Who is Shinzo Abe, Japan’s departing leader, and what legacy will he leave?

on the world stage since Imperial Japan’s defeat in World War II. Abenomics was a “shock therapy” policy. The “three arrow” strategy called for a combination of monetary easing, government spending and economic reforms to end a period of lost growth that had stretched since the 1990s. Debate over whether the strategy worked still rages. The pandemic has been a major economic setback, erasing gains. More controversial abroad was Abe’s push for Japan to assume an assertive international role. His administration was hawkish against Pyongyang — Tokyo said North Korea kidnapped at least 17 Japanese nationals between 1977 and 1983 — as well as Beijing, because of China’s economic and military rise. His most divisive effort was his proposed revision of Japan’s pacifist constitution written under U.S. occupation in 1947 — in particular its ninth article, which renounces war and prohibits an army. In 2014 and 2015, Abe’s coalition government enacted laws that changed the role of Japan’s Self-Defense Forces, allowing them to fight alongside allies overseas — a move that drew condemnation from China and South Korea. After an electoral victory in 2017, Abe again suggested he would move to alter Article 9, but lingering public division on the subject seems to have slowed plans for a referendum. Now it appears to be too late, for Abe at least. Abe bolstered right-wing nationalists at home and angered Japan’s regional neighbors by visiting the Yasukuni Shrine in Tokyo in 2013. The Shinto shrine honors Japan’s war dead, including 14 war criminals, and is seen abroad as a monument to Japanese militarism and revisionist views on WWII. Abe cultivated good relationships with many western leaders, but perhaps none defined the later years of his premiership more that his friendship with Trump. Abe first hosted the U.S. leader in November 2017, giving Trump a red-carpet welcome despite major policy differences on key issues like free trade and North Korea. During a visit to Japan in May 2019, Trump became the first foreign leader to meet Japan’s new emperor, Naruhito, and attended a sumo tournament as special guest. The two men have also bonded over a love of golf, though when Abe tripped and fell into a bunker in 2017, Trump failed to take notice (the footage was later aired on television). The Japanese prime minister’s fawning praise of his guest became a running joke: Trump claimed last year that Abe had even


Can dogs detect the novel coronavirus? The nose knows.

to recognize the role dogs can play in humankind’s ongoing battle with emerging diseases. “To me, it’s a world project,” said Grandjean, who has been contacted by countries in South America and the Middle East. “Once covid is over, then there will be other viruses.” There’s nothing new about the notion that diseases smell. In his aphorisms, written in 400 B.C., Hippocrates, the “father of modern medicine,” recognized a “heavy smell” in the sputa and urine of people suffering from certain illnesses. Physicians continued to rely on their noses to make some diagnoses — recognizing the putrid sweat of vitamin C deficiency or scurvy and the fruity-scented urine of diabetics. A sudden change in the way our breath or urine smells remains a reason to check in with the doctor. That’s because human bodies constantly give off a cocktail of chemicals known as volatile organic compounds, or VOCs, in sweat, saliva, urine, breath and sebum that change when cells grow, as in the case of cancer, or when they die after being infected, for example, by a virus. “With covid detection, you are not recognizing the virus,” Suslick said. “You are recognizing the volatile byproducts of cells dying because they have been infected with the virus.” Some VOCs have such strong smells that people have been able to detect them even without recognizing what the odor means. More than a decade before her husband was diagnosed with Parkinson’s disease, a Scottish woman noticed a change in the way he smelled. He had developed a “sort of woody, musky odor,” Joy Milne told a London newspaper — a telltale smell she was later able to recognize on T-shirts worn by other people with the disease. With mass spectrometry, which is used in explosives and drug detection as well as in the food and perfume industries to identify specific molecules within a sample, Barran, the University of Manchester professor, was able to analyze the Parkinson’s disease markers. For a condition in which diagnosis typically relies on identifying an array of physical symptoms (many of which can be confused with signs of aging), the possibility of presymptomatic diagnosis (and early treatment) is exciting. Milne’s nose did for Parkinson’s research much the same thing as Otto’s dogs are now attempting — establishing that a diagnostic odorprint exists. “The dogs are acting like Joy [Milne] did for us,” Barran said. There is an added mystique


Trump speaks with Big Ten commissioner, pushes conference to play football this fall

think they want to play. And the fans want to see it, and the players have a lot at stake, including possibly playing in the NFL. You have a lot of great players in that conference. “So we had a very good conversation, very productive,” Trump continued. “And maybe we’ll be very nicely surprised. They had it closed up. And I think they’d like to see it open, along with a lot of other football that’s being played right now.” Trump has not specifically mentioned the Pac-12 or any other conference that opted to postpone fall sports. The NCAA canceled Division I championship events for all fall sports apart from the top-tier Football Bowl Subdivision, which the NCAA does not govern. The Big Ten hopes to hold a football season that could begin in the winter. The NCAA’s Board of Directors recently approved the Division I Council’s recommendation that all fall-sport athletes, regardless of how many games they play this academic year, receive an additional season of eligibility. Following the Big Ten’s decision to postpone the football season, parents at multiple schools have pushed back. Ohio State star quarterback Justin Fields urged the conference to reverse its decision with a petition that has received more than 300,000 signatures. Eight Nebraska football players filed a lawsuit against the Big Ten last week, arguing that the postponement hurt the players’ ability to market themselves and their future professional opportunities. In a statement, the conference said, “This lawsuit has no merit and we will defend the decision to protect all student-athletes as we navigate through this global pandemic.” Before the Big Ten and Pac-12 punted on fall football, players from the Power Five conferences released a unified statement that expressed their desire to play this season. That effort was led by some of college football’s best players, including Fields, Clemson quarterback Trevor Lawrence and Oklahoma State running back Chuba Hubbard. Trump supported that movement and tweeted: “The student-athletes have been working too hard for their season to be canceled. #WeWantToPlay.” Read more on For Jordan McNair’s dad, an advocate for athlete safety, the coronavirus sparks familiar concerns How college football players discovered their power and why it’s just the beginning The College Football Playoff is a go for 2020, despite a reduced field and an active pandemic Iowa cuts four sports, becoming the first Big Ten school to ax programs during the pandemic


Muslim cleric, given life sentence for promoting religious combat, released pending appeal

A Northern Virginia cleric sentenced to life in prison for encouraging religious combat after the Sept. 11, 2001, terrorist attacks was set free Tuesday as he continues to fight his conviction. Ali al-Timimi, 56, will remain on home confinement in Virginia, after 15 years behind bars, while his appeal is resolved. He is the last member of a group known as the “Virginia jihad network” to leave prison, in a case touted by the Justice Department and decried by Muslim groups as unduly harsh. Judge Leonie M. Brinkema, who presided over al-Timimi’s 2005 trial in federal court in Alexandria, ruled last month that al-Timimi could be released after a 14-day quarantine because he has a strong chance of seeing his sentence shortened on appeal and a high risk of complications if infected by the novel coronavirus. “There are exceptional reasons why his continued detention is not appropriate,” she wrote. “He may well have already served excess years in prison.” His only disciplinary infraction, she noted, was a 2018 incident in which he told a guard that if he was threatened by another inmate again he would beat the man up. Al-Timimi was fined $20. Defense attorney Jonathan Turley confirmed that he picked up al-Timimi at a maximum-security prison in Colorado and drove him to Virginia on Tuesday but declined to comment further. A biologist and prominent lecturer at a Falls Church mosque, al-Timimi told a small group of his followers after the 9/11 attacks that it was time to join the fight overseas, including against U.S. troops in Afghanistan. Some members of the group were preparing for violent religious conflict by playing paintball in the woods; several went to Pakistan and got military training run by a group later designated as a terrorist organization. But none actually went to Afghanistan and fought against U.S. troops. The use of weapons at that camp led to steep prison sentences for three defendants who went to trial, including al-Timimi. The other two were released early because of court decisions finding the law’s definition of a “crime of violence” too vague, a position upheld last year by the Supreme Court. Brinkema found that al-Timimi was likely to see his sentence similarly cut by the U.S. Court of Appeals for the 4th Circuit. The cleric has also challenged his convictions as violating his free speech rights and maintains that the government failed to hand over


Why we shouldn’t over-promise on vaccines

of 2020, for example, I think they do a grave disservice to the public,” said Kenneth C. Frazier, chief executive of vaccine powerhouse Merck, in an interview with the Harvard Business School. Frazier dismissed the positive initial reports from rival vaccine manufacturers. “There are a lot of examples of vaccines in the past that have stimulated the immune system, but ultimately didn’t confer protection,” he said. Worse, he added, some vaccine candidates “actually helped the virus invade the cell.” Again, this is a remote but real possibility. Merck, which has developed more novel vaccines than any other company, was suddenly forced to stop its AIDS vaccine trial in late 2007 after investigators realized the vaccine offered no protection — and even made some volunteers more susceptible to HIV. Crash programs to develop vaccines can be risky. President Gerald Ford’s effort to vaccinate all Americans against swine flu ended in disaster in 1976 after 450 vaccinated individuals were paralyzed with Guillain–Barré syndrome. Tellingly, like Trump, Ford was running to stay in the White House that year. Meanwhile, some potentially promising therapies languish. Two antiviral drugs used against hepatitis C have demonstrated anti-covid-19 potential in laboratory tests and small clinical trials. Three Iranian studies published in the Journal of Antimicrobial Chemotherapy on Aug. 19 suggest that the drugs, sofosbuvir and daclatasvir, are effective against the virus. Yet scientists have struggled to raise the money needed to confirm these results in larger trials. Other researchers have told me its taken months to get the National Institutes of Health to commit lab space to test potential antiviral treatment candidates. More than 30 years ago, a small band of AIDS activists — many fighting for their own lives — changed history by demanding better treatments. Let’s follow their example, hedge our bets, and give equal priority and funding to covid-19 treatment research. As is written in the Bible, “Divide your investments among many places, for you do not know what risks might lie ahead,” (Ecclesiastes 11:2). It’s time to apply this ancient wisdom to a modern plague. Read more: The Post’s View: What if the coronavirus vaccine doesn’t arrive soon? FDA commissioner: No matter what, only a safe, effective vaccine will get our approval Jennifer Rubin: Covid-19 is still winning Steven Joffe: It’s time to start testing potential covid-19 vaccines on children Emily Oster: How the media has us thinking all wrong about the coronavirus


