The Health 202: Age or illness makes one-quarter of Americans more vulnerable to coronavirus complications

became the first city to order a lockdown — and now life has dramatically changed for virtually every American, as people face staying at home for at least four more weeks, and maybe longer. NPR’s Steve Inskeep: Vox’s Ezra Klein: New York is still considered the area hit hardest by the outbreak. Add reported cases in New Jersey and California, and all three states contain more than half of all reported cases in the United States. But now other states are being upgraded to a deep brown on acolor-coded mapmaintained by the CDC to show where the outbreak is worst. In Florida, reported cases have doubled in the past four days, to more than 7,000. West Virginia, just behind Florida in its share of the population who are elderly, has reported fewer than 200 cases — but doctors there are preparing for a surge, the Wall Street Journal reports. Amid all these dismal headlines, there’s a spot of bright news. Washington and California — those coastal states where the coronavirus first appeared — are finding that social distancing is working. “Those states were the first to report community cases of covid-19 and also the first in the nation to mandate residents stay at home to keep physically apart,” my Post colleagues Geoffrey Fowler, Heather Kelly and Reed Albergotti report.“Analyses from academics and federal and local officials indicate those moves bought those communities precious time — and also may have ‘flattened the curve’ of infections for the long haul. “While insufficient testing limits the full picture, it’s clear the disease is spreading at different speeds in different places in the United States. California and Washington continue to see new cases and deaths, but so far they haven’t come in the spikes seen in parts of the East Coast. Social distancing efforts need to continue for several more weeks to be effective, experts say.” Something else to make you feel a bit better about life right now — a random act of kindness: And some older people are amazingly leaving the hospital after recovering from the virus: You are reading The Health 202, our must-read newsletter on health policy. — The nation’s perennial health insurance problems are under a spotlight with the spread of the virus. Nearly 29 million Americans aren't covered, a serious financial problem if they find themselves with a complicated case of covid-19. President Trump was remarkably candid about


Yes, Russia spreads coronavirus lies. But they were made in America.

Studying disinformation is a little like being a virologist: The object of your investigation is challenging to detect, the symptoms can vary widely, and most importantly the source can be difficult to identify. This is especially true when studying disinformation about a virus. Unlike misinformation, disinformation isn’t simply inaccurate: It’s actively designed to mislead. On social media, the two can appear identical, as the message is sometimes the same. In practice, both can be just as dangerous, especially now. Factual information is essential to public health, particularly when it comes to something as urgent as how we respond to the novel coronavirus spreading in our communities. Online disinformation during a health crisis has literal life-or-death consequences for people in the real world. It’s easy to point at foreign actors like the Russians and Chinese for spreading disinformation across social media. It would also be accurate but incomplete. Sadly, foreign actors aren’t the biggest danger. We Americans are. Domestic production of misinformation is booming. Anything from false hope sold through fake cures to the creation of politically motivated memes and hashtags can sow confusion, making it more difficult to respond to the crisis in a cohesive, sensible manner. These efforts have made the crisis worse, and people will die or are dying as a result. While it is true there is Russian and Chinese disinformation pushing various narratives regarding the coronavirus, foreign actors are often merely curating messages that we Americans created. Instead of making stories up from whole cloth, foreign adversaries take the misinformation we give them and launder it into disinformation. Take, for instance, the persistent theory that the virus was created by scientists (it wasn’t) and escaped a lab in China (it didn’t). This theory did not spring forth from a St. Petersburg troll farm or a GRU bunker in Moscow. (The GRU is a Russian military intelligence agency.) According to our research, the first English-language tweet suggesting this theory was on Jan. 20. It came from an anonymous conservative American woman who, in her profile, claims to love Jesus, her family, her country, her freedom and her guns. Lest you think that reflects some partisan bias, consider that the second English-language tweet was sent the next day from a liberal, blue check-marked academic. The creation and dissemination of misinformation does not discriminate by ideology. Foreign actors are, of course, capable of creating their own false narratives and


Sanders was losing to Biden anyway. But he lost more in areas with coronavirus cases.

When coronavirus cases started surging the United States at the beginning of March, the Democratic nominee for U.S. president was still in doubt. During the primary, one of the two leading candidates — Sen. Bernie Sanders — had been running on a platform centered on universal health care. One might have expected support for Sanders to surge in the face of a growing epidemic. It did not. In a recent working paper, we find evidence that coronavirus-induced anxiety prompted a political “flight to safety” that cost Sanders votes. Our findings suggest that if a coronavirus case was reported in a county’s local media market before its primary, that news may have depressed Sanders vote share by between 1.15 and 12.65 percentage points. Here’s the background Fourteen states voted March 3, known as Super Tuesday. Although China’s coronavirus outbreak had already hit the news, many Americans weren’t yet especially worried. Just over 100 cases had been recorded nationwide on the eve of the election; the news media were focused on the elections; governors hadn’t yet begun holding daily briefings or issuing stay-at-home orders; and President Trump had said that covid-19, the disease caused by the coronavirus, was soon “going to disappear.” Just 14 days later, when voters in three states cast their primary ballots, circumstances had changed dramatically. Trump had declared a national state of emergency. Most of the nation’s schools were closed. The stock market had lost more than 20 percent of its value. And many people had begun staying home and practicing “social distancing.” We wanted to know whether the changes in the medical, social and economic climate between counties before and after the outbreak affected Democratic voters’ choices in the primary. How we did our research To examine covid-19’s effect on the primaries, we calculated the change in Sanders’s share of the vote between 2016 and 2020. Across most of our counties, Sanders got fewer votes in 2020 than he had in 2016. But did he lose even more in areas where voters went to the polls with disease on their minds? We compare counties with similar labor markets, racial and ethnic makeup, educational attainment, and rural/urban populations, but differences only in whether a covid-19 case appeared before their primary election date. We find that Sanders’s support was weaker in counties where a covid-19 case appeared before the primary. We tried to figure out what was driving this


Just 14 days later, when voters in three states cast their primary ballots, circumstances had changed dramatically. Trump had declared a national state of emergency. Most of the nation’s schools were closed. The stock market had lost more than 20 percent of its value. And many people had begun staying home and practicing “social distancing.” We wanted to know whether the changes in the medical, social and economic climate between counties before and after the outbreak affected Democratic voters’ choices in the primary. How we did our research To examine covid-19’s effect on the primaries, we calculated the change in Sanders’s share of the vote between 2016 and 2020. Across most of our counties, Sanders got fewer votes in 2020 than he had in 2016. But did he lose even more in areas where voters went to the polls with disease on their minds? We compare counties with similar labor markets, racial and ethnic makeup, educational attainment, and rural/urban populations, but differences only in whether a covid-19 case appeared before their primary election date. We find that Sanders’s support was weaker in counties where a covid-19 case appeared before the primary. We tried to figure out what was driving this result. We redefined the “outbreak date” to compare different groups of states, adjusted the number of reported cases beyond which we considered a county “exposed,” and explored whether the outbreak was worse in areas that voted strongly against Sanders in 2016. In all tests, our core finding persists: Sanders’s vote was already slipping when the outbreak occurred, but the epidemic reduced his share of the vote even more. Why might the pandemic turn voters away from Sanders? There are several possible explanations for our findings. Sanders’s support among younger voters is well-documented. Perhaps younger voters were less likely to turn out to vote in areas where the virus had spread. Of course, such a result would be surprising because covid-19 threatens older individuals’ health more than that of the young. Nevertheless, we tested this theory by comparing primary turnout in exposed and insulated counties, and found that the virus did not deter voters from the polls until the March 17 primaries in Arizona, Florida and Illinois, and in any case cannot explain these results — the decline in turnout was similar in counties with more young people and in those with more old people. Here’s another possibility. In The Washington


24 hours inside the lives upended by coronavirus in the nation’s capital

and medical technologist Elizabeth Zelaya stood just feet away from the pathogen that had killed thousands around the world. Here in their test tubes, it was frozen, harmless. As Zelaya waited for the afternoon’s results, she stood at a computer console next to a pair of white boxes, each about the size of a hotel minibar. Together, the machines cost as much as a Lamborghini. As the samples were processed, the monitor would display the results: Positive cases were shown as a line that sloped upward before leveling off. The District’s lab, through a combination of luck and foresight, was well-prepared for the arrival of covid-19. Last year, before anyone knew this coronavirus existed, the city purchased a Panther Fusion, a box-shaped robot with a tinted-glass exterior that could process 300 tests every eight hours. It was now performing covid-19 analyses around the clock, its pipette arm dipping and shifting across rows of test tubes overnight, while its human operators slept. The story told by these machines was as bleak in the capital as anywhere, following a classic exponential curve whose upward path — reaching a total of 499 that day — had no clear end. More samples were coming in every day as drive-through testing sites started to open. The results on Zelaya’s computer monitor would be reported directly to Mayor Muriel E. Bowser, who was providing updates on the city’s case tally every evening. Courtney left the room, and Zelaya examined the image before her: a cluster of upward-curving lines, peaking and arching like a wave about to crash. The mayor’s pleas to stay home, to slow the spread and flatten the curve, did nothing to dissuade the men and women who like to spend their afternoons on the benches at Girard Street Park in Northwest Washington. To them, it didn’t even matter that the gates were closed. Without access to their usual hangout, a couple dozen people — some in lawn chairs, others leaning against the fence — found new spots on the park’s perimeter. Someone played the Staple Singers from a speaker. A boy pulled up on a bike, honking his horn. “What you gonna do with your stimulus money?” Michael Johnson, 61, asked another man. “Females,” he responded. “That’s why you stay broke,” said Johnson, who planned to invest in a tent and a backpack. “Might have to go to the woods,” he said. “You


