Smart Energy Stimulus Means Thinking Small

between Covid-19 and climate change, phenomena where the impact of the next disaster will likely be worse than the last — “regression to the tail,” rather than the mean, as he calls it. In managing such risks, our aim should be to cut the tail of extreme outcomes — by, say, stockpiling medical equipment or developing zero-carbon energy — and err on the side of caution. That we would eventually face a pandemic was a known known, so to speak. Not only were we unprepared, though, but our response also lacked urgency and coordination, leading to tens of thousands of unnecessary deaths and the resort to mass lockdowns with huge economic costs. Similarly, we know climate change is happening and, if unaddressed, its impacts will compound over time. Flattening (and then crushing) the emissions curve is an immediate issue, not one to be deferred to the next generation. When planners in the Pacific Northwest feared blackouts, they responded with a vast, unwieldy program that left the region vulnerable to other tail risks of cost and delay. You might say they didn’t have a choice back then: If you needed more power, you built giant power stations. On the other hand, maybe they could have started with one nuclear plant and seen how it went. In any case, we no longer have that excuse today. We have options. For a climate-centered energy stimulus to achieve its objectives, it must create jobs and generate competitive power — fast. “What you want to do is projects that are COTS: Commercial off-the-shelf. That is the opposite of bespoke,” says Flyvbjerg, adding, “We don’t have 10 or 15 years to wait for the effects; effects on the economy, effects on employment but also effects on climate.” If recent history is anything to go by, then nuclear projects in the U.S. are still prone to overoptimistic forecasting, multibillion-dollar cost overruns and long delays (see this). So-called small modular reactors have long been touted as a way to reduce costs and shorten construction schedules. If they can be shown to work, then they may yet compete. But like other traditional generating technologies, they face ever stiffer competition from renewable energy. This isn’t to single out nuclear (or any other) generation. Rather, it’s to highlight renewable energy’s edge. Not only have the costs of solar and wind power dropped dramatically over the past decade. They are also, crucially,


Trump takes a first step toward returning medical supply chains to the U.S.

he said he warned administration officials in early February of inevitable drug shortfalls. Phlow later submitted a bid under a BARDA contract competition, he said. “I think it’s a good thing, a really interesting step forward to put an investment into our pharmacy supply chain,” said Erin Fox, pharmacist and drug-shortages expert at the University of Utah hospital. Maintaining adequate drug supplies — such as sedatives and painkillers for ventilator patients — has been a problem amid soaring demand during the pandemic, she said. Such shortages could worsen, as states reopen and hospitals resume performing elective surgeries. “You need some of those very same drugs for surgery that you need for critically ill and intubated patients with covid-19,” she said. To date, Phlow already has delivered to the government 1.6 million doses of antibiotics, sedatives, painkillers and blood pressure drugs, Edwards said. The U.S. imports annually more than $150 billion worth of biologics, human and animal drugs, and medical devices, the Food and Drug Administration said last year. Some experts were skeptical that Phlow’s relatively modest contract will mean much change. “This production has moved abroad for business reasons,” said Thomas Bollyky, director of the Council on Foreign Relations’ Global Health Program. “So it’s going to have to operate [in the U.S.] with a subsidy. The question is: how long are we willing to maintain that subsidy?” The contract can be extended to a 10-year total of $812 million, according to the Health and Human Services Department, which oversees BARDA. The agency’s former director, Rick Bright, recently filed a whistleblower complaint alleging he was dismissed from his job after resisting pressure from administration officials to stockpile the anti-malaria drug hydroxychloroquine, an unproven covid-19 treatment. Phlow is organized as a public benefit corporation, a for-profit venture that prioritizes positive social impact as one of its goals. Edwards is a veteran pharmaceutical executive who spent 18 years at Kaléo, a company that produced auto-injectible pens, including for emergency anti-allergy treatment. His tenure at that company, which he co-founded with his twin brother, was the subject of a Senate investigation. Between 2014 and 2017, at the height of the opioid crisis, Kaléo raised the price of a naloxone auto-injector, which reverses the effects of drug overdoses, from $575 to $4,100, according to a report by the Senate Homeland Security and Governmental Affairs’ permanent subcommittee on investigations. The increases cost taxpayers $142 million, the


Walmart’s Winning Ways Will Last After Lockdowns

at more than 3,000 stores helped it to navigate the spike in demand, as U.S. e-commerce sales soared by 74% in the first quarter. It wasn’t unalloyed good news. Despite the strong quarter, Walmart — like many other corporations — withdrew its full-year forecast made just three months ago. And the big-box retailer incurred an extra $900 million of costs, owing to enhanced wages and benefits for staff and increased safety and sanitation in stores. Fulfilling digital sales also entails higher expenses, as the retailer must do many of the things that the customer would have done in the past. As online demand rises, so do these costs, and this will be an ongoing challenge as sales migrate to the click or a mouse of tap of a smartphone. Meanwhile, in the early stages of the crisis, there was more demand for food, whose margins can be as thin as a slice of ham, as opposed to more profitable categories such as clothing. Consequently, Walmart’s U.S. operating profit didn’t increase as strongly as same-store sales in the quarter, and its gross profit margin narrowed by 1.1 percentage points. There are other challenges as well. Bulk buying of soup, pasta and hair dye is unlikely to be repeated, as consumers use up what they bought, particularly if they are managing their budgets, too. More frugal shoppers could play into Walmart’s everyday-low-price hands. But they may also be tempted to turn to other discounters, such as the European no-frills supermarkets Aldi and Lidl, which are expanding across the U.S. It was during the recession that these cheap chic grocers got a leg up in Europe and America. Walmart needs to keep its focus on the competitive pricing to stop hard-pressed customers defecting to them this time round, too. But even with these potential drawbacks, Walmart is one of the clear winners from the pandemic purchasing habits, alongside Amazon, which has been able to take advantage of consumers’ need for convenience and rivals’ reluctance or inability to deliver. Target Corp., which has also been investing in online and reports later this week, will likely show a similar boost in demand. It’s likely, for instance, that some of those who tried out food shopping via the internet during the pandemic will continue with this way of purchasing. Digital sales accounted for 4.8% of U.S. total grocery spending in 2019, according to GlobalData. This could


The Path Forward: Travel & Tourism

The dramatic spread of covid-19 has upended the hospitality industry. Hilton president and CEO Chris Nassetta will join Washington Post Live on Tuesday, May 19 at 1:00 p.m. ET to discuss how the coronavirus pandemic is affecting travel and tourism and how the industry is working to recover.


Navigating pandemic-era air travel: Here’s what it’s like to fly internationally right now

Paris, the other to London. That made gate announcements unnecessary. On the aircraft, everyone wore masks and every middle seat remained empty. No snacks, no drinks. And as in the waiting area, there was almost complete silence on the half-full flight. On any other Saturday, the international terminal at Paris Charles de Gaulle Airport would be controlled chaos. But when we arrived, it had been drained of passengers and sat like an empty monument to a forgotten war. I saw vacant gates, empty waiting areas, shuttered shops but almost no sign of human life. At passport control, the customs agent didn’t flinch at our overstayed visa. We found our Los Angeles flight at the far end of the terminal, with a few passengers milling around the gate. A flight attendant later told me that they expected 64 passengers on a Boeing 777-300 with a capacity of 296. Only 33 passengers checked in for Flight 66. It was an improvement, she said, from last week’s L.A. flight, where only 13 people boarded. Shortly after takeoff, the crew distributed health declaration forms that asked us where we’d been and whether we had any covid-19 symptoms. Air France takes social distancing seriously. Our section of the cabin had only three other passengers, all seated on the other side of the aircraft. The flight attendants appeared only occasionally on the almost 11-hour flight to offer a shrink-wrapped meal or snack and then disappeared behind the curtain. Otherwise, we were free to do what we wanted. We stood and walked around and practiced our yoga stretches and nobody cared. Keeping a face mask on for 11 hours isn’t easy. With no one else in the cabin, I saw other passengers reverting to “half mask” after a few hours, with the cloth covering only their mouth or chin. Breathing through a mask can be difficult, and with no cabin crew to enforce the mask rule, it was clear that for now, full mask usage, like seat belts, was meant for takeoff and landing. Air France disembarked the plane a few rows at a time to maintain social distancing. At the end of the boarding ramp, a customs agent wearing a clear plastic face shield checked our declarations and asked us how we were feeling. He didn’t perform a temperature check. Then he motioned for us to continue down the passageway, past several more uniformed agents. Based


Maryland to expand testing for asymptomatic people, another step toward lifting restrictions

Maryland Gov. Larry Hogan said Tuesday that people who have been exposed to the novel coronavirus but show no symptoms can get tested at state-run sites, an expansion that follows complaints from local leaders that a lack of testing has made it more difficult to ease shutdown restrictions. Although hospitalizations and deaths have mostly flattened across Maryland, Virginia and the District, dozens of fatalities are still reported each day, including the death over the weekend of a 15-year-old girl from Baltimore County. Sean Naron, a county government spokesman, said the girl was admitted to Johns Hopkins Hospital on May 11 and died there on Saturday from a multi-system inflammatory syndrome linked to covid-19. It is the same syndrome documented in New York and elsewhere, which has been described by medical professionals as a Kawasaki-like illness. “Any loss of life from this virus is tragic, but the loss of a child is devastating,” Baltimore County Executive Johnny Olszewski (D) said in a statement. “This is a stark reminder that this virus spares no one, and that we all must remain vigilant in our efforts to stay home, socially distance, and limit the spread of this deadly disease.” Virginia officials said Tuesday that a child in the Fairfax health district had the syndrome but was recovering. “The child was hospitalized on May 5 and has since been discharged and is recovering at home,” state health officials said in a news release. They declined to disclose additional information. The District, Maryland and Virginia on Tuesday announced 93 new covid-19 fatalities, the highest in five days after the usual weekend dip in reported deaths. Maryland reported 58 fatalities and 1,784 new cases — which is the highest single-day increase in confirmed infections since the pandemic started. The spike in cases coincides with more than 7,100 new test results received, which is also one of the highest one-day totals since Hogan (R) set a goal of testing 10,000 daily. Maryland now has 41,546 known cases and 2,081 deaths. Virginia disclosed 27 new deaths and 1,005 new cases, which are both higher than the seven-day average for new fatalities and positive test results. That brings the total to 1,041 deaths and 32,145 cases. The District reported eight new fatalities — all people older than 60 — bringing its death toll to 400. The city also disclosed 164 new cases of coronavirus, bringing the total number of


These restaurants are offering some of the best ice cream flavors in D.C.