Mexico is in crisis. Its president insists on alternative reality.

to the virus’s devastation in Mexico. “Mexico has set an example for the world,” López Obrador said in early June. This is nonsense. The country has paid a heavy price for its government’s ineptness: Only India, Brazil and the United States have higher numbers of reported deaths. On Tuesday, during his second annual address, López Obrador doubled down on his rosy diagnosis of the country’s predicament and his government’s response. He was particularly admiring of his own performance in a time of crisis. “I don’t want to brag, but we have the best government for the worst moment,” he boasted. His formula for tackling the pandemic’s economic challenges, he said, was “unique and different.” What made it special, he explained, was his decision to deliver aid directly to the poor, bypassing the business sector (including thousands of small businesses that are the backbone of the Mexican economy). Critics have questioned López Obrador’s intentions, pointing out the risk of creating a political clientele rather than truly effective social programs. López Obrador then touted the creation of close to 100,000 jobs, a fraction of those lost and far from the 2 million jobs he promised for 2020. “López Obrador is touting a recovery when what we are seeing is merely a bounce,” analyst Jorge Suárez Vélez told me. “If you throw a dead cat from a fourth floor, it will bounce. It doesn’t mean it’s alive.” Even if the facts point to a severe crisis, López Obrador seems set on propping up his misleading narrative. He also wants to divert attention away from the pandemic and its consequences and onto a useful boogeyman: the past. López Obrador has opened the possibility of judicial processes against five of Mexico’s former presidents over their alleged involvement in corruption cases. Conveniently, he has said he’s personally opposed to the idea, but has left it up to Mexicans to decide through a legally questionable referendum. The catch? The referendum would coincide exactly with Mexico’s next election, in June 2021, when control of Congress will be in play. This is no accident. López Obrador seems more interested in consolidating power than in exercising it responsibly. And if he has to twist the facts around the country’s mess or incite the public into prosecuting previous governments for electoral gain, so be it. Watch Opinions videos: Read more: León Krauze: López Obrador’s diplomacy of subservience at the White House


Trea Turner is all grown up and developing into one of the best shortstops in baseball

Breaking: Trea Turner did not get a hit Tuesday night. “You’re not going to get three hits every night,” Turner said. Except the previous four nights, that’s exactly what Turner had done. Oh, wait. Correction. Except for the night he had four hits. And the night he had five hits. The Washington Nationals are stumbling through this shortened baseball season. They enter play Wednesday having lost four straight. They have the second-worst record in the National League. They have to win two-thirds of their remaining games just to get to .500. If there were fans in the stands for next week’s homestand at Nationals Park, they would have more to boo than cheer. In situations such as this — when the World Series title is behind and the pursuit of another this season is unrealistic — it makes sense to look around and determine what building blocks remain so that another run can be made and soon. Juan Soto and his major league-best on-base-plus-slugging percentage at age 21 is obvious, a star deserving of more national acclaim. Stephen Strasburg, on the shelf with an injury but signed through 2026, must be a core piece, as he was in earning World Series MVP honors last fall. Other than that, who is more important than Turner? It has been five years since he first came to the majors. He played second base. He played center field. He was so baby-faced it was difficult then — and it’s difficult still — to see him as some sort of hardened veteran. “That definitely seems like a long, long time ago,” he said. Now he is their shortstop — both of the present and the future. Think of it this way: Turner is the longest-tenured Nats’ position player. Yes, Michael A. Taylor arrived in the majors in 2014, a year before Turner. But Taylor can’t — and won’t — crack a starting outfield of Soto, Victor Robles and Adam Eaton. So it’s time to acknowledge Turner as a potential star on the field — which we will get to — but an undeniable presence off it. Accurately grasping clubhouse dynamics is a challenge for reporters in normal times, even with daily pre- and postgame access. In covid-19 times, it’s nearly impossible because the clubhouses are closed, access is via Zoom and one-on-one conversations are almost nonexistent. Still, in 2020, think of all Turner has seen.


Those symptoms you Googled could help researchers better understand coronavirus

The first thing people should probably do when they fear they have contracted the novel coronavirus is call their doctor. The first thing most people actually do is Google their symptoms. That’s good news for researchers. Google is sharing its treasure trove of data about runny noses and fevers to help health researchers learn more about covid-19, the disease caused by the coronavirus. The data set could even help them predict future hot spots for the disease, or learn more about what long-term effects it has. On Wednesday, Google is making county-level data on symptom searches in the United States available to researchers and the public. The information goes back three years and includes up to 400 symptoms and conditions, not just those known to be associated with covid-19. It will have information on searches for things such as stress and diabetes so experts can learn more about secondary health impacts. The company has done some work to clean up the data for researchers, such as figuring out which search terms all describe a single symptom. For example, few people are going to type in “anosmia” when they lose their sense of smell or taste. They’re more likely to type something like “loss of smell covid” or “why can’t I taste this cantaloupe.” All the data is anonymized and not connected to individual users, says the company. Instead of actual numbers of people looking up a symptom in a single area, Google will present the volume of searches for each symptom as a range. The company tried to do something similar with symptom search data in the past. Google Flu Trends was a program that launched in 2008 to use symptom searches to predict flu outbreaks. It was originally accurate, but after a number of years, the results diverged from what was being found by public health organizations such as the Centers for Disease Control and Prevention. Eventually the program was shut down. However, Google has continued to provide flu and other health search data to researchers who have used it to monitor things such as Lyme disease and the spread of foodborne illnesses. With the coronavirus data set, Google says it is not trying to make any predictions itself, but allow outside researchers to dig in, combine it with other data for increased accuracy and learn more about what is still a relatively new disease.


A long-haul move is hard enough. A pandemic and racism make it even harder.

In the middle of the coronavirus pandemic, I needed to move to one of the country’s hot spots. Usually based in D.C. for work, I was away from my husband in Florida. He was looking for a job to join me, but after the pandemic hit, I went to him instead, thinking things would return to normal soon. That was March. Months passed, and I lived out of a duffle bag carry-on, hoping nobody noticed I was wearing the same shirts on Zoom. But I couldn’t afford to keep paying for an expensive empty apartment, so I made the difficult decision in July to relocate. Not only is it intimidating to travel right now and risk exposure to covid-19, the disease caused by the coronavirus, but I was also fearful of moving across the country as an Asian American. Hate crimes have increased against my community, which is frequently blamed as the cause of the virus. Asians were getting spit on and being set on fire. With so much at stake, we traveled as fast as possible — flying in on a Thursday, packing like maniacs so we could drive out that night and get back by Friday afternoon. It was a total of two days, across five states, with many wipes and a huge tub of Purell. I don’t suggest moving now, but if you have no other choice, like me, experts have many tips for how to make the trip as smooth — and safe, in multiple ways — as possible. For our move, we calculated the cheapest method with the least risk. We also wanted to do the move as quickly as possible, and on our own. This meant opting for a two-hour flight rather than a 14-hour drive, no movers and no hotel stays. My greatest fear was flying again, but experts said it may not be as risky as you think — especially if the airline cleans regularly and doesn’t pack customers in. “Your actual transmission on a flight is very, very small because they have very careful airflow that comes down from above you that goes out at the bottom,” said Adrian Hyzler, the chief medical officer of Healix International, a medical assistance company for travelers. “It kind of cones you, so it comes down like that and out. They recycle air from the outside every two or three minutes, so it’s 20 to


Covid-19 has killed more police officers this year than all other causes combined, data shows

In a speech this week in Pittsburgh, Joe Biden linked the Trump administration’s mismanagement of the coronavirus to its handling of protests and riots with a surprising statistic: “More cops have died from covid this year than have been killed on patrol,” he said. The Democratic presidential nominee’s claim is true, according to data compiled by the Officer Down Memorial Page and the National Law Enforcement Officers Memorial Fund, two nonprofits that have tracked law enforcement fatalities for decades. As of Sept. 2, on-the-job coronavirus infections were responsible for a least 100 officer deaths, more than gun violence, car accidents and all other causes combined, according to the Officer Down group. NLEOMF reported a nearly identical number of covid-related law enforcement deaths. NLEOMF reported a nearly identical number of covid-related law enforcement deaths. It also noted that fatalities due to non-covid causes are actually down year-over-year, undermining President Trump’s claims that “law enforcement has become the target of a dangerous assault by the radical left.” Both organizations only count covid deaths “if it is determined that the officer died as a result of exposure to the virus while performing official duties,” as the National Law Enforcement Officers Memorial Fund put it. “Substantive evidence will be required to show the death was more than likely due to the direct and proximate result of a duty-related incident.” In addition to the 100 confirmed coronavirus fatalities listed on the Officer Down website, the nonprofit said it is in the process of verifying an additional 150 officer deaths due to covid-19 and presumed to have been contracted in the line of duty, said Chris Cosgriff, executive director of ODMP, in an email. “By the end of this pandemic, it is very likely that COVID will surpass 9/11 as the single largest incident cause of death for law enforcement officers,” he wrote. Seventy-one officers were killed in the attacks on the twin towers, one officer was killed on United Flight 93, and more than 300 have passed away since then as a result of cancer contracted in the wake of the attacks, according to ODMP. At the state level, Texas stands out for having the highest number of law enforcement covid fatalities with at least 21, according to NLEOMF. At least 16 of those represent officers with the Texas Department of Criminal Justice, which manages the state’s correctional facilities. Louisiana has 12 covid-related officer deaths.


