could ripple across the wounded U.S. economy, hobbling prospects for a rapid recovery.” From the Andes to Tibet, the virus seems to be sparing populations at high altitudes. “The relative dearth of cases and deaths in the internationally connected but high-elevation region [of Cusco in Peru] has prompted speculation here that the coronavirus gets soroche, the Quechua word for altitude sickness,” Simeon Tegel reports. “Similar results have been seen elsewhere in the Andes, and in Tibet. Scientists warn that the apparent pattern might not last, but the as-yet-unexplained phenomenon has them intrigued. Researchers are starting to investigate a possible relationship between the coronavirus and altitude.” Hong Kong police canceled the city’s annual vigil for Tiananmen Square victims for the first time in 30 years, citing coronavirus concerns. But that seems like an excuse. (Adam Taylor) China said it is sending 30 million testing kits a month to Africa, plus 10,000 ventilators and 80 million masks. (Teo Armus) The U.S. sent Brazil two million dozes of hydroxychloroquine for use against the virus, despite medical warnings about the risks of using the drug. The two countries will also conduct a joint research effort, and the United States will also send 1,000 ventilators to Brazil. (Reuters) Raising kids in a dilapidated Venezuela was already hard, and the pandemic made it worse. Nicolas Maduros’s government has imposed one of the world’s strictest lockdowns, and there’s no timetable for a return to school. (Mariana Zúñiga) A top Italian medical official said the virus is losing potency and, “clinically,” does not exist in Italy anymore. (Reuters) Armenian Prime Minister Nikol Pashinyan tested positive for the virus but said he’s asymptomatic and will be working from home. Armenia, with a population of 3 million, has 9,282 confirmed cases and 131 fatalities. (Isabelle Khurshudyan) Manila ended a two-month lockdown with a ferocious traffic jam, caused by insufficient public transportation. Officials said limited transportation is necessary to curb the spread of covid-19, but critics are bracing for an even worse spike in cases from the clusters of stranded people. (Regine Cabato) Queen Elizabeth II was spotted outside for the first time since lockdown measures were implemented in Britain. The 94-year-old was photographed riding a black pony around Windsor Castle, where she has been isolating since March 23. (Jennifer Hassan) Biden canceled a scheduled (virtual) speech to the Maine Democratic Party and left his basement in Delaware to visit a


The Health 202: ‘The stories about protests are also the stories about covid-19 and racism,’ says one epidemiologist

This time, as the nation erupts over the latest example of police violence toward African Americans, there’s a pandemic in the background. The confluence of massive protests and a pandemic provides an unprecedented and tangible example of the steep challenges black people face every day in the United States. By nearly every benchmark, the coronavirus outbreak has produced more severe consequences in the lives of African Americans compared with their white counterparts. Black Americans are infected with the virus at higher rates and dying of it more frequently. They are more likely to have lost their employment because of the shutdowns. And they started out with fewer resources on hand to weather the health crisis. “It became really clear covid was not a leveler,” said Steven Brown, a research associate at the Urban Institute and author of an analysis on how the virus has affected the economic well-being of minorities. “Even though we’re all at risk, it was incredibly clear that some people were more at risk.” For nearly a week, people protesting George Floyd’s death have held nightly demonstrations in a number of U.S. cities, some of them marching peacefully even as others vandalize stores, government buildings and cars. As protests intensified yesterday in New York, Chicago and St. Louis, President Trump threatened to deploy federal troops if state and city leaders don’t act to quell the chaos. The protests are stoking concerns that black Americans gathering in close proximity could further worsen disparities that have been years in the making. These disparities are now getting unprecedented attention because of two of the biggest news events this year: the pandemic and Floyd’s death. Just as the protests over Floyd’s death have brought fresh attention to how black Americans are treated by law enforcement, the pandemic also stirred up a focus on how they lag far behind when it comes to personal health and access to affordable, high-quality care. “The stories about protests are also the stories about covid-19 and racism,” said Zinzi Bailey, a social epidemiologist at the University of Miami. One reason for this is they tend to live in cities, where the virus has taken hold more aggressively than in suburban or rural areas. U.S. localities with larger-than-average black populations account for more than half of coronavirus cases, according to a national study by Amfar, the Foundation for AIDs Research. “The Amfar study, based on data collected


to data compiled by Definitive Healthcare. More than 1,200 hospitals operated in the red in two or more of the last five years. Then the coronavirus hit with a one-two punch. Patient revenue dried up, and preparing for possible outbreaks drove up costs.” Hospitals have started to reschedule surgeries and reopen clinics, particularly in regions that never saw surges in coronavirus cases, or in places where cases are declining. “In the latest smartphone data from the location tracking company SafeGraph, hospital visits started to recover in the first half of May, although they were still down from 2019 by about 40 percent,” they add. A top doctor in northern Italy said patients in his hospital have been emerging with lower levels of the virus compared with two months ago — remarks that drew swift pushback, Joel Achenbach, Ariana Eunjung Cha, Ben Guarino and Chelsea Janes report. Alberto Zangrillo, head of San Raffaele Hospital in Milan, shook the global public health community when he told a national TV station over the weekend that the “virus clinically no longer exists in Italy.” In a follow-up interview with The Washington Post, he suggested something different may be happening “in the interaction between the virus and the human airway receptors.” Top WHO official Michael Ryan said at a news conference that “we need to be exceptionally careful not to create a sense that all of a sudden the virus by its own volition has now decided to be less pathogenic. That is not the case at all.” “The consensus among other experts interviewed Monday is that the clinical findings in Italy likely do not reflect any change in the virus itself,” Joel, Ariana, Ben and Chelsea report. “Zangrillo’s clinical observations are more likely a reflection of the fact that with the peak of the outbreak long past, there is less virus in circulation, and people may be less likely to be exposed to high doses of it. In addition, only severely sick people were likely to be tested early on, compared with the situation now when even those with mild symptoms are more likely to get swabbed, experts said.” The Centers for Medicare and Medicaid Services detailed the first national account of fatalities in the 15,000 nursing homes that receive Medicare and Medicaid funding. The government report found 60,000 were infected as the coronavirus swept through the nation’s long-term care facilities. Nursing homes with


The strange new quiet in New York emergency rooms

friend and colleague saved. You exhale. Two days later, a colleagues dies. He had been in the intensive care unit for weeks. Covid-19. On a ventilator helping him breathe. Infected like so many nurses who’ve been on the front lines. And then one day, life leaves him. When you started here years ago, he was one of the first to take you around. Show you how things worked. Together you cared for hundreds of patients. Now he’s gone. Then another tragedy hits. Your colleague, your friend. She dies by suicide. A few years ago, you told her to change her travel plans. Go to Montenegro, it’s cheaper than Croatia. You argued about whether Aperol was any good. You heard about all of her snowboarding trips. She survived covid-19. When she came back, you had walked around the emergency room together, lamenting your inability to do more in the face of the virus. What we saw and experienced was too much. Her death hurts you now. It will hurt you forever. At every step of this pandemic, we’ve been in crisis. Not enough tests. Not enough providers. Not enough PPE. Now our crisis is silent. But it lives in each of us. It empties us out. It makes us hollow. We can measure the number of tests we’ve done. We can follow the trends of patients intubated in the intensive care unit. We can chart the number of deaths per day to know when we can start working back toward normal. But there’s no way to measure the impact and toll this has had on our front-line providers. How much we cry. How much it hurts to see your friends struggle to breathe. Struggle to deal with the terrible reality. The curve will flatten. The cases will decline. And maybe one day, covid-19 will be an afterthought. But long after that, this trauma will define a generation of health-care workers. Most of us made it. The best among us didn’t. May they forever rest in peace. For the sacrifice they made. For all of us. Read more: Craig Spencer: Craig Spencer Craig Spencer: When the coughing stops and the sense of helplessness begins Michael L. Barnett: After the pandemic, visiting the doctor will never be the same. And that’s fine. Sophie A. Greenberg: As a doctor, I am willing to do whatever it takes to defeat this virus. Why isn’t Trump?


Mexico’s hospitals strain to treat coronavirus as officials say cases are peaking

Manuel López Obrador, a leftist populist, initially seemed to shrug off the disease. He said it was “not even as bad as the flu,” and attended rallies with throngs of supporters. López-Gatell began meeting with López Obrador, explaining the intricacies of virus transmission in long afternoon walks through the Spanish colonial National Palace. He found the president receptive to his concerns. “In no moment did he say, ‘calm down,’ or ‘for political reasons you can’t say this’ or ‘tone down the information,’ ” López-Gatell said in an interview. “This is very unusual in Mexican politics.” López Obrador changed his tone to project a new seriousness about the outbreak. López-Gatell considered that impractical. The United States had administered millions of tests and recorded more than 1.5 million positives. But in reality, he said, there were probably 12 or 15 million cases. “You can’t count them all,” he said. Trying to trace contacts and isolate the ill in a country as big and poor as Mexico was impossible. “I’d be fooling the public if I said this was the right control mechanism” at the height of a pandemic, he said. Instead, López-Gatell’s team watched data on suspected coronavirus cases from a sample of 475 medical centers across the country. On March 13, they noticed a jump in cases, from three to 11. “The curve was bending” upward, López-Gatell said. “We said, ‘That repertoire of measures we’d prepared for mitigation — let’s go.’ ” On March 20, Mexico shut down its schools. Three days later, it closed offices, malls and most shops. Officials felt they’d kept the virus from spiraling out of control. “We spotted the right moment,” López-Gatell said. Many health professionals are skeptical. Without testing, former health minister Julio Frenk said, the country was flying blind. He noted that pandemic modelers at the University of Washington had predicted up to 16,795 deaths in seven Mexican states including Mexico City by Aug. 4. “Many of these deaths would have been prevented with an earlier response,” said Frenk, now president of the University of Miami. Gustavo Cruz, a mathematician at the National Autonomous University of Mexico who models epidemics, said Mexico had “flattened the curve” more successfully than Spain or Italy. But new cases have recently been climbing faster than expected, he said, probably because people were ignoring the quarantine. Mexico resisted an early, strict lockdown. More than half of the country’s adults


