Coronavirus autopsies: A story of 38 brains, 87 lungs and 42 hearts

When pathologist Amy Rapkiewicz began the grim process of opening up the coronavirus dead to learn how their bodies went awry, she found damage to the lungs, kidneys and liver consistent with what doctors had reported for months. But something was off. Rapkiewicz, who directs autopsies at NYU Langone Health, noticed that some organs had far too many of a special cell rarely found in those places. She had never seen that before, yet it seemed vaguely familiar. She raced to her history books and — in a eureka moment — found a reference to a 1960s report on a patient with dengue fever. In dengue, a mosquito-borne tropical disease, she learned, the virus appeared to destroy these cells, which produce platelets, leading to uncontrolled bleeding. The novel coronavirus seemed to amplify their effect, causing dangerous clotting. She was struck by the parallels: “Covid-19 and dengue sound really different, but the cells that are involved are similar.” Autopsies have long been a source of breakthroughs in understanding new diseases, from HIV/AIDS and Ebola to Lassa fever — and the medical community is counting on them to do the same for covid-19, the disease caused by the novel coronavirus. With a vaccine probably many months away in even the most optimistic scenarios, autopsies are becoming a critical source of information for research into possible treatments. When the pandemic hit the United States in late March, many hospital systems were too overwhelmed trying to save lives to spend too much time delving into the secrets of the dead. But by late May and June, the first large batch of reports — from patients ranging in age from 32 to 90 years who died at a half-dozen institutions — were published in quick succession. The investigations have confirmed some of our early hunches of the disease, refuted others — and opened up new mysteries about the pathogen that has killed more than 500,000 people worldwide. Among the most important findings, consistent across several studies, is confirmation the virus appears to attack the lungs the most ferociously. They also found the pathogen in parts of the brain, kidneys, liver, gastrointestinal tract and spleen and in the endothelial cells that line blood vessels, as some had previously suspected. Researchers also found widespread clotting in many organs. But the brain and heart yielded surprises. “It’s about what we are not seeing,” said Mary Fowkes, an associate


vaccine probably many months away in even the most optimistic scenarios, autopsies are becoming a critical source of information for research into possible treatments. When the pandemic hit the United States in late March, many hospital systems were too overwhelmed trying to save lives to spend too much time delving into the secrets of the dead. But by late May and June, the first large batch of reports — from patients ranging in age from 32 to 90 years who died at a half-dozen institutions — were published in quick succession. The investigations have confirmed some of our early hunches of the disease, refuted others — and opened up new mysteries about the pathogen that has killed more than 500,000 people worldwide. Among the most important findings, consistent across several studies, is confirmation the virus appears to attack the lungs the most ferociously. They also found the pathogen in parts of the brain, kidneys, liver, gastrointestinal tract and spleen and in the endothelial cells that line blood vessels, as some had previously suspected. Researchers also found widespread clotting in many organs. But the brain and heart yielded surprises. “It’s about what we are not seeing,” said Mary Fowkes, an associate professor of pathology who is part of a team at Mount Sinai Health that has performed autopsies on 67 covid-19 patients. Given widespread reports about neurological symptoms related to the coronavirus, Fowkes said, she expected to find virus or inflammation — or both — in the brain. But there was very little. When it comes to the heart, many physicians warned for months about a cardiac complication they suspected was myocarditis, an inflammation or hardening of the heart muscle walls — but autopsy investigators were stunned that they could find no evidence of the condition. Another unexpected finding, pathologists said, is that oxygen deprivation of the brain and the formation of blood clots may start early in the disease process. That could have major implications for how people with covid-19 are treated at home, even if they never need to be hospitalized. The early findings come as new U.S. infections have overtaken even the catastrophic days of April, amid what some critics say is a premature easing of social distancing restrictions in some states, mainly in the South and West. A new modeling study has estimated that about 22 percent of the population — or 1.7 billion people worldwide, including


The virus that shut down the world

December. But the coronavirus, which has sickened at least 9.6 million people and killed more than 487,000, is now reshaping long-standing cultural, economic and political relations in an increasingly polarized world. “The pandemic has made it so that you now have an additional excuse to block human-to-human contact and intellectual and economic exchange,” Posen said. “It’s a corrosion of globalization, but it’s also an acceleration of a realignment that was already happening.” The golden era of globalization brought prosperity, but it also brought hubris. The Great Recession of the late 2000s, when frantic over-borrowing by people and governments, combined with cheap, easy and toxic financial instruments and weak regulation, led to a collapse that hollowed out personal savings and national reserves. The decade that followed saw a resurgence of protectionism; global trade patterns and foreign direct investment never really got their groove back. But that might be nothing compared to what comes next. Few are suggesting a complete unwinding of globalization. The pandemic’s substantial but relatively shallow hit to shipping, as compared to travel, show a world of people, companies and countries still prepared to do business with one another. Yet even as rebounding stocks and reopening businesses suggest a desire for a rapid return to normality, the way we travel, work, consume, invest, interact, migrate, cooperate on global problems and pursue prosperity has likely been changed for years to come. Passenger numbers suggest what happens when the world freezes in place. The pandemic has impacted global travel like no other event in history: By spring, every country in the world had thrown up some sort of entry restriction, according to the United Nations World Tourism Organization. In April, international air passenger travel fell to levels not seen since the 1970s. Analysts now project a record year-over-year drop in international tourist arrivals of as much as 80 percent. Compare that to the Great Recession of 2009, when arrivals dropped only 4 percent, or the SARS pandemic of 2002, when they fell 0.4 percent. Chile’s LATAM, Colombia’s Avianca, Virgin Australia and Britain’s Flybe airlines have all declared bankruptcy. But the collapse of travel endangers not only airlines and hotels — it also threatens conservation efforts in places such as Namibia, for example, where tourist dollars allowed a poor nation to maintain vast natural preserves for the world’s largest population of black rhinos. It threatens cultural exchanges, such as the semester- and


Inside the extraordinary race to invent a coronavirus vaccine

Ian Haydon, a healthy 29-year-old, reported to a medical clinic in Seattle for a momentous blood draw last week. “Oh yeah,” said the nurse taking his blood. “That is liquid gold.” Haydon is an obscure but important participant in the most consequential race for a vaccine in medical history. In early April, he was among the first people in the United States to receive an experimental vaccine that could help end the coronavirus crisis. He volunteered to be a test subject knowing about the risks and unknowns, but eager to do his part to help end the worst pandemic in a century. Scientists at the National Institutes of Health in Bethesda, Md., will study blood from Haydon and others for signs that the vaccine triggered an immune response to a pathogen they have never encountered. It would be the first, preliminary signal that the vaccine could provide immunity to covid-19, the disease caused by the novel coronavirus, which has claimed more than 200,000 lives worldwide. A coronavirus vaccine has become the light at the end of a very long tunnel, the tool that will bring the virus to heel, allowing people to attend sports events, hug friends, celebrate weddings and grieve at funerals. The goal to deliver a vaccine in 12 to 18 months, often repeated by the nation’s top infectious disease scientist, Anthony S. Fauci, has become the one reassuring refrain during briefings on the crisis. The White House put together a task force called Operation Warp Speed to try to move even faster, making hundreds of millions of doses ready by January. With at least 115 vaccine projects at companies and research labs, the science is hurtling forward so fast and bending so many rules about how the process usually works that even veteran vaccine developers do not know what to expect. Scientific steps that typically take place sequentially over years — animal testing, toxicology studies, laboratory experiments, massive human trials, plans to ramp up production — are now moving in fast-forward and in parallel. Experts keep using the word “unprecedented.” It’s a thrilling time in vaccine science, but also an unnerving one. U.S. regulators are firm in promising they will not sacrifice safety for speed, but some ethicists raise concerns about “pandemic research exceptionalism,” in which the demand to speed a vaccine to market could come at the expense of evidence and fuel the powerful anti-vaccine lobby.


We need smart solutions to mitigate the coronavirus’s impact. Here are 46.

an interim report by Sept. 15. The National Academies are the only institution that can provide advice on this issue in a scientifically credible, apolitical manner, unfiltered through the hyper-partisan lens of Congress or the administration. The National Academy of Medicine — one of three scientific institutions that were chartered by Congress to provide objective advice nationally and globally on science, technology and health — has more than 2,000 members selected by their medical peers for their outstanding achievement, many in infectious disease prevention and response. So far, Congress has been unresponsive to this ask, perhaps out of fear of vindictive pushback from President Trump. But if Congress can set aside politics at this critical moment and consider what’s best for the nation, it would immediately agree to convene this expert advisory panel. Rick Steiner is a retired professor from the University of Alaska and author of “ If society truly wants to fight the covid-19 pandemic, we must drastically change one standard modus operandi of the health industry: We must make non-identifiable patient data freely accessible. The recent retractions of two high-profile scholarly papers on potential covid-19 treatment drugs — in the Lancet and the New England Journal of Medicine — make this clear. Both papers were retracted due to problems accessing the raw study data. Authors on the retracted NEJM article state that they did not have access to the data, which came from a company that had refused to allow others to see it. It might sound unusual for authors of a scientific paper to never actually see data in their research, but it is not. This sort of secrecy is standard for studies using data from medical centers and insurance companies. Some blame it on privacy concerns even in cases where the data are just a simple table of numbers that can pass all checks of preserving privacy. Others blame it on cost or bureaucracy. The painful truth is that the vast majority of health-care research simply cannot be checked for accuracy. What would it take for the medical establishment to change? Months ago, there should have been at least one freely accessible data set on covid-19 patients to help predict death based on age and basic health issues such as diabetes and heart disease. Yet no hospital, insurer or national health service has (yet) released decent-quality individual patient data. And, yes, they all have that