African American newspapers are a vital source of public health information

As the racially disproportionate impact of the covid-19 pandemic becomes ever more apparent, the media has scrambled to keep up. Responding to demands for greater government transparency on covid-19 data, the Atlantic launched the COVID Tracking Project, which includes a “racial data tracker” developed in collaboration with Ibram X. Kendi’s Center for Antiracist Research at Boston University. However, while racial disparities are now being tracked and covered extensively, media outlets have struggled to provide deeper context for the disparate outcomes, and coverage has often provided more heat than light. Many outlets have given oxygen to fringe anti-lockdown protests and helped to circulate misinformation. Right-wing outlets have overlooked the significance of race as part of a broader effort to downplay the impact of the virus. Meanwhile, President Trump’s eagerness to “reopen” the nation and his racist naming of the virus show scant regard for America’s communities of color. In the face of such challenges, Black newspapers and media outlets such as the Sacramento Observer, the Chicago Defender and the Triibe have all turned their attention toward the pandemic. Trade organizations such as the National Newspaper Publishers Association (NNPA) have followed suit, stressing covid-19’s racially disproportionate impact on Black communities and pushing back against racist media narratives. In doing so, they are continuing the Black press’ historic mission as an important disseminator of public health information to Black communities. Yet even as Black-owned media outlets work to help African Americans remain informed during the pandemic, they are shouldering long-standing economic pressures that have only worsened in the age of covid-19. Since the early decades of the 19th century, the Black press has played a vital role in educating Black America on issues related to public health. Driven by a desire to be accepted within mainstream American society, early Black publishers stressed that “good health” was a vital part of achieving integration and becoming a “successful” member of the middle class. During the late 19th and early 20th centuries, tobacco-related health information and calls for temperance were a staple feature within the pages of Black newspapers such as the Chicago Defender and the Pittsburgh Courier. Black newspapers also became an important source of information about contraceptives after the emergence of the modern birth control movement — information that was often denied to African Americans living under the Jim Crow system in the South. In addition to providing public health information, Black newspapers also


Athletes who protest are doing something American: Exercising their rights

in Kenosha, Wisconsin. This action set off a chain reaction in other sports. Teams in Major League Baseball, the National Hockey League, Women’s National Basketball Association and Major League Soccer joined the protest and chose not to play games. So let’s talk about athletes and protests. This is not the first time athletes have staged political protests. In the 1960s, Muhammad Ali, the heavyweight boxing champion and probably the most famous athlete in the world, refused to serve in the United States armed forces. In those days, men ages 18 to 35 were required to go into the military if the government needed them. Ali’s refusal was seen as a protest of the United States’ involvement in the Vietnam War. Tommie Smith and John Carlos raised their gloved fists to protest the treatment of Black people in the United States after they won the gold and bronze medals in the 200-meter race at the 1968 Summer Olympics. And, of course, Colin Kaepernick and many other athletes have knelt during the national anthem at games in recent years to protest police violence against African Americans. Some argue that protests do not belong at sports events. Some people think sports should be a place where there are no political statements. However, an athlete in the United States has the same rights as any other American. All Americans have the right to protest as long as the protests are peaceful and do not interfere with the rights of others. But athletes’ protests are different. People may pay more attention to well-known athletes than a person who isn’t famous. However, just because someone is good at shooting a basketball or catching a football does not necessarily mean his or her opinion on public issues is more important than anyone else’s. That’s especially true when other people have studied these issues for a long time. That’s why it is good that the NBA players do more than just give their opinions. When they agreed to resume the playoffs, the players got NBA owners to promise to use their arenas as voting sites in the 2020 election. Using these large buildings will allow more people to vote safely during the coronavirus pandemic. Finally, when we say everyone, including athletes, has the right to protest peacefully, it means everyone — not just the people with whom we agree. That may be the hardest part of accepting protests.


Steroids can save lives of patients with severe covid-19, earning WHO endorsement

placebo; the third analyzed 379 patients to test hydrocortisone in the United States and seven other countries. All three trials halted after the British results became public in June. Trial steering committees around the world concluded it would be uncomfortable, if not unethical, for doctors to give patients placebos in randomized trials. Because of that, these steroid trials stopped short of enrolling enough patients for their results to be as statistically powerful as desired. “Although the individual trials weren’t necessarily conclusive, because they hadn’t run to term, they were all pointing in the right direction,” Angus said. He added: “It feels like the first fresh piece of fairly consistent, uncomplicated, straightforward, good news about something concrete to do for the sickest of patients." Similar results in dexamethasone and hydrocortisone indicate corticosteroids are helpful as a class of drugs. Such flexibility may allow hospitals to avoid the shortages of remdesivir, an antiviral coronavirus therapy. The NIH recommends treatment with the steroid methylprednisolone, for instance, if dexamethasone is not available; NIH said in a statement Wednesday its working groups will propose updates based on the latest research findings. “The steroids are pretty much readily available, and they’re not really expensive,” Rice said. That’s true not only in the United States but also in lower-income countries, where the WHO guidelines will carry significant weight. While providing a strong foundation for corticosteroid treatment, the studies left several questions unanswered. One of the biggest is more clearly determining which patients are most likely to be helped. The WHO guidance defines critical covid-19 by conditions, such as acute respiratory distress syndrome or septic shock, that require life-sustaining therapies. Signs of severe covid-19 include low blood oxygen and respiratory distress that prevents, for instance, speaking in complete sentences. “This sets forth that the sickest, the most severely ill in the ICU appear to be clearly benefited by this,” Rice said. Even within that group, however, there may be certain patients for whom “giving steroids isn’t the right thing to do.” Doctors are likely to agree an ICU patient on mechanical ventilation or significant respiratory support should receive steroids, Prescott said. But she said she will make case-by-case decisions for her “gray zone” patients — those who receive a few liters of oxygen. “Just because steroids work in sicker patients does not mean to say that we should be cavalierly starting steroids in every patient,” Angus said. Many


Maryland jurisdictions mixed on moving to Phase 3; local leaders express worry

the gains we have made over the past month by loosening restrictions now,” Mayor Bernard C. “Jack” Young (D) said during a news conference. Howard, which has had the lowest case count of the six most populous jurisdictions, has generally kept pace with the state’s timeline for reopening since June. County Executive Calvin Bell (D) said Howard would enter Phase 3 this Friday, allowing movie theaters and entertainment venues to reopen at 50 percent capacity or 250 people and religious services to increase to 75 percent capacity. For some venues, the lifting of restrictions that allow for small audiences won’t lead to reopening. “We are still in dire and desperate need. This does nothing for us,” said Audrey Schaefer, a spokeswoman for Merriweather Post Pavilion, a Howard County outdoor amphitheater that typically hosts events with 6,000 to 18,000 attendees. Merriweather this year was scheduled to host concerts by Rod Stewart, Halsey and Luke Bryan, but the events were canceled as the pandemic took hold. The lack of revenue has been crushing, Schaefer said. Smaller music venues such as the Soundry in Howard County have shut their doors amid the crisis. Maryland has seen its rolling seven-day average number of new infections decline over the past month, falling to 548 on Wednesday after hitting 940 on July 31. The state is averaging seven virus-related deaths per day. On Tuesday, Hogan cited improving infection rates, the declining use of intensive care beds and expanded testing availability in saying it is safe to lift more of the restrictions that have been in place since March. He said the state’s efforts “have crushed the curve and saved lives,” while noting that restrictions will remain on certain activities. Joshua Sharfstein, secretary of the Maryland Department of Health under former governor Martin O’Malley (D), said “things are certainly reasonably stable” in the region, but he cautioned residents against being complacent. “It’s not like it’s falling to a very low number,” he said. “There’s still coronavirus out there, and it’s really important to stay vigilant.” Neil J. Sehgal, assistant professor of health policy and management at the University of Maryland School of Public Health, said that although several key metrics have improved recently, the public should remain cautious. “We’re moving in a good direction, especially in this part of the country,” he said. “It seems like a preponderance of people have been vigilant and are respecting the


infections decline over the past month, falling to 548 on Wednesday after hitting 940 on July 31. The state is averaging seven virus-related deaths per day. On Tuesday, Hogan cited improving infection rates, the declining use of intensive care beds and expanded testing availability in saying it is safe to lift more of the restrictions that have been in place since March. He said the state’s efforts “have crushed the curve and saved lives,” while noting that restrictions will remain on certain activities. Joshua Sharfstein, secretary of the Maryland Department of Health under former governor Martin O’Malley (D), said “things are certainly reasonably stable” in the region, but he cautioned residents against being complacent. “It’s not like it’s falling to a very low number,” he said. “There’s still coronavirus out there, and it’s really important to stay vigilant.” Neil J. Sehgal, assistant professor of health policy and management at the University of Maryland School of Public Health, said that although several key metrics have improved recently, the public should remain cautious. “We’re moving in a good direction, especially in this part of the country,” he said. “It seems like a preponderance of people have been vigilant and are respecting the guidance of public health officials.” Sehgal cautioned that Maryland’s decision to move to Phase 3 could bring new challenges as people participate in activities that weren’t previously possible. He said the region may have reached an “irreducible minimum” of new cases, citing the lack of public motivation or political will for imposing new restrictions. “Things are getting better, but we’re not going to get past it at this pace unless we step up our vigilance individually,” he said. “This virus is relentless. It does not rest.” The seven-day rolling average of new cases in the greater Washington region stood at 1,610 on Wednesday, which is the highest daily average in more than a week as caseloads have mostly held steady. The increase is generally the result of cases slowly rising in northwestern and southwestern Virginia. The region added 1,411 new cases and 35 deaths on Wednesday. D.C. reported 28 new cases and one death, Maryland had 456 cases and five deaths, while Virginia had 927 new cases and 29 deaths. A recent rise in virus-related deaths in Virginia has increased the state’s seven-day average death toll to 18 — more than double the statewide average from mid-August. The rise is