Deaths double to 16 at Richmond-area long-term-care facility

to venture out for food, medicine, medical visits and exercise. Sit-down restaurant service has been banned, but takeout and delivery are allowed. — Laura Vozzella THE DISTRICT A union representing D.C. grocery store workers is urging city officials to treat them like first responders after an employee at the Giant in Columbia Heights tested positive for the coronavirus. Jonathan Williams, a spokesman for United Food & Commercial Workers Local 400, said his group has asked the office of Mayor Muriel E. Bowser (D) to allow grocery stores’ staff to qualify for free testing and protective supplies such as masks and gloves. A spokesman for Giant on Wednesday confirmed that an employee who has not worked at the location since March 19 tested positive for the virus. The store has been cleaned and disinfected, while the employee who tested positive and others who worked with the employee have been asked to self-quarantine and will receive sick pay, the spokesman said. — Fenit Nirappil Firefighters and paramedics in the District since early March have responded to more than 730 emergency calls for suspected coronavirus, the department said Thursday. Doug Buchanan, a spokesman for the Fire and Emergency Medical Services Department, stressed that the vast majority of callers did not have the virus. Dispatchers have been asking callers seeking help detailed questions about their symptoms. Buchanan said paramedics and firefighters are warned about the possibility of covid-19 even when people seeking help do not believe they are infected. But even amid the crisis, fire officials say calls for paramedics and emergency medical technicians have actually dropped over recent weeks. Buchanan said the fire department is preparing for spikes in calls and the possibility that many firefighters and paramedics will fall ill. So far, 21 members have tested positive for the coronavirus. — Peter Hermann MARYLAND A number of workers on the Purple Line construction project were asked Wednesday to self-quarantine for 14 days after a Washington Gas inspector on the project tested positive for the coronavirus, a project official and state spokeswoman confirmed Thursday. Another Purple Line worker, who spoke on the condition of anonymity because he was not authorized to comment publicly, said the quarantine order affects 30 to 40 workers from a construction site on University Boulevard in Prince George’s County. The man who tested positive is sick but recovering at home, the worker said. Carla Julian, spokeswoman for Purple Line


Metro board approves new budget amid fiscal uncertainty created by pandemic

a day in lost fare revenue due to service reductions, stay-at-home orders and general fear, according to General Manager Paul J. Wiedefeld. Metro officials said they anticipate much, if not all those losses will be covered by the $25 billion Congress included for public transit in the $2 trillion coronavirus relief package lawmakers passed last month. The Federal Transit Administration announced Thursday that the Washington region will receive $1 billion, but it wasn’t clear how much will go to Metro and other transit systems in the area, such as Montgomery County’s Ride On or the Fairfax Connector. Wiedefeld said Metro is waiting on the FTA to lay out what costs the federal bailout money can be used to reimburse. But it’s unknown how long travel will need to be restricted to fight the spread of the virus, and many transit experts have already said the $25 billion will not be enough federal aid. It’s also unclear what impact widespread joblessness will pose for Metro. Labor Department numbers released Thursday showed that more than 250,000 jobless claims had been filed in the District, Maryland and Virginia as of March 28. The shortfall local and state governments are facing continues to mount, and they have started making revenue projections that could impact Metro. Of the transit agency’s $2 billion operating budget for the coming fiscal year, nearly $1.25 billion comes from contributions from the District, Maryland and Virginia. “We are hearing now because of significant revenue shortfalls that they’re going to have difficulty paying the subsidies that are expected of them,” said Metro board member Matthew F. Letourneau, who also is a Loudoun County supervisor (R-Dulles). “We will be dealing with a very different ridership scenario and very different revenue projections.” Board member Michael Goldman said members should expect to revisit their decision in June. “We must be prepared to take a hard look at our budget initiatives in light of covid-19,” said Goldman, who represents Maryland. Across the region, elected officials aren’t just calculating what subsidies they can afford, but all services. The Montgomery County Council adopted a resolution last week asking the county executive to draw up a budget that essentially includes no growth. “The pandemic has thrown uncertainty into every budget in the region,” council member Evan Glass (At-Large) said. “We have to be mindful of how this crisis is affecting everyone’s bottom line.” “While we’re looking at a


How coronavirus grounded the airline industry

In December, Wuhan, one of China’s largest industrial hubs, reported its first cases of covid-19. As the infection started to spread, countries across East Asia, including Japan, Malaysia and Thailand, restricted flights to China and South Korea to prevent further transmission. In March, air traffic waned throughout the Middle East. Egypt, Kuwait, the United Arab Emirates and Saudi Arabia closed their major airports. Turkey banned air travel from most European countries. Flights over Europe nearly evaporated as covid-19 swept through northern Italy, forcing EasyJet, Ryanair and Lufthansa to cut flights by at least 80 percent. On March 13, President Trump announced sweeping restrictions on travel from more than two dozen European countries. On March 20, a more minor disruption occurred: Airspace east of Indianapolis was closed after an air traffic controller’s positive coronavirus test shut down the workspace for disinfecting and quarantine. The aviation industry’s unprecedented free fall from the coronavirus pandemic already has forced some airlines into bankruptcy, and others are on the brink. Business and leisure travel both have cratered, and pilots are flying nearly empty jets around the United States and Europe. According to Aireon, a satellite-based aviation tracking company, 37,826 aircraft were tracked on Nov. 5, before the coronavirus took its toll on international air travel. On Tuesday, however, just 26,217 planes were detected, a decrease of 30.7 percent. “These two Tuesdays, which would otherwise show comparable flight totals, demonstrate the acute impact of the covid-19 crisis on the aviation industry,” said Cyriel Kronenburg, vice president of aviation services at Aireon. Flight crews now often have eerily quiet airports to themselves. One longtime flight attendant for Alaska Airlines said the industry crisis is worse than the downturn after the attacks of Sept. 11, 2001, when her husband, a pilot for Alaska Air, was flying. They worry about losing their jobs, said the attendant, who spoke on the condition of anonymity because she was not authorized to discuss the business. And they “are both terrified of us getting sick on the road” and bringing the coronavirus home to their children, she said. “There’s a fear every time I go to work.” Furloughs and layoffs and anxiety ripple throughout an industry that employs 750,000 in the United States alone. Jon Weaks, president of the Southwest Airlines Pilots Association, said the rapid descent of industry fortunes has been stunning. “I think the shock to everyone is the speed of


Syria’s civil war will make fighting coronavirus particularly difficult

Syria reported its first covid-19 cases a week ago — and has now reported its first coronavirus deaths. But many analysts say the total of cases is much higher, noting independent reports of coronavirus-like cases in Damascus, Tartus, Latakia, Homs and Deir-Ezzor. How does a country engaged in civil war for the past decade face the coronavirus challenge? The United Nations special envoy called for an immediate cease-fire to prevent an outbreak of the virus in the conflict-ridden country — but no single authority can implement a cease-fire. And Syria’s fragmented and limited health services may leave many regions with little or no outside assistance to fight covid-19 outbreaks. The Syrian government unrolled sweeping measures on March 15 to combat the spread of the coronavirus, closing universities, schools, government offices, restaurants and markets, as well as shutting down all intercity public transportation across the country. The government also suspended military conscription, a cornerstone of its sustained military campaign. On March 20, the government banned entry for foreigners, after the first coronavirus victim reached Syria by road from Lebanon after returning from Europe. Health officials have limited testing capacity, but have deployed medical teams at the national level and to 1,864 health clinics across the country. The World Health Organization also supplied the government with testing kits, but only one Damascus-based lab is reportedly testing for the virus. Prices for masks, disinfectant and medicine have surged while the public health infrastructure remains fractured and under-resourced. China already deployed several medical teams to assist with the outbreak in Iraq and Iran, and has provided testing kits to Syria. China’s U.N. ambassador joined the U.N. call for the lifting of sanctions on Syria, suggesting it is only a matter of time before Beijing assists Damascus. The United States has committed an additional $16.8 million for humanitarian programming for Syria under USAID’s $274 million fund for countries affected by coronavirus. The threat of an outbreak could also thaw Syria’s relations with several countries in the region, and rally support for the Assad government. Last week, following the Group of 20 summit, Abu Dhabi Crown Prince Sheikh Mohamed bin Zayed extended the UAE’s support for the Syrian people in his first call with the Syrian president since a 2011 break in bilateral ties. My research suggests Syria’s opposition-held areas face a dire threat without the proper resources to prevent the spread of the disease —


emergency aid providers to address existing shortages of food, water, shelter and other daily essentials. However, hope for such an outcome is grim as major donor countries — the United States, United Kingdom, and European Union countries — address their own coronavirus crises. In northeast Syria, the Kurdish-led administration initiated a curfew ordered the closure of businesses, restaurants and events. The border with the rest of Syria is now closed, other than cross-border aid deliveries from Damascus. Only one of 16 hospitals in the region is fully functional. Two additional hospitals identified to quarantine and treat patients, are underequipped, with only 28 beds for intensive care, 11 ventilators, and two doctors trained to use them. Ongoing disputes between Turkish-held groups and the SDF exacerbate the situation. On March 24, Turkish-backed groups shut off water to the city of Al-Hasakeh, creating increased risks of coronavirus and other disease outbreaks for some 460,000 residents, including tens of thousands living in the Al-Hol displacement camp. The immediate challenge for Northeast Syria is access to outside coronavirus experts. While WHO officials can reach Idlib via U.N.-approved borders, they cannot cross from Iraq into northeast Syria. The push by China and Russia to end the Syria cross-border aid mechanism under Resolution 2449 in January left the northeast out of reach of U.N. assistance. Obtaining testing kits and expanding the region’s health-care capacity depends heavily on whether the WHO can access northeast Syria from Damascus, a process that historically has been fraught with political challenges for U.N. agencies. The U.N. Security Council could opt to grant WHO authorization for cross-border assistance at all official crossings — allowing aid to arrive via Iraq and Jordan. This might give the peripheral areas of Syria access to lifesaving medical care as the coronavirus spreads — which seems inevitable, given the experience of other countries. It will take more than a nationwide cease-fire to prevent a covid-19 disaster in Syria. The WHO hopefully will be able to coordinate a response with government and nonstate groups that addresses all of Syria’s medical needs, despite the country’s geographic and political fragmentation, deteriorating health-care infrastructure and lack of government resources. Otherwise, regions outside of government-held areas will be underprepared to face the crisis. The TMC newsletter is changing shape! Sign up here to keep receiving our smart analysis. Jesse Marks is an associate with the University of Cambridge’s Centre for the Study of