For those looking for a taste of the boardwalk experience, a recent addition has been the tropical twist Italian ice, which blends coconut, pineapple and passion fruit. Update: On Tuesday, Emilie's announced that it would temporarily close after a staff member came into contact with someone who tested positive for covid-19. Check its website for reopening information. 1101 Pennsylvania Ave. SE. emiliesdc.com. Open daily for takeout and delivery. $7-$10 per pint. Chef Ris Lacoste’s namesake restaurant has been a West End stalwart, serving up seasonal American cuisine for years. And according to The Washington Post restaurant critic Tom Sietsema, the restaurant is thriving under takeout conditions, calling Lacoste a “restaurant Superwoman.” In a recent review, Sietsema highlights the offerings of “lunch for $15, fresh produce from the farmers market, cocktails, free delivery and comfort foods such as chicken pot pie to heat and serve at home.” One of the best ways to put a cherry on top of your meal is taking home one of Lacoste’s handmade ice creams and sorbets. The frozen treats tend to lean on fruits of the season, including passion fruit and pineapple flavors, but those looking for classics would be well served snagging a pint of the cinnamon ice cream — as supplies last. 2275 L St. NW. risdc.com. Open Monday through Friday for takeout and delivery. $8 per pint. Trummer’s had been a fine-dining getaway in charming Clifton for a decade, but it recently shifted to a more casual approach, with a menu designed to appeal to the whole family. While you can still carry out some kiddie portions for dinner, the restaurant throws it back a little with nightly three-course dinners for two. Sure, you can add a bottle of champagne or batched summer cocktails to your order, but if you’re lucky enough to grab it in time, turn your attention to pastry chef Meagan Tighe’s gelato selection. Some of the most delectable options include the Nutella swirl and salted caramel truffle flavors — the latter of which is inspired by the bonbons typically served at the end of a typical Trummer’s meal. And for anyone looking to make their own elevated sundae, Trummer’s offers a DIY kit that includes housemade whipped cream, warm chocolate ganache, chocolate pearls and cherries. 7134 Main St., Clifton. trummersrestaurant.com. Open Tuesdays through Sundays for takeout and delivery. $7.75-$8 per pint. DIY sundae kit is an additional $4.50.


15-year-old dies after testing positive as toll hits five-day high; Va. Supreme Court rejects gym owner’s appeal over order

The number of known coronavirus cases in the District, Maryland and Virginia was 81,125 on Tuesday, with 41,546 cases in Maryland, 32,145 in Virginia and 7,434 in the District. The number of virus-related deaths reached 2,081 in Maryland, 1,041 in Virginia and 400 in the District, for a total of 3,522 fatalities. Here are some of the most significant recent developments as the region responds to the pandemic of the novel coronavirus, which causes the disease covid-19: • The District, Maryland and Virginia announced 93 new covid-19 fatalities, the highest in five days. Maryland reported 58 covid-19 fatalities and 1,784 new cases — the highest single-day increase in infections. The spike coincides with more than 7,100 new test results received, one of the highest in one day since the governor set a goal of testing 10,000 people daily. • A 15-year-old in Maryland has died after testing positive for the coronavirus, officials said, marking the first pediatric death in Baltimore County associated with the pandemic. The teenager had “symptoms of an inflammatory syndrome associated with COVID-19 infection that has been documented in children in New York and other locations,” according to a statement from local officials. • The Virginia Supreme Court on Tuesday rejected an appeal by a gym owner who was seeking to reopen Gold’s Gyms that were shuttered by business restrictions prompted by the coronavirus. • D.C. Mayor Muriel E. Bowser said she spoke to President Trump on Tuesday and made the case for the District receiving the same covid-19 relief funding as the 50 states. As part of the federal coronavirus relief legislation, all states received at least $1.25 billion, but the District was treated as a territory and instead received nearly $500 million. When will D.C. reopen?


Lebanese prime minister: The coronavirus is pushing Lebanon toward a major food crisis

Second, Lebanon is going through an unprecedented economic and financial crisis that led the country to default on its foreign debt. The International Monetary Fund (IMF) forecasts a 12 percent decline in Lebanon’s gross domestic product this year. People are losing their jobs while our national currency is depreciating rapidly. The price of imported food has more than doubled since the start of the year. Third, the covid-19 crisis and the necessary lockdown have dramatically worsened the economic crisis and profoundly disrupted the food supply chain. Eighty percent of our wheat has been coming from Ukraine and Russia. Last month, Russia suspended wheat exports as a result of covid-19, while Ukraine is considering a similar move. My government is taking important steps to address this dramatic situation. We are expanding social safety nets to protect the most vulnerable members of our society, and we are doing our best to provide specific aid packages. We are cracking down on supermarkets and shops that are artificially inflating prices. We have recently adopted Lebanon’s first financial recovery plan and have reached out to the IMF for support — this is indispensable to stabilize our currency and put our economy back on its feet. Last but not least, we are working on a series of measures to improve Lebanon’s food sovereignty. Lebanon’s resources are extremely limited, and a purely domestic answer will not suffice. In addition, Lebanon is not alone in this situation. As a consequence of the pandemic, a global food security crisis is emerging. The World Food Programme estimates that the pandemic could double the number of people in low- and middle-income countries facing acute food shortages by the end of 2020. To respond to this emergency and avoid a major food security crisis, I call on the international community to design and implement a three-tier plan. First, attempts to restrict food exports, which some countries have already given in to, must be resisted. These only reduce availability and increase prices. The United States, the Group of 20 (G-20) and the World Trade Organization must step forward and endorse policies on export restrictions. It is self-defeating in a crisis that affects all countries to be building barriers. Second, I call on the United States, the G-20 and the World Food Programme to co-ordinate a food security policy response aimed at both low- and middle-income countries. Maintaining food supply and avoiding price inflation


the IMF for support — this is indispensable to stabilize our currency and put our economy back on its feet. Last but not least, we are working on a series of measures to improve Lebanon’s food sovereignty. Lebanon’s resources are extremely limited, and a purely domestic answer will not suffice. In addition, Lebanon is not alone in this situation. As a consequence of the pandemic, a global food security crisis is emerging. The World Food Programme estimates that the pandemic could double the number of people in low- and middle-income countries facing acute food shortages by the end of 2020. To respond to this emergency and avoid a major food security crisis, I call on the international community to design and implement a three-tier plan. First, attempts to restrict food exports, which some countries have already given in to, must be resisted. These only reduce availability and increase prices. The United States, the Group of 20 (G-20) and the World Trade Organization must step forward and endorse policies on export restrictions. It is self-defeating in a crisis that affects all countries to be building barriers. Second, I call on the United States, the G-20 and the World Food Programme to co-ordinate a food security policy response aimed at both low- and middle-income countries. Maintaining food supply and avoiding price inflation should be at the heart of this response. Finally, the United States and the European Union should establish a dedicated emergency fund to help the Middle East avoid a severe food crisis; otherwise, starvation may spark a new migration flow to Europe and further destabilize the region. Explicit warnings came recently from Arif Husain, the World Food Programme’s chief economist. Food security is becoming a global crisis requiring a coordinated global response. It would be a tragedy upon a tragedy if our efforts to beat the covid-19 epidemic eventually gave way to mass starvation and migration, the effects of which would be felt for generations. Read more: Kareem Chehayeb: Lebanon’s elites could save themselves — or save the country Dima Sadek: At last, Lebanon is rising up against the sectarian system that keeps us divided Kareem Chehayeb: Lebanon’s riots come as no surprise — even during a pandemic David Ignatius: Syria is lost. Let’s save Lebanon. Kareem Chehayeb: Lebanon’s protests and wildfires tell the same grim story Global Opinions: Lebanon’s protests are full of hope and joy — for now


Covid-19 has been brutal in Indian country — just like past epidemics were

The novel coronavirus is terrorizing Indian country. The Indian Health Service (IHS) reports 7,244 confirmed cases of covid-19. Since March the Navajo Nation, with homelands stretching over Arizona, New Mexico and Utah, has emerged as a hot spot. The virus has taken the lives of 142 Navajos and the covid-19 infection rate is at 2,304.41 per 100,000 people, giving the Navajo Nation a higher per capita infection rate than both New York and New Jersey. The situation has spurred Doctors Without Borders to send a team to Navajo Nation, a signal of the magnitude of the disaster. The coronavirus is the latest epidemiological invasion in a long history of unwelcome foreign pathogens for indigenous people of the Americas. Since Columbus reached the Americas for the first time in 1492, foreign diseases have reshaped native communities. According to one recent study, the Americas were home to 60 million people before European colonization, only fractionally less than Europe’s population in the 1600s. Yet, between 70 and 90 percent of Native American populations were killed by diseases brought from overseas, like mumps and smallpox, between 1492 and the opening decades of the 20th century. This data makes for grim reading. But such high death tolls were due not only to diseases themselves. Europeans brought viruses like smallpox, but their presence also led to deaths of indigenous people due to cholera and typhus. These ailments arose from transatlantic commerce, for example from the lice, ticks or fleas brought on trading and slave ships, and from contaminated drinking water that resulted from polluted waterways due to European settlements. In short, European colonialism changed local ecosystems at unprecedented speeds, accelerating the effects of climate change and disrupting the ability of indigenous healers to treat the sick. These same vulnerabilities continue to exist today, showing why covid-19 is so deadly in Indian country as indigenous people once again fight disease amid today’s climate change crisis. Before Columbus’s invasion of the Americas, indigenous people grappled with an extended period of warming, which scientists call the medieval warm period. Between 900 and 1300, some regions of the Americas experienced higher temperatures and drought, leading to crop failures, hunger and displacement. Other regions, such as Southeastern North America, experienced warmer, wetter conditions and improved crop yields of corn and other staples. While the people of this region fared well during this period, they contended with illness and disease. Native people