drain, states’ balance sheets. Families with incarcerated loved ones should not be forced to decide between clinging to financial security and maintaining connection. During a global pandemic, inattention to this predicament is indefensible. Our heightened appreciation of the value of human connection should catalyze a national reckoning. Uzoma Orchingwa and Gabriel Saruhashi are co-founders of While we’re united in longing for better times in the midst of the covid-19 pandemic, we couldn’t be further apart socially and emotionally — and not just by six feet. Experts warn of a “silent pandemic” affecting those with mental health disorders. However, another pandemic is brewing — one of actual silence. In person, we silently navigate around each other. Not only are we not speaking, we aren’t even looking at each other. Humans are social creatures, and the emotional fallout from a pandemic of silence could be disastrous. I support social distancing in mitigating spread of the virus, but am increasingly concerned by the pandemic of silence. Those with mental health disorders — including depression and anxiety — may lack adequate social interactions even under the best conditions. What about now? What about people with alcohol or other substance-use disorders or who are sheltered in place in unsafe home conditions? How can they reach out in silence? How can we as friends, family, neighbors and health-care providers help? Stay six feet apart, use appropriate protective equipment — and say hello. It seems simple, but it works. Look at and acknowledge each other. Wave. Without human interaction, we risk disconnecting from what it means to be human. We need each other. We need to watch out for those most at risk in the pandemic of silence. Use technology, including video chat, to stay connected. Connect with someone you haven’t in a while. If you are a provider, offer video “check-in” appointments with your patients or use the time to create an app so your patients can have an alternative way to connect. We’re a world at war with a terrible foe, but we cannot let the human connection be collateral damage. Kimberlyn Maravet Baig-Ward is a psychiatry resident physician at the University of Texas Southwestern Medical Center in Dallas. America has a long, proud tradition of national service, especially in the wake of tragedies. As we rebuild from covid-19, recommitting to service — and scaling up AmeriCorps, in particular — should play a key role


Flight MH17 crashed six years ago. Ukrainians have very different views on who’s to blame.

Six years ago this week, a Russian-made missile shot Malaysian Airlines Flight 17 (MH17), a civilian passenger plane with 298 people on board, from the sky over war-torn Ukraine. Last week, the Dutch government, acting on behalf of the 193 Dutch nationals on the flight, announced it was taking Russia to the European Court of Human Rights. A criminal trial against four suspects involved in transporting the missile system that downed MH17 began in Amsterdam in March. The destruction of MH17 on July 17, 2014, sparked outrage and accusations. Russia — and Russian separatists in Ukraine — continue to deny any responsibility. Dutch prosecutors have accused Russia of undermining the investigation. But what do people in southeast Ukraine and Crimea think happened to this flight? We asked this question in December 2014, and again five years later. The results show very different views on who is to blame. From the outset it was evident Russian-backed separatists, who originally boasted of downing a Ukrainian military aircraft, were involved with the plane’s destruction. After arguments over access to the wreckage, a Dutch-led joint investigative team was created to establish the cause of the crash. Pioneering investigative reporting by the open source intelligence group Bellingcat brought crucial evidence to light. In October 2015 the joint investigative team concluded a Buk surface-to-air missile launched from pro-Russian separatist-controlled territory in Ukraine downed the aircraft. Thereafter, a criminal investigation led the Dutch-led team to conclude the missile system came from Russia, and the Russian government was culpable in the downing. This evidence is the basis for the MH17 trial against three Russians and a Ukrainian unfolding in Amsterdam. While factual evidence about who is responsible for downing MH17 has grown enormously during the past six years, so has the “information war.” There has been no consistent story from Russia on MH17 but instead a continued effort to deny and deflect blame. In 2015, we reported here in the Monkey Cage the results of a survey that we organized in six oblasts of southeast Ukraine and in Crimea (the part of Ukraine annexed to Russia in March 2014), which asked respondents why MH17 crashed. Our results at that time revealed significant ethnic divides in blame attribution in the six southeast oblasts. Half of ethnic Ukrainians blamed either the Donbas militants or the Russian military. By contrast, majorities of ethnic Russians and Ukrainians in Crimea blamed the Ukrainian


A tale of two vaccine searches

How the years-long hunt for an HIV vaccine gave researchers a leg up on a novel coronavirus vaccine. What Mary L. Trump’s new book has to say about the powerful family. And NBA players form a bubble at Disney World.


The Health 202: Schools are moving away from in-person teaching, even as more experts call for it

reporting and lead to more efficient distribution of supplies. The new order took effect yesterday. Critics say it’s a bad move to change data collection in the midst of a pandemic. “Critics…say they fear the elimination of the CDC’s role as a main data-keeper for the pandemic will be damaging, depriving states, hospitals and others of frequent analyses of data about the virus’s path in their communities,” Lena and Amy write. “Smaller hospitals, in particular, are ill-equipped to suddenly adopt new data methods, critics said, though the industry has pledged to comply with the change.” That’s the content of an inspector general report set to be released today, according to Politico, which first reported on the contracts and raised questions about their legality. The report details how Verma, administrator of the Centers for Medicare and Medicaid Services, used federal contracts to “install allies who managed high-priority projects and exercised broad authority within CMS, while circumventing the agency’s career officials and funding projects that ethics experts have said wasted taxpayers’ money,” Politico’s Dan Diamond and Adam Cancryn report. “The 70-page HHS inspector general report — the result of a 15-month audit — calls on HHS and CMS to take nine separate actions to address the ‘significant deficiencies’ that it identified,” Dan and Adam write. “Those actions include conducting a review of all the department’s contracts, and making a closer examination of whether CMS overpaid several of its contractors.” The Food and Drug Administration usually recommends that drug companies include pregnant woman in the third phase of vaccine trials and in the coronavirus vaccine effort has advised companies to consider including pregnant woman, The 19th’s Shefali Luthra reports. Research shows pregnant woman are especially vulnerable to the virus, yet four out of six pharma companies with government contracts to develop a vaccine haven’t included or don’t plan to include pregnant women in Phase 1 or Phase 2 trials. Moderna, which is starting a Phase 3 trial soon, announced it will exclude pregnant women from the trials. Data from the CDC suggests that pregnant woman who are infected “appear to have a 50 percent greater chance of entering intensive hospital care because of the virus and a 70 percent greater chance of being put on a ventilator,” Shefali writes. The research from Washington University in St. Louis found that mothers have decreased their working hours four to five times as much as fathers


Barbados wants you to work from its beaches during the pandemic

Want smart analysis of the most important news in your inbox every weekday, along with other global reads, interesting ideas and opinions to know? This has been the year a virus shut down our globalized lives. But even as the pandemic continues to rage, the government of Barbados, a country in the eastern Caribbean, is sending a very different message: Come here, not just for a holiday, but for up to a year. Bring your laptop. Soak up the sun, the sea, the sand — and forget about the coronavirus. “Covid-19 has placed a severe strain on people’s mental wellness,” Barbadian Prime Minister Mia Mottley told Today’s WorldView in an interview. “The sunshine is powerful. The seawater is powerful. They’re both therapeutic in ways that are hard to explain. And we felt that, why not share it?” Dubbed the “Barbados Welcome Stamp” and launching this week, the program will allow visitors to stay on the Caribbean island visa-free for up to one year. The aim is to attract remote workers, with a bill to be introduced in Parliament by the government that will remove the local income taxes that normally kick in after six months. The program has unsurprisingly sparked global interest. Considered from a cramped apartment in London or New York, working remotely on a beach has an appeal even to those who know little about Barbados. “And those who don’t know Barbados know Rihanna,” Mottley said, alluding to the fact that the international pop star was born on the island. Barbados is not the only country trying to open up to laptop-toting foreigners. With email, video chatting and cloud computing, there may no longer be a reason for many workers to travel to a centralized office every day. There has also been a concurrent trend toward freelancing; polls say many freelancers have little interest in office-working life anymore. Though the coronavirus has disrupted many aspects of our work lives, it may accelerate some trends. Gallup polling of Americans conducted this spring found that 62 percent said they had worked remotely at some point by April, an increase from 31 percent in mid-March. “In the last six months, we all became digital, but I don’t know how much we are nomads,” said Armand Arton, founder of the consulting firm Arton Capital. “Yes, we can work from home, but we can’t really travel. What is home becomes the question.” Arton


DCSAA postpones fall sports, plans for football in February

The D.C. State Athletic Association postponed its fall sports programs because of the novel coronavirus pandemic, the organization said Thursday, making it the first high school jurisdiction in the area to make such a move. “Given the current environment, it just is not feasible to begin practice August 1 and competition later this month,” DCSAA Executive Clark Ray said in a statement. “The safety of student-athletes and coaches remains our top priority." Pending approval from the D.C. Department of Health, as well as D.C. Mayor Muriel E. Bowser, the DCSAA plans to move forward with a “Condensed Interscholastic Plan” of three playing seasons aimed to allow athletes in fall sports an opportunity to compete this school year. “We have consulted with the DC Health, our member public, public charter and private schools to discuss the options for having athletics this school year,” Ray said. “Given the current science and data, this is the best solution to allow our student-athletes to compete in 2020-21.” According to the plan, each season (fall, winter, spring) will include a three-week preseason followed by a six-week regular season. From there, eligible teams will compete in their respective league playoffs before advancing to the DCSAA state championship bracket. Winter sports — basketball and indoor track — will be the first teams tentatively planning to be back in action, with practices scheduled to begin Dec. 14 and games ranging from Jan. 4 to Feb. 28. Fall sports — cross-country, football, volleyball and soccer — are scheduled to get underway Feb. 1, with games starting Feb. 22 and concluding April 16. Spring sports — baseball, softball, tennis, ultimate disc, chess and track and field — are set to start March 29. . “These are unprecedented times,” DCSAA chairwoman Rosalyn Overstreet-Gonzalez said in the statement. “And first and foremost the DCSAA remains committed to the welfare of our student-athletes.”