The Daily 202: Trump’s warning to Iran underscores risk of global instability amid coronavirus pandemic

Beyond the lucky three who get them, all Liberian coronavirus patients who need a ventilator to live will die,” Brian Klaas notes. Messages from the Islamic State and al-Qaeda have asserted that the coronavirus is intended as punishment for non-Muslims. ISIS urged followers in its newsletter to show no mercy and launch attacks, while al-Qaeda issued a statement on Tuesday urging non-Muslims use their time in quarantine to learn about Islam, the Associated Press reports: “There are signs elsewhere that the U.S., British and other militaries are pulling back because of the virus, leaving a possible opening for the extremists. That’s a danger in Africa’s hot spots of the Sahel, the Lake Chad region and Somalia, where the U.S. military already worried allies in recent months by contemplating cuts … The British army mission in Kenya, which provides counterterrorism training and other skills, this week announced that all army families are returning to the U.K. because of the virus. … “African military units, already stretched thin and under attack, are likely to take protective measures as the virus threatens their ranks. In Nigeria, which has struggled against the Boko Haram extremist group and an assertive IS-linked offshoot, the military has called for suspending much of its activities including large gatherings and training. A leaked memo signed by Nigerian army’s policy chief says its vehicles might have to be used for mass burials or transferring the sick to hospitals as the virus spreads. While security forces are targets, under-guarded prisons could be too.” The International Crisis Group expressed concern in a statement this week that the pandemic will undermine security cooperation aimed at combatting radical Islamic extremism: “It is almost certainly correct that COVID-19 will handicap domestic security efforts and international counter-ISIS cooperation, allowing the jihadists to better prepare spectacular terror attacks.” At the top of last night’s White House coronavirus briefing, Trump announced alongside Attorney General Bill Barr and Defense Secretary Mark Esper that he’s ordering an expansion of counternarcotics operations in the Western Hemisphere and sending more ships and planes to U.S. Southern Command in Florida to help. “We must not let the drug cartels exploit the pandemic to threaten American lives,” Trump said. A study released yesterday by two research groups, the Geneva-based ACAPS nonprofit and the London-based International Rescue Committee, illustrated how the rate of transmission of the virus in refugee camps in Syria, Greece and Bangladesh


called for suspending much of its activities including large gatherings and training. A leaked memo signed by Nigerian army’s policy chief says its vehicles might have to be used for mass burials or transferring the sick to hospitals as the virus spreads. While security forces are targets, under-guarded prisons could be too.” The International Crisis Group expressed concern in a statement this week that the pandemic will undermine security cooperation aimed at combatting radical Islamic extremism: “It is almost certainly correct that COVID-19 will handicap domestic security efforts and international counter-ISIS cooperation, allowing the jihadists to better prepare spectacular terror attacks.” At the top of last night’s White House coronavirus briefing, Trump announced alongside Attorney General Bill Barr and Defense Secretary Mark Esper that he’s ordering an expansion of counternarcotics operations in the Western Hemisphere and sending more ships and planes to U.S. Southern Command in Florida to help. “We must not let the drug cartels exploit the pandemic to threaten American lives,” Trump said. A study released yesterday by two research groups, the Geneva-based ACAPS nonprofit and the London-based International Rescue Committee, illustrated how the rate of transmission of the virus in refugee camps in Syria, Greece and Bangladesh could be faster and higher than on cruise ships. “The rapid spread of covid-19 on the Diamond Princess showed how the virus thrives in confined spaces, but for millions of displaced people their conditions are far more cramped and poorly serviced and the risks are far deadlier,” said IRC senior policy adviser Marcus Skinner. “The tip of the iceberg may be showing: On Tuesday, a woman in Greece’s Ritsona refugee camp, outside Athens, tested positive after giving birth in a hospital in the capital,” Miriam Berger reports. “Ritsona is smaller than Europe’s largest camp, Moria, on Lesbos Island, which houses 20,000 people but was designed for only 3,000. On March 24, Bangladesh confirmed its first case in Cox’s Bazar, a coastal city adjacent to camps housing about 1 million Rohingya from Myanmar. Meanwhile, in Syria, experts are concerned that the government is severely underreporting cases in the war-torn country, where about 6 million people are internally displaced, according to the United Nations.” Refugees International said on Monday that there are currently 70 million displaced people around the world – refugees, asylum seekers and those internally uprooted by war and other crises — who are at risk of getting the coronavirus


This is the scary part. But Americans will get through this.

homes. The planet’s apex predators are learning once again to live like prey. Living in fear is hateful to me, no matter how necessary. I’d imagine you loathe it, too. So I decided to ask different question: As we sit isolated in our homes, with nothing but a steady stream of awful news for company, what’s the best way to face this bravely and cheerfully? Well, if you find out, please do let me know. In the meantime, here are a few things that have been helping me. First, community. Americans are checking in on elderly neighbors, calling friends on other coasts or continents, sharing recipes and sourdough starters, clapping for the health-care workers on the front lines. This human instinct for helping each other is heartwarming, but more importantly, it’s our secret weapon. Even more than language or tools, community and cooperation are what separate us from most other species. It’s how we cured tuberculosis, split the atom, went to the moon. It’s how we’ll fix covid-19, too. So I remind myself of the courage of doctors and nurses risking their lives to save others, not just despite the virus, but despite the fact that we accidentally cut their pay. I remember the unprecedented global collaboration happening behind the front lines, where humans are cracking covid-19’s genetic code, fast-tracking vaccines and sharing everything they’ve learned about treatment, real time, so an invention that’s keeping doctors safer in Taiwan soon shows up on the other side of the planet. Human history can sometimes look like a race between the selfish and the incompetent, and the decent people who do the right thing. Well, the latter group has been pulling ahead for the past 15,000 years, and now has a comfortable lead. I’m betting on them to win this round too, hauling the rest of humanity across the finish line behind them. History comforts me in another way: Like you, I am descended from a long line of people who would consider my current worries some easy living. On one side, they crammed more than a hundred people into a ship the size of a large house, taking 63 seasick days to reach a wild land they’d never seen. Almost half their shipmates would die that winter, an ocean away from everyone they’d ever known. On the other side, my ancestors survived an even more perilous journey on the infamous “coffin


One of the world’s most vulnerable groups now finds itself confronting covid-19

The coronavirus has unleashed so many problems around the world that it’s almost impossible to keep track of them all. Even so, it’s worth taking a moment to consider the situation facing one of the planet’s most vulnerable groups. They’ve been persecuted, maligned and terrorized — and now they’re preparing to confront the virus with minimal protection. In the summer and fall of 2017, the Myanmar military launched a campaign of terror against the ethnic group known as the Rohingya, driving some 700,000 of them across the border into neighboring Bangladesh. Myanmar’s predominantly Buddhist ruling elite has long discriminated against the Muslim Rohingya, treating them as a nefarious alien presence in the country’s midst even though most have lived there for generations. Periodic waves of persecution had already sent many Rohingya fleeing across the border in the decades before the 2017 atrocities began. Today, 850,000 Rohingya are living in conditions of unimaginable hardship in refugee camps in Bangladesh. Crammed together in tiny makeshift shelters made of bamboo and plastic, many of the refugees already suffer from poor nutrition, compromised immune systems and lung illnesses. Last week, testing revealed a person infected with the coronavirus in the town of Cox’s Bazaar, just a few miles from the camps. Humanitarian groups are sounding the alarm. The International Rescue Committee, a charitable group, has just released a study warning that any covid-19 infections in refugee camps around the world, and particularly those inhabited by the Rohingya, would almost certainly spread far faster than on the notorious Diamond Princess cruise ship. The discovery of that first covid-19 case near the camps prompted the authorities in Bangladesh — itself one of the most impoverished countries in the world, making it poorly equipped to deal with any outbreaks — to order a “lockdown” in the camps on March 25. Yet the term feels like a mockery in such cramped conditions. Extended families, usually 10 to 15 people, live together in huts where there’s just enough room for everyone to lie down. Multiple households share water sources and latrines. The inhabitants have to line up for food and medical treatment, thus increasing their exposure to disease. Thomas Lee, a physician at UCLA Medical Center in Los Angeles and the founder of Community Partners International, one of the aid groups helping to maintain health care for the refugees, explains that “flattening the curve” — managing the number of


just a few miles from the camps. Humanitarian groups are sounding the alarm. The International Rescue Committee, a charitable group, has just released a study warning that any covid-19 infections in refugee camps around the world, and particularly those inhabited by the Rohingya, would almost certainly spread far faster than on the notorious Diamond Princess cruise ship. The discovery of that first covid-19 case near the camps prompted the authorities in Bangladesh — itself one of the most impoverished countries in the world, making it poorly equipped to deal with any outbreaks — to order a “lockdown” in the camps on March 25. Yet the term feels like a mockery in such cramped conditions. Extended families, usually 10 to 15 people, live together in huts where there’s just enough room for everyone to lie down. Multiple households share water sources and latrines. The inhabitants have to line up for food and medical treatment, thus increasing their exposure to disease. Thomas Lee, a physician at UCLA Medical Center in Los Angeles and the founder of Community Partners International, one of the aid groups helping to maintain health care for the refugees, explains that “flattening the curve” — managing the number of infected patients applying for treatment — will be a far greater challenge in an environment where there already aren’t enough resources to go around. “There are just a few hundred hospital beds with a population of nearly a million people,” he says, adding that many residents already suffer from pneumonia and other respiratory ailments, heightening their vulnerability to the coronavirus. To make matters worse, the Bangladesh authorities decided back in September to shut down mobile Internet access to the camps, effectively cutting off the refugees from desperately needed health information, one of the most important tools in combating pandemics. “Various different Rohingya civil society groups have been working hard on spreading awareness,” says Yasmin Ullah of the Rohingya Human Rights Network, who visited the camps at the end of February. “But you have to pick community members who can spread the information — and that requires a meeting. You have to go door to door.” That’s not exactly conducive to social distancing. Tun Khin, of the Burmese Rohingya Organization UK, told me that he and other activists understand perfectly well that Bangladesh will have to prioritize its own citizens with its limited resources: “But at least they could lift all