The coronavirus disarms the foot soldiers of the immune system. Scientists theorize that boosting them could fight covid-19.

in their blood, according to new research by Bali Pulendran, an immune system expert at Stanford University School of Medicine, and his colleagues. The team isolated immune cells from the blood of patients with severe covid-19, placed them in petri dishes and tried to provoke them with bacteria and viruses. Normally, such provocations would cause the immune cells to erupt in a shower of interferons and other defensive molecules. But, as the scientists reported in a paper published Aug. 11 in Science, those cells in covid-19 patients were inert. It was as though the coronavirus, or a consequence of its infection, had snipped their fuses. “After eight days or so, the type-1 interferon system is completely absent, and silenced, by the infection,” Pulendran said. Interferons’ therapeutic possibility Researchers caution that many questions about interferon treatments for coronavirus patients remain unanswered. Past clinical studies that tested them to treat SARS and MERS showed little or no benefit. But there are promising early signals. Preliminary results from a small randomized clinical trial, publicized in a news release in late July by the British company Synairgen, suggests that an inhaled interferon treatment reduced the odds of developing severe covid-19, compared with a placebo. Experts cautioned that the trial was small, just 101 patients, and the results were not yet published in a peer-reviewed study. In France, investigators plan to test interferon treatments if cases continue to rise. But they are currently too low to enroll enough patients in a clinical trial, Terrier said. A large, U.S. National Institutes of Health-sponsored clinical trial launched this month will test an interferon drug injected in patients hospitalized with covid-19. Those patients will receive interferon beta-1a, a synthetic molecule identical to the protein our bodies make, every other day for the first week of their hospital stay. The trial is recruiting about 1,000 patients from 100 hospitals around the world. The patients will be sick but not so ill as to require ventilators to breathe. That speaks to the goal of treating the disease before it worsens. “What you’re likely going to see, as more antivirals come along and then the monoclonal antibodies come along, will be a propensity to treating as early as you possibly can to prevent people from getting into the hospital,” Fauci said. The patients in the study will also get remdesivir, an antiviral agent the FDA authorized in the spring. Researchers will


unless we think it’s going to be beneficial.” She said she would like the NIH-sponsored trial to answer whether giving interferon drugs to hospitalized patients is helpful, and what dosages yield the best results. What’s more, pitting these virus fighters against the coronavirus too late in the process could actually worsen symptoms, according to animal models cited in a recent review of interferon studies. Missing interferons, severe symptoms Scientists theorize that the virus’s ability to disarm interferons early on may explain other aspects of the disease, such as the out-of-control inflammation reaction that develops in some patients. As the immune system mounts an inflammatory defense — but there are too few interferons to quickly contain the virus — the body’s response can spiral out of control, several scientists said. In some cases, this uncontrolled inflammation becomes deadly. Some experts also suggest that a person’s ability to mobilize interferons to wage a strong immune response at the start of the infection process may predict less severe disease. “We know that individuals differ in their ability to mount an interferon response,” said pediatrician Petter Brodin, who studies the immune system at the Karolinska Institute in Sweden. When otherwise healthy people fall ill, Brodin said, “it makes me wonder at least — do they have a genetic susceptibility, an underlying immunodeficiency that we haven’t picked up yet, which gives them this response, potentially because they failed to induce interferons?” There is preliminary evidence for this, such as a case study of four men under age 35 who had rare genetic variants associated with impaired interferon response and who were hospitalized in the Netherlands with severe covid-19. Cause and effect is very difficult to determine in the human immune system. The Science papers used a variety of techniques to examine the virus, but they described only single points in time. “You are getting more of a snapshot,” said Gaglia, who was not involved with these reports. What happens on the third day of an infection may not be what happens on the 10th. “And so you are trying then to make an inference of the sequence of events.” Additional studies of the immune system can help unravel the stages of infection. Pulendran said his team is collecting blood samples at regular, frequent intervals “to map out the trajectory of this disease.” The race to understand and shore up our inner defenses continues. Read more:


The targeted killings that have shaken Afghanistan

a mentor, said, “We were companions on a path, and he was like a light for us. “But now that he’s gone, we won’t lose the way,” Shagiwal said. “We will always have that ideology he gave us.” Hard-working, ambitious and smart, 25-year-old Wahid Shah could have excelled in any field, his family said. Right out of college, he decided to pursue his childhood dream of becoming a journalist. He worked as a cameraman and producer for Khurshid, a national television network that broadcasts news and cultural programming. He was rarely on camera himself, instead conducting, taping and editing interviews. Afghanistan’s struggling economy was the focus of much of his work, and he was passionate about telling the stories of the country’s poor. “I wanted him to give a voice to the people of Afghanistan,” said his father, Mir Taher Shah Amiri, 51, remembering how proud he felt when his son began working for a prominent news television network in Kabul. Amiri said even as attacks against other journalists became more frequent, his son never told him that he was afraid. But Wahid’s older brother Zahid said the journalist would sometimes confide in him, mentioning the risks to Afghan media. “But he was fearless, brave. He never said he wanted to quit his work because of the threats,” Zahid said. Their father said he doesn’t regret encouraging his son to pursue his dream of working in journalism, but he does regret not telling him to take a taxi instead of riding in the company bus that ferries employees to and from work. Wahid was killed when a bomb targeted that bus on May 30 as it was taking employees home. The blast also killed one of his colleagues and wounded seven others. The Islamic State asserted responsibility. The group has repeatedly targeted journalists in the past, accusing them of collaborating with its enemies. When asked if he still watches the news reports his son produced, Amiri nodded, then turned his head and covered his face with one hand. “Yes,” he said, wiping his tears with a tissue. “I watch them every day.” Mohammad Ayaz Niazi, 57, was respected across the political spectrum in a bitterly divided country. For 14 years, he preached at Wazir Akbar Khan Mosque in downtown Kabul, just blocks from the Afghan presidential palace and the U.S. Embassy. A vocal supporter of efforts to bring the Afghan


Transcript: New Mexico Governor Michelle Lujan Grisham

clear we're ready for our November elections. MR. SCOTT: You talked about COVID a bit. Can you give us an update on where New Mexico is with COVID-19 right now? GOV. LUJAN GRISHAM: New Mexico is actually in a really great place. But I want to be--I'm always cautiously optimistic, because we don't have a national strategy to combat the virus, you end up--right?--one day is good, one day is a little less good, the next day is stellar. Here are the realities. I have learned that safe, smart, slow, prudent work is the way in which you can introduce some risk so that you're building economic recovery. But I'm really clear that if we're going to do any in-person learning--and given that what's gone on around the country doesn't look good so far--that I have to have the lowest positivity rates possible, the lowest rate of infections possible. And we have a very strict gating criteria. We are meeting that. Frankly, we're crushing that. We went from when we saw the outbreaks in our neighboring states that were horrific, New Mexico went from, you know, about 100-plus seven-day average of cases to well more than 400 daily case count. We're back down now to a hundred or below, and we're seeing our positivity rate fall below two and a half percent. And we've been one of the lead states in the country for testing, so that you can go to an outbreak and deal with that proactively, which is the only way you can take a safe, smart, very limited approach. We're going to do a hybrid, so two days for one small group of kiddos, K-5, and then another two-day pod, small groups, mask-wearing, social distancing, no group settings so that we protect our students, we protect our educators and we protect their families. We think we're going to be able to do that just after Labor Day. New Mexico has to stay the course to achieve that. So far, so good. And I can tell the nation: Face coverings work. Social distancing, all those public health measures work. The more New Mexicans do, the better our outcomes are. And we never, even with some serious containment strategy problems--because the federal government doesn't have the right--they've never met their treaty responsibility, never provided the adequate funding or healthcare to sovereign nations, their testing results were taking five to


The coronavirus pandemic stranded this traveling family circus

When Steffie and Dennis Bossle arrived in the Dutch village of Laren in March, they assumed they would move along, their 30 animals in tow, within weeks. A busy season beckoned for their traveling circus. But almost six months later, the family, with their animals and three young children, is still in Laren — and the coronavirus pandemic has turned what should have been their busiest time of year into a test of patience. For Dennis, who grew up in a circus family traveling through Germany and the Netherlands, it is the longest he has ever spent in one place. “Usually, we’re always on the move,” he said in a phone interview during a consultation with the veterinarian treating his sick camel, Angeli. Like circus artists and other performers around the world, the Bossles have been hit hard by the pandemic, which has forced them to cancel almost all events, even as their operating expenses have remained high. Instead of performing before 500 spectators, Steffie and Dennis are juggling the challenges of an empty arena. They still have to feed their animals — including camels, cows, dogs, goats, horses and llamas — and care for them when they get sick, while raising their children and looking for new sources of income. “The bills keep coming,” Steffie said. Despite the pandemic, the circus has been allowed to organize some performances with social distancing restrictions for birthday parties and residents of nursing homes in the area in recent months. Laren residents have started to treat them like locals, Steffie said. But the circumstances have begun to weigh heavily on the itinerant troupe. “The animals are more agitated than they usually are; they notice that something is missing,” Dennis said. When they hear music, he said, “they jump around, seemingly eager to get back into the circus tent.” For Dennis, whose family has operated circuses for seven generations, closing shop is not an option. Starting Friday, as virus-related restrictions ease, the family will be able to resume performances under strict health and safety rules. With rising case numbers across Europe, however, the next big circus season — Christmas — remains at risk. “Most of the other towns are scared to let a circus into town,” Steffie said. Some day, the family hopes, they will resume life the way they knew it before the pandemic. But Angeli, the camel, won’t be with them. She


