three weeks worth of personal protective equipment, said head of emergency management Earl Stoddard, but is unable to provide them long-term reserves of masks or gloves. One of the region’s worst cases continues to be at Virginia’s Canterbury Rehabilitation & Healthcare Center in Henrico County outside Richmond. In all, 141 residents and staff have been infected at the 190-bed facility, and


Saudi Arabia executed them after questionable trials. Now it won’t give up the bodies for proper burial.

BEIRUT — Every two weeks, Zakiah al-Bakheet would visit the same library in Jiddah, Saudi Arabia, punch in a number on a fax machine and feed in the same piece of paper: a letter addressed to the Saudi state security agency demanding that it return what's left of her husband. She’d listed what she wants back: her husband’s belongings from his time in prison; more than 1,000 books that belonged to him; bank documents that were taken from their house. But most of all, she wants the return of his corpse. “I do not care if it takes a billion ages,” she said in a recent interview, before the coronavirus outbreak put much of the kingdom under lockdown and disrupted her efforts. “I want to bury him in a place that suits him, not like someone whose identity is unknown, or like someone who’s committed an ugly crime.” Saudi Arabia beheaded Abbas al-Hassan a year ago, after convicting him on treason and other charges in a trial that human rights groups say was deeply flawed. He was killed as part of a mass execution of 37 prisoners, and the government refused to turn over at least 33 of the bodies, ignoring repeated pleas from the families and instead burying the corpses itself. The government has not publicly explained why it refuses to return the bodies. The Saudi Embassy in Washington did not respond to a request for comment except to say it was reviewing the request. But human rights activists and family members say they suspect it’s because all 33 of those cases involve men from Saudi Arabia’s minority Shiite Muslim community, which has a fraught relationship with the government. Public funerals could turn into protests. Graves could turn into shrines for dissent. “Not returning bodies is part of the [Saudi] cycle of persecution of the community,” said Ali Adubisi, who founded the European Saudi Organization for Human Rights (ESOHR), a human rights group based in Europe that has compiled a list of those whose corpses have been withheld. From the start of 2016 through the end of 2019, at least 84 Saudi Shiite men were executed or killed in raids by Saudi security forces, according to ESOHR. None of their 84 families has received a body. “Refusing to return the bodies of executed men shows the contempt Saudi Arabia’s rulers have for basic humanity and the rule of law,”


Respiratory therapists are keeping many covid patients on ventilators alive

Many doctors and surgeons have already been — or are going to be — repurposed to take care of covid-19 patients as hospitals get overwhelmed. For some of us, this will mean treating conditions that we haven’t dealt with since medical school. And this might include putting breathing tubes into patients and using ventilators, which few doctors do routinely. Sure, many of us have broad enough experience that we can safely do the procedure. But as hospitals surge with patients experiencing coronavirus-related respiratory illness, one group of front-line workers is absolutely essential in managing these patients and running ventilators: respiratory therapists. These front-line workers are truly the unsung heroes in this battle. Not only do they run the machines, but in many instances, they also have more close contact with covid-19 patients than anyone else in the hospital — which means they’re putting themselves in more danger. My first encounter with a respiratory therapist was as a surgery resident managing a busy critical-care unit in the middle of the night. I was paged overhead. “Dr. Sathya, please report immediately to patient X’s room for respiratory distress.” I ran over and saw the patient was gasping for air. It was obvious the patient needed to be intubated with a breathing tube and quickly placed on a ventilator. I had done this before as a medical student but had no idea where to start. That’s when I saw the respiratory therapist, who arrived within seconds and had already prepared the equipment, drugs and ventilator needed. I thought to myself, “All I have to do is put the tube into the patient’s airway.” But I was sweating bullets. The respiratory therapist kept me calm and told me exactly what to do. The breathing tube slid nicely into the patient’s airway. The respiratory therapist hooked the patient up to the ventilator and single-handedly worked the machine over the next week, making sure it safely pushed air into the patient’s lungs and maintained proper oxygen levels. This was one of many times a respiratory therapist saved the day throughout my career. They serve as the glue that brings everything together when we doctors manage patients with respiratory illnesses. They’re often the first to be called by nurses when a patient is having trouble breathing. They know more about oxygen, breathing support and ventilators than most others in the hospital. They work complex machines, suction secretions


Four ways U.S. intelligence efforts should change in the wake of the coronavirus pandemic