The drama and appeal of ‘Tiger King’ is a century in the making

As millions of Americans remain confined at home thanks to the covid-19 pandemic, social media has been ablaze about what seems to be the distraction of the moment: Netflix’s sensational new docuseries, “Tiger King,” a sordid human drama that unfolds just beyond the cages of the thousands of big cats confined in private zoos and sanctuaries across the United States. The central drama in “Tiger King” revolves mainly around two exotic animal institutions: the Greater Wynnewood Exotic Animal Park in Oklahoma (the GW Zoo), and the Big Cat Rescue park in Tampa. It features a battle between Joe Exotic, the colorful GW Zoo proprietor, and Carole Baskin, owner of the Big Cat Rescue sanctuary. Both display tigers in confinement and capitalize on public fascination with big cats, as visitors willingly fork over hundreds of dollars for tours and selfies with tiger cubs (apparently a trend on social media). While Exotic relishes the shameless commercialism, Baskin has developed Big Cat Rescue in opposition to places like the GW Zoo, appealing more explicitly to the environmentalist and animal welfare crowd. The Big Cat Rescue nonprofit maintains a mission to “end the abuse of big cats in captivity and prevent extinction of big cats in the wild.” Baskin has teamed with PETA and sought the shutdown of the GW Zoo for years, and Joe Exotic has responded by accusing Baskin of literally feeding her former (and still missing) husband to the lions. While the murder mystery is distinctive, the fascination with exotic animals and the debate over their treatment is not. The way Americans treat animals — particularly as forms of entertainment and exhibition — has been a contentious question in the United States going back hundreds of years. Then, as now, debates about animals often descend into squabbles among our own species. Zoos in America go back at least to Montezuma, but in colonial times animal exhibitions were somewhat rare but noteworthy. Newspapers announced the arrival of the first caged lion in North America in 1720, the first camel in 1721, a polar bear in 1733 and a leopard in 1768. But it was in the 19th century that exotic animal exhibitions burst into popular entertainment — popularized most of all by P.T. Barnum and a flurry of other private zookeepers and showmen, including Robert Woodward in San Francisco and Grizzly Adams’s traveling show. Nineteenth-century cities became sites of countless small-scale zoos


The grim death-toll projections the White House offered Monday have already been revised upward

after former vice president Joe Biden won South Carolina, new data fed into coronavirus models can change the expected outcome. “What we do is that every time we get more data, you feed it back in and relook at the model. Is the model really telling you what is actually going on?” task force member Anthony S. Fauci said Monday. “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 added. One bit of data added to the IHME models was the actual number of deaths over the past few days. The graph presented on Monday, for example, included an estimate that there would be about 850 deaths on April 1. Data from Johns Hopkins University indicates that the number was closer to 890 — though even that figure includes some uncertainty. The model released on Wednesday night estimated there would be 899 deaths on April 1. President Trump had speculated that life would be returning to some semblance of normal by June 1. By then, the IHME data suggest, about 91,000 people will have died of covid-19, the disease caused by the coronavirus. If the model continues to be revised upward, the figure could approach 170,000 — just from the first three months of deaths. An important factor in the IHME data is how the peaks in deaths will be staggered around the country. New York, currently the main flash point of the outbreak in the United States, is expected to peak at 855 deaths on April 10. Alabama is projected to peak a bit later, with 303 deaths on April 19. (Its governor was right: Alabama is no California, where the model projects a peak of 119 deaths on April 28.) Those are median estimates. On the upper bound of possible deaths, late April and early May would see a series of staggered peaks from big states. Those, again, are worst-case scenarios. But they, too, will be revised as new data come in, and those revisions could be upward. In an interview with the New York Times, Fauci offered one bit of good news, in a way. “You will continue to see deaths at a time when you have actually very good control of the new infections and the outbreak itself,” he said. Some consolation for those who have survived, anyway.


A British man ran a marathon in his 20-foot backyard during the coronavirus lockdown — and thousands tuned in

James Campbell jogged to the end of his fenced-in yard, turning around when he reached the garden shed. He bounded back to the patio, sneakers pounding a postage stamp-sized patch of grass. He spun around and repeated the loop again. And again. And again. More than five hours later, he had run a full marathon in his 20-foot backyard. Campbell, a former world-class competitive javelin thrower from Cheltenham, England, had been feeling bored and restless while under lockdown due to the novel coronavirus. His Wednesday stunt was “literally the most stupid thing I could think of to do” on his 32nd birthday, he told the BBC. But thousands of people tuned in to watch him run around in circles, and by early Thursday morning, he had raised the equivalent of just over $32,000 for the United Kingdom’s National Health Service. For all the challenges that come with running 26.2 miles, marathoners can usually at least count on staving off boredom with changes in scenery. But the novel coronavirus has spawned a new kind of athletic feat that requires intense mental toughness as well as physical endurance. Die-hard long-distance runners are now running incredibly short distances — on balconies, around one-bedroom apartments or in backyards — for hours at a time, bearing a strong resemblance to a hamster on a wheel. The trend has followed the spread of the virus, beginning in February when Chinese marathon runner Pan Shancu ran a 50-kilometer ultramarathon (roughly 31 miles) in his apartment, according to the South China Morning Post. Posting images from his run-tracking app as proof, he estimated that he had run 6,250 loops around two massage tables in one room. When covid-19 swept Europe the following month, road races were canceled across the continent. But Elisha Nochomovitz, who had planned on competing in the Barcelona Marathon, didn’t let his training go to waste. Over the course of 6 hours and 48 minutes, he completed a full marathon on his 23-foot balcony in the south of France, growing nauseous from the constant turns. “It was about launching a bit of a crazy challenge and bringing a bit of humor, to de-dramatize the confinement situation,” Nochomovitz told the Associated Press. Lately, American runners have started rising to the challenge. Matt LeBlanc, a middle school teacher in New Hampshire, was trying to come up with math problems for his students when he had a burst


Performers are among the most vulnerable victims of our newly shuttered world

Actor Evan Casey was two weeks into the run of “The Amateurs” at Olney Theatre Center — a play set during a 14th-century plague — when the Maryland venue closed because of coronavirus concerns. His actress wife, Tracy Lynn Olivera, was deep into her duties as assistant director of “Guys and Dolls,” the spring production at Ford’s Theatre, when that musical was shut down. It has been rescheduled for next spring. The Maryland couple have no idea when their performing careers will resume, as theater closures are now stretching into late spring. They’ve also lost their side hustles, including Casey’s work with Capitol Steps and Olivera’s with a wedding band. In the span of just a few days, almost all of their income dried up. “You’re always prepared for lean times, but you tend to know in advance when the lean times are coming,” Casey says. “This came out of nowhere and it came quickly. And it’s not just us, it’s everyone.” Everyone includes musicians, visual artists, designers, dancers and other freelancers who are part of Washington’s vibrant arts economy. They are musicians with no tour dates. Art handlers with postponed exhibitions. Actors, dancers and designers booked for upcoming productions that are now in limbo. “We all live paycheck to paycheck,” says veteran D.C. actor Bobby Smith, who was in rehearsals for the world premiere of “Camille Claudel” at Signature Theatre last month. Work was halted and the show postponed. Along with other gig workers, artists are among the most vulnerable victims of our newly shuttered world. The D.C. government led the relief effort with a $25 million micro-grant program that allows freelance artists to apply, and the $2.2 trillion federal stimulus includes changes to unemployment benefits that will help performing artists who are seeing future work disappear. These are significant victories in a dark time, says Kate Shindle, president of Actors’ Equity Association, the union that represents 51,000 performers and stage managers and that pushed hard for those funds. Entertainers work under unusual circumstances, she adds, and such programs acknowledge that. “We often find ourselves with a promise of work, or a contact that is in the future,” Shindle says, so expanding the rules to include that lost work is critical and will help actors during the ever-growing hiatus. “Most of us are on pause, wondering whether what we have lined up for the summer will happen. It’s difficult.”