Penn State clarifies remark by doctor about myocarditis and covid-19 positive Big Ten athletes

athletes who had tested positive for the virus. Myocarditis is an inflammation of the heart muscle that can lead to arrhythmia, cardiac arrest and death, especially in a person who doesn’t know they have it and performs rigorous exercise. Cardiovascular experts are becoming increasingly aware that covid-19 can affect the heart and urge cardiac screening for athletes who are recovering from the virus. Two high-level athletes — Boston Red Sox pitcher Eduardo Rodriguez and Indiana offensive lineman Brady Feeney — made headlines when they experienced heart issues. Myocarditis causes about 75 deaths per year in athletes from 13 to 25, according to the Myocarditis Foundation. “You could have a very high-level athlete who’s got a very superior VO2 max and cardiac output who gets infected with COVID and can drop his or her VO2 max and cardiac output just by 10 percent, and that could make them go from elite status to average status,” Sebastianelli said Monday. “We don’t know that. We don’t know how long that’s going to last. What we have seen is when people have been studied with cardiac MRI scans — symptomatic and asymptomatic COVID infections — is a level of inflammation in cardiac muscle that just is alarming." There were no further details on the players or schools involved, but the conference’s 14 schools are in Nebraska, Minnesota, Iowa, Wisconsin, Illinois, Michigan, Indiana, Ohio, Pennsylvania, New Jersey and Maryland. Despite the economic consequences that will ensue in each place with no fall football seasons, presidents and chancellors from each school — and not Commissioner Kevin Warren — voted 11-3 not to play. In an open letter last month, Warren wrote that the decision was “based on sound feedback, guidance and advice from medical experts” and mentioned myocarditis as a topic in meetings of presidents, chancellors, athletic directors and health advisory board members. Warren wrote that there is “simply too much we do not know about this virus.” The Big Ten announced its decision to postpone the fall sports season on Aug. 11. Read more from The Post: Iowa State will play football opener in empty stadium, reversing plan to allow 25,000 fans Trump speaks with Big Ten commissioner, pushes conference to play football this fall Va. Tech football sees increase in coronavirus cases as season opener approaches If college football players have complications from coronavirus, expect lawsuits to follow How will the coronavirus change sports?


Democratic senators ask Trump administration for sanctions over election interference from Russia, other countries

Democratic senators asked the Trump administration Thursday to immediately impose sanctions on individuals and agencies acting on behalf of Russia and other countries that seek to interfere with this year’s U.S. election. In making the formal request to Treasury Secretary Steven Mnuchin, 11 senators cited a recent intelligence finding that Russia is using several measures “to denigrate former Vice President [Joe] Biden” and other Democrats in advance of the election. “Congress has mandated a broad range of sanctions tools, and it is long past time for the administration to send a direct message to President [Vladimir] Putin: the U.S. will respond immediately and forcefully to continuing election interference,” said the letter, written by Sen. Ron Wyden (Ore.), a member of the Senate Intelligence Committee, and co-signed by 10 others, including Senate Minority Leader Charles E. Schumer (N.Y.). The letter cited legislation A spokesman for the Treasury Department declined to comment Thursday, saying the department does not generally comment on communications or correspondence with Congress. Last month, the director of the National Counterintelligence and Security Center cited the activities of a pro-Russian Ukrainian parliamentarian, Andriy Derkach and other “Kremlin-linked actors” who have offered information critical of Democratic presidential nominee Biden and his family. While describing Russia’s efforts to undercut Biden, the counterintelligence official, William Evanina, said China would like to see President Trump defeated in his bid for reelection. On Wednesday, Attorney General William P. Barr said on CNN that he viewed China as more of a threat than Russia. “I’ve seen intelligence. That’s what I’ve concluded,” he said, with no elaboration. The request from the Democratic senators comes as the Senate considers a range of divisive election-year issues related to foreign interference. Sen. Ron Johnson (R-Wis.), chairman of the Senate Committee on Homeland Security and Governmental Affairs, has been examining a Ukrainian gas company’s hiring of Biden’s son onto its board and the activities of a lobbying firm it hired in Washington, a topic the president’s allies believe could damage the candidate. Johnson has said he is investigating whether Hunter Biden’s involvement with the gas company, Burisma, posed a conflict of interest to then-Vice President Biden’s work on Ukraine policy. Hunter Biden is no longer on the board of the company, and Biden advisers consistently make the case that the allegations pushed about Hunter Biden have been debunked. Johnson, who is working with Senate Finance Committee Chairman Charles E. Grassley


I treat colon cancer. Chadwick Boseman’s death underscores health care’s tragic racial disparities.

and prosperous Upper East Side, life expectancy is 85 years — the city’s highest. The lowest: 74 years, in the mainly African American Brownsville section of Brooklyn, which also has the highest concentration of public housing. The racial disparities in the United States begin at birth: Black infants are more than twice as likely to die as White infants, a wider gap than is estimated to have existed in 1850 during slavery, although there has been a steep decline in infant mortality for both races since then. If Black America were its own country, its maternal mortality rate would be comparable to that of developing countries such as Belize and Thailand. African Americans also have the highest age-adjusted death rate of any ethnic group in the United States. That translates to a pre-pandemic total of 83,000 excess Black lives lost per year and will surely be higher when the ravages of covid-19 are calculated. But those 83,000 annual excess deaths alone would essentially make being Black one of the leading causes of death in America, comparable to diabetes. The toll of these lives lost — on top of those lost to covid-19, which disproportionately affects African Americans — is staggering. Racism itself needs to be examined as a public health crisis. I wonder if the “Black Panther” writers invented vibranium because the belief in being unbreakable numbs the pain and the reality of being a person of color in America. Bitter pills buried in applesauce. As the deadly pandemic continues to unfold, life feels ever more fragile and fleeting. The world seems as though it has never been more in need of saving. As I come to terms with the mortality of my own superheroes, I also think about how too many lives in this country are being claimed by disease — and by racism. Those lives are more than statistics; and in their own way, they also represent other fallen superheroes. Watch Opinions videos: Read more: Karen Attiah: Why Chadwick Boseman’s fight for African accents in ‘Black Panther’ was so important Michele L. Norris: Chadwick Boseman helped us understand our history. His death shatters our hearts. Christine Emba: ‘Black Panther’ is a black triumph. America is afraid of those. The Post’s View: The data on covid-19’s racial and ethnic gap tells a painfully familiar story David R. Williams: Stress was already killing black Americans. Covid-19 is making it worse.


The election will likely spark violence — and a constitutional crisis

popular-vote loss, as in 2016; and finally, a period of extended uncertainty as we saw in the 2000 election. With the exception of the “big Biden win” scenario, each of our exercises reached the brink of catastrophe, with massive disinformation campaigns, violence in the streets and a constitutional impasse. In two scenarios (“Trump win” and “extended uncertainty”) there was still no agreement on the winner by Inauguration Day, and no consensus on which candidate should be assumed to have the ability to issue binding commands to the military or receive the nuclear codes. In the “narrow Biden win” scenario, Trump refused to leave office and was ultimately escorted out by the Secret Service — but only after pardoning himself and his family and burning incriminating documents. For obvious reasons, we couldn’t ask Trump or Biden — or their campaign aides — to play themselves in these exercises, so we did the next best thing: We recruited participants with similar backgrounds. On the GOP side, our “players” included former Republican National Committee chairman Michael Steele, conservative commentator Bill Kristol and former Kentucky secretary of state Trey Grayson. On the Democratic side, participants included John Podesta, chair of Hillary Clinton’s 2016 presidential campaign and a top White House adviser to Bill Clinton and Barack Obama; Donna Brazile, the campaign chair for Al Gore’s 2000 presidential run; and Jennifer Granholm, former governor of Michigan. Other participants included political strategists, journalists, polling experts, tech and social media experts, and former career officials from the intelligence community, the Justice Department, the military and the Department of Homeland Security. In each scenario, Team Trump — the players assigned to simulate the Trump campaign and its elected and appointed allies — was ruthless and unconstrained right out of the gate, and Team Biden struggled to get out of reaction mode. In one exercise, for instance, Team Trump’s repeated allegations of fraudulent mail-in ballots led National Guard troop to destroy thousands of ballots in Democratic-leaning ZIP codes, to applause on social media from Trump supporters. Over and over, Team Biden urged calm, national unity and a fair vote count, while Team Trump issued barely disguised calls for violence and intimidation against ballot-counting officials and Biden electors. In every exercise, both teams sought to mobilize their supporters to take to the streets. Team Biden repeatedly called for peaceful protests, while Team Trump encouraged provocateurs to incite violence, then used


Can gaming satisfy our pandemic thirst for travel and adventure?