Biden finds a better way to do ‘America First’

report that determined the tariffs “have not boosted manufacturing employment or output, even as they increased producer prices”; a Moody’s analysis finding that the trade war had cost 300,000 U.S. jobs; and a Federal Reserve study assessing the cost of these tariffs to the average American household at about $800 per year, erasing the benefits of the Trump tax cut. Oxford Economics estimated the trade war shaved 0.3 percent off U.S. gross domestic product growth last year. The Biden plan’s boldest idea is to massively ramp up investment in research and development. Biden proposes raising spending by $300 billion over four years, which represents a 60 percent increase over 2018 spending. If enacted, this would reverse the steady decline in federal investment in science and technology since its heyday in the 1950s and 1960s. (To get to those levels would still require hundreds of billions more.) Those investments led to the personal computer, the Internet, the Global Positioning System and a host of other technologies that have transformed the economy. More recently, it is worth remembering, an Energy Department loan of $465 million is what enabled Tesla to establish itself and experiment with electric cars. The Biden plan proposes investments in 5G technology, electric cars, lightweight materials and artificial intelligence. Some of this money will be wasted — as also happens to investments from venture capital firms — but all you need is for some, like Tesla, to succeed big. The plan also has a $400 billion “Buy American” component. The theory behind this is sensible. But the danger of this kind of approach is that it can too often become “industrial policy,” with the government trying to revive bygone industries like steel (as Biden wants to do) and favoring firms with the best lobbyists. More generally, the track record of most rich countries in practicing industrial policy has been pretty bad. Experts used to point to Japan as the country that had mastered government-directed investment, except that it turned out that Japan’s best companies all came out of its fiercely competitive private sector. The state-sponsored ones mostly did poorly. (China is different because its biggest advantage is not smart government investments but low wages.) The best model is not for government to set up or subsidize specific companies or industries, but to let the market know that it will buy certain kinds of innovative products, which then gives the


Olympic disappointment: The 1980 U.S. team that never was and the boycott Games

798, with delegates casting multiple votes apportioned according to the sports organizations they represented. Mondale at the time called the vote “truly a referendum on freedom” and said, “What is at stake is no less than the future security of the civilized world.” Gaines: Blazejowski: Hightower: Eleven days after the vote, DeFrantz and 24 other athletes filed a class-action lawsuit in U.S. District Court against the USOC, contending the boycott violated their constitutional rights. DeFrantz: On May 16, 1980, a judge ruled against the athletes, saying: “We can find no justification and no authority for the expansive reading of the Constitution which plaintiffs urge. To find as plaintiffs recommend would be to open the floodgates to a torrent of lawsuits. The courts have correctly recognized that many of life’s disappointments, even major ones, do not enjoy constitutional protection. This is one such instance.” DeFrantz: A memo to Cutler from Nelson Ledsky, head of the State Department’s task force on the boycott, revealed how the United States was rallying the global community against the Summer Olympics. “We have already substantially damaged the Moscow Games,” the memo read, “and we clearly can inflict still greater harm, even if we can not succeed in getting the Games postponed altogether.” DeFrantz: As spring turned to summer, athletes continued competing, earning spots on a team that had no hopes of participating in Moscow. Still, the USOC was contemplating ways to honor its Olympic team. Moran: Mills: Galimore: DeFrantz: Gaines: Blazejowski: The Moscow Games began July 19. Sixty-five other countries joined the United States in boycotting. The Soviet Union topped the medal table, and the Olympics received scant attention in the United States. Blazejowski: Galimore: Gaines: That fall, with the economy suffering and the Iran hostage crisis dominating headlines, Carter’s reelection efforts sputtered. He carried just six states and Washington, D.C., and Ronald Reagan won the White House in a landslide. The Soviets did not fully withdraw troops from Afghanistan until 1989. Carter later called the Olympic boycott “one of my most difficult decisions,” but he has voiced no regret publicly. A spokesperson said Carter, now 95, was unavailable to comment. Blazejowski: Eizenstat: Mills: In all, the 1980 U.S. Olympic team numbered 466 athletes. While some, such as DeFrantz, had competed at the 1976 Games and others, such as Gaines, competed in 1984, more than 200 never had another shot at an Olympics. Hightower: DeFrantz: Blazejowski:


Trump’s flawed Rose Garden assault on Joe Biden

lead the way instead of science.” Biden went on to criticize Trump for proposing cuts in global health programs and for folding a White House pandemic office into another unit. But he did not specifically mention the travel restrictions on China. The restrictions were signaled shortly after noon on Jan. 31, after rumors that the Trump administration was considering halting flights. The travel restrictions were announced at 3:55 p.m. Biden took the stage about 15 minutes later. The Biden campaign says Biden was not referring to the travel restrictions and notes that the former vice president’s remarks were similar to those in an opinion column he wrote that was published in USA Today four days earlier. “I remember how Trump sought to stoke fear and stigma during the 2014 Ebola epidemic,” Biden wrote on Jan. 27, such as advocating “reactionary travel bans.” The comment included a link to a Trump tweet from 2014, urging Obama to “close down the flights from Ebola infected areas right now.” (At the time, there were no direct flights from Ebola-affected areas to the United States.) “If we had listened to Joe Biden, hundreds of thousands of additional lives would have been lost.” There’s no evidence Trump’s restrictions on travel from China saved “hundreds of thousands” of lives. The Trump administration imposed an entry ban on all foreign nationals who were in the People’s Republic of China, excluding Taiwan, Hong Kong and Macao, in the previous 14 days, effective Feb. 2. But it included many exceptions. Moreover, many U.S. airlines already were canceling flights. The New York Times in early April estimated nearly 40,000 people had traveled from China to the United States in the two months after Trump imposed restrictions on such travel — and at least 430,000 people had arrived in the United States on direct flights from China since Dec. 31. While Trump often suggests the United States imposed the first ban, dozens of countries acted before the United States. The testing criteria set by the Centers for Disease Control and Prevention were extremely narrow: Only those with recent travel to China or those who had come into contact with a confirmed infection would be tested. Moreover, because the Trump administration bungled testing in February, allowing for few tests of Americans, it had little idea that the coronavirus was spreading silently through the country. “If you look at the job he did


comparison, just 42 percent approve of Trump’s handling of the coronavirus pandemic in the most recent Gallup poll. As for halting testing, this is strange Trump spin. The Obama administration decided that it would conserve government resources if it assumed flu cases with certain symptoms and risk factors could be deemed “probable” H1N1 flu. So testing for the flu did not end, just extensive testing to identify this particular strain. Laboratory-confirmed deaths continued to be counted. (The decision did earn some criticism, as it turned out the number of probable cases was probably overestimated.) “The 2009 H1N1 strain was highly transmissible but did not induce more severe illness in adults or children than typical seasonal influenza viruses,” said Tom Frieden, who was CDC director from 2009 to 2017. “Therefore, most people who contracted the virus had no reason to seek diagnosis or care; for every laboratory confirmed case from April to October 2009, there were estimated to be 79 cases that did not seek testing. So it was never practical to identify cases, trace their contacts, and ask exposed people to quarantine. In July 2009, the CDC advised states it was no longer necessary to report the individual cases up for aggregation — but never ‘stopped testing.’ Collecting national data was no longer important because under those circumstances, the data were not a good measure of the scale of the epidemic, nor actionable for contact tracing.” Frieden added: “The covid-19 pandemic is qualitatively different: the virus is highly transmissible and induces severe disease in many cases. Although not everyone who contracts the virus seeks and receives testing, a higher share do, so testing data is a more useful indicator of the direction of the epidemic.” “These are actual key elements of the Biden-Sanders unity platform: Abolish immigration detention. No more detention. You come in here illegally, no more detention.” Nope. Remember: Biden surged in the Democratic primary running as a moderate alternative to more liberal candidates who proposed to decriminalize border crossings or abolish the agency in charge of deportations, Immigration and Customs Enforcement (ICE). The Biden campaign’s immigration page says he would “seek alternatives” to migrant detention and work with nonprofits that help manage immigration cases for families awaiting hearings and released into the country. Under a legal settlement from 1997 known as the Flores agreement, U.S. immigration officials must release underage migrants in their custody within 20 days,


10 tips to get the most out of your data and devices while on a road trip

Managing my devices and data on travel-writing road trips used to be easy as pie. During the day, I’d charge my laptop when I ate at cafes or worked at coffee shops. At night, I’d deal with emails, upload photos and download podcasts via WiFi at hotels or friends’ houses. But now, when I travel on assignment, I avoid hotels and restaurants, and I don’t invite myself to stay with pals en route. That’s meant I’ve had to employ new tech strategies. We’re all recalculating these days. According to AAA, Americans are largely avoiding air, bus and cruise travel, choosing road trips for 97 percent of this summer’s leisure travel. Whether you’re escaping to a cabin in the woods or visiting family in another city, it’s important to figure out how to road trip smartly and safely, which includes having access to technology to keep you informed and entertained without breaking the bank with data usage. To prepare for a cross-country trip last month, I packed a couple coolers of meals, camping gear and what seemed to be a silo of dog food. Figuring out how to keep all the devices charged without access to traditional power sources was trickier. My partner planned to join me and work as I drove. He set up a hotspot through his iPhone and bought a power inverter that made it possible to charge his laptop — two game-changers that allowed him to host Zoom meetings, take calls and manage email like a boss from the passenger seat. I downloaded podcasts ahead of time and fully charged all my devices: flip phone and Bluetooth earpiece for calls, Garmin GPS for directions, iPad for podcasts and email, and LED bike lights for poking around the car and tent at night. I also charged my camera and MacBook and packed an external hard drive for backups. Within hours of our departure, the car became a jumbled mess of invasive cords. But we covered thousands of miles in four days and experienced only a few small tech hiccups. I made a note to find cable organizers before our return and asked friends and mobile experts to recommend gadgets and tech hacks from their own road trips. Here are 10 suggestions to get organized, stay connected and save data. Understand your limits: Find cheap entertainment: Power up: Get hot: Make connections: Rely on WiFi: Control those apps: Map