Glenn S. Gerstell, a senior adviser at the Center for Strategic and International Studies, was general counsel of the National Security Agency from 2015 to 2020. Michael Morell is a contributing columnist to The Post and the former deputy director and twice acting director of the CIA. The tens of thousands of men and women in our nation’s spy agencies who help keep us safe cannot work from home. Stationed around the world and handling classified information in secret offices, sometimes in countries with the poorest of health systems, they are the national security equivalent of our courageous doctors and nurses on duty. While intelligence professionals must continue working as usual during the coronavirus crisis, their jobs must change post-crisis in four fundamental ways: The scope of mission must be broadened; public information relied on much more; taxpayer dollars used with greater effectiveness; and our battle against foreign disinformation intensified. First, our intelligence community must adopt a broader definition of national security that reflects the United States’ true vulnerabilities. Of course, we should carefully watch adversarial nuclear-armed regimes, as well as the Islamic State and al-Qaeda. Still, the likelihood of nuclear conflict is extremely low. The serious threat of terrorism has been managed, and it was always unlikely to produce nationwide loss of life. By contrast, the consequences of non-military and political threats — such as economic, health or climate disruptions — are significant and must be assigned a high priority. The public health crisis and devastating economic shutdown from covid-19 are proof that our national well-being relies on more than what have traditionally been considered national security issues. Our intelligence community has developed sophisticated methods of collecting information and possesses deep, analytic expertise on wide-ranging matters, including terrorist groups and Russian, Chinese, Iranian and North Korean military doctrines and weapons systems. Comparatively speaking, however, we know little about the progress of China’s advances in bioengineering, robotics, metallurgy, quantum computing or artificial intelligence. Nor do we know enough about supply-chain risks across scores of industries that can affect U.S. national security, such as how much we rely on rare minerals or pharmaceuticals coming from overseas. The coming crises caused by climate change also have not received sufficient focus. This leads to the second needed change: Our spy agencies must rely more on gleaning insights from ever-increasing amounts of publicly available information. These agencies were designed to dig for secrets held


Pentagon considers new moves, including stop-loss policy, to maintain force amid coronavirus crisis

about what to do if there are large coronavirus outbreaks at recruit training centers. In one Navy memo obtained by The Washington Post last month, military officials suggested that a stop-loss order might need to be explored. To help contain the spread, military officials have paused or restricted training recruits. On Monday, Army officials said that the entry of recruits into basic combat training would be delayed by two weeks to ensure the health of incoming personnel and those around them. If approved, the measures under discussion would seek to ensure the force doesn’t undergo a dangerous contraction, and they follow other steps to maximize the military’s virus response capability. The Trump administration already has authorized the Pentagon to activate personnel from the National Guard, reserve units and Ready Reserves, as it also issues calls for volunteers, especially those with medical training, who want to return to service. But the use of stop-loss has been an unpopular move in the past. During the Iraq War, when it was used heavily by the Army, critics referred to it as a “backdoor draft.” In 2009, then-Defense Secretary Robert Gates called for the practice to be minimized. Brad Carson, who served as acting undersecretary of defense for personnel and readiness during the Obama administration, said consideration of a stop-loss policy was wise as the coronavirus challenges a military personnel system he characterized as a “well-oiled machine.” Under that system, each year’s cohort of retiring officers and other departing troops is compensated for by the entry of several hundred thousand recruits. “Given that training in general has had to grind to a halt, it definitely seems prudent to give the services the flexibility to use stop-loss as a way to keep billets filled so that the readiness hole that covid causes for us isn’t even deeper,” Carson said. Todd Harrison, a senior fellow at the Center for Strategic and International Studies, said such a move could help the military get closer to meeting its yearly troop-level targets. Most of the military’s vast recruiting enterprise already has moved online as a result of the outbreak, posing a further challenge to getting troops into the pipeline. But, he said, “I think the services and current team of leadership are going to be reluctant to use things like stop-loss because it does cause a pretty big hit in morale. It could be viewed as breaking a promise


Going outside is our only escape. But now that’s scary, too.

which is increased by talking or heavier breathing, such as when exercising,” Jimenez told the Denver Post. The professor added that he is trying to maintain a distance of 25 feet from others. Twenty-five! Tell that to the rush-hour crowd at Rock Creek Park in Washington — where, on a recent warm evening, no fewer than eight people tried to pass one another within a few seconds on a section of the paved path that appeared less than six feet wide. On the outdoor gym equipment below the Taft Bridge, some exercisers made use of the chin-up bar, without gloves, ignoring signs stating that the equipment is closed because of covid-19. All this running, with nowhere to go. It’s as if we’re trying to outpace our boredom, or our fear. But for Ben Foley, 30, who typically does a six-to-eight-mile run every day in his suburban Denver neighborhood, that runner’s high doesn’t provide the endorphin rush it used to. “You don’t know who’s practicing social distancing well,” he says. “You don’t know where some of these people continue to go.” So Foley plays it safe: When he sees too many people on his path, he will turn around and cut his run short. The government has struggled with how much to limit access to open-air attractions. The National Park Service has closed some parks, such as the Golden Gate National Recreation Area and Yellowstone, but more than 300 parks remain open, with waived admission fees. Cities have begun to close areas popular with hikers and walkers after seeing big crowds. Chicago closed its Lakefront Trail and the 606, an elevated rail trail. New Yorkers can no longer walk the High Line, and Angelenos can no longer visit the L.A. County beaches. City residents frustrated with the lack of sidewalk space have called for street closures to better enable social distancing. New York closed four streets to vehicular traffic, and other cities have opened certain roads to pedestrians — or, in the case of D.C., closed them to discourage people from driving to see the cherry blossoms. But some worry that turning roads into pedestrian byways will entice more people to spend time in the great outdoors. More like the terrifying outdoors. Anxiety about going outside is creating shut-ins among the shut-ins. “Because I have asthma, I’m very worried about getting this virus,” says Erika Kerekes, 53, of Santa Monica, Calif.