Social distancing and travel are two things, much like Kipling’s East and West, that you would imagine would never meet. Then the novel coronavirus made it clear that the tourism industry needed strategies to survive beyond the pandemic. Thus, we can now wander virtual galleries and museums, take off on digital safaris, and experience remote guided tours. Even university researchers have been taking an interest in the matter — consider this Cornell University project to re-sample photos of renowned landmarks into 4-D glory. But there is another way to be transported to new worlds and challenged in mind and, sometimes, body. We’re talking about gaming. Long before the pandemic encouraged the travel sector to go virtual, free-roaming or open-world games — where players can move about more or less without restraint — were taking us into fantastic, surrealistic times and places. They allowed us to live out impossible fantasies without worrying about life, limb or legal consequence, and they were far ahead of the travel industry when it came to offering digital excursions. “For years, clubs and groups have been meeting in spaces like GTA [Grand Theft Auto] and WoW [World of Warcraft] to go on virtual tours,” says Derek Burrill, an associate professor of media and cultural studies at the University of California at Riverside. “Since gamification is such a buzzword right now across so many industries, gamelike elements are finding their way into virtual tours, and vice versa. . . . This will continue to be true while augmented reality is rolled out with 5G.” Until the travel industry catches up or the pandemic ends, here are some incredible immersive games that will help you slake your thirst for new adventure and experiences. What was it like to live in the Wild West? An institution like the Pioneer Living History Museum in Arizona can tell you all about life in the frontier ages. But to be an outlaw in that period, coming face to face with a bounty hunter, or with feds on your heels, or staying out of the way of a gang with a bone to pick — what would that be like? The critically acclaimed 2018 title “Red Dead Redemption 2” pitches you headlong into a no-holds-barred adventure that plays out in one of the most spectacular open-world settings of our time. The expansive landscapes are breathtaking, never-ending wilderness infused with weather effects, ambient sounds,


Prince George’s joins Montgomery in opting out of Maryland’s move to Phase 3

said they will jump to the next phase. Leaders in Montgomery and Baltimore City decided Wednesday to stay in Phase 2. In Anne Arundel County, Health Officer Nilesh Kalyanaraman said Thursday the county didn’t want to reverse progress in limiting the virus’s spread. “When we have reopened in the past, we have seen cases go up,” he said. “We all want to get to Stage 3 and return to a sense of normalcy, but it just isn’t safe to do that yet.” Alsobrooks on Thursday said Prince George’s looks forward to loosening restrictions when infections decline further, but she did not provide a timeline for such changes. “Whatever openings we make are going to be sustainable and responsible,” she said. Alsobrooks urged residents not to gather in large groups over the Labor Day holiday weekend, adding that the county is still struggling to recover from a surge in cases that emerged after the Fourth of July holiday. As of Thursday, Prince George’s was posting a seven-day average of about 107 new daily infections, down from 170 in late July, but still higher than the low of 70 in late June. Alsobrooks’s announcement comes a day after Montgomery County Executive Marc Elrich (D) said he was disappointed by Hogan’s decision to move the state to Phase 3. He said that Montgomery does not plan to enter the next phase in the near future, but that it could lift certain restrictions on entertainment venues before the Labor Day weekend. The state’s move to Phase 3 will allow movie theaters and entertainment venues to reopen at 50 percent capacity, with a limit of 250 people, while retail establishments and religious services can increase to 75 percent capacity. The governor this week cited improving infection rates, the declining use of intensive care beds and expanded testing availability in saying it was safe to lift more of the restrictions that have been in place since March. Hogan also has empowered local officials to set their pace of reopening. Maryland reported 693 new coronavirus cases Thursday, the state’s highest total in a single day since Aug. 15. The state’s seven-day average of new infections stands at 564, down from 940 average cases on July 31. D.C., Maryland and Virginia reported 1,877 new cases and 24 additional fatalities Thursday. Across the greater Washington region, the seven-day rolling average of new infections reached 1,626 — the highest number


The pandemic is ruining our sleep. Experts say ‘coronasomnia’ could imperil public health.

upset routines. Bank accounts “Patients who used to have insomnia, patients who used to have difficulty falling asleep because of anxiety, are having more problems. Patients who were having nightmares have more nightmares,” said Alon Avidan, a neurologist who directs the UCLA Sleep Disorders Center. “With covid-19, we recognize that there is now an epidemic of sleep problems.” Even before the virus, lack of sleep was a simmering public-health crisis associated with a suite of maladies. Roughly 10 to 15 percent of people worldwide were suffering from chronic insomnia, the struggle to fall or stay asleep at least three nights a week for three months or longer. Crises such as natural disasters or terrorist attacks are known to trigger short-term sleeplessness. But experts say the pandemic’s unprecedented global impact and protracted nature threaten to expand the rate of chronic insomnia, which is much harder to treat. “Insomnia is not a benign problem. … The impact of insomnia on quality of life is enormous,” said Charles M. Morin, director of the Sleep Research Center at Université Laval in Quebec, who has called for large-scale campaigns about the value of shut-eye to stem a coronavirus-era sleep crisis. “We hear a great deal about the importance of exercising and good diet, but sleep is the third pillar of sustainable health.” Morin is leading a 15-country project to measure the pandemic’s impact on sleep, but there is already evidence of broad deterioration. Prescriptions for sleep medications jumped 15 percent between mid-February and mid-March in the United States, according to Express Scripts, a major pharmacy benefit manager. At the UCLA Sleep Disorders Center, the number of patients complaining of insomnia has risen 20 to 30 percent, and more of them are children. Web-based studies in China, France and Italy found insomnia or poor sleep in about 20 percent of respondents, particularly during pandemic-related shutdowns — which, Italian researchers wrote, seemed to cause people to lose track of days, weeks and time itself. While such surveys are not methodologically robust, they provide “an important signal, especially when it’s consistent across countries,” said Orfeu M. Buxton, a sleep researcher at Pennsylvania State University, who said it’s important to view anxiety and sleep troubles as appropriate at a time like this. “We evolved these brain mechanisms to help us react to literally existential threats, and they’re piling on right now, especially for the less advantaged,” Buxton said. “The


Why your groceries just got more expensive

Post Reports is the daily podcast from The Washington Post. Unparalleled reporting. Expert insight. Clear analysis. Everything you’ve come to expect from the newsroom of The Post. For your ears. Martine Powers is your host, asking the questions you didn’t know you wanted answered. Listen online. On today’s Post Reports, how presidential candidates are shifting their focus to the Midwest. How the pandemic is making us pay more for less at the grocery store. And how grocery store workers morale is at an all-time low. Read more: Democratic presidential nominee Joe Biden is shifting his strategy in an attempt to win the Midwest. Matt Viser reports that the intentional contrast with President Trump makes the region the most crucial battleground in the 2020 campaign. What’s on your grocery store shelves? Turns out, it’s a lot less, for a lot more. Laura Reiley reports on how the pandemic is affecting the food supply chain. “They don’t even treat us like humans anymore”: Abha Bhatarrai explains how grocery store worker’s morale is at an all-time low. Subscribe to The Washington Post: https://postreports.com/offer


Seven in 10 new coronavirus cases are emerging in red states

It’s hard to overstate the extent to which the coronavirus pandemic has been saturated with partisan politics. Simple recommendations like wearing a face mask have been recast as acts of devout patriotism or as mandates for fealty to an insidious federal government. It’s a direct and indirect function of the president: Everything President Trump touches becomes partisan, both intentionally and not, and Trump’s got his hands all over the pandemic. We are therefore no longer surprised when we see data like this, from a new poll conducted by CNN: Eighty-seven percent of those who plan to vote for former vice president Joe Biden are very or somewhat concerned about the pandemic. Seventy-one percent of Trump voters aren’t. To some extent, this is also a function of how views of the pandemic first emerged. The first hot spots were in California, Washington and New York. In New York City in April, thousands of people were dying a day. The pandemic was centered in cities in blue states, and red state residents, particularly in rural areas, seemed less concerned about the virus. That changed in early June. By then — shortly before Vice President Pence infamously boasted about the administration’s success in combating the virus — more new cases were emerging in states that supported Trump in 2016 than in those which voted for Hillary Clinton. When the pandemic was at its high, about three-quarters of new cases were in red states. Now, about 7 in 10 new cases are in red states. It’s still the case, though, that many of those new cases are in blue counties. While more new cases are emerging in states that voted for Trump, those outbreaks were often in places that voted for Clinton. But here, too, there’s been a shift. For the first time, about half of new cases are also in counties that voted for Trump. We’re using seven-day averages of new cases here because daily case reporting can be spotty. Using this metric, there was an average of 20,345 new cases on Wednesday in counties Clinton won and 20,117 in counties Trump won. If we instead used newly reported cases on Wednesday itself, there were 1,600 more new cases in red counties. We can look at the shift at the county level in another way. Until May, most of the new cases in red states were in counties that voted for Clinton. Since


People desperate for more space fuel a pandemic real estate boom

Before the pandemic, Anna and Josh Knight and their two small children enjoyed a social rowhouse life in Northwest Washington. From their elevated front porch in Mount Pleasant, they could chat with friends to the left or right. Out the front door, they could walk their kids three minutes to the Rosemount Center, an English- and Spanish-speaking day care. From there, it was another short stroll to Past Tense for yoga or Pear Plum Cafe to drink coffee with members of a Facebook group for area parents. The virus upended that life. The day care closed. Then Josh’s office in Northern Virginia shut its offices. He was sent home, where Anna had always worked remotely for a professional services firm. Jammed together day in day out, the couple found themselves scrounging for office space or hiding from the kids on Zoom calls. So, like multitudes of city residents stricken with coronavirus cabin fever, the Knights decided they needed more space — a desire fueling a pandemic real estate boom. According to statistics from TTR Sotheby’s International Realty, the real estate market in the city and the surrounding region is red hot. In July, $5.3 billion worth of homes sold in the District; Alexandria, Arlington, Prince William, Loudoun and Fauquier counties in Virginia; and Montgomery, Prince George’s, Anne Arundel counties plus the Eastern Shore in Maryland. Last July, the figure for those same places was $4.2 billion. With mortgage rates dipping below 3 percent, “People are coming out of the woodwork,” said Courtney Abrams, a vice president with TTR Sotheby’s based at the agency’s 14th Street NW location. Bidding wars are common and intense. “People are feeling overwhelmed and cramped in the pandemic,” she said, “and it’s pushing people to buy now because we don’t know what the fall is going to look like if the virus spreads and people get locked in their houses.” The Knights are part of that wave, exchanging their 2,400-square-foot rowhouse with a speck of a backyard for a 3,000-square-foot unattached Colonial with a bigger yard in the District’s Chevy Chase neighborhood, near the Maryland border. “If it weren’t for the pandemic, we would have stayed in Mount Pleasant for a few more years. We honestly were just too busy to move. . . . Plus, we had this incredible friend group. Everyone was international and had really interesting jobs,” said Anna, 40, who helps run