Forget the wine list: Foodies should ask how restaurants treat their workers

data, eight of the 10 lowest-paying jobs in the United States involve the food industry. By many accounts, this includes the full range of workers, from the sauté cook at a Michelin-starred restaurant to the barback at your local dive to a cashier at Burger King. The ranks aren’t small either — restaurant employees make up 10 percent of the American workforce. Restaurant workers also take on long, grueling shifts with few benefits, which can occasionally mean the choice between working sick and making rent. They rarely receive health insurance and often labor for a tipped wage, which has long enabled built-in inequities like sexual and racial discrimination in the industry, while also sometimes encouraging workplace harassment. Overwhelmingly, restaurant workers are women and people of color; many live in poverty and rely on public assistance. And now, these same workers are getting sick. Across the South, from Florida to Phoenix, newly reopened establishments are closing again with workers testing positive for the novel coronavirus and cases on a tragic upswing. Other restaurants, with their bottom-line survival at stake, are forging ahead without instruction from local government officials. “What steps owners take when faced with a sick employee — whether it’s deep cleaning the entire space, informing customers or testing other staffers — are largely up to them,” Emily Heil reported last month. One major reason restaurant workers are exceptionally vulnerable now has to do with the industry’s lack of worker protections. And previous efforts to bring widespread reform to the restaurant business have faltered in large part because diners have either failed to understand the consequences of the current system or chosen not to care. Past individual initiatives to eliminate tipping, from big-name restaurateurs like Gabe Stulman and Andrew Tarlow to chains like Joe’s Crab Shack, failed in part because diners balked at service fees. Meanwhile, following the passage of the Affordable Care Act, many restaurant owners set out to adjust their hiring and scheduling practices to avoid having to provide insurance to their workers. But with the unique clarity of an ongoing pandemic, ignoring these problems is a luxury we can no longer afford. After all, it was already immoral and dangerous for service workers to labor without sick days or health insurance. To do so now could unleash new catastrophes. And this is why diners have to change. As restaurants begin to reopen — under limited and potentially


Cases are rising and deaths are not far behind. But how far?

about the relationship between three of the data points the project is tracking: new cases, new hospitalizations and new deaths. “The deaths are also not happening in an unpredictable amount of time after the new outbreaks emerged,” Madrigal wrote. “Simply look at the curves yourself. Cases began to rise on June 16; a week later, hospitalizations began to rise. Two weeks after that — 21 days after cases rose — states began to report more deaths.” As with most aspects of the pandemic, there’s some grayness around the edges. The recent low point in The Washington Post’s seven-day average of new cases came June 9 and the low in the daily death toll July 6, a four-week difference — but not really a significant one. It’s worth looking at how those three metrics overlap, using data from the COVID Tracking Project. Overlaying new cases, hospitalizations and deaths (as at left below) gives a sense of how things have changed since early June. Sure enough: Cases (blue) rose first, then hospitalizations (light orange) and then deaths (dark orange). (A one-time adjustment by the state of New Jersey including probable coronavirus deaths since the pandemic began was removed for the sake of clarity.) The chart at right, though, is a bit clearer. It shows the weekly change in each metric relative to the seven-day period, May 28 to June 3. New cases were at a low in the seven-day period beginning June 4. New hospitalizations were at a low in the next seven-day period. New deaths were at a low 14 days after that. This matches Madrigal’s grim pattern: seven days from cases to the hospital and another 14 from the hospital to the morgue. On a state level, though, things are a bit more all over the place. We pulled data for five states that were among those that have seen the biggest increases in deaths and for which hospitalization data was available through the project’s data. The pattern of cases to hospital to death is generally consistent, but the relationship between the three metrics varies. Consider those last two states, for example. In Oklahoma, hospitalizations increased about a week behind new cases and deaths nearly three weeks after that. In Florida, hospitalizations increased two weeks after cases and deaths another week after that. Georgia looks more like Oklahoma; Arizona looks like its own entity. What this means is that it’s


Cigarette-filter maker settles allegations of violating North Korea sanctions

companies in China and other countries, using deceptive practices to move money through U.S. banks. The scheme, which lasted about a year, began in October 2017 when two employees of the Dubai subsidiary were warned that because of sanctions, a front company would be used to receive payments for a customer in North Korea, court documents said. They were instructed not to mention the country in contract documents, and instead falsely declared China as the destination of products, according to charging documents. “[D]on’t mention that customer is in my country … You just mention China or where else. Contract will be signed by other foreign company,” a North Korean buyer allegedly told an Essentra FZE manager and customer agent, according to a summary of facts filed with the court. “Understood,” one employee replied, according to the filing. Both employees have since left the firm, and court filings state they were in contact with the India-based firm’s employees regarding the terms and status of the contract. U.S. prosecutors in Washington filed a 25-page agreement and charging documents in federal court on Thursday, and the Treasury Department’s Office of Foreign Assets Control announced a civil fine. Both moves enforce sanctions imposed in March 2016 after North Korea tested what it claimed was a hydrogen bomb and conducted a launch using ballistic-missile technology. The sanctions bar international shipments that further the country’s nuclear or missile programs, cut Pyongyang off from the U.S. banking system and expand the list of luxury items its elite cannot receive. “The sanctions the United States has imposed on the North Korean regime are of the utmost importance to the national security of our nation,” said Assistant Attorney General for National Security John C. Demers, whose division announced the action with the FBI and the U.S. attorney’s office for the District of Columbia. “The company has now committed to working with our prosecutors to bring those individuals responsible for these acts to justice.” The filings cite three payments worth $333,000, for which U.S. officials sought double penalties. Of note, two of the payments were not completed in U.S. dollars and never transited the U.S. banking system — a typical tripwire for American criminal enforcement. Though the transactions were conducted in local currency, the UAE company used a foreign branch of a U.S. bank, triggering U.S. jurisdiction, according to the filings. The Office of Foreign Assets Control said in a


Howard County first in Maryland to enact bird-friendly design standards

Jung, who introduced the legislation. “They are dying by the millions as a result of these big, glass buildings.” Now when building permit applications are submitted to the county, applicants also must submit documentation showing the design meets bird-friendly specifications from the global Leadership in Energy and Environmental Design (LEED) green building certification program. To qualify for the LEED credit, a building must not exceed allowable bird threat levels, which are calculated by several factors including facade materials, height, outdoor lighting and fly-through considerations. Christine Conn, chair of the Howard County Environmental Sustainability Board, also testified at the public hearing and described the legislation as an environmental and economic win. “To me, sustainability is about . . . looking at the long-term benefits,” Conn said. “We’re protecting birds, we’re reducing energy consumption and we’re reducing greenhouse gas emissions. And at the end of the day, we’re saving money. It’s a cost-savings measure, and it just makes economic sense.” According to Sutherland, buildings with lots of windows require more energy to keep cool and to heat. When buildings are designed with birds in mind, they need less energy. While the legislation does not require buildings to be retrofitted, some facilities in the county will be, including the Robinson Nature Center in Columbia and the Howard County Conservancy in Woodstock. “[We’re] proud to see Howard County as the first in Maryland to pass bird-safe building legislation,” said Howard Schwartz, conservation chair of the Howard County Bird Club. The hope for conservationists now shifts to passing statewide legislation and similar bills in other local jurisdictions. “We hope this will serve as a model for other counties and provide a strong push to get legislation passed for a statewide bill in the General Assembly,” Schwartz said, noting that a measure passed the Maryland Senate and House of Delegates in 2019. “We hope for success in 2021 if the General Assembly reconvenes.” Conn said if the state legislation gets passed next year, Howard County’s law and the state’s will be complementary. A bill that passed the state House and was awaiting Senate approval when the coronavirus pandemic struck this spring would have required similar bird-friendly design standards for state buildings. Sutherland has shifted his efforts to bringing similar legislation to the forefront in neighboring counties including Anne Arundel, Baltimore, Frederick and Montgomery. “It takes government’s vision to move forward and break that barrier, and it’s


The lag in testing results is our Achilles’ heel. Here’s how we can fix it.

running genome sequencers), and veterinary labs. To date we have fully activated the first two categories, partially activated the third, and only sporadically activated the fourth through sixth. As a consequence, test results are being returned on time scales too slow for contact tracing to do any good. The goal is not merely to flatten the curve — to plateau as we did in May — but to break the chain of transmission and get back to near-zero case incidence. This requires that every test result come back in 24 hours — 48 hours tops. After that, it is too late. We may have contact tracers in the field, but if they are acting on results that took six to eight days to return, they cannot catch up with the virus, which moves like lightning. In June, Quest was returning results in two to three days. Now, because of the dramatic increases in volume, it and others are returning them in four to six days. Although the volume of samples processed has increased, the slower turnaround makes those increases less valuable for disease suppression than the absolute number of tests would suggest. While the nation’s current nominal testing rate is consistently above 500,000 tests a day, and exceeded 800,000 in a single day in early July, the nation’s effective testing rate should be measured via the number of daily tests results that have been returned in 48 hours or less. There is a solution. Congress could activate and fund regional interstate compacts that would have the express job of investing in the testing capacity we have not yet activated. Interstate compacts Interstate compacts are valuable tools for addressing problems that are complex, require scale to solve and also require state leadership because of on-the-ground variation. They are tools for empowering states. Congress should use its upcoming legislative session to turn the tide once and for all in our fight against covid-19 by investing in interstate compacts that have the single mandate to fully activate our testing supply chain. Next-generation genome sequencing labs, for instance, could process 1 million samples a day. But no single state needs that many. So long as the market is made by contracts emerging out of needs defined by states, we will not activate this currently latent tranche of the market. But bundled, bulk orders or projected commitments at the regional level would do it. We