U.S. government is urged to release race, ethnicity data on covid-19 cases

A civil rights group and hundreds of doctors are calling on the federal government to release race and ethnicity data on coronavirus infections and deaths from covid-19, citing reports that the pandemic is affecting African Americans at a disproportionate rate. The information is necessary to “better inform a robust public health response in the Black community” and to “ensure COVID-19 tests are not being administered or withheld in a racially discriminatory manner,” says a letter sent to Health and Human Services Secretary Alex Azar by the Lawyers’ Committee for Civil Rights Under Law. The letter also points to provisions in federal civil rights laws and the Affordable Care Act that prohibit health-care providers “from using federal funds to administer healthcare services that discriminate on the basis of race, color, or national origin.” The Lawyers’ Committee asks Azar for “a written response no later than April 20, 2020.” Some members of Congress have also asked for breakdowns of coronavirus cases by race and ethnicity. The Centers for Disease Control and Prevention and most state health departments have not released information about the race and ethnicity of those who have tested positive for the novel coronavirus or died of covid-19, the disease caused by it. The CDC’s public reports have broken down cases by age and gender, while most states have provided information only by county. “We know they are collecting the data,” Dariely Rodriguez, director of the Economic Justice Project for the Lawyers’ Committee, said in an interview Monday. She said the CDC’s covid-19 case report form includes sections for ethnicity, sex, race and age. It also asks about testing, hospitalization, admissions to intensive care units and mortality. “It’s a very detailed form,” she said. A handful of states report coronavirus cases and death by race and ethnicity. In Illinois, black people are 14 percent of the population but account for 30 percent of the confirmed cases and 41 percent of the deaths. In North Carolina, where African Americans represent 22 percent of the population, they make up 37 percent of cases and 22 percent of deaths. Data from Louisiana, where black people make up 33 percent of the population, shows they represent more than 70 percent of covid-19 deaths. Health-care and government officials in Michigan and Wisconsin also have acknowledged that African Americans have died at disproportionate rates from the disease. In Albany, Ga., which has the highest number of


caused by it. The CDC’s public reports have broken down cases by age and gender, while most states have provided information only by county. “We know they are collecting the data,” Dariely Rodriguez, director of the Economic Justice Project for the Lawyers’ Committee, said in an interview Monday. She said the CDC’s covid-19 case report form includes sections for ethnicity, sex, race and age. It also asks about testing, hospitalization, admissions to intensive care units and mortality. “It’s a very detailed form,” she said. A handful of states report coronavirus cases and death by race and ethnicity. In Illinois, black people are 14 percent of the population but account for 30 percent of the confirmed cases and 41 percent of the deaths. In North Carolina, where African Americans represent 22 percent of the population, they make up 37 percent of cases and 22 percent of deaths. Data from Louisiana, where black people make up 33 percent of the population, shows they represent more than 70 percent of covid-19 deaths. Health-care and government officials in Michigan and Wisconsin also have acknowledged that African Americans have died at disproportionate rates from the disease. In Albany, Ga., which has the highest number of deaths from covid-19 in the state, more than 90 percent of the fatalities are African Americans. Rodriguez said that “African Americans, across socioeconomic groups,” and other people of color historically have experienced bias in the health-care system. They also are more likely to be uninsured and live in communities that have few or no health-care facilities. As a result, people of color have higher rates of chronic diseases such as asthma, heart disease and hypertension. “These co-morbidities render Black Americans more susceptible to severe respiratory complications and death resulting from COVID-19,” the letter reads. The letter also notes that people of color are “highly vulnerable” to exposure to the coronavirus because they often have jobs in which they are not able to work from home. “Many of us have the good fortune to be able to stay at home and work from home, but that’s not the case for black people and other people of color who do not have that privilege,” Rodriguez said. Only 20 percent of black workers, compared with a third of white workers, can work from home. Women of color also are overrepresented and continuing to work in jobs that have been deemed essential, including health


America’s most influential coronavirus model just revised its estimates downward. But not every model agrees.

that determined the District would have essentially no medical surge needs was not indicative of what we anticipated would be our reality in the District and thought that a model that did not overestimate the impact of social distancing in the United States” was the right one, Nesbitt said. In the two weeks since IHME’s model was originally released — the researchers announced revisions Monday — it has been criticized by some experts as overly optimistic. But even critics are quick to note that in the absence of any tool offered by the federal government and with no other model offering nationwide state-by-state estimates, IHME could be a lifesaver. To coordinate their response, some states with few modeling resources or home-state experts have used the IHME forecast that projects peak deaths and the resources needed. The White House relied on it in part to generate its estimate last week that the epidemic would kill 100,000 to 240,000 people nationwide. Most epidemiological models look at different populations that interact in an outbreak — people susceptible to infection, those who are infectious and those already infected who go on to die or recover. Funded by the Bill & Melinda Gates Foundation, the IHME model embraces an entirely different statistical approach, taking the trending curve of deaths from China, and “fitting” that curve to emerging death data from U.S. cities and counties to predict what might come next. For that reason, many experts saw IHME as overly optimistic when it was launched March 26. Few U.S. states or cities are taking action as drastic as what was adopted in Wuhan, China — the birthplace of the coronavirus pandemic — or even Northern Italy in locking down residents. Another big difference between IHME and other models is a fundamental assumption about how effective social distancing can be. The creator of IHME’s model, Christopher Murray, said many state models assume that social distancing will only slow or reduce transmission to some degree. The IHME model, drawing from the example of Wuhan, assumes policies such as social distancing and stay-at-home orders, can effectively reduce transmission to the point where an epidemic — at least in its first wave — is actually brought under control by authorities. At the White House Coronavirus Task Force briefing Monday, health officials said they thought it was possible to have fewer deaths than have been projected by models, because of the