Yes, we miss professional sports. But it’s the amateur athletes who are suffering.

that inspires us in our own respective realms. But, keeping the original spirit of modern sports in mind, the joy of movement and play among the masses crucial to our society’s collective physical and mental health, it’s the amateurs who are also suffering hardship through this virus era. The high school soccer player who will never get her senior spring season back. She not only missed her final precious time to play with her teammates, perhaps the highlight of her secondary schooling, but she also hasn’t had a chance to work out in front of college scholarship recruiters. The 50-year-old basketball player who hadn’t missed a Sunday morning with his buddies for decades. That Sunday morning was fundamental to his happiness, and depression has set in without it. The woman who finally obtained paid leave to fulfill her lifelong dream of swimming the English Channel. Most beaches have been closed, along with pools. She has missed the crucial stretch of training for a summer attempt. The seniors for whom pickleball is the new rage sport. They are feeling low, their courts closed, not able to replace the game that helps them recapture the vitality of their youthful athlete selves. Even through the thickest of our isolation periods, we have been able to stay in shape. After all, a small space with no equipment whatsoever is all one needs to do some jumping jacks and hold a plank for a few minutes. But gymnasts can’t substitute time on their balance beams by doing hundreds of sit-ups. Swimmers can’t replicate the form needed to power across the surface with a dry-land simulation of the freestyle stroke. Team players can’t hone timing and unspoken synergy by doing solo footwork drills in the backyard. We athletes of course realize our sacrifices don’t deserve mention at the same time people are suffering, people are dying, health-care workers are taking chances on compromising their own well-being on our behalf. Many individuals have not been allowed time at the side of loved ones who perished, not allowed to host a proper burial. Unspeakable loss has come during these extraordinary times. We also respect the perspective that we’re no more special than college students missing their graduations or marginalized students without computers missing the entire end of their school year. But we athletes have come to live out loud a set of values. We hold high the discipline


The Health 202: Some social distancing policies worked better than others to stem covid-19

a week or two before the statewide lockdowns — parents simply took their kids to playgrounds and other social gathering spots. The question of school closures is one that needs much more study,Yelowitz believes, as policymakers seek better information about how kids can spread the virus and what that means for the fall semester. Yelowitz also believes the bans on mass gatherings didn’t result in reduced social interactions because people could have gone to restaurants or bars instead of attending sports games or concerts. And it provides some reassurance that at least the lockdowns worked, even as they gutted economic activity. Hospitals were equipped to handle seriously ill patients, despite dire initial predictions that the U.S, health-care system would be overwhelmed. Some hospitals even spent considerable resources preparing for an onslaught that never materialized, the Wall Street Journal’s Jim Carlton reports. Now politicians — and Americans — seem to have reached their maximum tolerance for staying at home. Governors across the political map are moving full speed ahead on reopening. As of today, all 50 states have started lifting their shutdowns, despite widely varying trends in their number of cases, deaths and tests performed. Connecticut, one of the final states to ease its shutdown, is allowing restaurants to offer outdoor seating, retail stores to let customers inside, and outdoor museums and zoos to resume operations, my colleague Marisa Iati reports. Hair salons and barbershops were also slated to start reopening today until Gov. Ned Lamont (D) pushed back the date to June 1. Even in New York, the hardest-hit state in the nation, upstate areas are starting to resume activity. Yesterday Gov. Andrew Cuomo (D) said the state’s outbreak has slowed to levels similar to when it began there. On Monday, 105 people died of the virus in the state — a figure comparable to daily deaths at the end of March. “We’re basically back to where we started before this tragedy descended upon us,” Cuomo said at a news conference. The guidance on reopening schools, childcare facilities, restaurants and mass transit was released after weeks of delay and an internal debate over whether the details were too strict, Laura Meckler and Rachel Weiner report. The White House had initially shelved the guidelines, saying they were “overly specific.” It says schools, for example, must place desks six feet apart, stagger student arrivals and require daily temperature screenings, among other guidelines.


“The guidelines arrive amid mixed messages from authorities over how and how quickly to reopen the life of the nation,” Laura and Rachel write. “… Inside the administration, the most contentious element of the CDC document was guidance over houses of worship, and the posted document eliminates that section. An administration official, speaking on the condition of anonymity because he was not authorized to discuss the matter, said additional guidance on religious gatherings may be coming.” The biotech company announced this week, to much fanfare, that it was seeing promising early results from its first human safety tests. “Several vaccine experts asked by STAT concluded that, based on the information made available by the Cambridge, Mass.-based company, there’s really no way to know how impressive — or not — the vaccine may be,” Stat News’s Helen Branswell reports. “While Moderna blitzed the media, it revealed very little information — and most of what it did disclose were words, not data. That’s important: If you ask scientists to read a journal article, they will scour data tables, not corporate statements. With science, numbers speak much louder than words.” “Even the figures the company did release don’t mean much on their own, because critical information — effectively the key to interpreting them — was withheld,” Helen adds. In an “The Moderna announcement described a safety trial of its vaccine based on eight healthy participants. The claim was that in all eight people, the vaccine raised the levels of neutralizing antibodies equivalent to those found in convalescent serum of those who recovered from covid-19,” wrote William Haseltine, founder of Harvard’s cancer and HIV/AIDS research departments. “What to make of that claim? Hard to say, because we have no sense of what those levels were. This is the equivalent of a chief executive of a public company announcing a favorable earnings report without supplying supporting financial data, which the Securities and Exchange Commission would never allow.” That’s according to a new sweeping study published yesterday in the Lancet. Its findings are “broadly consistent with clinical findings from China and Europe, and confirmed that advanced age is the greatest risk factor for a severe outcome, particularly if accompanied by chronic underlying diseases, such as hypertension, diabetes, heart disease and obesity,” Joel Achenbach and Ariana Eunjung Cha report. The research looked at 257 critically ill adults admitted at two hospitals in northern Manhattan from March 2


Presence of women in military has grown only slightly in recent years, study finds

The share of female troops in the U.S. military increased only slightly over 14 years, consistently representing less than a fifth of service members, and women remain more likely to leave the military than male troops, a government watchdog report shows. Women cited an array of challenges in deciding to end military careers at higher rates than men, including sexual assault and difficulty reconciling pregnancies and parenthood with career advancement, according to the study by the nonpartisan Government Accountability Office. The GAO’s analysis The report comes as the Pentagon seeks to modernize its force and reorient toward China after two decades of counterinsurgent operations. In recent years, the military has sought to prepare for high-tech conflicts by buying sophisticated weaponry and growing its digital capability as the Trump administration has promoted increased defense spending. But the GAO found that the military has failed over multiple administrations to adequately plan for and track the integration of women across the force, including into ground combat roles. More recently, the department — whose senior leaders remain predominantly male — has not established clear plans and metrics to ensure it can create a more diverse force, the watchdog found. In fiscal 2018, women represented 16.5 percent of the active-duty force, compared with 15.1 percent in fiscal 2004, making up a small share of the more than 1 million active-duty troops. In the most recent year examined, the Air Force and Navy had the highest number of female personnel, both around 20 percent, while the Marine Corps had the lowest, at less than 9 percent, the GAO said. “Without DOD guidance and service plans with goals, performance measures, and timeframes to monitor female recruitment and retention efforts, DOD may continue to miss opportunities to recruit and retain a valuable segment for its active-duty force,” the report stated. While the GAO found that the gap between the rate of male and female departures from the military has narrowed, women continue to leave at higher annual rates than men. Losing troops trained at great cost represents a persistent challenge for the military. In fiscal 2004, the attrition rate for men was 22.7 percent and 33.1 percent for women. In fiscal 2018, it was 6.1 percent for men and 8.6 percent for women. A statistical model based on historical data compiled by the GAO, meanwhile, showed that women are 28 percent more likely to leave the force than


The Daily 202: Temporary emissions decline during coronavirus slowdown spotlights challenge of hitting U.N. targets

in their daily lives, too. … Gem Manalo, a Mass General anesthesiology resident who is of Chinese and Filipino descent, was riding the ‘T’ … in early March when she said a man starting yelling: ‘F--- China! F--- the Chinese!’ … ‘He kept saying things like: ‘You people eat bats!’ … Manalo said. ‘Here I am in the hospital, working in all these makeshift ICUs,’ Manalo said. ‘We’re all at a loss, too, trying to come up with new protocols to keep everybody safe, and this guy is telling me that I am terrible.’” A 24-hour online vigil will be held starting this evening to mourn the loss of the fallen. The names of victims will be read aloud by loved ones and those who live in heavily impacted areas. Here are a few of those who have succumbed: “Amid these concerns about the risk of increased activity, every governor in the country has issued new guidelines removing bans on businesses and public gatherings to various degrees. One governor in particular, Alaska’s Mike Dunleavy, said he would reopen his state entirely before Memorial Day weekend,” Teo Armus reports. “Just four other states — North Dakota, South Dakota, Missouri and Wyoming — appear to have similarly lenient orders in place, according to an analysis by The Post, though all will remain in their reopening process through Memorial Day.” “The District, Maryland and Virginia announced 93 new covid-19 fatalities, the highest in five days. Maryland reported 58 covid-19 fatalities and 1,784 new cases — the highest single-day increase in infections. The spike coincides with more than 7,100 new test results received, one of the highest in one day since the governor set a goal of testing 10,000 people daily,” Justin Jouvenal and Dana Hedpgeth report. A three-judge panel upheld the ruling of a district judge who determined that the cancellation of the vote violated the constitutional rights of Andrew Yang and Bernie Sanders, whose names will appear on the ballot. (Shayna Jacobs and John Wagner) “Programmed with content for kindergarten through high school, it provides each grade one hour of curriculum per day, so students have to watch in shifts. Now, for millions of Pakistani schoolchildren, that single channel is their only access to education. And even that channel isn’t available to everyone,” Susannah George reports. “Pakistan already struggles to keep millions of children in school, and as partial shutdowns continue, educators