How to cancel, change or make new travel plans for the Olympics in 2021

The International Olympic Committee announced Monday that it has postponed the start of the Tokyo Olympics to July 23, 2021, and of the Paralympic Games to August 24, 2021, because of the coronavirus pandemic. The worsening outbreak, along with measures to prevent its spread — such as social distancing, stay-at-home orders and increasingly severe travel restrictions — impacted Olympic athletes’ training and made the 339-event spectacle no longer tenable this year in Tokyo, whose metropolitan area is the world’s largest by population. “In the meantime, we will strengthen our efforts to encourage travelers to visit Japan as soon as it’s safe to do so,” Naohito Ise, executive director of the Japan National Tourism Organization in New York, told The Washington Post in an email. “This means that many travelers may still be able to visit Japan this fall, and can certainly continue to plan trips for 2021.” The U.S. State Department has a Level 4: Do Not Travel advisory in place for all international travel; it is not advisable to take a trip to Japan at this time. But for travelers who had been planning to attend the 2020 Games, there are a lot of factors to juggle when it comes to canceling or changing Tokyo travel reservations. And for those who didn’t plan to attend but now would like to try for 2021, the postponement may offer new opportunities. Now that the Games have officially been pushed back, some travelers are stuck with summer plane tickets to Tokyo that they no longer want or need. During the pandemic, many airlines are allowing customers who booked directly with them to reschedule flight reservations without change fees, or exchange flights for airline credits to be used at a later date. That means travelers looking to attend the Olympics in 2021 can rebook their Tokyo flights without financial penalty. According to federal regulations, travelers should get cash back for their ticket if the airline cancels their reservation as long as it’s a flight to, from or within the United States, regardless of airline. “If your flight is cancelled and you choose to cancel your trip as a result, you are entitled to a refund for the unused transportation — even for non-refundable tickets,” the U.S. Transportation Department website reads. “You are also entitled to a refund for any bag fee that you paid, and any extras you may have purchased, such as


postpone reservations for up to a year. Marriott International hotels are allowing guests “with existing reservations for any future arrival date, including reservations with prepaid rates that are typically more restrictive,” to change or cancel a reservation without a fee up to 24 hours before check-in, “as long as the change or cancellation is made by June 30, 2020.″ (Exclusions, however, may apply.) Meanwhile, as with flights, online travel sites may have altered options for changing your hotel reservations. “If you’ve booked your hotel through an online travel agency like Orbitz or Travelocity, good news is canceling or changing plans has gotten a lot easier with new online tools that let travelers cancel plans online or in the app,” Mel Dohmen, senior manager of communications and public relations for Expedia Group, told The Post in an email. “Right now, both sites have negotiated with their travel partners to waive cancellation penalties and refund existing hotel bookings through the end of April or provide a voucher allowing you to rebook in the future.” It’s not yet clear whether coronavirus-related policy changes made for immediate reservations will apply to bookings later in 2020. “Travelers with reservations later this spring and summer should check back closer to their travel date as many lodging [options] are updating their policies daily to align with changing restrictions and local mandates,” Dohmen said. “That said, travelers who qualify for current COVID-19 related policies may want to play it safe with a refund or voucher to use toward a future stay. Regardless, whether you are canceling travel or changing travel dates, you likely won’t have to pay a change fee.” For lodging reservations made through an online travel agency, go online or in the app and see what cancellation options are available. If the offer isn’t appealing, start a chat with a virtual agent on-site or fill out a cancellation form. Airbnb’s response to the crisis, including changes to its cancellation and refund policies, has been in flux, and many travelers have been left with reservation frustrations during the pandemic. The company recommends that customers monitor its “Extenuating circumstances policy and the coronavirus (COVID-19)″ page for updates about coverage. Reuters reported that the Tokyo Olympics organizing committee was still considering the status of purchased tickets for the 2020 Games; the site says that, “in principle,” 2020 tickets would just “be valid for a new date.” According to the


check back closer to their travel date as many lodging [options] are updating their policies daily to align with changing restrictions and local mandates,” Dohmen said. “That said, travelers who qualify for current COVID-19 related policies may want to play it safe with a refund or voucher to use toward a future stay. Regardless, whether you are canceling travel or changing travel dates, you likely won’t have to pay a change fee.” For lodging reservations made through an online travel agency, go online or in the app and see what cancellation options are available. If the offer isn’t appealing, start a chat with a virtual agent on-site or fill out a cancellation form. Airbnb’s response to the crisis, including changes to its cancellation and refund policies, has been in flux, and many travelers have been left with reservation frustrations during the pandemic. The company recommends that customers monitor its “Extenuating circumstances policy and the coronavirus (COVID-19)″ page for updates about coverage. Reuters reported that the Tokyo Olympics organizing committee was still considering the status of purchased tickets for the 2020 Games; the site says that, “in principle,” 2020 tickets would just “be valid for a new date.” According to the Tokyo 2020 website, if you already bought tickets but cannot attend on the new dates, your tickets will be refunded. However, that may not be the case if someone purchased their tickets through Authorized Ticket Resellers (ATRs). Those who purchased their tickets through CoSport, for example, have been notified that refunds will not be issued at this time. They’ve recommended customers monitor their website for any updates on refund policies in the coming weeks. Travelers who had booked additional tourism activities in Japan during the Olympics, such as day trips and sightseeing excursions, should check with the activity providers. Out of precaution, many tours are being canceled during the pandemic anyhow. Some popular tour operators, such as Get Your Guide, are offering full refunds or future credits for canceled bookings. Attending the Olympics is a bucket-list travel experience for millions of people around the world. So, despite the unsettled landscape, travelers interested in attending the Games in 2021 should make reservations ASAP, says Nori Akashi, from the Tokyo Tourism Representative Office. “Many people book trips to Tokyo/Japan a year ahead (or even earlier) if they are trying to go in high seasons for cherry blossoms, festivals, etc.,” Akashi told The


As national parks remain open during a pandemic, seven workers are infected

for custodial staff and employees who come into close contact with visitors. News that the virus is spreading through national parks staffs has sparked complaints from employees who are still compelled to go to work. On Monday, Interior Secretary David Bernhardt sent a note to department employees reiterating the importance of keeping operations going despite the pandemic. “Your continued perseverance to continue the work at hand is recognized and appreciated,” Bernhardt wrote in the opening paragraph. He pressed employees to continue working. “I appreciate and expect that all department employees will continue to fulfill their duties and responsibilities as assigned while also taking necessary steps to preserve their health and safety and attend to the needs of their families,” he wrote. Roulett said the agency determined the risk posed by infected employees to others was low because the window for exposure occurred after the park curtailed access, employees were teleworking or “the employee who tested positive did not work in close contact with visitors and once identified, went into self isolation.” But many rank-and-file employees are afraid of transferring the illness to family members, said Dustin Stone, a Park Service worker in Alaska who quit about two weeks ago over Bernhardt’s refusal to close the parks. Like some park superintendents and leaders in neighboring communities, Stone is pressing to close parks during the outbreak. Sen. Joe Manchin III (W.Va.), the ranking Democrat on the Senate Energy and Natural Resources Committee, along with a group of 10 House Democrats led by House Natural Resources Chairman Raul Grijalva (Ariz.), urged Bernhardt in a pair of letters Tuesday to close off more sites to help stop the spread of the virus. The Park Service said it can operate its attractions in a way that is consistent with public health advisories. “We have issued messages on park websites, social media, and in the press to urge our visitors to follow CDC [Centers for Disease Control and Prevention] guidance, and provided additional measures for the public to follow if they choose to visit our parks,” Roulett said. The agency has limited the public’s access to narrow trails, park grounds and popular overlooks to adhere to the CDC’s guidance on social distancing. “The health and safety of National Park Service visitors, employees, volunteers, and partners is our number one priority,” said the spokeswoman. But many of the restrictions were implemented after visitors crowded onto paths, camps


D.C. region’s death toll rises; Hogan says worker believed to have brought virus into nursing home

The number of known coronavirus cases in the District, Maryland and Virginia stood at 3,411 on Tuesday, with 1,661 cases in Maryland, 1,251 in Virginia and 499 in the District. The total of virus-driven deaths stood at 31 in Virginia, 23 in Maryland and 9 in the District, for a total of 63 fatalities in the region. 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: • Maryland Gov. Larry Hogan (R) said in an interview on C-Span that an asymptomatic worker is believed to have carried the coronavirus into a Carroll County nursing home where 77 residents have tested positive. Three more residents of the facility have died, officials said Tuesday. • D.C. Mayor Muriel E. Bowser (D) said she does not expect the city to levy criminal penalties for violating her stay-at-home order, which allows the city to jail people for up to 90 days or fine them up to $5,000. • George Washington University Hospital is preparing to offer drive-through coronavirus testing, as covid-19 infections continue to increase in the Washington area. What a stay-at-home order means for you Earlier updates: March 13 | March 14 | March 15 | March 16 | March 17 | March 18 | March 19 | March 20 | March 21 | March 22 | March 23 | March 24 | March 25 | March 26 | March 27 | March 28 | March 29 | March 30


New CDC data shows danger of coronavirus for those with diabetes, heart or lung disease, other chronic conditions

People who have chronic medical conditions, such as diabetes, lung disease and heart disease, face an increased chance of being hospitalized with covid-19 and put into intensive care, according to data released Tuesday by the Centers for Disease Control and Prevention that is consistent with reports from China and Italy. The new data gives the most sweeping look at the way covid-19 is causing serious illnesses among people in the United States who already face medical challenges. The report reinforces a critically important lesson: Although the disease is typically more severe among older people, people of any age with underlying medical conditions are at increased risk if they contract the virus, for which there is no vaccine or approved drug treatment. The CDC data is an initial description of how the disease appears to be affecting people who are already dealing with health challenges. The study did not break down the disease demographically, for example by age, sex, race or income. The agency also notes that this is essentially a snapshot and can’t capture the ultimate outcome for people who have been infected with the virus and haven’t yet recovered. The report shows covid-19 is thrusting vulnerable people in the United States into intensive-care units and disproportionately taking the lives of people who already face medical challenges. The CDC analyzed more than 7,000 confirmed covid-19 cases across the country in which health officials had a written record about the presence or absence of any underlying medical condition. The preexisting conditions covered in the records include heart and lung diseases, diabetes, chronic renal disease, chronic liver disease, immunocompromised conditions, neurological disorders, neurodevelopmental or intellectual disability, pregnancy, current or former smoker status, and “other chronic disease.” The CDC found that, of people requiring admission to an intensive-care unit, 78 percent had at least one underlying health condition. Of people hospitalized but not requiring ICU admission, 71 percent had at least one such condition, compared with 27 percent of people who didn’t need to be hospitalized. Among all the cases analyzed, 10.9 percent of patients had diabetes mellitus, 9.2 percent had chronic lung disease, and 9 percent had cardiovascular disease. The report did not reach any conclusion about whether the severity of an underlying condition correlated to a more severe covid-19 illness. Of the 7,160 patients whose chronic illness status was known through health records, 184 died, and 173 of them had an