IHME model embraces an entirely different statistical approach, taking the trending curve of deaths from China, and “fitting” that curve to emerging death data from U.S. cities and counties to predict what might come next. For that reason, many experts saw IHME as overly optimistic when it was launched March 26. Few U.S. states or cities are taking action as drastic as what was adopted in Wuhan, China — the birthplace of the coronavirus pandemic — or even Northern Italy in locking down residents. Another big difference between IHME and other models is a fundamental assumption about how effective social distancing can be. The creator of IHME’s model, Christopher Murray, said many state models assume that social distancing will only slow or reduce transmission to some degree. The IHME model, drawing from the example of Wuhan, assumes policies such as social distancing and stay-at-home orders, can effectively reduce transmission to the point where an epidemic — at least in its first wave — is actually brought under control by authorities. At the White House Coronavirus Task Force briefing Monday, health officials said they thought it was possible to have fewer deaths than have been projected by models, because of the extreme social distancing efforts being undertaken by Americans. “Models are good, they help us to make projections. But as you get data in, you modify your model,” said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. “I don’t accept everyday we’re going to have to have 100,000 to 200,000 deaths. I think we can really bring that down." When it comes to predictions, statisticians have a favorite maxim: “All models are wrong, but some are useful.” By drawing on the multiple models, experts are often able to better triangulate their predictions and assumptions. This is why weather experts often draw on several models rather than one in forecasting storms, using an “ensemble” or “suite” of models. Such ensembles are also what generate the cone of uncertainty for hurricanes. In Illinois, state leaders are using four models — a version of the CHIME model and models from the University of Chicago, Northwestern University and the University of Illinois at Urbana-Champaign. New York state officials have said they are drawing on at least four different models, including IHME’s. In North Carolina, state leaders are using a “weather forecasting” approach that combines several models — and instead of


‘We need a Seder’: One family strives to celebrate Passover during a plague

At some point as she watched the parade of coronavirus cancellations on the news — no more sports seasons, no more school days, no more Broadway shows or book clubs or weddings — it dawned on Doris Geisler that she would have to cancel the Passover Seder. The Jewish holiday, which begins Wednesday night, was still weeks away at that point. But Geisler already had the gefilte fish ready and waiting in the freezer, enough to feed the 30 or more guests who cram into her home every year. She and her husband, Allan, are both retired teachers, and their days are normally filled with mah-jongg games and lunches with friends and lots of time at their Howard County synagogue. As the novel coronavirus descended, they found themselves with empty calendars. At ages 65 and 78, they feared leaving the house even for groceries. The couple sat alone at their home in Columbia, Md., and they wondered: Would the pandemic take away Passover, too? Or could they still find meaning in the holiday, in a world that had narrowed drastically? Worldwide, a night different from all other nights Passover is the most-observed Jewish holiday of the year. When Pew conducted a landmark study of Jewish Americans in 2013, it found that just 23 percent of Jews usually light Sabbath candles, and about half fast on Yom Kippur — but a whopping 70 percent had attended a Seder the previous year. The holiday is traditionally observed in the home, not in a synagogue. Families invite relatives and friends to eat symbolic foods, sing songs and say blessings, and recount the biblical story of the Jews leaving slavery in Egypt. This year, the dawning awareness that almost no one would be hosting guests has caused an outpouring of grief and creativity around the world. Jews of all ages and backgrounds mourned the prospect of being alone at the Seder table, or missing the once-a-year chance to see faraway relatives. Rabbis and writers rushed to come up with high-tech ideas for a virtual Seder. But for the Geislers, like so many others, Passover isn’t something you celebrate on a screen. Passover means pushing aside all the furniture in the house so dozens of people fit around three tables pushed together in a U shape. Passover means that she cooks for a week and he cleans up all night when it’s over. Passover means


The WNBA was ascendant before the coronavirus changed everything. What happens now?

WNBA is not alone when it comes to having lost its momentum,” said David Carter, associate professor of sports business at the USC Marshall School of Business. “ … Unlike the major sports leagues and events underway well into in the summer, the WNBA has to be concerned about being out of sight, out of mind. Fortunately, the league’s refined focus on the game and storytelling should help.” While Engelbert remains sanguine, players and prospects are in a holding pattern. For many current players, their economic worries are twofold. Concerns about taking an economic hit with an altered WNBA season are compounded by lost wages during the offseason; most WNBA players spend the fall and winter months playing in overseas leagues that were canceled or suspended. When Harrison scrambled to get home, she missed out on her last check from her Italian team, Virtus Segafredo Bologna. The 26-year-old spent about $2,500 out of her own pocket between her ticket home and the Dallas hotel room she booked to self-quarantine for two weeks. “That’s still my job, no matter what I do,” she said. “That’s how I get paid. So not even knowing the next time I’ll get a paycheck, it really alters how you operate in life.” Prospects, too, are fretting over their futures. The incoming rookie class already lost the end of their college careers — including the NCAA tournament, often a stage for players to garner national attention — and now aren’t sure what happens after they get drafted. Baylor forward Lauren Cox — the Big 12 player of the year and the No. 2 prospect behind Ionescu in many mock drafts — has been trying to stay in shape for whenever training camps begin. She runs sprints with her sisters in her Dallas neighborhood and uses outdoor courts for workouts. “Just not knowing what’s next is definitely the hardest part,” she said. “A lot of players that don’t go to the WNBA go overseas, and even that, we have no idea if that’s even going to happen. We thought we had a job lined up after college, and now we have no idea what’s going to happen.” The league declined to comment on whether players under contract will be paid during periods when games aren’t being played. Likewise, the players’ union is unsure of what happens next. Ogwumike is seeking input from other players. “Our league is