Enjoy summer drinks at the Kennedy Center’s new wine garden and these freshly reopened rooftops and patios

NW. victuraparkdc.com. Open Friday from 3 to 10 p.m., Saturday from noon to 10 p.m., and Sunday from noon to 8 p.m. Here are a few other new or revamped outdoor spaces to check out: Cork Wine Bar: The enticing and cozy little patio behind 14th Street's Cork Wine Bar was one of the best additions to D.C.’s al fresco scene in 2019, and it reopened to customers on July 10 with an expanded footprint. Colorful plants hang on the wooden walls, and the umbrella-shaded tables have now spread out onto the sidewalk on T Street, surrounded by planters. The menu includes cheese, charcuterie and, of course, avocado toast to snack on, and Cork's by-the-glass selection offers an interesting mix of roses and sparking wines. It's a solid choice for date night, but make sure to make reservations. 1805 14th St. NW. corkdc.com. Wednesday and Thursday from 5:30 to 9:30 p.m., Friday and Saturday from 5:30 to 10 p.m. Hook Hall The rest of us can make do with tables for two or four or Oktoberfest-style benches for six on the artificial-turf patio. You do have to pay to reserve these — $10 for two or four, $35 for six — but that includes a beer or seltzer for everyone in the party. The vibe on a recent Saturday evening was unexpected: lively, bordering on loud; busy, but not crowded. It was almost like the Before Times, but not in a way that felt unsafe. 3400 Georgia Ave. NW. hookhall.com. Wednesday from 3 to 10 p.m., Thursday from 3 to 11 p.m., Friday and Saturday from 11 a.m. to midnight, and Sunday from 11 a.m. to 7 p.m. The Imperial Reservations, which can be made 14 days in advance, are strongly suggested, though space is saved for walk-ins. If you want to stay out of the sun, you can request the stools on the lower portion of the rooftop, under a shaded roof and near a fan. 2001 18th St. NW. imperialdc.com. Wednesday through Friday from 4 p.m. to midnight, and Saturday and Sunday from 1 p.m. to midnight. Your Only Friend at the Columbia Room The idea, he says, is “to take something somebody knows and make it better than they ever thought it could be.” The gourmet sandwiches draw inspiration from Taylor’s regular orders at Vace or Wawa, his “2 a.m., after-five-drinks” cravings for chicken sandwiches, or, in


Chasing Cancer 2020

issues that the pandemic presents. You know, hospitals have been shut down to all things but coronavirus. They've stopped a lot of their normal clinical procedures. They've stopped everything they call "elective," which an elective procedure may be a very significant and medically necessary procedure. It's just one you can defer for a little bit of time. But, you know, we think that the problems that we're seeing in delayed diagnosis and delayed treatment of cancer will also play out in other non-cancer diseases, like heart disease and stroke and neurodegenerative disorders. And so, the things that are problems for Americans, if they're not delayed and treated--if they're not diagnosed and treated in a timely fashion, we expect that will be back. That will have public health consequences in lots of diseases. MS. SELLERS: So, what should the cancer industry be doing? What should doctors be doing to try to mitigate these impacts? DR. SHARPLESS: Well, I want to say, you know, first of all it's important to note that we've made a lot of progress in cancer over the last few decades, and our ability to treat it and care for it are much better than they've ever been, and this year we're seeing a record number of new therapies make it into clinical use, through FDA approval and other means. And so, there's this real great backdrop of progress, and now the pandemic has provided this new challenge against that backdrop of progress. And so, I believe, you know, we have to collectively, as a group of cancer doctors, researchers, and caregivers, you know, get together and, you know, take collective action to prevent our patients from suffering needlessly from the pandemic. And I think there are things we can do. We can be innovative in how we provide care. We're moving things to telehealth, you know, doing some areas of care over the phone that we used to do in person. We're being clever about how we do clinical trials. We're incorporating new modalities for therapy earlier and at different stages. So, I think through research and science and collective action we can mitigate the impact of the coronavirus pandemic on cancer patients, but we have to do that because we don't want to change one public health crisis for another. MS. SELLERS: Right. Do you see any advantages in this slowing down of screenings, biopsies, or


The pandemic will change Hollywood — forever. Five writers and actors predict what’s next.

I'm watching how my own kids are coping with covid-19 and trying to turn their struggles into drama. Echoing my youngest child's struggles with remote learning and being cut off from friends, one of the film's protagonists is dealing with crippling fear and anxiety around leaving his comfort zone. Another young character, meanwhile, deals with the challenge of trying to reconnect with friends he's been physically separated from and wonders whether they still have anything in common, a fear I've seen crop up in my own children. My hope is that viewers, especially younger ones, will get to see their own emotional struggles reflected in the characters and realize they're not alone, and that their feelings and challenges are real and important but also things that can be overcome or lived with, whether they're caused by an invisible virus or menacing aliens. Making movies and television is inherently intimate: Hundreds of people work in close quarters for long hours to produce the shows and films we all binge and love. The covid-19 pandemic has punctured that paradigm: Imagine making a romantic comedy in which no one can kiss, or a horror movie in which the killer stays six feet from his victim. In a town that believes it knows everything about everything, we’re all stumbling our way through uncharted territory. Now, more than ever, we need diversity in storytelling, and unflinching honesty from our storytellers. This global pause has provided a real opportunity for artists to create projects that are fully and singularly their own, outside the traditional system, and take them directly to viewers without the long development process they typically endure. And without the typical economic gatekeeping that filters out new voices, my fervent hope is that an army of underrepresented voices with new visions and perspectives will break through. As we figure out how to continue telling emotionally affecting stories under novel restrictions, we are taking new risks, and using unusual tools to tell stories that wouldn’t have gotten attention in the tentpole-focused culture of pre-covid Hollywood. For me personally, this has meant shooting projects on iPhones with skeleton crews of just a handful of people, moving quickly and letting unexpected moments dominate the work. During lockdown, I’ve shot several digital projects in a fraction of the time they typically take (employing best prevention practices) — some in just a single afternoon. And I’m developing several longer-form


You can’t go to the Olympics this year, but you can hang out with an Olympian through Airbnb Experiences

Like many people around the world, Olympian Pita Taufatofua had major summer travel plans canceled because of the coronavirus pandemic. The Tongan athlete, who bore his country’s flag at two Olympic opening ceremonies, was at his Brisbane, Australia, home when he got the news that the Tokyo 2020 Olympic Games had been postponed. It would have been Taufatofua’s second trip to Japan, a country he fell in love with during his first visit. But he’s making the most of the delay. “Now, I’ve got a whole year to enjoy [being an Olympic qualifier] and to prepare as well, so I’m excited,” said Taufatofua, who is trying to be the first person in history to qualify for three unrelated Olympic sports. (He has competed in Olympic taekwondo and cross-country skiing; his next goal is to qualify for kayaking.) This month, Taufatofua will take a break from mastering the kayak to host a master class on perseverance through Airbnb Online Experiences. The session is part of a summer festival of Olympian and Paralympian Airbnb Online Experiences featuring more than 100 elite athletes. The five-day series begins July 24 and is a collaboration between Airbnb, the International Olympic Committee and the International Paralympic Committee. “We decided to have this moment of celebration that launches next week on the day that the games would have started in Tokyo,” said Catherine Powell, head of Airbnb Experiences. Olympians and Paralympians have been a part of Online Experiences since Airbnb launched the service during the pandemic. The site now has a filter dedicated to the category so potential customers can easily browse opportunities, such as motivational coaching from bobsled Olympic medalist Lauren Gibbs and a core workout with Olympic pole vaulter Pauls Pujats. Airbnb says the program has created economic opportunities for the athletes while also giving their fans a once-in-a-lifetime experience. “We saw this amazing response from our guests, who were able to kind of get up close and personal with these heroic icons,” Powell said. “[The festival] was a very natural progression from having all these athletes on the platform anyway.” The festival sessions, which Powell said should cost an average of $25 each, will vary widely in focus, featuring health and fitness seminars, motivational speaking, cooking demonstrations and more. Syrian swimmer Yusra Mardini, who became a member of the first IOC Refugee Olympic Team in 2016, is hosting a workshop on resilience. Tennis superstar


The sports world offers a reality check on covid-19

Playing sports is good for kids for a lot of reasons. They are a fun way to get exercise and a great way to make friends and learn how to be a good teammate. Sports are also important because they are a reality check: Kids may think they are going to be the next LeBron James or Serena Williams, but when they start competing they usually find out they have a long way to go. That can be a humbling but valuable lesson. If you want to do well with any sport, you have to work at it. There are no shortcuts. You can’t just say you are terrific; you have to prove it on the field, on the court and in the game. Sports certainly provided a reality check in March when the novel coronavirus began to spread in the United States. When Major League Baseball (MLB), the National Basketball Association (NBA), National Hockey League (NHL) and college tournaments shut down, many people started thinking: “This virus must be really serious.” Sadly, sports may be providing another reality check for our country. Recently, several major sports have made efforts to restart their games, but the novel coronavirus has caused some problems. ● Two teams — FC Dallas and Nashville SC — dropped out of the Major League Soccer tournament because several of their players tested positive for the coronavirus. ●The Big Ten conference announced that its college football teams will play only nine games against in-conference opponents this fall instead of the full 12-game schedule. Some people fear there will be no college football season in 2020. ●The Ivy League conference announced that its eight member schools will not play football or any other fall sports this year. ● Several baseball players, including the Washington Nationals’ Ryan Zimmerman, said they will not play in the shortened 60-game 2020 MLB season because of concerns about the virus. ● Some MLB practices, including the Nationals’, were postponed because of delays in processing the players’ tests for the virus. ●Even though 24 of the NHL’s 31 teams are in the United States, the league announced it will play its 24-team playoffs in two Canadian cities. Despite a lot of talk by President Trump about the virus “getting under control” and the country being ready to open, the United States has not contained the novel coronavirus, as recent data shows. The United States