liver disease, immunocompromised conditions, neurological disorders, neurodevelopmental or intellectual disability, pregnancy, current or former smoker status, and “other chronic disease.” The CDC found that, of people requiring admission to an intensive-care unit, 78 percent had at least one underlying health condition. Of people hospitalized but not requiring ICU admission, 71 percent had at least one such condition, compared with 27 percent of people who didn’t need to be hospitalized. Among all the cases analyzed, 10.9 percent of patients had diabetes mellitus, 9.2 percent had chronic lung disease, and 9 percent had cardiovascular disease. The report did not reach any conclusion about whether the severity of an underlying condition correlated to a more severe covid-19 illness. Of the 7,160 patients whose chronic illness status was known through health records, 184 died, and 173 of them had an underlying condition, the CDC said. None of the deaths were among people under age 19. Covid-19 is a respiratory disease. Diabetes and heart disease are similarly worrisome. When a patient gets infected with something like this coronavirus, the fever causes a spike in the heart rate. Shortness of breath means the patient gets less oxygen. People with limited cardiac capacity can go into arrest. Diabetes is a metabolic syndrome that involves blood glucose levels and affects how the immune system works, and makes it less effective, Adalja said. “This is why patients with diabetes are at risk for many infections not just coronavirus,” Adalja said. “They often struggle with infections on their skin and soft tissues, with pneumonia and even more serious conditions.” Those in the high risk group need to be extremely careful. “If they do become infected, the threshold for them seeking medical attention needs to be much lower. They and their clinicians have to keep this in mind,” Adalja said. “These numbers show us just how crucial that is.” Wilbur Chen, an infectious-disease physician at the University of Maryland School of Medicine, added that while the virus seems to prey on the elderly and sick, “it does not mean it does not cause severe illness in younger adults or in children — in other words, the risk is not zero among the young.” He said, “We are now documenting a large number of covid-19 infections across the U.S. and we are now observing more and more of these ‘rare’ events of severe illness and even deaths among the young.” joel.achenbach@washpost.com william.wan@washpost.com


How a prayer meeting at a French megachurch may have led to scores of coronavirus deaths

the world — got to this point. For weeks, the coronavirus pandemic has shaken the French health system, although the system so far remains largely intact. Certain patients in critical condition are being transferred via medically equipped high-speed TGV trains from areas with overburdened ICU units to lesser-affected regions with greater capacity. On Wednesday, for instance, the first medical transfers from the Paris region left for Brittany in western France, carrying 36 patients. But as public health officials scramble to accommodate rising numbers of patients, details have been emerging about how the Mulhouse prayer meeting had seeded the country’s epidemic, sparking community transmission of the virus that went on for weeks before gaining notice. This, at least, is the opinion of France’s health minister, Olivier Véran. “The tipping point was the evangelical gathering in Mulhouse,” Véran told France’s Journal du Dimanche newspaper. “The epidemic spread across the country from the gathering.” Since the beginning of the pandemic, churches and other houses of worship have been linked to the transmission of the coronavirus around the world, in places such as South Korea, India and the United States. France appears to be no exception. When the five-day prayer meeting at the evangelical church — known as Christian Open Door — began Feb. 17, France only had 12 confirmed cases of covid-19, with none of those in Alsace, the region where Mulhouse is located. There was at the time little public anxiety over the virus, which was then still largely seen as a Chinese problem. Even in Italy, the first signs of the outbreak that would soon devastate much of the Lombardy and Veneto regions had yet to be detected. So local authorities in Alsace didn’t pay much attention to the fact that hundreds of people developed mild, flu-like symptoms in the days after the prayer meeting. The first confirmed case of covid-19 in Alsace wasn’t diagnosed until Feb. 29, according to Christophe Lannelongue, head of the Regional Health Agency in France’s Grand Est administrative region. The patient was a woman whose children had been at the church with their grandparents, though she did not attend it herself. Lannelongue’s office did not realize what had happened — or the scale of the potential outbreak — until two days later, he told Radio France, which traced the connections from the Mulhouse church across the country. On March 2, a man tested positive for covid-19


Tourists brought prosperity to an Idaho ski valley. They also brought covid-19.

that if it does hit them, it’s going to hit them harder,” said Olugbenga Ajilore, a senior economist at the Center for American Progress, a liberal think tank. The vast majority of American coronavirus patients remain clustered in and around cities. That’s where the disease got its start in the United States, as infected travelers arrived from abroad. But there are few areas — even remote ones — that remain untouched by the coronavirus as it continues its relentless spread. Montana and North Dakota recently recorded their first coronavirus deaths. In Washington state on Monday, Gov. Jay Inslee (D) noted a “disturbing” pattern of rural counties that had recorded remarkably high positive test rates — including one that was up to 21 percent. In rural Alabama, meanwhile, residents are bracing for bigger outbreaks of a virus that “could pop up anywhere,” said Rep. Robert B. Aderholt (R-Ala.), who represents a wide, thinly populated region in the northern half of the state. When it does, he said, he fears an impact that “exposes the vulnerabilities in all of rural America,” including underfunded health systems and patchy broadband networks. For now, at least, the virus’s early forays into the countryside have come with a silver lining: They’re hitting areas that are better able to withstand them than most. Some of the worst affected areas, per capita, are recreation centers renowned for their natural beauty that attract large numbers of tourists and have thrived during the past decade of economic growth. The counties surrounding Vail and Crested Butte in Colorado and Park City in Utah — skiing meccas, all — have seen especially high concentrations of patients. So has Blaine County, home to the Sun Valley ski resort, the city of Ketchum and Idaho’s largest coronavirus outbreak. Many celebrities have second homes in the region. The skiing is reputed to be some of the best in the country, and it’s a top destination on the conference circuit. But the same factors that have helped the region thrive have also made it vulnerable to the coronavirus. “We were doing so well, with lots of tourism,” said Scott Mason, who owns three restaurants in Ketchum. “But that’s why we’re getting so hard hit now.” The area is particularly popular among tourists from Seattle, with direct flights to the small regional airport. Health experts say visitors from the area with the nation’s first coronavirus outbreak probably


Public health experts: Coronavirus could overwhelm the developing world

Western journalist to leave the country in March for publishing them. Without her $75 monthly salary, Umm Muhammad has cut back on meat and vegetables for her family. Now she’s grappling with a critical decision: whether to spend her limited reserves on food or the face mask doctors recommend for her daughter with cancer. A high-quality mask costs 100 Egyptian pounds, nearly $7. “If I am going to slave for a hundred pounds, should I use it to buy a single face mask for my daughter or to buy her food?” she asked. “And where can I get money now?” India, one of the first nations in the world to impose social distancing rules, has reported 1,397 cases of covid-19. Analysts say the health system would not be equipped to deal with larger numbers. The country has 0.5 hospital beds for every 1,000 people, according to the Organization for Economic Cooperation and Development. The United States has 2.8. South Korea has 12.3. Experts say there’s no official count of intensive-care beds or ventilators. Mumbai anesthesiologist Atul Kulkarni, editor of the Indian Journal of Critical Care Medicine, has estimated there are about 67,000 intensive-care beds in the country of 1.3 billion. State-level resources offer a grimmer picture: One study found that Madhya Pradesh, home to more than 70 million people, had just 1,816 intensive-care beds. A spike in infections would quickly overwhelm those resources. In a worst-case scenario, a group of epidemiologists and biostatisticians predicted, India could have 915,000 infections by May 15. To prepare, India has banned the export of goods that could be crucial in the fight against the coronavirus, including ventilators, surgical masks and the anti-malaria drug hydroxychloroquine, now being studied as a possible treatment for covid-19 — a decision that could complicate the ability of other developing nations to obtain such items. Ibrahima Soce Fall, the World Health Organization’s assistant director general for emergency response, said the extent to which the virus spreads in a country depends on how authorities manage their first clusters — “and a lot of countries are not responding well.” One silver lining, he said, is that outbreaks of diseases such as Ebola have trained some developing countries to hew closely to WHO advice — something many are now rigorously doing. “In Congo, we were dealing with more than 6,000 alerts per day during the recent Ebola outbreak,” he said. “Of course, Congo


Decoding the graphs that may have saved millions of American lives

of tens of thousands of deaths this month alone. The model uses “the experience around the globe to really understand how this information that we have from Italy and Spain and South Korea and China could really help us get insight into the hospital needs, the ventilator needs, and, really, the number of people who potentially could succumb to this illness,” Birx explained. “It is this model that we are looking at now that provides us the most detail of the time course that is possible." “But,” she added, “this model assumes full mitigation.” Repeatedly, Birx and Fauci articulated two paths forward for states. Densely populated New York and New Jersey — which together constitute half of the confirmed cases in the United States — were slow to implement measures aimed at containing the spread of the coronavirus. California and Washington better managed its spread despite being the states in which the coronavirus first emerged. The difference between the lower and upper bounds of the expected death toll could be explained by the path taken by various cities over the next few weeks, Birx explained. “It just has to do with if you had more New Yorks and New Jerseys — you know, Chicago, Detroit, L.A., Dallas, Houston, all of our major cities modeled like New York, that is what gets us into trouble,” she said. “But I am reassured by looking at the Seattle line, by looking at the L.A. line, by looking at what California has been able to do." The worst case, she said, “is not something that I don’t believe that is going to happen. That is the outside case of having 10, 15 metros like New York and the New Jersey metro area.” Brix then presented the same data as above, but with each of the 50 states. The intent was to show how New York and New Jersey stand out. By showing the data relative to the day of the month, Birx may not have been conveying the actual performance of each state in controlling the virus. As when she last week downplayed the spread of the coronavirus in smaller states by noting nearly 20 had fewer than 200 confirmed cases (only seven still fit that criteria), the graph above makes New York and New Jersey look particularly problematic. If we show the same data relative to when the state saw its 10th confirmed