D.C, Md. to get 250 ventilators from California; coronavirus disproportionately hurting D.C.'s black residents

The number of known coronavirus cases in the District, Maryland and Virginia stood at 8,028 on Monday, with 4,046 cases in Maryland, 2,881 in Virginia and 1,101 in the District. The number of virus-related deaths was 54 in Virginia, 91 in Maryland and 24 in the District, for a total of 169 fatalities. Here are some of the most significant and recent developments as the region responds to the pandemic of the novel coronavirus, which causes the disease covid-19: • Vice President Pence announced Monday that 250 of the ventilators that were loaned by the state of California to the national stockpile will be going to Maryland and the District. • The D.C. government on Monday released coronavirus data broken down by race for the first time, showing African Americans are disproportionately represented among the dead. • D.C. and Arlington reported Monday the coronavirus crisis was causing large drops in revenue that would impact their budgets. Arlington said it would face a $56 million shortfall, while D.C. projected a $607 million shortfall • New coronavirus emergency relief before the D.C. Council would freeze rent increases, make it easier to free prisoners at risk of becoming infected with the covid-19 illness and require the D.C. Board of Elections to mail every registered voter an application for an absentee ballot. What a stay-at-home order means for you


The coronavirus could be wreaking havoc on the world’s last Stalinist state

Pyongyang ostensibly threatened to shoot anyone who even came close to the frontier. In February, the regime canceled a military parade celebrating the 72nd anniversary of the People’s Army — what would normally be a highly publicized and well-attended event. Kim has even quarantined thousands of his own citizens and hundreds of foreigners. Yet covid-19 appears to have gained a foothold nonetheless. Nearly a dozen prisoners at Chongori Prison in North Hamgyong, known for housing North Koreans repatriated from China, reportedly died from respiratory issues, prompting authorities to disinfect the entire prison. Additionally, 180 soldiers have presumably died from the virus (and another 3,700 were quarantined). Last month, Kim Jong Un ordered construction on a new hospital in Pyongyang to be completed in a mere 200 days. (He claimed this was to coincide with the 75th founding of the Workers’ Party.) And now North Korea has reportedly opened its borders with China slightly in an effort to bring in essentials, including medical-grade face masks and medicine. Yet the regime still denies any cases of covid-19. As it did during the 1990s famine, the North Korean government seeks to maintain an iron-clad grip on the flow of information. Kim Jong Un has not been seen publicly wearing a mask, suggesting that “Dear Respected” wants to send a message of business as usual to the populace. And those deaths? The regime has attributed them to virtually every respiratory illness but covid-19. (This is especially easy to do when you lack the capacity to test for the virus on a large scale.) It’s also rumored that agents at North Korea’s Ministry of State Security Bureau 10 have arrested North Koreans who attempted to discuss the virus via mobile phone. Last month, an anonymous social media commentator claimed that the regime had executed the first covid-19 patient in the country. Though this account hasn’t been verified, the regime has been known to kill any citizen it regards as an existential threat, and a person carrying the virus capable of wreaking havoc on the country’s economic and health-care systems would almost certainly fit the bill. Clamping down on information for the sake of controlling the narrative comes at a price. North Korea’s attempts to conceal the 1990s famine meant that experts could not take early action because it was impossible to investigate or exchange information. It wasn’t until the famine had ravaged the country that


D.C. projects about 93,000 people could become infected; coronavirus cases top 5,000 in Washington region

The number of known coronavirus cases in the District, Maryland and Virginia stands at 5,535 on Friday, with 2,759 cases in Maryland, 2,015 in Virginia and 761 in the District. The total of virus-related deaths was 47 in Virginia, 43 in Maryland and 15 in the District, for a total of 105 fatalities. Here are some of the most significant and recent developments as the region responds to the pandemic of the novel coronavirus, which causes the disease covid-19: • Mayor Muriel E. Bowser said Friday that officials estimate about 93,000 people could be become infected with covid-19 in the city, based on the District’s projections. See more about the models the city uses to project infections. • The Virginia House of Delegates is set to reconvene as scheduled on April 22, but is likely to do so at an outdoor location to help prevent members’ exposure to the novel coronavirus, Speaker Eileen Filler-Corn (D-Fairfax) said. • Virginia added 306 known coronavirus cases Friday, while Maryland added 427 and the District added 104, putting the number of known cases in the greater Washington region at 5,535. The number of fatalities is 104 in the two states and the District. • George Washington University Hospital will begin drive-through testing for the novel coronavirus beginning Monday in Foggy Bottom. What a stay-at-home order means for you