Global surge in coronavirus cases is being fed by the developing world — and the U.S.

only to find that the virus came roaring back. Now they are using a more limited arsenal to contain the spread, with little success. “Let me be blunt: Too many countries are headed in the wrong direction,” World Health Organization chief Tedros Adhanom Ghebreyesus declared in Geneva this week. “The virus remains public enemy number one, but the actions of many governments and people do not reflect this.” The severity of the toll on the United States was evident in new infection figures released Tuesday, with multiple states — including Oklahoma and Nevada — hitting record highs. Florida has now reported more cases in the past week — nearly 78,000 — than most European nations have in their entire struggle with covid-19, the illness caused by the novel coronavirus. That sort of explosive growth is mirrored in other nations, though none with the sort of wealth, infrastructure and scientific know-how of the United States. Across much of the developing world, rampant coronavirus outbreaks came relatively late. But now that the virus has taken root, governments are flailing in their attempts to halt it and citizens are resisting changes to their way of life. “As restrictions have been lifted, we’re going back to a new normal,” said Alain Labrique, a Johns Hopkins epidemiologist. “But this virus is still circulating. There are still high rates of susceptibility. We have to continue wearing masks and being smart about crowd activities. The new normal is not the old normal.” The struggle has been especially fraught in Latin America, where countries have been lashed by covid-19’s ferocity and many have not yet hit their peaks. Brazil has the second-highest number of covid-19 deaths in the world, at more than 74,000, while Mexico has the fourth-highest, with more than 37,000. (The United States, with at least 133,000 deaths, is far and away the global leader.) With their high levels of poverty and inequality, Latin American countries were more vulnerable to the pandemic than wealthier nations. An estimated one-fifth of people in Latin America and the Caribbean have at least one of the health conditions that puts them at higher risk of a severe covid infection. Many couldn’t afford to stay home for long periods. In Mexico, for example, more than half of workers are employed in the informal economy — as street vendors, gardeners, construction workers — surviving largely on their daily earnings. And people living


back to a new normal,” said Alain Labrique, a Johns Hopkins epidemiologist. “But this virus is still circulating. There are still high rates of susceptibility. We have to continue wearing masks and being smart about crowd activities. The new normal is not the old normal.” The struggle has been especially fraught in Latin America, where countries have been lashed by covid-19’s ferocity and many have not yet hit their peaks. Brazil has the second-highest number of covid-19 deaths in the world, at more than 74,000, while Mexico has the fourth-highest, with more than 37,000. (The United States, with at least 133,000 deaths, is far and away the global leader.) With their high levels of poverty and inequality, Latin American countries were more vulnerable to the pandemic than wealthier nations. An estimated one-fifth of people in Latin America and the Caribbean have at least one of the health conditions that puts them at higher risk of a severe covid infection. Many couldn’t afford to stay home for long periods. In Mexico, for example, more than half of workers are employed in the informal economy — as street vendors, gardeners, construction workers — surviving largely on their daily earnings. And people living in cramped homes and densely packed neighborhoods found it hard to isolate. Mexico ended its 70-day lockdown As with the U.S., though, cases are surging in Mexican states where reopening has moved especially rapidly. “The risk is that the opening, the end of quarantine, is moving too fast, that it’s not orderly, that people aren’t obeying the health measures, that they’re not social distancing,” the country’s coronavirus czar, Hugo López-Gatell, recently told reporters. Mexican authorities have been surprised by the lethal force of the pandemic. The virus appeared to spread slowly during its initial weeks, leading López-Gatell to initially predict there could be as few as 6,000 deaths in total. The country massively expanded its hospital system to receive patients, hiring 45,000 doctors, nurses and other professionals — a crucial step given its lack of beds and medical personnel. It has avoided the kind of disaster that occurred in Guayaquil, Ecuador, where bodies littered the streets in April. But Mexico has been slow to implement the kind of testing and contact tracing recommended by the WHO to break chains of transmission. “We don’t have the capacity,” López-Gatell said in a recent interview. “Nor do we have quarantine sites where we


will. In the Middle East, most governments were relatively swift to lock down during the earliest days of the pandemic, averting the sudden and deadly surge of infections seen in Europe and the United States. But the restrictions exacted a heavy economic toll, and few countries show any inclination to revert to the stringent measures of a few months ago even though coronavirus rates are rapidly climbing. The number of cases reported in the region in June alone was higher than during the previous four months combined, WHO Middle East director Ahmed al-Mandhari told reporters this month. The region, he said, is entering “a critical threshold,” having exceeded 1 million cases and 25,000 deaths. Over half of those are in three of the region’s most populous countries: Iran, Egypt and Saudi Arabia. The rate of new infections in both Saudi Arabia and Egypt has begun to slow in recent days. But Iran, with over 262,000 cases, has consistently struggled ever since it became an early global epicenter in March. On Sunday, the country’s supreme leader, Ayatollah Ali Khamenei, wearing a face mask as he addressed parliamentarians, called the latest resurgence “deeply tragic” and pleaded with citizens to observe preventive measures “to save the country.” Worse may lie ahead, according to Ali Mokdad, director of Middle Eastern initiatives at the University of Washington’s Institute for Health Metrics and Evaluation. Projections by his institute suggest there may be 160,000 deaths in the Middle East’s worst-affected countries by Nov. 1, including 62,000 in Iran and 50,000 in Saudi Arabia. The root of the problem, he told an online panel hosted by the Atlantic Council, is simple: “People are letting down their guard.” Countries where infection rates have jumped in recent weeks are continuing to open up. Egypt is inviting tourists to come back, including to the pyramids. Saudi Arabia has severely restricted travel to the annual hajj pilgrimage to Mecca but has not reimposed any of the lockdown measures that earlier kept citizens indoors. Russia, too, has held firm to its decision to lift most of its restrictions in late June, just ahead of a vote on a package of constitutional amendments that will enable President Vladimir Putin to seek two more terms in office. Putin cast his own ballot without wearing a mask. Russia continues to post more than 6,000 new infections per day, adding to a total of more than 735,000


You can make sazón at home. All you need are some common kitchen spices.

Overview Overview Grocery store shelves are lined with so many seasoning blends, from taco seasoning packets to Cajun spice mixes and Italian herb combinations. The commercially made products are convenient, but they also are — in most cases — exceedingly easy to re-create at home. And, homemade versions of these blends have the added benefit of allowing home cooks to adjust the proportions to taste, reduce sodium and added coloring and cut MSG, if desired. This is true of sazón, the popular salty blend that adds a kick of flavor to vegetables, beans, meats and the fillings for tacos and burritos. It is a pantry staple in homes wherever Hispanic foods are loved. In her cookbook, “Coconuts and Collards: Recipes and Stories from Puerto Rico to the Deep South” (University Press of Florida, 2018), Von Diaz writes: “Maybe you’ve seen those orange boxes of Goya Sazón at your local grocery store. It’s a miracle ingredient, a punch of MSG with enough other spices to flavor just about any soup, stew, bean dish, or braise. It’s an incredible cheat, and so full of sodium it might give you a migraine. I’ll admit that I have a box in my pantry right now in case of emergency. But I think you can do better.” Her recipe below contains no added food coloring, so it may not have quite the bright, vibrant orange-y color of the popular Goya brand, especially if you use sweet paprika in place of ground achiote. Also, the first ingredient listed on Goya’s original sazón is the flavor enhancer MSG, or monosodium glutamate. We didn’t miss it when we tasted the two side by side. Scale and get a printer-friendly version of the recipe here. Ingredients 1 tablespoon garlic powder 1 tablespoon onion powder 1 tablespoon ground cumin 1 tablespoon ground turmeric 1/2 teaspoon ground black pepper 2 tablespoons fine sea salt 2 tablespoons ground achiote powder or sweet paprika Steps Step 1 Combine the garlic powder, onion powder, cumin, turmeric, black pepper, salt and ground achiote powder or sweet paprika in an airtight container, cover and shake well to incorporate. Store in an airtight container indefinitely. Adapted from “Coconuts and Collards: Recipes and Stories from Puerto Rico to the Deep South” (University Press of Florida, 2018) by Von Diaz. Tested by Ann Maloney; email questions to Scale and get a printer-friendly version of the recipe here. Did you


A month later, Pence’s wildly optimistic view of the pandemic has proved almost entirely wrong