Strong regulations can help stave off disasters

The Aug. 31 front-page article “Days before Beirut blast, a rush to secure chemicals” concluded with the quote, “As crazy as it may seem, as outrageous as it may seem, the most obvious explanation is an accident.” This disaster, which killed nearly 200 people, is of course worthy of analysis to learn its causes. To conclude, however, that it was somehow an “accident,” which implies a certain randomness or inevitability, is dead wrong. The investigation by the U.S. Chemical Safety and Hazard Investigation Board, an independent federal agency, after a 2013 fire and explosion in West, Tex., which killed 15 people, found that improper use and storage of ammonium nitrate can lead to catastrophe. The report, which also described earlier incidents in the United States, found that without stronger regulations, such disasters could happen again. President Trump, unfortunately, boasts of his deregulatory efforts that will harm public safety. He has tried, so far unsuccessfully, to abolish the Chemical Safety and Hazard Investigation Board, the agency focused on finding the causes of preventable industrial incidents. If he believed in law and order, he would not roll back public safeguards. Rick Engler The writer is a former member of the U.S. Chemical Safety and Hazard Investigation Board. Read more letters to the editor.


Readers critique The Post: This comic showed arrogant disdain for certain professions

said Hurricane Laura was deadly, devastating and destructive. That sounds a lot worse than decimated. I suppose the fight to preserve the original meaning of “decimate” (reduce by one-tenth) is well and truly lost when it is used this way in a headline. Now, can we talk about “comprised of”? Paul Brown, Silver Spring ● The photograph of Rabbi Adin Steinsaltz with his Aug. 25 obituary, “Rabbi used his encyclopedic knowledge to make Talmud more accessible,” was wonderful. True art. Richard Borst ● As a former National Park Service ranger-naturalist, I am very familiar with mosquitoes. I was startled that a single, biased source was used for the Aug. 16 Metro article “After heavy rains and flooding, mosquitoes are swarming — and biting.” The Mosquito Joe company depends on scaring people into thinking that they cannot control mosquitoes without extensive chemical treatment. The article did not mention the threat to non-target species when mosquito-control companies spread insecticides. For example, bees in a neighbor’s hive were killed when a mosquito-control company sprayed an adjacent yard. The Master Gardeners of Northern Virginia discusses harm from companies that broadcast pesticides. I am not a member of that organization, but I try to reduce pesticide collateral harm to all wildlife, including birds and pollinators. Based on a Consumer Reports tip that a fan will significantly reduce bites because mosquitoes are weak fliers that shy from strong breezes, we use a fan on our deck. The Post would benefit all our local wildlife if it included information in a future column about reducing mosquito bites in less toxic ways. Sarah Mayhew ● I can put up with people saying they brought “momentos” back from vacation. I can deal with references to nonconformist people “flaunting” convention. I was even able to tolerate the (seemingly endless) references by the Rue McClanahan character on “The Golden Girls” to her “perky bosoms.” (She, of course, meant “breasts”; a woman has only one bosom.) But some misuses of language involve genuine ethical issues that demand to be called out. In his Aug. 28 op-ed, “Having a death penalty means fully funding a robust defense,” Mark W. Bennett referred to the recently executed murderer Dustin Honken as having “executed” his multiple victims. Honken murdered these people. No one can be “executed” unless they are put to death under color of a decree issued by a court of at least arguable legitimacy


One college’s students are on covid-19 dorm lockdown. They can only leave for food and bathrooms.

parties. “I’ve seen [police] pass by parties and big groups of people and not do anything,” student Jersia Pimente told the Gettysburgian, the student newspaper. Colleges around the country have seen major outbreaks of covid-19 as students have returned to campus, and many schools have struggled to enforce mask guidelines and crack down on large parties. Thousands of students have been infected at schools like the University of Alabama and the University of Missouri, while other large schools, like the University of North Carolina at Chapel Hill and the University of Notre Dame, quickly switched to online-only courses. The outbreak has been comparatively small at Gettysburg, a liberal arts college near the Civil War battlefield. About two dozen students tested positive early this week, the school said, bringing the rate of positives among the most recent tests up to 7 percent. But Julie Ramsey, the college’s dean of students, suggested in a letter on Tuesday that the campus was at an “inflection point” and that drastic action was needed this week to tamp down on the spread of the novel coronavirus. Ramsey didn’t specify where the outbreak had started, though she noted in the letter that it was linked to “certain affinity groups or social gatherings” on campus. For many students, though, the culprit was clear: the rise in cases coincided with rush week for the college’s fraternities and sororities, students told WHTM. After a town hall meeting with administrators, a few students held up cardboard signs outside the administrators’ hall demanding that Greek organizations be held more accountable. “We were disappointed with the town hall and wish that the administration would stop beating around the bush,” student Oskar Wilander told the Gettysburgian. The school informed students of the lockdown on Tuesday night, warning in a memo that anyone who breaks the rules will be kicked off campus. Besides food and bathroom breaks, the only reasons students can leave their rooms are for covid-19 tests or to see a counselor. Anyone who chooses to leave campus rather than shelter in the dorms would have to ask the school’s permission to eventually come back. While some students told WHTM they were optimistic that the tight rules would mean a quick return to in-person classes, others weren’t so sure. “We might as well just pack it up and go home because I don’t really see cases decreasing here,” student Carter Zamora told


Facing both covid-19 and racism, Black women are carrying a particularly heavy burden

as many hours per week caring for elderly or sick relatives as do White women. In June, a Washington Post-Ipsos poll found that 31 percent of Black adults personally knew someone who had died of covid-19, compared to 9 percent of Whites. An online survey of more than 1,000 Black women by Essence magazine had similar findings, and also noted that 63 percent of respondents felt their mental health was being affected by the pandemic. As Black female psychiatrists, we recognize the feeling of being overwhelmed. There aren’t many of us: Roughly 2 percent of practicing physicians in the United States identify as Black women. Of those, only a small number choose psychiatry as their specialty. Like our male counterparts, many of us choose to practice in Black communities because we know firsthand how the mental health profession overlooks Black people. We think often of the fact that only one in three African Americans who need mental health care receive it. We know that compared with the general population, African Americans who seek mental health care are less likely to be offered either evidence-based medications or talk therapy. Even if we all saw patients 24/7, we Black female psychiatrists could never meet the mental health needs of Black women. On the rare occasion that we meet, we speak freely about the anguish we feel. We tell each other how we cried when our own therapists asked how we were holding up. We let our shoulders slump from the weight of it. We admit that we have no answers, and at times feel hopeless. And then we get up again, and we do our jobs. Without doubt, all Americans are at an elevated risk of mental health problems because of the stress of the pandemic. However, the tremendous social, psychological and economic load placed on Black women in particular warrants dedicated attention. As psychiatrists, and as Black women, we believe it is imperative that our mental health is a national priority. Black women uphold households and serve the country as essential workers. We are strong. We are resilient. We persevere. But what we really need to maintain mental health is societal change, at all levels. Read more: Kelly Glass: The pandemic’s mental health impact is dangerous for new moms. Especially black moms. Nathaniel P. Morris: If health-care providers can’t overcome the stigma of mental illness, who will? Esther Choo: Covid-19 is


Republicans never flinch in their support of Trump — even when he insults our troops

honor their sacrifice — always.” It was an effective way to show the we need not continue to suffer with a small, petty and untrustworthy president. I do not much care what trait — envy, materialism, cowardice — explains Trump’s apparent disdain for military heroes who, unlike Trump (who got out of serving in Vietnam with five deferments), sacrificed their bodies and in many cases their lives for their country. What we know is that Trump’s character is deeply deformed, and his narcissism knows no bounds. This report is anything but shocking. However, we are reminded about something equally, if not more, disturbing than the outbursts of an unfit president. Why did the senior officials — who still refuse to go on record — not quit and tell their stories? Why did they not come forward with their accounts even during impeachment, when the president’s lack of loyalty to the country and betrayal of national security were at issue? We can only guess that the explanation is some mixture of cowardly careerism or, maybe, self-delusion that without them the country would be (more) endangered. Instead, they stayed, enabled him, defended him and kept critical information from their fellow Americans. The silence of these senior aides is really no different from the silence of virtually all elected Republicans. They, along with intellectually corrupt right-wing pundits and media outlets, have denied, deflected, ignored or excused almost everything that has come out of Trump’s mouth. The so-called Republican hawks — Sen. Ted Cruz (R-Tex.), Sen. Tom Cotton (R-Ark.) and Senate Majority Leader Mitch McConnell (R-Ky.) — have stuck with him through thick and thin. They did not condemn him when he first slandered POWs, nor excoriate him for refusing to address the poisoning of yet another political opponent of Russian President Vladimir Putin. They have not denounced his unwillingness to raise with Putin the Russian bounties on our troops. They did not disown him for commuting the sentences of war criminals; they did not rebuke him for slandering troops by accusing them of stealing money in Iraq and Afghanistan. It seems there is no insult, lie or exaggeration about our troops too great to prompt these Republicans to declare Trump unfit to serve as commander in chief. One legacy of the Trump era is to discredit virtually all elected Republicans and the sycophantic right-wing media figures whose silence (or even worse, their cheerleading)


The evolution of a damaging tornado that struck Edgewater, Md., near Annapolis, Thursday evening

