The storm inside

business trip the first week of March, and it was hard for them to connect the way they usually did. It wasn’t until Keith picked her up from the airport that Friday that she realized something was wrong. “This isn’t like you,” she told her husband. Keith waved her off, thinking his illness — loss of appetite, diarrhea, fatigue — was simply food poisoning. He insisted on getting dinner with his daughter and grandchildren, who were visiting from New York that weekend. He still went to work Monday morning. That he might have the strange new virus sickening people in places like China and Italy never occurred to the Reddings. Keith hadn’t traveled overseas. He hadn’t been on a cruise ship. Though there were five confirmed cases in Maryland, state health officials were still telling people not to worry about community transmission. Yet deep inside Keith’s cells, the virus was multiplying. Researchers say the diarrhea that plagued Keith and other covid-19 patients may be an indicator that the germ invaded his gastrointestinal tract. Scientists have found coronaviruses can interfere with a person’s blood pressure, damage the liver and irritate the digestive system. Over the course of that week, Keith began to cough and couldn’t stop. His temperature spiked, and his body was wracked with chills. Dana, too, was exhausted and aching. She went to a Veterans Affairs clinic, where she was given a mask and advice to quarantine for 14 days. Alarmed, Dana grabbed her phone and dialed Keith’s number: “You need to call your doctor,” she said. “I’m not asking you. I’m telling you.” On March 11, they drove together to the emergency room. Within hours of arriving at Fort Washington Medical Center, Keith was ushered into a CT scan machine, which X-rayed his lungs from multiple angles. Mortman would later assemble these images into a three-dimensional model of Keith’s airway. The doctor was stunned. Bacterial pneumonia is typically confined to one lobe of the lungs, and many cancers tend to look like solid masses. But in Keith’s CT scan, the virus was everywhere — a haze of ravaged tissue engulfing every branch of his lungs. Mortman said Keith had what doctors call “ground glass opacity,” a condition named for the way it shows up on scans as a semitransparent scattering of damage. The thousands of tiny air sacs with which the lungs take in oxygen and release carbon


D.C. closes nightclubs and restricts bars, restaurants; New cases in Md., Va.; NIH employee tests positive for coronavirus

The District, Maryland and Virginia entered an increasingly anxious shutdown mode because of the novel coronavirus pandemic, with public schools set to close in many districts and large gatherings canceled in Maryland, major tourist sites shuttered throughout the region, and the District and Virginia declaring states of emergency. Here are some of the significant and most recent developments: Coronavirus in the DMV: What you need to know


Anne Arundel County and Howard County home sales

Cindy Dr., Dolphin Ct., Ferndale Rd., Foxtail Ct., Geis Cir., Hopkins St., Lochaber Ct., McNamara Dr., Sunlight Cir., First Ave. S., GLEN BURNIE-MARLEY CREEK AREA Cedar Dr., Colby Cir., Edgerly Rd., Gatewater Ct., Hidden Oak Lane, Lombardee Cir., Mill Fall Ct., Pond View Dr., Pond View Dr., Thomas Rd., Water Fountain Way, HANOVER AREA Burnell Dr., Macedonia Dr., Siden Dr., Willow Oak Ct., HARWOOD AREA Conservation Lane, LAUREL AREA Brooktree St., Federalsburg S., Londonleaf Lane, Marganza S., Piney Woods Pl., Winding River Pl., MILLERSVILLE AREA Kenora Dr., Old Orchard Cir., Rustling Oaks Dr., ODENTON AREA Artillery Lane, Criterion Dr., Grand Ct., Kingbird Ct., Middle Neck Rd., Piscataway Run Dr., Scaffold Way, Trout Run Ct., Wandering Fox Trail, Winding Stream Way, OWINGS AREA Bella Vista Dr., PASADENA-ROCK CREEK AREA Cedrela Dr., Dark Sky Crossing, Forest Glen Dr., Garden Rd., Harlem Rd., Kenwood Rd., Long Hill Rd., Maywood Ave., New London Harbour, Oak Dr., Pine Dr., Riverside Dr., Saybrook Harbour, Wanda Rd., 221st St., RIVA AREA Escapade Cir., Shore Walk Rd., SEVERN AREA Averill Ct., Briarwood Pl., Eagle Ct., Hollow Ct., Merrimusic Cir., Roundhouse Ct., Sicily Lane, SEVERNA PARK AREA Beach Rd., Cottonwood Dr., Evergreen Rd., Idleoak Ct., Oak Ct., Robinson Landing Rd., Stinchcomb Rd., Wiltshire Lane, SHADY SIDE AREA Hine Dr., TRACYS LANDING AREA Franklin Gibson Rd., These sales data recorded by the Maryland Department of Assessments and Taxation in November were provided by Black Knight Inc. For information about other residential real estate transactions, visit washingtonpost.com/homesales. CENTENNIAL-BENSON AREA Cabery Rd., Chatham Rd., Fawn Run Ct., Joey Dr., Larkspring Row, Melba Rd., Poland Springs Dr., Starwreath Way, View Top Rd., Yearling Ct., CLARKSVILLE AREA Haviland Mill Rd., COLUMBIA (EAST) AREA Black Cherry Cir., Enberend Terr., Hayshed Lane, Lasting Light Way, Melting Shadows Lane, Owen Brown Rd., Sharp Antler, Spiral Cut, Thunder Hill Rd., Warm Granite Dr., Wild Swan Way, COLUMBIA (WEST) AREA Blue February Way, Cross Fox Lane, Grand Banks Rd., Ivy Bush Lane, Stonegate Lane, Watch Chain Way, DAYTON AREA Green Bridge Rd., ELKRIDGE AREA Daniel John Dr., Grouse Cir., Maplecrest Rd., Valley Oak Dr., ELLICOTT CITY AREA Brightwind Ct., Church Lane Rd., Duncan Dr., Halcyon Ct., Manahan Dr., Rogers Ave., Stonehouse Dr., FULTON AREA Queen St., GLENWOOD AREA Players Way, HANOVER AREA Florey Rd., HIGHLAND AREA Briaridge Ct., JESSUP AREA Savage Guilford Rd., KINGS CONTRIVANCE VILLAGE AREA Early April Way, Pine Dr., Stonebrook Lane, Weather Worn Way, SAVAGE AREA


The Health 202: Coronavirus testing is stalling. That’s not a good sign for re-opening the U.S. economy.

threat to Americans and the U.S. economy,” our Post colleague Anne Gearan reports. “It is not yet clear how the United States will cut off money to the main international organization focused on fighting the pandemic, or whether Trump is setting conditions for a resumption of U.S. payments.” Trump said U.S. funding to WHO would be suspended for a period of 60 to 90 days. Anne adds: “Conservative allies of the president have begun focusing on the WHO as complicit in a Chinese coverup of the outbreak in late 2019 and early 2020, before Trump moved to respond. The finger-pointing allows Trump to deflect blame from his own initial reaction to the outbreak as of no consequence to the United States. Trump also resents the WHO for opposing his decision, in late January, to block most air travel from China.” Trump said the funding halt will continue “while a review is conducted to assess the World Health Organization’s role and severely mismanaging and covering up the spread of the coronavirus.” He added: “The outbreak could have been contained at its source with very little death, very little death, and certainly very little death by comparison. This would have saved thousands of lives and avoided worldwide economic damage.” Trump and Vice President Pence held a White House roundtable with patients from California, Michigan and Arkansas who had recovered after battling through covid-19. They talked about their experiences in quarantine and some patients said it was the worst they’ve ever felt. Trump repeatedly questioned them about hydroxychloroquine, the treatment he has frequently touted. “What have you got to lose?” Trump asked at the meeting. From the New York Times’s Annie Karni: Michigan state Rep. Karen Whitsett (D) praised Trump, crediting the treatment with her recovery from the disease. Trump asked each person at the meeting about their symptoms. He asked if they thought they would die. He asked them to describe how it felt to be short of breath. When he asked one participant, Rachel Mangan of Arkansas, if she felt 100 percent better now, Mangan replied: “85 percent.” Trump joked: “Stay away. … Keep her away.” The Democratic state lawmaker contradicted the administration’s assurances about treatment at hospitals. Trump and Pence dismissed the idea this week that people are being turned away at hospitals. Whitsett said she’s “lost several family members to covid — all in one household … My cousin,


Trump’s critique of WHO may be a diversion, but it resonates beyond the White House

resumed reporting cases — a gap that raised eyebrows among scientists and researchers. If the WHO was concerned about the figures, it did not say so. “WHO just routinely repeated as if it were its own information, as if it were verifying it,” said Gostin, the Georgetown law professor. “WHO is reliant on member states for data, but it could have noted gaps in the data or simply noted that they were not able to independently verify it,” he continued. “By uncritically citing Chinese data, WHO officials lent credibility to information that was false.” In the meantime, the virus kept spreading, unchecked. It was not until Jan. 20 that Chinese officials acknowledged that the virus was spreading person to person. By that time, Wuhan was in crisis, and confirmed cases were in multiple Chinese cities, Japan, Korea, Thailand and — later that day — the United States. In Geneva, an emergency panel convened to decide whether to declare a public health emergency of international concern, or PHEIC, a post-SARS term that signals a health crisis “that poses a public health risk to other countries through international spread.” On Jan. 23, while the panelists were gathered, Chinese officials began locking down Wuhan. Officials in Geneva wrestled with whether to declare a PHEIC, weighing Chinese pushback about economic damage and assurances that everything was fine. The committee was split but decided that it was not an emergency, surprising public health experts. The panel waited until Jan. 30 — a full month after Chinese doctors issued a warning — to make the declaration. “The Chinese government is to be congratulated for the extraordinary measures it has taken,” said Tedros, the WHO chief. “I left in absolutely no doubt about China’s commitment to transparency.” In February and March, as evidence of a coverup intensified, the WHO continued to praised Beijing, baffling some experts. By late January, for instance, Chinese officials acknowledged that they should have acted sooner. But the WHO and Tedros assured the world that they were doing great. After meeting privately with Xi on Jan. 28 in Beijing, Tedros lauded the country’s handling of the outbreak, according to the state-run Xinhua News Agency, and the effectiveness of “China’s system.” Some say that the flattery was strategic to allow an international team of doctors, scientists and observers to enter the country. But when a WHO team finally made it to China in mid-February,