D.C. mayor issues order telling Washingtonians to stay home, following directives in Maryland and Virginia

The number of known coronavirus cases in the District, Maryland and Virginia stood at 2,934 on Monday, with 1,414 cases in Maryland, 1,021 in Virginia and 499 in the District. The regional total of virus-driven deaths also rose, increasing to 27 in Virginia, 17 in Maryland and 9 in the District, for a total of 53 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: • Maryland Gov. Larry Hogan (R), Virginia Gov. Ralph Northam (D) and D.C. Mayor Muriel Bowser (D) each issued mandatory stay-at-home orders that prohibit residents from leaving home, except for trips considered essential, such as venturing out for food and medicine. • Maryland opened three virus testing sites for people at high risk at vehicle emission testing locations. The state opened a fourth virus testing site in the parking lot of FedEx Field in Prince George’s County. • Three people within Maryland’s state prison system have tested positive for covid-19, officials said. A corrections spokesman said the total includes one inmate and two “non-correctional contract employees.” Coronavirus in the DMV: What you need to know Earlier updates: March 13 | March 14 | March 15 | March 16 | March 17 | March 18 | March 19 | March 20 | March 21 | March 22 | March 23 | March 24 | March 25 | March 26 | March 27 | March 28 | March 29


Member of Bowser’s staff dies of coronavirus complications; Maryland, Virginia report surge in known cases

The tally of known coronavirus cases in the District, Maryland and Virginia stands at 1,688 Friday, with 775 cases in Maryland, 605 in Virginia and 308 in the District. 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: • District officials announced the death of George Valentine, the deputy director of Mayor Muriel E. Bowser’s office of legal counsel — the fourth covid-19 fatality in the District. • D.C. officials announced the city will curtail most in-person voting for the June primary election to reduce coronavirus transmission risk and is encouraging people to instead request mail-in ballots. • Maryland added 194 known coronavirus cases Friday, while Virginia added 144 cases and D.C. added 37. Coronavirus in the DMV: What you need to know Earlier updates: March 13 | March 14 | March 15 | March 16 | March 17 | March 18 | March 19 | March 20 | March 21 | March 22 | March 23 | March 24 | March 25 | March 26


Trump declares D.C. a ‘major disaster’ area; Washington region reports 16 new coronavirus deaths

The number of known coronavirus cases in the District, Maryland and Virginia surged above 2,500 on Sunday, with 1,240 cases in Maryland, 891 in Virginia and 405 in the District. The regional total of virus-driven deaths also rose, increasing to 26 in Virginia, 16 in Maryland and 9 in D.C., for a total of 51 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: From Saturday: 66 nursing home residents test positive for coronavirus as Maryland cases surge • President Trump on Sunday declared the District a “major disaster” area, allowing it to receive an unspecified amount of federal funding to combat the spread and effects of the novel coronavirus. • Maryland, Virginia and D.C. reported 16 virus-driven deaths over the course of the day on Sunday, making it the deadliest day on record for the Washington region. • Advocates in D.C., Maryland and Virginia are calling for the swift release of as many jail inmates as possible. As of Sunday, only the D.C. jail system had reported cases: Four prisoners have tested positive for the virus in the past few days. Coronavirus in the DMV: What you need to know Earlier updates: March 13 | March 14 | March 15 | March 16 | March 17 | March 18 | March 19 | March 20 | March 21 | March 22 | March 23 | March 24 | March 25 | March 26


Fatalities double in Md. and state sees record surge in positive tests, including at nursing home in Carroll County

The tally of known coronavirus cases in the District, Maryland and Virginia surged past 2,000 Saturday, with 994 cases in Maryland, 740 in Virginia and 271 in the District. Here are significant and recent developments as the region responds to the pandemic of the novel coronavirus, which causes the disease covid-19: From Thursday: Washington-area jobless claims spike dramatically as virus cases surge • Maryland reported five new deaths on Saturday night, doubling the fatalities related to covid-19 in the state. Maryland also reported 219 new cases of coronavirus Saturday, a single-day record. The state also announced 66 cases at a nursing home in Carroll County. • Virginia reported a substantial increase of 135 new cases. D.C. has yet to update its case counts. • The National Park Service has shuttered additional facilities at parks in the region, and Maryland closed beaches in state parks. • A second inmate has tested positive for the coronavirus at the D.C. jail, officials announced. Coronavirus in the DMV: What you need to know Earlier updates: March 13 | March 14 | March 15 | March 16 | March 17 | March 18 | March 19 | March 20 | March 21 | March 22 | March 23 | March 24 | March 25 | March 26


Maryland announces second coronavirus death on same day District reported its first; D.C. schools will be closed until April 27

The greater Washington region’s total number of novel coronavirus cases sits at 338 on Friday. Maryland added 42 cases Friday, bringing the state’s total to 150. Virginia reported 22 more cases Friday, for a total of 116. The District reported 32 new patients Thursday evening, its highest single-day increase, for a total of 72. Here are some of the most significant and recent developments as the region responds to the pandemic of the coronavirus, which causes the disease covid-19: • The District Department of Health said the first known death in the city as a result of the virus is that of a 59-year-old man who was admitted to a hospital last week. The man had fever and a cough, as well as other underlying medical conditions, health officials said. • A Baltimore County resident in his 60s who suffered from underlying medical conditions has become the second known person to die of coronavirus in Maryland. Governor Larry Hogan (R) announced the death in a statement Friday evening. • D.C. Mayor Muriel E. Bowser (D) announced that traditional public schools will remain closed until April 27. The mayor had announced earlier this month that schools would be closed through March. • The number of D.C. police officers who have self-quarantined, that is isolated themselves, because of the coronavirus has grown to more than 70. Coronavirus in the DMV: What you need to know


Fact-checking President Trump’s marathon news conference

was a 50-50 chance that it was wrong. What kind of a test is that? These are highly accurate tests.” Trump often disparages covid-19 tests by other countries, even on March 17 falsely calling the World Health Organization test “a bad test.” (The WHO does not make tests, but its preferred one, created in Germany, received positive reviews for not having significant false positives or negatives.) It’s possible Trump was referring to a study of an early diagnostic test in China that indicated a false positive rate of 47 percent. But that study has been withdrawn. We asked the White House for an explanation but did not get a response. “I had a decision to make; maybe it was my biggest decision. China was heavily infected and thousands and thousands of people were coming from China to the United States. And against the wishes, not even wishes, but they disagreed with the decision I made, a decision to stop [people from] China from coming in, took a lot of heat even from China. … That was a big decision; that was earlier than the date you’re talking about so that was a big decision.” Trump was asked whether the administration’s projected number of coronavirus-related deaths in the United States, ranging from 100,000 to 200,000, would have been lower “if we had started the social distancing guidelines sooner in February or January.” Trump dodged the question and said he made a difficult decision, announced Jan. 31, to ban most foreign travelers from China to the United States. “We did catch it early and we stopped China really early,” Trump said later in the briefing. But as we noted, the Trump administration and several key agencies were slow to act on testing and public health measures when the outbreak began. Government documents, testimony, news reports and interviews tell the story; a video investigation by The Fact Checker team found the government was blind to the virus’s spread, and several errors opened the door for 11 confirmed cases to balloon to more than 100,000 in less than six weeks. “We gave him [New York Gov. Andrew M. Cuomo] a lot of ventilators. And you know what? He has a lot of ventilators. The problem is with some people, no matter what you give, it’s never enough.” More than 40 percent of coronavirus cases in the United States had occurred in New York as


As coronavirus cases surge in Florida, fears mount that action came too late

Francis Suarez said in an interview. Suarez was among the first people in his city to be infected with covid-19, the disease caused by the coronavirus, and he emerged from quarantine two days before the rest of his state was ordered to shelter in place. “We’re not quite a hot spot, but we have all the factors,” he said. “We can quickly become one.” Florida’s bout with the virus is likely to peak in early May, when an estimated 175 people will die of covid-19 every day, according to the University of Washington Institute for Health Metrics and Evaluation, which has provided a much-cited model of the outbreak. In total, it predicts 6,897 Sunshine State residents could eventually die of the coronavirus. “I would love it to be accurate and I very much hope it is, but we must be prepared for the possibility that is an optimistic scenario,” William Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health, said of that model. Hanage said he is “very worried” about what awaits the state. “My concern for Florida is rooted in the fact it has a population that skews old,” he said. “There have been reasonably large opportunities for super spreading events. And I don’t think there is very good evidence that the transmission of covid-19 is slowed in any meaningful way by warmer temperatures.” As recently as Tuesday, DeSantis said he had no plans to issue a statewide stay-at-home order, in part because the White House coronavirus task force had not explicitly recommended it. A day later, facing mounting criticism as caseloads multiplied, the governor ordered the state’s nearly 21 million residents to stay indoors for 30 days unless they are pursuing essential services or activities. His executive order takes effect at 12:01 a.m. Friday. “It makes sense to make this move now,” DeSantis said at a Wednesday afternoon news conference, saying he had spoken with President Trump about the decision. “We don’t really know how all these measures work, because it’s never been tried on American society before. But I think we find ourselves in a situation where we have a national pause, and we need to deal with this front and center.” Florida Agriculture Commissioner Nikki Fried has been imploring DeSantis to issue a statewide shelter-in-place order for two weeks. Fried said Thursday she’s glad the governor finally agreed. “The piecemeal approach wasn’t working,”