to other hospitals. Some didn’t make it, she said, speaking on the condition of anonymity because she was not authorized to comment. “It’s traumatic seeing people die because you can’t offer them intubation,” she said. Olivia López, Mexico City’s secretary of health, said she thought the hospital system would survive the coronavirus tsunami. “We are adding beds every day,” she said. But no one knows how long the virus will besiege the capital . Rafael Lozano, of the University of Washington’s Institute for Health Metrics and Evaluation, said he didn’t envision the city hitting its peak for a few more weeks. The institute initially projected 3,400 deaths in Mexico City. Lozano said updated figures, due out soon, will be “much higher.” Officials acknowledge that the death toll is greater than the official numbers. As in many countries, Mexico includes only coronavirus fatalities confirmed with a lab test. But there are indications that the undercount could be greater than expected. The civic group Critics say the government is hiding the real toll. The truth might be more prosaic. Mexican authorities have ordered testing of all patients with serious coronavirus-like symptoms. But “since there’s too many patients for the number of [health] personnel, sometimes the test isn’t done,” said Benito Alonso, an internist at the 20 de Noviembre hospital. And many patients die before a test is administered. Death certificates that list “possible” coronavirus, based only on symptoms, are being sent to medical committees to evaluate. Separately, Mexico’s bureaucracy will estimate “excess” deaths — including people who couldn’t get treatment for other conditions during the outbreak. But that could take months. López-Gatell said that it was too time-consuming to compile the full numbers at the height of an epidemic. Unless the real count is far higher than the official data, he said, “the number of deaths doesn’t change my decisions” on urgent matters such as ensuring hospital beds for the ill. Some say Mexico is missing the opportunity to break chains of transmission. Nahid Bhadelia studies infectious disease at Boston University. “How can you say you have a handle on an outbreak if you don’t know how many people are dying?” she asked. López-Gatell says that authorities are seeing signs of a reduction in covid-19 cases in Mexico City. But outbreaks probably will flare in different cities in coming months, he said. “We have to prepare for a long epidemic,” he said.


Experts dispute reports that coronavirus is becoming less lethal

to be less pathogenic. That is not the case at all.” The consensus among other experts interviewed Monday is that the clinical findings in Italy likely do not reflect any change in the virus itself. Zangrillo’s clinical observations are more likely a reflection of the fact that with the peak of the outbreak long past, there is less virus in circulation, and people may be less likely to be exposed to high doses of it. In addition, only severely sick people were likely to be tested early on, compared with the situation now when even those with mild symptoms are more likely to get swabbed, experts said. The pandemic is evolving rapidly, with the rate of new cases declining in some hard-hit areas of the world, including northern Italy and New York City, while rising dramatically in Brazil, Peru and India. The virus, however, is mutating at a slow rate, experts say. Some strains Vaughn Cooper, an infectious-disease expert at the University of Pittsburgh School of Medicine, said the new coronavirus mutates slowly compared with influenza and other microbes, and its genetic changes appear to be “mostly inconsequential.” “I believe it’s safe to say that the differences that doctors are reporting in Italy are entirely due to changes to medical treatment and in human behavior, which limit transmission and numbers of new infections initiated by large inocula — a larger dose of virus appears to be worse — rather than changes in the virus itself,” he said. All viruses evolve over time, and many infectious-disease experts think the novel coronavirus will eventually become less lethal to human beings, joining four other coronaviruses in causing common colds. But there is no solid evidence so far that it has changed significantly in the five months since it was first recognized among patients in Wuhan, China. “The virus hasn’t lost function on the time scale of two months,” said Andrew Noymer, an epidemiologist at the University of California at Irvine. “Loss of function is something I expect over a time scale of years.” In the United States, the pandemic has taken on a patchwork pattern, with much of the Northeast seeing marked improvement. But some places in the South — Alabama, Texas and Virginia, for example — as well as Wisconsin, California and Washington state are showing increases in confirmed cases, according to the coronavirus tracker of Johns Hopkins University. “Every place has


reporting in Italy are entirely due to changes to medical treatment and in human behavior, which limit transmission and numbers of new infections initiated by large inocula — a larger dose of virus appears to be worse — rather than changes in the virus itself,” he said. All viruses evolve over time, and many infectious-disease experts think the novel coronavirus will eventually become less lethal to human beings, joining four other coronaviruses in causing common colds. But there is no solid evidence so far that it has changed significantly in the five months since it was first recognized among patients in Wuhan, China. “The virus hasn’t lost function on the time scale of two months,” said Andrew Noymer, an epidemiologist at the University of California at Irvine. “Loss of function is something I expect over a time scale of years.” In the United States, the pandemic has taken on a patchwork pattern, with much of the Northeast seeing marked improvement. But some places in the South — Alabama, Texas and Virginia, for example — as well as Wisconsin, California and Washington state are showing increases in confirmed cases, according to the coronavirus tracker of Johns Hopkins University. “Every place has a different epidemic, and it’s not because of the virus,” said Jennifer Nuzzo, an epidemiologist at the Johns Hopkins Center for Health Security. Slight tweaks in the microbe’s genetic makeup appear in different places on the planet. Epidemiologists use those mutations to track the virus’s spread. Those changes are akin to stickers slapped on a well-traveled suitcase — markers of where the luggage has gone that don’t impart any functional change. Researchers Harm van Bakel, Emilia Sordillo and Viviana Simon at the Icahn School of Medicine at Mount Sinai, who have been focusing on the genetics of the novel coronavirus, said in an interview that they had not seen a dip in viral load among patients in that hospital system since March, nor have they detected any major genetic changes in the virus in New York City. People in the United States are collectively holding their breath, meanwhile, to see if there is an uptick in cases in response to the reopening of the economy, public gatherings over the Memorial Day holiday weekend and the eruption of protests against police violence in cities in recent days. Nuzzo pointed out that it usually takes around five days, and up to 14


Is Trump hurting the military?

confidence than do Democrats, and nonwhite Americans report about 10 percentage points less confidence in the armed services than do whites. In other words, despite the military’s commitment to nonpartisanship, and despite the fact the military’s enlisted ranks are even more diverse than the general U.S. population, a polarized American public increasingly views the military through a partisan political lens. The president has threatened to use the military, which he often refers to as if it were his political constituency and political resource, against a group of citizens not generally aligned with him, in an election year. That the secretary of defense and the chairman of the Joint Chiefs of Staff joined a photo op with the president Monday night and later walked around downtown “just checking” the security services around the White House could raise more questions about how Trump is using the military for political gain. Alice Hunt Friend As Lindsay Cohn explained here at TMC this morning, the president is within his rights to use the military domestically under certain circumstances, and the military is obliged to follow legal civilian orders. But one lesson of 20 years of continuous foreign wars — which have, in turn, helped militarize the police — is that engaging in heavy-handed tactics against civilians can inflame rather than calm tensions and can even escalate violence. How the military handles the role Trump is assigning it will affect its own future as an institution. The military’s status as one of the most trusted institutions in U.S. society could be compromised if the public and Congress perceive the military as using excessive force, particularly against peaceful protesters, or as behaving like a politicized tool of the president. Such a perception could hurt the military’s ability to maintain internal cohesion and to recruit a diverse force, which research suggests are important for combat effectiveness. It also could puncture the bubble of political invincibility that has protected large Pentagon budgets since the terrorist attacks of Sept. 11, 2001, leading the public and Congress to question whether spending hundreds of billions of dollars per year on defense has actually made the country safer. Caitlin Talmadge The U.S. government has deployed the military within its own borders to enforce domestic law more than 100 times in the nation’s history. Those episodes include enforcing desegregation of schools in the 1950s and protecting civil rights marchers in the 1960s, as


The Energy 202: Green groups back protesters. But they’re grappling with how best to address their own issues with race.

projects that were part of a $1 billion Obama-era program to defend those jurisdictions against climate change are at risk amid the ongoing public health crisis. State and local officials told federal lawmakers on Monday that they may not meet conditions of the program, which says the funding must be spent by the fall of 2022, the New York Times reports. “Missing that deadline, which officials say is likely because of delays caused by the coronavirus, would mean forfeiting the remaining money, scuttling the projects,” per the report. A group of states and cities asked Congress to extend the deadline for construction by three years. A new report from the Institute for Supply Management signaled that manufacturing activity eased off that low in May, the “strongest sign yet that the worst of the economic downturn was behind as businesses reopen, though the recovery from the COVID-19 crisis could take years because of high unemployment,” Reuters reports. The cyclone, which will be named Cristobal, could become a major rainmaker in coming days, Matthew Cappucci reports. “The storm was located about 50 miles west-southwest of Campeche, Mexico, as of 5 p.m. Eastern time. Forecasts call for it to intensify into a tropical storm on Tuesday,” he writes. “If the storm earns a name before June 5, which is likely, then the 2020 hurricane season would have the earliest third-named storm on record, according to hurricane researcher Phil Klotzbach of Colorado State University. The accelerated start to the season is in keeping with the active hurricane season that experts across the board are predicting.” The pandemic has shrunk the market demand for natural gas tankers. After years of expanding demand, export projects for liquefied natural gas are being pushed back, the Wall Street Journal reports. “Some gas projects are now being put on hold on the back of record low prices and brimming storage facilities, and some operators are pushing back orders for the new vessels they had been counting on as big profit engines,” per the report. “Middle East energy giant Saudi Aramco and its shipping arm Bahri have put on hold their planned entry this year into LNG shipping, pushing back an order of a dozen gas carriers worth up to $2.5 billion. The postponement came after San Diego-based Sempra Energy said in early May it would delay an investment decision on its Port Arthur, Texas, LNG export project until 2021.”