Maryland’s biggest coronavirus outbreak is at Baltimore nursing home

O’Shea did not respond to questions about how many residents have been hospitalized, or whether there have been any deaths from covid-19, the disease caused by the coronavirus. The nursing home opened in 2005 and is one of 15 facilities run by FutureCare in Maryland, most of which are in Baltimore. It is in the 21215 Zip code, which leads the state in cases, reporting 223 as of Wednesday. O’Shea said the facility decided to implement widespread testing, including of asymptomatic residents and staff, because of its location and how many elderly people with underlying conditions it cares for. She said FutureCare is the first company to implement such widespread testing before an outbreak was known. A state “strike team” arrived at the facility Wednesday morning to assist staff members, said Mike Ricci, spokesman for Gov. Larry Hogan (R). The team includes members of the Maryland National Guard, staff from local and state health departments and doctors and nurses from area hospitals. Hogan issued an emergency order last week requiring nursing home staff to wear protective gear and segregate infected patients to halt the spread of the disease. He also said nursing homes should send tests to the state lab. But Joseph DeMattos, president of Health Facilities Association of Maryland, which represents health-care providers at assisted-living facilities and nursing homes, said he has heard from providers across the state that there remains a shortage of tests available for nursing home residents and staff. He said that in the absence of more tests, nursing homes that are able to do so should provide for private testing. Baltimore Mayor Bernard C. “Jack” Young said Wednesday that the city health department is working closing with staff at the facility, as well as the state health department and the facility’s partners at LifeBridge Health and Johns Hopkins Health. He said the Baltimore City Health Department distributed personal protective equipment (PPE) from the Strategic National Stockpile and the Maryland Health Department’s PPE cache to the facility. There have been positive cases reported in at least 125 of the nursing homes and assisted-living facilities in Maryland. The state’s biggest outbreak before FutureCare’s announcement was at Pleasant View Nursing Home in Mount Airy, where 24 residents have died and 120 residents and staff tested positive. Carroll County health officials have said they are not sure what caused the rapid spread of the virus at Pleasant View. rachel.chason@washpost.com


Climate change affects everything — even the coronavirus

Is the coronavirus pandemic connected to climate change? — Tom, France The short — and incomplete — answer to this question is: not really. Although climate change is expected to worsen many kinds of disease, especially tropical illnesses carried by insects, coronaviruses like the current one are not on the list. Scientific evidence suggests that SARS-CoV-2, the germ that causes covid-19, is closely related to a virus found in bats. Humans may have contracted it through an intermediate host, a scaly anteater called a pangolin that is traded at illegal wildlife markets. The virus doesn’t appear to care what the average global temperature is; indeed, a National Academies of Sciences panel last week cautioned that changes in heat and humidity may not affect how covid-19 spreads. The more accurate answer is: of course. Climate change is frequently described as a threat multiplier, something that exacerbates existing problems and creates new ones. No aspect of life on this planet has been untouched by climate change — viruses included. The world is rife with viruses; at least 320,000 kinds are known to infect mammals alone. And these pathogens rarely stick within one species. Most of the pandemics of the past 100 years — indeed, most of the diseases that humans can have — were caused by “zoonoses,” or germs that come from other animals. HIV emerged from nonhuman primates. Ebola is borne by bats. The measles virus evolved from a disease that hurts cows sometime around the third century A.D. Viruses hijack the cellular machinery of their hosts to make copies of themselves, and many don’t have any proofreading mechanism to edit mistakes out of their genetic material. This means they mutate far faster than cellular life and can adapt to change rapidly. By altering the environment at a faster rate than any other moment in geologic history, scientists say, humans have created a wealth of chances for viruses to evolve. Habitat fragmentation is a major problem, said Dave O’Connor, a virologist at the University of Wisconsin at Madison. Human incursions into animal habitats — chopping down forests to build farms, venturing into parks to poach — bring us into increasing contact with animals and make us more likely to pick up their diseases. The shortage of places where animals can live also brings them into increasing contact with one another. “You have these complex networks of interactions that you wouldn’t be


particles that irritate the lungs. Thomas Friedrich, a colleague of O’Connor’s who spent much of his time studying the Zika virus (which is borne by mosquitoes) before SARS-CoV-2 overwhelmed the world, said people often ask him why humans can’t simply eliminate the sources of our zoonoses. That’s a dangerous way of thinking, he said. Aside from the impossibility of killing off entire species, these creatures play a vital role in their ecosystems. Bats, for example, participate in pollination and eat mosquitoes and agricultural pests. Even if killing them could avert the next coronavirus (which it can’t), it would hurt humanity — and the world — in myriad other ways. “The answer isn’t to just find the smoking gun that we can point and shoot,” Friedrich said. “The health of the animal-human interface is what’s important.” This is perhaps the strongest link between the coronavirus and climate change, said Elena Bennett, an ecosystem ecologist at McGill University in Montreal and a co-founder of the group Seeds of Good Anthropocenes, which collects and studies climate solutions. Both crises underscore that humans cannot be healthy unless the planet is, too. Both demand that people do what had been previously unimaginable, whether it’s shutting down society or transforming it. “I’m an optimist by nature,” Bennett said — someone who looks for bright spots when other people see only dark. In this time of uncertainty and loss, she is heartened by the speed with which humans have responded to the coronavirus. And she thinks the tools people have developed to deal with the pandemic may be helpful in confronting climate change. The mutual aid efforts that have sprung up to get groceries or create masks for vulnerable people show the potential for community action, Bennett said. The call for people to stay home — and the measurable impact of social distancing efforts when people comply — reveals the importance of official actions and the need for every person to participate. “The power of one person to do good or bad is kind of amazing, and that power happens because of all the interactions in the system,” Bennett said. In the months and years to come, when a covid-19 vaccine is developed and the pandemic is contained, she hopes people won’t forget these bright spots. “How do we take these good things and hold onto them,” she asked, “and steer them toward the larger climate conversation?”


U.S. Anti-Doping Agency tries ‘virtual testing’ with coronavirus disrupting normal protocols

anti-doping efforts around the world. Countries such as China, Russia and Canada halted testing altogether. Others, such as the United States, have scaled back severely, focusing on a limited number of “mission-critical” tests. Before the International Olympic Committee postponed the Tokyo Games by a year, many anti-doping officials worried a months-long lapse in testing would result in the dirtiest Olympics ever staged — and many still fear athletes around the world could reap benefits from this period of lax testing. “We saw that certain parts of the world had stopped testing — obviously there’s not as much testing anywhere right now — so it was concerning to all athletes. I mean, it still is,” said swimmer Katie Ledecky, who is preparing for her third Olympics. “So I think it’s important to find ways to continue to test. I’m glad they’ve figured out a way to keep that up during these times." At the USADA’s Colorado Springs office, officials had been toying with alternatives to in-person testing over the past year, and the rapid spread of the coronavirus made the matter urgent last month. The USADA approached 15 Olympic and Paralympic athletes — medal favorites such as Lyles, Ledecky, swimmer Lilly King and wheelchair racer Tatyana McFadden — and invited them to volunteer for the pilot program. “We hate the fact that our clean athletes are going to be questioned. They’re going to go to the Games, win medals and potentially be unfairly questioned because of this time period,” said Travis Tygart, chief executive of USADA. “It’s no fault of theirs. It’s the nature of the world we’re in. We get it. But it’s unfair. "So we said, ‘Look, we’ve got to reinvent ourselves.’ ” The result is the first-of-its-kind “virtual testing” program. Because World Anti-Doping Agency regulations don’t allow for virtual testing and some of the methods USADA has incorporated, athletes wouldn’t necessarily be subjected to punishment. But the 15 American athletes will be among very few around the world who will have a stack of test results they can point to from this period. The tests are still somewhat random. USADA has shipped about a half-dozen testing kits to each athlete. When athletes are notified it’s time for a test, they log into a video conferencing program. They don’t have to take their phone or laptop into the restroom, but the doping control officer does time how long it


How coronavirus will reshape the world’s borders

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. Martine Powers and Ishaan Tharoor explore the meaning of borders in a pandemic, and how coronavirus might change travel and migration in the future. And Mary Beth Sheridan walks us through public service announcements from around the world. Read more: Countries are slamming borders shut. What will it look like when they reopen? From Japan to Uganda, global public service announcements are emerging to help fight coronavirus. Check out our episode from December about “sober curiosity,” which one listener said is helping him through social distancing. Follow The Post’s live coronavirus coverage here. Subscribe to The Washington Post: https://postreports.com/offer


The Daily 202: Leaked CDC and FEMA plan warns of ‘significant risk of resurgence of the virus’ with phased reopening

in a Best Western.” “Experts agree there is no aggregate shortage of food or other retail items offered at the supermarket. But many factors are causing product deficits in particular regions and in particular stores,” Laura Reiley reports. “The biggest is that while about half of American expenditures for food used to be at restaurants and other such establishments, now almost all meals are being made in the home kitchen, so a distribution system that was built to supply restaurants with bulk items is struggling to adapt to far smaller packaging for home use. In addition, while supermarkets and food companies have based their business model in the past on offering a wide variety (grocery stores often have 40,000 items), now most consumers focus on a smaller sliver of products, so supply chains are overwhelmed.” “Almost every day an employee at Procter & Gamble Co.’s plant in Albany, Ga., a town with one of the nation’s highest rates of coronavirus, learns that someone close has become seriously ill or died of Covid-19. There is little time for consolation between co-workers. They are all racing to churn out one of the most in-demand products in America: toilet paper,” the Journal reports. “The sprawling Albany factory, one of six that make toilet paper, is P&G’s second-largest U.S. plant. … The factory has ramped up production by 20% of both toilet paper and paper towels, even as it revamps its operations to keep its roughly 600 workers healthy. Among other measures, it has instituted pre-shift temperature checks and staggered start times. … The plant sits in a midsize town of 75,000 people ravaged by the new coronavirus. More than 1,020 people have tested positive in Dougherty County, which includes Albany, and 62 have died.” Hundreds of thousands of fans would have gathered for a parade just as the coronavirus was beginning to spread in the Bay Area, the WSJ notes. Kansas City, home of the winning Chiefs, was one of the last NFL cities to detect its first case on March 18. By then, Bay Area residents had been ordered to shelter-in-place. “In Afghanistan, the Taliban has dispatched health teams to far-flung provinces to confront the coronavirus. In Mexico, drug cartels are offering aid packages to those feeling its economic impact. In Brazil and El Salvador, gangs enforce curfews to prevent its spread,” Kevin Sieff, Susannah George and Kareem Fahim report. “As governments