How Iranian hackers tried to phish me

increasingly active last year, targeting academic institutions, human rights organizations, and the media. During the 2018 attack — which came just as Trump reimposed a second round of punitive sanctions against Iran — Charming Kitten targeted more than a dozen U.S. Treasury officials. Other targets included Iranian civil society activists, think tank employees in Washington, and proponents of the nuclear deal as well as Iran hawks. Between August and September of last year, Charming Kitten unsuccessfully attacked Trump’s 2020 reelection campaign. Then, in November, the group impersonated New York Times journalist Farnaz Fassihi (but in her previous role as a Wall Street Journal reporter) to compromise academics and researchers working on Iran. ClearSky found that the hackers also assumed the guise of journalists at other outlets, including CNN and Germany’s Deutsche Welle. In February, the group used the identities of State Department officials to phish Baha’i researchers. Charming Kitten’s latest attacks seem to share a common theme: the coronavirus. Iran has the highest number of coronavirus cases and deaths in the Middle East, which may explain why the group attacked covid-19 drugmaker Gilead and even the World Health Organization by impersonating journalists. It seems the hackers were trying to gather information that could help combat the coronavirus. While experts describe Charming Kitten as a low-level group in the hierarchy of Iranian cyber espionage, the recent volume of attacks — those we know of — is troubling. Though Iran has not stated its intentions, and denies engaging in what it calls “cyber warfare,” this latest activity appears to focus on individuals in the Washington think tank community who follow Iran issues closely. People like me are involved in the public debate about the current and future of U.S. policy on Iran, so groups such as Charming Kitten could be seeking insights through these phishing attacks, often using the urgency of the coronavirus issue as bait for unsuspecting victims. My experience shows that there is a genuine cyber threat to U.S. institutions. Even amid the covid-19 pandemic, Iran is planning for the future. Allied defenses must be equal to the task. Read Amir Hossein Mahdavi: The covid-19 crisis could strengthen Iran’s ‘invisible government’ Jason Rezaian: One thing the virus hasn’t changed: Iran and the U.S. still hate each other Nazanin Boniadi: Why Iran’s coronavirus pandemic is also a crisis of human rights Jason Rezaian: Iran’s latest coronavirus gamble could be its deadliest


These 6 countries are cautiously reopening for summer travel

officials are accounting for social distancing with a system allowing beachgoers to book appointments on the sand via mobile app. The beach will be divided into a grid of socially distanced sites, with staggered arrival times and the option to choose either a morning or afternoon slot (but not both). In all, the restrictions will allow for a maximum of 5,000 people per day, about half of the beach’s normal capacity. “This summer will be very different,” Canet d’en Berenguer Mayor Pere Joan Antoni Chordá told CNN. “There’ll be more space between your neighbor. Like a ‘business-class’ beach.” When Iceland reopens its borders June 15, it will require all visitors to either take a covid-19 test, agree to a two-week quarantine or present official documentation of a recent negative test. Regardless of which option they choose, tourists will have to download a contact-tracing app. Iceland has tested more than 13 percent of its population, higher than any other country in the world. “Iceland’s strategy of large-scale testing, tracing and isolating have proven effective so far,” tourism minister Thordis Kolbrun Reykfjord Gylfadottir said in a statement. Indeed it has: Iceland has reported just 10 coronavirus-related deaths since the pandemic began. Greece will open to tourists a bit later, starting July 1, but the nation’s usual packed nightlife scene probably won’t be a part of it. Solo or socially distanced small-group activities, such as kayaking and boating, will be encouraged instead. “The tourism experience this summer may be slightly different from what you’ve had in previous years,” Prime Minister Kyriakos Mitsotakis told CNN. “Maybe no bars may be open, or no tight crowds, but you can still get a fantastic experience in Greece — provided that the global epidemic is on a downward path.” Every international traveler to Greece will have to enter through Athens and submit to a health screening, which includes a rapid covid-19 test. Beaches across Mexico will open to tourists starting in June, with multiple phases of reopening continuing through July and August. Los Cabos, the tip of the Baja California peninsula that includes popular spring break destination Cabo San Lucas, will allow for limited travel beginning June 1, as health screenings and enhanced sanitation measures ramp up to accommodate more tourists late into the summer. The Los Cabos tourism board said it will look to open many of the area’s hotels and, eventually, the international terminal at


encouraged instead. “The tourism experience this summer may be slightly different from what you’ve had in previous years,” Prime Minister Kyriakos Mitsotakis told CNN. “Maybe no bars may be open, or no tight crowds, but you can still get a fantastic experience in Greece — provided that the global epidemic is on a downward path.” Every international traveler to Greece will have to enter through Athens and submit to a health screening, which includes a rapid covid-19 test. Beaches across Mexico will open to tourists starting in June, with multiple phases of reopening continuing through July and August. Los Cabos, the tip of the Baja California peninsula that includes popular spring break destination Cabo San Lucas, will allow for limited travel beginning June 1, as health screenings and enhanced sanitation measures ramp up to accommodate more tourists late into the summer. The Los Cabos tourism board said it will look to open many of the area’s hotels and, eventually, the international terminal at its airport, provided the new safety protocols are effective in preventing the spread of the virus. Cancun and Riviera Maya will also reopen in phases in anticipation of interest from Americans, despite the U.S. State Department’s ongoing “Level 4: Do Not Travel” advisory. “For those looking further to international destinations, the overarching theme [in online searches] seems to be relaxation and beach time, with Mexico and the Caribbean dominating the list,” an Expedia spokeswoman told Travel + Leisure. On the other side of the world, Australia and New Zealand are experimenting with the idea of a “travel bubble” that would allow tourists to travel freely between the countries, which have both had relatively few deaths. The bubble, however, would apply only to residents of the two countries, “Our number one focus at the moment is making sure that both our countries are in the position where we’re domestically managing covid-19 to a point where we can with confidence open borders,” New Zealand Prime Minister Jacinda Ardern said at a recent news conference. For now, international tourists will have to wait. But if you want to buy your plane tickets to Sydney way ahead of time, you may never find a better rate. Read more: Your quarantine experience, reviewed like a hotel Airlines have instructed flight crews to not let masks lead to in-flight disruptions Meet the people who can’t wait to get back on a cruise ship


Prince George’s County Health Department employee dies of covid-19

When Chantee Mack was growing up, she and her older brother loved accompanying their mother to work as a clinical technician at Georgetown University Hospital. Aric Mack, 48, said he knew since those early days that his little sister would work in health care. She loved watching medical documentaries to prepare for the career she knew she wanted, said her younger brother Roland Mack, 38. Shortly after graduating from the University of Maryland at College Park, she went to work at the health department in Prince George’s County, where she had grown up. It was at work that her family believes she contracted covid-19. She died May 11 at Adventist HealthCare White Oak Medical Center. She was 44. “It was the first and only job she had,” said Aric Mack, who flew with his wife from Texas to see his sister in the hospital. His sister had been admitted April 14 because she was struggling to breathe. “I have no idea why they were still going to work,” Aric Mack said. Chantee Mack, who lived in Laurel, worked in the health department’s sexually transmitted disease clinic, informing people of their test results. Roland Mack said it was work that should have been done remotely once the pandemic started. Prince George’s County Health Officer Ernest L. Carter announced the death of an employee in the health department at a news conference Thursday but did not name Chantee Mack. “She was an excellent employee — she stepped up to the plate,” he said, appearing choked up. Mack was one of more than 100 clinical staff who the county “deemed essential to assist with the county’s unprecedented efforts in March to scale up our response to COVID-19, which included standing up our community screening and testing operations and other critical functions,” Carter later said in a statement. “She was a dedicated public health professional who made a difference in the health and well-being of Prince Georgians,” he said. Chantee Mack’s family remembered her as smart and caring. She was quiet but strong, Aric Mack said. She loved the Washington Redskins, watching tennis and going to the movies with her younger brother. She was passionate about helping others, said her sister-in-law, Renee Mack, who is a nurse. She said Chantee Mack told her a few months ago that she was interested in training to be a nurse. Growing up, she was like a second


Withdrawing from the WHO would hurt global security — and global respect for the U.S.