Parts of Virginia to enter Phase 2 of coronavirus shutdown recovery, Northam says

beds in use and positivity rates on tests have all been dropping, prompting Maryland Gov. Larry Hogan (R) to say he might also further ease restrictions soon. “All the numbers are down, so we’re very excited about that,” Hogan said in a radio interview. “I think we’re ready to take some further steps.” D.C. Mayor Muriel E. Bowser (D) did not address the pandemic Tuesday during a briefing that instead focused on the ongoing protests against police violence. Virginia, Maryland and the District have each had different restrictions in place during their initial stages of ending coronavirus-related shutdowns that have stifled the local economy. The District and its suburbs, where the pandemic was most intense, only recently began to reopen. Hogan warned in the interview with WBAL radio that large public gatherings, including protests that have attracted thousands of demonstrators in Baltimore, the District, Richmond and elsewhere in recent days, could lead to more infections. But, he said, it is too soon to tell. “It’s certainly still not safe to gather in large numbers in close proximity,” Hogan said. “And we saw an awful lot of that. So hopefully it’s not going to be bad, but it’s definitely something that the doctors and the scientists are worried about.” In Virginia, the next phase means that groups of as many as 50 people will be allowed to gather, instead of the initial limit of 10 or fewer. Besides restaurants and gyms, that will allow some entertainment venues to reopen, while pools, museums and zoos can reopen with restrictions, officials said. Recreational sports will also be allowed with proper distancing and no sharing of equipment. Accomack County on the Eastern Shore, which had also lagged behind the rest of the state because of hot spots in poultry processing facilities there, will also move into Phase 2, Northam said. But the governor resisted allowing Northern Virginia and Richmond to move forward, despite assurances from local officials in the District’s suburbs last week that the region has met four out of six benchmarks for a safe reopening. Virginia recorded an additional 15 covid-19 fatalities Tuesday, six of which were in Northern Virginia. The state saw 841 new cases, with more than half of those in Northern Virginia. The state had 1,362 covid-19 patients hospitalized Tuesday, compared with 1,524 on Friday. The seven-day average for new infections was 9.1 percent statewide, and 15.5 percent in


‘Am I making the right choice?’

spoons and lounges to decide whether she’d try dining in. Chain restaurants and mass gatherings of any kind are out of the question, but a backyard cookout with a few friends is a lifeline. She misses going to the casino but is not ready to take that chance. Olivo knows those decisions can put her at odds with her family. She said she depends on her gut instinct and common sense because she doesn’t trust what she is hearing from officials and doesn’t feel informed by the news updates her mother lives by hour upon hour. “No one is going to listen to these politicians fighting on TV,” Olivo said. “But if it comes from a pastor, a friend they trust, or the lady they buy their tamales from, that’s the information they value and respond to. In the end, we all make our own assumptions.” For Olivo and others, it can be tempting to believe that, as the nation reopens, the virus has become less of a threat. To relax a bit more or gamble on whether sitting close to a friend for a margarita could have no consequences or dire ones, particularly for vulnerable people like Martinez. Now, as people crave normalcy after weeks at home, it can be hard to know what to do. “The information out there is not good enough to help me make decisions,” Olivo said. Martinez keeps the television tuned to cable news for most of the day. What she knows is as terrifying as what she doesn’t. Martinez is familiar with the ways the virus can kill and its medical terminology. Antibodies. Cytokine storms. Asymptomatic vectors. The stories of people suffering haunt her, Martinez said, because her girls don’t have a choice when it comes to staying home. Olivo shrugged off her mother’s anxiety. “Oh Mom, I’m a cockroach, nothing can kill me,” she said. Olivo’s neighborhood in southeast Dallas has been one of the hardest hit in the city. More than 10,000 Dallas residents have tested positive for the virus and more than 229 have died as cases continue to rise. Like the Olivos, many in the neighborhood are also considered essential workers and could not shelter in place, leaving the house each day for jobs where it is difficult to practice social distancing. More than three-fourths of city residents who were hospitalized with covid-19, the disease caused by the novel


Canada’s Nunavut: A vast territory with few people — and no coronavirus

Michael Patterson was concerned — and then stumped. A resident of Pond Inlet, a hamlet of about 1,600 people in the vast, mostly empty Arctic Canadian territory of Nunavut, had tested positive for the novel coronavirus. The individual hadn’t been outside the territory, which had sealed itself off to most outsiders and enacted strict travel restrictions for residents. Within 24 hours, contact tracers isolated 20 people in the mostly Inuit community on the northeastern tip of Baffin Island who might have been exposed to the infected resident. Thirteen were swabbed for the virus. They tested negative. “We were a little bit confused,” said Patterson, Nunavut’s top doctor. So he had the original swab retested. This time, it was negative. The territory announced the false positive, the population of 39,000 scattered across an area slightly larger than Mexico breathed a sigh of relief, and Patterson revised the total number of confirmed covid-19 cases back down. To zero. More than a month after the false alarm, Nunavut remains the only state-level jurisdiction in North America not to record a single case of the virus that has sickened millions and killed more than 375,000 people worldwide. Every other Canadian province and territory and every U.S. and Mexican state has reported at least a few. “There are still no confirmed cases or probable cases of covid-19 in Nunavut,” Premier Joe Savikataaq announced during a news conference last week. “And I’m always happy to say that.” Keeping it that way is vital — and has meant making some tough decisions. The territory’s remoteness — its 25 hamlets and capital of Iqaluit are connected to one another and the rest of Canada only by air — might help reduce the risk of the virus arriving. But it also makes it one of the most vulnerable places in Canada were the virus to spread. Nunavut’s one hospital, in Iqaluit, has 35 beds. Most Nunavummiut leave the territory for medical attention, from chemotherapy to diagnostic imaging to childbirth. There are no intensive care beds, and only a dozen ventilators. A chronic shortage of housing in a territory where average temperatures are far below freezing most of the year means several generations typically live under one roof, making social distancing difficult. Nunavut also struggles with food insecurity and outbreaks of tuberculosis, a respiratory illness introduced by Europeans centuries ago. Canadian Prime Minister Justin Trudeau apologized last year for the


Waiting for Trump to speak, and bracing for whether his words will make matters worse

To get the best sense of what President Trump is really focused on and concerned with regarding the uprisings that are occupying the nation, one should turn to his preferred, unfiltered method of communication: Twitter. There you’ll find everything you need to know about why he and his staff debated this weekend whether he should address the nation. There’s plenty in those tweets to suggest that his words would only make things worse. The Washington Post’s Philip Rucker reported on the calculations in the White House about whether Trump should have addressed the nation Sunday in response to the days of protest and unrest. Here’s what he found on the decision not to do so yet: Many of those around him worry that the president’s ongoing response to the uprisings will reinforce the perception that at his core, he is a culture warrior whose interest in addressing anti-black racism will always be trumped by his inclination toward law and order. Such a message surely wouldn’t satisfy the protesters, and it could eclipse any attempts to unify the country. Trump on Twitter last week to responded to the killing of George Floyd, a 46-year-old security guard in Minneapolis who was pinned to the ground with the knee of a white police officer on his neck. He began his remarks at the SpaceX Falcon 9 launch Saturday by noting the actions taken following Floyd’s death and decry that the “memory of George Floyd is being dishonored by rioters, looters and anarchists." Since then, the president has mostly used social media platform to attack his Democratic rivals and the media, to defend police and to promise a tough stance against those who break laws in their protests. Conservative media hosts have called on the president to deliver remarks aimed at unifying the nation. “If there isn’t a reason to ever address the country that has been so diversely affected by one thing, this is the reason,” Fox News host Brian Kilmeade said Monday. “The president has to bring the country together, and in that speech can’t be anything about a Democrat and nothing about a Republican. It’s got to be about an American.” Believing that Trump’s rhetoric might only make matters worse is logical, given that the president has a history of sowing division on racial matters rather than seeking to address them constructively. He launched his campaign using divisive language about people


Peaceful protests in Baltimore contrast sharply with 2015 riots and unrest now sweeping some American cities

exhausted by seemingly intractable poverty, violent crime, police corruption and shattered public trust after the city’s last elected mayor resigned amid scandal. The years since the riots have been marked by more trouble. Baltimore City State’s Attorney Marilyn Mosby quickly announced criminal charges against the six officers involved in Gray’s arrest. A judge found three officers not guilty after separate trials, and charges were later dropped against the other three. Homicides have continued to climb, never dropping beneath 300 annually since the riots. Meanwhile, police corruption has continued with the arrest of more than a dozen officers after a federal probe determined members of the city’s Gun Trace Task Force were robbing citizens, conducting illegal searches and collecting fraudulent overtime pay. Baltimore City Hall also became engulfed in scandal when Catherine Pugh, the former mayor, was forced from office last year and pleaded guilty to a fraud scheme involving her self-published children’s books. Her replacement, Bernard C. “Jack” Young, 65, who left his role as City Council president to assume the job, is running to remain mayor but faces ample competition Tuesday. Whoever wins will also have to contend with the economic devastation wrought by the coronavirus, including rising unemployment and massive revenue shortfalls in a city that has lost about 30,000 residents since 2014. Yet the mostly African American city has been spared the very worst of the pandemic, ranking third in the number of coronavirus cases after Prince George’s and Montgomery counties. City officials have voiced concerns that the new wave of protests could cause the virus to spread, sparking new cases. Young decided against imposing a curfew after Sunday’s downtown gathering proceeded peacefully, without the destruction witnessed in other American cities. “We were a national example of what it looks like to engage in passionate protesting without widespread breaking of the law,” Young told the Baltimore Sun. The crowd on Monday was the largest yet, stretching from city hall and the War Memorial — where Mosby had announced that she was prosecuting the officers involved in Gray’s arrest five years ago — down a block to the police department. But while the station had been a target for demonstrators in 2015, it was nothing but a short stop this time before the protesters dissipated down Gay Street. Xavier Brooks noted the marked difference between then and now. Then, he was a college student at McDaniel College, engaged