“The sprawling Albany factory, one of six that make toilet paper, is P&G’s second-largest U.S. plant. … The factory has ramped up production by 20% of both toilet paper and paper towels, even as it revamps its operations to keep its roughly 600 workers healthy. Among other measures, it has instituted pre-shift temperature checks and staggered start times. … The plant sits in a midsize town of 75,000 people ravaged by the new coronavirus. More than 1,020 people have tested positive in Dougherty County, which includes Albany, and 62 have died.” Hundreds of thousands of fans would have gathered for a parade just as the coronavirus was beginning to spread in the Bay Area, the WSJ notes. Kansas City, home of the winning Chiefs, was one of the last NFL cities to detect its first case on March 18. By then, Bay Area residents had been ordered to shelter-in-place. “In Afghanistan, the Taliban has dispatched health teams to far-flung provinces to confront the coronavirus. In Mexico, drug cartels are offering aid packages to those feeling its economic impact. In Brazil and El Salvador, gangs enforce curfews to prevent its spread,” Kevin Sieff, Susannah George and Kareem Fahim report. “As governments around the world have responded to the coronavirus, so too have armed insurgents and terrorist groups and drug cartels and gangs, a parallel underworld of public health policy and strategic messaging. … Some groups have attempted to weave governments’ failures to control the virus into their own propaganda narratives. In Somalia, al-Qaeda-linked al-Shabab fighters say the pandemic was spread ‘by the crusader forces who have invaded the country.’ The Islamic State has told followers to prepare to exploit their enemies while they are overwhelmed by outbreaks. … Some governments have acknowledged that armed groups could exploit their weaknesses after the virus fades, seizing on the aftermath of economic dislocation. … Italian officials have suggested that the mafia could provide its own loans or cash handouts to undermine the government. … “Last month, as the Salvadoran government was enforcing one of Latin America’s earliest and most stringent lockdowns, leaders of MS-13 decided that they would institute their own curfew. … [It] reflected a reality in much of El Salvador: The police have limited access in neighborhoods under criminal control, and in those places, only a gang-enforced curfew would be observed. MS-13 explained its reasoning to the San Salvador newspaper El Faro:


Do health-care workers know if their colleagues have covid-19? Depends where they work.

in Sentara Healthcare’s 40,000-person system, which includes a medical center in Prince William County, must give the company’s occupational health service permission to contact their supervisor and begin contact tracing, said Mary Morin, vice president of clinical effectiveness. “I’ve never heard of someone with a potential exposure situation who hasn’t given permission,” Morin said. “They’re scared they may have hurt a co-worker or a patient.” A team of experts contacts each potentially exposed person to determine their risk level, she said. Every other day, a nurse calls anyone asked to quarantine, to check on them and see whether they are experiencing symptoms. “The calls,” Morin said, “send a message from our health system that we care about them — it sends a personal touch.” Staff in some medical centers and hospitals said that in addition to wanting more notice when a fellow employee tests positive, they would like to see more information provided about the number and condition of covid-19 patients being seen in their facilities. At Laurel Medical Center, which is run by the University of Maryland Medical System, a nurse said employees have not been told how many patients have tested positive for the coronavirus, although they heard from co-workers that there has been at least one. The nurse, who spoke on the condition of anonymity to speak candidly, said administrators declined to provide details about the case, even as the state aims to add 135 beds at Laurel to treat covid-19 patients in preparation for a potential surge. UMMS spokeswoman Jania Matthews said the system’s policy is that any employee who was not wearing personal protective equipment when they were exposed to a covid-19 patient would have been alerted. She said in a statement that the system has been transparent with staff, including providing updates on patients and safety precautions that do not violate the Health Insurance Portability and Accountability Act, or HIPAA. Schneider, the vascular surgeon, said a lack of accurate information about covid-19 patients being treated — in addition to a lack of data on the number of intensive care unit beds filled and number of ventilators being used — leads to fear that might be misplaced. He said his practice, which includes 11 doctors, has had several patients recently who have lost limbs because they waited too long to seek treatment for blocked arteries, fearing that hospitals were overwhelmed with coronavirus cases. Had there


Music that will settle you down — or at least resonate with your embattled vibe

Spotify, Apple Music, and through Pentatone. Baltimore Symphony Orchestra OffStage Orchestras around the world have adjusted and adapted quickly and admirably to shift operations and attentions (however scattered) online, but I find myself returning again and again to virtual Baltimore, where the BSO’s “OffStage” offerings of archival recordings and at-home live streams have been regularly rewarding (and helped me make up for lost Mahler). Pianist Lura Johnson’s at-home performances of Beethoven and Schubert, with their neighborly acoustics, have been pleasures. But on the day Polish composer Krzysztof Penderecki died, cellist Dariusz Skoraczewski’s take on Penderecki’s 2011 Violoncello totale — with its frayed nerves and climbing dread — felt uncharacteristically intimate and of the moment (even if the recording itself somewhat shortchanges the work’s fathomless depths). Visit bsomusic.org/bso-offstage. Bernard Parmegiani, “Violostries” If you’re feeling stir-crazy, Recollection GRM’s latest release collects three stunning electro-acoustic (or acousmatic) works realized by the French composer between 1963 and 1971 — and each one is a journey. The titular piece swirls like a massive cyclone around its second movement, a concertante for violin and “very tightly woven microsounds.” But it’s “Capture éphémère,” a stereo rendition of a quadraphonic composition assembled from “breaths, fluttering wings: ephemeral microsonic sounds streaking space, sound scratches, landslides, bounces, vertigo of solid objects falling into an abyssal void, multiple snapshots forever frozen in their fall” that can feel either like an escape from the confines of the crisis, or a plummet into its churning center, depending on how you listen. Download at recollectiongrm.bandcamp.com/album/violostries. Rhys Chatham, “Drastic Classical Music for Electric Instruments” (live at the Kitchen) And should you just need to unleash and let loose, pay a visit to the website of the storied New York City arts venue The Kitchen, which is approaching its 50th anniversary with regular updates to its Video Viewing Room. This month features a 1981 performance by the erstwhile “hardcore minimalist” Rhys Chatham of “Drastic Classicism,” a piece for four electric guitars, bass and drums that “synthesized two different traditions of music to arrive at a striking new form” and “was one of the pieces which inspired the noise-rock movement,” according to Chatham’s own program notes. What really matters is that it’s 10 minutes of pummeling, raw art-rock brute force that can keep you from clawing at the walls — though it may have your neighbors knocking on your door. Viewable through May 1 at thekitchen.org. michael.brodeur@washpost.com


Martine Powers and Ishaan Tharoor explore the meaning of borders in a pandemic, and how coronavirus might change travel and migration in the future. And Mary Beth Sheridan walks us through public service announcements from around the world.


The myth of rural America’s protection from the coronavirus

in Columbus Junction. At the beginning of April, there were no confirmed cases of the coronavirus in the county, but an outbreak at the plant pushed the county’s total to nearly 200. Louisa County has more cases of the coronavirus for every 1,000 residents than does New York City. The outbreak in Columbus Junction, the Des Moines Register wrote, has “sparked fears not only for the employees’ health but also for the vitality of this small town and the continuity of the nation’s meat supply.” It’s obviously true that the impact of the pandemic has been felt most dramatically in New York City. Data from Johns Hopkins University show more than 10,000 people in the city have died of covid-19, the disease caused by the virus, and more than 110,000 infections have been confirmed. The density of cases in New York City introduces a different problem for less-dense areas of the country, one that’s reflected in the microcosm of Louisa County: The virus doesn’t stop at county borders. A number of the counties with the most cases per capita in the United States are on the outskirts of New York City: Westchester County to the city’s north and in New Jersey. That holds elsewhere, too. In Louisiana, several counties with the most cases per capita are in the vicinity of New Orleans, even though the population density in those places is lower. The chart above, contrasting population density with per-capita spread of the coronavirus, uses lines to show some of those clusters. Notice the outliers. There’s Blaine County, Idaho, which apparently saw a surge in cases thanks to infected tourists. In Randolph County, Ga., an outbreak probably stemmed from an infected attendee at a funeral. Drop one infected person from outside a less densely populated area into even a localized pocket of density and case totals can spike. Put another way: Personal distance is not a substitute for social distancing. The highest density of cases is in more-urban counties. If we average the number of cases per 1,000 residents based on the National Center for Health Statistics’s categorization of county population densities, we see that urban counties have a higher density of cases per capita on average than do rural ones. But that again downplays a key factor: cases are still increasing in rural counties. In the past week, the counties with the biggest increases in new cases have been


A health care worker chose to quarantine with a disabled man who has covid-19. For that, he gets $4 more an hour and has to reuse masks and gowns.