The latest flexible policies at major airlines in the wake of coronavirus

With the coronavirus outbreak now a global pandemic, the travel industry has come to a halt. U.S. airlines have responded to the virus by suspending travel to various international destinations through the spring, and most gatherings around the world have been canceled altogether amid a steady rise in new infections. To help quell travelers’ worries over trips that are being disrupted, airlines have begun adding flexibility to their policies. If you had planned a trip for the near future, or were considering one further out, here are your options. (Note: Due to the rapidly changing nature of coronavirus and its effects on air travel, it’s a good idea to check directly with your airline.) Delta is waiving change fees for travelers on both international and domestic flight through May 31 for tickets issued during the months of March, April and May. In an unprecedented move for the industry, Delta is extending the life of previously purchased tickets for two years, meaning they can be rescheduled or used as “eCredit” for future tickets purchased through May 31, 2022. In addition to suspending travel from the United States to Shanghai and Beijing, Delta is giving customers the option to make a one-time change without any fees for people whose plans included Shanghai, Beijing, Seoul and all locations in Italy, including such popular locations as Bologna, Milan, Rome, Turin and Venice, through April 30. For tickets originally purchased during the month of March and including all travel dates through Dec. 31, Virgin has waived change fees for travel through April 30, 2021. Tickets that travelers have selected for a future date can be reissued up to the day before departure for the one-time change. “Virgin Atlantic wants to offer as much flexibility as possible for our customers impacted by the rapidly accelerating Covid-19 situation,” representatives for the airline said in a statement to The Washington Post. “We’re helping customers with upcoming travel plans rebook free of charge, to change their destination or date of travel, or receive a voucher and hold their ticket open, up until 30th April 2021. Where a flight is cancelled, we encourage our customers to discuss their options with us, including booking on an alternative date.” Alaska has waived change and cancellation fees for travel through April 30 for tickets purchased through the end of February until now. In addition to the fee waiver on all fares, travelers can


The Daily 202: CDC case study of Chicago coronavirus outbreak shows why it is dangerous to go to church on Easter

charged with making terroristic threats, among other things.” Ian Haydon, a public information specialist at the University of Washington, wrote about his experience as one of 45 volunteers taking part in Phase 1 of a clinical trial testing a potential cure: “Instead of injecting me with protein derived from the virus, the researchers jabbed me with genetic material encoding such a protein. If my body absorbs this code and carries out its instructions, some of my cells will produce a single protein from the virus. That should prompt my immune system to create antibodies against the viral molecule. The idea is that those antibodies would protect against the real virus.” “It’s hard enough being a doctor in the midst of the coronavirus pandemic. But Sanjibani Panigrahi, a psychiatrist at a government hospital in western India, now finds her own neighbors turning against her,” Mary Beth Sheridan, Niha Masih and Regine Cabato report. “‘We are sure you have corona,’ one woman recently shrieked at her, she says, — part of a torrent of abuse from residents at her apartment complex. ‘We will not allow you in the building.’ In some cities, health-care workers are earning standing ovations for the long, life-risking hours they’re putting in to battle the coronavirus. But in others, they’re facing discrimination and even attacks. In Mexico, Colombia, India, the Philippines, Australia and other countries, people terrified by the highly infectious virus are lashing out at medical professionals — kicking them off buses, evicting them from apartments, even dousing them with water mixed with chlorine.” That’s four times the size of the British armed forces, Karla Adam and Christine Spolar report. “Britain hasn’t seen such a surge in volunteers since World War II, when the country pulled together in a way still remembered with immense pride. Now — with more than 60,000 people here having tested positive for the novel coronavirus, and with the prime minister among those who have been hospitalized — organizers are figuring out how to deploy the army, while individuals and companies are engaged in informal volunteer activities throughout the British Isles. Michael Hayes, 55, is a taxi driver who joined the volunteer army and is awaiting his first official assignment. In the meantime, he spends about five hours a day driving NHS staff home, at no cost, from Newham University Hospital in East London, where his three children were born.” “A steady rise


hours they’re putting in to battle the coronavirus. But in others, they’re facing discrimination and even attacks. In Mexico, Colombia, India, the Philippines, Australia and other countries, people terrified by the highly infectious virus are lashing out at medical professionals — kicking them off buses, evicting them from apartments, even dousing them with water mixed with chlorine.” That’s four times the size of the British armed forces, Karla Adam and Christine Spolar report. “Britain hasn’t seen such a surge in volunteers since World War II, when the country pulled together in a way still remembered with immense pride. Now — with more than 60,000 people here having tested positive for the novel coronavirus, and with the prime minister among those who have been hospitalized — organizers are figuring out how to deploy the army, while individuals and companies are engaged in informal volunteer activities throughout the British Isles. Michael Hayes, 55, is a taxi driver who joined the volunteer army and is awaiting his first official assignment. In the meantime, he spends about five hours a day driving NHS staff home, at no cost, from Newham University Hospital in East London, where his three children were born.” “A steady rise in countries limiting or banning food exports has triggered warnings from U.N. food agency leaders about possible disruptions to the global food supply as the world retrenches amid the covid-19 pandemic — potentially making critical staples such as wheat and rice more costly and harder to find,” Robyn Dixon, David Stern and Almaz Kumenov report. “For exporting countries, domestic reserves of grains and rice are generally good after years of relatively good harvests, according to the U.N.’s food and agriculture program. But reductions in exports could hit countries in Africa, the Philippines, the Persian Gulf and other regions that import much of their food.” “When the people of Wuhan and elsewhere across China have wanted to share lockdown anxieties, seek advice or simply vent, many have turned to one of the country’s most famous Wuhan hero: Li Wenliang, the whistleblower doctor who died Feb. 7,” Gerry Shih reports. “In recent weeks, homebound Internet users have left hundreds of thousands of messages to ‘Brother Liang’ — or sometimes called ‘Old Li’ — as comments under Li’s final post from Feb. 1 on Weibo, the popular Chinese social media platform. In tones both casual and intensely personal, they have used Li a