More than 25,000 nursing home residents and 400 staff have died during pandemic, federal report shows

More than 25,000 residents died and 60,000 were infected as the coronavirus swept through U.S. nursing homes in recent months, particularly affecting facilities with a history of low marks for staffing and patient care, the federal government reported Monday. The virus also infected 34,000 staff and took the lives of more than 400, according to the Centers for Medicare and Medicaid Services, the federal agency that oversees the nation’s nursing homes. The numbers represent the first official national accounting of fatalities in the 15,000 nursing homes that receive Medicare and Medicaid funding. The tally, however, is incomplete. Only about 80 percent of the nation’s nursing homes reported data to the federal government, and they were required only to include cases since early May. CMS officials nevertheless said they were confident the figures offer a reliable snapshot of the pandemic in the nation’s hard-hit nursing homes. “This represents a good picture of where we’ve been,” CMS Administrator Seema Verma said in a call with reporters Monday afternoon. A Washington Post accounting of cases and deaths in nursing homes shows a higher toll and that tally rounds up data from less than half of the states. Based on reports from 21 states since the beginning of the pandemic, The Post found that more than 28,000 residents have died. Of the homes that reported data to CMS, 1 in 5 recorded at least one death from covid-19, the disease caused by the coronavirus, and 1 in 4 had at least one positive case. In the District of Columbia and three states — New Jersey, Connecticut and Massachusetts — more than 1 in 10 nursing home residents died, according to the data collected so far by CMS. An early analysis by CMS showed that nursing homes that have received poor marks for nurse staffing and patient care were more likely to see higher case counts than those with stronger track records. Statistical analyses touted by the industry, by contrast, suggest that the outbreaks have little to do with the quality of nursing homes. Instead, studies indicate that a home’s location and size are better predictors of an outbreak. "Significant research from leading health experts, including analysis from Harvard Medical School and Brown University as well as testimony to Congress by the University of Chicago, has shown no correlation between covid-19 outbreak and [Medicare’s] star rating system,” said Beth Martino, American Health Care Association senior


Americans are delaying medical care, and it’s devastating health-care providers

As coronavirus infections spread and sickened more people in March, visits to hospitals around the country actually began to drop off. By April, according to a Washington Post analysis of smartphone location data, that drop had turned into a crash. As in many other industries, those lost visits represented a widespread financial crisis for hospitals and other health-care providers, even in places the novel coronavirus hardly touched. One hospital is in a hot spot, battling a widespread virus that has resulted in thousands of patients. The other hospital has seen just a few covid-19 patients and there’s no surge in sight. Yet the disease threatens the financial health of both institutions as their most profitable customers — non-emergency patients — have stayed home. Both hospitals saw the number of their inpatients drop by half in April. The hospitals have much in common. Both are at medical schools and serve as regional safety nets. But as of last week, UMass Memorial Medical Center in Worcester, Mass., had admitted almost 2,700 covid-19 patients, while MU Health Care’s University Hospital in Columbia, Mo., had admitted only about 40. Yet each hospital has canceled more than 2,000 surgeries. Tens of thousands of clinic visits have disappeared. Monthly patient revenue dropped by tens of millions of dollars. Many of the nation’s hospitals can ill afford theses losses. A third were already losing money on patient care before the virus hit, according to data compiled by Definitive Healthcare. More than 1,200 hospitals operated in the red in two or more of the last five years. Then the coronavirus hit with a one-two punch. Patient revenue dried up, and preparing for possible outbreaks drove up costs. One result of this financial stress: 1.4 million health-care jobs disappeared in April, according to the latest monthly government jobs report. Those included nearly 135,000 jobs lost at hospitals, more than 243,000 at physician offices and more than 503,000 at dental offices. Over 260 hospitals have reported furloughs or layoffs due to coronavirus-related issues, according to tracking by Becker’s Hospital Review. At MU Health Care, even with only a handful of covid-19 patients at a time, cuts have affected 61 employees, 70 contract nurses and 300 open positions. UMass Memorial has been luckier, with no layoffs so far. Doctors and nurses whose usual work disappeared have been redeployed to help amid the pandemic. Hospital visits started to drop nationwide in March


have disappeared. Monthly patient revenue dropped by tens of millions of dollars. Many of the nation’s hospitals can ill afford theses losses. A third were already losing money on patient care before the virus hit, according to data compiled by Definitive Healthcare. More than 1,200 hospitals operated in the red in two or more of the last five years. Then the coronavirus hit with a one-two punch. Patient revenue dried up, and preparing for possible outbreaks drove up costs. One result of this financial stress: 1.4 million health-care jobs disappeared in April, according to the latest monthly government jobs report. Those included nearly 135,000 jobs lost at hospitals, more than 243,000 at physician offices and more than 503,000 at dental offices. Over 260 hospitals have reported furloughs or layoffs due to coronavirus-related issues, according to tracking by Becker’s Hospital Review. At MU Health Care, even with only a handful of covid-19 patients at a time, cuts have affected 61 employees, 70 contract nurses and 300 open positions. UMass Memorial has been luckier, with no layoffs so far. Doctors and nurses whose usual work disappeared have been redeployed to help amid the pandemic. Hospital visits started to drop nationwide in March as state and federal officials called for postponing non-covid-19 treatments when possible to free up health-care resources. These cancellations included surgeries, outpatient procedures and even preventive services. By mid-May, almost 94 million adults had delayed medical care because of the coronavirus pandemic, the Census Bureau reported in its Household Pulse Survey. Some 66 million of those needed but didn’t get medical care unrelated to the virus. “Whether you have a lot of cases, or don’t have a lot of cases, you’re going to have a financial hit,” said Will Ferniany, chief executive of the UAB Health System. While covid-19 patients never came close to filling intensive care beds at its Birmingham, Ala., hospital, occupancy of other beds dropped to less than half. Ferniany’s system is losing $70 million a month in patient revenue, which it must try to make up with cost-cutting and federal aid. Under the Cares Act, the Department of Health and Human Services says $175 billion was allotted for health-care providers, including hospitals in rural and high-impact areas and places treating uninsured covid-19 patients. But hospitals could miss out on some aid if they hadn’t treated a minimum of 100 covid-19 patients, despite the pandemic’s widespread financial


The coronavirus pandemic will turn into a poverty pandemic unless we act now

Sandro Galea, an epidemiologist, is a professor and dean at the Boston University School of Public Health and the co-author, with Michael D. Stein, of “ Discussions about the covid-19 pandemic’s effects tend to focus either on public health or the economy, as if they were two separate matters. But they are linked, and not just by data about the disease’s disproportionate impact on poor and minority populations. The worldwide economic devastation from lockdown policies is sending millions into poverty — increasing their exposure to potential covid-19 infection as well as to the deadly threat that comes simply from being poor. As challenging — and vitally important — as fighting the pandemic has been, the long-term health costs of an economic depression could ultimately far eclipse what covid-19 has wrought. The United Nations University World Institute for Development Economics Research estimates that the pandemic could drive as many as 580 million people around the world into poverty, the first increase in global poverty since 1990. This would be on top of the 734 million people already living on less than $1.90 a day, and the 38.1 million Americans who, as of 2018, met the federal government’s definition of poverty. More than 38 million Americans have filed unemployment claims in a nine-week period during the pandemic, and that number is almost certain to swell. A central determinant of health is money — the ability to afford such basic resources as nutritious food, access to good medical care, safe housing, quality education and the simple peace of mind that comes with having the means to weather sudden shocks. The link between income and health is well supported by data. Less money generally means shorter, sicker lives, as reflected by the approximately 14-year gap in life expectancy between the richest and poorest Americans. In 2011, I was involved in a study that quantified how socioeconomic conditions shape health in the United States. We estimated the number of U.S. deaths attributable to key social conditions through a systematic review of the available literature combined with vital-statistics data. We found that 133,000 deaths in 2000, out of 2,403,351 total U.S. deaths that year, were linked to living as an individual below the federal poverty level. Another 119,000 deaths were linked to income inequality (defined as the percentage of the adult population living in counties with a “Gini coefficient” — a formula for measuring wealth distribution


Here’s what experts want you to know before taking a road trip during the pandemic

Memorial Day Weekend signals the beginning of vacation season for Americans, and with that comes barbecues, beach visits and travel. But with the world battling the coronavirus pandemic, and much of the country still closed as a result, our typical vacation rituals have been disrupted. Right now, the nation’s top health officials are still urging people to stay home to prevent the spread of the coronavirus. However, with different pockets of America reopening and people becoming impatient with stay-at-home orders, some are looking for ways to vacation despite the obstacles. Thanks to the pandemic’s upset of traditional travel, industry experts are saying this will be the year of the road trip. “I think Americans will take a wait-and-see-attitude about longer trips this summer, but they may be interested in taking road trips,” says John B. Townsend II, a manager of public and government affairs for AAA. “We’ve seen surveys that show that about a third of Americans say they plan to take a road trip this summer.” According to Townsend and Roger Dow, president and CEO of U.S. Travel Association, America’s interest in road trips has translated to a spike in RV rentals and purchases. “Companies, like Cruise America where you can rent an RV, their numbers are getting a tremendous increase,” Dow says. “I’ve watched some of [the RV companies'] stocks go up.” For those considering a road trip in their car or RV, know that taking one isn’t risk-free. Here’s what else you should consider ahead of pandemic travel. Before you set off on the road, ask yourself if your trip is essential. “We’re still in the middle of the pandemic,” says special pathogens expert Syra Madad, who was recently featured in Netflix docuseries “Pandemic: How to Prevent an Outbreak.” “And, unfortunately, this is something that’s going to be with us for the foreseeable future.” With at least 1.5 million confirmed coronavirus cases in the United States and no available vaccine, experts say we’re still in a very critical stage, despite some parts of the country easing restrictions. “There’s still widespread community transmission all over the United States,” says Madad. “We understand people want to get out, but health and safety is paramount.” Madad’s advice to Americans mirrors that of the Centers for Disease Control and Prevention at this time, to stay home as much as possible and practice social distancing. “I think no one should be traveling,”