On Monday, President Trump issued a 30-day warning to the World Health Organization: Shape up or lose U.S. funding. In a May 18 letter to the WHO, Trump argued the organization “has been curiously insistent on praising China,” and failed to alert the world about the covid-19 danger in a timely manner. Both Bill and Melinda Gates criticized Trump’s announcement last month about freezing U.S. funding to the WHO — and in recent weeks, Bill Gates encouraged more than 200 billionaires who have signed onto Gates’s Giving Pledge to coordinate their efforts on the covid-19 response. Global health policy faces two challenges — a possible U.S. withdrawal from the WHO, and a likely increase in the need for philanthropy as the United States pulls back. Here’s what those changes are likely to mean. WHO funding is one example of how the U.S. provides “global public goods” as part of its leadership. In the U.S., global health security traditionally has been a bipartisan priority. Here’s an example: the U.S. partnership with the WHO on the Global Health Security Agenda expands the reach of U.S. foreign policy. The U.S. allocates only 5 percent of its global health budget to health security, but leverages this investment through the broader WHO effort. Beyond preventing the spread of disease, this has important security implications — inadequate health care elsewhere in the world makes countries vulnerable to instability and violence, particularly in the event of outbreaks. To understand the consequences of the U.S. threat to withdraw funding, I drew on a recent TRIP Snap Poll conducted between April 27 and May 4, capturing attitudes and opinions of more than 900 U.S. international relations experts. Over 90 percent of TRIP survey respondents anticipate foreign leaders would view the U.S. as either “less likely” or “much less likely” to provide global public goods after the covid-19 pandemic. In addition, respondents expect sharp declines in global perceptions of the U.S. as a “state that honors its international commitments” and a “state that is widely respected in the international system.” These views may reflect dismay at Trump’s attacks on the WHO, alongside restrictions the U.S. government has placed on its foreign aid to prevent other countries from buying up needed personal protective equipment for health-care workers. And freezing WHO funding would curtail the global response to a pandemic that has not yet peaked in many African countries and other areas


If MLB returns, the players’ health will be at stake. That should be worth something.

he said is accurate: The players will be at risk, and they have agreed to a pay cut. How much the players would be paid if they agreed to a revenue split is impossible to know, but there is also an important issue involved here. The 1994 strike happened because the owners attempted to unilaterally impose a salary cap. Baseball is the only major sport without a salary cap, although the Competitive Balance Tax — better known as a luxury tax — has curbed spending by big-money teams somewhat. Tony Clark, executive director of the MLB Players Association, has said the union won’t agree to revenue-splitting even for one season because the precedent could be dangerous. There is also the question of renegotiating a deal that had been agreed to in March. Baseball has had labor peace for the past 25 years in large part because leadership on both sides understands how right Vincent was about the damage done by the 1994 walkout: a lost World Series, the specter of replacement players, the fans’ disgust with both sides. If baseball can’t have a season because the logistics turn out to be impossible, everyone will understand. But if money is the issue a year after MLB reported record revenue of $10.7 billion, there is going to be a lot of anger. As is almost always the case when there is a work stoppage in sports, the players will get the brunt of the criticism. They are more visible, and the average fan finds their salaries stunning. But here’s a fact: The owners are far more wealthy and don’t have a limited earning window. What’s more, as Snell pointed out, albeit less than eloquently, the owners won’t be putting their health at risk and won’t have to live in some form of quarantine. It’s always easy to blame the “greedy millionaires.” But more often than not, the “greedy billionaires” are most at fault. That was the case in 1994. That’s the case now. Read more baseball coverage: Barry Svrluga: Baseball is a dream job, but it’s still a job with a workforce that needs protection Thomas Boswell: Ignore baseball’s labor squabbles. For once, the money isn’t what really matters. Less than 1 percent of MLB employees tested positive for covid-19 antibodies MLB will reportedly shorten 2020 draft to five rounds Analysis: Yankees would be biggest winners of MLB’s radical realignment, short-season proposal


From parking to concessions, here are the safety protocols you’ll see in Washington-area airports

Before the pandemic, most travelers paid little attention to the business operations of an airport. Your gate number and its proximity to the wine bar probably mattered more than who wipes down the security checkpoint bins or disinfects the parking lot shuttle buses. However, the coronavirus has created a heightened awareness of protective protocols, with travelers wondering who is responsible for implementing measures that will stymie the spread. In anticipation of our return to the skies, we reached out to the three Washington-area airports to better understand how the different agencies and entities are keeping the traveling public safe. For updates, check the websites of the airports and airlines. Reagan National The MWAA oversees these areas at Dulles and National and is adhering to the guidelines issued by several federal and state agencies including the Centers for Disease Control and Prevention and the Virginia Department of Health. The airports are paying extra attention to such high-touch areas as handrails, escalators, elevator buttons and restroom doors. Signage in public spaces, such as the baggage claim area, shares hygienic tips advocated by the CDC. The terminals are open only to ticketed passengers, airport employees and visitors meeting arriving passengers. BWI has also restricted access to its terminal to ticketed passengers and airport staff. Since the outbreak, the cleaning crew has doubled down on handrails, elevator buttons and other oft-handled surfaces. Top Dog Services, a contractor based in Montgomery County, is using electrostatic cleaning in the terminal. MarketPlace Development, which runs the food and retail shops at the Virginia airports, has closed many of its businesses during the pandemic. Passengers can choose among 11 dining and convenience stores at National and 18 establishments at Dulles. (The numbers can change by day or per demand.) No full-service dining options are currently available, only grab-and-go at the news stands and takeout at the restaurants. Sidney Woods, senior director of marketing at MarketPlace, said the concessions are following CDC guidelines. For instance, all employees wear masks. The company has also installed signs and markers to encourage social distancing and switched to contact-less payment methods, such as self-checkout. At BWI, the individual food and retail vendors are responsible for cleaning their areas. Many have temporarily closed or reduced their hours and altered their dining experience to takeout (Silver Diner) or limited menus (McDonald’s). Floor markers help customers stay six feet apart. The airport’s concessions developer, Fraport Maryland,


The Finance 202: Powell, Mnuchin split on next steps for economic recovery

scientists to read a journal article, they will scour data tables, not corporate statements. With science, numbers speak much louder than words. Even the figures the company did release don’t mean much on their own, because critical information — effectively the key to interpreting them — was withheld.” But what that means varies widely: The IRS is finding out that reopening can be challenging. The agency's struggles may foretell what's ahead for rest of the federal government: “The tax behemoth that touches virtually every American has made the government’s most aggressive effort so far to recall its workforce … Even before the recent covid-19 infections, few employees felt secure enough to go back. As of Monday, about 3,000 customer-service and clerical workers had volunteered to return to the office, an absentee rate of almost 75 percent.” Kevin Mayer's jump to TikTok complicates things for the media giant: “Still, the streaming platform faces speed bumps. The shutdown of most television and movie production has hampered plans to increase its original content, and new rivals, including AT&T Inc.’s HBO Max and Comcast Corp.’s Peacock, are coming on the scene. After more than two decades climbing the ranks at Disney, Mayer is leaving his role as head of direct-to-consumer and international operations to become chief executive of short-video app TikTok, owned by Chinese tech giant Bytedance Ltd.” Facebook to launch new shopping feature: “The move to build up e-commerce offerings follows Facebook’s launch last year of limited shopping options on photo-sharing app Instagram and messaging app WhatsApp. Company leaders wager making the platforms more business-friendly will generate fresh ad revenue, even as user growth slows. Facebook Shops will tie at least some of those efforts together, enabling businesses to set up a single online store accessible via both Facebook and Instagram.” Santander settles predatory auto-lending claims for $550 million: The banking regulator just finished a controversial overhaul of Community Reinvestment Act rules “Mr. Otting, a former bank CEO, told Senate lawmakers last week that he sought to accelerate completion of the change amid the coronavirus pandemic… The overhaul more precisely defines the types of lending and other investment in low-income communities that banks would be credited for under the law. A bad evaluation can restrict banks from merging or opening new branches.” From Gregg Gelzinis, a senior policy analyst at the Center for American Progress: Today: Thursday: Friday: From The Post's Ann Telnaes:


The pandemic shows that Putin is not a strong leader

especially outside of Moscow. Covid-19 is now exposing these lapses in state-building. Putin also personally has not stepped forward during this crisis. He has been absent for days at a time, deferring to governors to make their own decisions. He has seemed disengaged and sometimes even uninterested in leading his government’s response to the pandemic. Moreover, Russia’s minister of culture and minister of housing have both tested positive, while Putin’s press secretary, Dmitry Peskov, and Prime Minister Mikhail Mishustin have even been hospitalized. That doesn’t look like strength. Russians are noticing. It’s hard to conduct accurate polling in autocracies (especially when most of the polling firms are loyal to the regime and most know the tremendous intelligence capabilities of the Russian regime for tapping phones). Yet, even under these conditions, polls show that Putin’s approval rating has fallen to its lowest level — 59 percent in April 2020 — since he rose to power in 1999. The same month, only 27 percent of Russians said they trusted Putin to solve important issues. Fissures between federal and local officials — especially between the Moscow mayor and the federal government — are starting to show, as well as divides between the Kremlin’s technocrats and more ideological statists from Putin’s past and present circle of intelligence officer friends. Not all democracies have performed well against the coronavirus. South Korea, Taiwan, New Zealand and Germany have done much better than Italy, France, Britain, Brazil or the United States. But democracies have a built-in mechanism for allowing citizens to express their preferences about state performance. In the United States, voters in November will have the opportunity to evaluate Trump’s performance (provided, that is, we put in place the necessary conditions to conduct a healthy, free and fair election — a challenging metric of American state capacity). Autocracies do not. Covid-19 has exposed the myth of Russia as a strong state and Putin as a strong leader. Without free and fair elections to allow peaceful, orderly expression of citizen attitudes about Russia’s ineffective response to the virus, only two other options are available — regime change or greater repression. While neglecting hospitals, roads, and schools, Putin has increased the state’s capacity in one area: control through coercion. Tragically, therefore, that option is most likely. Read more The Post’s View: The pandemic’s big political losers Michael Carpenter: Putin has just made two huge mistakes — and his