are believed to have died. Others have been hospitalized. And some remain in their homes, receiving services. “The general feeling among the providers in the coalition is worry and disconnect,” Paregol says. “I think they’re really scared about what’s going to happen to the people they support and their staff.” On March 4, he sent a letter to D.C.’s Department on Disability Services, Department of Health, and the deputy mayor for health and human services to encourage them to get ahead of the challenges a local outbreak might bring for people in this community. His letter describes that population as “the very DC citizens who will require a proactive comprehensive governmental approach for the foreseeable outbreak.” Paregol says he sent another letter on March 12, and another after that. He describes city officials as not being quick to offer guidance to service providers who have had to restructure their staffing to make up for shuttered day programs, spend more money for overtime and hazard pay — without knowing whether they will be reimbursed — and find protective equipment. “It’s almost as if the District is not making their most vulnerable a priority,” Paregol says. “This population has been an afterthought.” He is not alone in that concern. Letters have also been emailed to city officials from people with disabilities and advocates for them, raising concerns about the community’s needs during the pandemic. One sent to Mayor Muriel E. Bowser (D) and the D.C. Council from Bob Williams, a disability activist, had this subject line: “WhyWeCantWait — Five Actions You Elected Officials Must Take Now to Blunt the Effects of COVID19 on People with Significant Disabilities of All Ages who Need Home and Community Services and Supports to #LiveAsEquals in #DC.” Another letter sent to the mayor and council came from Disability Rights DC at University Legal Services, the federally designated protection and advocacy agency for residents in the District. It was signed by 22 other organizations. Andrew Reese, the director of D.C.’s Department on Disability Services, says he and other officials have weekly phone calls with community members and service providers. He also points to other measures the department has taken. He says a quality resource specialist checks in with providers weekly to gather information about their supplies. The department has also put in a request with the appropriate federal agency to get approval for measures that would help staffing


6 zombie claims about the coronavirus that just won’t go away

The outbreak of a pandemic is when the accuracy of information is as important as it ever will be. Yet more than two months into it, misinformation and dubious claims continue to penetrate — many of them thanks to President Trump and some of his allies on Fox News. Below is a rundown of these persistent claims, along with the facts. As the number of daily deaths from the coronavirus has leveled off somewhat and certain projections have been adjusted downward, a number of people have rekindled previously abandoned comparisons between the novel coronavirus and the seasonal flu. Fox News contributor Bill Bennett offered perhaps the most high-profile comments on this in recent days, doubting this is even a “pandemic.” “If you look at those numbers, and see the comparable, we’re going to have fewer fatalities from this than from the flu,” Bennett said, citing the latest projections. “For this, we scared the hell out of the American people, we lost 17 million jobs, we put a major dent in the economy, we closed down the schools … shut down the churches, and so on. You know, this was not and is not a pandemic.” Fox News host Laura Ingraham has made similar arguments and also played up the idea that the death toll could be similar to that of the seasonal flu. “Given the fact that the death rate for covid-19 may end up being only slightly worse than a very tough flu season, we want answers,” she said recently. Two points: One is that the reason the numbers are leveling off in certain areas of the country is because of the severe measures taken. The second is that data in recent days have filled out the picture of how much more deadly this was than the flu. A piece this week from the New Atlantis compared deaths from the novel coronavirus to other causes, both nationally and — importantly — in the key hot spot of New York. The combined picture is that the weekly death toll from the novel coronavirus nationally was already surpassing even that of cancer and heart disease and, in New York, was far outpacing all other causes of death combined during the 2017-18 flu season. It’s not difficult to see what might have happened had even fewer precautions been taken. This is part and parcel of the above claim and has been used


The Energy 202: Trump administration declines tighter air rules as coronavirus grips country

emerging during the coronavirus pandemic shows covid-19 is also disproportionately killing African Americans. University of California at San Francisco School of Medicine professor John Balmes, who is working with covid-19 patients at Zuckerberg San Francisco General Hospital, said there’s “good evidence” communities of color are exposed to more soot pollution, the effects of which are compounded by factors including poverty and a lack of access to health care. “You add air pollution to these underlying vulnerabilities, and you have greater exposure. It’s no accident that we see greater covid-19 deaths in African American communities,” said Balmes, who serves as a voluntary medical spokesman for the American Lung Association. Even before the pandemic, EPA’s staff scientists had recommended lowering the annual particulate matter standard to between 8 and 10 micrograms per cubic meter, according to a draft report last year that cited estimates that reducing the limit to 9 could save roughly 12,200 lives a year. The EPA’s Clean Air Scientific Advisory Committee was split on the question, with some members calling for tighter standards and others saying the current one is sufficient. But Wheeler’s predecessor, Scott Pruitt, disbanded the independent panel that advised CASAC specifically on soot levels. So instead, those experts gathered in October at a two-day meeting organized by the Union of Concerned Scientists and concluded that the annual limit should be lowered to between 8 and 10 micrograms, and the daily between 25 and 30 micrograms per cubic meter. “The process was doomed from the start,” said Gretchen Goldman, research director for the Union of Concerned Scientists. “It’s not surprising they would retain the standards, because they broke the process.” “The United States has some of the cleanest air in the world, and we’re going to keep it that way,” Wheeler told reporters in a phone call. “We believe the current standard is protective of public health.” Wheeler cited “uncertainties” in existing studies about the impact of lower particulate matter on human health, and the fact that the EPA’s advisory panel was split, as reasons to retain the current pollution limits. The EPA chief also said that while the Harvard findings were “interesting,” it was “premature” to draw conclusions. Several big business groups in Washington, including the U.S. Chamber of Commerce and American Petroleum Institute, cheered the administration for retaining the existing standards, with both noting that annual concentrations of fine particulate matter are down by 39


Republicans wrapped the safety net in red tape. Now we’re all suffering.

a criminal record. While work requirements don’t address employment barriers or make jobs appear out of thin air, they are a highly effective tool for shrinking program enrollment. Arkansas was the first state to implement Trump’s new Medicaid work requirements, phasing them in beginning in 2018. Over seven months after the policy took effect, 18,000 people lost Medicaid coverage, many despite still being eligible. People were initially required to submit their work hours via an online system that was, absurdly, open during limited hours. With work requirements in Medicaid and SNAP sensibly being suspended for the duration of the pandemic — and multiple federal courts blocking states from adding them to Medicaid even before the pandemic — a critical lesson from this era should be the immense cruelty of tying something as essential as health insurance or food to employment in the first place. Even now, after more than 25,000 deaths related to covid-19, the disease caused by the coronavirus, Trump is using bureaucracy to block access to the Affordable Care Act, refusing to reopen the marketplace to allow the 28 million people who were uninsured heading into the pandemic to enroll in ACA coverage. As a result, workers who lost employer-based health insurance can sign up for coverage at healthcare.gov; others are out of luck. He’s also refused to waive paperwork requirements his own administration put in place in 2017, requiring workers to submit documentation showing they lost employer-based health insurance — an impossible feat for many whose employers shut down weeks ago. In the case of SNAP — the nation’s largest food assistance program, which before the pandemic helped about 37 million Americans afford food — Trump has spent the better part of two years advancing a constellation of controversial regulations that, before the pandemic, were set to strip an estimated 3.7 million people of food assistance through red tape. Trump has even proposed changing how poverty is measured in the United States, which could render millions ineligible for assistance under programs that base eligibility on the federal poverty line, even though their economic circumstances haven’t improved. Meanwhile, the pandemic has shined a long-overdue light on how asset limits — which bar recipients of certain types of assistance from having even a few thousand dollars in the bank — have come to function as a “deadly poverty trap.” The $2,000 Supplemental Security Income asset limit, for example, virtually


No, microwaving masks doesn’t sanitize them — and more lessons on what’s real and fake in covid-19 news

identify misinformation. Now, during the novel coronavirus pandemic, the project is offering access to Checkology Premium at no cost to educators and parents in the United States. In just two weeks of the offer, more than 1,100 educators and parents in 49 states and the District have registered to use the platform with as many as 90,000 students. You can learn more about the News Literacy Project and all of the educational resources it provides in this piece, but here’s a rundown: Founded more than a decade ago by Alan Miller, a Pulitzer Prize-winning reporter at the Los Angeles Times, the News Literacy Project is now the leading provider of news literacy education. It creates digital curriculums and other resources and works with educators and journalists to teach middle school and high school students how to recognize news and information to trust — and provides them with the tools they need to be informed and engaged participants in a democracy. It uses the standards of high-quality journalism as an aspirational yardstick against which to measure all news and information. Just as important, it provides the next generation with an appreciation of the First Amendment and the role of a free press. The following lessons come from the April 13 edition of the Sift and relate to the pandemic that has shut down public life in much of the world, including in the United States. NO: YES: YES: Online conspiracy theories pushing false connections between 5G technology and the covid-19 pandemic The theories range across a spectrum of false beliefs, including provably untrue claims that 5G radio waves cause covid-19 or suppress the immune system, and the even more outlandish notion that the entire pandemic is a hoax perpetrated by governments and media outlets around the world to facilitate the installation of 5G networks. One factor behind the recent rise of such theories was an interview published on Jan. 22 by the Belgian newspaper Het Laatste Nieuws, in which a doctor made a number of highly speculative and unfounded claims about 5G technology. (The article was taken down “within a few hours,” the publication’s editor said, but not before the doctor’s claims had been disseminated widely.) There is also evidence that the recent surge in 5G conspiracies is being intensified by coordinated disinformation campaigns online — some of which appear to be state-sponsored, researchers say. Note: Also note: Related: Discuss: Idea:


As humans stay indoors, wild animals take back what was once theirs

5,000 people in Hong Kong and Southeast Asia found 90 percent supported government closures of unregulated wildlife markets. “Humans are extraordinarily selfish,” said Vanda Felbab-Brown, a Brookings Institution scholar who studies wildlife trafficking. “If they start dying, they will start taking actions to minimize their dying. The most impactful and consequential legislation always comes after the health risks.” The impacts of the closures and crackdowns, if they persist, will be global, undercutting the demand that fuels illegal wildlife trafficking, an illicit trade valued at more than $23 billion annually. The ripple effects of enforcement in Asia could be felt as far away as Latin America, where jaguars and turtles are hunted and killed to meet demand in China. “Asian traders call it the Latin tiger,” Felbab-Brown said. “They are using jaguar bones and teeth to produce elixirs. . . . It’s picked up a lot in Latin America.” But analysts say the pandemic also heightens potential dangers for animals. Poverty and hunger, exacerbated by lockdowns and disruptions in food supplies, may drive more people to hunt. “And that’s okay,” said Joe Walston, a senior official with the Wildlife Conservation Society. “If people are put in a position of poverty, and we have failed providing economic alternatives, they should be able to do that.” More concerning, advocates say, is the possibility that people could abandon their pets, out of the mistaken fear they can spread the virus, or because they can no longer afford to feed them. “It is more likely to increase pet abandonment,” said Marco Ciampi, president of Brazil’s Humanitarian Association of Animal Protection and Well-Being. “And the fake news is terrible. But even with this, animals will be in a more safe position, if we listen to the call of animals: ‘We are here, and if the environment is friendly, we are friendly, too.’ ” “It’s an amazingly magical moment,” he said. “There are peacocks in the streets.” Bruce Borowsky, a videographer in Boulder, Colo., was walking through the main pedestrian strip of the college town last week when he experienced that magical moment. Up near the top of a tree, beside a building, he spotted a mountain lion, asleep, back paws hanging down. Down below, Pearl Street, which normally teems with restaurant patrons, shoppers, and University of Colorado students, was a “ghost town.” Nothing was waking up the mountain lion anytime soon. “I’ve lived in Boulder for


we have failed providing economic alternatives, they should be able to do that.” More concerning, advocates say, is the possibility that people could abandon their pets, out of the mistaken fear they can spread the virus, or because they can no longer afford to feed them. “It is more likely to increase pet abandonment,” said Marco Ciampi, president of Brazil’s Humanitarian Association of Animal Protection and Well-Being. “And the fake news is terrible. But even with this, animals will be in a more safe position, if we listen to the call of animals: ‘We are here, and if the environment is friendly, we are friendly, too.’ ” “It’s an amazingly magical moment,” he said. “There are peacocks in the streets.” Bruce Borowsky, a videographer in Boulder, Colo., was walking through the main pedestrian strip of the college town last week when he experienced that magical moment. Up near the top of a tree, beside a building, he spotted a mountain lion, asleep, back paws hanging down. Down below, Pearl Street, which normally teems with restaurant patrons, shoppers, and University of Colorado students, was a “ghost town.” Nothing was waking up the mountain lion anytime soon. “I’ve lived in Boulder for 30 years, and I’ve never seen a mountain lion before,” Borowsky said. “And I’m a filmmaker and am outdoors constantly. Animals are sensing that people aren’t around much and are coming out more. “We’re waiting for the bears to come out of hibernation and see how brazen they get.” Along Brazil’s northeastern shoreline, Andrade is also seeing sights he has never witnessed. He has cared for endangered sea turtles for more than a decade, and has seen all sorts of calamities befall them. Artificial light along the beach especially confuses the turtles. They mistake it for the water’s reflection, wander off toward it and die along the way. “For every thousand,” he said, “only one or two reach adulthood.” For years, he has tried to teach people about the fragility of baby sea turtles — an ongoing effort he compared to a boxing match. He has erected protective areas around their nests. He has held events to show children why they’re special. Life was getting better, safer for turtles. But nothing compared to this: an empty beach. For him, the beauty of it ached. “It was a surreal sensation,” he said. “You see nature living out its role in this


Md., D.C. report first inmate deaths; region adds hundreds of known coronavirus cases

The number of known coronavirus cases in the District, Maryland and Virginia stood at 16,661 on Monday, with 8,939 cases in Maryland, 5,763 in Virginia and 1,959 in the District. The number of virus-related deaths was 263 in Maryland, 149 in Virginia and 53 in the District, for a total of 465 fatalities. Here are some of the most significant and recent developments as the region responds to the pandemic of the novel coronavirus, which causes the disease covid-19: • The number of fatalities in the District, Maryland and Virginia hit 465 on Monday, as Northern Virginia and the Baltimore and Washington metropolitan areas continued to lead the region in cases. • A 51-year-old male inmate at D.C. jail has died of the novel coronavirus. Deon Crowell was awaiting trial on charges of first-degree murder. Also on Monday, Maryland officials announced the first death of a state prison inmate from covid-19. • Starting this week, Montgomery and Prince George’s counties will require shoppers at grocery stores, pharmacies and large retail outlets to wear masks. What a stay-at-home order means for you


Being sick and alone is miserable. Being sick at home with your family might be dangerous.

Sandy Brown’s husband knew he was infected. The 59-year-old church elder had the trademark dry cough and fever of covid-19, but when she drove him gasping for air to the emergency room, the doctor’s advice was to go home and stay home. So he did. Soon, their 20-year-old son was sick, and within 12 days, both had died. The standard prescription from the Centers for Disease Control and Prevention for the mildly ill to self-isolate at home is something doctors and nurses in coronavirus hot spots repeat hundreds of times each day. But there’s a devastating cost to the public policy decision: multiple families with multiple deaths. An 86-year-old matriarch and her three adult sons in New Orleans. High school sweethearts married for 57 years in Grove City, Ohio, and their son, who had visited recently. Sisters in Chicago. A mother and daughter in Baltimore. All dead within days of each other because of the coronavirus. Amid the family tragedies come increasing calls for U.S. officials to isolate the mildly ill and infectious away from their homes — in convention centers, school gyms, anywhere else. It’s not just a public health issue but an economic one. Focusing restrictions more narrowly on the infected and their contacts, so that others can be freed from lockdown, has become a vital pillar of proposals to reopen the country. The issue is especially critical in light of research that suggests genetics may partly explain the wide disparity in how people react to covid-19, with some shrugging off the virus without even knowing they are infected and others facing death. On March 30, the World Health Organization’s Michael Ryan warned of a new stage of transmission in countries that instituted lockdowns and social distancing, but left many of the contagious at home. “In a sense,” Ryan said, “transmission has been taken off the streets and pushed back into family units.” China’s success with isolating family members separately has been held up as a model for breaking transmission chains. But images of Chinese officials forcibly taking people from their homes drew visceral reactions from many. “We couldn’t under any circumstance do what China did,” said Thomas J. Bollyky, a senior fellow at the Council on Foreign Relations and director of its Global Health Program. “Large-scale, non-voluntary quarantines would be challenging from a legal point of view.” Yale University’s Gregg Gonsalves, an epidemiologist, tweeted Wednesday that family


on the infected and their contacts, so that others can be freed from lockdown, has become a vital pillar of proposals to reopen the country. The issue is especially critical in light of research that suggests genetics may partly explain the wide disparity in how people react to covid-19, with some shrugging off the virus without even knowing they are infected and others facing death. On March 30, the World Health Organization’s Michael Ryan warned of a new stage of transmission in countries that instituted lockdowns and social distancing, but left many of the contagious at home. “In a sense,” Ryan said, “transmission has been taken off the streets and pushed back into family units.” China’s success with isolating family members separately has been held up as a model for breaking transmission chains. But images of Chinese officials forcibly taking people from their homes drew visceral reactions from many. “We couldn’t under any circumstance do what China did,” said Thomas J. Bollyky, a senior fellow at the Council on Foreign Relations and director of its Global Health Program. “Large-scale, non-voluntary quarantines would be challenging from a legal point of view.” Yale University’s Gregg Gonsalves, an epidemiologist, tweeted Wednesday that family separation “is a cruel overreaction and a violation of human rights.” But other experts, such as Carl Minzner, a professor of law at Fordham University, believe isolation and quarantine can be done voluntarily, in a way that respects civil liberties. Minzner is especially worried about poor people living in dense housing, who, according to early reports, make up a disproportionate number of the infected. “Many people,” he said, “are terrified about infecting their family members and want to self-isolate but have nowhere to go.” Several U.S. communities recently began experimenting with isolation centers. On April 1, Hillsborough County in Florida set up two motels for those who have suspected or confirmed infections and are concerned about exposing vulnerable family members. Wisconsin and North Carolina have done the same in their largest cities. Other jurisdictions have set up “safe” housing for first responders such as doctors and police. South Korea, Singapore and Taiwan, which have been relatively successful at controlling the spread of the virus, isolated the mildly ill, while Italy and Spain, where infection rates skyrocketed, did not. Public health experts have said a steady stream of household infections may be to blame for that spike in numbers. China’s experience


For an Olympic canoeist, training alone on the water is its own kind of social distancing

His boat, an 11½-foot Vajda C1 MM racing canoe, stays strapped to the roof of his Volkswagen at all times, and most days Casey Eichfeld still manages to get out on the water. Social distancing is no issue for an Olympic canoeist during training. In those moments of waterborne solitude, familiar now after 16 years as an international competitor, he almost can trick himself into thinking everything is still normal. It’s the other 20-some hours each day that remind him how abnormal things really are. Right about now, Eichfeld, a 30-year-old slalom canoeist and three-time Olympian, should be in Rio de Janeiro for the Pan-American Championships — the start of what was to have been a four-month burst of competition, with only a few scattered weeks at home, culminating in the 2020 Tokyo Olympics. Instead, the sport, like most of the rest of the world, has been shut down indefinitely because of the novel coronavirus pandemic — with some competitions, such as the Pan-Am Championships, canceled outright and others, such as the Olympics, postponed. And instead of being away from his Huntersville, N.C., home for most of the next four months — not to mention his wife, Sarah Anderson, and their golden retriever and two cats — he is more or less stuck there, with North Carolina, like most states, under a stay-at-home order. An exception for “outdoor activity” gives Eichfeld the leeway to continue training. “I’m starting to adjust better to being home,” Eichfeld, an Olympian in 2008, 2012 and 2016, said in a telephone interview. “In the beginning I was having some trouble. There’s this not exactly adrenaline but general excitement to knowing you’re going to be going to all these places, doing all these things. And all of a sudden, the brakes hit, and you’re thrust forward into your seat belt, like you’ve just come up on an accident up ahead. And it’s like, ‘Okay, we’re going to be here awhile.’ ” More so than at any other time he can remember, Eichfeld’s life has settled into a routine, a sort of solitude bordering on monotony. Anderson, the manager of a veterinary hospital, is considered an essential employee and has been working 50-hour weeks. Most days, Eichfeld pulls a four-hour shift at the String Bean, a Southern bistro in nearby Belmont, N.C., where he works when he isn’t competing and which has carved out a niche during


The important question isn’t when the government is going to lift restrictions. It’s this.