Shrinking newsrooms could affect how we view the coronavirus pandemic

and within its sourcing,” Chappell said. This kind of list is particularly helpful to journalists on deadline, when “diversity of their sources may not be top of mind,” said Caroline Chen, a health-care reporter for ProPublica. “There is a tendency for the media to repeatedly go to the same experts over and over again. I see a lot of familiar names in the stories I read, and I certainly call those folks, too,” said Chen, who collaborated with Chappell to create the expert list. “To some degree, that is warranted. Those experts are called upon because they are truly knowledgeable in their field. But more often than not, I would say the principal investigators of studies, directors of research labs, heads of medical departments, etc., are male and white.” To find more diverse sources, Chen asks the people she interviews for recommendations. She said she also works on diversifying her source list on Saturday mornings, so she’s not scrambling to find folks on weekdays. “I think it’s our job as journalists to recognize that in a complicated and evolving situation like the coronavirus pandemic, that there’s no such thing as a uniform experience for Americans as a whole, or people in an entire state,” Chen said. “Things like income, Zip code, preexisting health conditions, all of which can be tangled up together with race, are critical factors in affecting the experience one has during this time.” News media legitimizes the experiences it covers, said Jonathan Corpus Ong, associate professor of global digital media at the University of Massachusetts at Amherst, so members of communities that are absent or misrepresented can suffer real-life consequences. “It’s a pattern of erasure,” Ong said. “In a way, you’re really forced now to wear some blinders to ignore all of these other experiences. And I think that’s disappointing for us as Asians. It’s a common experience to always be overlooked.” Read more: Masking while black: A coronavirus story Asian American doctors and nurses are fighting racism and the coronavirus Disproportionately black counties account for over half of coronavirus cases in the U.S. and nearly 60% of deaths, study finds Asians are stereotyped as ‘competent but cold.’ Here’s how that increases backlash from the coronavirus pandemic. Hispanics are almost twice as likely as whites to have lost their jobs amid pandemic, poll finds Covid-19 has been brutal in Indian country — just like past epidemics were


What white Americans can learn about racism from the coronavirus

About US No single crisis or event in recent history has so sharply magnified the country’s racial disparities and inequities as the coronavirus. Not even Hurricanes Katrina and Maria, whose death and destruction primarily affected people of color, but were localized. The coronavirus is omnipresent. It has infected people in every state, in big cities and rural communities, and from every economic class. It has infected and killed men and women of all ages and all races. Even so, in the words of the Centers for Disease Control and Prevention, African Americans and other people of color have shouldered “a disproportionate burden of illness and death” from covid-19, the disease caused by the virus. A new study this week, led by Amfar and Emory University’s Rollins School of Public Health, found that disproportionately black counties account for 22 percent of all counties but have 52 percent of coronavirus cases and 58 percent of deaths from covid-19. Darren Hutchinson, a law professor who studies the law’s impact on race and gender, thinks white Americans can learn a thing or two about racism from the pandemic. How the fear and uncertainty they are feeling now is not unlike what African Americans, Latinos, Asian Americans and others feel all the time. Hutchinson, an associate dean at the University of Florida’s Levin College of Law, elaborated on that notion during a recent conversation with About US. This interview has been lightly edited for length and clarity. Unlike other disasters and crises, the coronavirus seems to have laid bare the structural inequities across the board — in health care, economics, even in criminal justice — all at once. Do you agree? How is that affecting society? Everyone’s vulnerable. In terms of geography, it’s all over the country. Every age group potentially can be affected. It’s across gender. And to the extent that structural racism impacts people along all of those axes, this is a moment where it’s really going to stand out. In terms of the fear that a lot of people, generally, have right now — and I know it’s higher among people of color — but this is the fear and anxiety that people of color experience on a daily basis. The virus is not only showing us how pervasive inequality is, it’s also giving us a moment to think about how living daily in that structural racism creates this anxiety. You know


History shows we’re never ‘all in the same boat’ during a pandemic | Hannah Explains

The Washington Post’s Hannah Jewell looks back at plague and yellow fever outbreaks in Europe and New Orleans, which revealed stark divides between the rich and poor.


Washington region adds 62 covid-19 deaths as hospitalizations, positivity rates decline

The District and Northern Virginia lifted portions of their shutdown restrictions on Friday, and other parts of Maryland and Virginia mostly did so earlier in May. Hogan warned that large public gatherings, including protests against police brutality that have attracted thousands demonstrators in Baltimore, the District, Richmond and elsewhere, could lead to more infections. But, he said, it is too soon to tell. “It’s certainly still not safe to gather in large numbers in close proximity,” Hogan told WBAL radio. “And we saw an awful lot of that. So hopefully it’s not going to be bad, but it’s definitely something that the doctors and the scientists are worried about.” Election officials Barbara Christie, seated, Barbara Dodge and Marc Mitchell help Hannah Jacobs, reflected in the plexiglass shield, cast her ballot in the Maryland primary Tuesday at the William R. Talley Recreation Center in Frederick. Masks and other precautions were used to guard against spread of the novel coronavirus, and voters were encouraged to cast ballots by mail. (Katherine Frey/The Washington Post) The tally of known coronavirus infections reached 109,271 in the District, Maryland and Virginia, with 4,472 covid-19 deaths. Maryland reported 45 deaths, for a total of 2,597, and 848 new infections, more than half of them in Montgomery and Prince George’s. Eight new deaths were reported in Montgomery, bringing that county’s death toll to 624. Prince George’s added seven covid-19 deaths, for a total of 552. Maryland’s hospitals had a total of 1,148 covid-19 patients Tuesday, continuing a steady decline since mid-May, when about 1,500 were hospitalized. The state’s seven-day average of positive coronavirus tests has also been dropping, to 10.5 percent on Tuesday. The District recorded two additional covid-19 fatalities — both 79-year-old men — and 29 new infections. There were 295 hospitalized covid-19 patients in the District Tuesday, down from 353 a week ago. The city’s rate of infections was 18.6 percent, down from about 22 percent last month. Virginia recorded an additional 15 fatalities, six of which were in the commonwealth’s northern suburbs. There were 841 new cases, with more than half of those in Northern Virginia. The state had 1,362 covid-19 patients hospitalized Tuesday, compared to 1,524 on Friday. The seven-day average for new infections was 9.1 percent statewide, and 15.5 percent in Northern Virginia. In Alexandria, the Economic Development Partnership reminded businesses affected by the prolonged economic shutdown that they can apply for city


to cast ballots by mail. (Katherine Frey/The Washington Post) The tally of known coronavirus infections reached 109,271 in the District, Maryland and Virginia, with 4,472 covid-19 deaths. Maryland reported 45 deaths, for a total of 2,597, and 848 new infections, more than half of them in Montgomery and Prince George’s. Eight new deaths were reported in Montgomery, bringing that county’s death toll to 624. Prince George’s added seven covid-19 deaths, for a total of 552. Maryland’s hospitals had a total of 1,148 covid-19 patients Tuesday, continuing a steady decline since mid-May, when about 1,500 were hospitalized. The state’s seven-day average of positive coronavirus tests has also been dropping, to 10.5 percent on Tuesday. The District recorded two additional covid-19 fatalities — both 79-year-old men — and 29 new infections. There were 295 hospitalized covid-19 patients in the District Tuesday, down from 353 a week ago. The city’s rate of infections was 18.6 percent, down from about 22 percent last month. Virginia recorded an additional 15 fatalities, six of which were in the commonwealth’s northern suburbs. There were 841 new cases, with more than half of those in Northern Virginia. The state had 1,362 covid-19 patients hospitalized Tuesday, compared to 1,524 on Friday. The seven-day average for new infections was 9.1 percent statewide, and 15.5 percent in Northern Virginia. In Alexandria, the Economic Development Partnership reminded businesses affected by the prolonged economic shutdown that they can apply for city and federal relief funds. The agency said Tuesday it has $4.4 million to distribute to businesses that have lost 25 percent or more revenue due to the pandemic. Applications will be accepted between Thursday at 8 a.m. and Monday at 5 p.m., the agency said. Businesses with between two and 100 employees before Virginia’s shutdown orders went into effect in late March are eligible for grants of between $10,000 and $20,000, depending on the size of their business, the agency said. “The need is immediate,” said Stephanie Landrum, the AEDP’s president and chief executive. “Reopening and re-scaling is already happening.” Patricia Sullivan contributed to this story. Read more: This Maryland mayor has overseen his town’s coronavirus response. Up next, National Guard deployment. Mexico’s hospitals strain to treat coronavirus as officials say cases are peaking MLB’s proposal for severely shortened season is a step toward deal with union Local newsletters: Local headlines (8 a.m.) | Afternoon Buzz (4 p.m.) Like PostLocal on Facebook