Veteran nurse at Howard University Hospital dies of covid-19, family says

12, Gerardo said. But he had begun experiencing flu-like symptoms, so after work he went to an urgent care facility and was tested for the flu and for the coronavirus, she said. He did not return to work. “Then he felt better; he has seasonal allergies, so at first we thought it was just the allergies,” she said. “But he started to feel worse again.” He couldn’t eat or drink. On the evening of March 27, she took him to the hospital. Within an hour, she said, the doctors had to intubate him; then his heart failed, and they could not resuscitate him. The test confirming his diagnosis did not come back until after his death. “I got better,” Gerardo said. “But he didn’t.” Howard University Hospital said it could not confirm Sinkiat died of covid-19. The hospital did not respond to questions about what, if any, steps were taken to test or quarantine staff and patients who had contact with Sinkiat. But in a statement, the hospital said it has “increased efforts to ensure the safety of all of our health care workers,” including testing staff and patients who have been exposed, in line with Department of Health guidance. That guidance recommends against testing asymptomatic health-care workers who had contact with a known covid-19 patient. “Like healthcare organizations around the country, we are working diligently to expand our testing capabilities with the resources made available to us,” the hospital said. Edward J. Smith, executive director of the National Nurses United-affliated D.C. Nurses Association, said that members who worked with Sinkiat have been quarantined but not tested was a “blatantly irresponsible and a dangerous practice.” Across the District, he said, some nurses are being quarantined after exposure, but others are just told to wear masks. Five employees and one patient have also tested positive for the coronavirus at St. Elizabeths Hospital, a public psychiatric facility. “It really shows the need that nurses, all health-care workers, have to be tested if they have been exposed, whether they have symptoms or not,” Smith said. “The District government is not allowing for that. We need to make that change so we can save more lives.” Gerardo feels some relief knowing that their 4-month-old grandson, whom she and Sinkiat had been helping care for, has shown no sign of illness. Neither has his immunocompromised son, one of two children he leaves behind. But she


Israeli spy agency’s latest mission: Hunting worldwide for scarce ventilators to battle coronavirus

JERUSALEM — Israel has turned to the Mossad, its top spy agency, to acquire ventilators and other medical supplies from abroad as the country races to handle a coronavirus outbreak that threatens to overwhelm its hospitals, according to government officials and Israeli media reports. The Mossad has already flown in millions of masks, swabs and virus testing kits in recent days, as well as a small number of ventilators. While Mossad officials have confirmed for local media that the equipment has been secured, the agency has declined to say where it is coming from, raising speculation that agents could be shopping in Arab countries or other nations that lack diplomatic relations with Israel. One unidentified Mossad official described a chaotic international marketplace with governments from around the world scrambling for the same short list of suddenly hot commodities, including ventilators, N95 respirators and other protective gear. Agents don’t hesitate to outbid, or outwit, purchasers from other nations, the official said on “Uvda,” an investigative news program on Israel’s Channel 12. “We are utilizing our special connections to win the race and perhaps do what the whole world is doing,” he said. The Mossad, Israel’s national intelligence agency, answers directly to Prime Minister Benjamin Netanyahu. The prime minister’s office declined to comment on the scope of the program Thursday, other than to confirm that he ordered the operation in the middle of March. An Israeli official said that as the entire government shifted to a crisis footing, senior leaders tapped the Mossad to take a leading role in procurement, not because of the agency’s secret agents but because of its logistical prowess. This official, who spoke on the condition of anonymity because of the sensitivity of the subject, said Israel would not divert supplies earmarked for other countries. Israel has reported The country has a well-regarded, but dangerously underfunded, national health-care system. The hospital network was already struggling with one of the highest occupancy rates of any developed country when the outbreak began. National security observers say the Mossad’s speed, spy craft and international networks would make it good at identifying and securing medical supplies. “The Mossad doesn’t have logistical capacity, it has contacts everywhere, including in the Arab world,” said Yossi Melman, a longtime observer of Israel’s intelligence community and a columnist for Haaretz. Melman said the Mossad would be able to find ventilators for sale in the remotest corners


India confronts its first coronavirus ‘super-spreader’ — a Muslim missionary group with more than 400 members infected

NEW DELHI — The devotees came by the thousands from all corners of India and beyond, converging on a large white complex in a crowded quarter of Delhi to share a message of piety. When they left in the first weeks of March, they unknowingly carried the coronavirus with them. Gatherings last month at the headquarters of a prominent Muslim missionary group are emerging as India’s first “super-spreader” event, complicating efforts to control rising infections in this nation of 1.3 billion people. More than 400 confirmed cases and at least 10 deaths across the country — stretching from Tamil Nadu in the south to Kashmir in the north — have been linked to people who attended events at the Tablighi Jamaat center near a historic shrine in India’s capital. The infections, which represent about a fifth of India’s total cases, have sparked a frantic effort to track down anyone who attended the recent meetings. In at least two states, potential contacts are being traced using mobile-phone location data. The outbreak also has provoked a spasm of Islamophobia in India, a Hindu-majority nation that is home to 200 million Muslims. In February, the country witnessed its deadliest sectarian clashes in years after the government’s pursuit of a controversial citizenship law sparked violence. As the pandemic continues, people practicing their faith have become unwitting but powerful vectors in the spread of the virus. A cultlike church helped fuel the pandemic in South Korea. A synagogue north of New York City was at the center of an early outbreak. An evangelical congregation in France was the source of hundreds of infections. India banned all religious gatherings when it instituted a three-week nationwide lockdown March 25. But several states and cities already had implemented their own restrictions: Delhi, for instance, prohibited all assemblies of more than 50 people March 16. The activities of Tablighi Jamaat have emerged as a particularly potent vehicle for transmitting the virus. Founded in India nearly a century ago, the group has as many as 80 million adherents worldwide. It is built around small bands of itinerant missionaries who urge fellow Muslims to deepen their observance and model their lives directly on the ways of the prophet Muhammad. The group eschews politics and in theory operates without formal record-keeping, said Barbara Metcalf, a prominent historian of South Asian Islam. It stresses proselytizing and travel, producing a “state of vulnerability and


As pandemic and stay-at-home orders spread, so does alcohol consumption

likely leading many people to increase their consumption of beer, wine and hard alcohol, experts say. A recent survey by the market research firm Nielsen reported off-premises sales of alcoholic beverages across the United States have grown 55 percent in the week ending March 21, said John Bodnovich, executive director of the American Beverage Licensees, which represents about 13,000 bars, taverns, restaurants and package stores. (Some of that growth may be due to bars and restaurants now being closed in many places.) Stress is a common trigger for drinking, said C. Vaile Wright, director of clinical research and quality in the Practice Directorate for the American Psychological Association, and this pandemic has led to an unprecedented period of stress. “We are seeing more people using alcohol as a way to cope with the anxiety and stress and uncertainty of this situation,” she said. “I think a lot of people use it to numb out. While that’s certainly a very human response to what’s going on right now, it’s generally not the best way of managing stress.” For one thing, alcohol is a depressant, both physically and mentally, so those already prone to depression or sadness may find those feelings exacerbated by drinking, she said. And it can actually increase one’s anxiety, because it interferes with the ability to get quality sleep at night, Wright said. Without quality sleep, it can be hard to manage stress the next day. Anxiety is definitely a factor for Noelle Farra, a human resources officer in New Jersey. Since the pandemic has unfolded in her hard-hit state, her weekend cocktail has morphed into a nightly cocktail, sometimes two. “The real fear of the virus, as well as the manufactured fear, from the media, has made me more anxious,” she said. “Getting to the end of the day without paralyzing anxiety is almost a goal. I reward myself with a glass of wine or light beer.” During a recent weekend, Farra said, she actually worried she and her husband might run out of wine. That’s not a thought that would’ve cropped up in the past. Maria Sommerville, a school administrator in Pittsford, N.Y., says she used to drink about a glass or two of wine or bourbon a month. Now, she has a glass of wine or a cocktail every night. “There is so much uncertainty — illness, job insecurity, social isolation,” she said. The anxiety


Olympic officials face a logistical nightmare, from half a world away

As Olympic organizers set about the unprecedented task of postponing a Summer Games, they’re forced to rearrange the complicated chess set in unprecedented circumstances. The novel coronavirus pandemic prompted government restrictions and changed the way business is conducted around the world, and officials with the International Olympic Committee are working from their home offices and dining room tables, mostly in Switzerland, making plans to stage the world’s largest sporting spectacle seven time zones away. Most of the IOC staffers have no plans to return to Tokyo in the near future, so the business of reorganizing the Tokyo Games for 2021 is being conducted daily on telephones and video conferences. “We have adapted to this new virtual environment,” said Christophe Dubi, the IOC’s Olympic Games executive director. “So we’re missing to be with people, obviously, but we’ll do the right thing and we contribute to the fight against covid-19.” While Olympic officials are still in the early stages of plotting out a Summer Games in 2021, they feel confident they will be able to present a full Olympic offering with all sports and all disciplines planned for the Tokyo program next summer. Speaking on a conference call with reporters Thursday, Dubi said he’s hopeful the Summer Games in 2021 will resemble the 2020 blueprints, but much work needs to be done. Venues and facilities were contracted for 2020, and many have other plans or tenants lined up for next summer. New contracts need to be negotiated and drawn up, but the IOC is hopeful the sites will be available to host Olympic events a year later. “All of the 41 venues were incredibly proud of to have the Games because it’s a game-changer for any building to have hosted the event,” Dubi said. “So the likelihood is that those negotiations would go in the right directions.” Dubi declined to offer an estimate on the cost of postponing the Olympics, saying it’s “really premature to get into this. “I’ve read numbers, but these are really speculation because I can guarantee the work is really ongoing. It’s tens of thousands of line items on budgets that need to be reviewed.” For Olympic officials, the first step is done: This week, the IOC and Tokyo organizers announced the Summer Games would start July 23, 2021, 364 days after the original start date. That means that all the moving parts can start moving. “For us,