Someday, the world will reopen. Someday, you will attend birthday parties, cash paychecks, go to church, take vacations. You know that, of course. What you want to know is when. I suspect it’s the absence of a when that makes people so impatient with the lockdowns. If authorities would give us a certain date, we could plan. Without it, our quarantines seem to stretch, unreasonably, into eternity. That’s when our mouths start to form the words: “I can’t do this anymore.” Unfortunately, we’re not trying to make it to a particular date, but to an unknown day when the coronavirus is under control. So the only answer a responsible policymaker can offer at this point is “We’ll reopen when it’s safe.” Yes, I can hear you crying, but when will that be? Unfortunately, I can’t give you a when. But I can offer you a why and a how. Why we’ll lift the restrictions is clear: We’ll do it because the virus can be controlled by less-stringent means. Which brings us to the how: We’ll relax when, in addition to mask-wearing and scrupulous hand-washing, three new conditions are met. First, the viral transmission rate must fall until, on average, each infectious person isn’t infecting one other person. In epidemiological jargon, the reproduction rate (R0, or R-naught) of covid-19 must fall below 1. However, the R0 is partly a function of how many others a sick person comes into contact with. Right now, it’s not many, which is why the epidemic seems to be slowing. Unfortunately, if we all go back to acting as though it’s Jan. 15, the R0 will soar back above 2, and our exertions will have been for nothing. So we’ll want to err on the side of being a little late rather than too early, because too early gives us the worst of both worlds: nasty recession combined with lots of fatalities. Getting the timing right also means having the public health infrastructure ready to keep new infections low by identifying new cases, tracing everyone they’ve been in contact with and isolating those people, too. So our second criterion is the capacity to do widespread surveillance (of viruses, not people). That probably means a combination of policies: making covid-19 testing, for both active infections and antibodies, a standard part of medical care; setting up random testing programs in every sizable community; and making voluntary testing easy


Cruise ship crews: Stuck at sea, paydays dwindling and searching for a way home

across the globe by officials alarmed by infections and deaths linked to cruise travel. Scenes of testing kits being airlifted onto ships and passengers being medevaced off them have commanded worldwide attention since the cruise crisis struck. But left behind are nearly 80,000 crew members stuck on about 100 cruise ships in or near U.S. ports, according to the Centers for Disease Control and Prevention. Twenty-four of those ships have known or suspected infection among the remaining crew members, said the CDC, which on Thursday extended a no-sail order for up to 100 days for cruise ships in U.S. waters. The order calls for a halt of all cruise line activity on ships with capacity to carry 250 or more, including crew members, while the industry is required to put forward a new comprehensive plan to address a range of concerns including surveillance and reporting of illness on board, testing procedures, onboard medical care and evacuation logistics. Ships sit off the West Coast, the East Coast and the Gulf Coast, the CDC said. And they wait off the shores of other nations, including Australia, where sharp responses to outbreaks on ships have included a police team investigation of the Ruby Princess and its Miami-based owner, Carnival, after 15 passenger deaths and some 660 infected people from the vessel became the biggest individual contributor to covid-19 cases on that continent. For marooned crews and cruise lines, port closures and flight restrictions have further complicated efforts to repatriate staff members. In some cases, cruise liners have resorted to sailing for days to drop crew members off at ports in their home countries. “Sometimes in a global crisis such as this, caution and fear can take over in some people in some countries, and what would normally be a basic level of human decency to allow these men and women into a port to be able return to their homes — yet surprisingly it has been denied by some countries in recent weeks,” said Roger Frizzell, a senior vice president for Carnival. So, crews sit, waiting to be helped back home by an industry that the CDC in its order accused of not sufficiently controlling the scope of the coronavirus outbreak and of relying too heavily on federal, state and local resources as passengers and crew members became sick. In interviews, six crew members on four ships left at sea shared stories of


Covid-19 deaths pass 500 in Washington region after record tally of fatalities reported

The number of covid-19 deaths in the greater Washington region passed 500 Tuesday with a record one-day increase in reported fatalities, even as local leaders maintained that social distancing measures like closing businesses and schools appear to be working. D.C. Mayor Muriel E. Bowser (D) said hospitalizations in the nation’s capital could peak in late May, a month earlier than previously projected, if area residents continue to stay at home and avoid large groups. The city reported that 295 people had been hospitalized as of Monday, while Maryland had 1,975 hospitalizations and Virginia had 903. Just over 1,000 new infections were reported in the three jurisdictions, the second-lowest daily total over the past week, according to a Washington Post tracker. “We’re hopeful that our worst-case-scenario projections won’t be realized, which means we’ll see lower levels of infection or hospitalizations and possibly see our peak happen in mid-to-late May, rather than late June,” Bowser said in an interview with WTOP. On Tuesday, 61 more covid-19 fatalities were disclosed, for a total of 526 coronavirus deaths in the District, Maryland and Virginia. Many of the patients were probably infected several weeks ago, before the implementation of strict stay-home orders that have stalled the local economy and are aimed at limiting the virus’s spread. The total number of known coronavirus infections in the greater Washington area climbed to 17,735. Regional leaders say they are optimistic that social distancing measures have slowed the spread of the virus. But officials are warning that an abrupt return to normal life would lead to another surge in infections and deaths. “Nobody wants to get back open more than I do, get our kids back in learning environments,” Bowser said in the radio interview. “But we don’t want to see a rebound in infections, which would lose all the gains we’ve made over the last month.” Bowser plans to announce Friday whether she will extend school and business closures beyond the current end date of April 24. Maryland Gov. Larry Hogan (R) has said he is talking with scientists, doctors and business leaders about how and when to safely lift his state’s restrictions. His spokesman did not respond Tuesday to questions about whether the state is nearing its peak, if its hospitals are reaching capacity and how social distancing has helped reduce the virus’s spread. Virginia Gov. Ralph Northam (D) is expected to announce Wednesday how much longer


nonessential businesses will remain closed after his initial order expires on April 23. A separate stay-at-home order for Virginia residents extends through June 10. Northam spokeswoman Alena Yarmosky said the governor’s office does not believe the spike in fatalities contradicts the assertion that social distancing is working. “We are flattening the curve,” Yarmosky said. “It doesn’t mean we’re at the end of this. It doesn’t mean we’re going to stop seeing increases in cases and deaths. . . . We need to keep doing it. We’re clearly not out of the woods yet.” Eric R. Houpt, head of the Division of Infectious Diseases and International Health at the University of Virginia Health System, said he agrees that, without the social distancing, the curve of new cases would be higher. But “the part that concerns me is we are still seeing a hefty number of new daily cases — despite the social distancing,” Houpt said. “So it is not working 100 percent.” Maryland reported 40 new deaths Tuesday. Ten were in Baltimore County, six were in Montgomery County and nine were in Prince George’s — bringing that majority-black county’s total to 72 deaths, the highest in the state. The District reported 15 new deaths, for a total of 68, including a fourth patient — an 81-year-old woman — at St. Elizabeths, the public psychiatric hospital in Southeast Washington. The VA Medical Center announced its ninth and 10th patient deaths. All but two of the D.C. fatalities reported Tuesday involved black patients, further illustrating the disproportionate impact of the virus on African Americans in the city. The District is 46 percent black, but 76 percent of its covid-19 fatalities have been African Americans. Seven more D.C. police officers have tested positive, bringing the total number of infections in the department to 58. Virginia reported six new deaths, for a total of 155 fatalities. That includes a 49-year-old inmate at a Virginia correctional center for women and several residents of the Sunrise at McLean assisted-living facility in Fairfax County. On Tuesday, Sunrise Senior Living, which owns the McLean facility and several others in the region, informed families of McLean residents that “this insidious pandemic has taken several beloved residents from our community.” The letter, which was obtained by The Washington Post, said more than 10 employees and more than 20 residents have tested positive for the virus, though it did not provide specific


Man charged in fatal stabbing is D.C. jail’s first inmate to die of covid-19

up call so it does not happen to anyone else.” On March 20, five days before the jail announced its first inmate had tested positive for the virus, Weller filed her petition with Judge Danya Dayson. “He is considered high risk to suffer deadly or extremely serious consequences if he gets sick,” Weller wrote of Crowell. Weller asked that the judge allow Crowell to be confined at home with family members and be placed on GPS monitoring. He was scheduled to go to trial in September. Defense attorneys in the District have been seeking to have hundreds of inmates released, fearing the virus would spread throughout the jail. Many of those inmates were accused of nonviolent crimes or were nearing the ends of their sentences. Others have preexisting health conditions or are older, putting them at greater risk of illness. Similar efforts are ongoing across the country, including in Virginia and Maryland. Maryland on Monday announced the first covid-19 death of a prison inmate there. The inmate, who was hospitalized when he died, was in his 60s and had serious underlying medical conditions, officials said. Virginia prison officials on Tuesday said a 49-year-old female inmate who was serving a sentence in a drug case had died after contracting the virus. In federal court in the District, the city’s Public Defender Service joined the American Civil Liberties Union in a class-action lawsuit on behalf of city inmates. The lawsuit argues that the virus can spread quickly at the jail and seeks a federal judge’s intervention in an effort to improve conditions at the facility. Jail officials have argued that they have already met government standards in cleaning the facility and screening and treating inmates for the virus. The population of the facility has decreased amid the federal case and other efforts, including emergency legislation passed by the D.C. Council and litigation by the Public Defender Service. In a court filing Tuesday, a D.C. Superior Court judge said the number of D.C. jail inmates serving sentences for misdemeanor convictions has fallen from 94 to nine since the novel coronavirus outbreak, with an additional individual completing a sentence at a halfway house. Motions to release those nine were denied based on factors including dangerousness. The total number of inmates in the jail Tuesday evening could not immediately be determined. On Wednesday during a hearing for the lawsuit in federal court, two independent experts