Don’t Only Bet on Fast Vaccines, Root for Covid Treatments

efficacy, but there are plenty more in the pipeline. When it comes to development, the pathway for treatments is generally smoother than the one for vaccines, which can run into bottlenecks that are fundamentally difficult to break. For one, the fact that innoculations are aimed at healthy individuals means there is a higher safety bar. And the large trials necessary for trying out vaccines would have to occur in places where Covid-19 is spreading substantially to get the random exposure required to test them properly. With multiple candidates in development and ongoing precautions to avoid infection, getting robust data fast may be an issue. Finding volunteers is also an issue for treatment trials, as case counts level off. Still, many outcomes for infected patients can be determined comparatively rapidly. Along with a higher tolerance for side effects in individuals at possible near-term risk of dying, this permits smaller and faster tests. There are a few significant groups of possible treatments. The first involves repurposing existing drugs such as hydroxychloroquine and remdesivir. Because these types of medicines were originally designed to treat other conditions, they are less likely to produce a dramatic effect. However, if one is useful, it can be deployed quickly. One category within this group doesn’t aim at the virus, but the out-of-control immune response it can cause. Roche Holding AG’s arthritis drug Actemra has shown some early promise and is in larger trials. Researchers plan to test a variety of other medicines that target inflammation. If successful, they could provide several avenues to improved outcomes in critically ill patients. Another idea? Drug cocktails. That’s the thought behind a recently started trial combining remdesivir and Actemra. Several other repurposed combinations, existing flu drugs, and a host of other medicines have opportunities to prove their worth. A second category of drug treatments involves a different type of recycling: using the blood of recovered individuals. People who survive Covid-19 develop antibodies against the virus and their donated plasma is already part of treatment regimens for sick patients around the world. Early results look promising, but they need confirmation from randomized trials that are now under way. Scale and variability issues may prevent convalescent plasma from treating millions, so it’s worth boosting identification and collection efforts now even if the benefits of this type of treatment aren’t yet fully determined. A concentrated version under development by Takeda Pharmaceutical Co. also could


Brazil Has Deadliest Day; NYC Keeps Reopening Plan: Virus Update

in an interview on Bloomberg Television with David Rubenstein. “The availability of classrooms will be a challenge.” Journals Raise Concerns About Data in Covid Studies (5:15 p.m. NY) Two prestigious medical journals said they have significant concerns about a database that was used to look at how older drugs may work in the treatment of Covid-19. The New England Journal of Medicine published an “expression of concern” about a study published by the journal on May 1 that looked at the use of heart drugs called ACE inhibitors in coronavirus patients. Later Tuesday the Lancet, a nearly 200-year-old U.K. medical journal, issued its own similar warning on a study about treating Covid-19 patients with the malaria drug hydroxychloroquine. Both studies relied on data from a firm called Surgisphere Corp., which says it aggregates information from medical records around the globe. Last week, more more than 200 scientists signed a letter to the Lancet asking for greater transparency regarding the hospitals where patients’ medical records came from and the method of analysis, along with other issues. Sapan Desai, Surgisphere’s chief executive officer, said the firm would have an outside group audit the data used in the Lancet study, and would give the authors of the New England Journal paper access to the underlying information so they can review its accuracy. Zoom Sales Soars on Video Conference Use (5:30 p.m. NY) Zoom Video Communications Inc. reported quarterly sales that more than doubled, leapfrogging analysts’ estimates, showing that a surge in demand for its video-conference service has translated into more paying customers. The company also doubled its annual revenue forecast. U.S. Cases Rise 1.2% (4 p.m. NY) Coronavirus cases in the U.S. increased 1.2% as compared with the same time Monday, to 1.82 million, according to data collected by Johns Hopkins University and Bloomberg News. That’s higher than Monday’s 1% rate, and in line with the average over the past seven days. Deaths rose 0.9% to 105,644. • New York cases rose 0.4% to 373,040, compared with an average increas of 0.3% over the past seven days. • Florida cases rose 1.1% to 57,447, compared with an average of 1.3% in the past seven days, according to the state’s health department. Deaths rose 2.8% to 2,530, the biggest jump since May 8. • California cases climbed 2% to 115,310 while deaths increased 0.8% to 4,286, according to the state’s website. • Texas cases


U.S. Giving India Ventilators; Brazil Deaths Surge: Virus Update

President Donald Trump told India Prime Minister Narendra Modi the U.S. would ship 100 donated ventilators to the South Asian nation. Brazil reported a record day of deaths. New York Governor Andrew Cuomo warned that mass protests against police violence could accelerate the spread of coronavirus and undo weeks of social-distancing efforts. Even with the unrest, New York City still plans to begin reopening Monday. The U.K. will publish details of its plan to impose a 14-day quarantine on all overseas rivals, effective June 8. Prime Minister Boris Johnson plans to reset his government’s agenda with a financial statement and a speech on the post-pandemic landscape. Key Developments: • Virus Tracker: Cases pass 6.3 million; deaths exceed 378,000 • Wall Street sends wine, masks to clients with steakhouses closed • NYC businesses crushed by Covid now face riots • Trump’s WHO exit threatens polio, tuberculosis along with Covid • Indonesia’s most-populous province to ease curbs in 15 cities • Social distancing is improving your shopping experience Subscribe to a daily update on the virus from Bloomberg’s Prognosis team here. Click VRUS on the terminal for news and data on the coronavirus. For a look back at this week’s top stories from QuickTake, click here. U.K. to Publish Quarantine Plans for Overseas Arrivals (8:14 a.m. HK) The U.K. will publish details Wednesday of its plan to impose a 14-day quarantine on all overseas arrivals. The move, which takes effect June 8, was announced by Home Secretary Priti Patel last month. Aside from what her office called “a short list” of exemptions, it will cover everyone arriving in England from abroad. They will be required to fill in a form saying where they will self-isolate. “As we get the virus under control here, we must manage the risk of cases being imported from abroad,” Patel said in an emailed statement. “We owe it to the thousands who’ve lost their lives not to throw away our progress.” Under the government’s plan, officials will conduct spot checks to ensure compliance. Automakers Regain Sales Ground in U.S. After Worst Month in Decades (7:30 a.m. HK) Automakers started down the road to recovery last month, with U.S. industry sales rebounding from the slowest pace in decades. The annualized rate of car and truck sales rose to 12.2 million in May from 8.6 million in April, according to Ward’s Automotive Group. The earlier reading was the lowest


seasonally adjusted figure in data going back to 1976. Total sales fell 26% for Toyota Motor Corp., 17% for Honda Motor Co. and 13% for Hyundai Motor Co. in May from a year earlier. While Hyundai’s retail deliveries rose 5% for the month, fleet purchases plunged 79%. Brazil Reports Deadliest Day (6:45 a.m. HK) Brazil reported a record 1,262 new deaths on Tuesday, bringing the number of fatalities to 31,199. There were also 28,936 new reported cases, pushing the country’s total to 555,383, behind only the U.S. The nation of 210 million people has become an epicenter of the virus in the last few weeks. Brazil’s peak has not yet arrived, and “at the moment it is not possible to predict when it will arrive,” Michael Ryan, executive director of the World Health Organization’s Emergencies Program, said Monday. Harvard Weighs Changes for Virus Era (6:20 a.m. HK) Harvard University is weighing an array of options -- from disinfecting classrooms after each session to reducing the number of students sitting in lecture halls -- to cope with the coronavirus pandemic when it reopens, said President Lawrence Bacow. The Cambridge, Massachusetts, school will also likely cancel some fall sports, he said, and is holding off a decision to resume instruction on campus as long as possible. “Lots of things will be different when students come back,” Bacow said in an interview on Bloomberg Television with David Rubenstein. “The availability of classrooms will be a challenge.” Journals Raise Concerns About Data in Covid Studies (5:15 p.m. NY) Two prestigious medical journals said they have significant concerns about a database that was used to look at how older drugs may work in the treatment of Covid-19. The New England Journal of Medicine published an “expression of concern” about a study published by the journal on May 1 that looked at the use of heart drugs called ACE inhibitors in coronavirus patients. Later Tuesday the Lancet, a nearly 200-year-old U.K. medical journal, issued its own similar warning on a study about treating Covid-19 patients with the malaria drug hydroxychloroquine. Both studies relied on data from a firm called Surgisphere Corp., which says it aggregates information from medical records around the globe. Last week, more more than 200 scientists signed a letter to the Lancet asking for greater transparency regarding the hospitals where patients’ medical records came from and the method of analysis, along with other


biggest jump since May 8. • California cases climbed 2% to 115,310 while deaths increased 0.8% to 4,286, according to the state’s website. • Texas cases rose 2.6% to 66,568, exceeding the seven-day average of 2.1%, according to state health department figures. Hospitalizations increased by 1% to 1,773 patients. Tyson Foods Says 591 Plant Workers Test Positive (2:56 p.m. NY) Tyson Foods said it would resume limited production on June 3 at an Iowa plant that had an outbreak of the coronavirus. At the Storm Lake plant, 591 workers tested positive out of 2,303 that were tested, the company announced Tuesday. More than 75% of the positive cases are asymptomatic. Separately, at the company’s Council Bluffs plant, 224 tested positive out of its 1,483 employees. U.K. Minorities Face Higher Risk of Dying (12:37 p.m. NY) People from ethnic minority groups in England face a higher risk of dying if they develop a serious case of Covid-19 than white patients, an analysis by Public Health England showed. Males, people older than 80 years and those living in deprived areas are also more vulnerable, the agency said in a report published on Tuesday. The study didn’t take into account aggravating factors such as pre-existing medical conditions or obesity. NYC Mayor Says City Will Still Reopen (11:38 a.m. NY) Mayor Bill de Blasio still plans to begin reopening New York City on June 8, despite the unrest related to protests over the death of George Floyd and a curfew that will continue for the rest of the week. “It’s hard to believe that just a few days ago, all we were talking about was the pandemic,” de Blasio said Tuesday. “The pandemic is still there and we must address that. We need to reopen this city.” Last week, the mayor estimated that 200,000 to 400,000 people will be returning to work in construction, manufacturing, wholesale and curbside retail during the first phase of the city’s reopening. Eurostar Increases London-Paris Service (10:35 a.m. NY) Eurostar has made a small increase to service due to a slight rise in demand, according to a representative for the high-speed rail service. Eurostar has two trains a day in each direction on the Paris-London route Monday to Thursday and three trains on Friday, Saturday and Sunday. It maintains one train in each direction on the London-Brussels route. Iceland Proceeds With Airport Testing (9:45 a.m. NY) Iceland is proceeding


The Health 202: ‘The stories about protests are also the stories about covid-19 and racism,’ says one epidemiologist