Even at the time it was written, the fundamental proposition offered by Vice President Pence in his Wall Street Journal piece on June 16 was dubious. No second wave of the novel coronavirus pandemic was emerging, he wrote — an obviously true claim only because the first wave had not ended. But that wasn’t Pence’s point. His point was that the numbers showed that the United States had the pandemic well in hand and that there was no reason to believe anything but that things would keep getting better. He dropped a number of data points about case growth, test rates and deaths to reinforce his optimistic point. A month later, Pence has been proved wrong in nearly every way on every bit of data he offered. The vice president, as the head of the government’s response to the pandemic, presented a case for his own success that was shown to be inaccurate often only days after his article was published. The core of his case was articulated in two paragraphs. Broken down as individual assertions, Pence’s arguments can be seen as completely incorrect. “While talk of an increase in cases dominates cable news coverage, more than half of states are actually seeing cases decline or remain stable.” At the time he wrote this, it was generally correct, depending on how you define “stable.” If we say that stability necessitates deviating no more than 2.5 percent from the average daily number of new cases week over week, Pence’s claim was accurate at the time of publication. But in short order, it wasn’t. Within a week, most states were seeing new cases grow by at least 2.5 percent, week over week. As of Monday, only 11 states had experienced declines in their seven-day averages of new cases since a week ago. “Every state, territory and major metropolitan area, with the exception of three, have positive test rates under 10%.” This was apparently false at the time, as our coverage reflects. Pence has data we don’t, so it’s hard to be too certain about the numbers he was working with. What’s clear, though, is that this is now obviously false. Data from the Covid Tracking Project through Monday shows that more than a fifth of states have positive test rates in excess of 10 percent. This is important largely because it makes it much harder to track outbreaks. Experts think you can


Hospital officials, experts say new federal rules for covid-19 reporting will add burdens during pandemic

the information. Critics, however, say they fear the elimination of the CDC’s role as a main data-keeper for the pandemic will be damaging, depriving states, hospitals and others of frequent analyses of data about the virus’s path in their communities. Smaller hospitals, in particular, are ill-equipped to suddenly adopt new data methods, critics said, though the industry has pledged to comply with the change. “Especially when we are trying to be saving lives … it can be quite an undertaking,” said Carrie Kroll, vice president of advocacy, quality and public health for the Texas Hospital Association, many of whose members are overwhelmed as the virus surges in that state. She said the order Wednesday to shift to the new data-reporting method happened with little notice or time for retraining. “On Monday we were alerted it was happening, On Tuesday, hospitals got an email as to what would change.” Until Wednesday, Texas hospitals sent to the state all coronavirus data requested by state health officials and the federal government, and the state forwarded it to Washington. Suddenly, with the federal requirements expanded, hospitals must return to sending data separately to both places. Bruce Meyer, president of Jefferson Health in Philadelphia, said the CDC’s data collection and analyses have been “highly reliable and efficient. Sidestepping these established tracking systems creates deep concerns that we will be unable to obtain appropriate and relable information to perform research and manage our response to the virus.” During a telephone call between federal and state leaders Tuesday, several state health officials raised concerns about the additional burden placed on hospitals and the potential that late reporting would jeopardize allocation of critical medicine. “The fact the federal government chose to change the reporting requirements right in the middle of the day, before the allocations are done, and therefore we don’t get allocation that we need based on the burden of disease that we have, that’s going to be really problematic for everybody,” said one state official from Texas. The Washington Post obtained a recording of the call but was unable to identify the official. A Tennessee representative, who did not identify herself, told HHS officials that the short turnaround time could affect patient care. Not all hospitals have the same personnel do data reporting, she said. In places where resources are stretched thin, “they have to pull somebody from somewhere, which could very easily impede patient care


to important data about covid-19 that has been housed until now by the CDC. “We’re all very frustrated and very concerned. We use the [CDC system],” said Saskia Popescu, an infectious-disease epidemiologist at the University of Arizona. “We can pull data from [it] and extract reports. I have yet to hear if that’s possible for” the federal contracting system. Georges C. Benjamin, executive director of the American Public Health Association, predicted that the data-reporting switch, “is not going to happen as easily or as well as they think.” “I’m fundamentally against making changes in the middle of a disaster,” he said. “Changing data reporting, asking people to do a new task doesn’t go down easily.” Benjamin represents one of six public health organizations that issued a statement Tuesday condemning the change. In a letter to the nation’s governors this week, HHS Secretary Alex Azar and Deborah Birx, the White House coronavirus task force’s response coordinator, said the data that hospitals report Wednesday, Thursday and Friday this week will form the basis of federal distribution next week of remdesivir and other therapeutics and supplies. Hospitals were told that for the first days, they could focus on just seven of about 30 required data elements, including how much remdesivir they were using, along with admissions, adult patients and adults in intensive care with confirmed or suspected covid-19 cases. Benjamin said he was doubtful the daily reporting would lead to more precise and efficient allocation of resources. The distribution “will fail,” he predicted. “Most of the people you are asking to give you the data will not have a clue what to do. The process has to get to the people who push the buttons, who write things in. That takes weeks of training.” In the meantime, he said, “it means bad data in, bad distribution on the other end.” Tom Nickels, the American Hospital Association’s vice president for government relations, said that although his members would comply with the change, hospitals are frustrated with repeated federal rule changes since the pandemic began. “It’s unfortunate they keep changing their mind,” Nickels said. John Brady, vice president and chief financial officer for the Connecticut Hospital Association, said the latest change in requirements, on top of earlier ones, “is burdensome on hospitals, certainly those who are experiencing a crush of very ill patients from covid.” Frances Stead Sellers and Isaac Stanley-Becker contributed to this report.


‘The military failed him’: Soldier’s bones found months after he was labeled a deserter

Wedel recalled. That was the last conversation she had with her son. The last time anyone heard from him was the next day, according to Army investigators. His case sputtered for nearly a year, as the family reached out to Army investigators nearly daily for updates that rarely came, his mother said. But his disappearance rose in prominence during a search for another missing soldier at Fort Hood, Spc. Vanessa Guillén, who was last seen in April in a separate case. The remains of the two soldiers were both found outside the installation in late June, two days apart. Both families said the Army had not searched for either one with enough urgency and empathy. The Army offered a $15,000 reward for information on the disappearance of Wedel-Morales more than nine months after his disappearance. That came one day after Kimberly Wedel asked in an email why there was no previous reward, as there was in the Guillén case, according to an email provided to The Washington Post. The reward increased to $25,000 on June 15. His remains were found four days later, after investigators received a tip, the Army said. The Army then said officials suspected foul play was involved. The Wedel family said it was tangled in the Kafkaesque rules of military bureaucracy and the Army’s initial disinterest in finding him. A soldier who doesn’t report for duty in 30 days is automatically designated a deserter, the Army said, even if it doesn’t have evidence of where the soldier is, or if they are experiencing physical or mental duress. Another soldier then takes their place in the unit. “Generally, the Army doesn’t proactively search for deserters unless a serious crime has been committed,” said Lt. Col. Emmanuel Ortiz, an Army spokesman. The Army coordinates with various law enforcement agencies to bring in deserters, he said, and the policy on personnel absence is under review. In this case, the Army said, Wedel-Morales’s status as a deserter meant his family could not hold a funeral with military honors or bury him in a national cemetery — a fact that left the family in turmoil for months. The Army would not pay to have his remains shipped back to Oklahoma, his family said, adding that they had started a GoFundMe campaign to help cover the costs. Wedel said she learned late Tuesday during a conversation with a commander that her son


Target, CVS join slew of retailers requiring masks in U.S. stores

A slew of retailers have joined Walmart in requiring shoppers to wear face coverings at every U.S. store amid an upswing in novel coronavirus infections. Target and CVS Health announced new policies Thursday. Kohl’s and Kroger made the change Wednesday afternoon, hours after Walmart, the world’s biggest retailer, said it would require masks at its 5,300 namesake and Sam’s Club locations. Target said its new mask policy, which takes effect Aug. 1, does not apply to young children or those with underlying medical conditions. Like Walmart, it will station employees at store entrances to remind shoppers to wear masks and provide disposable ones if needed. It also will install signage, run reminders on store audio systems and encourage no-contact shopping options. More than 80 percent of Target’s 1,871 U.S. stores already have mask requirements in compliance with local and state mandates. CVS said its policy takes effect Monday at its 10,000 U.S. locations. “To be clear, we’re not asking our store employees to play the role of enforcer,” CVS Chief Operating Officer Jon Roberts said in a news release. “What we are asking is that customers help protect themselves and those around them by listening to the experts and heeding the call to wear a face covering.” Kroger, the nation’s largest supermarket chain, announced Wednesday in a tweet that masks will be required at all of its 2,758 stores starting Wednesday. The Ohio-based grocer’s banners include Kroger, Harris Teeter, Ralphs and Fred Meyer. The Kohl’s policy takes effect Monday at more than 1,100 stores nationwide. Both companies already required employees to wear masks. Walmart said that masks would be required at all its stores starting Monday and that it will position “health ambassadors” at the entryways to help with enforcement. The retailer said about 3,500 of its more than 5,300 Walmart and Sam’s Clubs locations already are observing public health mandates within their respective markets. “We know some people have differing opinions on this topic,” said a news release from Dacona Smith and Lance de la Rosa, the chief operating officers of Walmart and Sam’s Club. “We also recognize the role we can play to help protect the health and well-being of the communities we serve by following the evolving guidance of health officials like the CDC.” The world’s biggest retail trade group lauded Walmart’s move and expressed hope that it would be a “tipping point” for the retail industry.