Iran’s latest coronavirus gamble could be its deadliest

U.S. sanctions and internal mismanagement — at the potential cost of allowing a resurgence of the pandemic. “Economic activities and health protocols can be pursued simultaneously,” Rouhani said last week during a meeting of Iran’s coronavirus task force. “The opening of businesses does not mean we are ignoring the stay-home principle. Those whose outdoor presence is unnecessary should preferably continue to stay at home.” While Rouhani and his advisers insist they can mitigate the virus’s spread while keeping commerce flowing, domestic critics warn that Iran faces a second wave of the pandemic. A Tehran city council member called on the government for more transparency: Under the new guidelines, schools and universities will remain closed. Religious and sporting events are also being postponed. But two-thirds of people who work for the government — Iran’s biggest employer — have already returned to normal duty. Public transportation — the source, according to estimates from Iran’s health ministry, of a quarter of the country’s coronavirus cases — has resumed standard schedules. Buses and trains are reportedly already as crowded as ever. Since the initial outbreak in February, local authorities in some of the hardest-hit regions of Iran have called for stricter measures on domestic travel and greater transparency in reporting. Yet they have continued to face official policies of obfuscation and denial. This has forced an already weary Iranian public to decide for itself what risks are worth taking. Many have decided to self-isolate at home with their families. But the Iranian New Year festivities last month saw a surge in domestic travel that merely accelerated the spread. The lack of consistent and effective leadership has also led to a fatal spread of misinformation. One widespread rumor — that drinking industrial-grade alcohol provides immunity to the virus — has been responsible for at least 600 deaths. Adding to the public confusion was a decision late last month to temporarily halt the printing of all newspapers, under the pretext that handling the paper might increase the spread of infections. Many Iranians, distrusting the official explanation, saw the measure as a way of obscuring the destruction caused by the virus. (Newspapers remain a key source of distributing information in the country.) The printing presses were switched on again this week — a move apparently aimed at reassuring the public all is well. But that’s far from true. In an unprecedented sign of the urgency of the


under the pretext that handling the paper might increase the spread of infections. Many Iranians, distrusting the official explanation, saw the measure as a way of obscuring the destruction caused by the virus. (Newspapers remain a key source of distributing information in the country.) The printing presses were switched on again this week — a move apparently aimed at reassuring the public all is well. But that’s far from true. In an unprecedented sign of the urgency of the situation, a newspaper funded by the offices of Iran’s supreme leader, Ayatollah Ali Khamenei, published an article calling on three major religious foundations to help fund a desperately needed economic recovery plan. Khamenei himself, however, continues to blame the virus on Iran’s foreign enemies. In short, chaos still reigns. There is little indication that the threat of a resurgence of the virus has passed or that it is being effectively mitigated. The mixed messaging is bound to lead to more public confusion and mistrust. In all likelihood, it will also cause more avoidable deaths. If so, it won’t be the first time. Iran’s leaders have a long history of treating citizens’ lives as expendable when times get tough. The regime’s impatience to get on with the resumption of normal life makes the point yet again. Try as it might, the Tehran regime is likely to prove — in the form of Iranian lives lost — that countries cannot have it both ways. How Iran fares over the coming weeks will likely shape how other countries respond to the challenge of reopening their economies. In any case, the outside world should resist the temptation to crow at renewed evidence of the Iranian regime’s incompetence as ordinary Iranians pay the ultimate price. Few governments have covered themselves with glory in the current crisis, and almost all of them will face similarly unpleasant choices in the weeks to come. Let’s hope they don’t repeat Iran’s mistakes. The Opinions section is looking for stories of how the coronavirus has affected people of all walks of life. Write to us. Read more by Jason Rezaian: I survived solitary confinement. You can survive self-isolating. An ancient celebration is about to make Iran’s coronavirus nightmare even worse Iran badly needs coronavirus help. Releasing all hostages could be the key. Iran’s response to the coronavirus is just making everything worse In Iran, bad news is becoming journalism’s biggest obstacle


Md.’s chief judge directs courts to identify at-risk inmates for potential release; ‘several’ die at McLean facility

The number of known coronavirus cases in the District, Maryland and Virginia stood at 17,736 on Tuesday, with 9,487 cases in Maryland, 6,187 in Virginia and 2,062 in the District. The number of virus-related deaths was 303 in Maryland, 155 in Virginia and 68 in the District, for a total of 526 fatalities. Here are some of the most significant and recent developments as the region responds to the pandemic of the novel coronavirus, which causes the disease covid-19: • The District, Maryland and Virginia on Tuesday reported 61 covid-19 fatalities, the highest single-day increase, bringing the regional death toll to 526. • Sunrise Senior Living, one of the largest elderly care companies in the country, announced to families at its McLean community Tuesday that “several” residents have died from coronavirus infections and that at least 20 more residents and 10 employees have also tested positive. • Maryland’s highest court has ordered judges throughout the state to try to reduce the number of young people held in juvenile detention facilities to minimize their exposure to the deadly coronavirus. Later, the state’s chief judge directed courts to identify at-risk prison inmates for potential release. • D.C. Mayor Muriel E. Bowser (D) said Tuesday that stay-at-home order and social distancing measures put in place to combat covid-19 could result in the number of coronavirus cases peaking earlier than expected. What a stay-at-home order means for you


Tour de France postponed, French Grand Prix in doubt because of coronavirus

The extension through mid-July of a ban on mass gatherings in France amid the novel coronavirus pandemic has forced the postponement of the Tour de France and jeopardized Formula One’s French Grand Prix. President Emmanuel Macron on Monday extended France’s lockdown until May 11, with schools progressively reopening after that. But bars and restaurants will remain closed, and there will be no summer festivals “before mid-July.” Both the Tour and the F1 race draw enormous crowds, with 135,000 people attending last year’s auto race. The Tour, the biggest race in cycling, was scheduled to begin June 27 in Nice and end July 19 in Paris. The F1 race was scheduled for June 28 near Marseille. “Given that it’s now impossible that the Tour starts at its planned date, we are consulting with the [International Cycling Union] to try to find new dates,” organizers said Tuesday. The Tour was last called off in 1946, when France was still recovering from World War II. It also did not take place during World War I. One option is to cancel the race outright this year, but organizers hope to find a later date, and they are not likely to favor staging the race without the thousands of fans who line the roadsides. Egan Bernal won last year’s Tour de France. The Giro d’Italia earlier was called off along with the Milan-San Remo, Tour of Flanders and Paris-Roubaix single-day races. The ICU furloughed staff and cut its leaders’ salaries this month, with officials citing the postponement of the Olympics and Paralympics as well as losing most of its events. F1 officials continue to look for ways to rework the schedule, hoping to start it in Europe in the summer, and they have not ruled out holding some races without spectators. Ross Brawn, F1′s managing director, said he believed a season could be held even if the first race is not held until October. That could push the season into January. Like other sports, F1 is feeling the financial pinch as income from broadcast rights, sponsorships and race-hosting fees is cut off. Only the Monaco Grand Prix has been canceled outright. Last month, French Open officials moved the Grand Slam tennis event from May to September.


Brian Miller, whose blindness inspired a career helping disabled students, dies of covid-19

disabilities like his — and to a rich and busy life filled with friends and travel. Both were cut short Monday when Miller, who lived in Alexandria, died of complications of covid-19, the disease caused by the novel coronavirus. He was 52 and otherwise healthy, his mother said. Miller started having symptoms, including a fever and cough, in mid-March, shortly after returning from a trip to Jordan that was curtailed by the virus. Miller’s doctor at first told him to hunker down and wait out the illness at home, but his condition kept deteriorating, his mother said. He entered the hospital March 28, was put on a ventilator the next day and died Monday after he began bleeding internally and suffered organ failure. In the hours since, tributes from Miller’s friends and colleagues have flooded Facebook and McGinnis’s phone, she said. Everyone is eager to tell her how many lives Miller shaped, how many blind students her son uplifted. On Tuesday morning, Education Secretary Betsy DeVos phoned McGinnis to offer her condolences and to thank her for Miller’s service. In a message to department staff, Miller’s direct supervisor, Carol Dobak, praised his lifetime spent in service of those with disabilities. “Brian believed strongly in the capacity of individuals with disabilities to engage in all aspects of life,” Dobak wrote, “and his own life was a reflection of this philosophy.” That started in grade school, McGinnis said, when she and her son confronted a system ill-equipped to serve the blind. She remembers endless battles to secure accommodations her son needed: extra-large computer screens, special TVs, books in Braille. She remembers, too, his listening to audiobooks late into the night, and his unwavering love of learning — especially history. “All during school, they seemed to feel, ‘Why would a blind person need a degree?’ ” McGinnis said. “His thought, of course, was that he needs it even more.” Despite the science teacher’s worry, Miller graduated from high school, earned a degree in political science from San Diego State University and got a master’s and a PhD in history from the University of Iowa. McGinnis keeps a blue, bound copy of her son’s 471-page dissertation, “Speaking for Themselves: The Blind Civil Rights Movement and the Battle for the Iowa Braille School,” on a living room coffee table in her Michigan home. As she used to tell her son: It’s too heavy to hang


In a self-isolated world, New Orleans musicians fight to beat back the silence

NEW ORLEANS — The bars on Bourbon Street are sealed with hurricane shutters and plywood. The corner of Royal and St. Peters streets is silent. A family of musicians who typically perform there — a jazz clarinetist, her sousaphone-playing husband and their drumming daughter — last played their traditional closing number, "When the Saints Go Marching In," on March 19, the day the music went into quarantine. Calendars in the windows of the clubs on nearby Frenchmen Street still list who was to play each of the 31 days of March. Almost half those gigs never happened. On the balcony above the Snug Harbor Jazz Bistro, a couple is dancing. In defiance of the silence, they have turned a speaker to the street to share graceful, lilting piano runs. The music is not live, though — it is Spotify. The playlist is a tribute to Ellis Marsalis, patriarch of the musical Marsalis family and a pillar of New Orleans jazz. He died April 1, at 85, from complications of covid-19. “I’ve got Ellis’s spirit up here,” Jason Patterson, one of the dancers, called down to a lone pedestrian carrying a can of beer. Patterson is the landlord and talent booker of the shuttered bistro, where Marsalis performed weekly for 30 years. “He still wants to play.” But beyond the reach of Marsalis’s recorded tunes, an unfamiliar quiet has settled in the streets of New Orleans, sapping the soul of the city that gave birth to jazz. “It lets you know that things are different,” said Doreen Ketchens, the clarinetist exiled from her corner on Royal Street to self-isolation in her home. “It lets you know that things can die.” As of Tuesday afternoon, Louisiana had reported 21,518 cases of the novel coronavirus and 1,013 deaths — the fourth largest number of deaths in the country. New Orleans has accounted for 276 of those who died and 5,718 cases. Epidemiologists estimate that Mardi Gras festivities, which drew more than 1 million visitors and culminated Feb. 25, accelerated the spread. The first case in Louisiana was detected March 9. Mayor LaToya Cantrell issued a stay-at-home order on March 20, but most entertainment in the city had been canceled by the day before. The coronavirus turned off the music at the worst possible time of year for New Orleans and the practitioners of its boisterous style. Festival season was just gearing up —