Coronavirus-wracked nursing home evacuated after most of staff failed to show for two days

“had made a large staffing request for the next day which was considered an unusual event,” Kaiser said. The request came just days after testing confirmed an outbreak of covid-19 at the center. Upon contacting the nursing home, Kaiser said he was informed that a “substantial portion” of employees had not come in for their shifts. On Tuesday, only one certified nursing assistant out of the 13 scheduled to work showed up, which prompted facilities nearby to send more than 30 of their own nurses to the center, according to a news release from the county. The staffing problem persisted into Wednesday morning, Kaiser said at the news conference, leaving him with no choice but to order the evacuation “to safeguard the well-being of the residents and ensure appropriate continuity of care.” According to the most recent figures, Riverside County has 1,179 confirmed cases of the coronavirus, with 32 reported deaths. Bruce Barton, director of the county’s emergency management department, told reporters that Wednesday’s operation involved 53 ambulances as well as assistance from the fire department and police. The Southern California county isn’t alone in its struggles to care for its vulnerable residents amid the pandemic. Since the coronavirus reached the United States, reports of nursing homes and eldercare facilities becoming overwhelmed by outbreaks have surfaced regularly. Last month, a senior-care center in New Jersey relocated all 94 of its residents following a covid-19 outbreak that also sickened several workers, causing critical staffing shortages. Meanwhile, the CEO of a company running several eldercare facilities in New York, the epicenter of the U.S. outbreak, started advising family members to take their loved ones home if possible, NBC News reported this month. The Seattle Times reported Wednesday that at least 137 long-term-care facilities in Washington state had residents test positive for the virus. More than 200 deaths have been linked to them, according to the Times, about half the total fatalities in the state from covid-19. On Wednesday, as patients from the Riverside center were still waiting to be transported, Barton issued a plea to health-care workers for assistance. “We are in immediate need for help to care for our most vulnerable patients,” he said. “We will provide full PPE. We will pay you and provide malpractice. The facilities you work in will be clean. We have an amazing team that is working on this night and day. Please come join us.”


The ventilator shortage is here. The medication shortage is next.

Joshua Resnick is an emergency medicine physician at Massachusetts General Hospital and a managing director at RA Capital Management, a Boston-based biotech investment fund. Picture this: You’re struggling to breathe. There’s a plastic tube down your throat, and it feels like you’re choking. Your body is in panic mode; your lungs are screaming that you aren’t getting enough air, that you’re dying right now, in agony. Alarm bells shriek as you fight against the ventilator and flail against the masked people trying to pin you down. Even though oxygen is flowing, you are suffocating because your fighting makes the ventilator ineffective. Then a nurse adjusts your medication and you dissolve back into relief. Now imagine if the medication pump were empty and the hospital were out of critical medications to refill it. This is the next nightmare we face in the covid-19 war. Widespread reports of ventilator shortages and the prospect of doctors forced to choose who will live and die have belatedly stirred the United States to action. Last week, the Trump administration invoked the Defense Production Act to facilitate the rapid manufacture of ventilators. But make no mistake: These ventilators will be useless without a steady supply of the critical care medications that allow emergency and critical care physicians to sedate and support our intubated patients. It is terrifying to imagine being on a ventilator without sedation. But the medical issues here transcend patient anxiety and discomfort. These medications are life-saving, full stop. Oxygenating patients through severe acute respiratory distress syndrome, or ARDS, requires heavy sedation and often medical paralysis. Emergency intubation of patients without powerful sedatives and muscle relaxants is highly traumatic for patients and often unsuccessful. Intubating a covid-19 patient this way could also prove fatal to the doctor due to the aerosolization of massive doses of virus that would occur under these conditions. A recent survey of U.S. health-care facilities found that 70 percent reported at least one shortage of drugs for coronavirus treatment — a figure that’s bound to get worse. As an emergency physician, I am making an impassioned call to focus state and federal attention on this looming shortage of the medications required to treat patients in respiratory failure, particularly sedatives, neuromuscular blockers, analgesics and vasopressors. And as someone with more than 15 years of experience launching biotech companies, I know that our industry has the know-how to tap into existing drug


Postcards from a nervous world: ‘Hockey stick’ social distance and a comforting whiff of bakery bread