It contained a supercell with a core of rotation known as a mesocyclone, but a type embedded in heavy rain, termed an HP or “high precipitation” supercell. Two key radar snapshots in this storm’s evolution are shown below. The radar features used to identify this supercell, shown above, were subtle. In the set of rain intensity images, shown along the top, there is no hook echo, or spiraling inward of heavy rainfall, which can be indicative of a tornado. Rather, an indentation or “cleft” was adjacent to a prominent, and persistent, bowing section of the squall line. The radar panels showing the storm’s wind velocities, on the bottom of the above figure, reveal a fairly diffuse and spread-out mesocyclone initially. There is a small pocket of strong outbound flow (pink colors) over College Park, and a small region of inbound flow (green) just south of Calverton. The genesis of this circulation could be traced farther west, to near Potomac, Md., where a tornado warning was issued, but no twister confirmed. The inbound portion of the mesocyclone corresponds to the inflow notch seen in the rain reflectivity (top panels), the outbound portion to the bulging part of the storm line, farther south. The radar imagery at the later time (6 p.m.) takes on greater significance (right panels). Here, the mesocyclone was over the Annapolis-Londontowne region, and it is quite large and prominent. Velocities on both sides of the circulation (inbound and outbound) have intensified (lower right panel). This is also the time that tornado touchdown was noted. The mesocyclone remains wrapped in heavy rain (top right panel), making visual spotting of a tornado very difficult, if not impossible. In addition to the supercell, which tracked from near Potomac to Annapolis, another took a more northern route from Frederick, Md., following the Interstate 70 corridor, into Baltimore and beyond. For this additional supercell, radar implied a counterclockwise rotation indicative of a fairly broad mesocyclone. In the image below, the left radar panel displays a hook echo, while the right panel shows outbound winds by the red patch of color and inbound winds by the green. To the best of our information, this supercell did not produce a tornado, but there is photographic evidence, at times, of storm rotation. The longevity of both the southern and northern supercell storms is typical in high shear situations, as we experienced Thursday, and illustrates an interesting


Experts warn U.S. covid-19 deaths could more than double by year’s end

The specific timing of the second wave matters less, he said, than the fact that it is likely to happen — and that many deaths could be avoided if precautions are taken now. The IHME projects that with rigid adherence to social distancing and mask-wearing, 770,000 lives could be saved globally by year’s end. One of the most useful tools for public health officials following different projections has been “ensemble models” — an aggregation of several of the country’s leading models to make a more reliable forecast. One of the most heavily used ensemble models — assembled by Nicholas Reich, a biostatistician at the University of Massachusetts — shows deaths declining slightly but maintaining a fairly high rate of more than 5,000 a week for the next four weeks, with a likely total of 205,093 before the end of September. But the recent declines in cases and deaths appear to be prompting a relaxation in behavior that could quickly drive those numbers back up. One model that takes into account the extent of social distancing, using cellphone data, forecasts the daily number of deaths increasing over the course of this month from roughly 1,000 deaths a day to almost 2,000 by end of September. “We’ve been seeing mobility increase the last few weeks,” said Lauren Ancel Meyers of the University of Texas at Austin, who developed the model that factors in mobility. In Texas, for example, mobility data shows more people staying home in June when hospitalizations were going up at alarming rates. But since August, that mobility has accelerated. “One of the challenges is as soon as things look good in the community, it’s tempting to say the virus is gone,” Meyers said. “What we really should be thinking is: How did we get to this better place? By being cautious and vigilant. And instead of relaxing, we should focus on the things that worked.” About 910,000 people globally are known to have died of the virus, according to IHME — a tally higher than the 865,000 used by the World Health Organization. But most experts agree the true death toll is probably higher, with many people dying at home or without having been tested for the virus. The “most likely” scenario produced by IHME is for 2.8 million global deaths by the end of December. The best-case scenario would about 2 million and the worst-case about 4 million.


The Maryland legislature must call a special session

just four that must be addressed in a special session: the housing crisis, labor issues related to the pandemic, the HBCU lawsuit and police reform. If we don’t act, we will see scores of Maryland renters and homeowners drown in increasingly deep debt, and some will face eviction. The Trump administration’s “national eviction moratorium” announced on Tuesday has loopholes as gaping as the Grand Canyon. It doesn’t provide financial relief. And, even for those it purports to protect, it does nothing to address the financial issues accumulating for renters that will hit them like a brick when the moratorium expires and back rent, fees, penalties and interest payments come due. If we don’t act, we will continue to see courageous Maryland workers — front-line workers — exploited by a lack of employee protections, by unsafe conditions, by a lack of personal protective equipment, by a lack of hazard pay and by the threat of retaliation from managers who don’t heed their concerns. We should be passing statewide emergency legislation to address these issues, including through reforms to the Maryland Healthy Families Act and reforms to the Maryland Occupational Safety and Health Division. If we don’t act, we will see Historically Black Colleges and Universities languish for several months before they get a long-overdue settlement of Maryland’s infamous HBCU case. We should be overriding the governor’s veto of the HBCU funding bill. And, if we don’t act, we could see yet another Black victim of police brutality become a hashtag in Maryland under the state’s existing legislative framework, which provides special protections to officers who may use excessive force or engage in other forms of misconduct. We should be repealing the Maryland Law Enforcement Officers Bill of Rights immediately. That alone won’t solve all the problems in Maryland policing, but it would undoubtedly address one of the biggest. When I first called for a special session, General Assembly leaders argued against a special session, citing safety concerns. But now all we hear is crickets, even though the attorney general’s office recently provided a legal road map for us to reconvene remotely. The U.S. House is doing remote voting. Why can’t we? Even if we had to temporarily reconvene in person to change some rules before switching to remote voting, that is not a reason for us not to reconvene now. More than 40 percent of Maryland state workers are working in


One man’s battle shows why covid-19 and obesity are a toxic mix

a separate precursor to poor outcomes. When researchers at Kaiser Permanente of Southern California looked at nearly 7,000 people with covid-19, they found an association between a BMI over 40 and higher death rates, particularly among men and people younger than 60, when they controlled for other weight-related conditions. The latter finding is surprising, because deaths from covid-19 are overwhelmingly concentrated among older people. Sara Tartof, a Kaiser Permanente research scientist who led the analysis, speculated that large amounts of visceral fat — the fat stored in the abdomen around body organs — may play a role in producing severe covid-19. Fat is not inert; it secretes chemicals that can influence bodily systems. It may affect the angiotensin system that helps regulate blood pressure and blood flow, leading to more severe symptoms, Tartof said. “We almost think this is akin to throwing a match on a tinderbox,” she said. Jennifer Lighter, an NYU Langone hospital epidemiologist, has been studying a link between covid-19 and fat cells. Lighter said people with obesity seem to have more ACE2 receptors, the gateway the virus uses to invade cells. “So there are more opportunities to attack,” she said. Lighter, who published a study showing that people under age 60 are two to three times more likely to be admitted to the hospital for covid-19 if they are obese, also said it is possible a mechanism of the disease is hormonally regulated. That could explain why men are doing worse, she said, and why prepubescent children are faring well in the pandemic. “Obese people have more androgens and male hormones. Maybe that’s impacting the virus affecting the cells,” she hypothesized. Another study published in the International Journal of Obesity by Candida Rebello, a pharmacology researcher at Louisiana State University, found that the hormone leptin, which regulates metabolism and appetite and is found in greater amounts in obese people, may make them more vulnerable to covid-19. High levels of leptin have been associated with a type of systemic inflammatory state. “We propose that leptin may be the link between obesity and its high prevalence as a comorbidity of the SARS-CoV-2 infection,” she wrote. In addition to metabolic issues, “obesity in itself is a complex issue, because it usually leads to so many comorbidities” and can affect lung mechanics, said Maria Plataki, an assistant professor at Weill Cornell Medicine who studies the impact of obesity on lung


that people under age 60 are two to three times more likely to be admitted to the hospital for covid-19 if they are obese, also said it is possible a mechanism of the disease is hormonally regulated. That could explain why men are doing worse, she said, and why prepubescent children are faring well in the pandemic. “Obese people have more androgens and male hormones. Maybe that’s impacting the virus affecting the cells,” she hypothesized. Another study published in the International Journal of Obesity by Candida Rebello, a pharmacology researcher at Louisiana State University, found that the hormone leptin, which regulates metabolism and appetite and is found in greater amounts in obese people, may make them more vulnerable to covid-19. High levels of leptin have been associated with a type of systemic inflammatory state. “We propose that leptin may be the link between obesity and its high prevalence as a comorbidity of the SARS-CoV-2 infection,” she wrote. In addition to metabolic issues, “obesity in itself is a complex issue, because it usually leads to so many comorbidities” and can affect lung mechanics, said Maria Plataki, an assistant professor at Weill Cornell Medicine who studies the impact of obesity on lung cells. A recent study of 1,687 hospitalized adults by a team that included Plataki found that obese patients were more likely to have respiratory failure but not any more likely to die. Place, the Florida patient, had a BMI of 37 when the disease sent him to Westside Regional Medical Center in Plantation two months ago. His temperature had reached 103.9 degrees and pneumonia clogged both his lungs. When doctors discovered Place’s uncontrolled diabetes, they put him on an insulin drip. As the oxygen level in his blood plummeted, he was sent to the ICU, where he was sedated and intubated. At times, there was not enough staff for the delicate task of turning him onto his stomach — a procedure called “proning” that helps open airways — or returning him to his back, Zymet said. Five people were needed to accomplish the task because of Place’s weight and the medical devices he was attached to. Heavier people also are more likely to develop bed sores. “We prone obese people all the time,” said Russell Buhr, a pulmonary and critical care physician at Ronald Reagan UCLA Medical Center in Los Angeles. “Instead of needing four people to do it, you