It’s not easy for ordinary citizens to identify fake news

rated as false or misleading were related to the coronavirus. All four articles promoted the unfounded rumor that the virus was intentionally developed in a laboratory. Although accidental releases of pathogens from labs have previously caused significant morbidity and mortality, in the current pandemic multiple pieces of evidence suggest this virus is of natural origin. There’s little evidence the virus was manufactured or altered. When we asked people to rate the veracity of these four articles, the results mirrored those from the full study: Only 30 percent of participants correctly classified them as false or misleading. Additionally, on average, respondents seemed to have more trouble deciding what to think about false covid-19 stories, leading to a higher proportion of “could not determine” responses than we saw for the stories on other topics our professional fact-checkers rated as “false/misleading.” This finding suggests it may be particularly difficult to identify misinformation in newly emerging topics (although further research would be needed to confirm this). Study participants with higher levels of education did better on identifying both fake news overall and coronavirus-related fake news — but were far from being able to correctly weed out misinformation all of the time. In fact, no group, regardless of education level, was able to correctly identify the stories that the professional fact-checkers had labeled as false or misleading more than 40 percent of the time. Taken together, our findings suggest there is widespread potential for vulnerability to misinformation when it first appears online. This is especially worrying during the current pandemic, when governments, public health officials and the media are constantly updating information. Nothing we saw in our data suggested the potential for misinformation on covid-19 was any lower than the overall findings — though it’s important to note that our study did not include misinformation related to cures or treatments. How individuals respond to the pandemic will depend, in large part, on the quality of information to which they are exposed — and the stories and the reports they find credible. In the current environment, misinformation has the potential to undermine social distancing efforts, to lead people to hoard supplies, or to promote the adoption of potentially dangerous fake cures. Since the outbreak of covid-19, platforms such as Facebook and Twitter have been inundated with a diversity of false narratives, ranging from accusations of partisan hoaxes to medical misinformation propagating unverified treatments. This suggests the


misinformation all of the time. In fact, no group, regardless of education level, was able to correctly identify the stories that the professional fact-checkers had labeled as false or misleading more than 40 percent of the time. Taken together, our findings suggest there is widespread potential for vulnerability to misinformation when it first appears online. This is especially worrying during the current pandemic, when governments, public health officials and the media are constantly updating information. Nothing we saw in our data suggested the potential for misinformation on covid-19 was any lower than the overall findings — though it’s important to note that our study did not include misinformation related to cures or treatments. How individuals respond to the pandemic will depend, in large part, on the quality of information to which they are exposed — and the stories and the reports they find credible. In the current environment, misinformation has the potential to undermine social distancing efforts, to lead people to hoard supplies, or to promote the adoption of potentially dangerous fake cures. Since the outbreak of covid-19, platforms such as Facebook and Twitter have been inundated with a diversity of false narratives, ranging from accusations of partisan hoaxes to medical misinformation propagating unverified treatments. This suggests the rapidly changing information environment surrounding covid-19 has the potential to magnify the vulnerabilities revealed by previous studies of online misinformation. The four news articles included in our study, covering only a single rumor, are hardly representative of what social media users are seeing online. While more research is needed about other types of coronavirus-related misinformation, our findings suggest non-trivial numbers of people will believe false information to be true when they first encounter it. And it suggests that efforts to remove coronavirus-related misinformation will need to be swift — and implemented early in an article’s life cycle — to stop the spread of something else that’s dangerous: misinformation. The TMC newsletter is changing shape! Sign up here to keep receiving our smart analysis. Zeve Sanderson Kevin Aslett Will Godel Nathaniel Persily Jonathan Nagler Richard Bonneau Read more: Should U.S. states be free to close their borders to other U.S. citizens? Syria’s civil war will make fighting coronavirus particularly difficult The coronavirus is expanding the surveillance state. How will this play out? The World Bank’s 2017 pandemic response fund isn’t working How India plans to put 1.3 billion people on a coronavirus lockdown


Those covid-19 death figures are incomplete

The Centers for Disease Control and Prevention has estimated that from April 12, 2009, to April 10, 2010, there were 12,469 deaths in the United States because of the H1N1 (swine flu) virus. That was the midpoint of an estimate that ranged from a low of 8,868 to a high of 18,306. But that was an after-the-fact report. What was the CDC reporting as the swine flu pandemic unfolded? Here’s a comparison of the first 65 days of the 2009 swine flu in the United States and first 65 days of the 2020 covid-19 outbreak. Swine flu Covid-19 The 2009-2010 swine flu pandemic is considered to have been relatively mild — and in the United States, it hit harder in a second wave in the fall. Clearly, covid-19 is striking with more force — and faster. “We know that if you just look at laboratory-confirmed deaths, it is an undercount, especially in the case of flu,” said Cécile Viboud, senior research scientist in the Division of International Epidemiology and Population Studies of the Fogarty International Center at the National Institutes of Health, where she is part of the Multinational Influenza Seasonal Mortality Study (MISMS). Viboud said that many deaths are triggered by the flu but occur later, via secondary bacterial infection or exacerbation of underlying chronic diseases, even as flu symptoms may have disappeared. So a death might be recorded as a heart attack, not as having been caused by the flu, even though the flu led to the cardiac arrest. The CDC, which tracks weekly flu deaths, also closely tracks pneumonia deaths because pneumonia is so often a consequence of the flu. “Only counting deaths where influenza was recorded on a death certificate would be a gross underestimation of influenza’s true impact,” says the CDC in a website explanation of how it estimates deaths caused by seasonal influenza. Researchers such as Viboud use a time series analysis to estimate how many excess deaths in a given period can be attributed to a viral disease such as the flu but are not counted in the official death statistics. For instance, in the 2009 swine flu pandemic, 2,096 laboratory‐confirmed deaths were reported in the United States from Aug. 30, 2009, to April 6, 2010, the second wave. But a 2013 study that Viboud participated in concluded that the excess deaths that could be attributed to the pandemic in that period amounted


D.C., Va., Md. leaders seek more federal assistance, announce other steps in push to fight coronavirus

The tally of known coronavirus cases in the District, Maryland and Virginia rose to 684 on Monday as Maryland reported an additional 44 cases, bringing the state’s total to 289. Virginia reported 35 more cases Monday for a total of 254. The District reported 21 new patients Monday, bringing its total to 141. Here are some of the most significant and recent developments as the region responds to the pandemic of the novel coronavirus that causes the disease covid-19: [ • Gov. Ralph Northam (D) announced that public and private schools will be closed through the academic year to fight the spread of coronavirus. Northam had initially announced a two-week closure — although some Northern Virginia districts opted to close for longer — but the governor said Monday that schools will remain shuttered for the remainder of the academic year. • Maryland Gov. Larry Hogan is shutting down all nonessential businesses at 5 p.m. Monday as the number of coronavirus cases grows in the state. “Unless you have essential reason, then you should stay in your home,” he said during a news conference. “This is an exceptionally challenging time.” • D.C. Mayor Muriel E. Bowser (D) said Monday she will not follow the lead of California, New York and others in ordering residents to stay at home, despite weekend crowds to view Cherry Blossoms prompting some to urge tougher measures. • Virginia health officials announced three deaths late Sunday that were linked to the coronavirus, bringing the statewide total to six. Maryland announced 44 new cases Monday while Virginia announced 35 and the District reported 21. Coronavirus in the DMV: What you need to know


Metro to close 19 stations as D.C. reports largest single-day increase in coronavirus cases; four new deaths announced in region

The tally of known coronavirus cases in the District, Maryland and Virginia stood at 781 on Tuesday after Maryland reported an additional 61 cases Tuesday, bringing the state’s total to 350. Virginia reported 36 more cases Tuesday for a total of 291. The District reported 21 new patients Monday, bringing its total to 141. Here are some of the most significant and recent developments as the region responds to the pandemic of the novel coronavirus that causes the disease covid-19: • Early Tuesday, Virginia Beach health officials said a man in his 70s with underlying health conditions had died from the virus. Later in the day, Henrico County officials announced that two people — both elderly residents of the Canterbury Rehabilitation and Healthcare Center — had also died, bringing Virginia’s total to nine. • Maryland announced a fourth person has died of coronavirus in the state — a Prince George’s County man in his 60s who had underlying medical conditions. • Tuesday night, D.C. announced it’s largest single-day increase in cases to date: 46, bringing the total to 187. • D.C. Mayor Muriel E. Bowser (D) said ordered nonessential businesses to close starting at 10 p.m. Thursday. They include nail salons, barbershops, tattoo parlors and tanning salons (see a more complete list in the post below). • Bowser said it’s possible the city will join Virginia in closing schools for the rest of the academic year, but no such decision was imminent, according to four council members who were on a call with the mayor. The mayor said she and her health department are monitoring coronavirus data and measuring whether containment measures are working before making that call. Coronavirus in the DMV: What you need to know Earlier updates:


Air Force evacuates 89 Americans from Honduras after coronavirus travel advisory; states increase restrictions

Restrictions are dramatically ramping up amid the growing coronavirus pandemic, with Illinois and its 13 million residents — 10 million in the Chicago area — the latest to join California by moving closer to an effective lockdown. Meanwhile, New York told nonessential workers to stay home, Florida closed restaurants, bars and gyms amid spring-break revelry, and the U.S.-Mexico border is closing to nonessential travel. Here are some significant developments: Sign up for our coronavirus newsletter