The walls of our homes are seen as protection from covid-19, whose death count ticks up at a gut-wrenching pace each day. But those walls also are a constant reminder of how much has changed under the pandemic — and the wait until we can step outside without being on guard. The Washington Post has asked contributors around the world to share their experiences. On the same day the World Health Organization declared a pandemic, March 11, I had surgery. Complications afterward necessitated two uneasy emergency room visits. During one of them, my nurse volunteered she’d been busy testing people for covid-19. While inserting catheters and cannulas, she rattled off several reasons she thought the hospital was unprepared. My mom, who is immunocompromised, and I exchanged alarmed glances. For weeks, calls with relatives in Italy had provided a grim play by play of what it’s like to sleepwalk into a crisis. Were they tales from our future? Much of Toronto is shuttered. Liquor stores, pharmacies and supermarkets are considered “essential” and are open. Cannabis shops — deemed essential weeks earlier — are closed. There’s no Blue Jays’ home opener to dissect. The Raptors’s 2019 title run is being rebroadcast, but watching games played in packed stadiums is surreal at a time of social distancing. My neighborhood is eerily quiet. People walk on the road to avoid those approaching on the sidewalk. More and more of them are wearing masks. The only sounds during a recent walk were birds chirping and a neighbor’s wind chimes. Others flock to the city’s parks, flouting repeated calls to keep two meters — “about the length of a hockey stick,” signs say — apart. After weeks of pleas fell on deaf ears, police were dispatched to enforce the rules. My dad, meanwhile, reported good news. He’s not touching his face — and has broken a lifelong nail-biting habit. “Must be the fear of dying,” he said. This is mostly a vertical city, a dark and misty megalopolis. Many of us live in crumbling old high-rises. People flash their lights, bang pots or project messages onto other buildings during protests each evening against the right-wing government of President Jair Bolsonaro, who has flouted social distancing rules and encouraged supporters to do the same. We’re stuck inside. It does not help our anxiety to know there is an open power struggle in the country. Look down and


How daily coronavirus cases and deaths have shifted by state

New York. On Wednesday, the most recent day for which complete data is available, the number of new cases nationally was nearly 33,000, with more than 11,000 in New York alone. You can see, though, that the number of confirmed cases each day has some variability. Confirmed cases are a function of tests being completed and reported, after all, and the number of tests conducted each day can itself vary. If we take a seven-day average of new cases, we get a better sense of the trend. Here, we can see an apparent slowdown in New York. On Saturday, the seven-day average was about 8,800 confirmed infections a day. By Monday, it was 9,300 — an increase of 500 cases a day. On Wednesday, though, the average moved to only about 9,600. That’s still the highest average the state has seen since March 1, but the increase is slower. If we use that figure as the high-water mark, we can compare the daily average as a percentage of the state’s high-water mark. On Monday, the seven-day average was at 97 percent of the high. On Tuesday, it dropped a bit, to 95 percent of the high. The idea is that, over time, that percentage will slide down from the high. If it keeps going up, of course, we get a new high. We pulled data on confirmed cases, deaths and testing (from the Covid Tracking Project) and calculated the actual and relative seven-day averages nationally and in each state. The interactive below allows you to explore the data. Before you change the settings, notice Montana. Its high in new cases was March 31, with the seven-day average of new cases declining since. This may not be the final peak in the state, but it’s what we hope the charts in each state will look like eventually. The interactive below allows you to explore the data. (The values shown are those from Wednesday’s data. One thing worth noting — which has been highlighted by the Covid Tracking Project — is that the number of tests being conducted each day has stagnated. After expanding rapidly over the past month, the past several days of reported tests have been fairly flat, in the 140,000-per-day range. The seven-day average of tests is at a high, but that necessarily constrains the number of confirmed cases we’re seeing. Which is a primary driver of why it’s


How to secure a refund for a flight canceled due to coronavirus, according to the experts

In the months the coronavirus outbreak has spread around the world, the Department of Transportation noticed another uptick: an increasing number of Americans being denied their rights to airfare refunds. “The Department has received a high volume of complaints on air travel matters related to the COVID-19 public health emergency,” a DOT spokesperson told The Washington Post in an email. “Many of these complaints concern lack of refunds, assessment of change fees, and inability to reach an airline representative.” Before the coronavirus pandemic took a major toll on travel, the DOT had a rule in place that if an airline cancels a flight, it must provide ticket-holders with a cash refund for the airfare and fees. (Note that if a traveler cancels their own ticket, there’s no rule or guarantee for a refund.) But as people were told to stay home to “flatten the curve,” travel restrictions were issued and nonessential travel was all but banned, airlines stopped following this DOT regulation, according to the complaints received by the agency, tweets from customers and industry insiders. On Friday, the DOT issued an enforcement notice to airlines that even during this pandemic, U.S. and foreign airlines must give customers a cash refund if a flight to, within, or from the United States is canceled or has a significant schedule change. For people still struggling to get a refund, industry experts told us their advice. Travelers who were stonewalled by airlines in recent weeks may have a different result when calling back after that latest DOT enforcement notice. “Everybody should be able to get their cash refunds,” says Charles Leocha, the president and co-founder of the advocacy group Travelers United. “They paid for something. They’re not getting it. It’s basic American law.” For those who were given a flight credit for a cancellation and would like their money back instead, airlines are also required to honor that request. “In that [DOT] memo, they said at the end that the airlines should now contact everyone whose arm they twisted into taking credit and inform them that they have their choice,” Leocha says. “They can now get cash back, or they can leave the credit in place.” As the saying goes, if at first you don’t succeed, try, try again. “First, politely say, ‘Thank you, appreciate your time.’ Hang up. Call again,” says Scott Keyes, founder of Scott’s Cheap Flights. “The reason why is