Hawaii isn’t messing around when it comes to enforcing tourist quarantines

the Attorney General, and county police departments were making other arrests. At least 14 tourists have been arrested by authorities in Kauai, Hawaii and Maui counties. “We continue to understand that enforcement is very important for both residents and travelers, and we continue to work with the counties to improve both the screening process as well as the enforcement process,” Ige said in a news conference Monday. “Because we know that the quarantine can only be successful if the general public believes that there is enforcement and that anyone breaking quarantine would be subject to a fine or arrest.” A nonprofit that typically comes the aid of tourists in trouble, the Visitor Aloha Society of Hawaii, has been working since early April to return tourists home immediately — in some cases, buying plane tickets with grant money from the Hawaii Tourism Authority — if they arrive at the airport without a hotel reservation for the quarantine period and without money to buy a return ticket. For those who do have resources but don’t want to quarantine, the organization will work with the airline to change their ticket to return home right away. President and chief executive Jessica Lani Rich said the group has sent 53 people back home so far. “We want people to come to Hawaii when we’re open for business again,” she said. Amir Eylon, chief executive of tourism-focused consultancy Longwoods International, said in an email that governments in destinations that depend on tourists, such as Hawaii, New Zealand and Puerto Rico, have been forced to make difficult decisions curbing visitors to protect their residents. “While these acts by island destinations like Hawaii may seem to be anti-tourism, if they can avoid becoming a ‘hot zone’ for the pandemic and keep the incidence level low or even eliminate it, this may actually help their image as a safe destination for when the majority of states and other feeder markets ease restrictions on nonessential travel,” Eylon said. “Once folks begin traveling for leisure again, and start looking at long-haul destinations again, those that were successful in containing the coronavirus may very well be sought after more initially than those that struggled with the illness.” Read more: 10 questions about visiting the beach during the pandemic, answered More people are flying again. Here’s what to expect at airports and on planes. These 6 countries are cautiously reopening for summer travel


Saudi Arabia, other gulf states reimpose strict measures after coronavirus cases spike during Ramadan

BEIRUT — Saudi Arabia and other Persian Gulf Arab countries are seeing a sharp spike in coronavirus cases, prompting governments to reimpose some restrictions that had been lifted late last month ahead of the holy fasting month of Ramadan. Saudi Arabia, the largest Arab gulf country, had recorded about 15,000 cases when Ramadan began. But in less than a month, the kingdom’s numbers quadrupled, with nearly 60,000 confirmed cases as of Wednesday, making it the Arab world’s new hotbed of infection. In response, the kingdom has announced it will enforce a nationwide 24-hour curfew starting Saturday and continuing into next week during the Eid al-Fitr festival, which marks the end of Ramadan. Kuwait has experienced an even sharper increase in cases, the most dramatic in its neighborhood, with confirmed infections up nearly sevenfold since the first day of Ramadan to 16,800 on Tuesday. Kuwait announced plans earlier this month to reimpose a complete lockdown from May 10 until May 30 in response to the spike. Walking for exercise is permitted for two hours every evening, but driving cars is not. In Qatar, where case numbers have quadrupled to 37,000, the government decreed new restrictions Monday. It announced the closure of nonessential stores for 10 days and required that all citizens and residents download a cellphone tracking app to monitor those who come into contact with people who test positive for the novel coronavirus. Noncompliance can be punished with three years in jail and a fine of up to $55,000. The three other gulf Arab countries — the United Arab Emirates, Oman and Bahrain — had also eased restrictions at the onset of Ramadan, an especially social month when pious and impious alike make social calls and hold dinner parties. All those countries have now seen their numbers of infections surge. Public health officials say many of the new cases are in the large communities of foreign workers, who represent a major part of the labor force in these six countries. After Saudi Arabia recorded its first coronavirus case on March 2, the public health response was swift. The deeply religious kingdom barred Muslims from conducting daily prayers inside mosques, and pilgrimages to the holy sites of Mecca and Medina were halted. International flights were suspended, most major cities were placed under 24-hour lockdowns, most public places were closed, and curfews were put in place. In the third week of April,


Major nursing home chain violated federal standards meant to stop spread of disease even after start of covid-19, records show

homes, as well as the state of Michigan and Life Care, though the universe of total inspections may be larger. In 16 inspections, regulators found no deficiencies. The Tennessee-based Life Care has said that no amount of preparation could have kept the virus at bay and that administrators worked early and often with health authorities to contain the spread of infection. Since the outbreak in Kirkland, the privately owned company with more than 200 nursing homes has seen at least 2,000 cases and 250 deaths among residents and staff, according to a Post tally of state data and local media accounts. Five Life Care nursing homes have experienced outbreaks of 100 or more cases. There is no comprehensive national data available to determine whether the rate of infections and deaths at Life Care facilities is higher than at other chains — or how often other chains have been cited for violations after the pandemic began. Nursing homes across the country have been hit particularly hard: About 1 in 4 have reported at least one case of the coronavirus, according to a Post analysis. Around the country, even nursing homes with strong track records have publicly reported cases of covid-19, which is particularly lethal among the elderly. “We have a virus that has attacked our vulnerable populations who have co-morbidities, and that has made this extremely difficult to manage,” said Tim Killian, public information liaison for Life Care Centers of America. “We need help. We need hands on the ground. We need money. We need equipment. We need doctors. And none of that is happening in a significant way anywhere in the country.” Killian declined to comment on the specifics of the most recent inspections. Two of the reports obtained by The Post included Life Care’s responses to inspectors, with the homes noting that staff had received additional training and would be monitored for compliance. “Choosing a handful of reports, especially during this time of great difficulty, has allowed the press to paint a picture of our company that does not accurately reflect our values or the hard work we do every day to take care of our residents and staff,” Killian said. Life Care President Beecher Hunter said the homes submit plans of correction to the government. “Life Care Centers of America and its affiliated facilities are not perfect; no organization is because it is made up of people, and


‘Express burials’ raise fears that Nicaragua is hiding a coronavirus tragedy

only 25 cases and eight deaths. Health officials give far higher estimates. And the speedy burials are hardly the norm for victims of common respiratory illnesses. Often, they are carried out at night by white-suited medical personnel, with police or members of pro-government paramilitary groups watching nearby. They come as signs of the outbreak are multiplying. Sixty-seven doctors or other health-care workers have been infected with the coronavirus, according to the independent Nicaraguan Medical Unit. It bases its count on symptoms and lung X-rays, because tests are scarce and controlled by the government. Around 90 patients with severe respiratory disease were being treated Friday at the Hospital España in the western city of Chinandega, where Maltez died, according to hospital officials who spoke to The Washington Post on the condition of anonymity for fear of reprisal. Doctors there suspect most are covid-19 cases. Among those who are believed to have been infected recently are top hospital officials, radiologists, internists and nurses. The government doesn’t recognize any of those infections as covid-19. It did not respond to several requests for comment. “The hospitals are overwhelmed, the health system is maxxed out,” said Taki Moreno, president of the Pulmonologists’ Association. From the start of the pandemic, Nicaragua has been a radical outlier. As neighboring countries imposed strict quarantines and curfews, the Sandinista government encouraged festivals, beach tourism and professional sporting events. Nicaraguan authorities say they have made preparations for the pandemic, training tens of thousands of health-care workers, and sending teams door-to-door to promote measures to avoid contagion. But in April, the Pan American Health Organization criticized the government for “inadequate infection prevention and control.” Analysts say the government may be downplaying the epidemic for fear of more damage to the already slumping economy. Ortega, a former Marxist rebel who first came to power in the 1979 Sandinista revolution and returned to the presidency in 2007, has said the country will have to “learn to live with the pandemic.” But the government has declined to say how many people have been tested for the coronavirus. Authorities have said the confirmed cases in Nicaragua are all tied to foreign travel, and there has been no community transmission. Silvio Maltez thinks otherwise. He believes his father was infected while driving his taxi in Chinandega, a city of a half-million people. His family was not allowed to view the body before burial, he said. “They


to live with the pandemic.” But the government has declined to say how many people have been tested for the coronavirus. Authorities have said the confirmed cases in Nicaragua are all tied to foreign travel, and there has been no community transmission. Silvio Maltez thinks otherwise. He believes his father was infected while driving his taxi in Chinandega, a city of a half-million people. His family was not allowed to view the body before burial, he said. “They only let my brother see through a window that they’d wrapped him in black plastic,” he said. Guillermo Maltez is not one of the country’s eight recognized coronavirus deaths. Nicaragua’s official count pales beside those of its neighbors. Costa Rica, with one of the strongest health systems in Latin America, has reported 863 confirmed cases and 10 deaths from covid-19, according to a tally by Johns Hopkins University. Honduras had 2,565 cases and 138 deaths. “Of course there’s an undercount,” said Álvaro Ramírez, the epidemiologist who led Nicaragua’s response to the cholera epidemic that swept through Latin America from 1991-93. “The government isn’t reporting the real number of deaths or those infected.” A Sandinista legislator, Carlos Emilio López, said in a video on May 6 that Nicaragua was prepared to confront covid-19. “It’s not true that in Nicaragua, the hospitals are collapsed, full, overwhelmed or saturated,” he said. Outside hospitals, though, the reality is different: desperate families seeking information about their relatives, hearses driving away with bodies. Then there are the “express burials,” documented in cellphone videos shared on social media and in local news reports. Late last month, a 57-year-old government worker was quietly interred in Managua, after dying of what was classified as cardiogenic shock, a heart problem. The burial was so swift that “they put him in the coffin in his hospital gown,” said the man’s daughter, who spoke on the condition of anonymity for fear of reprisal. “At 5 in the morning they buried him without his family present.” A group of 600 Nicaraguan doctors and other health professionals signed a letter late last month calling on the government to impose social distancing, suspend classes in schools and provide protective equipment for health personnel. Ortega and his wife, Vice President Rosario Murillo, have not responded. They have also not appeared in public since April. Meanwhile, the hospitals are filling with mysterious cases of a severe respiratory disease. marybeth.sheridan@washpost.com