This time, as the nation erupts over the latest example of police violence toward African Americans, there’s a pandemic in the background. The confluence of massive protests and a pandemic provides an unprecedented and tangible example of the steep challenges black people face every day in the United States. By nearly every benchmark, the coronavirus outbreak has produced more severe consequences in the lives of African Americans compared with their white counterparts. Black Americans are infected with the virus at higher rates and dying of it more frequently. They are more likely to have lost their employment because of the shutdowns. And they started out with fewer resources on hand to weather the health crisis. “It became really clear covid was not a leveler,” said Steven Brown, a research associate at the Urban Institute and author of an analysis on how the virus has affected the economic well-being of minorities. “Even though we’re all at risk, it was incredibly clear that some people were more at risk.” For nearly a week, people protesting George Floyd’s death have held nightly demonstrations in a number of U.S. cities, some of them marching peacefully even as others vandalize stores, government buildings and cars. As protests intensified yesterday in New York, Chicago and St. Louis, President Trump threatened to deploy federal troops if state and city leaders don’t act to quell the chaos. The protests are stoking concerns that black Americans gathering in close proximity could further worsen disparities that have been years in the making. These disparities are now getting unprecedented attention because of two of the biggest news events this year: the pandemic and Floyd’s death. Just as the protests over Floyd’s death have brought fresh attention to how black Americans are treated by law enforcement, the pandemic also stirred up a focus on how they lag far behind when it comes to personal health and access to affordable, high-quality care. “The stories about protests are also the stories about covid-19 and racism,” said Zinzi Bailey, a social epidemiologist at the University of Miami. African Americans have higher coronavirus infection rates. One reason for this is they tend to live in cities, where the virus has taken hold more aggressively than in suburban or rural areas. U.S. localities with larger-than-average black populations account for more than half of coronavirus cases, according to a national study by Amfar, the Foundation for AIDs Research.


disease,” they wrote. “These are also the wards with some of the highest-known case counts of the virus, according to city health data.” In Louisiana, another area hit hard by the virus, the state’s health department estimated that black Americans account for 55 percent of all deaths. Almost 60 percent of residents who died had hypertension and 37 percent had diabetes, my colleagues reported. Larger shares of African Americans lost jobs, work hours or income during the lockdowns. Black people, as well as Hispanics, tend to have jobs impossible to do at home, like working in grocery stores or warehouses or as caregivers in hospitals or nursing facilities. Just 35.4 percent of black adults reported in an Urban Institute survey that they can do part of their work remotely, compared with 43.4 percent of white adults. And while many black people work in jobs considered “essential,” black families reported financial losses during the March and April lockdowns at a slightly higher rate. Forty-one percent of blacks said their families experienced a loss of a job, work hours or job-related income, compared with 38 percent of whites. And in the event of job loss, African American families tend to have fewer savings to draw upon. More than half of black adults with pandemic-related income losses reported drawing on savings or running up credit card balances, compared with 36 percent of whites. More black Americans are struggling to pay for housing. Black Americans were more likely to miss their May housing payments than their white counterparts, according to U.S. Census Bureau data analyzed by the Urban Institute. About a quarter of black renters said they didn’t pay their rent last month, compared with 14 percent of white renters. The differences were more pronounced among those who own homes; 28 percent of black homeowners didn’t pay their mortgage, compared with just 9 percent of white homeowners. And black people reported slight or no confidence in their ability to make their housing payments at a rate nearly double that of white people. AHH: Americans are delaying medical care amid the pandemic. Doctors and hospitals can't afford the losses. Hospital visits have been declining nationwide. By the middle of May, almost 94 million American adults had delayed medical care because of the pandemic, according to the Census Bureau’s Household Pulse Survey. About 66 million of those people needed care unrelated to the virus but did


of federal standards meant to prevent the spread of illness,” Peter, Debbie and Joel report. “…Verma said the agency will distribute $80 million to states to increase infection-control inspections of nursing homes during the pandemic. States that fail to inspect all Medicare-certified homes by July 31 will be required to submit a corrective plan to the federal government. Those still lagging by August will lose some of the money.” Even amid the fear, risk and isolation, residents in some homes are still finding ways to connect. Residents in nursing homes, assisted-living facilities and retirement communities across the country are quarantined because of the coronavirus that has impacted the elderly more than anyone else. But they’re not always completely alone, Marc Fisher reports in this uplifting piece. “On Radio Recliner, a new online radio station, the DJs are elderly folks who have spent the past two months stuck in their rooms, meals delivered to their doors, activities canceled, their relatives relegated to waving through a window, at best,” he writes. “At a time of great fear and risk — old-age home residents make up about 40 percent of the nation’s deaths from the virus — the disc jockeys get to tell stories of better times as they spin their favorite tunes, from Elvis and ’40s big band tunes to ’60s rock (including the hard stuff) and a whole lot of love songs.” Eli Lilly said it started an early-stage trial of a potential covid-19 treatment. The drugmaker is conducting the first study in the world of an antibody treatment against the disease caused by the novel coronavirus. It was derived from a blood sample from one of the first patients in the United States to recover from the illness, Reuters’s Ankur Banerjee reports. “Lilly said its early stage study will assess safety and tolerability in patients hospitalized with COVID-19 and results are anticipated by the end of June,” Ankur reports. “ … Lilly said it expects to move into the next phase of testing, studying the potential treatment in non-hospitalized COVID-19 patients, if the drug is shown to be safe.” Gilead Sciences said remdesivir has helped some patients with moderate covid-19 cases. New data from a study the company conducted found the drug benefited patients with “moderate” covid-19 when they received the treatment for five days, though there was not a statistically significant benefit when the treatment was administered for 10


Why Is Beijing Bailing Out Car Inc.?

Famed investor Carl Icahn couldn’t save an American emblem, Hertz Global Holdings Inc. So why does a Beijing-backed enterprise think it can rescue China’s largest car rental company? With its prospects for fresh capital dimming, Car Inc., which shares a chairman with scandal-hit Luckin Coffee Inc., says it’s selling a stake to Beijing Automotive Group Co., the Chinese joint venture partner for Daimler AG-owned Mercedes-Benz and Hyundai Motor Co. BAIC plans to buy up to 21.26%, or a maximum 450.8 million shares, the entire ownership of parent UCAR Inc. That would make the state-owned entity the second-largest shareholder behind Legend Holdings, parent of computer maker Lenovo Group Ltd. Another agreement that was in the works between UCAR and a vehicle linked to private equity giant Warburg Pincus LLC will be terminated. Investors cheered Monday’s news, with the stocks and bonds rising from near rock-bottom. The sale would help sever ties between Car Inc. and Luckin and, in theory, reduce further fallout from the scandal engulfing the coffee chain and Chairman Charles Lu Zhengyao that has riled regulators. But the rescue doesn’t make much strategic or financial sense for either Car Inc. or BAIC.The last thing BAIC needs in the current auto market, which was sagging even before the pandemic, is the stress of a troubled rental company and all the strings attached. The auto giant’s first-quarter results showed that net profit declined 95% on year. The local Beijing brand posted a loss of 1.4 billion yuan ($196 million). Mercedes-Benz was better off because premium-segment demand has held up. Sales volume halved on the Hyundai side. BAIC is already playing rescuer elsewhere, bolstering dealerships with financial support like payable extensions, interest waivers and higher subsidies.What BAIC will — or can — do for Car Inc. through such an arrangement is unclear. The company may end up being a sink for BAIC. The rental business relies heavily on financing and needs capital with high costs on vehicle acquisitions and other such operations. UCAR, the parent, has also been a source of revenue for Car Inc. through fleets; what happens to those relationships once ties are cut will be in doubt. Car Inc. has to deal with the residual value of its cars because in China, manufacturers don’t offer guaranteed depreciation or repurchase programs. The company also has guaranteed subsidiary borrower loans onshore along with other shadow financing arrangements. It will be on


The Health 202: 'The stories about protests are also the stories about covid-19 and racism,' says one epidemiologist

with Paulina Firozi This time, as the nation erupts over the latest example of police violence toward African Americans, there’s a pandemic in the background. The confluence of massive protests and a pandemic provides an unprecedented and tangible example of the steep challenges black people face every day in the United States. By nearly every benchmark, the coronavirus outbreak has produced more severe consequences in the lives of African Americans compared with their white counterparts. Black Americans are infected with the virus at higher rates and dying of it more frequently. They are more likely to have lost their employment because of the shutdowns. And they started out with fewer resources on hand to weather the health crisis. “It became really clear covid was not a leveler,” said Steven Brown, a research associate at the Urban Institute and author of an analysis on how the virus has affected the economic well-being of minorities. “Even though we’re all at risk, it was incredibly clear that some people were more at risk.” Demonstrators confront law enforcement during a protest on June 1 in downtown Washington, DC. (Photo by Drew Angerer/Getty Images) ***BESTPIX*** For nearly a week, people protesting George Floyd’s death have held nightly demonstrations in a number of U.S. cities, some of them marching peacefully even as others vandalize stores, government buildings and cars. As protests intensified yesterday in New York, Chicago and St. Louis, President Trump threatened to deploy federal troops if state and city leaders don't act to quell the chaos. The protests are stoking concerns that black Americans gathering in close proximity could further worsen disparities that have been years in the making. These disparities are now getting unprecedented attention because of two of the biggest news events this year: the pandemic and Floyd’s death. Just as the protests over Floyd’s death have brought fresh attention to how black Americans are treated by law enforcement, the pandemic also stirred up a focus on how they lag far behind when it comes to personal health and access to affordable, high-quality care. “The stories about protests are also the stories about covid-19 and racism,” said Zinzi Bailey, a social epidemiologist at the University of Miami. Protesters march in New York City during a solidarity rally for George Floyd on Saturday. (Wong Maye-E/AP) African Americans have higher coronavirus infection rates. One reason for this is they tend to live in cities,