I’m from Wuhan. I got covid-19 — after traveling to Florida.

private. My doctor reassured me that I would not be contagious eight days after my first symptoms and that additional tests were not necessary. In the United States, it’s mostly up to individuals to decide how they want to cope with the pandemic, but China acts more like an enormous machine, allocating resources and manpower to each challenge. It’s the difference between collectivism and individualism: China is battling one pandemic, whereas each American state, community and person is fighting their own. Yet neither model has been entirely successful. In the United States, inconsistent and delayed policies have seen cases soar, hospitals become overwhelmed and vulnerable communities bear a disproportionate burden. In China, whistleblowers and citizen journalists have been silenced, censors have been scrubbing content of dissent online, and rigid quarantine policies have displaced migrant workers and immigrants. There are hybrid approaches out there. South Korea, Germany and New Zealand are all examples of how collectivism and individualism work wonders together. But stuck between the Chinese and U.S. approaches, I have been asking myself: Is it better to be able to venture out without fear that my safety will be undermined, or should I feel lucky I don’t need to endure stigma and weeks of quarantine for getting the virus? In the context of a pandemic, freedom is inevitably a double-edged sword. It isn’t just a universal right, but also a social pact that works only if everyone is on board, careful not to infringe on others’ freedom with their choices. On the Fourth of July, 10 days after my first symptoms, I decided to go out to watch the fireworks after much internal wrangling and consulting with my doctor. In doing so, I embraced the American way, with the sobering knowledge that, as cases continue to climb, what I chose wouldn’t really make a difference. Read more: Xinyan Yu: My hometown showed us how a pandemic begins. Could it also show us how one ends? Michael Berry: I translated ‘Wuhan Diary’ to amplify the author’s voice of courage Samuel G. Freedman: In Miami Beach, the palpable sensation of an unfolding tragedy Brian Klaas: Trump’s performance on covid-19 looks especially bad compared with the rest of the world Fareed Zakaria: Smart states have the edge in fighting covid-19. The United States isn’t one of them. Leana S. Wen: If Trump wants to reopen schools, here’s what his administration needs to do


Canada’s coronavirus performance hasn’t been perfect. But it’s done far better than the U.S.

Parliament from all parties have been elevating the messages of health experts over the course of the crisis,” said Eric Merkley, a political scientist at the University of Toronto. “That distinguishes us from the United States, where the Republican Party has elevated covid skeptics quite substantially.” Merkley is the lead author of a paper that describes Canada’s response as a “rare moment of cross-partisan consensus” among political elites and the public. Canada’s performance has included missteps. Before the country recorded its first case, officials assured the public that the health-care system was ready and the risk posed by the virus was “low.” They would repeat that message into early March. But as cases began to tick up in February, some infectious-disease experts worried that inertia had slowed the government’s response. Some said Canada was too slow to close its borders, screen travelers and enforce quarantines. Some provinces dispatched their own public health workers to airports to screen travelers, encroaching on an area of federal jurisdiction. There were worries about shortages of personal protective equipment. Government efforts to procure supplies ran into barriers. The problem has not been entirely rectified. Chagla said his hospital still faces shortages of N95 respirator masks. Long-term-care homes quickly emerged as hot spots. Roughly one-fifth of Canada’s cases and more than 80 percent of its deaths have occurred in those facilities, according to government figures, despite repeated warnings about their vulnerabilities. Spiraling outbreaks in Ontario and Quebec were so severe that Ottawa agreed to send the Canadian military to help. Soldiers documented abuses including cockroach infestations, force feeding and “significant gross fecal contamination” in patients’ rooms. Canada had nearly two decades to prepare for a pandemic. In 2003, the severe acute respiratory syndrome, or SARS, killed 44 people in Toronto — the most deaths outside Asia. A commission that reviewed the province’s response to the outbreak said the public health-care system was “broken, neglected, inadequate and dysfunctional.” In the next outbreak, it advised against waiting for scientific certainty before implementing measures to reduce risk. Kobinger, who helped pioneer the Ebola vaccine, said the advice has not been followed, particularly with respect to guidance on masks. Canada recommended wearing masks many weeks after the United States, reversing an earlier position and confusing citizens, he said. Gardam, who worked on the front lines of the 2003 outbreak, said he agreed at the outset of the coronavirus pandemic with


Pandemic shutdowns saved thousands of animals from becoming roadkill, report suggests

of view, it’s all interesting.” The report relied on data collected regularly by the three states’ departments of transportation, highway patrol units and wildlife agencies. With information dating back to 2015, the scientists were able to compare what happened during shutdowns in each state to normal roadkill numbers. They found no significant difference between what happened before or after the stay-at-home orders, but during that low-activity window, the results were striking. In just California, Idaho and Maine, the declines would translate to 13,000 fewer large mammal carcasses along roads. In California, a state that is considering extending endangered species protections to some mountain lion populations that are often hit by vehicles, less traffic could save about 50 big cats a year, the report found. The report relied on statistics from only three states because they collect solid roadkill data — and even those numbers are likely to be significantly underreported, Shilling said. The Davis study does not account for the deaths of smaller creatures such as raccoons, opossums, turtles, snakes or songbirds. Loop in all of those animals and scale it across the nation, and the true toll of car strikes could rocket into the hundreds of millions. Shilling, an ecologist who studies the impact of transportation systems on nature, said the sudden and extreme dip in road traffic presented scientists with an experiment that could never be carried out in typical times. Fortunately, data sampling already in place allowed them to make use of the unprecedented circumstances. Last month, more than a dozen researchers in several countries published a commentary in the journal Nature Ecology and Evolution calling on scientists to investigate how the coronavirus pandemic and its reverberations could allow for precisely this kind of research. Normally it’s extremely difficult to disentangle how humans affect animal movements and behaviors, said Francesca Cagnacci, an animal ecologist at the Edmund Mach Foundation in Italy and senior author of the commentary. Many variables could explain an outcome or cast doubt on the level of human influence on an animal behavior. But the coronavirus shutdowns have offered new signs of our sway, as well as opportunities to gather evidence. This is why scientists were eager to study how a lack of human observers might affect large swarms of mating fireflies this summer. It’s also why the Centers for Disease Control and Prevention issued a warning after city-dwelling rats appeared to be acting


ecologist who studies the impact of transportation systems on nature, said the sudden and extreme dip in road traffic presented scientists with an experiment that could never be carried out in typical times. Fortunately, data sampling already in place allowed them to make use of the unprecedented circumstances. Last month, more than a dozen researchers in several countries published a commentary in the journal Nature Ecology and Evolution calling on scientists to investigate how the coronavirus pandemic and its reverberations could allow for precisely this kind of research. Normally it’s extremely difficult to disentangle how humans affect animal movements and behaviors, said Francesca Cagnacci, an animal ecologist at the Edmund Mach Foundation in Italy and senior author of the commentary. Many variables could explain an outcome or cast doubt on the level of human influence on an animal behavior. But the coronavirus shutdowns have offered new signs of our sway, as well as opportunities to gather evidence. This is why scientists were eager to study how a lack of human observers might affect large swarms of mating fireflies this summer. It’s also why the Centers for Disease Control and Prevention issued a warning after city-dwelling rats appeared to be acting more aggressively as their supplies of restaurant garbage shriveled. Cagnacci said that the shutdown underscores the importance of ongoing studies that record observations before anything unusual happens — even though it can be unclear what the results will be good for. “Sometimes it’s very difficult to explain to a funding agency or to the general public why it is important to conduct baseline observations about what’s happening in ecosystems,” she said. For Shilling, tracking large animals killed by vehicles has revealed the weighty toll of human transportation on wild animals. This translates to costs for humans: An earlier report from the Road Ecology Center found that wildlife-vehicle collisions in 2018 cost Californians $232 million in medical bills, lost wages, vehicle damage and emergency response costs. That sort of information is important when trying to determine — and persuade policymakers and the public about — the value of erecting roadside fences or building overpasses that allow animals to bypass highways, said Marcel Huijser, a road ecologist at Montana State University’s Western Transportation Institute. Such “animal exclusion” projects can carry hefty price tags. But there are many stretches of road in the United States where it’s actually more costly to do nothing,


Signs increasingly point to sabotage in fiery explosion at Iranian nuclear complex

A massive explosion and fire at a highly sensitive Iranian nuclear facility last week was probably an act of sabotage, intelligence officials and weapons experts said Monday, but analysts were divided over the severity of the damage to Iran’s nuclear program. Satellite photos released over the weekend show a gaping hole in a large industrial building where Iranian technicians assembled machines that make enriched uranium. The building, on the grounds of Iran’s sprawling Natanz uranium-enrichment complex, was rocked early Thursday by a mysterious blast that Iranian officials acknowledge caused “significant” damage. A spokesman for Iran’s nuclear energy agency on Monday said the country’s security agencies knew the cause of the explosion but would provide no details for now, citing “security considerations.” Other Iranian officials have publicly suggested that the United States or Israeli operatives were to blame, although neither country has acknowledged any involvement in the incident. A Middle Eastern security official said in an interview that the damage was caused by a “huge explosive device” planted by Israeli operatives to “send a signal” to Tehran. The official spoke on the condition of anonymity, citing the sensitive nature of the intelligence and insisting that his name and nationality not be revealed. “There was an opportunity, and someone in Israel calculated the risk and took the opportunity,” the official said. He described the building as having been “completely destroyed.” Other analysts and nuclear experts also said the evidence so far strongly suggests that a bomb detonated in the facility, known as the Iran Centrifuge Assembly Center. In addition to satellite images, photos released by Iran’s Atomic Energy Organization show doors blown off hinges, cracked walls and missing roof panels. “The simplest explanation is an explosion inside the building,” said Jeffrey Lewis, a professor and weapons expert at the Middlebury Institute of International Studies in Monterey, Calif. “It’s getting really hard to see this as an accident.” The building began operating in 2018 as Iran’s main center for assembling new centrifuge machines for the large uranium-enrichment plant at the same complex south of Tehran. Iran was permitted to operate the facility under the terms of the 2015 Iran nuclear agreement, and the site had been visited by inspectors of the International Atomic Energy Agency, the U.N. nuclear watchdog. Iran’s Natanz facility produces low-enriched uranium of the type used in commercial nuclear power plants to make electricity. With additional processing, the uranium could