Hope in hydrangeas

flowers project, “the hydrangea gave another possibility after the conflict. You can’t eat a hydrangea,” she says, and unlike livestock, “it is more difficult to steal.” The town of La Ceja, just 25 miles from Medellín, was once a dangerous area for even agronomists to pass through while making routine visits to flower farms. Now, the region is calm. “The hydrangea gave producers the possibility to set down their arms and offered the agricultural sector a new chance to come to life,” Palacio says. “The hydrangea helped generate prosperity and hope. The hydrangea gives life to Antioquia.” “The Colombian flower sector was perhaps the first sector in Colombia that was affected by the coronavirus crisis,” says Augusto Solano, executive president of Asocolflores. As soon as the virus appeared in China, and progressed across Europe, country after country began to cancel orders. The first action Asocolflores took was to coordinate with local authorities and enact strict safety and hygiene measures along the entire supply chain, from the fields to the factories to international transport. While the cancellation of events and weddings has been a significant cause of decreased demand for cut flowers, the strong link between the United States and Colombian floriculture has been a positive connection for the industry. Solano explains: “Fortunately, supermarkets in the United States have maintained permanent activity; not high, but [sales] have been active.” While this is a difficult time for flower producers, Solano reminds consumers that “flowers help combat stress” and, as homes have become home offices, flowers “are a source of calm, attract energy and bring well-being.” And, he says, supporting floriculture supports workers. The Colombian cut-flower industry, including hydrangeas, generates work for 150,000 people in Colombia, the majority of whom are women who are the head of the household. This reporting was supported by the International Women’s Media Foundation as part of its Adelante Latin American Reporting Initiative. In Sight is The Washington Post’s photography blog for visual narrative. This platform showcases compelling and diverse imagery from staff members and freelance photographers, news agencies and archives. If you are interested in submitting a story to In Sight, please complete this form. More on In Sight: This photographer shows how the covid-19 pandemic has changed life in one Virginia neighborhood Restricted by the covid-19 pandemic, this photographer is creating an intensely personal ‘Quarantine Ballad.’ These photos explore how rising sea levels are affecting Miami


Md. releases ‘staggering’ forecast of economic damage; 103,633 filed jobless claims last week; Pr. George’s extends order

The number of known coronavirus cases in the District, Maryland and Virginia was 70,452 on Thursday, with 35,903 cases in Maryland, 27,813 in Virginia and 6,736 in the District. The number of virus-related deaths reached 1,866 in Maryland, 955 in Virginia and 358 in the District, for a total of 3,179 fatalities. [From Wednesday: Hogan announces gradual reopening; D.C. shutdown extended through June 8] Here are some of the most significant recent developments as the region responds to the pandemic of the novel coronavirus, which causes the disease covid-19: • As some areas of the region prepare to reopen, other localities plan to extend stay-at-home orders. In Prince George’s County, executive Angela D. Alsobrooks (D) signed an executive order continuing a stay-at-home order in the Washington suburb through June 1. • Maryland expects to lose at least $925 million in state tax revenue by the end of June, forecasters said Thursday, less than half the worst-case scenario predicted a month ago. Virginia officials reported state tax revenue plummeted 26 percent last month compared to April 2019 in the first monthly revenue report to reflect the economic ravages of the coronavirus pandemic. • Virginia officials said Thursday they will no longer include the results of unreliable antibody tests in their overall data about covid-19 in the state, a practice that had been criticized as undermining the state’s depiction of its efforts to control the spread of the novel coronavirus. The Virginia Department of Health said the change does not significantly alter the statistical trends that led Gov. Ralph Northam (D) to move toward easing restrictions for most of the state, beginning Friday. • More than 103,000 unemployment claims were filed last week in the District, Maryland and Virginia, according to figures released Thursday by the Labor Department. In the eight weeks since social distancing measures shut down all but essential businesses in the region, more than 885,000 people have sought jobless benefits in the three jurisdictions. When will D.C. reopen?


The Health 202: Nursing home residents may account for one-half of all U.S. coronavirus deaths

The nation’s nursing homes — housing many of the most vulnerable Americans — are ground zero in the devastation wrought by the novel coronavirus. Look no further than Maryland, where cases are spreading as many residents still don’t receive testing, workers struggle to obtain sufficient protective equipment and managers play down the severity of the outbreaks. In this extensive report, my colleagues Rebecca Tan and Rachel Chason spoke with former and current staff members of Sagepoint Senior Living Center and six other Maryland facilities. Staffers at several facilities said they weren’t provided with masks and gowns until patients had tested positive. An administrator sleeps overnight at one Silver Spring center because of staff shortages. At Potomac Valley Rehabilitation and Healthcare in Rockville, a nurse said patients who have tested positive for the coronavirus are “all over” the building even though managers say those patients are separated from others. The daughter of one Potomac Valley resident reached out to me to share her frustrations with the lack of testing and communication from the center. In an April 24 phone conversation with a social worker, Peyser said she probed for information about how many patients in the facility had tested positive, whether staff was getting tested and why her mother hadn’t been tested. Peyser said she wasn’t able to get satisfactory answers. And her mother isn’t able to communicate sufficiently to answer any questions herself. “Our conversation was frustrating at best,” Peyser told me. “I asked how many cases are there. She said a couple. So that ended that unsatisfying conversation.” Last week, Gov. Larry Hogan (R) ordered universal testing for residents of the state's 226 long-term care facilities. “Nursing home employees said the help has been slow to materialize, and the staffing won’t cover yawning gaps,” Rebecca and Rachel write. “The death toll at Sagepoint is the highest among nursing homes in Maryland, where long-term care facilities accounted for more than 6,000 of the state’s coronavirus infections as of Wednesday and 804 confirmed covid-19 deaths,” they add. “More than 1,900 employees of such facilities had contracted the virus, according to a state database.” Erin Cox, Maryland politics reporter for The Washington Post: Peyser only found out details about Potomac Valley once Montgomery County health officials said that because of the pandemic they haven’t conducted in-person compliance visits as usual. The federal Centers for Medicare and Medicaid Services suspended non-emergency inspections March


for Medicare and Medicaid Services picked about 200 ambulance organizations to test a program to enable such emergency services to get Medicare reimbursement even when they treat patients in place, but that pilot program has been delayed amid the pandemic, Sarah reports. They want the next coronavirus response package to include measures that would ensure Gilead Sciences, which makes the antiviral drug remdesivir, does not have exclusive rights to treatments and vaccines for the coronavirus, Bloomberg Law’s Alex Ruoff reports. The drug recently received emergency use authorization from the Food and Drug Administration to allow doctors to use the drug to treat patients hospitalized with serious covid-19 cases. Eli Zupnick, spokesman for the group Patients Over Pharma, said: “While we all hope that remdesivir pans out as an effective covid-19 treatment, there is absolutely no reason to trust that Gilead would make it affordable and accessible for patients if doing so hurt their bottom line.” Lower Drug Prices Now and other groups have been “sending messages to lawmakers and buying digital ads outlining Gilead’s pricing decisions in the past: setting the cost of its Hepatitis C drug at $1,000 per pill and reaping billions of dollars in profits from its HIV drug Truvada. The group also organized a petition to be sent to lawmakers calling for action on drugs related to Covid-19,” Alex writes. They wrote a letter to the Department of Health and Human Services citing the administration’s own plans for addressing the pandemic and assessing any shortages in critical supplies. “In March, the Administration authored a report that outlined critical information that should be collected to address shortages in PPE as a part of the Administration’s greater strategy to address the COVID-19 pandemic,” reads the letter to HHS Secretary Alex Azar, which was sent to The Health 202. “To date, it remains unclear if this information is being collected. If it is, the data are not being shared with Congress.” Warren and Casey want the agency to provide information, no later than May 15, about any PPE shortages it’s monitoring, including the types of supplies that are in limited supply and the types of facilities that are seeing gaps. They also called for additional information, including whether the federal government is securing PPE from foreign sources and how it’s protecting against any vulnerabilities in supply chains. A few more headlines and developments to catch up on this morning:


¡Caray! Coronavirus shuts the Mexican beer industry down, and the country is running dry

MEXICO CITY — During the bone-dry days of Prohibition, Americans slipped over the border to guzzle beer in Mexico. A century later, Mexican towns are the ones going dry. The government has largely shut down beer production, saying that it is not essential during the country’s coronavirus outbreak. The last bottles of Tecate, Corona, Modelo Especial and Dos Equis for Mexican consumption rolled off the lines in early April. Now the country has a new black market — in beer. “Many people are desperately searching for beer,” said Raúl Funes, the head of a craft-brew association in Tijuana, just south of San Diego. “It’s like toilet paper.” It’s not that Mexico has no booze. The wine industry is still open. But Mexican adults, on average, drink a quart of wine per year. They knock back 72 times as much beer. That is 18 gallons a person. “Beer is a symbol of celebration, of refuge, it’s something to cure depression, to have at a party, a wedding, to drink at home,” said Luis Alberto Medina, the host of a radio show in the northern city of Hermosillo. “It’s always been present in Mexican culture.” Until now. The country’s biggest convenience-store chain, Oxxo, announced the doomsday news on April 30: It had only 10 days’ worth of beer left. Already, six-packs were becoming as rare as cruise ships off Cozumel. Panicked shoppers For the few beers left, prices have soared. One Twitter user reported buying a can of Modelo Especial for 27 pesos, or around $1.15. That is more than the hourly minimum wage. “Yes, the world is coming to an end,” he wrote. In Tijuana, Facebook pages have sprung up to direct people to stores that still have beer, or to people willing to sell from their private stashes. “Where is there beer at a normal price?” one user anguished. Someone responded with an American flag emoji. Indeed, at a number of border crossings, beer is being discreetly carried south, even as illicit drugs flow north. Lupita Flores, 34, runs a corner store in Reynosa, just across from McAllen, Tex. She ran out of beer weeks ago. So she arranged to have it sent from “the other side” — as Mexicans call the United States. “Sometimes it costs double or triple,” she said. Her suppliers can bring only small amounts on each trip, to avoid getting into trouble. Travelers are allowed