where the virus has taken hold more aggressively than in suburban or rural areas. U.S. localities with larger-than-average black populations account for more than half of coronavirus cases, according to a national study by Amfar, the Foundation for AIDs Research. “The Amfar study, based on data collected April 13, focused on counties in which black people made up more than 13 percent of the population,” my colleague Vanessa Williams wrote last month. “Disproportionately black counties account for 22 percent of all U.S. counties but have been home to 52 percent of coronavirus cases and 58 percent of deaths from covid-19.” Black Americans are dying from covid-19, the disease the virus causes, at a rate nearly two times higher than white Americans. While African Americans comprise 13 percent of the U.S. population, they account for 24 percent of deaths where race is known, according to the Covid Tracking Project. Chronic health conditions including hypertension and diabetes — which significantly increase a person’s risk for serious covid-19 complications — are a major factor here. In Washington, D.C., for example, a majority of confirmed cases are in some of the city’s densest neighborhoods with large majority-minority populations and high rates of chronic health conditions, my colleagues Aaron Williams and Adrian Blanco reported. “Wards 5, 7 and 8, which flank the eastern edge of the city, are majority-black areas and have above national rates of chronic health conditions such as diabetes, obesity and heart disease,” they wrote. “These are also the wards with some of the highest-known case counts of the virus, according to city health data.” In Louisiana, another area hit hard by the virus, the state’s health department estimated that black Americans account for 55 percent of all deaths. Almost 60 percent of residents who died had hypertension and 37 percent had diabetes, my colleagues reported. Larger shares of African Americans lost jobs, work hours or income during the lockdowns. Black people, as well as Hispanics, tend to have jobs impossible to do at home, like working in grocery stores or warehouses or as caregivers in hospitals or nursing facilities. Just 35.4 percent of black adults reported in an Urban Institute survey that they can do part of their work remotely, compared with 43.4 percent of white adults. And while many black people work in jobs considered “essential," black families reported financial losses during the March and April lockdowns at a slightly


reports in this uplifting piece. “On Radio Recliner, a new online radio station, the DJs are elderly folks who have spent the past two months stuck in their rooms, meals delivered to their doors, activities canceled, their relatives relegated to waving through a window, at best,” he writes. “At a time of great fear and risk — old-age home residents make up about 40 percent of the nation’s deaths from the virus — the disc jockeys get to tell stories of better times as they spin their favorite tunes, from Elvis and ’40s big band tunes to ’60s rock (including the hard stuff) and a whole lot of love songs.” Industry efforts Eli Lilly said it started an early-stage trial of a potential covid-19 treatment. The drugmaker is conducting the first study in the world of an antibody treatment against the disease caused by the novel coronavirus. It was derived from a blood sample from one of the first patients in the United States to recover from the illness, Reuters’s Ankur Banerjee reports. The Eli Lilly corporate headquarters in Indianapolis. (Darron Cummings/AP) “Lilly said its early stage study will assess safety and tolerability in patients hospitalized with COVID-19 and results are anticipated by the end of June,” Ankur reports. “ … Lilly said it expects to move into the next phase of testing, studying the potential treatment in non-hospitalized COVID-19 patients, if the drug is shown to be safe.” Gilead Sciences said remdesivir has helped some patients with moderate covid-19 cases. New data from a study the company conducted found the drug benefited patients with “moderate” covid-19 when they received the treatment for five days, though there was not a statistically significant benefit when the treatment was administered for 10 days, Stat News’s Matthew Herper reports. The Gilead Sciences headquarters in Foster City, Calif. (Ben Margot/AP) These “moderate”-case patients were hospitalized but did not require mechanical ventilation. The new data “add to the evidence that the medicine is at least somewhat effective treatment for Covid-19. But they will also likely add to the debate of exactly how effective the remdesivir is, and in what patients,” Matthew adds. “ … An earlier study showed that patients with severe disease who received remdesivir recovered four days faster than similar patients who received placebo.” Moving toward a new normal Most Americans still favor curbing the spread of the coronavirus over reopening the economy.


Live updates: Pennsylvania braces for chaos during Tuesday primary; coronavirus could haunt economy for next decade

Election officials in Pennsylvania anticipate chaos on Tuesday as the state’s primary election takes place amid the coronavirus pandemic and protests over police brutality. Thousands of voters who requested absentee ballots still have yet to receive them, and many Philadelphia poll workers are backing out of their commitment out of fear of civil unrest. The coronavirus pandemic will haunt the U.S. economy for the next decade, costing nearly $8 trillion by 2030, according to a report released Monday by the Congressional Budget Office. That figure reflects the long-term impact of reductions in consumer spending, as well as the growing number of businesses that have collapsed under the financial strain in recent months. Senate Minority Leader Charles E. Schumer (D-N.Y.) and Sen. Bernie Sanders (I-Vt.), who requested the report, said on Monday that Congress should “act with a fierce sense of urgency” to approve relief funds in light of the grim forecast. Here are some significant developments: Experts are pushing back on recent reports claiming that the coronavirus is becoming less lethal, though many infectious-disease specialists say the virus will eventually mutate in ways that make it less deadly to humans. More than 25,000 nursing home residents have died of covid-19, the disease caused by the coronavirus, in recent months, according to the Centers for Medicare and Medicaid Services. Facilities with low ratings for patient care and staffing were hit particularly hard. A Washington Post-ABC News poll found that Americans’ viewpoints on reopening the country are starkly divided along partisan lines, with Democrats saying that controlling the spread of the virus was more important and Republicans prioritizing the economy. Mexico lifted its 70-day lockdown on Monday, but officials say that the danger is hardly over. Senate lawmakers are introducing a bipartisan bill to regulate contact-tracing apps and ensure users’ privacy. Sign up for our coronavirus newsletter | Mapping the spread of the coronavirus: Across the U.S. | Worldwide | Which states are reopening | Has someone close to you died of covid-19? Share your story with The Washington Post.


U.S. coronavirus cases surpass 1.8 million as concern over potential spread rises with turmoil

The number of reported coronavirus cases in the United States has surpassed 1.8 million, including more than 104,000 deaths. Officials emphasized the need for testing, physical distancing and face covering, a reflection of concern that the easing of stay-at-home restrictions, as well as large protests against police brutality across the nation, could lead to a spike in new cases. Amid the turmoil, on Tuesday eight states and the District of Columbia held primary elections; four of them — in Indiana, Maryland, Pennsylvania and Rhode Island — were rescheduled from earlier dates because of the coronavirus outbreak. Voters encountered fewer voting locations, signs encouraging social distancing and poll workers in protective gear, though no serious issues were initially reported. Here are some significant developments: About 7 in 10 Americans say they would get a vaccine to protect against the novel coronavirus if immunizations were free and available to everyone, according to a Washington Post-ABC News poll. The nationwide survey finds that a majority of people of all political affiliations are interested in receiving such a vaccine, but the extent of that interest varies along partisan lines. Experts are pushing back on recent reports claiming that the coronavirus is becoming less lethal, although many infectious-disease specialists say the virus will eventually mutate in ways that make it less deadly to humans. In an interview Tuesday evening, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said he was “cautiously optimistic” about Modern’a vaccine candidate. However, he is unsure of the durability of its protection. The pandemic will haunt the U.S. economy for the next decade, costing nearly $8 trillion by 2030, according to a report released Monday by the Congressional Budget Office. As Mexico City hits what officials say is the peak of its outbreak, it’s facing an onslaught of cases with an understaffed and undersupplied hospital system. There is concern the country’s death toll is far higher than the official figures. Iran reported nearly 3,000 new coronavirus cases on Monday, the highest daily rise in two months, as the country’s health minister warned that Iranians are facing another wave. Sign up for our coronavirus newsletter | Mapping the spread of the coronavirus: Across the U.S. | Worldwide | Which states are reopening | Has someone close to you died of covid-19? Share your story with The Washington Post.


Virus tests Mexico’s fragile health system

Doctors and nurses prepare to treat covid-19 patients in intensive care at Juarez Hospital in Mexico City. (Carlos Jasso/Reuters) MEXICO CITY — In some ways, López-Gatell is Mexico’s Dr. Fauci. The Mexican epidemiologist has serious academic chops — a Ph.D. from Johns Hopkins — and years of experience battling pandemics. But he has staked out a radically different path from many of his peers. Mexico hasn’t imposed a curfew or used police to keep people home. It’s not attempting mass testing for the coronavirus. Early on, Mexican officials were optimistic their strategy was working — and by some measures, it appeared to be. Mexico City recorded its first coronavirus case a day before similarly sized New York City. While New York has suffered more than 16,000 confirmed deaths from covid-19, Mexico’s capital has reported around 3,000. [Coronavirus on the border: Patients from Mexico overwhelm hospitals in California] But now, as Mexico City hits what officials say is the peak of its outbreak, it’s facing an onslaught of cases with an understaffed and undersupplied hospital system. There is concern the country’s death toll is far higher than the official figures. The government originally projected 6,000 to 15,000 deaths nationwide, with a small chance they could rise to double that upper limit. By Monday, authorities had confirmed 10,167 deaths. López-Gatell has acknowledged that the catastrophic scenario of 30,000 fatalities is no longer remote. A worker walks among graves dug for covid-19 victims at a cemetery in Acapulco. (Javier Verdin/Reuters) “We hope there aren’t that many deaths,” he told senators last week. But he noted Mexico is afflicted by high rates of obesity, diabetes and other conditions. “These chronic illnesses have a stunning effect on the death toll.” Mexico’s government maintains it is trying to balance public health concerns and the economic needs of the large low-income population. Critics say authorities failed to communicate the gravity of the challenge early on, and took a huge risk in not testing more of the population. Many worry whether the fragile health-care system can hold up. [Coronavirus outbreaks at Mexico’s hospitals raise alarm, protests] The brightly colored graph displayed at López-Gatell’s nightly news conferences showed the capital’s hospitals at 80 percent capacity on Monday. “We all ask ourselves if we can hold on,” said Ana Belem Castro, an internist at La Raza, one of the capital’s better public hospitals. “Or if there will be a point