to bring up to three liters of beer into Mexico duty-free — around eight 12-ounce cans. Despite the premium cost, Flores needed to stock up. Many of her customers work in the border assembly plants known as maquiladoras. “When they get paid, the first thing they do is come get their beer,” she said. Karen Treviño, 30, a graphic designer, had scoured Reynosa for Corona and Michelob Ultra. “We’ve been looking in supermarkets, shops, in Oxxos, in 7-Elevens,” she reported. “Nothing.” She, too, turned to contacts in the United States, where the flow of suds has continued, uninterrupted. Beer as a nonessential product? Por favor. “We northerners are party people,” she said. Tijuana boomed during Prohibition, the period from 1920 to 1933 during which the United States banned alcohol production and sales. Beer-deprived Americans flocked to “the longest bar in the world,” the 200-foot marvel at the city’s Mexicali Beer Hall. These days, though, Tijuana’s stores are nearly out of beer. And because of restrictions imposed after the coronavirus outbreak, it’s harder to cross the border. But residents with jobs in California can still make the trip and pick up a six-pack or two on their way home. Thanks to the commuters, “20 percent of the population has beer,” said Ricardo Ocampo, a professor of food science at the Technological Institute of Tijuana. Everyone else, he said, faces a dire situation. “We are talking about a very high percentage of people whose only option is craft beer.” Yes, craft beer — long dismissed by the Corona crowd as too hoppy, too cloudy, too pricey. Never mind that Mexico’s independent breweries were winning increasing respect. They’ve got plenty of beer, now that restaurants and brewpubs no longer offer dine-in service. “The outlook is bright for the craft brewers,” Ocampo said. “People will dare to try their beer.” Consumers are not the only victims of the beer shortage, of course. Mexico’s beer industry, dominated by Grupo Modelo and Heineken Mexico, generates 55,000 direct jobs, according to the beermakers’ chamber, Cerveceros de Mexico. But counting everyone else involved — barley farmers, restaurants, stores — the number of jobs supported by the industry balloons to 650,000, the chamber says. “Beer accounts for 25 percent of exports of the agro-industrial sector,” Karla Siqueiros, the head of the chamber, said in an interview. “So we are an agro-industry.” That argument seemed to win the day with


Number of nursing homes with publicly reported cases of the coronavirus soars

The number of nursing homes publicly reporting cases of covid-19 has doubled in the past week, with more than 1 in 6 facilities nationwide now acknowledging infections among residents or staff, a Washington Post analysis of state and federal data found. The rise is driven in part by newly released information about previous novel coronavirus infections from states including Michigan, Maryland, Kentucky and South Carolina. Some states have not yet publicly released the names of affected nursing homes. In five states — Maryland, Massachusetts, Connecticut, Georgia and New Jersey — the virus has struck a majority of nursing homes, the data shows. In New Jersey, second only to New York in total number of confirmed coronavirus cases, health officials have reported infections at 80 percent of the state’s homes. Maryland released a list earlier this week of more than 130 nursing homes with cases, about 60 percent of homes in the state. Overall, Maryland reported 185 long-term care facilities with cases. Covid-19, the illness caused by the novel coronavirus, has been especially deadly for the elderly as it spreads across the world. State health officials have been slow to publicly identify nursing homes with positive cases, but in recent days, prodded by the Centers for Medicare and Medicaid Services (CMS), more states have released the names of facilities. The tally paints a grim picture of the scale of the outbreak in homes tasked with caring for the elderly and infirm. More than 2,700 Medicare-certified nursing homes had publicly reported cases as of Tuesday, The Post found. “People who work in nursing homes didn’t have the proper equipment and there wasn’t widespread testing,” said Laurie Facciarossa Brewer, the long-term care ombudsman in New Jersey. “Without those two critical components, you cannot avoid such a devastating outcome.” The Post is updating a searchable database of Medicare-certified nursing homes that have at least one reported case of the coronavirus among patients or staff, using state lists and media accounts of local outbreaks. The count is incomplete. In New York, officials are releasing the names of only homes with at least five deaths, citing patient confidentiality. Virginia has released a total count of all long-term care facilities with covid-19 cases but has declined to name them. Last week, CMS announced a mandate for nursing homes to report cases of covid-19 to families, patients and the federal government. CMS Administrator Seema Verma said the information


From cooking to calligraphy, people stuck at home are finding new space for creativity

Vincent Djokoto saw an opportunity while procuring lentils, soap and other essentials ahead of a looming lockdown in Ghana last month. As the streets of Accra shuttered and much of the city’s commerce ground to a halt, he realized he would need more than food: He also purchased a stockpile of colored pencils and an assortment of paint. It had been 15 years since Djokoto, 24, let go of his dreams of painting, squashed by the creative restrictions that tormented him in his art class at elementary school. It took a global quarantine — the prospect of spending countless, aimless hours in his home — to consider taking paintbrush to canvas again. “I’ve learned how fast-paced this world is and how long I spend working, giving very little time to creative stuff,” Djokoto said. “It’s really like the child in me coming out in such times; I think it’ll be something that will become an essential part of my habits.” The novel coronavirus’s spread across the globe has caused seismic disruptions to everyday life. Daily activities rarely extend beyond the confines of one’s home. Social distancing often feels more akin to social isolation. With fewer distractions and increased downtime, some have found space to start new projects or complete those long forgotten. When The Washington Post asked readers how they’ve used their time under quarantine or stay-at-home orders, more than 250 people responded with stories about learning to play instruments, trying culinary techniques and tackling other creative endeavors. A woman from Arlington, Va., took up dip-pen calligraphy. A freelance photography producer from New York started an ASMR YouTube channel for her pug. A grandmother from Owings Mills, Md., taught herself stop-motion animation to entertain her 2-year-old grandchild. Online learning has seen a surge in activity worldwide. The celebrity-led tutorials offered by Master Class and the language-learning program Rosetta Stone reported spikes in users. Global traffic to Duolingo, another language-learning platform, reached an all-time high in March, when new users more than doubled from the previous month, according to the company. The rate of new enrollments in Virtual Art Academy exploded fivefold in March compared to the previous 12 months, founder Barry John Raybould said. It’s the most drastic jump in the academy’s 13-year history. Social media has become an artistic outlet, too, with people showing off their creations of “quarantine murals” in time-lapse videos posted to TikTok. “What we are


In some nations, government isolation centers helped reduce covid-19 infections. The U.S. has resisted the strategy.

In Hong Kong, anyone known to have been exposed to the novel coronavirus was dispatched by authorities to a government-run facility to quarantine for two weeks. Recently, officials announced that weeks had passed with no new locally transmitted coronavirus cases. In South Korea, people with moderate symptoms were ordered to decamp to isolation centers. That country’s response to the virus is hailed as a model for the world. But even as centralized, out-of-home quarantine and isolation appeared helpful in breaking the chain of transmission in other countries, the United States has remained largely resistant to isolating people in government-run centers away from their homes. And in places where voluntary isolation facilities are available, local officials are finding fewer people taking advantage of them than expected. It’s a reflection, experts said, of cost and conflicting priorities, of cultural norms and mistrust of government. Although great time and effort are being devoted to testing for the virus, treating the ill and tracking those who are exposed, isolation centers have received relatively scant attention. Then there are the associated costs, for government and for people taken out of the workforce. Americans’ suspicions about government intervention also mean large swaths of the population — especially immigrants and people of color who have been subject to government restrictions in the past — are wary of placing their lives in the hands of local officials. “We just don’t have enough civic trust, in many different ways, to make that something people are going to let happen with confidence,” said Michael Fine, former director of the Rhode Island Department of Health. “You can see that in people on the right, you can see that from the perspective of people of color, and others.” Because states and cities generally control the nuances of their public health efforts, coordinating an isolation policy on a grand scale is next to impossible. And forcing those infected with covid-19, the disease caused by the coronavirus, to quarantine in government-run facilities could provoke legal challenges and social resistance. Scholars have expressed concern about the consequences of requiring Americans to enter out-of-home isolation or quarantine centers. In March, 450 organizations and public health and legal experts published a letter on the American Civil Liberties Union’s website saying mandatory quarantine or isolation measures should be a last resort and steps should be taken to protect people’s civil and economic rights. ACLU spokesman Abdullah Hassan said


the disease caused by the coronavirus. http://www.washingtonpost.com/video/national/health-science/volunteers-fight-a-mental-health-crisis-amid-the-coronavirus-outbreak/2020/04/14/9aa9a580-8065-4f54-8e16-56422fe0d2bc_video.html (REF:Luis Velarde/The Washington Post) Earlier this month, New York Gov. Andrew M. Cuomo (D) ordered a survey of New York City hospitals to gather information about patients they had treated for covid-19 during a recent three-day period. He expected to hear about front-line medical workers being hospitalized, or about patients whose jobs required regular contact with people throughout the U.S. city hardest hit by the coronavirus. Cuomo expressed surprise at the results: 66 percent of those who were hospitalized had been staying at home, and just 17 percent were employed. “They’re not working; they’re not traveling,” Cuomo said at a news conference where he shared the survey’s results. “We were thinking that maybe we were going to find a higher percent of essential employees who were getting sick because they were going to work — that these may be nurses, doctors, transit workers. That’s not the case. They were predominantly at home.” The disheartening implication of that data is that home isolation is not necessarily offering protection to those participating in it — especially for people in densely populated cities such as New York. “Some of us tend to think everyone lives in four-bedroom suburban houses. But that’s not the case,” said Eric Toner of the Johns Hopkins Center for Health Security. “But there are an awful lot of people — the same people who disproportionately represent those who are infected — who live in much more densely crowded spaces. They can’t isolate. They don’t have a guest bedroom where they can isolate.” In an effort to help jurisdictions looking to implement out-of-home isolation, the Federal Emergency Management Agency issued guidance regarding what it called non-congregate shelters. Unlike overflow hospital facilities established in some cities, isolation centers are not meant to house people needing treatment or medical attention. Instead, they’re designed for people who test positive for the coronavirus or who have been exposed. Those cities and states that have opened quarantine and isolation facilities — often in hotels — have largely geared them toward emergency workers or homeless people. For the most part, these facilities do not require those staying in them to do so against their will. But almost all of them prohibit coming and going for anyone exposed to or known to be carrying the virus. “It’s not vacation. You can’t go back and forth,” said Thomas G. Ambrosino, city